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1.
Gan To Kagaku Ryoho ; 48(7): 878-881, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267020

RESUMO

The third-term Basic Plan to Promote Cancer Control Programs in Japan started in 2018. Preparation of the cancer genomic medicine has been newly demanded in this program. Since 2018, the Cancer Genome Medicine Core Base Hospitals( CGM-CBHs), the Cancer Genome Medicine Base Hospitals(CGM-BHs)and the Cancer Genome Medicine Cooperation Hospitals(CGM-CHs)were appointed by the Ministry of Health, Labour and Welfare in Japan. Among these, the CGM-CBHs(including our Tohoku University Hospital)play a key role, and the preparation of the system of the cancer genomic medicine in the district is pushed forward in cooperation with the CGM-BHs and the CGM-CHs. Although the cancer genomic medicine is constantly advancing, a difference in cancer genomic medicine is getting wide between these cancer genomic medicine affiliated hospitals and other medical institutions. Tohoku University Hospital is pushing forward the spread and enlightenment of the cancer genomic medicine in this district as the center in the Tohoku district. Here, we introduce activity in Tohoku University Hospital as a CGM-CBH.


Assuntos
Genômica , Neoplasias , Institutos de Câncer , Hospitais Universitários , Humanos , Japão , Neoplasias/genética , Neoplasias/terapia
2.
J Cancer Res Ther ; 17(2): 551-555, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34121707

RESUMO

Background: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. Purpose: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. Conclusion: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.


Assuntos
COVID-19/diagnóstico , Serviços de Laboratório Clínico/organização & administração , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Centros de Atenção Terciária/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/virologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Serviços de Laboratório Clínico/normas , Descontaminação/métodos , Descontaminação/normas , Países em Desenvolvimento , Desinfecção/métodos , Desinfecção/organização & administração , Desinfecção/normas , Hospitais Rurais/organização & administração , Hospitais Rurais/normas , Humanos , Índia/epidemiologia , Controle de Infecções/normas , Pessoal de Laboratório Médico/organização & administração , Pessoal de Laboratório Médico/normas , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/patogenicidade , Manejo de Espécimes/normas , Centros de Atenção Terciária/normas , Recursos Humanos/organização & administração , Recursos Humanos/normas
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(5): 521-528, 2021 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34148889

RESUMO

OBJECTIVES: To understand the influence of medical insurance policy reforms in Guangxi on the hospitalization expenses of breast cancer patients by analyzing the composition and changing trend in breast cancer diagnosis and treatment expenses in the Guangxi Medical University Cancer Hospital, and to provide the evidence for the improvement of medical insurance policy reform. METHODS: A total of 3 950 breast cancer patients were collected from 2014 to 2017 and analyzed. Kruskal-Wallis test and multiple linear regression model were used to discuss the breast cancer related epidemiology and analyze the composition of hospitalization expenses and its influential factors. RESULTS: The median hospitalization cost of breast cancer patients in our hospital from 2014 to 2017 was 29 266.94 Chinese Yuan. Single factor analysis showed that the impact of year, hospitalization days, age, payment method, tumor stage, and treatment method on hospitalization cost was significant (all P<0.01). Multiple linear regression analysis showed that the power of influential factors of hospitalization costs arranged descending from 2014 to 2017 as follows: hospitalization days, treatment methods, payment method, tumor staging, and age. CONCLUSIONS: Reasonably controlling hospitalization days and actively promoting the integration of urban and rural medical insurance can effectively reduce the economic burden for breast cancer patients.


Assuntos
Neoplasias da Mama , Institutos de Câncer , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , China/epidemiologia , Feminino , Gastos em Saúde , Hospitalização , Humanos , Políticas , Universidades
5.
J Cancer Res Ther ; 17(2): 551-555, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1268377

RESUMO

Background: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. Purpose: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. Conclusion: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.


