scholarly journals The influence of the SARS-CoV-2 pandemic on esophagogastric cancer services: an international survey of esophagogastric surgeons

2020 ◽  
Vol 33 (7) ◽  
Author(s):  
Sivesh K Kamarajah ◽  
Sheraz R Markar ◽  
Pritam Singh ◽  
Ewen A Griffiths ◽  
Keyword(s):  
Online Survey ◽  
International Survey ◽  
Definitive Chemoradiotherapy ◽  
Available N ◽  
Cancer Management ◽  
Cancer Services ◽  
Esophagogastric Cancer ◽  
Polymerase Chain ◽  
Practice Variations ◽  
Tomography Scan

Abstract Background Several guidelines to guide clinical practice among esophagogastric surgeons during the COVID-19 pandemic were produced. However, none provide reflection of current service provision. This international survey aimed to clarify the changes observed in esophageal and gastric cancer management and surgery during the COVID-19 pandemic. Methods An online survey covering key areas for esophagogastric cancer services, including staging investigations and oncological and surgical therapy before and during (at two separate time-points—24th March 2020 and 18th April 2020) the COVID-19 pandemic were developed. Results A total of 234 respondents from 225 centers and 49 countries spanning six continents completed the first round of the online survey, of which 79% (n = 184) completed round 2. There was variation in the availability of staging investigations ranging from 26.5% for endoscopic ultrasound to 62.8% for spiral computed tomography scan. Definitive chemoradiotherapy was offered in 14.8% (adenocarcinoma) and 47.0% (squamous cell carcinoma) of respondents and significantly increased by almost three-fold and two-fold, respectively, in both round 1 and 2. There were uncertainty and heterogeneity surrounding prioritization of patients undergoing cancer resections. Of the surgeons symptomatic with COVID-19, only 40.2% (33/82) had routine access to COVID-19 polymerase chain reaction testing for staff. Of those who had testing available (n = 33), only 12.1% (4/33) had tested positive. Conclusions These data highlight management challenges and several practice variations in caring for patients with esophagogastric cancers. Therefore, there is a need for clear consistent guidelines to be in place in the event of a further pandemic to ensure a standardized level of oncological care for patients with esophagogastric cancers.

scholarly journals International survey: real-world pain management strategies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Hagen ◽  
A Georgescu
Keyword(s):  
Pain Management ◽  
Real World ◽  
Pain Control ◽  
Online Survey ◽  
Management Strategies ◽  
Pain Medication ◽  
International Survey ◽  
Nationally Representative ◽  
Online Panels ◽  
Control Pain

Abstract Background Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies. Methods From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region. Results Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain. Conclusions This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use. Key messages More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.

scholarly journals Inverted papilloma of the ureter: study of a rare case with emphasis on clinicopathologic implications

2012 ◽  
Vol 6 (6) ◽  
pp. 274 ◽  
Author(s):  
Nikolaos Mertziotis ◽  
Diomidis Kozyrakis ◽  
Andreas Petrolekas ◽  
Maria Terzi ◽  
Nikiforos Kapranos
Keyword(s):  
Clinical Course ◽  
Endoscopic Examination ◽  
Inverted Papilloma ◽  
Renal Unit ◽  
Macroscopic Hematuria ◽  
Papilloma Virus ◽  
Polymerase Chain ◽  
Consensus Primers ◽  
Ureteral Lesion ◽  
Tomography Scan

A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscreterenal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable.

scholarly journals Care of adolescents and young adults with cancer in Asia: results of an ESMO/SIOPE/SIOP Asia survey

ESMO Open ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. e000467 ◽  
Author(s):  
Chi Kong Li ◽  
Rashmi Dalvi ◽  
Kan Yonemori ◽  
Hany Ariffin ◽  
Chuhl Joo Lyu ◽  
...  
Keyword(s):  
Young Adults ◽  
European Society ◽  
Cancer Care ◽  
Online Survey ◽  
Healthy Lifestyle ◽  
Insurance Coverage ◽  
Paediatric Oncology ◽  
Adolescents And Young Adults ◽  
Human Papillomavirus Vaccination ◽  
Cancer Services

BackgroundAdolescents and young adults (AYAs) with cancer require dedicated management encompassing both adult and paediatric cancer services. Following a European survey, the European Society for Medical Oncology, the European Society for Paediatric Oncology and the Asian continental branch of International Society of Paediatric Oncology undertook a similar survey to assess AYA cancer care across Asia.MethodsA link to the online survey was sent to healthcare professionals (HCPs) in Asia interested in AYA cancer care. Questions covered the demographics and training of HCPs, their understanding of AYA definition, availability and access to specialised AYA services, the support and advice offered during and after treatment, and factors of treatment non-compliance.ResultsWe received 268 responses from 22 Asian countries. There was a striking variation in the definition of AYA (median lower age 15 years, median higher age 29 years). The majority of the respondents (78%) did not have access to specialised cancer services and 73% were not aware of any research initiatives for AYA. Over two-thirds (69%) had the option to refer their patients for psychological and/or nutritional support and most advised their patients on a healthy lifestyle. Even so, 46% did not ask about smokeless tobacco habits and only half referred smokers to a smoking cessation service. Furthermore, 29% did not promote human papillomavirus vaccination for girls and 17% did not promote hepatitis B virus vaccination for high-risk individuals. In terms of funding, 69% reported governmental insurance coverage, although 65% reported that patients self-paid, at least partially. Almost half (47%) reported treatment non-compliance or abandonment as an issue, attributed to financial and family problems (72%), loss of follow-up (74%) and seeking of alternative treatments (77%).ConclusionsLack of access to and suboptimal delivery of AYA-specialised cancer care services across Asia pose major challenges and require specific interventions.

