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Sample records for hospitalized cancer patients

  1. 'Patient satisfaction' in hospitalized cancer patients.

    Science.gov (United States)

    Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D

    2002-01-01

    Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.

  2. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ali Alkan

    2017-03-01

    Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

  3. Cancer patients and positive sensory impressions in the hospital environment

    DEFF Research Database (Denmark)

    Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

    2013-01-01

    This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysi...... sensory impressions and the opportunity for recreation through environmental facilities strengthen the patient's positive thoughts and feelings....... process was guided by the hermeneutical–phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital...... environment had a significant impact on their mood, generating positive thoughts and feelings. A view to nature also helped them to forget their negative thoughts for a while. The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them...

  4. Cancer Pain Management and Pain Interference with Daily Functioning among Cancer Patients in Gondar University Hospital

    OpenAIRE

    Henok Getachew Tegegn; Eyob Alemayehu Gebreyohannes

    2017-01-01

    Cancer is an increasing public health burden for Ethiopia. Pain is among the most common symptoms in patients with cancer. Hence, we aimed to assess cancer pain prevalence, cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of an Ethiopian teaching hospital. Of 83 patients, total of 76 (91.6%) cancer patients experienced pain with varying degree of severity, and 7 (8.4%) patients experienced severe pain. Of the 76 cancer patients with pain, 68 (89.2%) experie...

  5. Pain and its treatment in hospitalized patients with metastatic cancer.

    Science.gov (United States)

    Cascinu, Stefano; Giordani, Paolo; Agostinelli, Romina; Gasparini, Giampietro; Barni, Sandro; Beretta, Giordano D; Pulita, Franca; Iacorossi, Laura; Gattuso, Domenico; Mare, Marzia; Munaò, Stefania; Labianca, Roberto; Todeschini, Renata; Camisa, Roberta; Cellerino, Riccardo; Catalano, Giuseppina

    2003-09-01

    The aim of this prospective study was to assess the quality of pain management hospitalized cancer patients. In a quantitative and qualitative evaluation from six oncology centers in Italy, all consecutive cancer patients complaining of pain and hospitalized during the same 2 weeks were requested to fill in a McGill pain questionnaire (MPQ), a present pain intensity scale (PPI), and a hospital anxiety and depression acale (HADS), and to answer a questionnaire focused (QF) on the quality of medical and nursing care. The healthcare provider's antalgic prescriptions were assessed by an index of pain management (IPM). Of 120 patients with pain admitted to oncology divisions (65 men and 52 women; mean age 57 years, range 21-79 years), 117 completed the questionnaires. The quantitative evaluation (PPI) showed a significant pain reduction between admission and discharge pain levels-from 2.65 to 1.50 ( p<0.001). While a significant reduction of anxiety (HADS) was also found-from 10.24 to 9.11 ( p<0.001)-depression did not improve (9.83 and 9.72). The most relevant information from qualitative evaluation (QF) was: in 37.6% of patients, pain level was higher overnight; 47% waited for spontaneous decrease of pain intensity before asking for nurse or physician intervention; 69% asked for nurse help when pain level was really high. The health care response to patients' pain was not completely satisfactory, since analgesic prescription was adequate in 56.52% but inadequate in 43.47%. Pain control in hospitalized cancer patients is not completely satisfactory. The physician's attitude is to underestimate and undertreat pain, while nurses are not adequately trained for timely intervention despite published guidelines for pain management. The findings of this study support the concern of inadequate knowledge and inappropriate attitudes regarding pain management, even in cancer patients hospitalized in medical oncology divisions.

  6. [Anxiety and depression of cancer patients hospitalized and at home].

    Science.gov (United States)

    Vellone, Ercole; Sinapi, Nadia; Piria, Paola; Bernardi, Francesca M; Dario, Lucia; Brunetti, Annarita

    2004-01-01

    The aim of this study was to investigate the anxiety and depression of cancer patients hospitalized and at home. Using a descriptive, correlational and comparative design and the Roy Adaptation Model, a sample of 80 oncologic patients was studied. Several instruments were used to measure anxiety and depression (HADS), quality of life and symptoms (RSCL), sociodemographic factors, variables connected to the hospitalization, quality of the relationship with health practitioners, family members and friends and the degree of satisfaction for the received information and support. The examined variables were measured on the same patients at hospital and at home. About the 30% of the patients were anxious and depressed. Statistical analysis showed that while anxiety did not change from the hospital to home, depression increased soon after the discharge and decreased over time and after the increasing of the number of hospital access. Anxiety and depression were positively correlated to boredom during the hospitalization, physical symptoms, number of the patients children, and previous anxious and depressive problems. Anxiety and depression were negatively correlated to the ward comfort, the support of health practitioners, family members and friends and the satisfaction for the received information. Differences between this study and the international literature are discussed. Recommendations for the future research and nursing practice are given.

  7. Hospital variation in 30-day mortality after colorectal cancer surgery in denmark: the contribution of hospital volume and patient characteristics

    DEFF Research Database (Denmark)

    Osler, Merete; Iversen, Lene Hjerrild; Borglykke, Anders

    2011-01-01

    This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals.......This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals....

  8. Cancer Pain Management and Pain Interference with Daily Functioning among Cancer Patients in Gondar University Hospital

    Directory of Open Access Journals (Sweden)

    Henok Getachew Tegegn

    2017-01-01

    Full Text Available Cancer is an increasing public health burden for Ethiopia. Pain is among the most common symptoms in patients with cancer. Hence, we aimed to assess cancer pain prevalence, cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of an Ethiopian teaching hospital. Of 83 patients, total of 76 (91.6% cancer patients experienced pain with varying degree of severity, and 7 (8.4% patients experienced severe pain. Of the 76 cancer patients with pain, 68 (89.2% experienced pain interference with their daily activities. Fifty-four (65% patients were receiving inadequate cancer pain treatment with negative Pain Management Index. Therefore, it is vital to anticipate and assess pain of the cancer patients as routine clinical practice, to optimize analgesic therapy, and to identify and overcome barriers to adequate pain management.

  9. The need for hospital care of patients with clinically localized prostate cancer managed by noncurative intent

    DEFF Research Database (Denmark)

    Brasso, Klaus; Friis, S; Juel, K;

    2000-01-01

    We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy.......We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy....

  10. Adverse events in hospitalised cancer patients: a comparison to a general hospital population

    DEFF Research Database (Denmark)

    Haukland, Ellinor; von Plessen, Christian; Nieder, Carsten

    2017-01-01

    ) compared to a general hospital population. Material and methods: A total of 6720 patient records were retrospectively reviewed comparing AEs in hospitalised cancer patients to a general hospital population in Norway, using the IHI Global Trigger Tool method. Results: 24.2 percent of admissions for cancer...... risk. The rate of AEs increases by 1.05 times for each day spent in hospital. For every year increase in age, the risk for AEs increases by 1.3%. Cancer patients more often have hospital-acquired infections, other surgical complications and AEs related to medications. Conclusions: Because of higher age...

  11. End-of-life hospital care for cancer patients: an update.

    Science.gov (United States)

    Dudevich, Alexey; Chen, Allie; Gula, Cheryl; Fagbemi, Josh

    2014-01-01

    Cancer is the leading cause of death in Canada, and the number of new cases is expected to increase as the population ages and grows. This study examined the use of hospital services in the last month of life by adult cancer patients who died in Canadian acute care hospitals in fiscal year 2012-2013. Almost 25,000 Canadian cancer patients - excluding those in Quebec - died in acute care hospitals, representing approximately 45% of the estimated cancer deaths in 2012-2013. The proportion of in-hospital deaths varied across jurisdictions. Twenty-three percent of these patients were admitted to acute care multiple times in their last 28 days of life, with a higher percentage for rural (29%) compared to urban (21%) patients. Relatively few patients used intensive care units or received inpatient chemotherapy in their last 14 days of life.

  12. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

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    Aymen Mudawe Nurain

    2015-12-01

    Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1% with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

  13. Variation in case-mix between hospitals treating colorectal cancer patients in the Netherlands

    NARCIS (Netherlands)

    Kolfschoten, N.E.; Marang van de Mheen, P.J.; Gooiker, G.A.; Eddes, E.H.; Kievit, J.; Tollenaar, R.A.E.M.; Wouters, M.W.; Bemelman, W.A.; Busch, O.R.; Dam, R.M. van; Harst, E. van der; Jansen-Landheer, M.L.E.A; Karsten, T.M.; Krieken, J.H.J.M. van; Kuijpers, W.G.T.; Lemmens, V.E.; Manusama, E.R.; Meijerink, W.J.H.J.; Rutten, H.J.; Wiggers, T.; Velde, C.J. van de

    2011-01-01

    AIMS: The purpose of this study was to determine how expected mortality based on case-mix varies between colorectal cancer patients treated in non-teaching, teaching and university hospitals, or high, intermediate and low-volume hospitals in the Netherlands. MATERIAL AND METHODS: We used the databas

  14. Patient Survey (HCAHPS) - PPS-Exempt Cancer Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  15. Quality of life estimate in stomach, colon, and rectal cancer patients in a hospital in China.

    Science.gov (United States)

    Deng, Muhong; Lan, Yanhong; Luo, Shali

    2013-10-01

    The objective of this study was to investigate the outcome and coping patterns of patients with stomach, colon, and rectal cancer in a hospital in China. Health-related quality of life was assessed in 118 stomach, colon, and rectal cancer patients in Chinese People's Liberation Army General Hospital, Beijing, China, using the generic version of the European Organization for Research and Treatment of Cancer Quality of Life (QOL) Questionnaire Core 30 Items, Self-rated Anxiety Scores (SAS), Self-rated Depression Scores (SDS), Medical Coping Modes of Questionnaire (MCMQ), and Social Support Requirement Scale (SSRS) questionnaires. The overall QOL was 50.7 ± 6.5, 48.1 ± 7.7, and 47.6 ± 6.4, respectively, for stomach, colon, and rectal cancer groups. Correlations between QOL and SAS and SDS in stomach cancer patients were significantly higher than observed in the cohort of colon or rectal cancer patients (Spearman coefficient of 0.366 and 0.129, respectively). Cluster analysis of MCMQ data revealed four identifiable patterns (resign, confront, avoid-confront, and avoid-resign) of coping in the study group. Subjective support was significantly higher than objective support (p Stomach, colon, and rectal cancer patients had anxiety and depression stemming from their cancer diagnosis and postdiagnosis treatment, and sex dependency was prevalent in SSRS response. Coping patterns were reliable indicators of psychosocial side effects in patients with stomach, colon, and rectal cancers.

  16. Psychological process from hospitalization to death among uninformed terminal liver cancer patients in Japan

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    Kobori Eiko

    2006-09-01

    Full Text Available Abstract Background Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. Methods Terminal cancer patients hospitalized during the recruiting period voluntarily participated in in-depth interviews. The data were analyzed by grounded theory. Results Of the 87 uninformed participants at the time of hospitalization, 67% (N = 59 died without being informed of their diagnosis. All were male, 51–66 years of age, and all experienced five psychological stages: anxiety and puzzlement, suspicion and denial, certainty, preparation, and acceptance. At the end of each stage, obvious and severe feelings were observed, which were called "gates." During the final acceptance stage, patients spent a peaceful time with family, even talking about their dreams with family members. Conclusion Unlike in other studies, the uninformed patients in this study accepted death peacefully, with no exceptional cases. Despite several limitations, this study showed that almost 70% of the uninformed terminal cancer patients at hospitalization died without being informed, suggesting an urgent need for culturally specific and effective terminal care services for cancer patients in Japan.

  17. Nursing pain management--a qualitative interview study of patients with pain, hospitalized for cancer treatment.

    Science.gov (United States)

    Rustøen, Tone; Gaardsrud, Torill; Leegaard, Marit; Wahl, Astrid K

    2009-03-01

    Pain is a significant symptom in cancer patients. Understanding of patients' experiences in relation to pain management is important in evidence-based nursing in the field of pain. The aim of this study was to explore cancer patients' experiences of nursing pain management during hospitalization for cancer treatment. Eighteen cancer patients participated in the study, all with advanced cancer, including skeleton metastases. The female participants all had breast cancer, and the male participants all had prostate cancer. Data were collected by in-depth interviews, and qualitative description was used to entail low-inference interpretation to reach an understanding of the essence of pain and nursing pain management. Patients found it somewhat difficult to express their expectations of nursing pain management and competencies. However, 1) being present and supportive; 2) giving information and sharing knowledge; 3) taking care of medication; and 4) recognizing the pain emerged as themes in nursing pain management. Although patients believed that nurses were caring persons, they perceived differences between nurses in the ways they handled pain management. Furthermore, some patients experienced a lack of information from nurses in relation to pain management. Although cancer patients' experiences showed the importance of nurses in pain management, it seems that nurses should have a clearer role in cancer pain management in relation to counseling and patient education. The results from this study can increase nurses' awareness of their role in pain management as a first step in improving pain management for patients.

  18. Breast cancer mortality among patients attending a cancer hospital, Vitoria, ES

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    Cristina Arthmar Mentz Albrecht

    2013-09-01

    Full Text Available This study aimed to investigate the association between mortality of breast cancer women and the social-demographic and clinical characteristics. During the mortality study of 1,086 women diagnosed with breast cancer and treated from 2000 to 2005 at a cancer hospital in the city of Vitória, Espírito Santo, medical records and tumor registration cards were controlled. The Mortality Information System and the Reclink program were used to identify 280 deaths. Patients were classified under death and non-death, and variables percentages were calculated. For variables that showed statistical significance, considering the level of 0.10, the crude and adjusted odds ratio (OR were calculated by logistic regression model. There was a correlation between mortality and the following variables: women coming from the Unified Health System (p = 0.014; OR = 2.38, negative c-erb B-2 tumor marker (p = 0.027; OR = 2.03, advanced (III and IV staging (p = 0.001; OR = 6.89 and OR = 17.13, respectively, presence of metastasis (p = 0.001; OR = 18.23 and recurrence (p = 0.010; OR = 3.53. Mortality associated with staging underlines the necessity of warning the population about the benefits of early diagnosis of the disease of cancer.

  19. Evaluating patients' walking capacity during hospitalization for lung cancer resection†.

    Science.gov (United States)

    Esteban, Pedro A; Hernández, Nieves; Novoa, Nuria M; Varela, Gonzalo

    2017-05-04

    The goal of this study was to describe non-supervised daily physical activity in patients during the period immediately following anatomical lung resection. The study was an observational study on 50 consecutive patients (33 men) admitted for anatomical lung resection over a 4-month period. All cases were approached using a minimally invasive technique. Patients were instructed by nursing and physiotherapy staff and asked to wear a portable pedometer (Omron HJ-720 T-E2) from admission until hospital discharge, excluding the day of the operation and the first hours in the recovery room. The variables collected included sex, age, body mass index, type of lung resection, cardiopulmonary postoperative complications, percentage forced expiratory volume in 1 s, percentage single-breath carbon monoxide diffusing capacity, predicted postoperative forced expiratory volume in 1 s calculated according to functional segments removed at surgery, predicted postoperative single-breath carbon monoxide diffusing capacity calculated according to functional segments removed at surgery, total steps, aerobic steps and daily total strolled distance in metres. Comparison of activity was analysed using the paired t -test for individual data evolution and the unpaired t -test for patients showing complications or not. Body mass index and exercise capacity were analysed using the Spearman correlation analysis. A total of 34 patients underwent lobectomy or bilobectomy. All patients could walk on the first postoperative day. The average walked distance on the first and fourth postoperative days was 6100 m and 7400 m, respectively. Compared with the preoperative day, patients walked significantly fewer total steps on Day 1 and Day 2 (Day 1, P  = 0.0001; Day 2, P  = 0.049). The rate of aerobic to total daily steps was comparable after the second postoperative day. Patients having any postoperative cardiopulmonary complication showed a significantly inferior walking capacity ( P

  20. Increased cancer risk in patients referred to hospital with suspected fibromyalgia

    DEFF Research Database (Denmark)

    Dreyer, Lene; Mellemkjaer, Lene; Kendall, Sally;

    2007-01-01

    OBJECTIVE: To analyze whether fibromyalgia (FM) and FM-like symptoms are related to an increased incidence of cancer. METHODS: We identified 1361 patients referred on suspicion of FM in the period 1984-99 from hospital records. Following the American College of Rheumatology (ACR) criteria, patients...

  1. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen Mudawe Nurain; Naser Eldin Bilal; Mutasim Elhadi Ibrahim

    2015-01-01

    Objective: To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments. Methods: A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum, Sudan. A total of 1 503 samples (505 clinical and 998 environmental) were examined. Isolates were identified, and their antimicrobial susceptibility was determined using standard laboratory procedures. Results: Out of 505 clinical samples, nosocomial pathogens were found as 48.1%. Among hospital environment samples, bacterial contaminants were detected in 29.7%of samples. The main microorganisms recovered from cancer patients were Proteus spp. (23.5%), Escherichia coli (22.2%), Pseudomonas aeruginosa (P. aeruginosa) (21.0%) and Staphylococcus aureus (20.2%). The most frequent isolates from hospital environ-ments were Bacillus spp. (50.0%), Staphylococcus aureus (14.2%) and P. aeruginosa (11.5%). The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin, cefotaxime, ceftazidime and ceftriaxone. Moderate resistance rates were recorded to ciprofloxacin, such as 51.0%for P. aeruginosa, 21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli. Except Klebsiella, there were no significant differences (P ? 0.05) of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments. The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly (P=0.763) from those collected from the hospital environments (49.2%;91/185 vs. 47%;32/68). Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1%) with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

  2. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen; Mudawe; Nurain; Naser; Eldin; Bilal; Mutasim; Elhadi; Ibrahim

    2015-01-01

    Objective:To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments.Methods:A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum,Sudan.A total of 1 503 samples(505 clinical and 998 environmental)were examined.Isolates were identified,and their antimicrobial susceptibility was determined using standard laboratory procedures.Results:Out of 505 clinical samples,nosocomial pathogens were found as 48.1%.Among hospital environment samples,bacterial contaminants were detected in 29.7%of samples.The main microorganisms recovered from cancer patients were Proteus spp.(23.5%),Escherichia coli(22.2%),Pseudomonas aeruginosa(P.aeruginosa)(21.0%)and Staphylococcus aureus(20.2%).The most frequent isolates from hospital environments were Bacillus spp.(50.0%),Staphylococcus aureus(14.2%)and P.aeruginosa(11.5%).The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin,cefotaxime,ceftazidime and ceftriaxone.Moderate resistance rates were recorded to ciprofloxacin,such as 51.0%for P.aeruginosa,21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli.Except Klebsiella,there were no significant differences(P0.05)of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments.The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly(P=0.763)from those collected from the hospital environments(49.2%;91/185 vs.47%;32/68).Conclusions:The prevalence of nosocomial infection among cancer patients was high(48.1%)with the increasing of antimicrobial resistance rates.Hospital environments are potential reservoirs for nosocomial infections,which calls for intervention program to reduce environmental transmission of pathogens.

  3. Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969-1993

    DEFF Research Database (Denmark)

    Dalton, Susanne Oksbjerg; Mellemkjær, Lene; Thomassen, L.

    2005-01-01

    with schizophrenia (SIR, 1.20; 95% CI: 1.05, 1.38) should be interpreted with caution, given the high proportion of nulliparous women with schizophrenia in Denmark. The data might support reduced risks for prostate and rectal cancer among male patients with schizophrenia, whereas a changing smoking pattern might......We investigated the cancer risk of patients hospitalized for schizophrenia in a nationwide cohort study. All 22766 adults admitted for schizophrenia, ICD-8 295, in Denmark between 1969 and 1993 were followed up for cancer through 1995. The incidence of site-specific cancers was compared...... with national incidence rates, adjusted for sex, age and calendar time. The risk for cancer was increased for both men and women during the first year of follow-up. When the first year of follow-up was excluded, the risk for all tobacco-associated cancers and for prostate and rectal cancers was reduced for male...

  4. Lived experiences and challenges of older surgical patients during hospitalization for cancer: An ethnographic fieldwork

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    Lisbeth Uhrenfeldt

    2014-02-01

    Full Text Available This paper explores the lived experiences of older surgical patients’ (aged 74 years and older experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n = 9, aged 74 years and older were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients’ experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer.

  5. Epidemiological Trends of GI Cancers in Patients Visiting a Tertiary Care Hospital in Chandigarh, North India.

    Science.gov (United States)

    Sharma, Munesh K; Singh, Tarundeep; Pandey, Avdesh K; Kankaria, Ankita

    2015-01-01

    Cancer has become an epidemic disease. Nearly ten million new cancer cases are diagnosed annually in the world and out of these about half are from the developing world. To appropriately plan for treatment, management and prevention of the disease, it becomes necessary to study the trends about morbidity caused by cancers. Data for patients diagnosed with any form of gastrointestinal (GI) cancers was extracted from records maintained in the outpatient department registers of the Oncology Department of Government Medical College and Hospital in Chandigarh from 1999 to 2012. Trends were analysed for different categories of GI cancers for the period of 12 years. In present study GI cancers accounted for 23 % of all registered cases (n-9603) of carcinomas. Males predominated for all GI cancers except in the gall bladder. Gastrointestinal cancers as a proportion of total cancers increased from 21% in 1999 to 25.9% in 2012 with a significant increasing trend in our series (χ2 for linear trend=9.36, pGI (χ2=19.6, pGI cancers form a significant proportion of all cancers reporting to our data. In depth studies to ascertain the reasons for the changing trends are required to design intervention programs. Further information is necessary from cancer registries and from the hospital records of oncology departments.

  6. Cancer patients and positive sensory impressions in the hospital environment--a qualitative interview study.

    Science.gov (United States)

    Timmermann, C; Uhrenfeldt, L; Birkelund, R

    2013-01-01

    This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis process was guided by the hermeneutical-phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital environment had a significant impact on their mood, generating positive thoughts and feelings. A view to nature also helped them to forget their negative thoughts for a while. The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive sensory impressions and the opportunity for recreation through environmental facilities strengthen the patient's positive thoughts and feelings. © 2012 Blackwell Publishing Ltd.

  7. Impact of a Fast-track Esophagectomy Protocol on Esophageal Cancer Patient Outcomes and Hospital Charges

    DEFF Research Database (Denmark)

    Shewale, Jitesh B; Correa, Arlene M; Baker, Carla M

    2015-01-01

    OBJECTIVE: To evaluate the effects of a fast-track esophagectomy protocol (FTEP) on esophageal cancer patients' safety, length of hospital stay (LOS), and hospital charges. BACKGROUND: FTEP involved transferring patients to the telemetry unit instead of the surgical intensive care unit (SICU) after.......655; 95% confidence interval = 0.456, 0.942; P = 0.022). In addition, the median hospital charges associated with primary admission and readmission within 90 days for group B ($65,649) were lower than that for group A ($79,117; P

  8. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

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    Manisha Bisht

    2008-01-01

    Full Text Available Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. The data obtained from the patients included symptoms reported by the patients, currently prescribed treatments and the site of cancer. Results: The average number of symptoms reported per patient was 5.33 ± 0.67 (mean ± SE. The most common symptoms were pain, weakness/fatigue, anorexia, insomnia, nausea/vomiting, dyspnea, constipation and cough. Polypharmacy was frequent. Patients consumed approximately 8.7 ± 0.38 (mean ± SE drugs on average during the 2-month period of follow-up. Conclusion: The result gives insight into the varied symptomatology of patients with advanced cancer. Polypharmacy was quite common in patients with advanced cancer, predisposing them to complicated drug interactions and adverse drug reactions.

  9. Socio-demographic characteristics of cancer patients: Hospital based cancer registry in a tertiary care hospital of India

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    S Puri

    2014-01-01

    Full Text Available Aim: To determine the socio-demographic characteristics of cancer patients. Materials and Methods: Review of the Cancer registry, and patient interview. Information on socio-demographic profile, medical history, family history and previous treatment, if any, was retrieved from the patient. If the patient couldn′t be contacted then information was taken from pathology/radiotherapy or medical records department. Results: A total of 684 patients participated in the study. More than 40% of males and 53.7% of females were illiterate, P < 0.05. The majority (33.5% of participants were of low socioeconomic status. The most frequently reported cancer (ca in males it was ca lung (40.9 and ca oesophagus (9.8. In females most common cancer were ca breast (23.9 followed by ca cervix (11.7.

  10. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    Directory of Open Access Journals (Sweden)

    Efstratios Athanassakis

    2012-01-01

    Full Text Available Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLINE (2000-2010 database and using as key words music, music therapy, alternative-complementary therapy, cancer, children. Results: Music therapy, the last few years, seems to be one of the forms of alternative-complementary therapy for patients treated for cancer. Music therapy is applied as part of complementary therapy in pediatric and adult patients with cancer. Complementary-alternative methods are non-invasive, non-toxic, cheap, safe and can be easily used by the patients themselves. Primarily, the music therapy aimed to the reduction of the emotional trauma and the feeling of the pain during the process of the treatment (radiotherapy, chemotherapy, other painful procedures but also in the whole patients life. Conclusions: Scientific bibliographic databases research concerning the music therapy in patients with cancer seem encouraging, especially in children. Nevertheless, the further study of the role of the music during hospitalization in the outcome of the treatment is essential

  11. Transition from Hospital to Community Care: The Experience of Cancer Patients

    Directory of Open Access Journals (Sweden)

    Hanna Admi

    2015-12-01

    Full Text Available Purpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77 and quantitative (n=422 methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs. The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001. Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as:  Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4:34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

  12. [Standards, options and recommendations: Good clinical practice in the dietetic management of cancer patients: hospital catering].

    Science.gov (United States)

    Dayot, F; Bataillard, A; Keré, C; Ducès, F; Bachmann, P; Blanc-Vincent, M P; Besnard, B; Bonneteau, C; Champetier, S; Claude, M; Combret, D; Cometto, F; Duguet, A; Duval, N; Finck, C; Freby-Lehner, A; Garabige, V; Lallemand, Y; Massoud, C; Meuric, J; Montane, C; Poirée, B; Puel, S; Rossignol, G; Roux-Bournay, P; Simon, M; Tran, M

    2001-10-01

    The "Standards, Options and Recommendations" (SOR) project, started in 1993, involves a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Regional Cancer Centres, some French public university and general hospitals and private Clinics and medical scientific societies. Its main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on a literature review followed by a critical appraisal by a multidisciplinary group of experts to produce the draft guidelines which are then validated by specialists in cancer care delivery. To develop clinical practice guidelines for hospital catering for cancer patient using the methodology developed by the Standards, Options and Recommendations project. Data were identified by a literature search of Medline and the reference lists of experts in the groups. After the guidelines were drafted, they were validated by independent reviewers. The main recommendations are: 1) While taking into consideration the specific needs of cancer patients, the dietician is responsible for the hygiene, the sanitary quality of alimentation, the equilibrium and nutritional quality of the hospital catering. 2) Ordering and distribution of meals, and clearing up afterwards contribute to the quality of hospital catering and the personnel who do this should have time and be willing to listen to the patients. 3) The ordering of meals should be adapted to individual patient's requirements and must take into account the patient's medication. 4) The method of transporting the food chosen by the institution (cold or warm method) should be respected. The personnel responsible should receive regular and specific training to use the method correctly. 5) The intake of patients with nutritional follow-up should be reliably and reproducibly evaluated by the personnel after every meal. 6) Patient satisfaction should be assessed

  13. Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia

    DEFF Research Database (Denmark)

    Conner, J Michael; Aviles-Robles, Martha J; Asdahl, Peter H;

    2016-01-01

    . The median length of hospital stay for malnourished patients was 15 days, which corresponded with a 50% (TR=1.5, 95% CL 1.0, 2.3) relative increase in length of stay compared with patients who were not malnourished. Patients with body mass indices equal to the mean of the world reference population had...... in Mexico City, and assess the association between malnourishment and length of hospital stay. METHODS: Individuals eligible for this study were paediatric cancer patients (aged Hospital Infantil de Mexico Federico Gomez (Mexico City) with febrile neutropaenia. Our exposure...... of interest, malnourishment, was defined as an age-adjusted and sex-adjusted z-scorehospital stay. RESULTS: Our study...

