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1.
Anticancer Res ; 40(1): 305-313, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892581

RESUMO

BACKGROUND: Cancer-associated thrombosis (CAT), the second leading cause of death in patients with cancer can be treated with low molecular weight heparin (LMWH) according to guidelines. PATIENTS AND METHODS: A multicenter prospective observational study was carried out to record anti-thrombotic treatment practice, assess thrombosis recurrence and bleeding, and identify potential risk factors. Adult patients from 18 Oncology Departments throughout Greece were followed-up for 12 months. RESULTS: A total of 120 patients with CAT receiving anticoagulant treatment were enrolled (35% incidental); 85% were treated for more than 6 months, 95.8% were treated with tinzaparin and smaller percentages with other agents. Thrombosis recurred in three patients and there was minor bleeding in four patients. Bleeding was associated with high body mass index (>35 kg/m2), trauma history, renal insufficiency and bevacizumab use. CONCLUSION: Incidental thrombosis contributes significantly to CAT burden. Long-term use of LMWH seems to be effective and safe. Several risk factors associated with bleeding should be considered during anti-coagulation therapy planning.


Assuntos
Neoplasias/complicações , Trombose/etiologia , Trombose/terapia , Feminino , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Fatores de Risco
2.
Gan To Kagaku Ryoho ; 46(12): 1814-1817, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879394

RESUMO

Cachexia is well known to be a complication with malignant disease. The frequency of cancer-associated cachexia is different among various type of cancer, and relatively high in pancreas cancer, gastric cancer or lung cancer. The typical symptoms with cancer-associated cachexia includes body weight loss, appetite loss and general fatigue. In 2011, EPCRC published the consensus report of definition for cancer-associated cachexia in 2011, and the diagnostic criteria based on body weight loss is used widely. Although the systemic inflammation complicated with cancer plays an important role for cachexia development, basic research has clarified that cancer promotes cachexia directly using proteolysis inducing factor, lipid mobilizing factor and others. Recently, anamorelin, ghrelin mimics gathers attention as a treatment drug for cancer-associated cachexia. Clinical trials confirmed that anamorelin increased the lean body mass in cancer patients probably due to improve the appetite and protein anabolism. Treatment strategy for cancer-associated cachexia needs the comprehensive approach with nutritional and exercise therapy in addition with anti-cachexia drug.


Assuntos
Caquexia/etiologia , Neoplasias , Anorexia , Apetite , Humanos , Neoplasias/complicações
3.
Gan To Kagaku Ryoho ; 46(12): 1818-1822, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879395

RESUMO

Cachexia is considered as a complex metabolic disease accompanied by systemic inflammation. However, we still do not understand the essential nature of the metabolic disorder associated with cachexia or the precise molecular mechanisms that drive cachexia. This reviewsummarizes the current knowledge on the pathogenesis of cancer cachexia obtained mainly from mouse models with emphasis on the findings that could reach the bedside in the future. Basic studies using animal models of cancer cachexia indicate that mediators such as pro-inflammatory cytokines and members of TGF-b superfamily disturb the cross-talks among metabolism-related organs including skeletal muscle, adipose tissue, liver, and CNS and thereby induce the collapse of metabolic homeostasis. The inhibitors of these mediators are currently under development for the treatment of cancer cachexia. Skeletal muscle atrophy is a key feature of cancer cachexia and is induced by enhanced proteolysis via ubiquitin-proteasome system and autophagy-lysosome system, as well as by decreased protein synthesis and increased fatty acid oxidation. Adipose tissue atrophy due to excessive lipolysis is another common feature of cancer cachexia, and the involvement of the browning of white adipose tissue and of the increased energy expenditure associated with the futile cycle of lipolysis/lipogenesis is suggested. The liver of cachectic tumor-bearing mice shows increased gluconeogenesis which leads to energy expenditure via futile cycle, and also develops steatosis due to decreased triglyceride usage. In the CNS, inflammation in the hypothalamus induces anorexia and excessive peripheral energy expenditure. Cachectic animals also showresistance to the appetite-promoting effects of ghrelin. We hope that cancer cachexia will gain better awareness in the near future, leading to the growth and progress of the research field, and that the elucidation of its pathogenesis will contribute to the development of novel preventive/therapeutics strategies.


