scholarly journals Prescribing Empiric Antibiotics for Febrile Neutropenia: Compliance with Institutional Febrile Neutropenia Guidelines

Pharmacy ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 83 ◽  
Author(s):  
Doaa Naeem ◽  
Majed Alshamrani ◽  
Mohammed Aseeri ◽  
Mansoor Khan
Keyword(s):  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Bacterial Infections ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Management Guidelines ◽  
Empiric Antibiotics ◽  
Inappropriate Use ◽  
Common Diagnosis ◽  
The Mean

Background: Febrile neutropenia (FN) is an oncologic emergency which should be treated immediately with empiric antibiotics. Different institutions observe different antibiograms and use different FN management guidelines. Our center implemented FN management guidelines for adult cancer patients in 2009. Hence, we decided to assess compliance with FN management guidelines and to describe the pattern of bacterial infections. Method: We conducted a cross-sectional study on all adult cancer patients admitted with FN. Data were collected from electronic medical records between January and December 2014. Results: One hundred FN episodes met the study inclusion criteria. The mean age of the patients was 41 ± 17 years; 52% (52 patients) were women. The most common diagnosis was lymphoma (33%). In terms of compliance to institutional FN guidelines, 55% of patients received guideline non-compliant treatment. The most common non-compliant treatment was incorrect amikacin dosing in 31% of patients, followed by incorrect vancomycin dosing in 20%, incorrect piperacillin/tazobactam dosing in 19%, inappropriate use of carbapenems in 18%, and non-compliant vancomycin use in 12% of patients. Bacterial isolates were only observed in 19% of the FN episodes. Among these 19 episodes of FN, Gram-negative pathogens were predominant and were identified in 74% of the episodes, followed by Gram-positive pathogens in 16% and polymicrobial pathogens in 10%. The mean time to defervescence was 2.21 ± 2 days. Conclusion: Our study concluded that there was a high percentage of non-compliance with our institutional FN management guidelines. We recommend following appropriate empiric antibiotic doses and indications as per institutional guidelines.

Evaluate the delay in the management of acute abdomen at the Yaounde central hospital: a prospective cohort study

2021 ◽  
Vol 11 (6) ◽  
pp. 155-158
Author(s):  
Joseph Cyrille Chopkeng Ngoumfe
Keyword(s):  
Cross Sectional Study ◽  
Good Prognosis ◽  
Central Hospital ◽  
Indication For Surgery ◽  
Continuous Training ◽  
Cross Sectional ◽  
Generalized Peritonitis ◽  
Common Diagnosis ◽  
The Mean

Background: Early surgical treatment remains the first factor of good prognosis for the management of acute abdominal diseases. The aim of this study was to evaluate the delay in the management of these pathologies in our context. Material and methods: We conducted a prospective cross-sectional study at the Yaoundé Central Hospital (HCY) over 7 months. All patients over 15 years of age presenting with an acute non-traumatic digestive surgical abdomen were included. The follow-up was done during the entire hospital stay of the patients. The dates and times of the different stages of management were recorded. Results: We collected 63 patients, 37 men, with a sex ratio M/F of 1.42. The mean age was 41.06±18 years. The mean time between arrival in the emergency room and the indication for surgery was 16.9 hours. Acute generalized peritonitis (n=26) was the most common diagnosis with 41.3% of cases. The average time between the indication for surgery and the availability of the surgical kit was 19 hours. The average time between the availability of the operating kit and the start of the surgical procedure was 6.2 hours. The complication rate was 33.3%. The mortality rate was 15.9%. Conclusion: Our delays in the management of acute abdomens are relatively long. A better organisation of the system and continuous training of the medical staff of peripheral hospitals would improve the prognosis of our patients.

scholarly journals The Relationship Between Social Support From Family and Quality of Life Among Cancer Patients: A Cross-Sectional Study

2020 ◽  
Vol 30 (4) ◽  
pp. 217-223
Author(s):  
Ismail Toygar ◽  
Öznur Usta Yeşilbalkan ◽  
Merve Kürkütlü ◽  
Tuğba Akgün
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Cancer Patients ◽  
Perceived Social Support ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Relationship

