scholarly journals Increase in Candida parapsilosis candidemia in cancer patients

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Mingyue Sun ◽  
Chunguang Chen ◽  
Weiqiang Xiao ◽  
Yanmin Chang ◽  
Cailin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parenteral Nutrition ◽  
Cancer Patients ◽  
Candida Parapsilosis ◽  
Cancer Center ◽  
Candida Spp ◽  
Logistic Regression Models ◽  
Need To Evaluate ◽  
Clinically Significant ◽  
Antifungal Use

Background: This study aimed to identify the risk factors of candidemia and asses possible clinically significant differences between Candida parapsilosis and other candida species among cancer patients.Methods: A retrospective study was conducted in a Chinese tertiary cancer center over a 6-year period. A total of 323 cancer patients were enrolled and analyzed from 2012 to 2018. Data about demographic characteristics, underlying diseases, and risk factors of candidemia were collected. Univariate and multivariate logistic regression models were used to identify the risk factors associated with the development of candidemia.Results: Among the isolates, the species most frequently isolated was C. parapsilosis (37.15%, 120/323), and C. albicans only accounted for 34.37%. Based on statistical analysis, when candidemia patients who had C. parapsilosis were compared with other Candida spp., the following factors were found to be significantly associated with C. parapsilosis fungemia: parenteral nutrition (p < 0.001), neutropenia (p < 0.001), receipt of chemotherapy (p = 0.002), and previous antifungal use (p < 0.001). Parenteral nutrition was a factor that independently predicted C. parapsilosis candidemia (OR, 0.183; 95% CI, 0.098–0.340; p < 0.001).Conclusions: In short, C. parapsilosis as the leading non-albicans Candida spp. isolates in candidemia is posing a major threat for cancer patients. The study highlights the urgent need to evaluate the possibility of development of C. parapsilosis candidemia in cancer patients exposed to these risk factors effective and prevention strategies against this causative agent transmitted through nosocomial route should be implemented.

scholarly journals 440Incidence and Risk Factors for Pneumococcal Disease in Cancer Patients: A 20 Year Single Center Study at Memorial Sloan-Kettering Cancer Center

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S167-S167
Author(s):  
Yeon Joo Lee ◽  
Yao-Ting Huang ◽  
Victoria Gonzalez ◽  
Marina Kerpelev ◽  
Genovefa A. Papanicolaou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Pneumococcal Disease ◽  
Cancer Center ◽  
Single Center ◽  
Single Center Study ◽  
Center Study

Biopsychosocial problems identified by women with breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19514-19514
Author(s):  
M. Loscalzo ◽  
K. Clark ◽  
J. Mortimer
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Psychosocial Problems ◽  
Complete Information ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Common Problems ◽  
Clinically Significant ◽  
Self Administered Questionnaire ◽  
Breast Malignancies

19514 Background: It is frequently assumed that women with breast cancer have higher levels of distress and psychosocial problems than women with other malignancies. We compared the biopsychosocial needs of breast cancer patients with women with non-breast malignancies. Methods: A biopsychosocial screening tool was developed from clinical practice, focus groups, and the administration of questionnaires to over 3,000 patients. The refined 36-item self-administered questionnaire was completed by all new patients evaluated in the Moores Cancer Center. The severity of each problem was scored from 1 (not a problem) to 5 (the worst problem I could have). Problems scored as 3 or above were identified to be clinically significant. The screening results from women with breast cancer were compared with those of women with non-breast malignancies. Results: Between December 2005 and December 2006, 2063 patients completed screening questionnaires. Complete information, including staging, is available on 299 women, 155 of whom were diagnosed with breast cancer and 144 with non-breast malignancies. The two groups were comparable with respect to age, ethnicity, and the number of significant problems reported. The 5 most common problems identified to be significant by breast cancer patients included: fatigue, sleeping, being dependent on others, feeling depressed, and pain. The non-breast cancer women identified a greater number of significant problems overall with the 5 most significant being: fatigue, sleep, controlling my fear and worry about the future, being dependent on others, and pain. Getting medications and recent weight loss were more commonly identified in the non-breast cancer patients (p<0.05). Conclusions: Our data suggest that breast cancer patients identify similar biopsychosocial needs as women with other primary malignancies. No significant financial relationships to disclose.