  14. Pain management of opioid-treated cancer patients in hospital settings in Denmark

    DEFF Research Database (Denmark)

    Lundorff, L.; Peuckmann, V.; Sjøgren, Per

    2008-01-01

    AIM: To evaluate the performance and quality of cancer pain management in hospital settings. METHODS: Anaesthesiologists specialised in pain and palliative medicine studied pain management in departments of oncology and surgery. Study days were randomly chosen and patients treated with oral opioids......-treated patients in hospital settings: however, focussing on average pain intensity, the outcome seems favourable compared with other countries. Pain mechanisms were seldom examined and adjuvant drugs were not specifically used for neuropathic pain. Opioid dosing intervals and supplemental opioid doses were most...

  15. Use of Hospital-Based Food Pantries Among Low-Income Urban Cancer Patients.

    Science.gov (United States)

    Gany, Francesca; Lee, Trevor; Loeb, Rebecca; Ramirez, Julia; Moran, Alyssa; Crist, Michael; McNish, Thelma; Leng, Jennifer C F

    2015-12-01

    To examine uptake of a novel emergency food system at five cancer clinics in New York City, hospital-based food pantries, and predictors of use, among low-income urban cancer patients. This is a nested cohort study of 351 patients who first visited the food pantries between October 3, 2011 and January 1, 2013. The main outcome was continued uptake of this food pantry intervention. Generalized estimating equation (GEE) statistical analysis was conducted to model predictors of pantry visit frequency. The median number of return visits in the 4 month period after a patient's initial visit was 2 and the mean was 3.25 (SD 3.07). The GEE model showed that younger patients used the pantry less, immigrant patients used the pantry more (than US-born), and prostate cancer and Stage IV cancer patients used the pantry more. Future long-term larger scale studies are needed to further assess the utilization, as well as the impact of food assistance programs such as the this one, on nutritional outcomes, cancer outcomes, comorbidities, and quality of life. Cancer patients most at risk should be taken into particular consideration.

  16. Clinicopathological Profile of Lung Cancer Patients in a Teaching Hospital in South India

    Directory of Open Access Journals (Sweden)

    Srinath Dhandapani

    2016-06-01

    Full Text Available Introduction: Lung cancer is one of the leading causes of cancer related deaths in the world. The incidence of lung cancer is increasing in India and there is a need to understand the natural history of this disease. Aim of the study: To study the clinico- pathological- radiological profile of patients diagnosed with lung cancer from January 2013 to May 2015 at a tertiary care teaching hospital. Materials and Methods: Inpatient records of all patients admitted during the study period were examined and  all patients with a histologically proven diagnosis of bronchogenic carcinoma were recruited. Demographic characteristics, clinical, radiological and pathological details of each patient were recorded. Results: Fifty four patients with lung cancer were identified. Forty three (79.6% were male and 11 (20.4% were female. Thirty two (59.7% were smokers and 22 (40.7% were non smokers. Cough and expectoration (61.1% was the most common presenting symptom followed by breathlessness (59.3%. Mass lesion (81.5% was the most common radiological presentation and adenocarcinoma (42.6% was the most common histological subtype. When compared to fiber optic bronchoscopy, image guided percutaneous biopsy had a better  yield for diagnosing lung cancer (51.9% vs 48.1%. But this difference was not statistically significant (p=0.892 Conclusion: Adenocarcinoma is replacing squamous cell carcinoma as the most common type of lung cancer in India.

  17. Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

    Science.gov (United States)

    Siegel, Pamela; da Motta, Pedro Mourão Roxo; da Silva, Luis G; Stephan, Celso; Lima, Carmen Silvia Passos; de Barros, Nelson Filice

    2016-01-01

    The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

  18. Performance of activities of daily living among hospitalized cancer patients

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen;

    2015-01-01

    Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results...... differed between women and men. There was significant overlap between problems identified using the COPM and the ADL-Q instruments. RESULTS from the COPM showed that 65% of problems were related to self-care, 25% to leisure, and 19% to productivity. Using both instruments identified more ADL problems than...

  19. Clinical characteristics and rehabilitation of hospitalised cancer patients in a Korean tertiary hospital.

    Science.gov (United States)

    Uhm, Kyeong Eun; Yoon, Tae Hee; Hwang, Ji Hye

    2017-08-01

    With the increase in the patient survival rates of many types of cancers, a greater proportion of cancer patients live with disease-related problems that diminish their quality of life. This study aimed to investigate the clinical characteristics and rehabilitation of hospitalised cancer patients who were referred to the Department of Physical and Rehabilitation Medicine (PRM) at Samsung Medical Center, a tertiary university hospital in Seoul, Korea. Hospitalised cancer patients aged > 18 years who were referred to the Department of PRM from January to December 2012 were enrolled in this retrospective study. We reviewed the clinical characteristics of the patients, the principal reasons for their referral and relevant details of their rehabilitative management. A total of 1,340 cases were included. The most common primary cancer was lung cancer (19.0%) and 28.6% of the cases had solid organ metastasis. The most common reason for referral was deconditioning (31.7%), followed by weakness (23.1%) and respiratory problems (14.5%). Bedside exercise was prescribed to 28.4% of the patients, exercise in the rehabilitation therapy unit to 28.0% and pulmonary rehabilitation to 14.3%. Among the 1,340 cases, 107 (8.0%) were transferred to the Department of PRM for comprehensive rehabilitation. The 32 patients with an identifiable Modified Barthel Index score showed significant functional improvement. The findings of the present study contribute to a better understanding of rehabilitation for hospitalised cancer patients. The information obtained will also be helpful in the development of appropriate cancer rehabilitation strategies.

  20. Oral cancer presentation among Malay patients in hospital Universiti Sains Malaysia, Kelantan.

    Science.gov (United States)

    Razak, Asmani Abdul; Saddki, Norkhafizah; Naing, Nyi Nyi; Abdullah, Nizam

    2009-01-01

    The objective of this study was to identify the characteristics of oral cancer among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan. A retrospective record review was conducted from August to December 2006 in HUSM. Of 133 patients with oral cancer diagnosed from 1986 to 2005, 118 were Malay. Data on socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients were obtained. Malay patients with oral cancer were predominantly elderly, aged 60 years old and above (51.7%) at the time of diagnosis, with a mean age of 58.1 years (SD 16.81). Most patients were males (64.4%) and the majority of them were married (83.9%). More than half (58.5%) had been smokers, and of those who smoked, 89.9% were males. Some had a betel quid chewing habit (22.9%) but none ever consumed alcohol. The majority of the patients (77.1%) were diagnosed at stage IV. The tongue was the most usual site involved (37.3%) and squamous cell carcinoma was the most common histological type seen (75.4%). The prevalence of oral cancer among Malay patients in HUSM is high (88.7%). It is predominantly found in elderly males and the majority of cases present at advanced stage.

  1. Comparison of nutritional status assessment parameters in predicting length of hospital stay in cancer patients.

    Science.gov (United States)

    Mendes, J; Alves, P; Amaral, T F

    2014-06-01

    Undernutrition has been associated with an increased length of hospital stay which may reflect the patient prognosis. The aim of this study was to quantify and compare the association between nutritional status and handgrip strength at hospital admission with time to discharge in cancer patients. An observational prospective study was conducted in an oncology center. Patient-Generated Subjective Global Assessment, Nutritional Risk Screening 2002 and handgrip strength were conducted in a probabilistic sample of 130 cancer patients. The association between baseline nutritional status, handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome. Nutritional risk ranged from 42.3 to 53.1% depending on the tool used. According to Patient-Generated Subjective Global Assessment severe undernutrition was present in 22.3% of the sample. The association between baseline data and time to discharge was stronger in patients with low handgrip strength (adjusted hazard ratio, low handgrip strength: 0.33; 95% confidence interval: 0.19-0.55), compared to undernourished patients evaluated by the other tools; Patient-Generated Subjective Global Assessment: (adjusted hazard ratio, severe undernutrition: 0.45; 95% confidence interval: 0.27-0.75) and Nutritional Risk Screening 2002: (adjusted hazard ratio, with nutritional risk: 0.55; 95% confidence interval: 0.37-0.80). An approximate 3-fold decrease in probability of discharge alive was observed in patients with low handgrip strength. Decreasing handgrip strength tertiles allowed to discriminate between patients who will have longer hospital stay, as well as undernutrition and nutritional risk assessed by Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. Oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia, Kelantan.

    Science.gov (United States)

    Razak, Asmani Abdul; Saddki, Norkhafizah; Naing, Nyi Nyi; Abdullah, Nizam

    2010-01-01

    This study was performed to determine oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan. The medical records of 118 Malay patients with oral cancer admitted in HUSM from 1st January 1986 to 31st December 2005 were reviewed. Data collected include socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients. Survival status and duration were determined by active validation until 31st December 2006. Data entry and analysis were accomplished using SPSS version 12.0. The Kaplan-Meier method was used to perform survival estimates while the log-rank test and the Cox proportional hazards regression model were employed to perform univariate analysis and multivariable analysis of the variables, respectively. The overall five-year survival rate of Malay patients with oral cancer was 18.0%, with a median survival time of 9 months. Significant factors that influenced survival of the patients were age, sex, tumour site, TNM stage, histological type, and treatment received. Survival of oral cancer patients in HUSM was very low. Being elderly, male, presenting with an advanced stage at diagnosis, and not having treatment all contributed to poor survival.

  3. Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

    Science.gov (United States)

    Faheem, Muhammad; Fahim, Ammad; Innocent, Haran; Mansoor, Zainab; Rizvi, Shehrbano; Farrukh, Hizra

    2016-01-01

    Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS). Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated p value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient's awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients. PMID:27752508

  4. Are general practitioners getting the information they need from hospitals to manage their lung cancer patients?: A qualitative exploration

    National Research Council Canada - National Science Library

    Rowlands, Stella; Callen, Joanne; Westbrook, Johanna

    2012-01-01

    .... The aim of this study was to investigate perceptions of the quality, format and timeliness of the patient information GPs receive from a multidisciplinary hospital-based lung cancer team, and elicit...

  5. Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Anish Khalil

    2016-01-01

    Full Text Available Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS. Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7% patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated p value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7% uneducated patients, 85 (59.4% were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients.

  6. [Professional practice of nurses who care for cancer patients in general hospitals].

    Science.gov (United States)

    da Silva, Josiane Travençolo; Matheus, Maria Clara Cassuli; Fustinoni, Suzete Maria; de Gutiérrez, Maria Gaby Rivero

    2012-01-01

    The present article discusses a qualitative study which aimed to understand the typical of nurses' professional practice caring for patient with cancer in general hospitals. In order to find out the reasons that motivate nurse's action, and to put in evidence what is original, significant, specific and typical about this phenomenon, we have taken into consideration the premises of the philosopher Alfred Schütz, which provide us with subsidies to unveil them. The data collected through semi-structured interviews reported that nurses admit not having the required theoretical knowledge and experience or enough practice to take care of a cancer patient. Thus, they don't feel capable of developing actions which may positively influence care on patients and their family members.

  7. Cancer-related therapies at the end of life in hospitalized cancer patients from four Swiss cantons: SAKK 89/09.

    Science.gov (United States)

    Matter-Walstra, Klazien W; Achermann, Rita; Rapold, Roland; Klingbiel, Dirk; Bordoni, Andrea; Dehler, Silvia; Jundt, Gernot; Konzelmann, Isabelle; Clough-Gorr, Kerri; Szucs, Thomas; Pestalozzi, Bernhard C; Schwenkglenks, Matthias

    2015-01-01

    The use of cancer-related therapies in cancer patients hospitalized at the end of life has increased in many countries over time. Given the scarcity of published Swiss data, the objective of this study was to evaluate the influence of hospital type and other factors on the delivery of health care during the last month before death. Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating Swiss cantons) who deceased between 2006 and 2008. Primary endpoints were delivery of cancer-related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of hospital type, patient and geographic characteristics. Of 3,809 identified cancer patients in the claims database, 2,086 patients dying from cancer were hospitalized during the last 30 days before death, generating 2,262 inpatient episodes. Anticancer drug therapy was given in 22.2% and radiotherapy in 11.7% of episodes. Besides age and cancer type, the canton of residence and hospital type showed independent, statistically significant associations with intensity of care, which was highest in university hospitals. These results should initiate a discussion among oncologists in Switzerland and may question the compliance with standard of care guidelines for terminal cancer patients.

  8. Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases

    Directory of Open Access Journals (Sweden)

    Corica Francesco

    2005-08-01

    Full Text Available Abstract Background Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study. Methods We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399, and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326. Functional capabilities were ascertained using the activities of daily living (ADL scale, and categorical variables for dependency in at least 1 ADL or dependency in 3 or more ADLs were considered in the analysis. Cognitive status was evaluated by the 10-items Hodgkinson Abbreviated Mental Test (AMT. Results Cognitive impairment was more prevalent in patients with CHF (28.0% or COPD (25.8% than in those with cancer (solid tumors = 22.9%; leukemia/lymphoma = 19.6%; metastatic cancer = 22.8%. Dependency in at least 1 ADL was highly prevalent in patients with metastatic cancer (31.3% vs. 24% for patients with CHF and 22.4% for those with non-metastatic solid tumors, p Conclusion Cancer should not be considered as an ineluctable cause of severe cognitive and physical impairment, at least not more than other chronic conditions highly prevalent in older people, such as CHF and diabetes mellitus.

  9. Delay in referring and related factors in patients with advanced breast cancer - Emam Hospital (2000

    Directory of Open Access Journals (Sweden)

    "Ghaem Maghami F

    2002-07-01

    Full Text Available Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000. Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing. Results: From the cases, 64 patients (32 percent referred without delay and 136 patients (68 percent referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004, lower education level (P=0.002, and lower economic status (P=0.001. The frequency rate of single were lower among them (P=0.001, fewer percent were residual of big cities (P=0.01 and they had less rate of available physician (P=0.004. 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001. 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E (P=0.002 and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01. 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference. Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.

  10. A rural cancer outreach program lowers patient care costs and benefits both the rural hospitals and sponsoring academic medical center.

    Science.gov (United States)

    Desch, C E; Grasso, M A; McCue, M J; Buonaiuto, D; Grasso, K; Johantgen, M K; Shaw, J E; Smith, T J

    1999-01-01

    The Rural Cancer Outreach Program (RCOP) between two rural hospitals and the Medical College of Virginia's Massey Cancer Center (MCC) was developed to bring state-of-the-art cancer care to medically underserved rural patients. The financial impact of the RCOP on both the rural hospitals and the MCC was analyzed. Pre- and post-RCOP financial data were collected on 1,745 cancer patients treated at the participating centers, two rural community hospitals and the MCC. The main outcome measures were costs (estimated reimbursement from all sources), revenues, contribution margins and profit (or loss) of the program. The RCOP may have enhanced access to cancer care for rural patients at less cost to society. The net annual cost per patient fell from $10,233 to $3,862 associated with more use of outpatient services, more efficient use of resources, and the shift to a less expensive locus of care. The cost for each rural patient admitted to the Medical College of Virginia fell by more than 40 percent compared with only an 8 percent decrease for all other cancer patients. The rural hospitals experienced rapid growth of their programs to more than 200 new patients yearly, and the RCOP generated significant profits for them. MCC benefited from increased referrals from RCOP service areas by 330 percent for cancer patients and by 9 percent for non-cancer patients during the same time period. While it did not generate a major profit for the MCC, the RCOP generated enough revenue to cover costs of the program. The RCOP had a positive financial impact on the rural and academic medical center hospitals, provided state-of-the-art care near home for rural patients and was associated with lower overall cancer treatment costs.

  11. Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?

    NARCIS (Netherlands)

    Lu, W.L.; Jansen, L.; Schaapveld, M.; Baas, P.C.; Wiggers, T.; de Bock, G.H.

    2011-01-01

    Background: After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare. Methods: Information regarding the utilization of routine hospital follow-up care was retrieved from

  12. Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Mohammad Ashraf Wani

    2013-01-01

    Materials and Methods: After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. Results: The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96. This includes expenditure incurred both by the hospital and the patient (out of pocket. Conclusion: The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

  13. Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?

    Directory of Open Access Journals (Sweden)

    Schaapveld Michael

    2011-06-01

    Full Text Available Abstract Background After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare. Methods Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE. Results The median follow-up time was 9.0 (0.3-18.1 years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74, patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52 and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25. Conclusions Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended.

  14. Detection of Strongyloides stercoralis infection among cancer patients in a major hospital in Kelantan, Malaysia.

    Science.gov (United States)

    Zueter, AbdelRahman Mohammad; Mohamed, Zeehaida; Abdullah, Abu Dzarr; Mohamad, Norsarwany; Arifin, Norsyahida; Othman, Nurulhasanah; Noordin, Rahmah

    2014-07-01

    Strongyloidiasis is one of the most commonly neglected but clinically important parasitic infections worldwide, especially among immunocompromised patients. Evidence of infection among immunocompromised patients in Malaysia is, however, lacking. In this study, microscopy, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to detect Strongyloides stercoralis (S. stercoralis) infection among cancer patients in a Malaysian hospital. A total of 192 stool and serum samples were collected from cancer patients who were receiving chemotherapy with or without steroid treatment at a hospital in northeastern Malaysia. Stool samples were examined for S. stercoralis using parasitological methods and real-time PCR. Serology by ELISA was performed to detect parasite-specific immunoglobulin G (IgG), IgG4 and immunoglobulin E (IgE) antibodies. For comparison, IgG4- and IgG-ELISAs were also performed on the sera of 150 healthy individuals from the same area. Of the 192 samples examined, 1 (0.5%) sample was positive for S. stercoralis by microscopy, 3 (1.6%) by real-time PCR, 8 (4.2%) by IgG-ELISA, 6 (3.1%) by IgG4-ELISA, and none was positive by IgE-ELISA. In comparison, healthy blood donors had significantly lower prevalence of parasite-specific IgG (2.67%, p < 0.05) and IgG4 (2.67%, p < 0.05) responses. This study showed that laboratory testing may be considered as a diagnostic investigation for S. stercoralis among immunocompromised cancer patients.

  15. Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors

    Directory of Open Access Journals (Sweden)

    Mathoulin-Pélissier Simone

    2012-07-01

    Full Text Available Abstract Background Colorectal cancer (CRC care has improved considerably, particularly since the implementation of a quality of care program centered on national evidence-based guidelines. Formal quality assessment is however still needed. The aim of this research was to identify factors associated with practice variation in CRC patient care. Methods CRC patients identified from all cancer centers in South-West France were included. We investigated variations in practices (from diagnosis to surgery, and compliance with recommended guidelines for colon and rectal cancer. We identified factors associated with three colon cancer practice variations potentially linked to better survival: examination of ≥12 lymph nodes (LN, non-use and use of adjuvant chemotherapy for stage II and stage III patients, respectively. Results We included 1,206 patients, 825 (68% with colon and 381 (32% with rectal cancer, from 53 hospitals. Compliance was high for resection, pathology report, LN examination, and chemotherapy use for stage III patients. In colon cancer, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients. 84% of stage US T3T4 rectal cancer patients received pre-operative radiotherapy. In colon cancer, factors associated with examination of ≥12 LNs were: lower ECOG score, advanced stage and larger hospital volume; factors negatively associated were: left sided tumor location and one hospital district. Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location; whereas under-use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals. Conclusions Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care

  16. Opioid medications and longitudinal risk of delirium in hospitalized cancer patients.

    Science.gov (United States)

    Gaudreau, Jean-David; Gagnon, Pierre; Roy, Marc-André; Harel, François; Tremblay, Annie

    2007-06-01

    Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium. A prospective cohort study was conducted in an oncology/internal medicine population. Patients were assessed continuously for the presence of delirium until they were discharged by using the Nursing Delirium Screening Scale (Nu-DESC). Follow-up for outcome began after incident delirium. The primary outcome was the presence of a delirium event, which was defined as a Nu-DESC score >1. Strengths of associations of medications with delirium were expressed as odds ratios (ORs) in univariate and multivariate analyses. In total, 114 patients (1823 patient-days) met the inclusion criteria for the study. The mean follow-up from incident delirium was 16 days. The mean number of delirium events by patient was 6 (total number, 667 delirium events). Analysis by day on several occasions revealed significant associations between opioids and delirium. Corticosteroids and benzodiazepines were not associated significantly with an increased risk of delirium on any given day. Analysis by patient using generalized estimating equation (GEE) models showed an increased risk of delirium on any day of follow-up associated with opioid exposure in univariate analysis (OR of 1.70; Phospitalization was associated significantly with an increased longitudinal risk of delirium. (c) 2007 American Cancer Society.

  17. Assessment of a Hospital Palliative Care Unit (HPCU) for Cancer Patients; A Conceptual Framework

    Science.gov (United States)

    Rouhollahi, Mohammad Reza; Saghafinia, Masoud; Zandehdel, Kazem; Motlagh, Ali Ghanbari; Kazemian, Ali; Mohagheghi, Mohammad Ali; Tahmasebi, Mamak

    2015-01-01

    Introduction: The first hospital palliative care unit (HPCU) in Iran (FARS-HPCU) has been established in 2008 in the Cancer Institute, which is the largest referral cancer center in the country. We attempted to assess the performance of the HPCU based on a comprehensive conceptual framework. The main aim of this study was to develop a conceptual framework for assessment of the HPCU performances through designing a value chain in line with the goals and the main processes (core and support). Materials and Methods: We collected data from a variety of sources, including international guidelines, international best practices, and expert opinions in the country and compared them with national policies and priorities. We also took into consideration the trend of the HPCU development in the Cancer Institute of Iran. Through benchmarking the gap area with the performance standards, some recommendations for better outcome are proposed. Results: The framework for performance assessment consisted of 154 process indicators (PIs), based on which the main stakeholders of the HPCU (including staff, patients, and families) offered their scoring. The outcome revealed the state of the processes as well as the gaps Conclusion: Despite a significant improvement in many processes and indicators, more development in the comprehensive and integrative aspects of FARS-HPCU performance is required. Consideration of all supportive and palliative requirements of the patients through interdisciplinary and collaborative approaches is recommended. PMID:26600701

  18. Estimating the five-year survival of cervical cancer patients treated in hospital universiti sains malaysia.

    Science.gov (United States)

    Razak, Nuradhiathy Abd; Mn, Khattak; Zubairi, Yong Zulina; Naing, Nyi Nyi; Zaki, Nik Mohamed

    2013-01-01

    The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia. One hundred and twenty cervical cancer patients diagnosed between 1st July 1995 and 30th June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups. The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)]. The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

  19. Evaluation of Nutritional Status of Cancer Patients during Treatment by Patient-Generated Subjective Global Assessment: a Hospital-Based Study.

    Science.gov (United States)

    Sharma, Dibyendu; Kannan, Ravi; Tapkire, Ritesh; Nath, Soumitra

    2015-01-01

    Cancer patients frequently experience malnutrition. Cancer and cancer therapy effects nutritional status through alterations in the metabolic system and reduction in food intake. In the present study, fifty seven cancer patients were selected as subjects from the oncology ward of Cachar Cancer Hospital and Research Centre, Silchar, India. Evaluation of nutritional status of cancer patients during treatment was carried out by scored Patient-Generated Subjective Global Assessment (PG-SGA). The findings of PG-SGA showed that 15.8% (9) were well nourished, 31.6% (18) were moderately or suspected of being malnourished and 52.6% (30) were severely malnourished. The prevalence of malnutrition was highest in lip/oral (33.33%) cancer patients. The study showed that the prevalence of malnutrition (84.2%) was high in cancer patients during treatment.

  20. Insurance Status and Hospital Payer Mix Are Linked With Variation in Metastatic Site Resection in Patients With Advanced Colorectal Cancers.

    Science.gov (United States)

    Healy, Mark A; Pradarelli, Jason C; Krell, Robert W; Regenbogen, Scott E; Suwanabol, Pasithorn A

    2016-11-01

    Despite substantially improved survival with metastatic site resection in colorectal cancers, uptake of aggressive surgical approaches remains low among certain patients. It is unknown whether financial determinants of care, such as insurance status, play a role in this treatment gap. We sought to evaluate the effect of insurance status on metastasectomy in patients with advanced colorectal cancers. This was a retrospective cohort study. Using the National Cancer Data Base Participant User File, incident cases of colorectal cancer metastatic to the lung and/or liver with diagnosis from 2010 to 2013 were identified. We identified 42,300 patients in our cohort with a mean age 64 years. Controlling for patient, tumor, and hospital characteristics, hierarchical regression was used to examine associations between hospital payer mix and metastatic site resection. Metastatic site resection occurred in 12.3% of all patients. Adjusting for patient and hospital fixed effects, we found that patients who were uninsured or on Medicaid were 38% less likely to undergo metastasectomy (OR = 0.62 (95% CI, 0.56-0.66)). Patients in hospitals with staff treating a high percentage of uninsured patients or patients with Medicaid were less likely to undergo metastasectomy, even after controlling for individual patient insurance status. The study was limited by its retrospective design and the granularity and accuracy of the National Cancer Data Base. Differences in insurance status and hospital payer mix are associated with differences in rates of metastatic site resection in patients with colorectal cancer that is metastatic to the lung and/or liver. There is a need for improved access to metastatic site resection for individual patients who are uninsured or who have Medicaid insurance, as well as for all patients who seek care at hospitals treating a large proportion of patients who are uninsured or on Medicaid. Remedies for individual patients could include improved access to private

  1. Breast cancer surgery and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard

    2013-10-01

    Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

  2. [The impacts of the multidisciplinary team model on the length of stay and hospital expenses of patients with lung cancer].

