Effectiveness of early antibiotic administration in septic patients with cancer

2013 ◽  
Vol 12 (4) ◽  
pp. 196-200
Author(s):  
Benjamin Parish ◽  
◽  
Timothy Cooksley ◽  
Philip Haji-Michael ◽  
◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Therapy ◽  
Cancer Patients ◽  
Antimicrobial Therapy ◽  
Antibiotic Administration ◽  
Inpatient Stay ◽  
Early Administration ◽  
Patients With Cancer ◽  
Intravenous Antibiotics ◽  
The Mean

Introduction: First dose intravenous antimicrobial therapy should be administered within 1 hour of admission but this is achieved in a minority of patients.. Methods: We performed a retrospective analysis at the largest Oncology hospital in Europe. Nurse-led administration of initial antibiotic therapy was introduced to the admissions unit. Results: The nurse led protocol increased compliance with the 1 hour target from 40% to 88.6%. There was a statistically significant decrease in the mean length of stay (p=0.045) which was more pronounced in the neutropenic population (p=0.006). There was a trend to improved 30 day mortality. Conclusions: A nurse led protocol can be effective in improving compliance with the 1 hour target. Early administration of intravenous antibiotics in cancer patients with sepsis is associated with a shorter length of inpatient stay and a trend to decreased mortality.

scholarly journals INVESTIGATING THE EFFECT OF REFLEXOLOGY IN INTENSITY OF PAIN AND ANXIETY AMONG PATIENTS SUFFERING FROM METASTATIC CANCER IN ADULTS’ HEMATOLOGY WARD

2018 ◽  
Vol 11 (6) ◽  
pp. 401 ◽  
Author(s):  
Simin Jahani ◽  
Fatemeh Salari ◽  
Nasrin Elahi ◽  
Bahman Cheraghian
Keyword(s):  
Cancer Patients ◽  
Metastatic Cancer ◽  
Test Group ◽  
Control Group ◽  
Anxiety Management ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
And Control

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward.  Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.

Anticoagulation in cancer patients in hospice

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20509-e20509
Author(s):  
H. M. Holmes ◽  
K. T. Bain ◽  
R. Luo ◽  
A. Zalpour ◽  
E. Bruera ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Characteristics ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Length Of Service ◽  
Chi Square ◽  
Patients With Cancer ◽  
Hospice Patients ◽  
The Mean ◽  
The Impact

e20509 Background: Low-molecular weight heparin (LMWH) is preferred over warfarin in patients with thromboembolic disease and active cancer, but no guidelines exist in hospice. Although warfarin may be less safe in hospice patients, hospices may prefer to provide warfarin due to lower cost and less invasiveness compared to LMWHs. We sought to identify disparities in the use of warfarin vs. LMWHs in cancer patients enrolled in hospice. Methods: We analyzed a dataset from a national pharmacy provider for more than 800 hospices. We identified patients with a terminal diagnosis of cancer who were enrolled and died in hospice in 2006 and who were prescribed warfarin or LMWH. Patient characteristics included age, gender, race, cancer diagnosis, length of hospice service, and number of comorbidities. For descriptive comparisons, the Kruskal-Wallis test was used for continuous variables, and the Chi-square test was used for categorical variables. Results: Of 54,764 patients with cancer admitted and deceased in 2006, 3874 (7.1%) were prescribed warfarin, and 1137 (2.1%) were prescribed LMWH. Patients prescribed warfarin (n=576) or enoxaparin (n=5) for treatment of atrial arrhythmias were excluded. The mean age was 70.6 years for warfarin and 64.8 years for LMWH (p<0.0001). The mean and median lengths of service, respectively, were 43.6 days and 23.0 days for warfarin and 35.0 and 18.0 days for LMWH, (p<0.0001). There were no differences for gender, and a higher proportion of white patients were prescribed warfarin. Patients prescribed warfarin had an average of 2.1 comorbid conditions, versus 1.6 conditions for LMWH (p<0.0001). Cancer diagnoses were significantly different between the two groups, with a higher proportion of patients with lung and prostate cancer taking warfarin. Conclusions: Patients prescribed warfarin were older, had more comorbidities, and a longer length of service than patients prescribed LMWHs. Further research is needed to determine the impact of anticoagulation on outcomes, especially cost and quality of life, for cancer patients in hospice. This study raises the need to establish guidelines for the appropriateness of anticoagulation in hospice patients with cancer. No significant financial relationships to disclose.