Assuntos
Caquexia , Neoplasias , Tecido Adiposo , Animais , Anorexia , Caquexia/etiologia , Citocinas , Camundongos , Músculo Esquelético , Neoplasias/complicações
4.
Gan To Kagaku Ryoho ; 46(12): 1823-1828, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879396

RESUMO

There are 4 purposes in the nutritional management for cancer patient. At first, we had better perform the early metabolic recovery from several invasive damages by some cancer treatments. At second, we give some special nutritional management for improvement from cancer cachexia. At third, we consider palliative nutritional management to terminal cancer patients based on pathophysiology of cachexia, their life styles and ethics. Finally, we give the social nutritional management for keeping high quality of life through well eating until the end of life. In this paper, we explained about the metabolic influences to normal tissues during cancer treatments such as surgical operation, chemotherapy and radiotherapy. The mechanism and pathophysiology of cancer cachexia due to tumor expanding and metabolic disorders could be clear by our experimental results and other literatures. Also the nutritional management and metabolic regulation to control of symptoms and development of cachexia could be shown with prevention of sarcopenia. Administration of protein and amino acids, especially, branched chain amino acids, and some other micro nutrients should be useful for prevention of sarcopenia and cachexia. However, 3-4 weeks before death, the energy expenditure should decrease at the stage of refractory cachexia. Thus, in this point, we can recommend to reduce the total mounts of energy and solution at the nutritional management without overloading.


Assuntos
Caquexia , Neoplasias , Caquexia/etiologia , Metabolismo Energético , Humanos , Neoplasias/complicações , Qualidade de Vida
5.
Gan To Kagaku Ryoho ; 46(12): 1829-1834, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879397

RESUMO

Cancer cachexia is a functional disorder which potentially co-exists in many types of malignancies. Its pathophysiology is macroscopically invisible by means of radiographic or pathologic tests. Recently, the international consensus on definition, diagnosis, and staging have been reported. However, the current diagnostic criteria is immature and unable to differentiate cancer cachexia from other similar disorders caused by aging, complications, disuse syndrome, or adverse events of cancer treatment. In addition, an early detection of pre-cachexia is still challenging. Despite vigorous efforts in development of treatment options, there is no standard treatment. There are discrepancies in recognition of clinically relevant outcomes among researchers, pharmaceutical companies, and regulatory authorities. True endpoint of cancer cachexia care may be the expansion of active life with better QOL. Although the classical endpoints of measuring body or lean body mass would be an important outcome, it may not always contribute as a true endpoint. Thus, an optimal measurable endpoint should be identified, and better combination of pharmacological and non-pharmacological treatments be established to improve functional prognosis in patients with cancer cachexia.


Assuntos
Caquexia , Neoplasias , Composição Corporal , Caquexia/etiologia , Ensaios Clínicos como Assunto , Consenso , Humanos , Neoplasias/complicações , Prognóstico , Qualidade de Vida
6.
Rinsho Ketsueki ; 60(10): 1418-1424, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31695001

RESUMO

Autoimmune hemolytic anemia (AIHA) is secondary to underlying diseases, such as autoimmune diseases and lymphoid malignancies. Recently, solid cancers have also been reported to be associated with AIHA, although there is not much information available. In this study, we retrospectively examined the correlation between AIHA and onset of malignancy in 100 patients diagnosed with AIHA based on the broad definition of AIHA at our hospital and cooperating institutions from January 1, 1995 to May 31, 2016. Malignancies were detected in 52 of the 100 patients (hematological malignancies: 39 patients; solid cancers: 22 patients; total malignancies including multiple primary malignancies: 67 patients). Of the 67 patients with malignancies, 28 were diagnosed with malignancies within 6 months of AIHA diagnosis. All patients with cold agglutinin disease (CAD) were associated with malignancies. Compared with warm AIHA, solid cancers were significantly more common among the patients with CAD. These findings emphasize the importance of investigating the malignancies upon diagnosis of AIHA.


