bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of age, smoking, alcohol use, and exercise among adults with cancer.
Authors: Alston Shani Malia , Deal Allison Mary , Gordon Brittaney-Belle Elizabeth , Jolly Trevor Augustus , Williams Grant Richard , Dixon Samara Ann , Muss Hyman Bernard 
Published: March 2020

e20582 Background: Smoking, alcohol use, and exercise among cancer patients (pts) are important health concerns due to their effects on treatment outcomes. Few studies have focused on health behaviors (HB) in this group. The goal of this study was to assess HB in cancer pts seen at an academic medical center. Methods: The Health Behavior Questionnaire (HBQ) is a nine-item survey that assesses smoking, alcohol and exercise behaviors based on the 2006/7 National Health Interview Survey (http://www.cdc.gov/nchs/nhis.htm). Pts completed the HBQ from 2010 to present as part of two breast cancer (BC) trials and a geriatric assessment trial. The Jonckheere-Terpstra test compared differences among groups as age increased (Jonckheere, Biometrika 41:1/2, 1954). Results: Of 371 pts, 66% were age ≥60 (median 66), 81% white, 16% black and 95% were female. BC was most common (92%). 5% were current and 40% former smokers. 43% reported having ≥1 drinks per week (dpw). Alcohol users averaged 5 dpw (range of 1-18). 40% never exercised vigorously (≥10 minutes that causes heavy sweating or large increases in heart rate/breathing). Older pts were less likely to exercise (p <0.001). Pts who exercised vigorously were more likely to drink (p<0.02). Former smokers were more likely to use alcohol (p<0.0004). The frequency of HB by age is tabulated below. Conclusions: The % of current smokers in this sample of cancer pts was lower than the national average (5% vs 19%) as was the % of current drinkers when compared nationally (43% vs 51.5%). There was no association of age with alcohol use or smoking status. Older pts in this cohort were significantly less likely to report vigorous exercise. As exercise is important for older pts, future studies in exercise intervention would be beneficial. Support: Breast Cancer Research Foundation, New York, NY and Lineberger Comprehensive Cancer Center, Chapel Hill, NC. [Table: see text]
Phase I, double-blind, placebo-controlled, ascending single subcutaneous dose, safety, tolerability, and pharmacokinetic study of sustained release granisetron (APF530).
Authors: Barr John , O'Boyle Erin , Johnson Martin 
Published: March 2020

e20587 Background: Although several 5-HT3antagonists are approved for chemotherapy-induced nausea and vomiting, agents with longer duration of therapeutic benefit are needed. APF530 incorporates a polymer that allows for controlled and sustained release of granisetron. Methods: Adult males were randomized to receive subcutaneous (SC) APF530 125 mg, 250 mg, 500 mg, or 1 g (groups A-D, respectively) and simultaneous placebo. Groups B-D subsequently received intravenous (IV) granisetron ≥ 7 days after APF530 dosing. Safety, tolerability, pharmacokinetics (PK), and absolute bioavailability of granisetron from APF530 were examined. Results: 26 subjects were randomized. All APF530 doses were well tolerated; most adverse events (AEs) were mild injection site reactions (pain on palpation, erythema); all resolved. Other AEs included headache (IV, SC), upper abdominal pain (SC), and constipation (SC). PK parameters were generally dose proportional (Table). APF530 elicited slow sustained absorption of granisetron; tmax was 8-10 h, and some subjects had secondary plasma peaks at 24-96 h. Systemic levels were reached within 30 min. Based on AUCall, granisetron was shown to be completely bioavailable from the SC dose formulation of APF530. Conclusions: APF530 safety profile was similar to that of granisetron, with the addition of mild injection site reactions. Granisetron was completely bioavailable at all APF530 doses. PK parameters were generally dose proportional. Absorption of granisetron from APF530 was prolonged compared with that from IV granisetron. Clinical trial information: NCT01416259. [Table: see text]
Patterns of follow-up in oncologic care across Canada.
Authors: Ye Allison Y. , Cheung Winson Y. , Goddard Karen , Olson Robert Anton 
Published: March 2020