Development and validation of a new clinical prediction model of catheter-related thrombosis in cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14031-e14031
Author(s):  
Binliang Liu ◽  
Junying Xie ◽  
Xiaoying Sun ◽  
Yanfeng Wang ◽  
Zhong Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Prediction Model ◽  
Receiver Operating Characteristic ◽  
Cancer Patients ◽  
Retrospective Cohort ◽  
Operating Characteristic ◽  
Risk Group ◽  
Cancer Center ◽  
Catheter Related Thrombosis

e14031 Background: The central venous catheter brings convenience for drug delivery and improves comfort for cancer patients, it also causes serious complications. The most common one is catheter-related thrombosis (CRT). This study aimed to evaluate the incidence and risk factors of CRT in cancer patients, and to develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on the data of a retrospective cohort (n = 3131) from National Cancer Center. The validation of our prediction model was done in a prospective cohort from National Cancer Center (n = 685) and a retrospective cohort from Hunan Cancer Hospital (n = 61). The predictive accuracy and the discriminative ability were determined by the receiver operating characteristic curves and calibration plots. Results: Multivariate analysis demonstrated that sex, cancer type, catheter type, position of the catheter tip, chemotherapy status, and antiplatelet/anticoagulation status at baseline were independent risk factors for CRT. The area under receiver operating characteristic (ROC) curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort; 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts respectively. Good calibration and clinical impact were also shown in primary and validation cohorts. The high-risk group had a higher incidence of CRTs than the low-risk group in the primary cohort and two validation cohort (p < 0.001). Conclusions: Our model is a novel prediction tool for CRT risk which helps to assigning cancer patients into high-risk or low-risk group accurately. Our model will be valuable for clinicians in decision making of thromboprophylaxis.

An open trial of aripiprazole for the treatment of delirium in hospitalized cancer patients

2011 ◽  
Vol 9 (4) ◽  
pp. 351-357 ◽  
Author(s):  
Soenke Boettger ◽  
William Breitbart
Keyword(s):  
Cancer Patients ◽  
Clinical Care ◽  
Performance Status ◽  
Preliminary Finding ◽  
Cancer Center ◽  
Delirium Assessment ◽  
Institutional Review ◽  
The Mean ◽  
Hypoactive Delirium ◽  
Clinically Significant

AbstractObjective:The purpose of this study was to examine the efficacy and safety of aripiprazole in the treatment of delirium in hospitalized cancer patients, and to examine differential responses based on delirium subtypes.Method:We conducted an analysis of 21 hospitalized cancer patients at Memorial Sloan-Kettering Cancer Center (MSKCC) who had been evaluated and treated for delirium with aripiprazole, using an MSKCC Institutional Review Board (IRB) approved Clinical Delirium Database. Measures used were the Memorial Delirium Assessment Scale (MDAS), the Karnofsky Scale of Performance Status (KPS), and side effect rating at baseline (T1), 2–3 days (T2), and 4–7 days (T3). All measurements were integrated into the routine clinical care of patients. Doses of aripiprazole were adjusted based on clinical response.Results:Patients treated for delirium with aripiprazole experienced significant improvement and resolution of delirium, with MDAS scores declining from a mean of 18.0 at baseline (T1) to mean of 10.8 at T2 and a mean of 8.3 at T3. KPS scores improved from 28.1 at baseline (T1) to 35.2 at T2 and 41 at T3. Delirium resolved (based on MDAS < 10) in 52.4% of cases at T2 and in 76.2% at T3. The mean dosage of aripiprazole required was 18.3 mg (range of 5–30) daily at T3. In our cohort of patients with hypoactive delirium, we observed a delirium resolution rate of 100% compared to the cohort of patients with hyperactive delirium (58.3% rate of delirium resolution). MDAS scores improved from 15.6 at T1 to 5.7 at T3 in hypoactive delirium and from 19.9 at T1 to 10.2 at T3 in hyperactive delirium. In patients with pre-morbid cognitive deficits and the hyperactive subtype of delirium, we observed a more limited treatment response to aripiprazole treatment for delirium. There were no clinically significant side effects noted.Significance of results:Aripiprazole is effective and safe in the treatment of delirium in hospitalized cancer patients. These preliminary finding suggest that aripiprazole may be most effective in resolving delirium of the hypoactive subtype.