Osteomyelitis of the hand

2015 ◽  
Vol 41 (4) ◽  
pp. 431-440 ◽  
Author(s):  
R. Pinder ◽  
G. Barlow
Keyword(s):  
Antibiotic Therapy ◽  
Antimicrobial Therapy ◽  
Lower Limb ◽  
Hand Function ◽  
Surgical Debridement ◽  
Antibiotic Administration ◽  
Level Of Evidence ◽  
Hand Length

Osteomyelitis of the hand is uncommon, but if not adequately and promptly treated the detrimental effects on hand function can be devastating. The majority of literature on osteomyelitis relates to the lower limb, but the principles of management are applicable to the hand, with good surgical debridement and culture-guided antimicrobial therapy. For osteomyelitis in general, antibiotic therapy of 4–6 weeks’ duration (intravenous and/or oral) is typically recommended. In the hand, length and mode of antibiotic administration are still under study. Level of Evidence: V

Increased urinary excretion of pyridinium cross-links in cancer patients

1993 ◽  
Vol 39 (4) ◽  
pp. 614-618 ◽  
Author(s):  
A Lipton ◽  
L Demers ◽  
Y Daniloff ◽  
E Curley ◽  
C Hamilton ◽  
...  
Keyword(s):  
High Performance Liquid Chromatography ◽  
Bone Metastases ◽  
Cancer Patients ◽  
High Performance ◽  
Urine Samples ◽  
Patients With Cancer ◽  
Control Subjects ◽  
Urine Concentrations ◽  
Cross Links ◽  
The Mean

Abstract Pyridinoline (PYD) and deoxypyridinoline (DPD), two collagen-based cross-links found in bone, were measured by high-performance liquid chromatography in urine samples from 65 control subjects and 97 patients with either untreated or progressive cancer. Patients with cancer had significantly (P &lt; 0.001) higher urine concentrations of PYD and DPD than did control subjects. Both cross-links were increased in cancer patients with and without clinically detectable bone metastases, although patients with bone and liver involvement had higher mean concentrations. The mean concentrations of both cross-links were also significantly higher in the urine samples of inpatients than in an outpatient ambulatory population. These findings suggest that the measurement of PYD and DPD in urine may be useful in assessing bone metastases and bone resorption in cancer patients.

scholarly journals Does the Platelet Index Have a Guiding Role in the Association of Cancer and Pulmonary Thromboembolism?

2020 ◽  
pp. 6-14
Author(s):  
Ramazan Öcal ◽  
Nesrin Öcal
Keyword(s):  
Cancer Patients ◽  
Troponin I ◽  
Pulmonary Thromboembolism ◽  
Morphological Characteristics ◽  
Distribution Width ◽  
Mean Values ◽  
Platelet Counts ◽  
Patients With Cancer ◽  
The Mean ◽  
D Dimer

Introduction: The diagnostic value of the D-dimer test varies with variable platelet numbers and functions in patients suffering from cancer and concomitant pulmonary thromboembolism (PTE). This requires easy and reliable evaluation tests. In this study, we aimed to investigate the hypothesis that platelet functions may be more guiding in the prediction and diagnosis of PTE rather than the number of platelets in cancer pa- tients. Methods: The clinical, laboratory and radiological findings of all patients diagnosed with PTE were retrieved, retrospectively. Comparisons were performed between “can- cer-free” and “cancer” patients. The patients were also evaluated according to their active and remission status. Results: The data of 232 patients with PTE were reviewed. 172 patients were cancer- free and 60 were diagnosed with cancer. The mean values of D-dimer, mean platelet volume (MPV) and platelet distribution width (PDW) were found to be significantly higher in patients with cancer (P=0.015, P=0.026, and P=0.023; respectively). On the other hand, mean platelet counts were significantly higher in patients without cancer (P=0.05). It was also observed that the mean values of D-dimer, Troponin-I, MPV, and PDW were found to be significantly higher in patients with active cancer (P=0.05, P=0.044, P=0.05, and P=0.042; respectively). However, the mean platelet counts were significantly higher in patients with cancer who were in remission (P=0.05). Conclusions: The morphological characteristics of the platelets are more determinant than the number of platelets in cancer patients with PTE. Platelet indexes such as MPV and PDW may be useful in the prediction, diagnosis, and follow-up of PTE in patients with cancer.

scholarly journals Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

2020 ◽  
Author(s):  
ELENA ÁLVARO SANZ ◽  
JIMENA ABILÉS ◽  
MARGARITA GARRIDO SILES ◽  
FRANCISCO RIVAS RUÍZ ◽  
BEGOÑA TORTAJADA GOITIA ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Nutritional Intervention ◽  
Normal Weight ◽  
Nutritional Risk ◽  
Nutritional Interventions ◽  
Patients With Cancer ◽  
The Mean