Introduction: Improving the Quality of Life (QoL) is considered one of the main objectives in the care of cancer patients. Achieving this objective, it is essential to determine the factors affecting QoL in cancer patients. The studies in the literature have determined the effects of various factors on QoL but social support from family has remained to be studied.  Objective: The present study aimed to determine the relationship between perceived social support from family and QoL in cancer patients. Materials and Methods: This cross-sectional study was conducted in an oncology unit of a university hospital in İzmir City, Turkey, from March to October 2019. A convenience sample of 276 cancer patients participated in the study. A patient identification form, the Perceived Social Support from family scale (PSS-Family), and the Quality of Life index-cancer version (QLI-C) were used for data collection. The scores of PSS-Family and QLI-C range from 0 to 20 and from 66 to 396, respectively. Regression analysis was used to estimate the effect of perceived social support from family on QoL. Results: Of the participants, 65.2% were female. The Mean±SD age of the study sample was 47.5±14.4 years. Also, the Mean±SD scores of PSS-Family and QLI-C were 16.43±3.01 and 307.77±27.48, respectively. Regression analysis revealed that perceived social support from family was associated with a relative increase in QoL index (B=3.44, P=0.001, R2=0.141). Conclusion: Perceived social support from family is positively associated with QoL in cancer patients. Nurses should consider this relationship when they plan to improve the QoL of cancer patients.

scholarly journals Awareness of Diagnosis and Decision-Making Preferences of Greek Cancer Patients

2020 ◽  
pp. 5-12
Author(s):  
Despoina G Alamanou ◽  
Konstantinos Giakoumidakis ◽  
Dimosthenis G Theodosiadis ◽  
Nikolaos V Fotos ◽  
Elissavet Patiraki ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Active Role ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Encounter ◽  
The Mean ◽  
The Impact ◽  
The City

Objective: In Greece, the old phenomenon of hiding cancer diagnosis and depriving cancer patients of their right to participate in decisionmaking remains a reality. The aim of this study was to assess the decision-making preferences of Greek cancer patients and their awareness of diagnosis. Methods: It was a cross-sectional study. The sample consisted of 229 adult Greek patients diagnosed with cancer, attending the oncology outpatient department (outpatients) or being hospitalized (inpatients), in one general hospital in Athens. Patients who were aware of cancer diagnosis (n=209) were administered at the Control Preference Scale (CPS), a tool, designed to elicit decision-making preferences. The IBM SPSS program, version 21.0 was used for statistical analysis. Results: One hundred and one patients (52.8%) were males. The mean [±standard deviation (SD)] age was 64.8 (±11.2) years. The vast majority of patients knew they suffered from cancer (n=209, 91.3%). Older patients (p=0.003), those who lived in suburbs of the city (p=0.01), those who had lower educational level (p=0.001), those with lower personal income (p=0.001) and shorter disease duration (p=0.001) stated that were unaware of cancer diagnosis. Seventy five (36.2%) patients chose the shared-decision role in decision-making procedures. Lower age (OR 1.04, 95%, CI: 1.00-1.08, p= 0.05) and higher education level (OR 2, 63, 95%, CI: 1.11-6.29, p=0.03) were significantly associated with the preference of patients to actively participate in decision-making regarding treatment. Conclusions: Although Greek cancer patients are aware of cancer diagnosis and treatment, nowadays, they still seem to hesitate in playing a more active role in the decision-making procedures, which portrays the impact of the dominating paternalistic model of doctor-patient relationship in the Greek medical encounter

scholarly journals Characteristics of tobacco consumption among cancer patients at a tertiary cancer hospital in South India—A cross-sectional study

2021 ◽  
Vol 14 ◽  
pp. 1179173X2110503
Author(s):  
Vinod K Ramani ◽  
Ganesha D V ◽  
Neethu Benny ◽  
Radheshyam Naik
Keyword(s):  
Substance Use ◽  
Cancer Patients ◽  
Cumulative Dose ◽  
Tobacco Consumption ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cancer Hospital ◽  
Diagnosis Of Cancer ◽  
The Mean