e20589 Background: With continual advancements in cancer care, improved outcomes and increasing survivor populations, cancer survivorship has become an important area of research. Methods: A 35-question electronic survey was sent to physician members of the Canadian Association of Radiation Oncologists. Based on their scope of practice, respondents were presented with brief clinical scenarios pertaining to various survivor populations. A subsequent series of questions were posed to determine routine follow-up practices. Results: In total, 111 radiation oncologists (RO) responded (44% response rate); 29% were female, 43% were in practice less than 10 years, and most regions of Canada were well represented. Most worked in centers staffed by more than 10 oncologists (69%), and saw more than 200 new patient consults per year (78%). 10% would not follow patients routinely, mainly in cases involving breast or prostate survivors. 73% of such patients (73%) would be followed by their primary care providers (PCP) whereas ROs would follow their CNS, GI, HN and GYNE patients. Lack of resources (55%) and a belief that follow-up by PCPs is equally effective (55%) were the top two reasons for not following patients. Treatment toxicity (92%) and the possibility of salvage or palliative treatment (86%) were the two most common reasons for routine follow-up. The majority (55%) of ROs follow patients for < 5 years, with 36% following for 5-10 years, and a minority (9%) following for longer than 10 years. 54% would not change the frequency of their follow-up, but 39% would decrease and only 7% would make no change. Workload and lack of resources were major barriers to follow-up, but in addition, many felt that follow-up by FPs or Advanced Practice Nurses could be equally effective. Some felt this would require additional training and more guidelines to make this effective. Conclusions: The majority of ROs follow their patients, especially when salvage treatment is possible. A significant portion would decrease their follow-up in frequency because of workload burden, resource limitations and a belief that there can or should be increased involvement from FPs and other allied health care providers.
Low molecular weight heparin (LMWH) for primary thrombophylaxis in patients with solid malignancies: Systematic review and meta-analysis.
Authors: Ben-Aharon Irit , Stemmer Salomon M. , Shpilberg Ofer , Sulkes Aaron , Gafter-Gvili Anat 
Published: March 2020

e20595 Background: Patients receiving chemotherapy for cancer are at increased risk for venous thromboembolism (VTE). The role of low molecular weight heparin (LMWH) as antithrombotic prophylaxis has been appraised in several studies, yielding conflicting results. We performed a meta-analysis of all randomized controlled trials (RCTs) which evaluated the addition of LMWH as primary prophylaxis in patients with solid malignancies while receiving chemotherapy. Methods: RCTs were identified by searching the Cochrane Library, MEDLINE databases and conference proceedings. Relative risks (RR) of thrombotic events, mortality as well as adverse events were estimated and pooled. Results: Nine trials met the inclusion criteria, and evaluated a total of 6691 patients. Primary prophylaxis with LMWH reduced both symptomatic VTEs: (RR 0.47, 95% CI(0.32 to 0.69)) and the rate of pulmonary embolism(PE): (RR 0.51, 95% CI(0.30 to 0.86)).Symptomatic DVT was reduced as well (RR 0.35, 95% CI(0.21 to 0.60). Meta-analysis of six trials which reported survival outcomes revealed no statistically significant benefit for LMWH in 1 year mortality rates (RR 0.93, 95% CI(0.83 to1.04)). There was no significant increase in major bleeding events. Conclusions: LMWH reduces the incidence of symptomatic VTE and PE in patients receiving chemotherapy for cancer, with no apparent increase in major bleeding. Nevertheless, LMWH had no significant effect on survival outcomes. Future studies should delineate whether specific populations may derive a survival benefit from LMWH primary prophylaxis.
Impact of palliative care on end-of-life management of cancer patients dying in the hospital.
Authors: Karim Syed Mustafa , Zekri Jamal M , Abdelghany Ehab Mosaad , Rizvi Azhar , Al-Gahmi Aboelkhair , Munsoor Husna , Ahmad Imran , Dada Reyad , Ansari Mohammed Iqbal , Kerr Ian G. 
Published: March 2020