Assuntos
Anemia Hemolítica Autoimune/complicações , Neoplasias/complicações , Humanos , Estudos Retrospectivos , Fatores de Risco
7.
Medicine (Baltimore) ; 98(44): e17809, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689865

RESUMO

INTRODUCTION: Almost all patients with end-of-life cancer experience cancer-related fatigue; however, there are only a few known effective coping methods. OBJECTIVES: We will conduct a prospective, multi-center, single-blinded randomized controlled study to evaluate the efficacy of acupuncture for cancer-related fatigue in patients with end-of-life cancer. METHODS: We will enroll 120 patients with cancer hospitalized in a palliative care unit or receiving consultation from a palliative care team in four hospitals. We will add acupuncture treatment; specifically, contact needle therapy (CNT), consisting of an intervention per week period to the usual care. The primary outcome measure will be the Cancer Fatigue Scale (CFS) score while the secondary outcome measures will be the Numerical Rating Scale (NRS) score for fatigue, pain, and salivary amylase levels. CONCLUSION: We will evaluate the possibility of using acupuncture therapy, that is, CNT, in relieving fatigue sensation in patients with advanced cancer. TRIAL REGISTRATION: UMIN000028304, registered on July 21st, 2017; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000032401.


Assuntos
Terapia por Acupuntura/métodos , Fadiga/terapia , Neoplasias/complicações , Neoplasias/terapia , Cuidados Paliativos , Adulto , Fadiga/etiologia , Humanos , Medicina Kampo , Estudos Prospectivos , Método Simples-Cego , Assistência Terminal
8.
BMC Infect Dis ; 19(1): 836, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601195

RESUMO

BACKGROUND: Moraxella nonliquefaciens is a usually non-pathogenic biofilm-producing Gram-negative coccobacillus which may colonize the upper respiratory tract, rarely causing invasive disease. Although very rare, bloodstream infections caused by this organism have been described, showing often a fatal outcome. Here, we report the case of a pediatric cancer patient with bloodstream infection and sepsis due to M. nonliquefaciens showing full recovery after appropriate antibiotic treatment. CASE PRESENTATION: A three-year-old boy with stage IV neuroblastoma was admitted for high-dose chemotherapy with autologous stem cell rescue after standard neuroblastoma treatment. Despite receiving antimicrobial prophylaxis with trimethoprim/sulfamethoxazole, acyclovir and amphothericin B, the patient presented with fever of up to 39.5 °C and neutropenia. Besides a chemotherapy-related mucositis and an indwelling Broviac catheter (removed), no infection focus was identified on physical examination. Moraxella nonliquafaciens was identified in blood cultures. After antibiotic treatment and neutrophil recovery, the patient was fit for discharge. CONCLUSIONS: The case described highlights the importance of an otherwise non-pathogenic microorganism, especially in immunosupressed cancer patients. It should be kept in mind that, although very infrequently, Moraxella nonliquefaciens may cause bloodstream infections that can be successfully treated with prompt focus identification and antibiotic therapy.


Assuntos
Bacteriemia/diagnóstico , Moraxella/isolamento & purificação , Neoplasias/patologia , Sepse/diagnóstico , Antibacterianos/uso terapêutico , Antineoplásicos/uso terapêutico , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Pré-Escolar , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Neutropenia/diagnóstico , Neutropenia/etiologia , Sepse/etiologia , Sepse/microbiologia
9.
Bratisl Lek Listy ; 120(7): 485-493, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31602982

RESUMO

Growing cancer incidence in reproductive age goes hand in hand with a rising survival rate of patients who underwent anticancer therapy. This trend points to the necessity of discussion regarding the fertility maintenance. The patient´s future with respect to his reproductive ability has to be addressed properly to achieve a complex approach to cancer management. The germinal epithelium of the testes is highly susceptible to deleterious effects of chemotherapy. After the administration of gonadotoxic chemotherapeutic agents, a patient can develop oligospermia, or even azoospermia. Similarly, radiation exposure can damage spermatogenesis, while higher doses lead to azoospermia. This review brings an overview of the methods of assisted reproduction, which are currently in use for fertility maintenance in oncological patients, but also in those with non-malignant indications. Also, novel, yet still experimental, methods are discussed, which represent promising technologies applicable to prepubertal oncological patients. We also discuss historical milestones in the development of assisted reproduction, summarize the options of semen analysis, and we present a practical guide through the process of sperm cryopreservation and subsequent in vivo or in vitro fertilisation. We deem that fertility maintenance should be an integral part of the health care in oncological patients in reproductive age (Tab. 1, Ref. 85). Keywords: assisted reproduction technique, sperm cryopreservation, testicular tissue cryopreservation, spermatogenesis, sperm quality in oncological patients.