Assuntos
COVID-19/diagnóstico , Serviços de Laboratório Clínico/organização & administração , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Centros de Atenção Terciária/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/virologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Serviços de Laboratório Clínico/normas , Descontaminação/métodos , Descontaminação/normas , Países em Desenvolvimento , Desinfecção/métodos , Desinfecção/organização & administração , Desinfecção/normas , Hospitais Rurais/organização & administração , Hospitais Rurais/normas , Humanos , Índia/epidemiologia , Controle de Infecções/normas , Pessoal de Laboratório Médico/organização & administração , Pessoal de Laboratório Médico/normas , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/patogenicidade , Manejo de Espécimes/normas , Centros de Atenção Terciária/normas , Recursos Humanos/organização & administração , Recursos Humanos/normas
6.
Gan To Kagaku Ryoho ; 48(6): 749-752, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34139717

RESUMO

Based on the basic plan to promoting cancer control programs, a cooperation between designated cancer care hospitals and regional medical institutions was outlined. Regional designated cancer care hospitals supports the system of regional cancer medical treatment cooperation, and prefectural designated cancer care hospital manage a prefectural cancer medical treatment cooperation. Although system is progressing, such as sharing regional cooperation pass and holding multi-facility joint meetings to promote regional cooperation, there are regional disparities, and we believe that further promotion is necessary.


Assuntos
Institutos de Câncer , Neoplasias , Atenção à Saúde , Hospitais , Humanos , Japão , Neoplasias/terapia
7.
BMC Infect Dis ; 21(1): 510, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059022

RESUMO

OBJECTIVE: To determine the prevalence of Latent Tuberculosis in patients with hematological neoplasms at the Instituto Nacional de Cancerología in Mexico City using the Tuberculin skin test (TST). METHODS: This retrospective study included all patients with a recent diagnosis of hematological neoplasms who were admitted for treatment from 2017 to 2018 and who were screened for latent tuberculosis with the TST. The prevalence of latent tuberculosis in this group, tolerance and therapeutic adherence in treated patients are described. RESULTS: The files of 446 patients with hematological malignancy who had a TST were reviewed. The prevalence of latent tuberculosis was 31.2% (n = 139). Ninety-three patients received isoniazid, 15.1% had some adverse reactions, but only 4 (4.3%) had to discontinue treatment. Two patients with latent tuberculosis under treatment with Isoniazid reactivated tuberculosis infection. CONCLUSIONS: The prevalence in our study was within the range of other similar Mexican populations. Isoniazid treatment had an adequate tolerance and adherence. Longer follow-up could offer more information on the risk of reactivation in both groups.


Assuntos
Neoplasias Hematológicas/epidemiologia , Tuberculose Latente/epidemiologia , Adulto , Antituberculosos/efeitos adversos , Antituberculosos/uso terapêutico , Institutos de Câncer , Feminino , Neoplasias Hematológicas/microbiologia , Humanos , Isoniazida/efeitos adversos , Isoniazida/uso terapêutico , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Prevalência , Estudos Retrospectivos , Teste Tuberculínico , Tuberculose/epidemiologia , Tuberculose/etiologia
8.
Jpn J Clin Oncol ; 51(7): 1094-1099, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33989400

RESUMO

OBJECTIVE: This survey was conducted to clarify the current status of inpatient cancer rehabilitation provided by designated cancer hospitals in Japan. METHODS: A survey questionnaire was sent to 427 designated cancer hospitals in Japan. Information was sought regarding whether inpatient cancer rehabilitation was provided by the center, and if so, whether respondents regarded such provision as satisfactory. RESULTS: Responses were obtained from 235/427 surveyed institutions (55.0%). Cancer rehabilitation was provided in inpatient settings by 97.4%. Two-thirds of respondents (67.7%) regarded inpatient cancer rehabilitation provision as still inadequate. The primary reasons claimed for this inadequacy were a lack of human resources, a lack of rehabilitation professionals with the requisite knowledge/skills and patients who would benefit from cancer rehabilitation present but not prescribed. The total number of rehabilitation staff was identified as associated factor of inadequate inpatient cancer rehabilitation in multivariate analysis (odds ratio = 0.979, 95% confidence interval = 0.96-1.00, P = 0.009). CONCLUSIONS: In order to provide adequate cancer rehabilitation, a sufficient supply of rehabilitation staff, education and recognition of the need for cancer rehabilitation within oncology units are necessary.