e20613 Background: A substantial number of cancer patients receive inpatient care at the end-of-life (EoL). Involvement of palliative care teams during the course of cancer treatment has been shown to improve quality of life (QoL) in cancer patients. In this study, we compare the EoL care of cancer patients dying in the hospital under medical oncology (MO) and palliative care (PC) services. Methods: A retrospective review of medical records of adult cancer patients who received chemotherapy during their illness and died in our hospital between January 2010 and January 2012 was conducted. The quality metrics measured as endpoints were: chemotherapy given within 21 days of death, death in the ICU, CPR at time of death, and time from last chemotherapy to death (TLCD). These endpoints were compared between patients who died under the MO service (cohort A) and those dying under PC service (cohort B). Chi-square test and T-test were used to compare the endpoints between the two cohorts. Results: Of the 106 cancer patients who died in the hospital, 40 and 66 were in cohorts A and B respectively. 30% of all patients were 65 years of age or older, and were equally distributed between the two cohorts. Patients in cohort A were more likely to receive chemotherapy within last 3 weeks of life (27.5% versus 7.5%, p=0.012, 95% CI 4.16-37.15), to have CPR at time of death (15% versus 0%, p=0.005, 95% CI 4.2-29.8) and to die in the ICU (52.5% versus 1.5%, p=<0.001, 95% CI 33.3-67.1) as compared to patients in cohort B. The average time from last chemotherapy to death was significantly longer (221 days) for cohort B patients as compared to cohort A patients (96 days), p=0.01. Patients in cohort A who had PC consultation during their hospitalization had no differences in the measured endpoints when compared to patients in cohort B. Conclusions: Cancer patients who die in the hospital while under MO service without PC involvement tend to have more aggressive EoL care. This may impact negatively on some QoL features. Early referral to palliative care services may facilitate better understanding and fulfillment of the needs of cancer patients and their caregivers by the healthcare-providers.
Arrhythmias during and after zoledronic acid infusion patients with bone metastasis.
Authors: Yazici Ozan , Aksoy Sercan , Ucar Ozgul , Özdemir Nuriye , Demir Mevlut , Sendur Mehmet Ali Nahit , Arik Zafer , Yaman Sebnem , Eren Tulay , Uncu Dogan , Zengin Nurullah 
Published: March 2020

e20614 Background: Zoledronic acid (ZA) is one of the important biphosphanate which is widely used in bone metastatic cancer patients and osteoporotic patients. In a few studies it has been reported that treatment with biphosphonate was associated with an increased risk for atrial fibrillation. We aim to evaluate the arrhythmias that developed during infusion and immediately after infusion of the ZA. Methods: Bone metastatic 52 patients were included in study group. All of patients had totally 24 hour holter motorization during the first dose ZA infusion day. All of patients had 4 hours basal cardiac rhythm records before ZA infusion and about 19 hours after infusion. A short survey including demographic data and past medical history was completed. None of patients had clinically important arrhythmias before ZA infusion. We divided arrhythmias as supraventricular and ventricular. We evaluated arrhythmias pre, during and after ZA infusion. ZA were administered 4 mg IV in 15 minutes. Results: Thirty three of patients (63,5%) were male and 19 (36,5%) female. Median age of the patients was 52 (27-73). Most frequent cancers were breast (25%) and lung cancer (15,3%).Twelve (23%) patients had history of mediastinal radiotherapy. Three patients had history of myocardial infarction. In basal records we detected that twenty four of patients had supraventricular tachycardia (SVT) or ventricular premature systole (VPS). Fifteen of patients had SVT and fourteen had VPS during infusion period. After infusion period 48 of patients had SVT and 41 had VPS. Only 3 patients had none of arrhythmia after infusion. Three of the patients had sinusoidal arrhythmia and two had Mobitz type 2 bloc after infusion and also one of our patient who had no history of co morbidities and had SVT basal records, developed atrial fibrillation that refractory to medical cardioversion after 10 days of seventh dose ZA infusion. Conclusions: In this study we found that both SVT and VPS increased in cancer patients treated with ZA. Furthermore ZA may induce clinically important arrhythmias.
Predictive factors for winged scapula in breast cancer patients after immediate axillary dissection.
Authors: Nevola Teixeira Luiz Felipe , Lohsiriwat Visnu , Veronesi Paolo , Rietjens Mario , Teixeira Luiz Carlos , Garusi Cristina , Luini Alberto , Simoncini Maria Claudia , Sandrin Fabio , Zanatta Sarian Luis Otavio , Gandini Sara , Casales Schorr Mario , Sasse Andre Deeke 
Published: March 2020