Abstract Background Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Methods Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Results Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ±8.2. By the end of the chemotherapy, the mean weight gain was 0% ±7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. Conclusion More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.

scholarly journals Coalescent mastioditis as a complication of acute otitis media

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Ratna Dwi Restuti ◽  
Harim Priyono ◽  
Dora A Marpaung ◽  
Ayu Astria Sriyana ◽  
Rangga Rayendra Saleh
Keyword(s):  
Antibiotic Therapy ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Evidence Based ◽  
Antibiotic Administration ◽  
Intravenous Antibiotic ◽  
Literature Searches ◽  
Intravenous Antibiotics ◽  
Intracranial Complications ◽  
Common Infections

ABSTRACTBackground: Acute otitis media (AOM) is one of the most common infections in children. AOM disease can lead to complications such as coalescent mastoiditis. Mastoidectomy surgery in cases of coalescent mastoiditis in children is still a debate. Purpose: To convey the management of coalescent mastoiditis in pediatric patients as complication of AOM using an evidence-based literature search. Case Report: A 10-month patient with a diagnosis of AOM and coalescent mastoiditis, who was given antibiotic therapy and abscess drainage incision. Clinical question: In a child with coalescent mastoiditis as a complication of otitis media, could the disease be cured with intravena antiobitic therapy only without mastoidectomy operation? Review methods: Evidence-based literature searches through Pubmed, Proquest and Cochrane, were performed using the keywords mastoidectomy, antibiotics and coalescent mastoiditis. Result: The search resulted in 277 literatures, and 12 were relevant with the case, and two journals stating that in cases of uncomplicated coalescent mastoiditis, mastoidectomy operation could be delayed and intravenous antibiotic administration could be conducted by monitoring the patient's condition for 48 hours. Conclusion: Intravenous antibiotics are the main therapy in cases of coalescence mastoiditis accompanied by clinical monitoring for 48 hours. Additional mastoidectomy and other surgeries were performed in cases of clinical deterioration after intravenous antibiotic therapy, and in cases of intratemporal or intracranial complications.

scholarly journals Cost of Cancer-Related Neutropenia or Fever Hospitalizations, United States, 2012

2017 ◽  
Vol 13 (6) ◽  
pp. e552-e561 ◽  
Author(s):  
Eric Tai ◽  
Gery P. Guy ◽  
Angela Dunbar ◽  
Lisa C. Richardson
Keyword(s):  
Length Of Stay ◽  
Hospital Cost ◽  
Unknown Origin ◽  
Patients With Cancer ◽  
Hospitalization Costs ◽  
Life Threatening ◽  
Adults And Children ◽  
The Mean ◽  
Nationally Representative ◽  
The Cost

Purpose: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations. Methods: We examined data from the 2012 National Inpatient Sample and Kids’ Inpatient Database. Hospitalizations for cancer-related neutropenia were defined as those with a primary or secondary diagnosis of cancer and a diagnosis of neutropenia or a fever of unknown origin. We examined characteristics of cancer-related neutropenia hospitalizations among children (age < 18 years) and adults (age ≥ 18 years). Adjusted predicted margins were used to estimate length of stay and cost per stay. Results: There were 91,560 and 16,859 cancer-related neutropenia hospitalizations among adults and children, respectively. Total cost of cancer-related neutropenia hospitalizations was $2.3 billion for adults and $439 million for children. Cancer-related neutropenia hospitalizations accounted for 5.2% of all cancer-related hospitalizations and 8.3% of all cancer-related hospitalization costs. For adults, the mean length of stay for cancer-related neutropenia hospitalizations was 9.6 days, with a mean hospital cost of $24,770 per stay. For children, the mean length of stay for cancer-related neutropenia hospitalizations was 8.5 days, with a mean hospital cost of $26,000 per stay. Conclusion: We found the costs of cancer-related neutropenia hospitalizations to be substantially high. Efforts to prevent and minimize neutropenia-related complications among patients with cancer may decrease hospitalizations and associated costs.

scholarly journals Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elena Álvaro Sanz ◽  
Jimena Abilés ◽  
Marga Garrido Siles ◽  
Francisco Rivas Ruíz ◽  
Begoña Tortajada Goitia ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Nutritional Intervention ◽  
Normal Weight ◽  
Nutritional Risk ◽  
Nutritional Interventions ◽  
Patients With Cancer ◽  
The Mean

AbstractPatients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ± 8.2. By the end of the chemotherapy, the mean weight gain was 0% ± 7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.

Sign in / Sign up

Export Citation Format

Share Document