Outcome of cancer patients admitted through the emergency department (ED) of a comprehensive cancer center: A call for ED-based palliative care.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 194-194
Author(s):  
Ahmed F. Elsayem ◽  
Julio Silvestre ◽  
Kelly W. Merriman ◽  
Patrick S. Chaftari ◽  
Carmen E. Gonzalez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Palliative Care ◽  
Hospital Mortality ◽  
Respiratory Distress ◽  
Cancer Patients ◽  
Altered Mental Status ◽  
Cancer Center ◽  
Hospital Death ◽  
Icu Admission

194 Background: The National Cancer Policy Forum advocated for improving quality of end life care, and reducing cost for cancer patients. Identifying those at high risk for Intensive Care Unit (ICU) admission, and hospital death may allow earlier palliative care and avoid futile interventions. The purpose of this study is to examine risk factors for ICU admission, and hospital death among cancer patients admitted through the emergency department (ED). Methods: We queried MD Anderson Cancer Center databases for all patients who visited our ED in 2010. ICU admission and hospital deaths of these patients were reviewed, and individual patients’ data were analyzed. Results: In 2010, 16,038 ED visits were made by 9,246 unique cancer patients. Of these patients, 5,362 (58%) were admitted to the hospital at least once (range 1-13 admits). Of all patients admitted through the ED, 697 (13%) were admitted at least once to ICU. Of all patients admitted, 11% died during hospitalization; of those, 29% died in ICU. Among patients who died in ICU, 73/233 (31.3%) had hematologic malignancies and 96/354 (27.1%) had solid tumors (P<0.001). Patients admitted to ICU had median lengths of hospital stay (MLOS) of 13 days for hematologic and 8 days for solid tumors (P<0.001; using means); patients without ICU admission had MLOS of 6 and 5 days, respectively (P<0.001). In a multivariate logistic regression model for predicting in-hospital mortality, we found that ED presenting symptoms of respiratory distress or altered mental status; primary tumor of lung cancer, leukemia, unknown primary, or lymphoma; and nonwhite ethnicities were independent predictors of death. Insignificant factors included age, gender, residence, fever and pain. Conclusions: Cancer patients admitted through the ED experience high ICU admission rate, and hospital mortality. Lung and certain other cancers; race; and symptoms of respiratory distress and altered mental status were associated with increased risk of in-hospital death. Patients with these risk factors may benefit from efforts to improve palliative care and prevent futile interventions.

scholarly journals Risk factors for immune-related adverse events associated with anti-PD-1 pembrolizumab

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yeonghee Eun ◽  
In Young Kim ◽  
Jong-Mu Sun ◽  
Jeeyun Lee ◽  
Hoon-Suk Cha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Medical Center ◽  
Multivariate Regression Analysis ◽  
Study Data ◽  
Endocrine Disorders ◽  
Logistic Regression Models ◽  
Neutrophil Lymphocyte Ratio ◽  
Increased Risk ◽  
Clinically Significant

Abstract We investigated risk factors for immune-related adverse events (irAEs) in patients treated with anti-programmed cell death protein1 antibody pembrolizumab. A retrospective medical record review was performed to identify all patients who received at least one dose of pembrolizumab at Samsung Medical Center, Seoul, Korea between June 2015 and December 2017. Three hundred and ninety-one patients were included in the study. Data were collected on baseline characteristics, treatment details, and adverse events. Univariate and multivariate logistic regression models were used to identify risk factors for irAEs. Sixty-seven (17.1%) patients experienced clinically significant irAEs; most commonly dermatologic disorders, followed by pneumonitis, musculoskeletal disorders, and endocrine disorders. Fourteen patients (3.6%) experienced serious irAEs (grade ≥ 3). Most common serious irAEs were pneumonitis (2.3%). Four deaths were associated with irAEs, all of which were due to pneumonitis. In multivariate regression analysis, a higher body mass index (BMI) and multiple cycles of pembrolizumab were associated with higher risk of irAEs (BMI: odds ratio [OR] 1.08, 95% confidence interval [CI] 1.01–1.16; pembrolizumab cycle: OR 1.15, 95% CI 1.08–1.22). A derived neutrophil-lymphocyte ratio (dNLR) greater than 3 at baseline was correlated with low risk of irAEs (OR 0.37, 95% CI 0.17–0.81). Our study demonstrated that an elevated BMI and higher number of cycles of pembrolizumab were associated with an increased risk of irAEs in patients treated with pembrolizumab. Additionally, increased dNLR at baseline was negatively correlated with the risk of developing irAEs.

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