Resource and reimbursement barriers to comprehensive cancer care (CCC) delivery: An Association of Community Cancer Centers (ACCC) survey research analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2075-2075
Author(s):  
Al Bowen Benson ◽  
Leigh Boehmer ◽  
Latha Shivakumar ◽  
Julia Rachel Trosman ◽  
Christine B. Weldon ◽  
...  
Keyword(s):  
Online Survey ◽  
Internal Validity ◽  
Payment Reform ◽  
Delivery Of Care ◽  
Expert Review ◽  
Cancer Management ◽  
Out Of Pocket Payments ◽  
Or Practice ◽  
Care Models ◽  
Supportive Oncology

2075 Background: CCC delivery is recommended in guidelines, required by accreditation bodies, and essential for high-quality cancer management. Barriers, such as insufficient reimbursement and lack of specialist staff, prevent consistent access to and delivery of CCC, particularly supportive oncology services. Challenges especially persist in community programs, where access to philanthropy and similar funding is limited. ACCC conducted a representative survey of its member programs to elucidate capacity and barriers to CCC delivery in the community/academic setting in order to inform policy and value-based payment reform. Methods: Survey development methodology included item generation with expert review, iterative piloting and cognitive interviews to achieve content and internal validity. An online survey was piloted at the ACCC 2018 Annual Meeting and sent to member programs via email link. The final survey included 22 questions on availability and funding for supportive services. Twenty-seven supportive oncology services were assessed for availability, reasons not offered, reimbursement/funding and patient payment. Analyses were conducted with SAS. Results: 172 of 704 ACCC member programs responded and completed the majority of survey as of 10/7/19. Despite a high proportion of programs offering supportive oncology services, gaps between cost and reimbursement were present for all (Table). Deficits in reimbursement are compensated by patient out-of-pocket payments, grants and donations. Most centers report needing more staffing in psychology (61%), social work (60%), navigation (59%), nutrition (57%), palliative care (56%), genetic counseling (52%), and financial counseling (53%). Gaps were observed regardless of region or practice type. Conclusions: There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the U.S., regardless of region or practice type. Oncology care models and reimbursement policies must include CCC services to optimize delivery of care. [Table: see text]

Resource and reimbursement barriers to comprehensive cancer care (CCC) delivery: An association of community cancer centers (ACCC) survey research analysis.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 31-31
Author(s):  
Al Bowen Benson ◽  
Leigh Boehmer ◽  
Latha Shivakumar ◽  
Julia Rachel Trosman ◽  
Christine B. Weldon ◽  
...  
Keyword(s):  
Online Survey ◽  
Internal Validity ◽  
Payment Reform ◽  
Delivery Of Care ◽  
Expert Review ◽  
Cancer Management ◽  
Out Of Pocket Payments ◽  
Or Practice ◽  
Care Models ◽  
Supportive Oncology

31 Background: CCC delivery is recommended in guidelines, required by accreditation bodies, and essential for high-quality cancer management. Barriers, such as insufficient reimbursement and lack of specialist staff, prevent consistent access to and delivery of CCC, particularly supportive oncology services. Challenges especially persist in community programs, where access to philanthropy and similar funding is limited. ACCC conducted a representative survey of its member programs to elucidate capacity and barriers to CCC delivery in the community/academic setting in order to inform policy and value-based payment reform. Methods: Survey development methodology included item generation with expert review, iterative piloting and cognitive interviews to achieve content and internal validity. An online survey was piloted at the ACCC 2018 Annual Meeting and sent to member programs via email link. The final survey included 22 questions on availability and funding for supportive services. Twenty-seven supportive oncology services were assessed for availability, reasons not offered, reimbursement/funding and patient payment. Analyses were conducted with SAS. Results: 172 of 704 ACCC member programs responded and completed the majority of survey as of 10/7/19. Despite a high proportion of programs offering supportive oncology services, gaps between cost and reimbursement were present for all (Table). Deficits in reimbursement are compensated by patient out-of-pocket payments, grants and donations. Most centers report needing more staffing in psychology (61%), social work (60%), navigation (59%), nutrition (57%), palliative care (56%), genetic counseling (52%), and financial counseling (53%). Gaps were observed regardless of region or practice type. Conclusions: There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the U.S., regardless of region or practice type. Oncology care models and reimbursement policies must include CCC services to optimize delivery of care.