e20634 Background: Axillary lymph node dissection is an inevitable part of breast cancer surgery in certain cases. Definitive data regarding the incidence of postoperative winged scapula remains inconsistent. Ignorance of its diagnosis may lead to under-treatment and result in physical morbidity. Methods: All breast cancer patients who underwent axillary lymph node dissection procedures were recruited. In the early postoperative period, within 24 hours after surgery, the physiotherapy staff performed physical examinations to evaluate and identify the physical signs of long thoracic nerve injury by means of two specific orthopedic evaluation tests. The factors that may relate to winged scapula were recorded and analyzed. Results: From July to October 2012, 51 out of 187 patients were diagnosed with winged scapula (27.2%). The median age was 49.0 years old. 130 patients had undergone mastectomy and 100 cases had immediate breast reconstruction. Age, BMI, history of shoulder joint morbidity and previous breast surgery were not significantly associated with winged scapula. Administration of neoadjuvant treatment, mastectomy or breast conservative surgery, immediate reconstruction and its type, tumor size and nodal involvement also did not show any correlation. Conclusions: The winged scapula is not an infrequent sequela after axillary lymph node dissection in the breast cancer patient. It is usually underestimated and overlooked. There is no association between age, BMI, neoadjuvant treatment, type of breast surgery, tumor size or nodal stage. As breast reconstruction plats an ever-increasing role in current breast surgery practice it is interesting to note that reconstruction with prosthesis, even with serratus muscle dissection does not increase the incidence of winged scapula. Post reconstruction morbidity could interfere with the physical evaluation and outcome, but the result of our subgroup analysis showed no significant correlation among them. In our clinical experience, this sequela is not irreversible, being a transitory problem. Our series show only immediate 24 hr result that lack of long term follow-up and still need physical therapy proctocols to evaluate the recovery.
Which personal qualities do cancer patients value the most in their clinical oncologists?
Authors: Gil Deza Ernesto , Martin Reinas Gaston , Gercovich Daniela , Morgenfeld Eduardo L. , Tognelli Flavio , Montiel Monica , Garcia Gerardi Carlos Fernando , Rivarola Edgardo G. J. , Gercovich Felipe G. 
Published: March 2020

e20636 Background: In the History of medicine, the most desired qualities in a doctor have changed over time. The objective of the following paper is to analyze which qualities do our patients (Pt) consider most important in their doctors. Methods: Between Oct 15th and Nov 15th, 2012, 1003 out of 3,795 Pt who were assisted at the IOHM were given the option to partake in an anonymous survey which evaluated the qualities they valued the most in their doctor, such as: knowledge, experience, honesty, sympathy, availability, humility, humanity or other. Each Pt was asked to pick the three they thought most important. Answers were gathered and analyzed according to frequency distribution. Results: A total of 845 out of 1003 (84%) Pt elected to participate. Population characteristics: Sex: fem: 332, male: 207, left blank (LB): 306. Mean age 58y (range 18 – 94). Married: 355, unmarried: 211, LB: 279. Children: Yes 460 No/LB: 385. Highest educational level achieved: primary studies:186, high school: 348, university: 216. LB: 98. Employed: 382, retired: 240, unemployed: 112, LB 111. The following results are expressed as a percentage of 845 Pt. The most valued qualities in a doctor were: knowledge (51%), honesty (44%), humanity (43%), availability (32%), experience (31%), humility (19%), sympathy (18%), others (3%). Although the most important quality was always knowledge, there was a marked difference between sexes: women valued humanity more than honesty (Chi square p=0.001) while men believed honesty (Chi square p=0.001) and experience (Chi square= 0.01) were more important than humanity. Conclusions: These results showed that there is no set of qualities that is valued above all others. Even though knowledge was always the most important, the value of the other six characteristics depends in great measure from the individual condition of the patients (such as sex, age and stage of the disease). However as the Pt usually do not have the skills to evaluate the Dr’s knowledge, honesty and humanity remains the most valued personal conditions.
Prospective assessment of hypercalcemia of malignancy and infectious complications.
Authors: Tavares Monique Celeste , Dal Molin Graziela Zibetti , Felismino Tiago Cordeiro , Fanelli Marcello Ferretti , Freitas Helano C. , Barros e Silva Milton Jose 
Published: March 2020