    Science.gov (United States)

    Zou, Jing; Xu, Xingxiang; Wang, Daxin; Xu, Jin; Gu, Wenju

    2015-05-01

    To explore the impacts of the multidisciplinary team model on the average length of stay and hospital expenses of patients with lung cancer. After the multidisciplinary team discussion, 97 patients with lung cancer were selected as the lung cancer group according to the enrollment and elimination criteria the control group was 97 patients with lung cancer managed without team discussion during the same period. All the patients were firstly diagnosed to have lung cancer from December 2011 to December 2013 in Subei People's Hospital. The length of stay, hospital expenses, stages of tumor, types of tumor, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age of all the patients were collected. The difference in the average length of stay and hospital expenses between the 2 groups and the associated factors were analyzed by using χ² test, t test and multi-factor stepwise regression analysis. There were 68 males and 29 females with a mean age of (61 ± 9) years in the lung cancer group, while there were 73 males and 24 females with a mean age of (63 ± 10) years in the control group. There were no differences between the 2 groups in tumor staging, tumor types, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age (χ² = 4.854, P = 0.563, χ² = 4.248, P = 0.097; χ² = 0.395, P = 0.821; χ² = 1.191, P = 0.554; χ² = 0.108, P = 0.977; χ² = 1.011, P = 0.389; χ² = 0.649, P = 0.519; P = 0.474, P = 0.845, respectively). The average hospital expenses (13 303 vs 16 553, Yuan) were lower and the length of stay (10.33 vs 12.49, days) was shorter in the lung cancer group as compared to the control group (t = 2.616, P = 0.010; t = 2.730, P = 0.007), especially so for the first clinical hospitalization (15 953 vs 19 485 yuan, t = 2.315, P = 0.022; 12.71 vs 14.75 days, t = 1.979, P = 0.049). The average length of stay and the tumor stages were the main factors associated with the average hospital expenses. Except for patients with the

  3. Prognostic factors in patients with colorectal cancer at Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Ghazali, Anis Kausar; Musa, Kamarul Imran; Naing, Nyi Nyi; Mahmood, Zainal

    2010-07-01

    To determine the 5-year survival rate and prognostic factors for survival in patients with colorectal cancer treated at the Surgical Unit, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia. We retrospectively reviewed the records of 115 patients treated in HUSM from 1996 to 2005. Data of variables considered as prognostic factors were obtained from the records. Simple and multiple Cox proportional hazard regression using the stepwise method were used to model the prognostic factors for survival. We found that the significant prognostic factors were liver metastases [adjusted hazard ratio (HR): 3.75; 95% confidence interval (CI): 1.95-7.22], Dukes C stage (adjusted HR: 4.65; 95% CI: 2.37-9.11), Dukes D stage (adjusted HR: 6.71; 95% CI: 2.92-15.48) and non-surgical treatment (adjusted HR: 3.75; 95% CI: 1.26-11.21). Colorectal patients treated at HUSM with Dukes C staging, presence of liver metastases and received treatment with both chemotherapy and radiotherapy are at the greatest risk of death from colorectal cancer. Copyright © 2010 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

  4. Risk for Hospitalization With Depression After a Cancer Diagnosis: A Nationwide, Population-Based Study of Cancer Patients in Denmark From 1973 to 2003

    DEFF Research Database (Denmark)

    Dalton, S.O.; Laursen, T.M.; Nylandsted, Lone Ross

    2009-01-01

    ) for depression among cancer survivors relative to the cancer-free population was estimated by Poisson regression analysis with adjustment for age and period and stratified by sex, site of cancer, and extent of disease. Results The risk for depression in the first year after a cancer diagnosis was increased......Purpose As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. Methods We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born...... for both men and women surviving hormone-related cancers, for women surviving smoking-related cancers, and for men surviving virus- and immune-related cancers. Conclusion This study confirms an increased risk for depression in patients facing a disruptive event like cancer. Early recognition and effective...

  5. High prevalence of diabetes mellitus and impaired glucose tolerance in liver cancer patients: A hospital based study of 4610 patients with benign tumors or specific cancers [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Chen Roujun

    2016-06-01

    Full Text Available Objective: The prevalence of diabetes mellitus (DM, impaired glucose tolerance (IGT and impaired fasting glucose (IFG were hypothesised to be different among different tumor patients. This study aimed to study the association between the prevalence of DM, IGT and IFG and liver cancer, colorectal cancer, breast cancer, cervical cancer, nasopharyngeal cancer and benign tumor. Methods:  A hospital based retrospective study was conducted on 4610 patients admitted to the Internal Medical Department of the Affiliated Tumor Hospital of Guangxi Medical University, China. Logistic regression was used to examine the association between gender, age group, ethnicity , cancer types or benign tumors and prevalence of DM, IFG, IGT. Results: Among 4610 patients, there were 1000 liver cancer patients, 373 breast cancer patients, 415 nasopharyngeal cancer patients, 230 cervical cancer patients, 405 colorectal cancer patients, and 2187 benign tumor patients. The prevalence of DM and IGT in liver cancer patients was 14.7% and 22.1%, respectively. The prevalence of DM and IGT was 13.8% and 20%, respectively, in colorectal cancer patients, significantly higher than that of benign cancers. After adjusting for gender, age group, and ethnicity, the prevalence of DM and IGT in liver cancers patients was 1.29 times (CI :1.12-1.66 and 1.49 times (CI :1.20-1.86 higher than that of benign tumors, respectively. Conclusion: There was a high prevalence of DM and IGT in liver cancer patients.

  6. Association of SDF-1 with Metastasis in Breast Cancer Patient at Sanglah Hospital, Bali

    Directory of Open Access Journals (Sweden)

    Kristanto Yuli Yarso

    2016-10-01

    Full Text Available Objectives: More than 24% breast cancer patients came to Sanglah Teaching Hospital with distant metastasis which cause 90% of cancer related death. Distant metastasis is complex process of interaction between tumor cells and its micro environment involving a chemoattractant cytokines which lead circulating tumor cells toward target organs. One of the most common cytokines involved in metastasis of multiple tumor is SDF-1, produces by target organ or tumor cells itselves. However, only few stucy ever evaluate the relationship between its concentrations in tumor tissue with metastasis. Method: A cross sectional analysis study was conducted involving clinical data and paraffin blocks from 46 patients. Samples were grouped into metastasis and non-metastasis group and level of tumor tissue SDF-1 was evaluated by immunohistochemistry method. Numerical conversion was done using modified “Mirisola” technique and statistical analysis was conducted using SPSS 16 software. Results: The overall median expression of SDF-1 was 4.83 in which the median is 4.08±2.25 in non-metastatic group and 5.71±2.61 in metastatic group (p=0.012. In addition, parenchymal carcinoma cell had significantly higher expression of SDF-1 compared with microenvironmental cell both in metastatic group (carcinoma cell vs microenvironment; 4,57+1,91 vs 3,68 +2,06; p=0,004 and non-metastatic group (3,19 +2,29 vs 2,16+1,11; p=0.011. Finally, logistic regression analysis of SDF-1 expression also gave significant result that MBC had significantly higher expression of SDF-1 (p=0.039.  Conclusions: There was significant association between of SDF-1 expression and distant metastasis in breast cancer and majority of SDF was produced by cancer cells

  7. Hospitals report on cancer centers.

    Science.gov (United States)

    Rees, T

    2001-01-01

    Woman's Hospital, Baton Rouge, La., is first-place winner among cancer centers. Holy Cross Hospital's Michael and Dianne Bienes Comprehensive Cancer Center, Ft. Lauderdale, Fla., is named second; and, Cardinal Health System's Ball Cancer Center, Muncie, Ind., third.

  8. Postoperative Survival Estimation of Gastric Cancer Patients in Cancer Institute of Tehran, Imam Khomeini Hospital and Its Relative Factors

    Directory of Open Access Journals (Sweden)

    A. Kazemnejad

    2010-10-01

    Full Text Available Introduction & Objective: Gastric Cancer (GC is one of the most common causes of death in the world. The most important cause of high death rate related to GC is late diagnosis of the disease. The main treatment of gastric cancer in its primary stage of is surgery, and radiotherapy and chemotherapy are supplementary treatments. There are some factors that affect survival after surgery. This study aimed to assess the survival of patients with GC under surgery and to determine the risk factors of this cancer. Materials & Methods: A total of 262 patients with GC under surgery were followed and included in the study from 21st of March 2003 to 21st of March 2007 in the cancer institute of Tehran, Imam Khomeini Hospital, . The staging of the disease before the surgery was based on CT-Scan and endosonography and after the surgery was based on the pathologic reports. The survival of the patients was determined by their periodical referrals and our telephone contacts with their relatives. The survival times were considered as the time from the diagnosis up to the death or the end of the study. The effect of the various risk factors including gender, age at diagnosis, tumor site, pathologic stage of the disease, type of treatment, metastases and relapse were evaluated. Kaplan-Miere approach was used to estimate survival and Log-rank test and proportional Cox model to evaluate the related factors. Data were analyzed using Spss16 statistical software. Results: 75.2% of patients were men and 34.4% cases of patients experienced death. The mean follow-up time was 19.317.4. The mean age at diagnosis was 5811.5 and survival mean and median were 49 and 27 months respectively. The one, three and five year survival of the patients were 0.85, 0.41 and 0.3 respectively. Gender, pathologic stage, age at diagnosis and weight-loss were significantly related to the survival in multivariate analysis. Conclusion: The diagnosis of the cancer in primary stages causes

  9. Long-term prognosis of breast cancer: An analysis of 462 patients in a general hospital in south east Netherlands

    NARCIS (Netherlands)

    H.W. Nab (Henk); N. Kluck (Nadine); E.J.T. Rutgers (Emiel); J.W.W. Coebergh (Jan Willem); W.C.J. Hop (Wim)

    1995-01-01

    textabstractIn this study the long-term prognosis was analysed of all 462 consecutive female breast cancer patients who were diagnosed and carefully staged between 1970 and 1980 in a 600-bed community hospital in Eindhoven, south east Netherlands. Follow-up of recurrence and causes of death was obta

  10. Developing a Rehabilitation Model of Breast Cancer Patients Through Literature Review and Hospital Rehabilitation Programs

    Directory of Open Access Journals (Sweden)

    Bok-Yae Chung, PhD, RN, APN

    2008-03-01

    Conclusion: Rehabilitation of breast cancer patients deserves special attention to achieve optimal quality of life. Health care professionals need to be educated about rehabilitation as an effective intervention.

  11. Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Kai-na; LI Xiao-mei; YAN Hong; DANG Shao-nong; WANG Duo-lao

    2011-01-01

    Background Breast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However,few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy. Methods One hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups.The experimental group (n=60) received music therapy on the basis of routine nursing care, whereas the control group (n=60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS)respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital. Results The mean depression score of all subjects was 37.19±6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F=39.13, P<0.001; F=82.09, P<0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62±2.04) days) was shorter than that of the control group ((15

  12. Effects of Smoking on Cost of Hospitalization and Length of Stay among Patients with Lung Cancer in Iran: a Hospital-Based Study.

    Science.gov (United States)

    Sari, Ali Akbari; Rezaei, Satar; Arab, Mohammad; Majdzadeh, Reza; Matin, Behzad Karami; Zandian, Hamed

    2016-01-01

    Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable nancial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Our study indicated that cigarette smoking imposes a signi cant nancial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

  13. Hotel-based ambulatory care for complex cancer patients: a review of the University College London Hospital experience.

    Science.gov (United States)

    Sive, Jonathan; Ardeshna, Kirit M; Cheesman, Simon; le Grange, Franel; Morris, Stephen; Nicholas, Claire; Peggs, Karl; Statham, Paula; Goldstone, Anthony H

    2012-12-01

    Since 2005, University College London Hospital (UCLH) has operated a hotel-based Ambulatory Care Unit (ACU) for hematology and oncology patients requiring intensive chemotherapy regimens and hematopoietic stem cell transplants. Between January 2005 and 2011 there were 1443 patient episodes, totaling 9126 patient days, with increasing use over the 6-year period. These were predominantly for hematological malignancy (82%) and sarcoma (17%). Median length of stay was 5 days (range 1-42), varying according to treatment. Clinical review and treatment was provided in the ACU, with patients staying in a local hotel at the hospital's expense. Admission to the inpatient ward was arranged as required, and there was close liaison with the inpatient team to preempt emergency admissions. Of the 523 unscheduled admissions, 87% occurred during working hours. An ACU/hotel-based treatment model can be safely used for a wide variety of cancers and treatments, expanding hospital treatment capacity, and freeing up inpatient beds for those patients requiring them.

  14. Nutritional issues and self-care measures adopted by cancer patients attending a university hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Sevgisun Kapucu

    2016-01-01

    Full Text Available Objective: This study aimed to assess the nutritional status of cancer patients and the self-care measures they adopted as a response to nutritional problems. Methods: This descriptive study included seventy cancer patients staying in the oncology and internal disease clinics of a university hospital in Turkey. Data were collected using a questionnaire with 29 questions. Results: The mean age of participants was 40.2 ΁ 1.82 years. Approximately, 62.9% of the patients ate only half of the meals offered to them, 65.7% experienced weight loss, and 45.7% had difficulty eating their meals on their own. Moreover, 47.1% of the patients received nutritional support and nutritional problems were observed in 71.4% of the patients; 80% were unable to eat hospital food, 54.3% had an eating disorder related to a special diet, 30% suffered from loss of appetite, 27% had nausea, and 14.3% had difficulty swallowing. Furthermore, 48.5% of patients responded that they ate home-cooked food or ordered food from outside when questioned about the self-care measures taken to avoid the aforementioned nutritional problems. Conclusions: Most of the cancer patients had serious nutritional problems and ate home-cooked food and used nutritional supplements to overcome these problems. Oncology nurses are responsible for evaluating the nutritional status of cancer patients and eliminating nutritional problems.

  15. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital – State

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of the state averages for the HCAHPS survey responses. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...

  16. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia.

    Science.gov (United States)

    Edib, Zobaida; Kumarasamy, Verasingam; Binti Abdullah, Norlia; Rizal, A M; Al-Dubai, Sami Abdo Radman

    2016-02-22

    Addressing breast cancer patients' unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients' characteristics, and their unmet supportive care needs. A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants' socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical

  17. Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

    Science.gov (United States)

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

    2015-03-01

    Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

  18. Statistic analysis of 6891 cancer-paining patients' information from Gansu Province Tumour Hospital, China%6891例癌痛患者信息统计分析

    Institute of Scientific and Technical Information of China (English)

    Yuzhong Jin; Yandong Chai; Hua Yang

    2009-01-01

    Objective: To analyze and gain the interlinking degree of the cancer pain with patients' cancer-species, sexual-ity and age etc. Methods: The information of narcotic drugs used for cancer pain patients in our hospital (Gansu Province Tumour Hospital, China) during 2002-2007 were typed in designed EXCEL form, then counted and analyzed. Results: The total number of cancer pain patients used narcotic drugs during 2002-2007 was 6891 (n = 6691), among them, 4164 (60.44%) were males, and 2727 (39.56%) females. The top-range of cancer-species in those patients was as follows: lung cancer (20.39%), gastric cancer (14.85%), esophageal cancer (9.71%), hysterecarcinoma (6.79%), liver cancer (6.70%) and breast cancer (6.31%). Conclusion: (a) The male number of cancer pain patients using narcotic drugs is higher than the female number (1.53:1). (b) In the cases of lung cancer, gastric cancer, esophageal cancer, liver cancer and kidney cancer, the male numbers are twice more than the female numbers, and the difference between the two groups are significant. (c) Most of the cancer pain patients (over 87%) are over 40 years old.

  19. Assessment of quality of life in breast cancer patients at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    G Damodar

    2013-01-01

    Conclusion: These findings have shown that there exists a strong correlation between the length of treatment and the QoL among breast cancer patients. Future interventions should target each specific aspect of QoL.

  20. Histopathological prognostic factor comparison of endometrial cancer patients in a tertiary hospital in India

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    P. Swarna Latha

    2014-02-01

    Conclusions: This study highlights the prognostic characteristics of endometrial cancer patients with most of them presenting in early stages thereby having a good prognostic outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 102-104

  1. Prognostic Factors in Patients With Colorectal Cancer at Hospital Universiti Sains Malaysia

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    Anis Kausar Ghazali

    2010-07-01

    Conclusion: Colorectal patients treated at HUSM with Dukes C staging, presence of liver metastases and received treatment with both chemotherapy and radiotherapy are at the greatest risk of death from colorectal cancer.

  2. [Incidence of oral cancer in AIDS patients at the "20 de Noviembre" Regional Hospital, ISSSTE].

    Science.gov (United States)

    Solís Morán, C E; Molina Moguel, J L

    1990-09-01

    Ever since its initial outbursts in high-risk groups, AIDS has had an appalling impact within the oncological sphere, since it combines opportunistic pathologies with the occurrence of malignancies caused by loss of defensive cells, thus allowing abnormal or cancerous cells to multiply. This paper conveys some recent concepts on AIDS, as well as a study undertaken at the "20 de Noviembre" Hospital, aimed at identifying the most common opportunistic diseases which often occur in the oral cavity upon contracting AIDS.

  3. Health Related Quality of Life (HRQoL) among Breast Cancer Patients Receiving Chemotherapy in Hospital Melaka: Single Centre Experience

    Science.gov (United States)

    Chee Chean, Dang; Kuo Zang, Wong; Lim, Michelle; Zulkefle, Nooraziah

    2016-12-01

    Objective: To investigate the impact of chemotherapy on quality of life (QoL) among breast cancer patients and to evaluate the relationship with age, cancer stage and presence of any comorbidity. Methods: A prospective study was conducted among breast cancer patients receiving chemotherapy in Hospital Melaka from 1st January 2014 to 31st July 2014. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was given to patients to fill in prior chemotherapy (baseline) and after the third cycle of chemotherapy. Socio-demographic and clinical data were collected and analyzed using SPSS version 20. Result: Respondents were 32 female patients [mean age (SD): 49.7(9.93) years]. They reported a significant lower global health status (P 0.05). Conclusion: Chemotherapy did reduce the QoL of breast cancer patients. Management of chemotherapy-induced loss of appetite, diarrhea, nausea and vomiting should be improved for a better outcome.

  4. Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital.

    Science.gov (United States)

    Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

    2017-05-18

    Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814

  5. Risk of breast cancer recurrence in patients receiving manual lymphatic drainage: a hospital-based cohort study

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    Hsiao PC

    2015-02-01

    Full Text Available Pei-Chi Hsiao,1,2 Jung-Tai Liu,3 Chien-Liang Lin,4 Willy Chou,1,2 Shiang-Ru Lu5 1Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan; 2Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 3Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 4Department of Hematology and Oncology, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 5Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Background: This retrospective cohort study evaluated whether manual lymphatic drainage (MLD therapy increases the risk of recurrence of breast cancer. Methods: We analyzed 1,106 women who were diagnosed with stage 0­–3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The patients were divided into two groups: group A (n=996, in which patients did not participate in any MLD therapy, regardless of whether they developed breast cancer-related lymphedema (BCRL after cancer treatment; and group B (n=110, in which patients participated in MLD therapy for BCRL. All patients were monitored until October 2013 to determine whether breast cancer recurrence developed, including local or regional recurrence and distant metastasis. Patients who developed cancer recurrence prior to MLD therapy were excluded from analysis. Risk factors associated with cancer recurrence were evaluated using Cox proportional hazards models. Results: During the monitoring period, 166 patients (15.0% developed cancer recurrence, including 154 (15.5% in group A and 12 (10.9% in group B. The median period from surgery to cancer recurrence was 1.85 (interquartile range 1.18–2.93 years. Independent risk factors for cancer recurrence were tumor histological grading of grade 3, high number (≥3 of axillary lymph node invasion, and a large tumor size (>5 cm. Factors

  6. [The second report from Sapporo Tsukisamu hospital--chemotherapy for patients with advanced colorectal cancer].

    Science.gov (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Shirasaka, Tetsuhiko

    2007-08-01

    The remedy,especially recent chemotherapy,against colorectal cancer is improving median survival time (MST) of patients with Stage IV advanced colorectal cancer. According to other reports,however,it seems to be difficult to improve it longer than 20 months. In May 2002, we devised a new regimen by intermittent dosage of 5-FU (-->S-1), CDDP and paclitaxel utilizing the difference of cell cycle between normal and cancer cells, and thirteen patients with advanced colorectal cancer (Stage IV) were treated with this regimen. As a result, a satisfactory efficacy rate of 53.8%, 1-year survival rate of 69 .2%, 2-year survival rate of 53.9%, 3-year survival rate of 44.9%, 5-year survival rate of 17.9%, and MST 36 months were achieved. Five patients had hematological toxicities over grade 3 (38.5%) and most of them were anemia (3 cases) and neutropenia (5 cases). Thrombocytopenia and gastroenterological toxicity were all under grade 2. Adverse effects related to this regimen were clinically manageable. These results, although for a limited number of patients, indicated that this may contribute to the extension of survival time of patients with Stage IV advanced colorectal cancer.

  7. Determinants of hopelessness and depression among Chinese hospitalized esophageal cancer patients and their family caregivers.

    Science.gov (United States)

    Han, Yanhong; Yuan, Jie; Luo, Zhiguo; Zhao, Jing; Wu, Junbo; Liu, Rongying; Lopez, Violeta

    2013-11-01

    It has been well documented that the diagnosis of cancer is psychologically devastating to both the patients and caregivers. The incidence and mortality of esophageal cancer were 20.85 and 16.24 per 100,000 persons and the sixth most commonly diagnosed cancer and the fourth main cause of cancer death in China. We surveyed patients-caregivers dyad and examined the determinants of their depression and hopelessness. The prevalence of depression among patients and caregivers was 52.8% and 47.2%, and the prevalence for hopelessness was 64.4% and 53.9%, respectively Regression models indicate that the variables measured could explain 58.9% and 51.7% of the variance in depression and 66.8% and 45.7% of the variance in hopelessness among patients and caregivers, respectively. Overall, hopelessness was a determinant of depression and vice versa to both patients and caregivers. Esophageal patients' depression and hopelessness could also affect caregivers' depression and hopelessness despite the social support that family caregivers have. Psychosocial interventions should be planned to both Chinese patients and caregivers considering the predictors found in this study. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... in hospitals today. Purpose The purpose was to explore how informal relationships between patients affect their hospital experiences in the hospital. The assumption is that, on the one hand, the impacts on patients' suffering affect the way they act and experience encounters with fellow patients for good....... Methods The study is designed within a phenomenological-hermeneutical philosophic frame of reference and is based on ethnographic fieldwork among hospitalised patients in a Danish university hospital. Data for the study were collected through participant observations over a period of 18 months. Nine males...

  9. Prevalence of BRCA1 in a hospital-based population of Dutch breast cancer patients

    NARCIS (Netherlands)

    Papelard, H; de Bock, GH; van Eijk, R; Vlieland, TPMV; Cornelisse, CJ; Devilee, P; Tollenaar, RAEM

    2000-01-01

    The prevalence of disease-related BRCA1 mutations was investigated in 642 Dutch breast cancer patients not selected for family history or age at diagnosis. They were tested for germline mutations in the BRCA1 gene using an assay which detects small deletions and insertions (DSDI), as well as the two

  10. Frequency of thyroid cancer in patients operated at Cantonal Hospital Zenica, Bosnia and Herzegovina, in the period 2007- 2014

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    Nermin Hrnčić

    2016-08-01

    Full Text Available Aim To determine frequency and type of thyroid cancer (TC as well as gender and age distribution of patients operated at the Department of Ear, Nose and Throat (ENT, Cantonal Hospital Zenica, Bosnia and Herzegovina. Methods A retrospective analysis of data obtained from an operating protocol and disease history of patients operated in the eightyear period (2007- 2014 was made according to the frequency and type of thyroid cancer, as well as age and gender of the patients. χ2 test was used for statistical with p˂0.05. Results A total of 818 surgeries of the thyroid gland were conducted, in 714 (87.29% female and 104 (12.71% male patients. Malignancies were diagnosed in 74 (9.05% patients, of whom 64 (86.49% were females and 10 (13.51% were males, resulting in the gender prevalence of 8.96% and 9.62%, respectively. The most often presented type was papillary carcinoma, in 48 (out of 74, 64.86% patients, followed by follicular carcinoma in 10 (13.51%, medullary carcinoma in four (5.41%, Hurthle cell carcinoma in four (5.41% patients, while anaplastic carcinoma was found in one (1.35% patient. The number of diagnosed malignancy varied from 0% (in 2007 to 13.91% (in 2014 (p=0.05. Conclusion The prevalence of thyroid cancer is low, but has an increasing trend. A large number of unnecessary surgeries on thyroid gland was performed. Preoperative diagnostic procedures for diseases of the thyroid gland in Cantonal Hospital Zenica should be improved in order to avoid unessential surgeries.

  11. Prevalence of psychiatric morbidity among cancer patientshospital-based, cross-sectional survey

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    Mohan Roy Gopalan

    2016-01-01

    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  12. Leptomeningeal metastases presenting exclusively with ocular disturbance in 34 patients: A tertiary care cancer hospital experience.

    Science.gov (United States)

    Mayer, Rory Richard; Frankfort, Benjamin Jay; Strickland, Ben A; Debnam, James Matthew; McCutcheon, Ian E; Groves, Morris D; Weinberg, Jeffrey S

    2017-02-16

    Leptomeningeal disease (LMD) represents disseminated intracranial metastatic disease that requires early detection and initiation of therapy. Patients with LMD typically present with a variety of neurologic problems, including ocular disturbances. However, little is reported on LMD presenting exclusively with ocular-related disturbances in the absence of any other central nervous system (CNS) dysfunction. Our goal was to describe the workup for ocular disturbances in the setting of known cancer diagnosis. Retrospective case study utilizing prospectively collected database at a tertiary cancer care center for all patients with diagnosis of LMD between 2001 and 2009. Main outcome was descriptive analysis of ocular findings by primary or admitting service with or without formal ophthalmology exam in workup for LMD. 34 patients demonstrated ocular disturbances without any other CNS manifestations. Our findings demonstrate that 71% of ocular disturbances were detected by the primary admitting services. Formal consultation with ophthalmology resulted in the detection of the remaining cases. The most common findings were cranial nerve deficits, papilledema, and optic disc or retinal infiltration by tumor. These findings supported a further work-up for CNS disease. Therefore, it is appropriate to refer cancer patients with visual complaints or findings on exam to ophthalmology to evaluate for evidence suggestive of LMD that may support a further work-up.

  13. Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general ward - a questionnaire study

    DEFF Research Database (Denmark)

    Sølver, Lisbeth; Østergaard, Birte; Rydahl Hansen, Susan;

    2012-01-01

    SOELVER L., OESTERGAARD B., RYDAHL-HANSEN S. & WAGNER L. (2012) European Journal of Cancer Care21, 667-676 Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards - a questionnaire study Most cancer patients receiving life......-prolonging or palliative treatment are offered non-specialist palliative services. There is a lack of knowledge about their problem profile. The aim of this article is to describe the incidence of patient-reported physical and emotional problems on admission and discharge from general hospital wards and health staff......-reported problems and reported intervention for physical function, pain, constipation and loss of appetite. Palliative cancer patients' self-reported problem profile on admission and discharge from hospital has not previously been described and the results indicate a need to focus on improvements to palliative...