Assuntos
Institutos de Câncer/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Neoplasias/reabilitação , Humanos , Japão , Recursos Humanos em Hospital , Qualidade da Assistência à Saúde , Inquéritos e Questionários
9.
Gynecol Oncol ; 162(1): 12-17, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33941382

RESUMO

OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Neoplasias dos Genitais Femininos/cirurgia , Hospitais Privados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Tempo para o Tratamento/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Canadá/epidemiologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Institutos de Câncer/estatística & dados numéricos , Controle de Doenças Transmissíveis/normas , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Ginecologia/economia , Ginecologia/organização & administração , Ginecologia/normas , Ginecologia/estatística & dados numéricos , Hospitais Privados/economia , Hospitais Privados/organização & administração , Hospitais Privados/normas , Hospitais Públicos/economia , Hospitais Públicos/organização & administração , Hospitais Públicos/normas , Humanos , Oncologia/economia , Oncologia/organização & administração , Oncologia/normas , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estudos Retrospectivos , Centros de Atenção Terciária/economia , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/normas , Centros de Atenção Terciária/estatística & dados numéricos , Fatores de Tempo , Triagem/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
10.
Bull Cancer ; 108(7-8): 761-770, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33933290

RESUMO

Mucositis is defined as inflammatory and/or ulcerative lesions of the oral and/or gastrointestinal tract. It occurs in approximately 40% to 50% of adults patients receiving conventional chemotherapy and up to 75% of patients receiving high dose chemotherapy as conditioning for hematopoietic stem cell transplantation. It is a toxic side effect, which strongly impairs quality of life and leads to refractory pain, increasing risk of infection and even therapeutic modifications. Despite improvements made, the management of mucositis remains a challenge and is still not consensual. A multicentric survey of practices concerning the preventive and curative management of chemo-induced mucositis in pediatric oncology department in France was carried out using a standardized questionnaire. Results confirm heterogeneous practices and the small progress made during the last decade. This national survey and an analysis of the recent literature leads to propose guidelines for the prevention and treatment of oral mucositis in children receiving treatment for cancer.


Assuntos
Antineoplásicos/efeitos adversos , Mucosite/induzido quimicamente , Padrões de Prática Médica/normas , Institutos de Câncer/estatística & dados numéricos , Criança , França , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Transplante de Células-Tronco Hematopoéticas , Humanos , Terapia a Laser/métodos , Mucosite/complicações , Mucosite/microbiologia , Mucosite/prevenção & controle , Higiene Bucal , Manejo da Dor , Qualidade de Vida , Condicionamento Pré-Transplante/efeitos adversos
11.
BMC Cancer ; 21(1): 578, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: covidwho-1238711

RESUMO

BACKGROUND: The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is an important matter in daily practice. METHODS: ONCOSARS-1 was a single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were prospectively included. All patients (n = 363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the first peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to retrospectively determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients. RESULTS: Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P < 0.001). This association remained significant (odds ratio (OR) 4.1, P = 0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P < 0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients. CONCLUSION: Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Neoplasias/terapia , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Bélgica/epidemiologia , COVID-19/complicações , Institutos de Câncer , Estudos de Coortes , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Fatores de Risco , SARS-CoV-2
12.
Cancer Control ; 28: 10732748211017166, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1247532

RESUMO

BACKGROUND: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care. METHODS: As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease. CONCLUSIONS: The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.


Assuntos
COVID-19/prevenção & controle , Institutos de Câncer , Transmissão de Doença Infecciosa/prevenção & controle , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Oncologia , SARS-CoV-2/isolamento & purificação
13.
Gynecol Oncol ; 162(1): 12-17, 2021 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1213578

RESUMO

OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Neoplasias dos Genitais Femininos/cirurgia , Hospitais Privados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Tempo para o Tratamento/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Canadá/epidemiologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Institutos de Câncer/estatística & dados numéricos , Controle de Doenças Transmissíveis/normas , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Ginecologia/economia , Ginecologia/organização & administração , Ginecologia/normas , Ginecologia/estatística & dados numéricos , Hospitais Privados/economia , Hospitais Privados/organização & administração , Hospitais Privados/normas , Hospitais Públicos/economia , Hospitais Públicos/organização & administração , Hospitais Públicos/normas , Humanos , Oncologia/economia , Oncologia/organização & administração , Oncologia/normas , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estudos Retrospectivos , Centros de Atenção Terciária/economia , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/normas , Centros de Atenção Terciária/estatística & dados numéricos , Fatores de Tempo , Triagem/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
14.
Acta Oncol ; 60(8): 984-991, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33979241