Assuntos
Preservação da Fertilidade , Infertilidade Masculina/prevenção & controle , Neoplasias/terapia , Criopreservação , Humanos , Infertilidade Masculina/terapia , Masculino , Neoplasias/complicações , Espermatogênese , Espermatozoides , Testículo
10.
Niger J Clin Pract ; 22(10): 1319-1323, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607718

RESUMO

Background: Morphine is a common analgesic often used to manage chronic pain, especially for patients with pain due to malignancies. Since UGT2B7 plays an important role in the metabolism of morphine, UGT2B7 gene mutation may influence the efficacy of morphine in patients with cancer being treated by this medication. Aims: The aim of this study is to investigate the relationship between the polymorphisms of UGT2B7 and the efficacy of morphine treatment on cancer pain among the Chinese Han population. Materials and Methods: A total of 120 patients with cancer pain were enrolled in this study. Morphine was administrated through patient-controlled analgesia infusion pump, and the visual analog score (VAS) was used for pain assessment at 0.5, 4, 6, 12, 24, 48, and 72-h post morphine treatment, respectively. The plasma concentration of morphine and genetic polymorphism of UGT2B7 C802T and G221T was analyzed, respectively. Results: The frequencies of UGT2B7 C802T were CC: 13.33%, CT: 45% and TT: 41.67%, and the frequencies of UGT2B7 G221T were GG: 76.67%, GT: 22.5% and TT: 0.83%. Moreover, the VAS score of patients with either C802T CT or TT was significantly higher than that in patients with C802T CC. However, no difference of VAS scores was observed between patients carrying G221T GG and patients carrying G221T GT. The plasma concentration of morphine for patients with the C802T CC was significantly lower than that in patients carrying C802T CT or TT, while there was no significant difference in the level of morphine between patients with G221T GG and G221T GT. Conclusion: The polymorphism of UGT2B7 C802T, but not UGT2B7 G221T, has been associated with the efficacy of morphine treatment on cancer pain among Chinese Han population.


Assuntos
Analgésicos Opioides/sangue , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Dor do Câncer/tratamento farmacológico , Glucuronosiltransferase/genética , Morfina/sangue , Neoplasias/sangue , Polimorfismo Genético/genética , Adulto , Analgesia Controlada pelo Paciente , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Grupo com Ancestrais do Continente Asiático/genética , Dor do Câncer/genética , Feminino , Genótipo , Humanos , Bombas de Infusão , Masculino , Pessoa de Meia-Idade , Morfina/administração & dosagem , Morfina/uso terapêutico , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Neoplasias/genética , Medição da Dor , Escala Visual Analógica
11.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 427-430, 2019 Sep 26.
Artigo em Chinês | MEDLINE | ID: mdl-31612681

RESUMO

OBJECTIVE: To investigate the prevalence of the serum anti-Toxoplasma gondii antibody among patients with malignant tumors of the digestive tract in Hainan Province. METHODS: A total of 1 932 patients with malignant tumors of the digestive tract were enrolled in Hainan Province from 2016 to 2019, including 376 esophageal cancer patients, 475 gastric cancer patients, 401 colorectal cancer patients, 427 hepatic cancer patients and 253 pancreatic cancer patients, and 400 healthy people served as controls. The serum IgG and IgM antibodies specific to T. gondii were detected using enzyme-linked immunosorbent assay, and the seroprevalence was compared. RESULTS: The overall seroprevalence of anti-T. gondii IgG antibody was significantly greater in patients with malignant tumors of the digestive tract than in healthy controls (19.82% vs. 3.75%; χ2 = 60.49, P < 0.01), and no significant difference was seen in the overall seroprevalence of anti-T. gondii IgM antibody between patients with malignant tumors of the digestive tract and healthy controls (1.09% vs. 0.50%; χ2 = 1.17, P > 0.05). The seroprevalence of anti-T. gondii IgG antibody was 15.16%, 19.58%, 21.70%, 23.65% and 17.79% in patients with esophageal cancer, gastric cancer, colorectal cancer, hepatic cancer and pancreatic cancer, which was all significantly greater than in healthy controls ( χ2 = 29.97, 50.29, 58.03, 67.85 and 36.59; all P < 0.01); however, the seroprevalence of anti-T. gondii IgG antibody in patients with esophageal cancer (1.06%), gastric cancer (1.47%), colorectal cancer (0.75%), hepatic cancer (1.17%) and pancreatic cancer (0.79%) did not differ from that in healthy controls ( χ2 = 0.80, 2.02, 0.20, 1.11 and 0.21; all P > 0.05). There was a significant difference in the seroprevalence of anti-T. gondii IgG antibody among various types of malignant tumors of the digestive tract ( χ2 = 10.65, P < 0.05); however, no significant difference was detected in the seroprevalence of anti-T. gondii IgM antibody ( χ2 = 1.33, P > 0.05). CONCLUSIONS: There is a high seroprevalence of anti-T. gondii IgG antibody among patients with malignant tumors of the digestive tract in Hainan Province, and there is a significant difference in the seroprevalence in terms of the cancer type. It is suggested that the screening for T. gondii infections should be intensified in patients with malignant tumors of the digestive tract to effective prevent and control the damages to patients with malignant tumors of the digestive tract caused by T. gondii infections.