  14. Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

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    Saikat Majumdar

    2014-01-01

    Full Text Available Background: Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. Materials and Methods: From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F and (P Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS and amount of fentanyl were measured for postoperative pain assessment (24 h. Results and Statistical analysis: The mean VAS score in 1 st , 2 nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU and hospital stay which was also statistically significant. Conclusion: The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

  15. Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study

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    Cleghorn Geoffrey

    2010-05-01

    Full Text Available Abstract Background Length of hospital stay (LOS is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006. Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G scale measuring quality of life (QOL were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results Patients' mean age was 58 years (SD 14 years. Preoperatively, 81 (52% patients presented with suspected benign disease/pelvic mass, 23 (15% with suspected advanced ovarian cancer, 36 (23% patients with suspected endometrial and 17 (11% with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C, low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients.

  16. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital – National

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  17. The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer.

    Science.gov (United States)

    Hartung, Tim J; Friedrich, Michael; Johansen, Christoffer; Wittchen, Hans-Ulrich; Faller, Herman; Koch, Uwe; Brähler, Elmar; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Mehnert, Anja

    2017-06-27

    Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer. This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard. The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%). In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.

  18. An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy

    Institute of Scientific and Technical Information of China (English)

    Ming-Hua Cong; Shu-Luan Li; Guo-Wei Cheng; Jin-Ying Liu; Chen-Xin Song; Ying-Bing Deng; Wei-Hu Shang

    2015-01-01

    Background: The prevalence of malnutrition is very high in patients with cancer.The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT).Methods: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group.The nutritional statuses of 25 patients in the NST group were managed by the NST.The other 25 patients in the control group underwent the supervision of radiotherapy practitioners.At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated.Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups.Results: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, andALB parameters (P =0.001, 0.000, and 0.000, respectively).The complication incidences, including bone marrow suppression (20% vs.48%, P =0.037) and complications related infections (12% vs.44%, P=0.012), in the NST group were lower and significantly different from the control group.In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs.76%, P =0.103).Furthermore, the average LOS was decreased by 4.5 days (P =0.001) and in-patient cost was reduced to 1.26 4 0.75 thousand US dollars person-times (P ≥ 0.05) in the NST group.Conclusions: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF.Moreover, the NST could be helpful on reducing LOS and in-patient costs.

  19. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial.

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    Sietske J Tamminga

    Full Text Available OBJECTIVE: One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. METHODS: Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65 or control group (n = 68. The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial, quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. RESULTS: Return-to-work rates were 86% and 83% (p = 0.6 for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14-435 versus 192 days (range 82-465 (p = 0.90 with a hazard ratio of 1.03 (95% CI 0.64-1.6. Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. CONCLUSION: The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which

  20. Utilization Evaluation of Antimicrobial Agents in Neutropenic Cancer Patients in a Teaching hospital: Urgent of Drug Utilization Evaluation Studies

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    Hadi Hamishehkar

    2015-10-01

    Full Text Available Background: More than 80% of patients with hematologic malignancies will develop fever during more than one chemotherapy cycle combined with neutropenia. We aim to evaluate empiric antibiotic strategies in Febrile Neutropenic (FN cancer patients.Methods: This is a concurrent study performed in the “Shahid Ghazi” teaching hospital, hematology-oncology center of Tabriz, Iran during the period of December 2011 to September2012. During this period, patients with FN were evaluated in view of antibiotics utilization based on Infectious Disease Society of America (IDSA and National Comprehensive Cancer Network (NCCN instructions.Results: Seventy patients had a total of 91 episodes of FN in the duration of this study. Among them 63 (90% patients were the cases of acute leukemia. For 88 (96.7 % patients, imipenem was used as the initial empirical antibiotic regimen. It was changed to piperacillin/tazobactam in 8 (8.8% of them without indication. Cultures didn’t obtain before the initiation of empirical therapy in 19 (20.9% episodes. Empiric vancomycin didn’t discontinue after 3 days even if it was not warranted in 23 episodes. In 16 cases vancomycin was switched to teicoplanin. The fluconazole dosages generally given to patients were all suboptimal. Adjusting the dosages of vancomycin or imipenem was not done correctly in 13 (14.29% episodes.Conclusion: The results of this study showed that choosing antimicrobial agents and their dosing for prophylaxis and treatment of FN patients and discharge antimicrobial planning of FN patients do not follow the evaluated guidelines. Drug Usage Evaluation studies need to be done regularly in such a center.

  1. A study on risk factors of breast cancer among patients attending the tertiary care hospital, in Udupi district

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    Ramchandra Kamath

    2013-01-01

    Full Text Available Background: Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. An increasing trend in incidence is reported from various registries of national cancer registry project and now India is a country with largest estimated number of breast cancer deaths worldwide. Aim: To study the factors associated with breast cancer. Objectives: To study the association between breast cancer and selected exposure variables and to identify risk factors for breast cancer. Materials and Methods: A hospital based Case control study was conducted at Shirdi Sai Baba Cancer Hospital and Research Center, Manipal, Udupi District. Results: Total 188 participants were included in the study, 94 cases and 94 controls. All the study participants were between 25 to 69 years of age group. The cases and controls were matched by ± 2 years age range. Non vegetarian diet was one of the important risk factors (OR 2.80, CI 1.15-6.81. More than 7 to 12 years of education (OR 4.84 CI 1.51-15.46 had 4.84 times risk of breast cancer as compared with illiterate women. Conclusion: The study suggests that non vegetarian diet is the important risk factor for Breast Cancer and the risk of Breast Cancer is more in educated women as compared with the illiterate women. Limitation: This is a Hospital based study so generalisability of the findings could be limited.

  2. Patterns of care in geriatric cancer patients – An audit from a rural based hospital cancer registry in Kerala

    Directory of Open Access Journals (Sweden)

    V M Patil

    2015-01-01

    Full Text Available Background: There is deficit of data from India on elderly patients with cancer. Comprehensive geriatric assessment may lead to a better decision making capacity in this population. However, routine implementation of such assessment is resource consuming. Aim: The aim of this study was to determine the patterns of care in elderly patients treated at a tertiary rural cancer center in India. Materials And Methods: All patients with age 70 or above with solid tumors without any definitive treatment prior to the registration at our center and registered between 01/01/2010 and 31/12/2011 were selected for this study. The baseline demographic pattern and the pattern of care of treatment were analyzed. SPSS version 16 (IBM Inc, Armonk, New York, U.S. was used for analysis. Descriptive data are provided. Results: A total of 761 patients were evaluable subject to the aforementioned inclusion criteria. The median age of this cohort was 75 years (70-95 years. The most frequent primary sites of malignancies in 451 males were head neck (32.4%, lung (23.3% and gastrointestinal (23.3%. In 310 females, the most common sites were head neck (31.6%, gynecological (18.4% and gastrointestinal (24.5%. 228 (30% of the patients had localized disease, 376 (49.4% had loco-regionally advanced disease and 145 (19.1% had distant metastases at presentation. 334 (46.32% of patients were treated with curative intent. On logistic regression analysis the factors that predicted use of curative intent treatment were age <75 years, performance status 0-1, primary site and clinical extent of disease. Conclusion: Routine comprehensive geriatric assessment needs to be implemented in our setting as almost 50% of our geriatric patients undergo curative intent treatment.

  3. [A randomized controlled trial of preoperative oral immunonutrition in patients undergoing surgery for colorectal cancer: hospital stay and health care costs].

    Science.gov (United States)

    Manzanares Campillo, María Del Carmen; Martín Fernández, Jesús; Amo Salas, Mariano; Casanova Rituerto, Daniel

    2016-12-09

    The use of enteral formulas with immunonutrients in patients with gastrointestinal malignancies susceptible to surgery can reduce postoperative morbidity, at the expense of reduced infectious complications, with the consequent reduction in hospital stay and health care costs. Prospective randomized study. 84 patients operated on a scheduled basis for resectable colorectal cancer were recruited. In the group YES IN Impact © Oral was administered for 8 days (3 sachets a day), compared with the NOT IN group who did not receive it. 40.5% (17) patients without immunonutrition suffered infectious complications vs. 33.3% (14) of YES IN. In patients with rectal cancer NOT IN, 50% (8) suffered minor infectious complications (p=.028). In each group (YES IN, NOT IN, colon and rectal cancer) when infectious complications were observed, the variables total hospital stay and costs doubled, with significant differences. These variables showed higher values in the group NOT IN compared with those who received immunonutrition, although these differences were not statistically significant. NOT IN patients suffered infectious complications more frequently than YES IN, with significant results in the subgroup of patients with rectal cancer. The total hospital stay and costs were slightly higher in the group not supplemented, doubling in each category significantly (YES IN, NOT IN, colon and rectal cancer), when infectious complications were observed. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  4. Survey of patient dosimetry for head and neck cancer patients undergoing external radiotherapy treatment: A study from northeastern hospitals of India

    Directory of Open Access Journals (Sweden)

    Sharma Arunkumar

    2009-01-01

    Full Text Available Aim : To study dosimetry of patients during the external radiotherapy of head and neck cancers from different hospitals of the northeastern region (NER of India. Materials and Methods : 35 confirmed cases of head and neck cancers reporting to three different hospitals in the NER of India who underwent radiation treatment were the materials for the study. Dosimetry was carried out at 8(eight anatomical points to these patients, namely, target (entrance and exit points, forehead, chest, abdomen, gonad, arm, and leg respectively by thermoluminescence (TL as well as optically stimulated luminescence (OSL dosimeters. Unlike conventional appliances, we used common iodized salt as TL/OSL phosphor. Results : Patient dosimetry was found to vary with an average of 1.17 ± 0.39 Sv at forehead, 1.24 ± 0.39 Sv at chest, 0.52 ± 0.13 Sv at gonad to a minimum of 0.26 ± 0.07 Sv at leg areas when exposed to a cumulative dose of 65 Sv at the target. Conclusion : Maximum dose received from a stray radiation is about 1.5 Sv at forehead/chest and dosimetry of patient among the three centers is not significantly different at the 5% level of probability.

  5. Discharge of breast cancer patients to primary care at the end of hospital follow-up : A cross-sectional survey

    NARCIS (Netherlands)

    Roorda, Carriene; Berendsen, Annette J.; Haverkamp, Manon; van der Meer, Klaas; de Bock, Geertruida H.

    2013-01-01

    Aim: The present study explored (a) the discharge of breast cancer patients to primary care by specialists, at the end of hospital follow-up and (b) the experiences and views of general practitioners (GPs) regarding transfer of follow-up to the primary care setting. Methods: A cross-sectional survey

  6. Attitude of Patients in a General Hospital to Cervical Cancer Screening

    African Journals Online (AJOL)

    ... programme, as a result of infrastructural, financial and personnel constraints. However, there are newer cost effective, yet reliable screening methods adaptable ... activities were the main sources of information on cervical cancer screening.

  7. Hospitalization Cost Analysis of Patients with Lung Cancer in a Cancer Hospital from 2011 to 2013%某肿瘤专科医院2011~2013年肺癌患者住院费用分析

    Institute of Scientific and Technical Information of China (English)

    缪艳瑶; 胡欣

    2015-01-01

    目的对某肿瘤专科医院2011~2013年肺癌患者住院费用结构和变化趋势进行分析,为控制该疾病的住院费用提供科学依据,从而减轻患者负担。方法收集浙江省肿瘤医院2011~2013年住院肺癌患者的病案资料,对住院费用基本情况、构成情况、人均费用、日均费用进行描述性统计分析。结果共收集2011~2013年肺癌患者资料32201例,人均住院费用2012年同比增长7.05%,2013年同比增长7.82%,日均住院费用2012年同比增长8.49%,2013年同比增长8.64%,2013年全部肺癌患者住院总费用构成中,西药费所占比例最高(55.80%),自付金额占58.90%。手术患者人均费用为41421.85元,其中手术用材料费和西药费分别占32.72%和24.65%,自付金额占69.93%。化疗患者住院费用中,西药费占73.70%,自付金额占53.99%。结论肺癌患者经济负担呈现增长趋势,西药费是重要因素。应加强药品管理力度,合理用药;进一步深化医疗改革,降低恶性肿瘤费用的自费比例,减轻患者经济负担。%Objective To analyze the status and trend of hospitalization cost caused by lung cancer in a cancer hospital from 2011 to 2013,and to provide evidence for control ing hospitalization cost, thus reduce the economic burden. Methods The data of Hospitalization cost was col ected from the medical history of Zhejiang Cancer Hospital, to conduct a descriptive statistical analysis of the basic situation of hospitalization cost, the proportions, the per capita cost and the average daily cost. Results A total of 32201 cases were col ected. The results of statistical analysis showed that,per capita hospitalization cost in 2012 increased by 7.05%and 7.82%in 2013.Daily hospitalization cost in 2012 increased by 8.49%and 8.64%in 2013.Cost of medicine accounted for the biggest proportion of 55.80% in al patients of 2013.Self payment part accounted for 58.90%. The per capita expenses of surgical patients was 41421.85 Yuan, of which

  8. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  9. Days spent in acute care hospitals at the end of life of cancer patients in four Swiss cantons: a retrospective database study (SAKK 89/09).

    Science.gov (United States)

    Matter-Walstra, K W; Achermann, R; Rapold, R; Klingbiel, D; Bordoni, A; Dehler, S; Konzelmann, I; Mousavi, M; Clough-Gorr, K M; Szucs, T; Schwenkglenks, M; Pestalozzi, B C

    2016-02-09

    Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.

  10. Breastfeeding and breast cancer: a case-control study in patients at Arzobispo Loayza National Hospital. Lima - Peru

    OpenAIRE

    Rojas Camayo, José; Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos (UNMSM). Lima, Perú

    2013-01-01

    Introduction: Breast cancer is a global public health problem with incidence increasing in the world. Breastfeeding has been shown to be a protective factor, but evaluation in Latin American populations has scant. Objective: To evaluate the effect of breastfeeding on breast cancer developing risk in a Peruvian population. Design: A case-control study. Setting: Departments of Medical Oncology and Radiology, section of Mammography, at Arzobispo Loayza National Hospital, Lima - Peru. Participant...

  11. Acceptance of genetic counseling and testing in a hospital-based series of patients with gynecological cancer

    NARCIS (Netherlands)

    Dekker, N.; Dorst, E.B. van; Luijt, R.B. van der; Gijn, M.E. van; Tuil, M. van; Offerhaus, J.A.; Ausems, M.G.E.M.

    2013-01-01

    Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseli

  12. Current Status of Malignant Neuropathic Pain in Chinese Patients with Cancer: Report of a Hospital-based Investigation of Prevalence, Etiology, Assessment, and Treatment.

    Science.gov (United States)

    Lu, Fan; Song, Li; Xie, Tian; Tian, Jie; Fan, Yuchao; Liu, Hui

    2017-01-01

    This study investigated the prevalence, etiology, assessment, treatment of pain in patients with cancer as well as their quality of life (QOL). Patients at the West China Hospital Cancer Center were invited to complete a questionnaire under the guidance of pain specialists. The questionnaire included general information, cancer pain status, its assessment, use of analgesics, and the effects of pain on QOL. In total, 1,050 patients were enrolled in the study. Of these, valid data were collected from 919 patients, among whom 454 (49.4%) suffered from pain, including 333 (36.2%) patients who had neuropathic pain symptoms. On average, the visual analog scale (VAS) score of patients with cancer pain was 3.30 ± 1.68. Significant differences in the VAS score and pain frequency between patients with nociceptive and neuropathic pain were observed (both P pain ranked first (64, 52.9%) among the patients with nociceptive pain, whereas pins and needles pain (97, 64.7%) was the most common type of pain in patients with neuropathic pain. There was a significant difference in QOL between the nociceptive and neuropathic pain groups (P pain used analgesics. Compared with the patients with pain not using any analgesics, those receiving analgesics had a significantly lower average pain relief rate (P = 0.027). Adjuvant analgesics were inadequately used (9.3%) in patients with neuropathic cancer pain. This study revealed the prevalence of neuropathic cancer pain in Chinese patients with cancer. Malignant neuropathic pain significantly impaired the patients' QOL. Insufficient assessment and inadequate analgesia still exist. These require more awareness and attention from both doctors and patients. © 2016 World Institute of Pain.

  13. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospitals.

    Science.gov (United States)

    Pan, Hongming; Cai, Sanjun; Ji, Jiafu; Jiang, Zhiwei; Liang, Houjie; Lin, Feng; Liu, Xiyong

    2013-01-01

    To better understand the impact of undernutrition, nutritional risk, and nutritional treatment on the clinical outcomes of hospitalized cancer patients in China, the authors conducted a multicenter, cross-sectional study with 2248 cancer patients from 20 hospitals from January to June 2010. The authors defined 19.7% and 26.8% patients as undernourished at baseline and reassessment, respectively. Patients with gastrointestinal malignancies had a higher rate of undernutrition than other patients. The nutritional risk rate was 24.6% and 40.2% at baseline and reassessment, respectively. For patients with nutritional risk, the relative risk (RR) of adverse events (AEs) significantly increased with and without nutritional treatment. In comparison with the nonnutritional treatment subgroup, patients who received enteral nutrition (EN) or total parenteral nutrition (TPN) significantly reduced the RR of AE development. The RR of AEs for EN and TPN were 0.08 (95% CI: 0.01-0.62) and 0.56 (95% CI: 0.33-0.96), respectively. Separated nutrient infusion increased the risk of AEs. The authors concluded that undernutrition and nutritional risk are general problems that impact the outcomes of hospitalized cancer patients in China. Higher NRS2002 scores are related to AE risk but not weight loss. In nutritional treatment, EN and TPN can significantly reduce the risk of AEs.

  14. [The third report from Sapporo Tsukisamu Hospital--chemotherapy for patients with advanced gastric cancer (peritoneal dissemination, peritonitis carcinomatosa)].

    Science.gov (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Yamaguchi, Kouji; Shirasaka, Tetsuhiko

    2007-09-01

    Recently, it became possible to reduce the size of tumors in patients with advanced or relapsed gastric cancer by chemotherapy with the combination of several kinds of anti-cancer drugs which are all effective and allowed for use with gastric cancer patients. However, chemotherapy alone can not cure patients with advanced gastric cancer that was shown to improve median survival time (MST), compared with patients provided with the best supportive care (BSC). According to reports from Europe, US and Japan,the MST of patients with advanced gastric cancer and those with peritoneal expansion treated by chemotherapy is almost 7-12 months and 5-6 months,respectively, both of which are short and unsatisfactory. From March 2002, we started to treat patients with advanced gastric cancer (stage IV) with a new regimen; intermittent dosage of 5-FU (-->S-1), CDDP and paclitaxel utilizing the difference of cell cycle between normal and cancer cells (intermittent FP . weekly PTX). In the present study, therefore, we analyzed advanced gastric cancer patients with peritoneal expansion (9 cases, 4 with cancerous peritonitis) treated with this regimen. The results were as follows. The one-and 2-year survival rate was 55.6% and 27.8%, respectively, and the MST was 14 months. Four patients (44.4%) had hematological toxicities over grade 3. All of them had anemia (3 cases) and neutropenia (3 cases). Toxicities of thrombocytopenia were all under grade 1 and nonhematological toxicities were all under grade 2, which were clinically manageable. These results, although the sample was small, suggested that this may contribute to the extension of survival time of patients with stage IV advanced gastric cancer with peritoneal expansion.

  15. Mucormycosis in patients without cancer: a case series from A tertiary care hospital in South India.

    Science.gov (United States)

    Ghafur, A; Shareek, P S; Senthur, Nambi P; Vidyalakshmi, P R; Ramasubramanian, V; Parameswaran, Ashok; Thirunarayan, M A; Gopalakrishnan, R

    2013-05-01

    Mucormycosis (Zygomycosis) is a life-threatening infection. We attempted to analyse clinical features and risk factors of Mucormycosis cases in a tertiary care referral institution in India, in patients without underlying malignancy. We retrospectively analyzed data of patients diagnosed as having Mucormycosis over a 10 year period of 2000-2010. Patients with a histopathology report and/or a Microbiology report of Zygomycetes or Mucor from a biopsy specimen were included in the study. Out of the 27 cases, rhino-orbital/rhino-cerebral involvement occurred in 12 (44.4%) patients, pulmonary involvement in 3 (11.1%) cases, soft tissue involvement in 11 (40.7%) cases and gastrointestinal involvement in one patient (3.7%). Diabetes mellitus is the main risk factor, followed by renal failure and trauma. Mean ESR value of these patients was 118 mm/1 hour. Mean WBC count was 20 x 10(9)/L, and neutrophil count 82%. The mean absolute neutrophil count (ANC) was 16.8 x 10(9)/L. The interesting finding in our study was the presence of neutrophilic leucocytosis and high ESR in most of the patients. In a predisposed individual, especially in a diabetic, in countries with high environmental fungal burden; presence of high ESR and neutrophilic leucocytosis with a compatible clinical presentation should raise suspicion of Mucormycosis.

  16. Patient survey (HCAHPS) - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  17. Skeletal-related events among breast and prostate cancer patients: towards new treatment initiation in Malaysia's hospital setting.

    Science.gov (United States)

    Ezat, Sharifa Wan Puteh; Syed Junid, Syed Mohamed Aljunid; Noraziani, Khamis; Zafar, Ahmed; Saperi, Sulong; Nur, Amrizal Muhammad; Aizuddin, Azimatun Noor; Ismail, Fuad; Abdullah, Norlia; Zainuddin, Zulkifli Md; Mohd Kassim, Abdul Yazid; Haflah, Nor Hazla Mohamed

    2013-01-01

    The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

  18. Breast Cancer Profile in a Group of Patients Followed up at the Radiation Therapy Unit of the Yaounde General Hospital, Cameroon

    Directory of Open Access Journals (Sweden)

    J. D. Kemfang Ngowa

    2011-01-01

    Full Text Available Objective. To describe the profile of breast cancer in the patients attending the radiation therapy unit of Yaounde General Hospital. Method. From 1989 to 2009, we conducted a descriptive retrospective study based on the register and medical records of patients. Results. During the study period, 531 breast cancer patients were recorded of which 0.75% were male. Age range was 18 to 82 years, with a mean of 45.17 years. Out of these, 66.1% were less than 50 years old and 31.9% less than 40. Self detection was the discovery method in most cases (95.34% of patients. Mean delay before presentation at hospital was 10.35 months, and 54.94% had used traditional medicine before medical evaluation. Metastasis and locally advanced breast cancer at diagnosis were present in 08.13% and 62.78%, respectively. Mastectomy was used in 88.08% of patients. Conclusion. The study reinforces the position occupied by late presentation and advanced stage at diagnosis of breast cancer profile in developing countries.

  19. Behavior and awareness of thyroid cancer patients in Korea having non-hospitalized low-dose radioiodine treatment with regard to radiation safety

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seog Gyun; Paeng, Jin Chul; Eo, Jae Seon; Shim, Hye Kyung; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2010-12-15

    With the recent increase in incidence of thyroid cancer, non-hospitalized low-dose (NH-LD) radioiodine treatment (RIT) has also increased rapidly. The radioactivity limit that is allowed to be administered without hospitalization depends on individual calculation, based partly on patients' behavior. In this study, Korean patients' behavior in relation to radiation safety in NHLD RIT was surveyed. A total of 218 patients who underwent NH-LD RIT of 1.1 GBq {sup 131}I in a single center were surveyed. The patients underwent RIT with a standard protocol and the survey was performed by interview when they visited subsequently for a whole-body scan. The survey questionnaire included three parts of questions: general information, behavior relating to isolation during RIT, and awareness of radiation safety. After administration of radioiodine, 40% of patients who returned home used mass transportation, and another 47% went home by taxi or in car driven by another person. Isolation at home was generally sufficient. However, 7% of patients did not stay in a separate room. Among the 218 patients, 34% did not go home and chose self-isolation away from home, mostly due to concerns about radiation safety of family members. However, the places were mostly public places, including hotels, resorts, and hospitals. About half of the patients replied that access to radiation safety information was not easy and their awareness of radiation safety was not satisfactory. As a result, 45% of patients wanted hospitalized RIT. In many countries, including Korea, RIT is continuously increasing. Considering the radiation safety of patients' family members or the public and the convenience of patients, the pretreatment education of patients should be enhanced. In addition, the hospitalization of patients having low-dose therapy is recommended to be seriously considered and expanded, with the expansion of dedicated treatment facilities

  20. Medical hospitalizations in prostate cancer survivors.

    Science.gov (United States)

    Gnanaraj, Jerome; Balakrishnan, Shobana; Umar, Zarish; Antonarakis, Emmanuel S; Pavlovich, Christian P; Wright, Scott M; Khaliq, Waseem

    2016-07-01

    The objectives of the study were to explore the context and reasons for medical hospitalizations among prostate cancer survivors and to study their relationship with obesity and the type of prostate cancer treatment. A retrospective review of medical records was performed at an academic institution for male patients aged 40 years and older who were diagnosed and/or treated for prostate cancer 2 years prior to the study's observation period from January 2008 to December 2010. Unpaired t test, ANOVA, and Chi-square tests were used to compare patients' characteristics, admission types, and medical comorbidities by body mass index (BMI) and prostate cancer treatment. Mean age for the study population was 76 years (SD = 9.2). Two hundred and forty-five prostate cancer survivors were stratified into two groups: non-obese (BMI obese (BMI ≥ 30 kg/m(2)). The study population's characteristics analyzed by BMI were similar including Gleason score, presence of metastatic disease and genitourinary-related side effects. Only 13 % of admissions were for complaints related to their genitourinary system. Neither the specific treatment that the patients had received for their prostate cancer, nor obesity was associated with the reasons for their medical admission. Survivorship after having a diagnosis of prostate cancer is often lengthy, and these men are at risk of being hospitalized, as they get older. From this inquiry, it has become clear that neither body mass index nor prior therapy is associated with specific admission characteristics, and only a minority of such admissions was directly related to prostate cancer or the genitourinary tract.

  1. Nutritional status of patients with gastrointestinal cancer receiving care in a public hospital; 2010-2011.

    Science.gov (United States)

    Dias do Prado, Corina; Alvares Duarte Bonini Campos, Juliana

    2013-01-01

    Objetivo: Identificar el estado nutricional de los pacientes con cáncer gastrointestinal y verificar su asociación con características demográficas y clínicas. Métodos: Se realizó un estudio transversal, con un diseño de muestreo no probabilístico. Los participantes fueron 143 pacientes adultos con cáncer gastrointestinal, que reciben atención en el Hospital Amaral Carvalho (Jaú-SP, Brasil) entre noviembre de 2010 y octubre de 2011. Se realizó una encuesta para recoger información con el fin de caracterización demográfica y clínica. Para identificar el estado nutricional se aplico la Valoración Subjetiva Global - Generada por el Paciente Score (VSGGP score). La razón de prevalencia (RP) fue estimada. El nivel de significancia adoptado fue de 5%. Resultados: La edad media de los pacientes fue de 57,45 (DE = 9,62) AÑOs, con los estadíos III y IV de la enfermedad es la más frecuente (39,2% y 35,0%). Había 44,8% de prevalencia de la malnutrición. La persona desnutrida tenía problemas más frecuentes para comer. La estadística descriptiva y la prueba de Chi-cuadrado (< 0,001), presentaron menor deseo de comer (p < 0,001), más náuseas (p = 0,001), vómitos (p = 0,006), estreñimiento (p < 0,001) y dolor (p < 0,001) que los pacientes eutróficos y se declararon enfermos por el olor de los alimentos (p = 0,012), dificultad para tragar (p = 0,002) y la saciedad precoz (p = 0,020) com más frecuencia. En cuanto a la proporción de prevalencia, se observó una probabilidad mayor de individuos desnutridos expuestos a una porción más grande de los síntomas relacionados en la puntuación VSG-GP score. Conclusión: La alta prevalencia de desnutrición se observó en pacientes con cáncer gastrointestinal, con asociación significativa con los síntomas clínicos directamente relacionados con el proceso de alimentación.