RESUMO

BACKGROUND: An important goal of health care systems is equitable access to health care. Previous research, however, indicates that men receive more cancer care and health care resources than women. The aim of this study was to investigate whether there is a gender difference in terms of end-of-life cancer treatment in hospitals in Norway. MATERIAL AND METHODS: We used nationwide patient-level data from the Norwegian Patient Registry (2013-2017, n = 64,694), and aggregated data from the Norwegian Cause of Death Registry (2013-2018, n = 66,534). We described direct medical costs and utilization of cancer treatment in hospitals (in-patient stays and out-patient clinics) and specialized palliative home care teams by the means of the following variables: gender, type of cancer, age, region of residence, place of death, and use of pharmaceutical anti-cancer treatment last month before death. Generalized linear models with a gamma distribution and log-link function were fitted to identify determinants of direct medical costs in hospital's last year of life. RESULTS: Women aged 0-69 years had an average direct medical cost in hospitals of €26,117 during the last year of life, compared to €29,540 for men, while they were respectively €19,889 and €22,405 for those aged 70 years or older. These gender differences were confirmed in regression models with gender as the only covariate. Adjusted additionally for the type of cancer, the difference was 11%, while including age as a covariate reduced the difference to 6%. When the place of death was also included, the difference was down to 4%. DISCUSSION: The gender difference in hospital costs last year of life can largely be explained by age at death and the proportion dying in hospitals. When adjusting for confounding factors, the differences in end-of-life costs in hospitals are minimal.


Assuntos
Neoplasias , Assistência Terminal , Institutos de Câncer , Morte , Feminino , Hospitais , Humanos , Masculino , Neoplasias/terapia , Noruega , Estudos Retrospectivos
15.
J Pak Med Assoc ; 71(2(B)): 696-698, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33941961

RESUMO

OBJECTIVE: To determine the oncological outcome and pattern of ovarian tumours in patients who underwent surgical management. METHODS: The retrospective, descriptive hospital-based study was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised data of all patients who underwent surgical intervention for ovarian cancer between January 2010 and December 2015. Data was retrieved from the hospital database and analysed using SPSS 20. RESULTS: Of the 236 patients, 203(86%) had undergone open surgery, while 33(14%) had had laparoscopic surgery. Neo-adjuvant chemotherapy was given in 60(25.42%) cases and adjuvant chemotherapy in 102(43.22%). Epithelial ovarian cancer in 201(85.16%) cases was the most common tumour type. Mortality was recorded in 36(15.5%) cases, while 41(19.9%) were lost to follow-up. CONCLUSIONS: Ovarian tumours were found to be difficult to treat and were associated with frequent recurrence.


Assuntos
Institutos de Câncer , Neoplasias Ovarianas , Feminino , Humanos , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/cirurgia , Paquistão/epidemiologia , Estudos Retrospectivos
16.
J Pak Med Assoc ; 71(2(B)): 699-703, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33941962

RESUMO

OBJECTIVE: To monitor the frequencies of different adverse transfusion reactions and to assess the compliance of clinical staff with the process of sending proper transfusion reaction workup within the specified time. METHODS: The retrospective audit was conducted at the blood bank of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised all transfusion reaction forms received from July 1, 2017, to June 30, 2018. The forms were analysed for type of blood component, time in which it was received by the blood bank, whether or not the form was completely filled, whether or not all required samples were provided, and the type of reaction. RESULTS: Of the 12,787 units dispensed and transfused, 50(0.39%) transfusion reactions were noted. Allergic was the most frequent type 24(48%). Red cells accounted for 38(76%) of the reactions. In 58(95%) cases, reaction forms were completely filled. Blood bags in 36(59%) and post-transfusion ethylenediaminetetra acetic acid samples in 35(57.3%) cases were received at blood bank within 2 hours of reaction. CONCLUSIONS: Incidence of transfusion reactions was found to be low as there was good compliance with procedures on the part of the clinical staff.