Assuntos
Gastroenteropatias , Neoplasias , Toxoplasmose , Anticorpos Antiprotozoários/sangue , Gastroenteropatias/complicações , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Neoplasias/complicações , Estudos Soroepidemiológicos , Toxoplasma , Toxoplasmose/sangue , Toxoplasmose/complicações , Toxoplasmose/prevenção & controle
12.
Vet Clin North Am Small Anim Pract ; 49(6): 981-991, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31581985

RESUMO

Surgery is the mainstay of therapy for canine and human solid cancers. Alarmingly, evidence suggests that the process of surgery may exacerbate metastasis and accelerate the kinetics of cancer progression. Understanding the mechanisms by which cancer progression is accelerated as a result of surgery may provide pharmacologic interventions. This review discusses surgery-induced cancer progression. It focuses on immunomodulatory properties of anesthesia and opioids and evidence that studies evaluating the role of opioids in tumor progression are indicated. It concludes by discussing why companion animals with spontaneously arising cancer are an ideal model for clinical trials to investigate this phenomenon.


Assuntos
Analgésicos Opioides/uso terapêutico , Doenças do Cão/tratamento farmacológico , Manejo da Dor/veterinária , Dor/veterinária , Animais , Progressão da Doença , Cães , Metástase Neoplásica , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Neoplasias/cirurgia , Neoplasias/veterinária , Dor/tratamento farmacológico , Manejo da Dor/métodos , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/veterinária
13.
Medicine (Baltimore) ; 98(40): e16950, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577697

RESUMO

BACKGROUND: Anorexia is a common cause of malnutrition and is associated with negative effects on the quality of life (QOL) for patients with cancer. Management of appetite is the key to improving both the QOL and the prognosis for such patients. Yukgunja-tang (YGJT) is a traditional herbal medicine extensively prescribed in Korea as a remedy for various gastrointestinal syndromes. Currently, no standardized herbal medicine treatment exists for patients with cancer who are suffering from anorexia after surgery, chemotherapy, and/or radiotherapy. For that reason, this study aims to examine the efficacy and the safety of using YGJT to treat anorexia in such patients and to establish whether or not YGJT can be recommended as the primary therapy. METHODS: We will enroll 52 cancer patients diagnosed with anorexia. The enrolled participants will be randomly allocated to 2 groups: The control group will receive nutrition counseling, and the YGJT group will receive nutrition counseling and be administered YGJT at a dose of 3 g twice a day for 4 weeks (a total of 56 doses of 3.0 g per dose). The primary outcome of this study is the change in the score on the anorexia/cachexia subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes are the changes in the FAACT score with the A/CS score excluded, the score on the Visual Analogue Scale (VAS) for appetite, the weight and the body mass index (BMI), and laboratory tests for compounds such as leptin, tumor necrosis factor-α (TNF-α), ghrelin, and IL-6. All variables related to the safety assessment, such as vital signs, electrocardiography results, laboratory test results (CBC, chemistry, urine test), and adverse events, will be documented on the case report form (CRF) at every visit. CONCLUSION: This study is the first randomized controlled trial to investigate the efficacy and the safety of using YGJT for treating patients with cancer-related anorexia in Korea. We designed this study based on previous research about YGJT. This study will serve as a pilot and provide data for planning further clinical trials on herbal medicine and cancer-related anorexia. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0002847. Registered retrospectively on 3 April 2018.