  2. Transferred and delayed care of patients with colorectal cancer in a safety-net hospital system--manifestations of a distressed healthcare system.

    Science.gov (United States)

    Shah, Jessica P; Valdes, Marisa; Rockey, Don C

    2012-09-01

    Safety-net hospital systems provide care to a large proportion of United States' under- and uninsured population. We have witnessed delayed colorectal cancer (CRC) care in this population and sought to identify demographic and systemic differences in these patients compared to those in an insured health-care system. DESIGN, PATIENTS, AND APPROACH/MEASUREMENTS: We collected demographic, socioeconomic, and clinical data from 2005-2007 on all patients with CRC seen at Parkland Health and Hospital System (PHHS), a safety-net health system and at Presbyterian Hospital Dallas System (Presbyterian), a community health system, and compared characteristics among the two health-care systems. Variables associated with advanced stage were identified with multivariate logistic regression analysis and odds ratios were calculated. Three hundred and eighteen patients at PHHS and 397 patients at Presbyterian with CRC were identified. An overwhelming majority (75 %) of patients seen at the safety-net were diagnosed after being seen in the emergency department or at an outside facility. These patients had a higher percentage of stage 4 disease compared to the community. Patients within the safety-net with Medicare/private insurance had lower rates of advanced disease than uninsured patients (25 % vs. 68 %, p system were transferred from outside systems after diagnosis, thus leading to delayed care. This delay in care drove advanced stage at diagnosis. The data point to a pervasive and systematic issue in patients with CRC and have fundamental health policy implications for population-based CRC screening.

  3. Prospective observational study to evaluate the pattern of adverse drug events in cancer patients receiving anti-cancer agents in a tertiary care hospital

    OpenAIRE

    Pooja B. Joshi; Neha G. Kadhe

    2016-01-01

    Background: Adverse drug reactions (ADRs) associated with the use of anticancer drugs are a worldwide problem and cannot be overlooked. They range from nausea, vomiting or any other mild reaction to severe myelosuppression. The study was planned to evaluate the pattern of adverse drug events to anti-cancer agents in a tertiary care hospital. Methods: This observational prospective study was carried out in a tertiary care hospital from 1st January 2011 to 31st December 2011. A total of 213 ...

  4. Supraclavicular Lymph Node Excision Biopsy in Patients with Suspected Supraclavicular Lymph Node Metastasis of Lung Cancer: Experience in a Tertiary Hospital

    Science.gov (United States)

    Lee, Dong Hoon; Yoon, Tae Mi; Lim, Sang Chul

    2017-01-01

    The aim of this study was to evaluate the usefulness and accuracy of supraclavicular lymph node excision biopsy in the diagnosis of suspected supraclavicular lymph node metastasis of lung cancer. A retrospective review was performed to evaluate patients with suspected supraclavicular lymph node metastasis of lung cancer who underwent supraclavicular lymph node excision biopsy from January 2011 to July 2014. Forty-six patients with suspected supraclavicular lymph node metastasis of lung cancer underwent supraclavicular lymph node excision biopsy, which diagnosed benign diseases in 6 patients and malignant diseases in 40 patients. Supraclavicular lymph node excision biopsy was usually performed on patients during their first clinical visit under local anesthesia. For diagnosing suspected lung cancer, supraclavicular lymph node excision biopsy had a diagnostic sensitivity of 100%, specificity of 97.6%, positive-predictive value of 83.3%, negative-predictive value of 100%, and accuracy of 97.8%. No major complication resulted from surgical intervention. Supraclavicular lymph node excision biopsy is a useful and accurate adjunct for the evaluation of suspected supraclavicular lymph node metastasis of lung cancer in a tertiary hospital. PMID:28184341

  5. Effects of Honey on Oral Mucositis among Pediatric Cancer Patients Undergoing Chemo/Radiotherapy Treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia

    Science.gov (United States)

    Al Jaouni, Soad K.; Al Muhayawi, Mohammad S.; Hussein, Abear; Elfiki, Iman; Al-Raddadi, Rajaa; Al Muhayawi, Saad M.; Almasaudi, Saad

    2017-01-01

    One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis. A significant reduction of oral mucositis, associated Candida, and aerobic pathogenic bacterial infections was noted in patients in the honey treatment group. Also, there is a significant decrease in the duration of hospitalization for all those in the treatment group combined with a significant increase of body weight, delayed onset, and decreased severity of pain related to oral mucositis. Complications of oral mucositis can be tremendously reduced by the topical application of local Saudi honey and honey should be used as an integrative approach in prophylaxis and treatment of chemo/radiotherapy-induced oral mucositis in pediatric cancer patients. Further research is needed to elucidate and better understand the underlying mechanism.

  6. The effectiveness of the Liverpool care pathway in improving end of life care for dying cancer patients in hospital. A cluster randomised trial

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    Pellegrini Fabio

    2011-01-01

    Full Text Available Abstract Background Most cancer patients still die in hospital, mainly in medical wards. Many studies in different countries have shown the poor quality of end-of-life care delivery in hospitals. The Program "Liverpool Care Pathway for the dying patient" (LCP, developed in the UK to transfer the hospice model of care into hospitals and other care settings, is a complex intervention to improve the quality of end-of-life care. The results from qualitative and quantitative studies suggest that the LCP Program can improve significantly the quality of end-of-life care delivery in hospitals, but no randomised trial has been conducted till now. Methods and design This is a randomized cluster trial, stratified by regions and matched for assessment period. Pairs of eligible medical wards from different hospitals will be randomized to receive the LCP-I Program or no intervention until the end of the trial. The LCP-I Program will be implemented by a Palliative Care Unit. The assessment of the end-points will be performed for all cancer deaths occurred in the six months after the end of the LCP-I implementation in the experimental wards and, in the same period of time, in the matched control wards. The primary end-point is the overall quality of end-of-life care provided on the ward to dying cancer patients and their families, assessed using the Global Scale of the Italian version of the Toolkit "After-death Bereaved Family Member Interview". Discussion This study can be interpreted as a Phase III trial according to the Medical Research Council Framework. In this study, the effectiveness of a fully defined intervention is assessed by comparing the distribution of the endpoints in the experimental and in the control arm. Research ID RFPS-2006-6-341619 Trial registration ClinicalTrials.gov Identifier: NCT01081899

  7. Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians

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    Jennifer L. McQuade

    2012-01-01

    Full Text Available Background. In China, the use of traditional Chinese medicine (TCM is very popular, but little is known about how it is integrated with conventional cancer care. We conducted parallel surveys of patients and physicians on TCM utilization. Methods. Two hundred forty-five patients and 72 allopathic physicians at the Fudan University Shanghai Cancer Center completed questions on their use of and attitude towards TCM. Results. Patient mean age was 51, with 60% female. Eighty-three percent of patients had used TCM. Use was greatest for Chinese herbal medicine (CHM; 55.8%. Only 1.3% of patients used acupuncture and 6.8% Qi Gong or Tai Qi. Sixty-three percent of patients notified their oncologist about TCM use. The most common reason for use was to improve immune function. CHM was often used with a goal of treating cancer (66.4%, a use that 57% of physicians agreed with. Physicians were most concerned with interference with treatment, lack of evidence, and safety. Ninety percent of physicians have prescribed herbs and 87.5% have used TCM themselves. Conclusion. The use of TCM by Chinese cancer patients is exceptionally high, and physicians are generally well informed and supportive of patients’ use. Botanical agents are much more commonly used than acupuncture or movement-based therapies.

  8. AETIOLOGY AND CLINICAL PROFILE OF ORAL CANCERS IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN RURAL KERALA

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    Thulaseedharan Sreedharan

    2016-11-01

    Full Text Available BACKGROUND Oral cancer is the sixth most common cancer in the world. Oral cancer represents 14% of all cancer cases in Kerala. The aim of this study is to find out the aetiological factors, symptomatology, morphologic types and the distribution in the sub-sites of oral cavity. MATERIALS AND METHODS A cross-sectional study was conducted in the Department of ENT, Government Medical College, Thrissur, Kerala from May 2009 to October 2013; 136 patients (88 males and 48 females with histopathologically confirmed oral cancers were studied. Variables such as age, sex, residing area, occupation, educational level, socio-economic status, substance abuse, oral hygiene, family history and premalignant conditions were assessed. The presenting complaints, the site, morphology and histopathology of the lesions were noted. RESULTS Mean age in this study was 57.83 with male-to-female ratio of 1.83:1. Majority of cases were from socially and economically weaker section, 62% patients were smokers, 45% patients were alcoholic, 41% patients were pan chewers and 90% had more than one bad habit; 72.05% patients had poor orodental hygiene. Most common symptom in our patients was growth in the mouth. Tongue and buccal mucosa were the most affected sites. Majority presented with ulcerative type and most of the cases were squamous cell carcinoma. CONCLUSION Oral cancers are mainly seen in males of 55 – 64 years’ age group. Important aetiological factors identified in this study are substance abuse, poor oral hygiene and poor socio-economic status. Tobacco consumption is the most dominant risk factor. Most common symptom in our patients is growth in the mouth. Tongue and buccal mucosa are the most affected sites. Most of the cases were squamous cell carcinoma. The study of aetiology and common clinical presentations may help in prevention, early detection and management.

  9. A randomized controlled trial to determine the effects of music and relaxation interventions on perceived anxiety in hospitalized patients receiving orthopaedic or cancer treatment.

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    Eckhouse, Diane R; Hurd, Mary; Cotter-Schaufele, Susan; Sulo, Suela; Sokolowski, Malgorzata; Barbour, Laurel

    2014-01-01

    Nonpharmacological interventions, including combinations of music, education, coping skills, and relaxation techniques, have been found to have a positive effect on patients' perceived anxiety in many settings. However, few research studies have assessed and compared the effectiveness of music and relaxation interventions in reducing the anxiety levels of orthopaedic and oncology patients. We conducted a prospective, randomized, controlled study to examine the effectiveness of music and relaxation interventions on perceived anxiety during initial hospitalization for patients receiving orthopaedic or cancer care treatment at a Midwestern teaching hospital. This was a pre-test/post-test study design utilizing the State-Trait Anxiety Inventory. One hundred twelve patients were randomized into 3 study groups. Thirty-eight subjects (34%) were randomized in the music-focused relaxation group, 35 subjects (31%) in the music and video group, and 39 (35%) subjects in the control group. Fifty-seven (51%) were orthopaedic patients and 55 (49%) were oncology patients. Comparison of the 3 study groups showed no statistically significant differences with regard to patients' demographics. Although reduced anxiety levels were reported for all 3 groups postintervention, the differences were not statistically significant (p > .05). Also, there was no significant difference found between the perceived anxiety levels of patients admitted to the orthopaedic and oncology care units (p > .05). Finally, the results of the intragroup comparisons (regardless of the group assignment) showed a significant decrease in anxiety levels reported by all patients postintervention (p Music and relaxation interventions could be an additional tool in assisting patients to become less anxious during their hospital stay. Music focused relaxation and music and video are both valuable and cost-effective strategies that can assist the orthopaedic and oncology patient population. Identifying opportunities to

  10. Microsatellite instability analysis using BAT-26 marker in patients with gastric or colorectal cancer diagnosed at Hospital Universitario de Santander.

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    Wilmer Cárdenas

    2009-11-01

    Full Text Available Introduction: The path of microsatellite instability has mainly been found in cancers of digestive tracts, of which 90% of cases are hereditary cancer patients and 15% are patients with sporadic cancer. That instability produces a phenotype called Microsatellite instability (IMI+ or phenotype by replication mistake (RER+ that leads to the accumulation of mutations in higher rates to normal. Objectives: To identify the presence of IMI+ phenotype in patients analyzed and evaluated its relationship with the differentiation histopathologic tumor, because which together have been associated with a better prognosis and improved response to treatment given to the patient. Methodology: DNA was extracted from blood samples (normal cells and biopsy of the tumor (tumor cells of the 23 patients who were included in the study and through the amplification by PCR and subsequent capillary electrophoresis was typified the microsatellite mononucleotidic BAT-26, who was employed by his sensitivity to detect IMI+ phenotype (95%. Finally, we made a statistical correlation between the microsatellite instability phenotype, the presence (IMI+ or the absence (IMI-, with histopathological findings using Fisher’s exact test. Results: In 17% of cases (4 patients had IMI+: 3 of them with colorectal cancer (CRC -2 cases possibly with hereditary cancer- and one with gastric cancer (GC. There was no association between phenotype IMI+ with the pathological diagnosis, age, sex and differentiation histopathologic tumor. Conclusion: We found the phenotype IMI + in 17% of cases without association with the degree of differentiation histopathologic tumor, possibly by the reduced number of samples analyzed, making it essential to review the methods of fixation, paraffin and storage tissue because current techniques hinder digestion of proteinase k and PCR.

  11. Changes in the distribution of lung cancer cell types and patient demography in a developing multiracial Asian country: experience of a university teaching hospital.

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    Liam, Chong-Kin; Pang, Yong-Kek; Leow, Chai-Hooi; Poosparajah, Shyamala; Menon, Ashoka

    2006-07-01

    A comparison of patients with lung cancer diagnosed at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia from October 1991 to September 1999 with another group of lung cancer patients diagnosed at the same hospital during an earlier period of 1967-1976 was undertaken to determine whether there had been a change in the distribution of lung cancer cell types and patient demography. The number of histologically and/or cytologically proven lung cancer cases was 583 from October 1991 to September 1999 and 278 from 1967 to 1976. The mean (S.D.) age of the patients during the period 1991-1999, 60.1 (12.0) years was similar to that of patients during the period 1967-1976, 60.3 (12.2) years. There was no shift of the peak age distribution of lung cancer (i.e., the 7th decade) between the two periods. In the recent period, the percentage of patients with adenocarcinoma had increased significantly to 43.2% from 25.2% while that of large cell carcinoma had decreased to 3.3% from 11.9%. The percentages of patients with squamous cell carcinoma (SCC) and small cell lung cancer remained stable. In the period 1967-1976, SCC was the commonest cell type in men and in smokers while adenocarcinoma was the commonest cell type in women and in never smokers. In the period 1991-1999, adenocarcinoma was the commonest cell type in both men and women as well as in smokers and never smokers.

  12. [The fourth report from Sapporo Tsukisamu Hospital - chemotherapy and its regimen as second choice for patients with early gastric cancer].

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    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Yamaguchi, Kouji; Shirasaka, Tetsuhiko

    2007-10-01

    Surgical treatments for early gastric cancer, such as endoscopic procedures, are currently performed as standard therapy. However, when surgery is not possible due to physical or mental conditions, effective chemotherapy with minimum side effects is a second choice, although a suitable regimen has yet to be recommended. We thus retrospectively evaluated the Int FP regimen for 10 early gastric cancer patients. The results show an efficacy ratio of 100% (CR 8 cases, PR 2 cases). The two PR cases subsequently underwent surgical treatment. The 1-, 3-, and 5-year survival rates of all cases were 100%, 90% and 60%, respectively. The 1-, 3-, and 5-year survival rates of patients with chemotherapy alone were 100%, 87.5% and 50%, respectively, although none of the patients died of cancer (5-year survival rate of 100%). One out of the 8 CR cases relapsed 7 months after achieving CR. This patient then received chemotherapy with the same regimen, achieving a second CR and survived for 66 months without disease. All cases developed hematological toxicities, although they were all under grade 2 except for 2 cases which were grade 3 (decrease of WBC or Hb). Non-hematological toxicities were seen in 7 cases, all under grade 2. These results, although from a limited number of subjects, indicated that the IntFP regimen is safe and may contribute to achieving pathological CR and long-term survival of patients with early gastric cancer.

  13. [The first report from Sapporo Tsukisamu Hospital--chemotherapy and chemoradiotherapy for patients with advanced pancreatic cancer].

    Science.gov (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Koito, Kazumitsu; Shirasaka, Tetsuhiko

    2007-07-01

    The remedy, especially chemotherapy, for advanced pancreatic cancer is hardly ever successful in terms of efficacy rate and survival period, because it is virtually unable to contribute to the improvement of median survival time (MST). Thus,we devised a new intermittent dosage regimen utilizing the cell cycle difference of normal GI tract, bone marrow cell and pancreatic cancer cell, making use of 5-FU (-->S-1), CDDP and paclitaxel in March 2002. Ten patients with advanced pancreatic cancer (4 in Stage IVa and 6 in Stage IVb) were treated with this new regimen. As a result, an efficacy ratio of 50.0% and a 1-year survival ratio of 60.0% were achieved. However, 2-year survival ratio of 12.0% was low, and there was no 3-year survivor. The MST was 19 months as of December 31, 2006. All of the non-hematological toxicities were under grade 2. Eight patients had hematological toxicities over grade 3 and most of them were anemia and neutropenia. Only 2 cases had thrombocytopenia. Although adverse effects related to this regimen were clinically manageable, it was difficult to improve MST of patients with advanced pancreatic cancer with chemotherapy alone including this regimen. Hence, we devised another regimen with the joint use of radiotherapy along with the same chemotherapy regimen in January 2003. Twenty patients with advanced pancreatic cancer (Stage IV) were treated with this regimen. It is presently under way, and an efficacy ratio of 35.0%, 1-year survival ratio of 86.3% and 2-year survival ratio of 64.0% were obtained by May 2005, showing that this may contribute to the extension of survival time of Stage IV pancreatic cancer patients.

  14. Disease specific productivity of american cancer hospitals.

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    Jeffery A Goldstein

    Full Text Available Research-oriented cancer hospitals in the United States treat and study patients with a range of diseases. Measures of disease specific research productivity, and comparison to overall productivity, are currently lacking.Different institutions are specialized in research of particular diseases.To report disease specific productivity of American cancer hospitals, and propose a summary measure.We conducted a retrospective observational survey of the 50 highest ranked cancer hospitals in the 2013 US News and World Report rankings. We performed an automated search of PubMed and Clinicaltrials.gov for published reports and registrations of clinical trials (respectively addressing specific cancers between 2008 and 2013. We calculated the summed impact factor for the publications. We generated a summary measure of productivity based on the number of Phase II clinical trials registered and the impact factor of Phase II clinical trials published for each institution and disease pair. We generated rankings based on this summary measure.We identified 6076 registered trials and 6516 published trials with a combined impact factor of 44280.4, involving 32 different diseases over the 50 institutions. Using a summary measure based on registered and published clinical trails, we ranked institutions in specific diseases. As expected, different institutions were highly ranked in disease-specific productivity for different diseases. 43 institutions appeared in the top 10 ranks for at least 1 disease (vs 10 in the overall list, while 6 different institutions were ranked number 1 in at least 1 disease (vs 1 in the overall list.Research productivity varies considerably among the sample. Overall cancer productivity conceals great variation between diseases. Disease specific rankings identify sites of high academic productivity, which may be of interest to physicians, patients and researchers.

  15. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

  16. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

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    Marcela Mercado

    2012-12-01

    Full Text Available The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five percent of the patients had a positive perception of using medicinal plants and 57% used them simultaneously with the oncologist recommended allopathic treatment. We concluded that the frequency of CAM use in breast cancer patients at the Javeriana Oncology Center is within the prevalence range reported worldwide, despite differences in CAM types and frequencies. The high rates of plant-based CAM use without physician consent, brings about the lack of assessment of the synergic or antagonistic effects of CAM therapies on the allopathic treatment of breast cancer and evaluation of the antitumor and immunomodulatory potential of the traditionally used plants.

  17. Mutation analysis of BRCA1, BRCA2, PALB2 and BRD7 in a hospital-based series of German patients with triple-negative breast cancer.

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    Franziska Pern

    Full Text Available Triple-negative breast cancer (TNBC is an aggressive form of breast carcinoma with a poor prognosis. Recent evidence suggests that some patients with TNBC harbour germ-line mutations in DNA repair genes which may render their tumours susceptible to novel therapies such as treatment with PARP inhibitors. In the present study, we have investigated a hospital-based series of 40 German patients with TNBC for the presence of germ-line mutations in BRCA1, BRCA2, PALB2, and BRD7 genes. Microfluidic array PCR and next-generation sequencing was used for BRCA1 and BRCA2 analysis while conventional high-resolution melting and Sanger sequencing was applied to study the coding regions of PALB2 and BRD7, respectively. Truncating mutations in BRCA1 were found in six patients, and truncating mutations in BRCA2 and PALB2 were detected in one patient each, whereas no truncating mutation was identified in BRD7. One patient was a double heterozygote for the PALB2 mutation, c.758insT, and a BRCA1 mutation, c.927delA. Our results confirm in a hospital-based setting that a substantial proportion of German TNBC patients (17.5% harbour germ-line mutations in genes involved in homology-directed DNA repair, with a preponderance of BRCA1 mutations. Triple-negative breast cancer should be considered as an additional criterion for future genetic counselling and diagnostic sequencing.

  18. Results of a nurse-led intervention: connecting pediatric cancer patients from the hospital to the school using videoconferencing technologies.

    Science.gov (United States)

    Ellis, Sarah J; Drew, Donna; Wakefield, Claire E; Saikal, Samra L; Punch, Deborah; Cohn, Richard J

    2013-01-01

    The objectives of this study were to assess the feasibility and perceived academic/psychosocial outcomes of a pilot program using videoconferencing facilities to connect children with cancer to their home school. Eight parents, three patients, and five teachers (n = 16) participated in semistructured interviews evaluating the efficacy/feasibility of this program. Results were analyzed using the qualitative framework of Miles and Huberman. Parents reported that videoconferencing provided the family with a sense of normalcy and connection to the outside world (4/8), often boosting patients' mood (6/8). Further benefits included stronger relationships with classmates and teachers (15/16) and improved peer acceptance and school reintegration. There were no notable impacts on patients' academic progression. Reported barriers included: costs, time commitments, bureaucratic hurdles, and technical and logistical difficulties. Videoconferencing technologies provide an important tool to connect childhood cancer patients to their classrooms; however, further solution-based investigation is warranted to overcome existing barriers.

  19. Cancer Patients Use Hospital-Based Care Until Death : A Further Analysis of the Dutch Bone Metastasis Study

    NARCIS (Netherlands)

    Meeuse, Jan J.; van der Linden, Yvette M.; Post, Wendy J.; Wanders, Rinus; Gans, Rijk O. B.; Leer, Jan Willem H.; Reyners, Anna K. L.

    2011-01-01

    Purpose: To describe health care utilization (HCU) at the end of life in cancer patients. These data are relevant to plan palliative care services, and to develop training programs for involved health care professionals. Methods: The Dutch Bone Metastasis Study (DBMS) was a nationwide study proving

  20. Cancer patients use hospital-based care until death: a further analysis of the dutch bone metastasis study

    NARCIS (Netherlands)

    Meeuse, J.J.; Linden, Y.M. van der; Post, W.J.; Wanders, R.; Gans, R.O.; Leer, J.W.H.; Reyners, A.K.

    2011-01-01

    Abstract Purpose: To describe health care utilization (HCU) at the end of life in cancer patients. These data are relevant to plan palliative care services, and to develop training programs for involved health care professionals. Methods: The Dutch Bone Metastasis Study (DBMS) was a nationwide study

  1. Venous thromboembolism in cancer patients

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    Mehmet Fuat Eren

    2013-09-01

    Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

  2. The Socio-Demographic and Clinical Factors Associated with Quality of Life among Patients with Haematological Cancer in a Large Government Hospital in Malaysia.

    Science.gov (United States)

    Priscilla, Das; Hamidin, Awang; Azhar, Md Zain; Noorjan, Kon; Salmiah, Md Said; Bahariah, Khalid

    2011-07-01

    The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P

  3. Screening for Depression In Hospitalized Pediatric Patients

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    Mohammad-Reza ESMAEELI

    2013-12-01

    Full Text Available Abstract How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1:47-51. Objective In chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhood malignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad. Materials & Methods After receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, aged between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded. Three groups of children (children with chronic renal disease, malignancy, and acute disease were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI. Two specifically trained nurses with the supervision of a psychiatrist filled out the questionnaires at patients’ bedside. Depression scores were then analyzed by SPSS software. Results Of 90 children, 43(47.7% were male and 47(52.2% were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days. Depression was detected in various degrees in 63% of patients (N=57, and 36.6% of children (N=32 had no symptoms of depression. Severe depression was not seen in any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had

  4. Dermatoglyphics and Cheiloscopic Patterns in Cancer Patients; A Study in Ahmadu Bello University Teaching Hospital (ABUTH, Zaria, Nigeria

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    Uduak Umana

    2013-09-01

    Full Text Available The aim of this study was to determine the association between digital dermatoglyphics of the hands and lip prints with cancer. Dermatoglyphics has proved to be a very important tool used for identification of many gene-linked abnormalities or diseases. Same can also be said of Lip prints which as dermatoglyphics are unique to individuals and has been shown to be a useful genetic markers in some congenital and clinical diseases. It has been used widely as a marker for the inheritance of cleft lip deformity. The study was conducted using 100 confirmed cancer patients. The digital dermatoglyphic patterns were studied using method of Cummins while the lip prints were identified and classified according to method of Suzuki and Tsuchihashi (1970. A control group of healthy subjects numbering 126 without familial history of diagnosed cancer were selected at random. Associations between the variables were tested using the Chi-square test for independence. The result indicated statistically significant association between finger print pattern and lip prints of the female and cervical cancer. The cervical cancer group presented with 74.9% of loop pattern on the right compared to the 64.0% in the normal, while the left hands had 68.5% in the case compared to the 61.2% (p<0.001. While the lip prints in the cancer cases were found to have high percentage of the branched type; 62.4%, compared to the 56.5% in the normal. In conclusion, dermatoglyphics and cheiloscopy can be used as a maker in the detection of females at risk of developing cervical cancer.

  5. Clinical evaluation of BIOXTRA in relieving signs and symptoms of dry mouth after head and neck radiotherapy of cancer patients at Seyed-al-Shohada Hospital, Isfahan, Iran

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    Abbas Gookizadeh

    2012-01-01

    Full Text Available Background: Radiotherapy of head and neck cancers causes acute and chronic xerostomia and acute mucositis. Xerostomia increases risk of radiation caries and affects on oral comfort, fit of prostheses, speech, swallowing, and the growth of caries-producing organisms. Salivary flow rate can be measured by asking patients some questions. There are different types of commercial synthetic saliva such as BIOXTRA, but until now, no one can effectively relieve xerostomia. We tried to design a clinical research on BIOXTRA efficacy for treating xerostomia. Materials and Methods: In this research, 58 patients with head and neck cancer (except salivary gland cancers treated in Seyed-al-Shohada Hospital. The patients received at least 40-50 GY; and after 2 months of compilation treatment, they were evaluated by asking about having xerostomia. Before and after treatment with the BIOXTRA, the PH of the oral cavity, candida albicans, and lactobacillus counts measured and documented in laboratory. We used BIOXTRA for 2 weeks, 3 times daily, and then re-evaluated patients with some questions. Results: The counts of candida albicans and lactobacilli statistically significant decreased. Conclusion: Xerostomia for most patients improved clinically during the day and night while PH of the oral cavity increased.