Introduction Cancer patients commonly present with antecedent addiction to tobacco consumption. Our study describes the characteristics of this substance use. Following the diagnosis of cancer, continued consumption of tobacco results in reduced tolerance to treatment, failure of treatment, tumor progression, other primary tumors, secondary cancers, and poor quality of life. The aim of our study is to enumerate the clinico-social aspects of tobacco consumption among cancer patients. Methods This cross-sectional study includes 100 cancer patients admitted to Healthcare Global cancer hospital, Bangalore, India. The study subjects were assessed for tobacco consumption, as well as other substance use such as intake of alcohol. We assessed various dimensions of exposure to tobacco consumption such as duration, intensity, and cumulative dose as independent risk factors for cancer. Results Among the study subjects, 46.2% were found to smoke filter cigarettes. The mean duration of tobacco consumption among beedi users was found to be longer (25.9 years, SD: 14.4). When stratified for exclusive consumption, the mean durations were as follows: beedis (29 ± 14.4 years), cigarettes (23.8 ± 13.3 years), and chewing (15.9 ± 9.6 years). Along with tobacco, a large proportion (59.3%) of patients consumed alcohol as well. After attempts to quit, 89.01% patients had reversal of tobacco substance use. The data did not show significance for duration, intensity, and cumulative dose of tobacco consumption. Conclusion The diagnosis of cancer is a life-altering event, which results in higher motivation to quit the use of tobacco. Smoking cessation initiatives can reduce the risk of developing tobacco-related malignancies.

scholarly journals Patients' Knowledge and Awareness towards Use of Antibiotics in Bangladesh: A Cross-sectional Study Conducted in Three Tertiary Healthcare Centers in Bangladesh

1970 ◽  
Vol 3 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Moni Rani Saha ◽  
Shammy Sarwar ◽  
Manik Chandra Shill ◽  
Mohammad Shahriar
Keyword(s):  
Health Education ◽  
Bacterial Infections ◽  
Cross Sectional Study ◽  
General Knowledge ◽  
Self Medication ◽  
Cross Sectional ◽  
Medical College ◽  
Inappropriate Use ◽  
Key Words Antibiotics ◽  
Tertiary Healthcare

This study is aimed to estimate general knowledge and awareness of patients regarding use of antibiotics to find out possible reasons of irrational use of antibiotics in Bangladesh. It was a questionnaire based crosssectional health survey conducted on 350 subjects aged 18 or over who came to get service at three tertiary healthcare centers named Dhaka Medical College (DMC) Hospital, Sir Salimullah Medical College (SSMC) Mitford Hospital and Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital of Dhaka, Bangladesh. It was found from the study that the general knowledge of the patients about the indication of antibiotics was very poor. Majority of the patients did not know the appropriate use of antibiotics. Only 26% respondents answered correctly that antibiotics are indicated for bacterial infections. In addition, 38.97% of them also did not know that an antibiotic is a prescription drug and should not be used without doctor’s prescription. The awareness about the patients towards use of antibiotics was also poor. A very high percentage of the patients (51.71%) answered that they do not complete the full course of therapy. Surprisingly, 39.14% of the patients replied that they stop antibiotics when the symptoms disappear and remarkably 14.29% just make the dose double if they forget to take due dose. On the other hand, 28.86% of the patients said that they do not maintain dosing schedule during the course of therapy. Moreover, prevalence of self-medication with antibiotics in cold and fever was also extremely high (60.86%). This study indicates that there is an urgent need of health education for the community to increase knowledge and awareness about use of antibiotics to decrease the self-medication and inappropriate use of antibiotics. Key words: Antibiotics; General Knowledge; Awareness; Tertiary Healthcare Center; Health Education DOI: 10.3329/sjps.v3i1.6799S. J. Pharm. Sci. 3(1): 54-58

Assessment of procalcitonin as a diagnostic marker of infection in pediatrics with cancer complicated by fever and neutropenia

2020 ◽  
Author(s):  
Soheila Zareifar ◽  
Anahita Sanaei Dashti ◽  
Tayebe Masoomzade ◽  
Mojtaba Anvarinejad ◽  
Omid Reza Zekavat ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Predictive Value ◽  
Urine Culture ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Pediatric Cancer Patients

Background: Febrile neutropenia is still one of the most important complications of treatment in cancer patients. These patients become prone to infection and consequently higher mortality and morbidity. This study aimed to determine the accuracy of serum procalcitonin (PCT) level in the detection of infection in pediatric cancer patients complicated with febrile neutropenia. Materials and Methods: In this cross-sectional study, all pediatric patients affected by cancer and febrile neutropenia following chemotherapy (n=107) were investigated from August 2014 to August 2015. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum levels of PCT, as well as blood and urine culture, were evaluated in all patients. Results: The mean age of the patients was 78 ± 55 months (3 - 214 months), and in terms of gender, 53 patients (49.5%) were male. Overall, 25 patients (23.4%) and 13 patients (12%) showed positive blood and urine culture, respectively. The area under the curve (AUC) receiver operating characteristic (ROC) curve was illustrated to determine how much PCT can couldpredict infection.(AUC =0.74, 95% CI: 0.61-0.87, P<0.001). Considering the cut-off of serum PCT levels as 0.70ng/mL, sensitivity, specificity, and positive and negative predictive valueof PCT were 0.76, 0.744, 0.475, and 0.91, respectively. In addition, PCT showed significant correlations with CRP (rs=0.415, P<0.001) and ESR (rs =0.262, P=0.009). Conclusion: According to the findings of this study, serum PCT levels can be used as a diagnostic test with acceptable sensitivity and specificity and high negative predictive value, but the low positive predictive value in the evaluation of infections in patients affected by cancer and complicated with fever and neutropenia.