Assuntos
Anorexia/tratamento farmacológico , Anorexia/etiologia , Caquexia/tratamento farmacológico , Caquexia/etiologia , Medicamentos de Ervas Chinesas/uso terapêutico , Neoplasias/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Apetite , Índice de Massa Corporal , Peso Corporal , Método Duplo-Cego , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Testes Hematológicos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , República da Coreia , Projetos de Pesquisa , Adulto Jovem
14.
J Opioid Manag ; 15(4): 272-274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637679

RESUMO

OBJECTIVE: To determine the utility of the screener and opioid assessment for patients with pain-revised (SOAPP-R) for patients with cancer-related pain. DESIGN: The authors performed a retrospective analysis of cancer patients screened with the SOAPP-R. Opiate abuse was determined using a combination of urine drug screens and analysis of patients' electronic medical records. SETTING/PATIENTS: Patients who were seen at a palliative care clinic presenting with pain or needing an opioid prescription at an academic medical center with any type of cancer were screened using the SOAPP-R (N = 69). OUTCOME MEASURES: Aberrant opioid-related behavior was determined using a combination of provider notes and urine drug screens. RESULTS: A positive SOAPP-R score (⩾18) was observed in 27 participants (39.1 percent). The sensitivity and specificity of the SOAPP-R in the study population was 0.75 and 0.80, respectively. CONCLUSIONS: The SOAPP-R, in its current form, may have value in screening patients with cancer for substance abuse. Incorporation of the screening tool in palliative and oncology settings may help reduce opioid abuse in cancer patients.


Assuntos
Analgésicos Opioides , Neoplasias/complicações , Transtornos Relacionados ao Uso de Opioides , Dor/tratamento farmacológico , Inquéritos e Questionários/normas , Analgésicos Opioides/uso terapêutico , Humanos , Programas de Rastreamento/métodos , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Dor/etiologia , Manejo da Dor , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade
15.
J Registry Manag ; 46(1): 4-14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490916

RESUMO

PURPOSE: As survival rates for individuals with HIV/AIDS diagnoses increase, cancer is becoming a more prevalent disease in this population. Data regarding the concurrent diagnoses of HIV/AIDS and cancer has not previously been examined and analyzed in the state of Iowa. METHODS: The Iowa Cancer Registry and Iowa Department of Public Health's HIV/AIDS surveillance databases were linked, and matches were identified. Characteristics of Iowans with HIV/AIDS later diagnosed with cancer between 1991 and 2015 were compared to Iowans without HIV/AIDS using proportional incidence ratios (PIRs). RESULTS: 490 patients met inclusion criteria; 91% had AIDS and 9% had HIV only. Compared to individuals without HIV/AIDS, significantly higher PIRs for cancer were found in younger persons, males, African Americans, metropolitan (metro) residents, and Iowans with Medicaid or the uninsured. Specifically, PIRs associated with the following cancers were higher in the population with HIV/AIDS: Kaposi sarcoma, non-Hodgkin lymphomas (NHLs), and squamous cell neoplasms of the anus. When stratified by AIDS-defining cancers and non-AIDS-defining cancers, the main differences were individuals with AIDS-defining cancers had elevated PIRs among those diagnosed between 1991-1998 and had Kaposi sarcoma or Burkitt lymphoma, while those with non-AIDS-defining cancers were diagnosed between 2007-2015 and were diagnosed with anal, male or female genital, lymphoma other than NHL, liver, lung, or other squamous cell neoplasm cancers. When comparing nonmetropolitan (nonmetro) vs metro Iowans with HIV/AIDS, PIRs for nonmetro patients were elevated in those diagnosed with cancer between 50-59 years old, whites, and individuals diagnosed with squamous cell neoplasms. CONCLUSION: Our results indicate Iowans with HIV/AIDS have higher proportions of certain types of cancers compared to the general population and provide baseline information for future initiatives aimed at preventing or detecting cancer among those living with HIV/AIDS.


Assuntos
Infecções por HIV/epidemiologia , Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Infecções por HIV/complicações , Humanos , Incidência , Lactente , Recém-Nascido , Iowa/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Adulto Jovem
17.
Vnitr Lek ; 65(6): 405-415, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484481

RESUMO

Oncologic emergencies and life-threatening cancer-related and treatment-related complications are the net effect of gradually increasing incidence of malignant diseases, improvement of therapeutic options and survival of oncologic patients. These complications are relatively specific for such population of patients and they are quite rare within the individuals without malignancy. Selected oncological emergencies are discussed in this review.