  6. Cancer Patients Versus Cancer Survivors

    Science.gov (United States)

    Mosher, Catherine E.; Danoff-Burg, Sharon

    2013-01-01

    Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer. PMID:24371366

  7. Impact of hospice care on end-of-life hospitalization of elderly patients with lung cancer in Taiwan

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    Shih-Chao Kang

    2012-05-01

    Conclusion: Hospice care has provided a humane and cost-efficient pathway for end-of-life elderly patients with lung cancer. Parenteral nutrition/hydration should be limited for terminal care patients. Opioids should be promoted for the relief of pain and dyspnea in acute ward care. Family physicians and radiation oncologists play important roles in hospice care. Compared with the prevalence of hospice care in the United Kingdom and other developed countries, hospice care in Taiwan is in the position to be expanded.

  8. Palonosetron versus other 5-HT(3) receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with cancer on chemotherapy in a hospital outpatient setting.

    Science.gov (United States)

    Balu, Sanjeev; Buchner, Deborah; Craver, Chris; Gayle, Julie

    2011-04-01

    Despite favorable evidence from clinical trials for single-dose palonosetron versus other commercially available 5-HT(3)-receptor antagonists for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), clinical comparative data are scarce from hospital outpatient settings, where these antiemetic agents are used in patients diagnosed with cancer who are receiving chemotherapy (CTH). The purpose of our retrospective study was to assess the hospital claims to evaluate the rate of uncontrolled CINV with antiemetic prophylaxis using palonosetron versus other 5-HT(3)-receptor antagonists in patients diagnosed with cancer who are receiving CTH (highly emetogenic CTH, moderately emetogenic CTH, low-emetogenic CTH, or minimally emetogenic CTH) treatment in a hospital outpatient setting. Patients aged ≥18 years who had cancer and were being treated with CTH and antiemetic prophylaxis with palonosetron (Group 1) and other 5-HT(3) receptor antagonists (Group 2) for the first time between April 1, 2007, and March 31, 2009, were identified using a hospital-service database. Within each CTH cycle, CINV events were identified through International Classification of Diseases (ICD)-9 codes for nausea, vomiting, and/or volume depletion (from Day 1 of each CTH administration until the end of the CTH cycle) or for use of rescue medications (Day 2 until the end of the CTH cycle). A multivariate regression model was developed to predict uncontrolled CINV event rates per CTH cycle between Groups 1 and 2 matched on CTH emetogenicity distribution in the study follow-up period (first of 8 cycles or 6 months). A subgroup analysis of patients on CTH with the highest risk of nausea and vomiting (highly emetogenic CTH or moderately emetogenic CTH) was also conducted. Of 9144 identified patients, 1775 were prescribed palonosetron (Group 1). Group 1 patients were statistically younger (61.2 vs 62.8 years; P < 0.001), composed of more females (57.1% vs 51.9%; P < 0.001) and more

  9. Speciation and antifungal susceptibility of esophageal candidiasis in cancer patients in a tertiary care hospital in South India

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    J. Abirami Lakshmy

    2016-01-01

    Full Text Available Esophageal candidiasis is the most common opportunistic infection in patients with altered immunity such as Human Immunodeficiency Virus (HIV infection, cancer patients on chemotherapy and radiotherapy. Neutropenia, irradiation and chemotherapy will facilitate deeper mucosal invasion leading to esophageal candidiasis. Empirical treatment of esophageal candidiasis without antifungal susceptibility testing will lead to the emergence of drug resistant species increasing the morbidity and mortality associated with cancer. The present study aimed to study the frequency of esophageal candida in individuals with cancer, species level identification and antifungal susceptibility pattern. Scrapings of whitish appearing lesions were obtained from a total of thirty five cases of endoscopically identified esophageal candidiasis were obtained from cancer patients. Identification of the Candida isolates were done by cultivation in Sabouraud dextrose agar (SDA, Gram staining, germ tube test, colony morphology in Chrom agar and corn meal agar, sugar assimilation and fermentation tests. Antifungal susceptibility was done by Microbroth dilution method for Fluconazole, Itraconazole and Amphotericin B. We found that Candida albicans was the predominant species isolated followed by Candida tropicalis and Candida glabrata. Sensitivity rates were 94%, 96% and 100% for Fluconazole, Itraconazole and Amphotericin B. Species level identification of Candida isolated from esophageal candidiasis and their antifungal sensitivity testing should be performed for early identification of resistant strains and for promptly treating the cases there by preventing the dissemination of infection in case of immune-compromised individuals. Further the susceptibility pattern will facilitate therapeutic guidance especially in individuals prone to relapse. [J Med Allied Sci 2016; 6(1: 29-34

  10. Clinical analysis of nosocomial infections in hospitalized patients with lung cancer%肺癌住院患者医院感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    涂英华; 练祖平; 白广德

    2015-01-01

    目的:探讨肺癌住院患者感染病原菌分布、动态变化以及感染相关因素,为临床制定感染预防措施提供参考。方法对2009年1月-2014年1月入院的357例肺癌患者感染资料进行回顾性分析,收集患者的痰液、咽拭子、尿液、胸腔积液、粪便、局部病灶分泌物等标本进行病原菌的分离、培养及鉴定,采用 SPSS统计软件进行数据处理。结果357例肺癌患者发生感染71例,感染率为19.9%,小细胞肺癌较非小细胞肺癌更容易发生感染;感染发生部位以呼吸道和肺部为主,占43.7%;共检出病原菌168株,其中革兰阳性菌51株占30.3%,以金黄色葡萄球菌为主,革兰阴性菌92株占54.8%,以大肠埃希菌为主,真菌25株占14.9%,主要为白色假丝酵母菌;5年内真菌感染呈上升趋势,革兰阳性菌感染呈下降趋势;患者的年龄、住院时间、肺癌 TNM分期、侵入性操作、白细胞计数、预防用药等是肺癌住院患者医院感染的相关危险因素(P<0.05)。结论肺癌患者是医院易感人群,且真菌感染呈逐年上升趋势,应引起医务人员的重视;患者的年龄、住院时间、肺癌 TNM分期、侵入性操作、白细胞计数、预防用药等是肺癌住院患者医院感染的相关危险因素,应针对上述危险因素采取有效的干预措施,减少医院感染的发生。%OBJECTIVE To explore the dynamic change of distribution of pathogens causing infections in hospital-ized patients with lung cancer and analyze the related factors for the infections so as to provide guidance for clinical prevention of infections.METHODS The clinical data of 357 lung cancer patients with infections who were hospital-ized from Jan 2009 to Jan 2014 were retrospectively analyzed;the sputum,throat swab,urine,pleural effusion, stools,and local lesions secretions specimens were collected for the isolation

  11. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    basic tool for emplotting the encounters between patients with the message that we are in an awaiting position and obliged to stay here for a while is a specific set of behaviours that patients perform. The emplotment of waiting is communicated as a frame within which minor plots appear. These plots...

  12. The effectiveness of the quality program Pac-IficO to improve pain management in hospitalized cancer patients: a before-after cluster phase II trial.

    Science.gov (United States)

    Ripamonti, Carla Ida; Prandi, Cesarina; Costantini, Massimo; Perfetti, Elisa; Pellegrini, Fabio; Visentin, Marco; Garrino, Lorenza; De Luca, Anna; Pessi, Maria Adelaide; Peruselli, Carlo

    2014-03-29

    Cancer-related pain continues to be a major healthcare issue worldwide. Despite the availability of effective analgesic drugs, published guidelines and educational programs for Health Care Professionals (HCPs) the symptom is still under-diagnosed and its treatment is not appropriate in many patients. The objective of the study is to evaluate the efficacy of the Pac-IFicO programme in improving the quality of pain management in hospitalised cancer patients. This is a before-after cluster phase II study. After the before assessment, the experimental intervention - the Pac-IFicO programme - will be implemented in ten medicine, oncology and respiratory disease hospital wards. The same assessment will be repeated after the completion of the intervention. The Pac-IFicO programme is a complex intervention with multiple components. It includes focus group with ward professionals for identifying possible local obstacles to optimal pain control, informative material for the patients, an educational program performed through guides from the wards, and an organisational intervention to the ward. The primary end-point of the study is the proportion of cancer patients with severe pain. Secondary end-points include opioids administered in the wards, knowledge in pain management, and quality of pain management. We plan to recruit about 500 cancer patients. This sample size should be sufficient, after appropriate statistical adjustments for clustering, to detect an absolute decrease in the primary end-point from 20% to 9%. This trial is aimed at exploring with an experimental approach the efficacy of a new quality improvement educational intervention. ClinicalTrials.gov: NCT02035098.

  13. Hospitalized Older Adults’ Patient Satisfaction

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    Neale R. Chumbler

    2016-04-01

    Full Text Available This article examines the extent to which older adult patients’ perceptions of inpatient dimensions of care experiences are associated with their overall satisfaction. A secondary objective is to determine if these specific care experiences differed between elderly female and male patients. Patient satisfaction data from 6,021 older patients (65 years of age and older were collected by using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS Survey through telephone interviews of older patients who were recently discharged. Multiple linear regression analyses with older patients’ HCAHPS dimensions (Communication With Nurses, Communication With Doctors, Responsiveness of Hospital Staff, Communication About Medicines, Cleanliness of the Hospital Environment, and Quietness of Hospital Environment and gender were conducted while controlling for self-rated health status, age, race, and education. Multiple linear regression analysis showed that all of the HCAHPS dimensions were significantly associated with overall satisfaction. Older female patients reported substantially more positive global evaluations than their male counterparts. However, for older male patients, Communication With Doctors was more influential in their ratings of overall satisfaction than for older female patients. For older female patients, Communication With Nurses was more influential in their ratings of overall satisfaction than for older male patients.

  14. Use of general practice, diagnostic investigations and hospital services before and after cancer diagnosis - a population-based nationwide registry study of 127,000 incident adult cancer patients

    DEFF Research Database (Denmark)

    Christensen, Karina Garnier; Fenger-Grøn, Morten; Flarup, Kaare Rud;

    2012-01-01

    ,272,100 controls. Monthly consultation frequencies, monthly proportions of persons receiving health services and three-month incidence rate ratios for one year before and one year after the cancer diagnosis were calculated. Data were analysed separately for women and men. RESULTS: Three months before...... one month after diagnosis and the number of hospital contacts three months after diagnosis. The proportion of cancer patients receiving each of these three types of health services remained more than 10% above that of the reference population from two months before diagnosis until the end of the study...

  15. Role of serum sodium in assessing hospital mortality in cancer patients with spontaneous tumour lysis syndrome inducing acute uric acid nephropathy.

    Science.gov (United States)

    Hsu, H-H; Chen, Y-C; Tian, Y-C; Chan, Y-L; Kuo, M-C; Tang, C-C; Fang, J-T; Lee, S-Y; Yang, C-W

    2009-05-01

    Spontaneous tumour lysis syndrome (STLS) inducing acute uric acid nephropathy, a rare and neglected disease, presents more insidiously than conventional post-treatment tumour lysis syndrome. Although STLS is a serious and potentially fatal complication in patients with neoplastic disorders, few investigations have addressed the relevance of clinical and laboratory features in assessing prognosis. A retrospective study was conducted, reviewing the records of all patients who developed acute renal failure (ARF) at Chang Gung memorial hospital between 1 July 1999 and 30 June 2003. STLS-induced acute uric acid nephropathy was identified in 12 of 1072 ARF patients (1.1%) during the study period. All patients had advanced stage tumours with large tumour burden, and 66.7% of cases had abdominal organ involvement. All 12 hyperuricemic patients became oliguric despite conservative therapy, and remained hyperuricemic (21.6 +/- 5.2 mg/dl) before dialysis therapy. Diuresis developed in eight patients (66.7%), with associated resolution of hyperuricemia, azotemia and metabolic derangements following dialysis initiation. Overall hospital mortality was 58.3%. Death in most patients was related to hyponatremia and hypoalbuminemia on admission. The serum sodium was found to have the best Youden index (0.86) and highest overall prediction accuracy (93%). Moreover, serum sodium and serum albumin for individual patients were significantly and positively correlated (r = 0.617, p = 0.032). This investigation confirms a grave prognosis for cancer patients with STLS inducing acute uric acid nephropathy. Hyponatremia and hypoalbuminemia on the first day of admission indicate poor prognosis in such patients.

  16. German hospital database-allocation of patients to appropriate hospitals.

    Science.gov (United States)

    Schneider, Rita; Reiners, Christoph

    2010-06-01

    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

  17. Pulmonary embolism in cancer patients

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    S P Sawant

    2012-01-01

    Full Text Available Aims and Objectives: Pulmonary embolism (PE is rare in the Indian population and is under-reported in patients with malignancy. We studied the clinical profile and outcome of patients with PE and cancer in the Indian population. Materials and Methods: Data of cancer patients with PE, admitted in a tertiary cancer centre, was analyzed. The prevalence of PE was calculated as the number of patients with PE per 10,000 hospital admissions. The demographic data, details of cancer, co-morbidities, details of PE, and treatment given for PE and their outcomes were recorded and analyzed. Results: There were 56,425 hospital admissions in the study period. The prevalence of PE was 6.4 per 10,000 hospital admissions .Thirty-six cancer patients were diagnosed to have PE. In females, gynecological malignancies (36.84% and in males gastrointestinal, head and neck cancers, and hematological malignancies were the most common sites (17.7% each. PE was associated with DVT in 41.7%. Dyspnea was the most common presenting symptom. Five patients (13.88% were asymptomatic and were incidentally detected to have PE . The most common echocardiographic finding was right ventricular dysfunction (55.55%. Mortality among the treated patients was 22% (7 / 31 and in untreated patients it was 80% (4 / 5. The factors that had an impact on a three-month survival were, the presence of massive PE (P = 0.019 and the presence of RV dysfunction at presentation (P = 0.005. Conclusion: The prevalence of PE and mortality due to PE is high in cancer patients. Risk stratification for venous thromboembolism (VTE should be done in all cancer patients and thromboprophylaxis should be optimally used.

  18. Socio-economic and cultural vulnerabilities to cervical cancer and challenges faced by patients attending care at Tikur Anbessa Hospital: a cross sectional and qualitative study.

    Science.gov (United States)

    Tadesse, Sara Kebede

    2015-09-16

    Cervical cancer is a leading cause of death among women in Ethiopia, affecting them at a time of their life when they are critical to social and economic stability. This study was mainly focused on assessing different socioeconomic and cultural related factors that make women vulnerable to cervical cancer and challenges women face in the process of diagnosis and treatment. To achieve the objective of the study both qualitative and quantitative methods were utilized.198 participants were enrolled in a cross- sectional survey and 10 in-depth interviews were conducted with patients in Tikur Anbessa Hospital. A consecutive sampling method was used to select participants in the survey while purposive sampling was employed to select participants in the qualitative design. For the population covered in the study, poverty along with other socio-cultural practices such as early marriage, high parity and to certain extent polygamy were identified as factors that increased the vulnerability of women to cervical cancer. In addition, the study has uncovered several challenges faced by cervical cancer patients in the diagnosis and treatment process. Three types of challenges that include, health care based, psychological and economic were identified. System and practitioner delay were found as the main hurdles within the variable of health care related challenges. What's more, the psychological challenges identified included, fear of recurrence, negative social attitude and distress associated with the side effects from treatments such as fecal & urinary leakage. Furthermore, inability of bearing costs related to treatment and accommodation were cited as the main economic challenges. The study showed various socio-economic and cultural vulnerabilities that expose women to cervical cancer and the challenges encountered by cervical cancer patients after their diagnosis. Addressing this issue largely lies in strengthening primary and secondary preventive mechanisms, providing

  19. Influence of socioeconomic status and BMI on the quality of life after mastectomy in Bangladeshi breast cancer patients in a public hospital.

    Science.gov (United States)

    Rahman, Md Mizanur; Ahsan, Md Abul; Monalisa, Nazratun Nayeem; Rahman, Khadiza

    2014-12-01

    Quality of life after diagnosis and during treatment phases of breast cancer varies across individual to individual, country to country and from ethnicity to ethnicity. So factors affecting it are of growing research interest. The aim of the study was to investigate the influence of socioeconomic status and body mass index on the quality of life of breast cancer patients during the phases of treatment-before and after mastectomy. Two hundred and fifty-one women with breast cancer undergoing surgery were interviewed prior to and after mastectomy in National Institute of Cancer Research and Hospital, Dhaka from January 2012 to March 2013 using European Organization for Research and Treatment of Cancer Core Questionnaire (and QLQ-Br23). Socioeconomic factors like educational status, family income, occupation and body mass index were taken as investigating factors against global health status and breast cancer-related factors. Significant reduction of the scores found that means deterioration of function in the following domains of the quality of life were found such as physical well-being (P = 0.019), emotional well-being (P = 0.035), cognitive status (P = 0.05) and the breast-specific subscales like BRBI (body image), BRBS (breast symptoms), BRAS (arm symptoms); (P = 0.013, 0.103, 0.015) was observed after surgery in lower income group. Worker group expressed also similar effect on the global health status/quality-of-life scales (P = 0.05, 0.043, 0.021) and breast subscales (P = 0.002, 0.027, 0.05), patients with lower body mass index also have a lower score also. Educational status does not affect the two groups. Younger age group patients expressed much distress. Improvement of family income, nutritional status and improvement of working environment might have an impact on the improvement of the quality of life of breast cancer patients during the phases of treatment. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions

  20. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study

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    Belachew SA

    2016-12-01

    Full Text Available Sewunet Admasu Belachew,1 Daniel Asfaw Erku,2 Abebe Basazn Mekuria,3 Begashaw Melaku Gebresillassie1 1Department of Clinical Pharmacy, 2Department of Pharmaceutical Sciences, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, Ethiopia Background: Adverse drug reactions (ADRs are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia.Methods: A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization’s causality assessment scale and Naranjo’s algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pearson’s chi-square test was employed to examine the association between two categorical variables.Results: A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%, infections (16.7%, neutropenia (14.7%, fever and/or chills (11.3%, and anemia (9.3%. Platinum compounds (31.4% were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3–4 (severe level, 29.9% were grades 1–2 (mild level, and 4.3% were grade 5 (toxic level. Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3–5 toxicity.Conclusion: The high incidence of

  1. Clinical and economic burden of chemotherapy-induced nausea and vomiting among patients with cancer in a hospital outpatient setting in the United States.

    Science.gov (United States)

    Craver, Chris; Gayle, Julie; Balu, Sanjeev; Buchner, Deborah

    2011-01-01

    This study evaluated the overall burden of illness of chemotherapy-induced nausea and vomiting (CINV) and associated all-cause costs from a hospital's perspective (costs to the hospital) in patients with cancer treated with chemotherapy (CT) in the US hospital outpatient setting. Patients with a cancer diagnosis aged ≥18 years initiating CT in a hospital outpatient setting for the first time between April 1 2007 and March 31 2009 were extracted from the Premier Perspective Database. Patients were followed through eight CT cycles or 6 months post-index date, whichever occurred first. Within each CT cycle, the follow-up time for CINV event estimation was from day 1 (except rescue medication use that was identified from day 2) to cycle end. A multivariate regression model was developed to predict the CINV event rate per CT cycle in the study follow-up period. Associated total all-cause costs of managing CINV from a hospital's perspective were analyzed descriptively. Event rate and associated costs were estimated in the entire hospital setting (outpatient, inpatient, and emergency room). All-cause costs included inpatient, hospital outpatient, and ER visit costs (identified through a primary or secondary diagnosis code for nausea, vomiting, and/or volume depletion) and pharmacy cost (rescue medications for CINV treatment). All physician costs and non CINV-related treatment (pharmacy) costs were excluded from the analyses. Among 11,495 study patients, 8,806 patients (76.6%) received prophylaxis for all cycles in the follow-up period. The overall base population had an average age of 63.3 years, was 51.0% female, and 72.7% White. The distribution of emetogenicity for cycle 1 CT cycle was 26.0% HEC, 46.1% MEC, and 26.4% LEC/MinEC combined. In the follow-up period, a total of 47,988 CINV events with an associated total all-cause treatment cost of $89 million were observed. Average daily treatment cost for all care settings was $1854.7. The regression model predicted a 20

  2. Candidiasis in pediatric patients with cancer interned in a university hospital Candidíases em pacientes pediátricos com câncer internados em um hospital universitário

    Directory of Open Access Journals (Sweden)

    Ana Maria Rabelo De Carvalho Parahym

    2009-06-01

    Full Text Available Fungi are common causes of infection in immunocompromised patients. Candida species are frequently involved in these cases. In order to investigate candidiasis in pediatric patients with cancer, clinical samples were collected from one hundred and twenty two patients interned in the Oswaldo Cruz University Hospital in Recife, Brazil. Yeasts were isolated from thirty-four clinical samples. The species isolated were: Candida albicans (fourteen isolates, C. parapsilosis (nine isolates, C. guilliermondii (two isolates and C. tropicalis (two isolates. We found that candidemia was most frequent in patients with malignant hematology and that C. parapsilosis infections caused the highest mortality.Os fungos são causas comuns de infecções em pacientes imunocomprometidos e espécies de Candida são freqüentemente envolvidas nesses casos. A fim de investigar infecção fúngica em pacientes pediátricos com câncer, amostras clínicas foram coletadas de cento e vinte dois pacientes internados no Hospital Universitário Oswaldo Cruz em Recife, Brasil. Leveduras foram isoladas de trinta e quatro amostras clínicas. As leveduras isoladas foram: Candida albicans (catorze isolados, C. parapsilosis (nove isolados, C. guilliermondii (dois isolados e C. tropicalis (dois isolados. Descobrimos que candidemia foi mais freqüente em doentes com hematologias malignas e que C. parapsilosis apresentou maior mortalidade.

  3. Superiority of Minimally Invasive Oesophagectomy in Reducing In-Hospital Mortality of Patients with Resectable Oesophageal Cancer: A Meta-Analysis.

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    Can Zhou

    Full Text Available Compared with open oesophagectomy (OE, minimally invasive oesophagectomy (MIO proves to have benefits in reducing the risk of pulmonary complications for patients with resectable oesophageal cancer. However, it is unknown whether MIO has superiority in reducing the occurrence of in-hospital mortality (IHM.The objective of this meta-analysis was to explore the effect of MIO vs. OE on the occurrence of in-hospital mortality (IHM.Sources such as Medline (through December 31, 2014, Embase (through December 31, 2014, Wiley Online Library (through December 31, 2014, and the Cochrane Library (through December 31, 2014 were searched.Data of randomized and non-randomized clinical trials related to MIO versus OE were included.Eligible studies were those that reported patients who underwent MIO procedure. The control group included patients undergoing conventional OE.Fixed or random -effects models were used to calculate summary odds ratios (ORs or relative risks (RRs for quantification of associations. Heterogeneity among studies was evaluated by using Cochran's Q and I2 statistics.A total of 48 studies involving 14,311 cases of resectable oesophageal cancer were included in the meta-analysis. Compared to patients undergoing OE, patients undergoing MIO had statistically reduced occurrence of IHM (OR=0.69, 95%CI =0.55 -0.86. Patients undergoing MIO also had significantly reduced incidence of pulmonary complications (PCs (RR=0.73, 95%CI = 0.63-0.86, pulmonary embolism (PE (OR=0.71, 95%CI= 0.51-0.99 and arrhythmia (OR=0.79, 95%CI = 0.68-0.92. Non-significant reductions were observed among the included studies in the occurrence of anastomotic leak (AL (OR=0.93, 95%CI =0.78-1.11, or Gastric Tip Necrosis (GTN (OR=0.89, 95%CI =0.54-1.49.Most of the included studies were non-randomized case-control studies, with a diversity of study designs, demographics of participants and surgical intervention.Minimally invasive oesophagectomy (MIO has superiority over open

  4. Analysis of the factors influencing lung cancer hospitalization expenses using data mining

    OpenAIRE

    Yu, Tianzhi; He, Zhen; Zhou, QingHua; Ma, Jun; Wei, Lihui

    2015-01-01

    Background Hospitalization expenses for the therapy of lung cancer are not only a direct economic burden on patients, but also the focus of medical insurance departments. Therefore, the method for classifying and analyzing lung cancer hospitalization expenses so as to predict reasonable medical cost has become an issue of common interest for both hospitals and insurance institutions. Methods A C5.0 algorithm is adopted to analyze factors influencing hospitalization expenses of 731 lung cancer...

  5. EFFICACY OF MOHS" SURGERY IN PATIENTS WITH SKIN CANCER: (AL-ZAHRA HOSPITAL; SEP. 1999 - DEC. 2000

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    A ASILIAN

    2001-03-01

    Full Text Available Introduction: Modified Mohs" Surgery (MMS has not ever been performed for management of skin cancers in Iran. The aim of this study was evaluation of the efficacy of MMS in recurrence, metastasis rate and cosmetic results. Methods: Fifty one patients with known indications for MMS were selected. They were operated under standard method of MMS, followed and evaluated for a 12 months period about recurrence, metastasis and cosmetic results. Results: 58 tumors from 51 patients were operated. 27.5 percent of patients were females and 72.5 percent were males (57.4± 13.4 year. Eight percent had more than one tumor. In 84 percent, MMS was the first treatment procedure. Anatomically lesions of scalp and face, trunk, and limbs constituted 92.5 percent, 1.9 percent, and 5.6 percent, respectively. Mean size of lesions was 16.9 mm (range: 4-70. The number of layers to clear the tumors was 1-5 (mean: 1.5. Histologically 81 percent of lesions were BCC, 9.4 percent SCC. Immediate reconstruction was performed in all patients as follows: 37 percent primary simple closure, 5.5 percent secondary healing, 50 percent skin flaps, 3.7 percent skin grafts and 3.7 percent a combination model. The percent of relative frequency of recurrence was 3.7 with no case of metastasis. Cosmetic results were excellent in 35 percent, good in 50 percent, intertmediate in 11.5 percent and poor in 3.5 percent of cases. Discussion: Despite paucity of patients" number, higher incidence of tumors in males of 50 or more, higher occurrence on scalp and face and most frequently occurring as BCC is prominently evident. One year recurrence rate of 3.7 percent is probably due to paucity of patients. Cosmetic results were mostly favorable (85 percent, and unfavorable results were due to secondary healing and large facial lesions repaired with flaps. For more valid evaluations, long term studies with greater number of patients is recommended.