scholarly journals Complementary and Integrative Medicines Used by Cancer Patients to Cope With Chemotherapy-Related Taste Alterations

2022 ◽  
Vol 32 (1) ◽  
pp. 69-77
Author(s):  
Tugbamenekli Tugbamenekli ◽  
◽  
Yasemin Yildirim ◽  
Keyword(s):  
Cancer Patients ◽  
Multivariate Logistic Regression Analysis ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Study Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Complementary And Integrative Medicine ◽  
Chi Square Test ◽  
The Mean

Introduction: Cancer is a global health problem. Taste change is one of the most common symptoms in cancer patients undergoing chemotherapy. Cancer patients often use Complementary and Integrative Medicine (CIM) to manage chemotherapy complications. Objective: This study aimed to evaluate CIM used by cancer patients to cope with chemotherapy-related taste alterations. Materials and Methods: This cross-sectional study was carried out on 318 cancer patients receiving chemotherapy in an oncology hospital in Malatya City, Turkey. The samples were recruited by convenience sampling method. The study data were collected with a data form developed by the research team. Written permissions were obtained from all participants and the Ethics Committee. Frequencies, mean scores, and standard deviation were used to present descriptive findings. The independent t-test, Chi-square test, and multivariate logistic regression analysis were used to analyze the obtained data. Results: The Mean±SD age of the patients was 65.18±8.36 years, and the mean duration of their diseases was 35.34±16.27 months. About 54.1% of the patients were female, and 42.8% had some information about CIM. Their primary source of information was other patients (49.6%), and 34.9% used CIM to cope with chemotherapy-related taste alterations. The most common method used was phytotherapy (50.5%), and the most commonly used herb was miracle fruit (21.4%). It was also determined that the frequency of CIM use was affected by age, illness duration, gender, living in a city, family history of cancer, having breast cancer, having information on CIM, having metastasis, and lacking complications (R2= 0.426, P=0.025). Conclusion: Cancer patients frequently use CIM to cope with chemotherapy-related taste alterations, and phytotherapy was the most commonly-used CIM.

scholarly journals Correlation Between PSA Density and Gleason Score In Prostate Cancer Patients

2020 ◽  
Vol 23 (2) ◽  
pp. 164-168
Author(s):  
Md Naved Yusuf ◽  
Sudip Das Gupta ◽  
Mohammed Mianur Rahman ◽  
Md Mahmud Ur Rahman
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Histological Grade ◽  
Specific Antigen ◽  
Cross Sectional Study ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Psa Density ◽  
The Mean

Background: Prostate cancer is the most common form of malignancy and the second leading cause of cancer death among men. The histological grade is an independent determinant of disease prognosis and survival. The Gleason System (GS) grading is the most widely accepted classification. Several recent studies have searched for factors that could predict GS upgrading. High prostate specific antigen density (PSAD) has been shown to be predictors of risk progression in many studies, reflecting the possibility of undetected aggressive cancer. Objective: To detect the association between PSA density and Gleason score in prostate cancer patients. Methodology: This cross sectional study was carried out at the department of urology, Sir Salimullah Medical College Mitford hospital, Dhaka. Patients diagnosed as prostate cancer meeting the inclusion criteria admitted in the above mentioned place was the study population. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 23.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Student t-test was used for continuous variables. Pearson’s correlation coefficient was used to test the relationship between the groups. P values <0.05 was considered as statistically significant. Results: Total eighty three patients were included in this study. The mean age was found 69.2±7.7 years ranging from 50 to 85 years. The mean volume of prostate was 42.3±17.6 ml ranging from 13.0 to 68.0 ml. The mean Gleason score was 7.8±1.4 ranging from 6.0 to 10.0. More than one third (33.7%) patients had PSA density 0.15- 0.5 ng/ml/ml. Three patients had found Gleason score 9 (5+4) within PSA density 0.51-1.0 ng/ml/ml, 5 patients within PSA density 1.1-1.5 ng/ml/ml, 3 patients within PSA density 1.51-2.0 ng/ml/ml, 6 patients within PSA density 2.1-2.5 ng/ml/ml, 5 patients within PSA density 2.51-3.0 ng/ml/ml and 2 patients within PSA density >3.0 ng/ml/ml. The difference was statistically significant (p<0.05) among seven groups. Positive correlation (r=0.717; p=0.001) between PSA density with Gleason score. Conclusion: In this study, we find there is a strong correlation between PSA density and Gleason score. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.164-168