Assuntos
Emergências , Neoplasias , Humanos , Neoplasias/complicações , Neoplasias/terapia
18.
Medicine (Baltimore) ; 98(37): e17181, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517875

RESUMO

In this single-center, retrospective study, we aimed to report the clinical outcomes, among Asian comorbid cancer patients with venous thromboembolism (VTE), and compare them with those of VTE patients without cancer.Between January 2013 and December 2017, a total of 322 consecutive patients-diagnosed with acute VTE involving the leg, pelvis, or lung-were screened for inclusion. Comorbid cancer patients with VTE (n = 135, 41.9%) were included in this study and analyzed in comparison with VTE patients without cancer (n = 187, 58.1%). The study outcomes were the composite incidence of symptomatic and radiologically confirmed recurrence of VTE, or any-cause mortality.The study outcome incidence was 62.2% (n = 84) during a mean follow-up period of 10 months: VTE recurrence in 7 patients and any-cause mortality in 83. Upon multivariate analysis, higher body mass index, diabetes mellitus, cancer stage IV, and radiotherapy were independently associated with study outcome incidence. VTE involving the inferior vena cava (hazard ratio [HR], 12.1; 95% confidence interval [CI], 1.20-120.80; P = .034), lung cancer (HR, 16.5; 95% CI, 2.32-117.50; P = .005), and use of vitamin K antagonists (HR, 36.4; 95% CI, 3.00-442.70; P = .005) were independent predictors of VTE recurrence. Compared with VTE patients without cancer, the study outcome incidence was significantly higher among comorbid cancer patients with VTE (62.2% vs 7.5%, P < .001), although there was no significant difference in VTE recurrence between the 2 groups (5.2% in patients with cancer vs 3.7% in patients without cancer, P = .531).We found that various cancer-related and patient-related factors were associated with outcomes among comorbid cancer patients with VTE. The composite incidence of VTE recurrence or any-cause mortality was significantly higher among cancer patients with VTE than among VTE patients without cancer.


Assuntos
Neoplasias/complicações , Neoplasias/terapia , Tromboembolia Venosa/complicações , Tromboembolia Venosa/terapia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/epidemiologia , Recidiva , República da Coreia , Estudos Retrospectivos , Tromboembolia Venosa/diagnóstico por imagem , Tromboembolia Venosa/epidemiologia
19.
Anticancer Res ; 39(9): 4619-4625, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519559

RESUMO

Cancer patients are at risk for both venous and arterial thrombotic events. Accumulating evidence suggests a link between cancer and arterial thrombosis events. The pathophysiology of arterial thrombosis in cancer is complex and multifactorial. The risk of arterial thrombosis in cancer patients relies on individual risk factors, on cancer-related hypercoagulability, on anticancer drugs and radiotherapy often via a common underlying mechanism of endothelial dysfunction. This review describes the mechanisms involved in the development of arterial thrombotic events and their clinical manifestations. Furthermore, it provides an overview on therapeutic agents associated with arterial thrombosis.


Assuntos
Artérias/patologia , Neoplasias/complicações , Trombose/etiologia , Animais , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Gerenciamento Clínico , Humanos , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/terapia , Neovascularização Patológica , Radioterapia/efeitos adversos , Radioterapia/métodos , Avaliação de Sintomas , Trombose/diagnóstico , Trombose/epidemiologia
20.
Adv Gerontol ; 32(3): 397-404, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31512427

RESUMO

The cancer incidence increase in elderly patients determines the actuality of this study, because oncological illnesses are often accompanied by mental disturbances. This article considers clinical psychological risk factors of the posttraumatic stress disorder (PTSD) onset in prostate and rectal cancer elderly patients after surgical treatment. The study results showed that lack of social support, deficit of the successful stress coping experience in the past, maladaptive internal disease model, and destructive personality profile proved to be statistically significant risk factors and consequently psychotherapeutic interventions targets in PTSD treatment and prevention. Consideration of the elderly oncology patient clinical, psychological and social characteristics allows to elaborate effective personalized strategies of the complex medical-psychological care in geriatric medicine.


Assuntos
Neoplasias , Transtornos de Estresse Pós-Traumáticos , Adaptação Psicológica , Idoso , Comorbidade , Humanos , Masculino , Neoplasias/complicações , Neoplasias/reabilitação , Neoplasias/cirurgia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/reabilitação
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