  6. Investigation of the hospitalized patients with human immunodeficiency virus infection in Shanxi Cancer Hospital%山西省肿瘤医院住院患者人类免疫缺陷病毒感染的调查分析

    Institute of Scientific and Technical Information of China (English)

    石砚海; 魏让

    2015-01-01

    目的 调查山西省肿瘤医院住院患者人类免疫缺陷病毒(HIV)感染的流行病学特征.方法 在2004年1月至2014年12月山西省肿瘤医院住院患者中共检出70例HIV阳性确诊患者,其中,经组织病理学确诊的HIV感染合并恶性肿瘤患者55例,单纯HIV感染患者15例.结果 55例HIV感染合并恶性肿瘤患者年龄7~80岁,以46~ 55岁年龄组患者比例高,15例单纯HIV感染患者平均年龄为35岁(7 ~ 55岁).合并恶性肿瘤共15种,以肺癌最多,为11例(20%),其次为肝癌、胃癌和非霍奇金淋巴瘤,均为5例(9%).70例HIV感染患者中,职业以农民为主,占43%(30例),明显高于其他职业.结论 HIV感染合并恶性肿瘤患者年龄大于单纯HIV感染患者,可能与此年龄段免疫功能逐渐低下、继发机会性感染率升高或恶性肿瘤的发病率较高有关,提示随着HIV感染患者生存期的延长,恶性肿瘤发病率呈升高的趋势.%Objective To investigate the epidemiological characteristics of the hospitalized patients with human immunodeficiency virus (HIV) infection in Shanxi Cancer Hospital.Methods 70 patients with HIV positive were detected in Shanxi Cancer Hospital from January 2004 to December 2014.55 patients with HIV infection combined with malignant tumors were diagnosed by histopathology,however,15 patients were HIV infection alone.Results 55 cases of HIV infection combined with malignant tumors were 7-80 years old,and 46-55 years old was a high incidence of disease age,15 patients with simple HIV infection were 35 years old (7-55 years old).During 15 kinds of malignant tumors complicated with HIV infection,lung cancer was the most [11 cases (20 %)],followed by hepatocellular carcinoma in 5 cases (9 %),gastric cancer in 5 cases (9 %),and non-Hodgkin lymphoma in 5 cases (9 %).In 70 patients with HIV infection,farmers accounted for 43 % (30 cases),they were significantly higher than other occupations.Conclusions The age of HIV

  7. Screening for Depression In Hospitalized Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza ESMAEELI

    2014-01-01

    Full Text Available How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1:47-51. ObjectiveIn chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhoodmalignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad.Materials & MethodsAfter receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, aged between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded.Three groups of children (children with chronic renal disease, malignancy, and acute disease were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI. Two specifically trained nurses with the supervisionof a psychiatrist filled out the questionnaires at patients’ bedside. Depression scores were then analyzed by SPSS software.ResultsOf 90 children, 43(47.7% were male and 47(52.2% were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days.Depression was detected in various degrees in 63% of patients (N=57, and 36.6% of children (N=32 had no symptoms of depression. Severe depression was not seenin any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had moderate

  8. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  9. Nutrition in the hospitalized patient.

    Science.gov (United States)

    Kirkland, Lisa L; Kashiwagi, Deanne T; Brantley, Susan; Scheurer, Danielle; Varkey, Prathibha

    2013-01-01

    Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission. If screening identifies malnutrition risk, a nutrition assessment is required to create a nutrition care plan. The plan should be initiated early in the hospital course, as even patients with normal nutrition become malnourished quickly when acutely ill. While the Harris-Benedict equation is the most commonly used method to estimate calories, its accuracy may not be optimal in all patients. Calculating the caloric needs of acutely ill obese patients is particularly problematic. In general, a patient's caloric intake should be slightly less than calculated needs to avoid the metabolic risks of overfeeding. However, most patients do not receive their goal calories or receive parenteral nutrition due to erroneous practices of awaiting return of bowel sounds or holding feeding for gastric residual volumes. Patients with inadequate intake over time may develop potentially fatal refeeding syndrome. The hospitalist must be able to recognize the risk factors for malnutrition, patients at risk of refeeding syndrome, and the optimal route for nutrition support. Finally, education of patients and their caregivers about nutrition support must begin before discharge, and include coordination of care with outpatient facilities. As with all other aspects of discharge, it is the hospitalist's role to assure smooth transition of the nutrition care plan to an outpatient setting.

  10. Magnitude and Leading Sites of Cancer in A Tertiary Cancer Care Hospital of Western Maharashtra

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    Kapil H Agrawal, S.S. Rajderkar

    2011-01-01

    Full Text Available Context: It is observed that cancers are increasingly seen in both genders and all the age groups due to a complex interaction of various risk factors. To implement the Public health intervention measures it is essential to have the baseline data regarding frequency, distribution of cancers in the population. Aims: To study the magnitude of cancers by obtaining a baseline data regarding the frequency, distribution, leading cancer sites among the patients in a tertiary cancer care hospital of Western Maharashtra. Study settings: Shri Siddhivinayak Ganapati Cancer Hospital, Miraj Study Design: Hospital based, Cross sectional study involving retrospective information of patients from 1st March 2005 to 28th February 2006. Methods and Material: Retrospective, questionnaire study of patients from 1st March 2005 to 28th February 2006. Out of the total 2168 new patients registered, 1891 patients were detected to be malignant and included in the study. Results: 63.5 % Males and 67% Females in the age group 35-64 years had cancer. The sex ratio percent was 1.01%. Top five Cancer in males in our study were Oral Cavity, Oesophagus, Lung, Larynx and NHL. Top five Cancer in females in our study were Cervix, Breast, Ovary, Oral Cavity and Oesophagus. 27% were TRCs (Tobacco Related Cancers in males while 9.6% were TRCs in females. 34% cancers were in easily accessible parts of body. Conclusions: The Tobacco Related Cancers represent the most preventable form of cancer in our society. It was 27% in males and 9.6% in females in our study. Additionally 34% cancers were in easily accessible parts of body. It highlights the possibility of easy and early detection of cancers in the population thus decreasing the cancer burden in the community.

  11. [Pain therapy in in-patients with cancer. Effects of a manual-based approach as guideline for pain-consulting service at a university hospital].

    Science.gov (United States)

    Brinkers, M; Pfau, Gernot; Lux, A; Pfau, Giselher; Schneemilch, C; Meyer, F; Grond, S

    2016-03-01

    Appropriate medication is an important and substantial part in the therapy of tumor-induced pain. The objective of this study was to investigate the efficiency of anaesthesiology-based consultant service characterizing the quality of this type of treatment in daily clinical practice of a university hospital, i. e., in the patient profile of a tertiary center (study design: systematic clinical, unicenter observational study reflecting clinical practice and study-based control of therapeutic care quality). In the course of consulting function with regard to pain care on the single wards a considerable portion of cancer patients are recieving drugs. For most patients such care comprises several consultations and subsequently initiated treatment modifications. The consulting function ends if the patients feel free of pain or report a substantial improvement. From 1/1/2010 to 12/31/2012 detailed information on the drug therapy applied prior to, during and after the consultation was prospectively documented.This data was retrospectively evaluated as "pre-vs.-post" comparison (Chi-squared test, Fisher's exact test and McNemar's test), in particular, focussing on the quality of pain medication using the WHO index as well as pain intensity obtained by means of the visual analogue scale (VAS). In total, 375 in-patients were treated. The modified pain medication by the anesthesiological consultant service led to a significant increase (p < 0.001; Wilcoxon's test) in the mean WHO index from 6.37 (SD, 1.83) to 8.43 (SD, 1.47). Furthermore, a reduction of VAS from 5.00 (SD, 2.39) to 2.64 (SD, 1.64) was noted (p < 0.001; Wilcoxon's test). The consequent application of established guidelines (according to WHO scheme) and the WHO index leads to a qualitative and measurable improvement of drug therapy for cancer-related pain. © Georg Thieme Verlag KG Stuttgart · New York.

  12. [Nutritional status of patients with breast cancer attended in the Mastology Service of Belo Horizonte's Hospital das Clínicas in the state of Minas Gerais, Brazil].

    Science.gov (United States)

    de Oliveira, Dirce Ribeiro; Carvalho, Erika Simone Coelho; Campos, Liliane Cunha; Leal, José Adalberto; Sampaio, Estela Viana; Cassali, Geovanni Dantas

    2014-05-01

    The scope of this article is to evaluate the nutritional status, body composition and tumor characteristics of 31 patients with breast cancer attended at the Mastology Service of Hospital das Clínicas of the Federal University of Minas Gerais. Dietary data were obtained from the 24-hour dietary recall in the pre-operative state and analyzed by the DietWin Professional 2008 Nutrition Software. Body composition was assessed by bioelectrical impedance analysis. The tumor characterization data were collected from medical records. The mean age of patients was 50.75 ± 14.34 years. Excess body weight was found in 58% and waist circumference greater than 80 cm in 64.5% of patients Excessive consumption of oils and sugars was observed in 90.3% and 83.8%, respectively. Most had low intakes of calcium and vitamins B6, B12 and A. The predominant diagnosis was type II histological grade invasive ductal carcinoma in stage II or III. The prevalence of overweight and inadequate dietary intake demonstrate the need for individualized nutritional guidance and monitoring to improve the prognosis and quality of the life of patients.

  13. Improving Breast Cancer Screening Adherence Among Hospitalized Women.

    Science.gov (United States)

    Khaliq, Waseem; Landis, Regina; Wright, Scott M

    2017-02-03

    More than a third of hospitalized women are both overdue for breast cancer screening and at high risk for developing breast cancer. The purpose of the study was to evaluate if inpatient breast cancer screening education, scheduling an outpatient mammography appointment before hospital discharge at patients' convenience, phone call reminders, and a small monetary incentive ($10) would result in improved adherence with breast cancer screening for these patients. A prospective intervention pilot study was conducted among 30 nonadherent women aged 50-75 years hospitalized to a general medicine service. Sociodemographic, reproductive history, family history for breast cancer, and medical comorbidity data were collected for all patients. Chi-square and unpaired t-tests were utilized to compare characteristics among women who did and did not get a screening mammogram at their prearranged appointments. Of the 30 women enrolled who were nonadherent to breast cancer screening, the mean age for the study population was 57.8 years (SD = 6), mean 5-year Gail risk score was 1.68 (SD = 0.67), and 57% of women were African American. Only one-third of the enrolled women (n = 10) went to their prearranged appointments for screening mammography. Not feeling well enough after the hospitalization and not having insurance were reported as main reasons for missing the appointments. Convenience of having an appointment scheduled was reported to be a facilitator of completing the screening test. This intervention was partially successful in enhancing breast cancer screening among hospitalized women who were overdue and at high risk. Future studies may need to evaluate the feasibility of inpatient screening mammography to improve adherence and overcome the significant barriers to compliance with screening.

  14. 医院感染对肺癌患者住院费用与住院日的影响研究%Impact of nosocomial infections on hospitalization costs and length of hospital stay of lung cancer patients

    Institute of Scientific and Technical Information of China (English)

    应筱莉; 吴敏华; 叶忠伟; 陈旭烽

    2015-01-01

    目的:探讨肺癌患者医院感染病原菌种类及对患者住院费用和住院日的影响。方法回顾性分析肿瘤内科2007年1月-2013年6月收治的肺癌患者300例,其中50例发生医院感染为观察组,在其余未发生医院感染的患者中匹配选择50例为对照组,比较两组患者住院费用和住院天数。结果观察组医院感染病原菌以革兰阴性菌为主占68.0%,其次为真菌占26.0%、、革兰阳性菌占 6.0%;观察组肺癌患者住院费用为(27366.5±5132.47)元、住院时间为(26.5±3.55)d,对照组分别为(19275.25±4212.56)元、(19.5±2.75)d,两组比较差异有统计学意义(P<0.05),观察组费用高、住院时间长、呼吸系统感染多见,感染病原菌以革兰阴性菌和真菌为主。结论导致肺癌患者医院感染的病原菌以革兰阴性菌和真菌为主,发生医院感染将增加患者住院费用、延长住院时间,需临床工作高度重视。%OBJECTIVE To explore the species of pathogens causing nosocomial infections in the lung cancer pa‐tients and observe the impact on the hospitalization costs and length of hospital stay .METHODS A total of 300 lung cancer patients who were treated in the oncology department from Jan 2007 to Jun 2013 were retrospectively analyzed ,then 50 patients with nosocomial infections were assigned as the observation group ,50 matched patients without nosocomial infections were set as the control group ,and the hospitalization costs and length of hospital stay were observed and compared between the two groups .RESULTS Among the pathogens causing nosocomial in‐fections in the patients of the observation group , the gram‐negative bacteria accounted for 68 .0% , the fungi 26 .0% ,the gram‐positive bacteria 6 .0% .The mean hospitalization cost was (27 366 .5 ± 5 132 .47)yuan in the observation group ,(19 275 .25 ± 4 212 .56)yuan in the control group ;the

  15. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Lee, Kang Hyun; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    2000-12-01

    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers.

  16. Febrile neutropaenia in cancer patients.

    Science.gov (United States)

    Walwyn, M; Nicholson, A; Lee, M G; Wharfe, G; Frankson, M A

    2010-03-01

    Febrile neutropaenia is a common complication of chemotherapy in cancer patients. Empirical antibiotic regimes are based on the epidemiological characteristics of bacterial isolates globally and locally. This study retrospectively reviewed all cases of febrile neutropaenia in patients with confirmed cancer admitted at the University Hospital of the West Indies in the four-year period between, January 1, 2003 and December 31, 2006 and who received chemotherapy. Cases were identified from blood culture records and hospital charts which were reviewed to determine the aetiological agents causing bacteraemia, their antimicrobial susceptibilities and clinicalfeatures. These cases were compared with non-neutropaenic cancer patients admitted with fever. A total of 197 febrile episodes in cancer patients were reviewed. Thirty-seven per cent had febrile neutropaenia while 62% were non-neutropaenic. Acute myeloid leukaemia was the most common haematological malignancy and the most common solid tumour was breast cancer. Twenty-six per cent of patients had a positive blood culture. In febrile neutropaenic patients, Escherichia coli was the most common organism isolated followed by coagulase-negative staphylococci while in non-neutropaenic patients, coagulase-negative staphylococci was most common. Acinetobacter infections was prominent in non-neutropaenic patients but absent in neutropaenic patients. More than one organism was cultured in 9 neutropaenic and 18 non-neutropaenic patients. Mortality was 10.8% in neutropaenic and 24.4% in non-neutropaenic patients. Gram-negative organisms are the predominant isolates in febrile neutropaenic episodes in this cohort of patients. Non-neutropaenic patients had an increased mortality with an increase in Acinetobacter infections and multiple isolates.

  17. Depression Can Slow Hospital Patients' Recovery

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166427.html Depression Can Slow Hospital Patients' Recovery: Study Screening for ... 9, 2017 FRIDAY, June 9, 2017 (HealthDay News) -- Depression affects about one-third of hospital patients and ...

  18. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    Science.gov (United States)

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  19. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health †,‡

    Science.gov (United States)

    Piscitelli, Prisco; Marino, Immacolata; Falco, Andrea; Rivezzi, Matteo; Romano, Roberto; Mazzella, Restituta; Neglia, Cosimo; Della Rosa, Giulia; Pellerano, Giuseppe; Militerno, Giuseppe; Bonifacino, Adriana; Rivezzi, Gaetano; Romizi, Roberto; Miserotti, Giuseppe; Montella, Maurizio; Bianchi, Fabrizio; Marinelli, Alessandra; De Donno, Antonella; De Filippis, Giovanni; Serravezza, Giuseppe; Di Tanna, Gianluca; Black, Dennis; Gennaro, Valerio; Ascolese, Mario; Distante, Alessandro; Burgio, Ernesto; Crespi, Massimo; Colao, Annamaria

    2017-01-01

    Background: Cancer Registries (CRs) remain the gold standard for providing official epidemiological estimations. However, due to CRs’ partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT) study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS) project under the auspices of the Europe for Citizens Program, to assess population health indicators. Objective: To assess the burden of all cancers in Italian children and adults. Methods: We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated), we have excluded from our analyses all re-hospitalizations of the same patients (n = 1,878,109) over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007–2011) have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR) were computed for each Italian province by sex and age-groups (0–19 and 20–49). Results: The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0–19 years old) and adults (20–49 years old), respectively. Women accounted for the majority of cancer cases in adults aged 20–49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers (n = 392, SHR = 9.9), followed by Naples (n = 378; SHR = 9.9) and Milan (n = 212; SHR = 7.3). However, when we look at SHR, minor

  20. Identifying patient risks during hospitalization

    Directory of Open Access Journals (Sweden)

    Lucélia Ferreira Lima

    2008-12-01

    Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.

  1. Vancomycin use in hospitalized pediatric patients.

    Science.gov (United States)

    Keyserling, Harry L; Sinkowitz-Cochran, Ronda L; Harris, James M; Levine, Gail L; Siegel, Jane D; Stover, Beth H; Lau, Sharon A; Jarvis, William R

    2003-08-01

    To assess vancomycin utilization at children's hospitals, to determine risk factors for vancomycin use and length of therapy, and to facilitate adapting recommendations to optimize vancomycin prescribing practices in pediatric patients. Two surveys were conducted at Pediatric Prevention Network hospitals. The first (Survey I) evaluated vancomycin control programs. The second (Survey II) prospectively reviewed individual patient records. Each hospital was asked to complete questionnaires on 25 consecutive patients or all patients for whom vancomycin was prescribed during a 1-month period. In Survey I, 55 of 65 (85%) hospitals reported their vancomycin control policies. Three quarters had specific policies in place to restrict vancomycin use. One half had at least 3 vancomycin restriction measures. In Survey II, personnel at 22 hospitals reviewed 416 vancomycin courses, with 2 to 25 (median = 12) patients tracked per hospital. Eighty-two percent of the vancomycin prescribed was for treatment of neonatal sepsis, fever/neutropenia, fever of unknown origin, positive blood culture, pneumonia, or meningitis. In an additional 6% (26/416), vancomycin was prescribed for patients with beta-lactam allergies and in 13% (56/416) for prophylaxis. Median duration of prophylaxis was 2 days (range: 1-15 days). Almost half (196, 47%) of the patients who received vancomycin were in intensive care units; 27% of the vancomycin courses were initiated by neonatologists and 19% by hematologists/oncologists. The predominant risk factor at the time of vancomycin initiation was the presence of vascular catheters (322, 77%); other host factors included cancer chemotherapy (55, 13%), transplant (30, 7%), shock (24, 6%), other immunosuppressant therapy (17, 4%), or hyposplenic state (2, <1%). Other clinical considerations were severity of illness (96, 23%), uncertainty about diagnosis (51, 12%), patient not responding to current antibiotic therapy (40, 10%), or implant infection (13, 3%). When

  2. Perioperative nutrition in cancer patients.

    Science.gov (United States)

    Daly, J M; Redmond, H P; Gallagher, H

    1992-01-01

    Cancer patients have the highest incidence of protein-calorie malnutrition seen in hospitalized patients, with significant malnutrition occurring in more than 30% of cancer patients undergoing major upper gastrointestinal procedures. Clinically significant malnutrition occurs as a result of diminished nutrient intake, increased nutrient losses, and tumor-induced derangements in host metabolism. In the absence of adequate exogenous nutrients, the body utilizes endogenous substrates to satisfy the ongoing requirements of both host and tumor for energy and protein. In those patients with malignant obstruction of the gastrointestinal tract, the tumor itself may induce diminished nutrient intake. Present day treatment modalities including gastrointestinal resection, chemotherapy, and radiotherapy compound these metabolic derangements, further increasing the risk of postoperative morbidity and death. The presence of malnutrition in cancer patients has prognostic importance. In a review of more than 3000 cancer patients, DeWys and colleagues identified significantly improved survival in those patients without weight loss compared with those had lost 6% of their body weight (Am J Med 69:491-497, 1980). Other investigators have noted increased postoperative morbidity and mortality associated with malnutrition. Early hypotheses suggested that reversal of weight loss would improve survival. The development and refinements of enteral and parenteral nutrition have provided the opportunity for studying the relationship between nutritional supplementation and postoperative prognosis. Nutrition support is therefore often instituted to improve nutritional status and thereby reduce the risks of postoperative complications. This article addresses the beneficial role of preoperative nutrition therapy in cancer patients.

  3. Pressure Ulcers in Hospitalized Patients

    OpenAIRE

    Hoyos Porto, Saith; Pontificia Universidad Javeriana; García Arias, Ronald Leonel; Pontificia Universidad Javeriana; Chavarro-Carvajal, Diego Andrés; Pontificia Universidad Javeriana; Alberto Heredia, Rodrigo; Pontificia Universidad Javeriana

    2015-01-01

    Pressure ulcers (PU) are ischemic lesions located at the skin and underlying tissues with skin loss by prolonged pressure or friction between two hard planes. Almost 60,000 hospital patients in the United States are estimated to die each year from complications due to pressure ulcers acquired inpatient level and the estimated cost of treatment is about 11,000 billion of dollars per year. These skin lesions are a common and serious problem in the elderly, represent one of the major complicatio...

  4. Treatment of Hormone Resistance with Docetaxel in Metastatic Prostate Cancer Patients: Results of a Clinical Experience at Omid Hospital, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Mina Tajvidi

    2017-01-01

    Full Text Available Background: Metastatic prostate cancer is one of the most important cancers among men worldwide. Androgen ablation therapy can be used in treatment of these patients; however, most will progress to metastatic hormone-refractory prostate cancer. In this regard, docetaxel has been approved to treat metastatic hormone-refractory prostate cancer in the United States. In this study, we aimed to investigate the results of this treatment modality in metastatic prostate cancer patients from Iran. Methods:We evaluated PSA response and bone pain relief in 18 metastatic prostate cancer patients who underwent treatment with docetaxel at a dose of 75 mg/m2 intravenously on the first day of treatment. The treatment was repeated every three weeks (6 cycles along with 10 mg of prednisolone. Results: Of 18 patients, 39% had >50% decline in PSA levels.There were 16% of the patients with a PSA decline of approximately 30% to 50% of the pre-treatment levels. In addition, 29% of the patients had progressive PSA levels during chemotherapy. Among them, 55% had significant pain relief. Conclusion: This research showed the effectiveness of docetaxel to decrease PSA levels in metastatic hormone-refractory prostate cancer patients from Iran. Docetaxel was also valuable in alleviation of pain in these patients. However, prospective studies should validate this approach.

  5. The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan.

    Science.gov (United States)

    Higashi, Takahiro; Nakamura, Fumiaki; Shibata, Akiko; Emori, Yoshiko; Nishimoto, Hiroshi

    2014-01-01

    Monitoring the current status of cancer care is essential for effective cancer control and high-quality cancer care. To address the information needs of patients and physicians in Japan, hospital-based cancer registries are operated in 397 hospitals designated as cancer care hospitals by the national government. These hospitals collect information on all cancer cases encountered in each hospital according to precisely defined coding rules. The Center for Cancer Control and Information Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report. The report reveals the national profiles of patient characteristics, route to discovery, stage distribution, and first-course treatments of the five major cancers in Japan. A system designed to follow up on patient survival will soon be established. Findings from the analyses will reveal characteristics of designated cancer care hospitals nationwide and will show how characteristics of patients with cancer in Japan differ from those of patients with cancer in other countries. The database will provide an infrastructure for future clinical and health services research and will support quality measurement and improvement of cancer care. Researchers and policy-makers in Japan are encouraged to take advantage of this powerful tool to enhance cancer control and their clinical practice.

  6. Fever and neutropenia in cancer patients : the diagnostic role of cytokines in risk assessment strategies

    NARCIS (Netherlands)

    Nijhuis, CSMO; Daenen, SMGJ; Vellenga, E; van der Graaf, WTA; Gietema, JA; Groen, HJM; Kamps, WA; de Bont, ESJM

    2002-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. Therefore, all neutropenic cancer patients with fever receive standard therapy consisting of broad-spectrum antibiotics and hospitalization. However, febrile neutropenia in cancer patients is often due to other causes

  7. Fever and neutropenia in cancer patients : the diagnostic role of cytokines in risk assessment strategies

    NARCIS (Netherlands)

    Nijhuis, CSMO; Daenen, SMGJ; Vellenga, E; van der Graaf, WTA; Gietema, JA; Groen, HJM; Kamps, WA; de Bont, ESJM

    2002-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. Therefore, all neutropenic cancer patients with fever receive standard therapy consisting of broad-spectrum antibiotics and hospitalization. However, febrile neutropenia in cancer patients is often due to other causes

  8. TESTICULAR CANCER AT KENYATTA NATIONAL HOSPITAL ...

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... detection of relapse in germ cell cancers(15). Other less ... enlarged supraclavicular and cervical lymph nodes, one patient (2.56%) had orbital .... from supraclavicular adenopathy, haemoptysis from lung metastasis, back pain.

  9. A Computerized Hospital Patient Information Management System

    Science.gov (United States)

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  10. Identifying factors significant to continuity in basic palliative hospital care-from the perspective of patients with advanced cancer

    DEFF Research Database (Denmark)

    Soelver, Lisbeth; Rydahl-Hansen, Susan; Oestergaard, Birte;

    2014-01-01

    . The interviews were based on selected problems that patients found significant. The results are distilled into the core category disheartening interactions and four categories: falling outside the professional framework, not being seen as a person, unidentified/unmet need for guidance and involvement...

  11. Effect of hospital volume on processes of breast cancer care: A National Cancer Data Base study.

    Science.gov (United States)

    Yen, Tina W F; Pezzin, Liliana E; Li, Jianing; Sparapani, Rodney; Laud, Purushuttom W; Nattinger, Ann B

    2017-05-15

    The purpose of this study was to examine variations in delivery of several breast cancer processes of care that are correlated with lower mortality and disease recurrence, and to determine the extent to which hospital volume explains this variation. Women who were diagnosed with stage I-III unilateral breast cancer between 2007 and 2011 were identified within the National Cancer Data Base. Multiple logistic regression models were developed to determine whether hospital volume was independently associated with each of 10 individual process of care measures addressing diagnosis and treatment, and 2 composite measures assessing appropriateness of systemic treatment (chemotherapy and hormonal therapy) and locoregional treatment (margin status and radiation therapy). Among 573,571 women treated at 1755 different hospitals, 38%, 51%, and 10% were treated at high-, medium-, and low-volume hospitals, respectively. On multivariate analysis controlling for patient sociodemographic characteristics, treatment year and geographic location, hospital volume was a significant predictor for cancer diagnosis by initial biopsy (medium volume: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.05-1.25; high volume: OR = 1.30, 95% CI = 1.14-1.49), negative surgical margins (medium volume: OR = 1.15, 95% CI = 1.06-1.24; high volume: OR = 1.28, 95% CI = 1.13-1.44), and appropriate locoregional treatment (medium volume: OR = 1.12, 95% CI = 1.07-1.17; high volume: OR = 1.16, 95% CI = 1.09-1.24). Diagnosis of breast cancer before initial surgery, negative surgical margins and appropriate use of radiation therapy may partially explain the volume-survival relationship. Dissemination of these processes of care to a broader group of hospitals could potentially improve the overall quality of care and outcomes of breast cancer survivors. Cancer 2017;123:957-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

  12. Hospitalized Patients and Fungal Infections

    Science.gov (United States)

    ... These types of infections are called healthcare-associated infections (HAIs). Hospital staff and healthcare providers do everything they can ... IV tube) can increase your risk for fungal infection. During your hospital stay you may need a central venous catheter, ...