scholarly journals Incidence of Febrile Neutropenia in Neutropenic Cancer Patients Admitted to Oncology Ward of Shahid Ghazi Tabatabai Hospital in Tabriz, Iran, During 2018 - 2020

2021 ◽  
Author(s):  
Loghman Ghaderi ◽  
Ali Reza Naseri
Keyword(s):  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Perianal Abscess ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Oncology Ward

Background: Chemotherapy-induced neutropenia is one of the risk factors for infection in patients undergoing chemotherapy (due to the weakened immune system). Febrile neutropenia (FN) may be the sole indicator of an underlying infection in these patients. Objectives: Since infection is associated with an increased risk of mortality in patients undergoing chemotherapy, the present study aimed to assess the incidence of FN in neutropenic cancer patients admitted to an oncology ward. Methods: This retrospective, descriptive, and cross-sectional study was conducted on 52 patients (selected using the census method) with signs of infection (i.e., FN) hospitalized in Ghazi Tabatabai Hospital in Tabriz, Iran, within 2018 - 2020. The data were collected by a researchermade form and analyzed using descriptive statistics (e.g., frequency, percentage, and mean) and chi-square in SPSS software (version 20). The significance level was considered less than 0.05 Results: The absolute neutrophil count was less than 500 cells/ml in 15.38% of the patients (n = 8). Infection was the cause of FN in 69.23% of the subjects (n = 36). An unknown factor was the cause of infection in 30.77% of the cases. The incidence of all types of infections (i.e., perianal abscess, sepsis, oral infection, cutaneous infection, gastrointestinal infection, pharyngitis, pneumonia, and urinary tract infection) was higher in patients undergoing chemotherapy than that reported for those not receiving chemotherapy. Conclusions: The results of this study suggested that cancer patients undergoing chemotherapy should be aware of infection signs; accordingly, they can visit treatment centers in case of the first symptoms of infection to prevent progression of infection and reduce mortality rates.  

scholarly journals Nursing presence from the perspective of cancer patients: A cross-sectional study

2021 ◽  
Author(s):  
Mahshid Mahdavi ◽  
Mansour Ghafourifard ◽  
Azad Rahmani
Keyword(s):  
Cancer Patients ◽  
Nursing Care ◽  
Pearson Correlation ◽  
Essential Element ◽  
Cross Sectional Study ◽  
Spiritual Needs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nursing Presence ◽  
The Mean

Background & Aim: Nursing presence is an essential element of nursing care. Since the perception of nursing presence is influenced by different factors depending on the culture within which patients receive nursing care, this study aimed to investigate Iranian patients' nursing presence with cancer. Methods & Materials: In this cross-sectional study, 130 cancer patients were selected by random sampling from an oncology teaching hospital. Data was collected by the Presence of Nursing Scale and analyzed by SPSS software. Results: The results showed that the mean score of nursing presence (in a range of 0 to 125) was 101.91±16.19. According to the results, the highest and lowest scores belonged to the items "I trusted in these nurses" and "These nurses met my spiritual needs" with a mean score of 4.38±0.81 and 3.68±1.16, respectively. Data analysis by Pearson correlation coefficient showed no significant correlation between the mean score of nursing presence and quantitative variables such as patients' age, length of stay in the hospital, and the number of hospitalization (p>0.05). Conclusion: Although the total score of nursing presence was high, improvements in some items such as fulfilling the spiritual needs of cancer patients seem necessary. Evaluation of nursing presence by valid measures, encouraging nurses to spend more time and interacting with their patients, and providing special courses on nursing presence could help nurses improve and implement oncology nursing.  

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