e20644 Background: The hypercalcemia of malignancy (HM) is the major metabolic disorder seen in oncologic patients. Is a poor prognostic factor, given the median survival of 60 to 90 days. One hypothesis for this high mortality is a predisposition to infections. In the immune system, the vitamin D receptor and the vitamin D are responsible for immunomodulatory activities and may lead to an inhibition of proinflammatory cytokines production. Consequently, it creates an immunosuppression environment favoring the presence of infections. Methods: Descriptive study with prospective data collection. Data of selected adult patients, with ionized calcium (ICA) levels greater than or equal to 1.4mmol/L, hospitalized on Hospital AC Camargo, São Paulo, Brazil, were prospectively colected. Main objective: correlate the HM with infection and mortality. Survival analysis was performed by Kapplan-Meier curve and group’s comparison by the log-rank test. Results: Between Jan/2012 to Jan/2013, 90 patients were assessed. Mean age: 61 years. Most male (54.4%), solid tumors (89.9%), adenocarcinoma (46%). Tumors with higher incidence were gastrointestinal, head and neck and gynecological. Immunosupressive therapy was used by 10% of patients and 5.6% were neutropenic. Infection was diagnosed by 74,4% overall. Pulmonary and urinary tract were the main infection sites. Infection was observed in 100% of patients with ICA above 2mmol/L and 71% with ICA above 1.7 mmol/L. Fever was present in 58.9% of patients. 71,6% of these developed infection. Among patients with infection, the agent was isolated in 33.8%. Related to these, 52.7% were Gram-negative (GN) and 34.7% Gram-positive (GP). The overall survival (OS) at 90 days was 63% for all. OS at 90 days was 82.1% in patients without fever versus 47% in febrile (p = 0.040) and 82.2% in patients without infection versus 42.1% with documented infection site (p = 0.002). When the agent has been isolated, OS at 90 days was 62.9% for GN versus 33.4% for GP (p = 0.027). Conclusions: This study suggests that the prognosis of HM may be associated with higher incidence of infection. In this study we observed that the association of HM, fever and GP infection contributed significantly to higher mortality.
The psychological projective test Wartegg-Zeichentest: A contribution to the knowledge of patient with cancer—The experience of two Italian centers.
Authors: La Spina Chiara Maria , Beretta Giordano D. , Stinco Sergio , Ceresoli Giovanni Luca , Salvini Piermario , Ripa Cristina , Sauta Maria Grazia , Squadroni Michela , Rossi Agnese , Barone Carlo 
Published: March 2020

e20650 Background: There is growing recognition that psychological implications are important in the comprehensive care of cancer patients (pts); the personality conformation may be an useful and constructive tool ground in order to promote psychic adaptation to cancer, improve communication with patient and keep a good level of quality of life. Methods: A personality projective test, the Wartegg-Zeichentest (WZT), was administered to cancer pts at the start of chemotherapy, in two Italian Oncology Departments from February 2010 to August 2012. During treatment, quality of life level with the Edmonton Symptom Assessment Scale (ESAS) and the possible presence of psychological disorder with the Psychological Distress Inventary (PDI) were also evaluated. Each patient followed a psychological support program. Results: Overall, 106 pts were enrolled. 47 (44%) received adjuvant chemotherapy, while palliative treatment was delivered in the remaining 59 (56%) cases. 39 (37%) pts showed ESAS values related to a poor quality of life, and PDI scores showed the presence of moderate-severe psychological disorders in 38 (35%) pts. Considering both test (ESAS e PDI), 24% of subjects had poor quality of life and moderate to severe psychological disorders. In this subgroup, 81% of pts showed a WZT profile characterized by depressive tendencies, liabilities, inhibition and passiveness behaviour. There was a significant correlation between ESAS and WZT (p<0.001), and between PDI and WZT (p<0.001). WZT had a predictive role in disclosing susceptibility to psychological disorders and treatment compliance. Conclusions: Cancer diagnosis affects perception of reality and discloses in some pts a personality profile characterized by depression, demoralization, inhibition and passiveness behaviour. This group of pts may be more keen to develop physic and psychological distress following cancer diagnosis and treatment. Early evaluation by WZT may be a useful instrument in preventing patient distress, as well in promoting the adaptation process to illness and maintaining a better level of quality of life.