RESUMO
Despite important medical progress, supportive care still plays a central role in cancer therapy. Severe tumour- and therapy-related symptoms not only affect the patient's quality of life, but can also compromise the therapy outcome. Therefore, an effective supportive care is crucial in cancer therapy. In community pharmacies as well as in hospital pharmacies pharmacists contribute essentially to supportive care through qualified advice and individual support. Case examples within the field of cytotoxic and targeted therapy provide insight into the management of nausea and vomiting, diarrhoea, and papulopustular rash.
Assuntos
Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias/terapia , Serviços Comunitários de Farmácia , Humanos , Neoplasias/patologia , Neoplasias/fisiopatologia , Qualidade de VidaRESUMO
Neurological manifestations of coronavirus disease 2019 (COVID-19) have been frequently described. In this prospective study of hospitalized COVID-19 patients without a history of neurological conditions, we aimed to analyze their prevalence and prognostic value based on established, standardized and objective methods. Patients were investigated using a multimodal electrophysiological approach, accompanied by neuropsychological and neurological examinations. Prevalence rates of central (CNS) and peripheral (PNS) nervous system affections were calculated and the relationship between neurological affections and mortality was analyzed using Firth logistic regression models. 184 patients without a history of neurological diseases could be enrolled. High rates of PNS affections were observed (66% of 138 patients receiving electrophysiological PNS examination). CNS affections were less common but still highly prevalent (33% of 139 examined patients). 63% of patients who underwent neuropsychological testing (n = 155) presented cognitive impairment. Logistic regression models revealed pathology in somatosensory evoked potentials as an independent risk factor of mortality (Odds Ratio: 6.10 [1.01-65.13], p = 0.049). We conclude that hospitalized patients with moderate to severe COVID-19 display high rates of PNS and CNS affection, which can be objectively assessed by electrophysiological examination. Electrophysiological assessment may have a prognostic value and could thus be helpful to identify patients at risk for deterioration.