Assuntos
Neoplasias , Reação Transfusional , Institutos de Câncer , Humanos , Neoplasias/epidemiologia , Paquistão/epidemiologia , Estudos Retrospectivos
17.
BMC Health Serv Res ; 21(1): 446, 2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-33975580

RESUMO

BACKGROUND: A quality accreditation program (AP) is designed to guarantee predefined quality standards of healthcare organizations. Evidence of the impact of quality standards remains scarce and somewhat challenging to document. This study aimed to investigate the accreditation of a cancer research hospital (Italy), promoted by the Organization of European Cancer Institutes (OECI), by focusing on the individual, group, and organizational experiences resulting from the OECI AP. METHODS: A focused ethnography study was carried out to analyze the relevance of participation in the accreditation process. Twenty-nine key informants were involved in four focus group meetings, and twelve semistructured interviews were conducted with professionals and managers. Inductive qualitative content analysis was applied to examine all transcripts. RESULTS: Four main categories emerged: a) OECI AP as an opportunity to foster diversity within professional roles; b) OECI AP as a possibility for change; c) perceived barriers; and d) OECI AP-solicited expectations. CONCLUSIONS: The accreditation process is an opportunity for improving the quality and variety of care services for cancer patients through promoting an interdisciplinary approach to care provision. Perceiving accreditation as an opportunity is a prerequisite for overcoming the barriers that professionals involved in the process may report. Critical to a positive change is sharing the values and the framework, which are at the basis of accreditation programs. Improving the information-sharing process among managers and professionals may limit the risk of unmet expectations and prevent demotivation by future accreditation programs. Finally, we found that positive changes are more likely to happen when an accreditation process is considered an activity whose results depend on managers' and professionals' joint work.


Assuntos
Acreditação , Neoplasias , Antropologia Cultural , Institutos de Câncer , Humanos , Itália , Neoplasias/terapia
18.
BMC Cancer ; 21(1): 578, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016086

RESUMO

BACKGROUND: The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is an important matter in daily practice. METHODS: ONCOSARS-1 was a single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were prospectively included. All patients (n = 363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the first peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to retrospectively determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients. RESULTS: Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P < 0.001). This association remained significant (odds ratio (OR) 4.1, P = 0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P < 0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients. CONCLUSION: Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Neoplasias/terapia , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Bélgica/epidemiologia , COVID-19/complicações , Institutos de Câncer , Estudos de Coortes , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Fatores de Risco , SARS-CoV-2
19.
Cancer Control ; 28: 10732748211017166, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34044598

RESUMO

BACKGROUND: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care. METHODS: As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease. CONCLUSIONS: The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.


Assuntos
COVID-19/prevenção & controle , Institutos de Câncer , Transmissão de Doença Infecciosa/prevenção & controle , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Oncologia , SARS-CoV-2/isolamento & purificação
20.
Med Educ Online ; 26(1): 1929045, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34024270

RESUMO

Given the well-documented inequities in health care outcomes by race, ethnicity, and gender, many health career pipeline programs have focused on supporting the development of a diverse and inclusive workforce. The State of Utah, is vast, but sparsely populated outside the Salt Lake City metropolitan area. More than 96% of our nearly 85,000 square miles is designated rural (<100 people/square mile) or frontier (<7 people/square mile). The Salt Lake City area is home to the Hunsman Cancer Institute, the only NCI-designated Comprehensive Cancer Center in the region, also noted the limited diversity in the biomedical cancer research workforce. Our primary objective was to increase the number of underrepresented trainees who pursue higher education with the goal of a career in cancer research. PathMaker is a regional, competitive pipeline program that nurtures high school or undergraduate trainees from historically underrepresented backgrounds towards a career in cancer research. Our faculty and staff team collaboratively developed a cohort model curriculum that increased student awareness of research career options; provided academic and professional development, cultural and social support, evolutionary success strategies, active mentorship, and leadership skill development; and fostered an environment of continuous evaluation and improvement. Since pilot program initiation in May 2016, the PathMaker Research Program (PathMaker) has engaged a total of 44 underrepresented trainees in cancer research labs at Huntsman Cancer Institute, the majority still in college. Eleven trainees graduated college: five employed in STEM, one pursuing a PhD in STEM; two in medical school, and three are lost to follow-up. Alumni report high levels of satisfaction with PathMaker and will be followed and supported for academic success. PathMaker is a replicable model to increase diversity and inclusion in the biomedical cancer research workforce.


Assuntos
Pesquisa Biomédica/educação , Institutos de Câncer/organização & administração , Tutoria/organização & administração , Grupos Minoritários/educação , Apoio ao Desenvolvimento de Recursos Humanos/organização & administração , Escolha da Profissão , Competência Cultural , Currículo , Feminino , Humanos , Liderança , Masculino , Apoio Social , Fatores Socioeconômicos , Universidades , Utah , Recursos Humanos , Adulto Jovem
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