scholarly journals Robust Protective Effect of COVID-19 Vaccination in India—Results of Survey in the Midst of Pandemic’s Second Wave

2021 ◽  
Vol 10 (01) ◽  
pp. 28-31
Author(s):  
Purvish M. Parikh ◽  
Udip Maheshwari ◽  
V. M. Krishna ◽  
S. Gupta ◽  
T. Patil ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Online Survey ◽  
Normal Activity ◽  
High Risk Group ◽  
Fake News ◽  
Rt Pcr ◽  
Positivity Effect ◽  
Polymerase Chain ◽  
Second Wave

Abstract Introduction Our objective was to document the incidence of COVID-19 in vaccinated health care professionals and related personnel. Method We conducted an online survey to ascertain the incidence of COVID-19 symptoms, reverse transcriptase polymerase chain reaction (RT-PCR) positivity, effect on normal activity, need for anti-COVID-19 medication, hospitalization, and death among individuals who had completed both doses of COVID vaccination at least 2 weeks earlier. Results A total of 351 unique valid responses were received. Among the 340 people who had been vaccinated in India, 5% (17/340) had COVID-19 symptoms, 4.7% (16) became COVID-19 RT-PCR positive, 12 (3.5%) had sickness preventing normal daily activity, 2.65% (9) required anti-COVID-19 medication, and 1.18% (4) required hospitalization. Among family members living with the survey responders, the corresponding incidence was even lower. There was one death in this group. Discussion Being health care professionals, the responders would be at higher risk of daily exposure to COVID-19. Even in this high risk group, the vaccine efficacy is good. Vulture journalists should stop spreading fake news and misinformation that makes people hesitate taking the vaccine or be afflicted analysis paralysis. Every person who chooses to remain unvaccinated increases the risk for our entire community. We also need to follow universal precautions (wearing mask, physical distancing, handwashing) diligently without letting down our guard.

scholarly journals Current Imaging Trends in COVID-19 Pneumonia

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Anamika Jha ◽  
Benu Lohani ◽  
Ram Kumar Ghimire
Keyword(s):  
Computed Tomography ◽  
Health Care ◽  
Disease Transmission ◽  
Medical Council ◽  
X Ray ◽  
System Functioning ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Tomography Scan

COVID-19 has rapidly emerged as a pandemic threatening lives and healthcare systems worldwide.With the emergence of the disease in Nepal, all faculties of medicine need to be well prepared toface the challenge. Fortunately, now plenty of research is available to facilitate our preparednessin the war against COVID-19. The reverse transcriptase-polymerase chain reaction is the currentgold standard diagnostic test and chest Computed Tomography scan for screening the disease isconsidered inappropriate by most society recommendations. The Nepal Radiologists’ Associationhas proposed its guidelines which have been endorsed by the Nepal Medical Council. This articleaims to summarize the role of imaging focusing on chest X-ray and Computed Tomography scanincluding the indications, specific findings, and important differentials. Imaging needs to be donetaking necessary precautions, to minimize disease transmission, protect health care personnel, andpreserve health care system functioning.

scholarly journals An Overview of Novel Corona Virus 2019-nCoV and Their Clinical and Immune Responses

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 62-67 ◽  
Author(s):  
Sheetal Devi ◽  
Manish Kumar ◽  
Prabhat Kumar Upadhyay ◽  
Anuj Malik ◽  
Beena Kumari ◽  
...  
Keyword(s):  
Drug Testing ◽  
World Health ◽  
The Novel ◽  
Viral Shedding ◽  
Corona Virus ◽  
Direct Exposure ◽  
Novel Virus ◽  
Polymerase Chain ◽  
Tomography Scan

The novel virus such as corona virus 2019 is the main cause of the disease that is declared by the WHO (World Health Origination). Some other virus similar to this virus were also discovered in initial year of 21th century such as SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 in 2019. The first few cases of covid-19 were detected from direct contact to the infected animal to human which is also called as animal to human transmission. Due to direct exposure of this virus to infected animals the human to human transmission of the virus is as well possible, which is also likely to be consider and measured as core form of transmission. According to the reports of WHO by 26 February 2020, patients suffering from COVID-19 reduced gradually in China but rapidly increased in countries like Italy, Iran and South Korea. The infection caused by the COVID 19 is detected by looking at the symptoms and it ultimately confirmed by the reverse transcription polymerase chain reaction (rRT-PCR) of infected secretions with 71% sensitivity and computed tomography scan with 98%.  The antimalarial medicate, hydroxychloroquine, is authorized for the chemoprophylaxis and treatment of intestinal sickness and as a disease changing antirheumatic drugs. Pharmacological demonstrating dependent on observed drug absorptions and in vitro drug testing propose that prophylaxis with hydroxychloroquine at affirmed portions could anticipate SARS-CoV-2 contamination and improve viral shedding. Clinical preliminaries of hydroxychloroquine treatment for COVID-19 pneumonia are in progress in China (NCT04261517 and NCT04307693).

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