  13. Implementing Patient Safety Initiatives in Rural Hospitals

    Science.gov (United States)

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  14. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Caregivers Flu Treatment for Cancer Patients and Survivors Flu Publications Stay Informed Cancer Home Information for Patients and Caregivers Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Cancer patients ...

  15. Factors associated with management of cervical cancer patients at ...

    African Journals Online (AJOL)

    Factors associated with management of cervical cancer patients at KCMC Hospital, Tanzania: a retrospective cross-sectional ... Abstract: Cervical cancer is an important public health problem among adult women worldwide. ... Article Metrics.

  16. A Randomized Controlled Trial of Hospital-based Case Management in Cancer Care

    DEFF Research Database (Denmark)

    Wulff, Christian N; Vedsted, Peter; Søndergaard, Jens

    2012-01-01

    BACKGROUND: Case management (CM) models based on experienced nurses are increasingly used to improve coordination and continuity of care for patients with complex health care needs. Anyway, little is known about the effects of hospital-based CM in cancer care.Aim.To analyse the effects of hospital......-based CM on (i) GPs' evaluation of information from the hospital and collaboration with the hospital staff and (ii) patients' contacts with GPs during daytime and out of hours. DESIGN: A randomized controlled trial allocated 280 colorectal cancer patients 1:1 to either a control group or CM intervention...

  17. Patients who fall in hospital - Contributing factors

    Directory of Open Access Journals (Sweden)

    M.I. Bright

    1983-09-01

    Full Text Available This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.

  18. Epidemiology of Cancers in Kashmir, India: An Analysis of Hospital Data.

    Science.gov (United States)

    Qurieshi, Mariya A; Khan, S M Salim; Masoodi, Muneer A; Qurieshi, Uruj; Ain, Quratul; Jan, Yasmeen; Haq, Inaamul; Ahmad, Sheikh Zahoor

    2016-01-01

    Cancer is a leading cause of mortality and morbidity in the world. The aim of the present study was to measure the pattern of different cancers in Kashmir, India, a cancer belt with peculiar cancer profile. A hospital based cancer registry was started by the Department of Community Medicine, Government Medical College, Srinagar, in January 2006, wherein information was collected from cancer patients who were diagnosed and treated in the hospital. Data has been analysed for a period extending from January 2006 to December 2012. Descriptive analysis has been done by using statistical software. A total of 1598 cancer patients were admitted during this period. Overall male to female ratio was 1.33 : 1. Stomach cancer was the most commonly reported cancer (25.2%), followed by colorectal cancer (16.4%) and lung cancer (13.2%) among males. For females, colorectal cancer (16.8%), breast cancer (16.1%), and stomach cancer (10.4%) were the most frequently reported cancers in order of frequency. Tobacco related cancers contributed to more than three-fourths of cancers among men and more than half of cancers for women. There is an urgent need to set up a population based cancer registration system to understand the profile of cancers specific to this geographic region.

  19. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198

  20. Incidence of breast cancer in the five-year period (2001-2006 in patients treated surgically in the Cantonal Hospital in Zenica

    Directory of Open Access Journals (Sweden)

    H. Drljević

    2006-02-01

    Full Text Available Breast cancer is currently one of the most common malignant tumors of human race and at the same it is the most frequent cancer of female population. The war and post-war migrations of population have significantlychanged the demographic and age structure in Bosnia and Herzegovina. Absence of a National Cancer Register and a unique database on malignant diseases makes monitoring of breast cancer even more difficult.Theobjectiveof this retrospective study was to analyze the incidence of breast cancer in Zenica-Doboj Canton, to conduct a survey based on the age of patients in the five-year period starting from 1 January 2001 until 30 November 2005 and results of the study have been compared with 1990. All the patients were treated surgically with pre-surgical clinical examination, ultra-sound examination and mamography, and pathohistological verification of cancer and pathologically determined size of tumor. A total of 297 patients were treated out of the series of 583 breast surgeries.During this five-year survey a continuous increase of breast cancers in Zenica-Doboj Canton was noted.Therehas been an increased incidence of breast cancer in women aged 30-45, the average size of tumor has decreased, and there has been no change in the relationship between the pathohistological types of tumors and tendencies in surgical treatments to use breast conserving surgical methods. The program of early detection of breast cancer or screening of healthy women and search for “small” cancers (screening programs will enable a wider use of breast conserving surgical methods and it requires a more active involvement of the state and society.

  1. Does hospital discharge policy influence sick-leave patterns in the case of female breast cancer?

    DEFF Research Database (Denmark)

    Lindqvist, Rikard; Stenbeck, Magnus; Diderichsen, Finn

    2005-01-01

    in 2000 were selected from the National Cancer Register and combined with data from the sick-leave database of the National Social Insurance Board and the National Hospital Discharge Register (N = 1834). A multi-factorial model was fitted to the data to investigate how differences in hospital care......The objective was to investigate how differences among hospitals in the shift from in-patient care to day surgery and a reduced hospital length of stay affect the sick-leave period for female patients surgically treated for breast cancer. All women aged 18-64 who were diagnosed with breast cancer....... The effect of the hospital median length of stay (LOS) was U-shaped, suggesting that hospitals with a median LOS that is either short or long are associated with longer sick-leave. In the intermediate range, women treated in hospitals with a median LOS of 2 days had 22 days longer sick-leave than those...

  2. Lung cancer diagnostic delay in a Havana hospital.

    Science.gov (United States)

    Fernández de la Vega, Joan F; Pérez, Hayvin; Samper, Juan A

    2015-01-01

    Lung cancer is one of the leading causes of death worldwide and in Cuba, where its incidence and mortality are on the rise. Diagnostic delay is a variable linked to survival and prognosis. Quantifying this delay and comparing it with data from other national and international sources may lead to planning actions to reduce its impact. Assess diagnostic delay of lung cancer in patients at the Joaquín Albarrán Clinical-Surgical Teaching Hospital, Havana, Cuba, from 2007 to 2010. A retrospective descriptive study was conducted based on administrative data from patients diagnosed with lung cancer. The length of overall diagnostic delay was determined, as well delay between symptom onset and the patient's first contact with the health system, and delay at the primary and secondary levels of the national health system. Descriptive statistics were used to summarize the different time intervals. The study comprised a total of 54 patients; 74.1% were men; the largest age group was 51-60 years. Of the total, 61.1% sought care first at the primary level. Total diagnostic delay for these patients was 67.4 days: 24.3 days due to patient delay (SD 32.8), 16.2 days due to primary care delay (SD 5.2), and 26.9 days due to secondary care delay (SD 20.1). The total delay for patients first seen at the secondary care level was 79.1 days (SD 81.8): 47.8 days due to patient delay (SD 25.6), and 31.3 days due to secondary level delay (SD 14.4). Diagnostic delay in lung cancer is high. Patients who went directly to hospital did not benefit from shorter delay in diagnosis.

  3. The effectiveness of the quality program Pac-IficO to improve pain management in hospitalized cancer patients: a before-after cluster phase II trial

    National Research Council Canada - National Science Library

    Ripamonti, Carla Ida; Prandi, Cesarina; Costantini, Massimo; Perfetti, Elisa; Pellegrini, Fabio; Visentin, Marco; Garrino, Lorenza; De Luca, Anna; Pessi, Maria Adelaide; Peruselli, Carlo

    2014-01-01

    ...) the symptom is still under-diagnosed and its treatment is not appropriate in many patients. The objective of the study is to evaluate the efficacy of the Pac-IFicO programme in improving the quality of pain management in hospitalised cancer patients...

  4. Systemic treatment with capecitabine as maintenance therapy in patients with recurring or metastatic breast cancer: experience in the Oncology Hospital, National Medical Center Siglo XXI, Mexican Social Security Institute.

    Science.gov (United States)

    Segura-González, Manuel; Quintana-Quintana, Miguel

    2015-04-01

    Metastatic breast cancer as initial onset represents between 20 and 30 % of cases and is considered an incurable disease. The goal of its treatment is palliative, looking for increasing the survival while reducing the symptoms. Maintenance chemotherapy studies for metastatic breast cancer have demonstrated to prolong the progression-free survival, with unclear results in terms of overall survival. The main objectives of our study were the progression-free survival and overall survival in patients with recurring or metastatic breast cancer treated with capecitabine in the maintenance chemotherapy setting compared with patients not receiving maintenance chemotherapy. As secondary objectives, the frequency of dose-limiting toxicities and response rate were determined. A non-probabilistic sampling was used, through expert selection of patients from the recurring/metastatic breast cancer survey cared within the period from January 1, 2007, to December 21, 2012. A total of 77 patients were included. Clinical data of advanced/recurrent breast cancer patients that were treated with capecitabine were recorded. The study achieved its primary objective, since the progression-free survival was prolonged for the maintenance therapy group: 6.6 versus 18.1 months, p Siglo XXI Oncology Hospital extends the overall survival and progression-free survival with a good toxicity profile.

  5. Patient involvement in hospital architecture

    DEFF Research Database (Denmark)

    Herriott, Richard

    2017-01-01

    This paper examines user-involvement in the process used to design new hospitals. Denmark is in the midst of a phase of hospital building. This recent experience is studied by means of expert interviews with senior practitioners involved in three projects. Examined thematically, the data covers......-studied area, design for hospitals. It highlights difficulties in applying the goals of user-centred design and Design for All in large projects....

  6. Dutch hospitals provide reliable "one click" patient information using a Quality Window.

    Science.gov (United States)

    Van Rooy, Yvonne

    2014-01-01

    In 2014, the Dutch Association of Hospitals (Nederlandse Vereniging van Ziekenhuizen, NVZ) launched the "Quality Window" at general hospitals across the Netherlands. The Quality Window is an online platform for patients which shares a hospital's current and previous scores on ten quality indicators, from patient experience to employee satisfaction. The Quality Window therefore responds to the growing demand for information and transparency when it comes to hospital care and performance. Not only can patients access helpful information about a hospital's quality through the Quality Window, they can also compare results with other hospitals, the national average, and more. Many hospitals also take the opportunity to expand on how indicators work in practice and the actions being taken towards improvement. The Quality Window was developed with the help of hospitals and patients. Over the coming years it will be expanded to university hospitals across the country. General hospitals will also begin developing Quality Windows for specific patient groups, such as cancer patients.

  7. [Nutrition and cancer patients].

    Science.gov (United States)

    Katsuramaki, T; Hirata, K; Isobe, M

    1998-03-01

    Nutritional therapy for cancer patients includes various objectives such as improvement of cachexia, elucidation of the mechanism of malnutrition, development of therapy for anorexia, nutrition support during chemotherapy or radiotherapy, and inhibition of tumor growth under controlled caloric intake. This review describes recent remarkable developments in nutritional therapy for cancer patients. Cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor which induce proteolysis and lipolysis are involved in the cause of malnutrition and cachexia in cancer patients. IL-1 also plays a significant role in the development of cancer anorexia via direct action in the brain. For anorexia therapy, progestogens have been shown to improve appetite and food intake in cancer patients. Moreover, glutamine supplementation improves the host protein metabolism without enhancement of tumor growth during chemotherapy. Among the effects of caloric intake on anticancer therapy, AO-90, a methionine-free intravenous amino acid solution, has been shown to increase the antitumor effect of 5-fluorouracil in clinical studies. From these observations, recent progress in nutritional therapy for cancer patients has been remarkable. Further study of nutritional therapy is required in order to maintain or improve the quality of life of cancer patients in the future.

  8. Malnutrition among hospitalized patients in King Khalid university hospital, Riyadh

    OpenAIRE

    Bani Ibrahim; Al-Kanhal Mohammad

    1998-01-01

    The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, ...

  9. Utilization of operating room time in a cancer hospital

    Directory of Open Access Journals (Sweden)

    P Ranganathan

    2013-01-01

    Full Text Available Background: Appropriate usage of operating room (OR time can improve efficiency of utilization of resources and help to decrease surgical waiting lists. Aims: This study was conducted to evaluate the pattern of usage of OR time in a tertiary referral cancer hospital. Setting and Design: This was a prospective audit carried out over 2 months in 11 major ORs in a cancer hospital. Materials and Methods: OR anesthesiologists filled a standard form for all patients undergoing elective surgery and documented the following times: entry into OR, start of anesthesia, handover to surgeon, incision, start of reversal, end of anesthesia, and shifting out of patient. Statistical Analysis: Median time utilized for various OR processes was calculated. Results: An average of two surgeries were performed per OR session (828 surgeries in 407 OR sessions. Anesthesia and surgery-related processes contributed to 17% and 79%, respectively, of total OR time, with turnover time between cases accounting for the remaining 4%. Fifteen percent (60 out of 407 OR sessions started more than 10 min later than the planned start time, and 17% (70 of 407 of OR sessions ended more than 2 h after the scheduled finish time. An anesthesia procedure room was utilized in only 15% of cases where it could potentially have been used. Conclusion: This audit identified patterns of OR usage in a cancer hospital and helped to detect areas of inefficient utilization. Anesthesia-related processes contributed to 17% of the total OR time.

  10. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women: e0145492

    National Research Council Canada - National Science Library

    Waseem Khaliq; Ali Aamar; Scott M Wright

    2015-01-01

    .... Patients and Methods A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years...

  11. The place of high dose rate curie-therapy in cutaneous cancers: experience of the Neufchatel hospital on 140 patients; Place de la curietherapie de haut debit de dose dans les cancers cutanes: experience de l'hopital neuchatelois a propos de 140 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yanes, B.; Fraija, L.; Guibert, G.; Notter, M. [Hopital neuchatelois, La Chaux-de-Fonds (Switzerland)

    2011-10-15

    The authors report the experience of the Neufchatel hospital in the treatment by curie-therapy of 140 patients exhibiting cutaneous cancers. The apparatus comprised an iridium 192 source and a Leipzig-type applicator. The distributions of carcinoma type and treated localizations are indicated. Results are analyzed in terms of age, tumour size, aesthetic result, local control for the different types of carcinomas. Short communication

  12. Candiduria in Hospitalized Patients in Teaching Hospitals of Ahvaz

    Directory of Open Access Journals (Sweden)

    Ali Zarei Mahmoudabadi

    2012-12-01

    Full Text Available Background and Objectives: Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran.Materials and Methods: During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten μl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80.Results: In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male. The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%, followed by C. glabrata (24.4%, C. tropicalis (3.7%, C. krusei (2.2%, and Geotrichum spp. (0.7% Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%.Conclusion: Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  13. Improvement of best practice in early breast cancer : Actionable surgeon and hospital factors

    NARCIS (Netherlands)

    Gort, Marjan; Broekhuis, Manda; Otter, Rene; Klazinga, Niek S.

    To identify actionable elements for improving best practice, this study examined the relative effects of patient, surgeon and hospital factors on surgical treatment variation of 2,929 early breast cancer patients, diagnosed from January 1998 to January 2002 in the region of the Comprehensive Cancer

  14. Epidemiology of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital

    Institute of Scientific and Technical Information of China (English)

    QIAO Chun-yan; WANG Liang-hai; TANG Xin; WANG Tao; YANG Di-ya; WANG Ning-li

    2009-01-01

    Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes.Results Pediatric patients (n=1452) accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and et all ages, with a total ratio of boys to girls of 2.32:1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years.Patients with traumatic glaucoma were the second most common group (n=128, 12.13%), and presented at older age (the median presenting age was 11 years). The majority of traumatic glaucoma occurred in children between 10 and 15 years of age (n=72, 56.25%). Aphakic glaucoma was the third most common (9.19%) subtype.Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.

  15. [Postoperative radiotherapy in patients with invasive uterine cervix cancer treated previously with simple hysterectomy. Results from the Hospital de Oncología, Centro Médico Nacional SXXI. ].

    Science.gov (United States)

    Huerta Bahena, Judith; Labastida Almendaro, Sonia; Cortez Arroyo, Héctor; Calva, Angel

    2003-06-01

    Invasive carcinoma found after simple hysterectomy for several causes is an increasing clinical condition. That situation results in the necessity for further therapy: re-operation or radiotherapy. The purpose of this review is to analyze our results with postoperative radiotherapy for these patients. In 1998, 59 patients were submitted to postoperative radiotherapy at the Oncology Hospital, Medical Cancer Center for invasive cervical cancer found after simple hysterectomy for several causes. All patients had postoperative radiotherapy, the dose depended of the magnitude of residual disease after surgery (range 10-80 Gy). After surgery 27 patients had gross residual disease; and no residual disease or microscopic disease was present in 32 patients. Three years overall survival rate was 59% for the whole group. With the results of the univariate analysis, prognostic factors found that significantly affect disease free survival were interval between hysterectomy and radiotherapy of more than 6 months, radiotherapy dose less than 50 Grays and histology. With multivariate analysis only presence of gross residual disease affect significantly disease free survival p = 0.0000. Postoperative radiotherapy results in patients with invasor cervical cancer incidentally found in hysterectomy specimens with minimal residual disease are excellent. However with the presence of more extensive residual disease the results in disease free survival are worse than those obtained in patients with similar stages who had not been treated with hysterectomy. A well established diagnostic procedure must be done in all patients candidates to simple hysterectomy.

  16. [Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

    Science.gov (United States)

    Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

    2017-04-01

    On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

  17. Should hospitals collect blood components? Yes: hospitals put patients first.

    Science.gov (United States)

    Ciavarella, D

    1997-12-01

    Stand-alone blood collection centers throughout the world have suffered in recent years from cost overruns, quality and regulatory problems of major proportion, and a subsequent deterioration of service levels to their communities. Their leaders have been probed by public interest groups, the media and governmental bodies, removed from positions of authority, and sadly, subpoenaed, vilified in public and even jailed. Patients, healthcare providers and hospitals have suffered through this period as well, and continue to search for alternatives to their largely monopoly suppliers. In most cases, the best alternative is the one they control themselves. Should hospitals collect blood components? Yes, since their mission--patient care--takes precedence over that of any non-provider healthcare organization. Patients and the public-at-large gain many things by the continued presence of hospitals in the provision of donor services: provider and patient needs are given first billing, and innovation in blood services is encouraged by the transfusion medicine physicians and allied health professionals who are closest to the patient. Service requirements are recognized and met faster and in simpler ways, and quality concerns are addressed with a minimum of bureaucracy and a maximum of common sense. Finally, when hospitals control their own donor programs, costs are more easily tracked and better controlled.

  18. Sarcopenia in Cancer Patients.

    Science.gov (United States)

    Chindapasirt, Jarin

    2015-01-01

    Sarcopenia, characterized by a decline of skeletal muscle plus low muscle strength and/or physical performance, has emerged to be an important prognostic factor for advanced cancer patients. It is associated with poor performance status, toxicity from chemotherapy, and shorter time of tumor control. There is limited data about sarcopenia in cancer patients and associated factors. Moreover, the knowledge about the changes of muscle mass during chemotherapy and its impact to response and toxicity to chemotherapy is still lacking. This review aimed to provide understanding about sarcopenia and to emphasize its importance to cancer treatment.

  19. Breast Cancer Survivor Advocacy at a University Hospital: Development of a Peer Support Program with Evaluation by Patients, Advocates, and Clinicians.

    Science.gov (United States)

    Mirrielees, Jennifer A; Breckheimer, Kayla R; White, Teresa A; Denure, Deb A; Schroeder, Michelle M; Gaines, Martha E; Wilke, Lee G; Tevaarwerk, Amye J

    2017-03-01

    Peer-to-peer support programs provide unique psychosocial and educational support for breast cancer patients. A Patient Survivor Advocacy (PSA) program was developed by the University of Wisconsin Breast Center (UWBC) to provide support for newly diagnosed patients from peers who had completed primary treatment. In this study, we evaluated patient, advocate, and clinician experience with the PSA program. A program matching volunteer peer advocates at least 1 year removed from primary treatment with newly diagnosed patients was developed. Peer advocates were recruited from the practices of UWBC clinicians and received in-person training on six dimensions of peer advocacy. Trained advocates were then paired based on demographic and medical history with new patients referred to the program. Survey assessment tools were distributed to assess peer advocate and patient satisfaction, as well as clinician experience. Forty patients have been matched with seven advocates, with contact largely by email (53 %) or phone (36 %). Patients and peer advocates reported satisfaction with the program. The majority of patients (92.9 %) reported that the program was "helpful" and that they would recommend the PSA program to another woman with breast cancer. All peer advocates (100 %) responded with a sense of achievement in their advocate roles. Clinicians noted challenges in referral to the program. Peer advocates can provide key emotional and psychosocial support to newly diagnosed breast cancer patients. The peer advocate, patient, and clinician feedback collected in this study will inform the future development of this program at our and peer institutions.

  20. Oral cancer in Myanmar: a preliminary survey based on hospital-based cancer registries.

    Science.gov (United States)

    Oo, Htun Naing; Myint, Yi Yi; Maung, Chan Nyein; Oo, Phyu Sin; Cheng, Jun; Maruyama, Satoshi; Yamazaki, Manabu; Yagi, Minoru; Sawair, Faleh A; Saku, Takashi

    2011-01-01

    The occurrence of oral cancer is not clearly known in Myanmar, where betel quid chewing habits are widely spread. Since betel quid chewing has been considered to be one of the important causative factors for oral cancer, the circumstantial situation for oral cancer should be investigated in this country. We surveyed oral cancer cases as well as whole body cancers from two cancer registries from Yangon and Mandalay cities, both of which have representative referral hospitals in Myanmar, and we showed that oral cancer stood at the 6th position in males and 10th in females, contributing to 3.5% of whole body cancers. There was a male predominance with a ratio of 2.1:1. Their most frequent site was the tongue, followed by the palate, which was different from that in other countries with betel quid chewing habits. About 90% of male and 44% of female patients had habitual backgrounds of chewing and smoking for more than 15 years. The results revealed for the first time reliable oral cancer frequencies in Myanmar, suggesting that longstanding chewing and smoking habits are etiological backgrounds for oral cancer patients. © 2010 John Wiley & Sons A/S.

  1. Malnutrition among hospitalized patients in King Khalid University Hospital, Riyadh.

    Science.gov (United States)

    Bani, I A; Al-Kanhal, M A

    1998-09-01

    The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM) of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9%) of medical cases were found to be obese compared to surgical cases (19.7%). If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.

  2. Malnutrition among hospitalized patients in King Khalid university hospital, Riyadh

    Directory of Open Access Journals (Sweden)

    Bani Ibrahim

    1998-01-01

    Full Text Available The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM. Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9% of medical cases were found to be obese compared to surgical cases (19.7%. If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.

  3. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  4. 姑息护理对住院癌症患者生活质量的影响%Effect of palliative care on the quality of life of cancer patients in hospital

    Institute of Scientific and Technical Information of China (English)

    李湘辉; 赖世伟; 成沛玉; 彭丽彬

    2011-01-01

    目的:探讨姑息护理对住院癌症患者生活质量的影响.方法:将420例入选癌症患者随机分为研究组和对照组各210例,对照组给予常规治疗护理,研究组由姑息护理小组实施姑息护理.问卷调查和评定两组患者入组前和入组1个月后的生活质量.结果:研究组住院后1个月生活质量明显优于入组前,且优于对照组(P<0.01=.结论:姑息护理有效提高了癌症患者的生活质量.%Objective:To discuss the effect of palliative care on the quality of life of cancer patients in hospital.Methods:420 patients with cancer were divided into research group and control group,210 patient in each group.The patients in control group were given normal treatment and nursing ,the patients in research group implemented palliative care by palliative care group.The quality of life of patients before and after 1 month in group were investigated by questionnaire.Results: After 1 month in hospital ,the quality of life of patients in researchi group was better than before in group, and better than in control ( P <0.01 ).Conclusion:Palliative care could effectively improve the quality of life of cancer patients.

  5. An evaluation of nursing care in cancer patients.

    Science.gov (United States)

    Karadeniz, G; Yanikkerem, E; Altiparmak, S; Sevil, U; Ertem, G; Esen, A

    2004-01-01

    The aim of the present study was to identify what hospitalized cancer patients expect from nurses in terms of the care they receive. The specific aims of this study were: (i) to identify those individuals to whom the patients felt closest in the hospital setting and (ii) to evaluate nurses' management of cancer patients during their stay in the hospital. The sample included patients hospitalized at Ege University Hospital and Suat Seren District Hospital, Izmir, Turkey. We found significant differences between the scores of satisfaction and dissatisfaction and gender age, education, occupation, type of cancer and the mode of treatment (p patients reported that nursing management was unsatisfactory. Some demographic factors such as cultural and social status affected patients' expectations.

  6. Choosing a doctor and hospital for your cancer treatment

    Science.gov (United States)

    ... htm Choosing a doctor and hospital for your cancer treatment To use the sharing features on this page, please enable JavaScript. When you seek cancer treatment, you want to find the best care possible. ...

  7. [Prevalence of breast cancer sub-types by immunohistochemistry in patients in the Regional General Hospital 72, Instituto Mexicano del Seguro Social].

    Science.gov (United States)

    Pérez-Rodríguez, Gabriel

    2015-01-01

    Breast cancer mortality has increased in women 25 years and over, and since 2006 it has surpassed cervical cancer. Breast cancer is a heterogeneous disease, with several clinical and histological presentations that require a thorough study of all clinical and pathological parameters, including immunohistochemistry to classify it into subtypes, have a better prognosis, provide individualised treatment, increase survival, and reduce mortality. To evaluate the prevalence of sub-types of breast cancer and the association with the clinical and histopathological features of the tumour. An observational, retrospective, cross-sectional and analytical study conducted on 1380 patients with a diagnosis of breast cancer have been classified by immunohistochemistry into four subtypes: luminal A, triple negative, luminal B and HER2. An analysis was performed on the association with age, risk factors, and the clinical and histopathological features of the tumour. The mean age of the patients was 53.3 ± 11.4. The frequency was luminal A (65%), triple negative (14%), luminal B (12%), and HER2 (9%). The most frequent characteristics were the 50 to 59 age range, late menopause, the right side, upper external quadrant, stage II, metastatic lymph nodes, and mastectomy. The most frequent sub-type was luminal A, and together with the luminal B are those which have better prognosis compared with the triple negative and HER2. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  8. Profiling Interfacility Transfers for Hospitalized Pediatric Patients.

    Science.gov (United States)

    Rosenthal, Jennifer L; Hilton, Joan F; Teufel, Ronald J; Romano, Patrick S; Kaiser, Sunitha V; Okumura, Megumi J

    2016-06-01

    The hospital-to-hospital transfer of pediatric patients is a common practice that is poorly understood. To better understand this practice, we examined a national database to profile pediatric interfacility transfers. We used the 2012 Kids' Inpatient Database to examine characteristics of hospitalized pediatric patients (transfer admission source. We performed descriptive statistics to compare patient characteristics, utilization, and hospital characteristics between those admitted by transfer versus routine admission. We constructed a multivariable logistic regression model to identify patient characteristics associated with being admitted by transfer versus routine admission. Of the 5.95 million nonpregnancy hospitalizations in the United States in 2012, 4.4% were admitted by transfer from another hospital. Excluding neonatal hospitalizations, this rate increased to 9.4% of the 2.10 million nonneonatal, nonpregnancy hospitalizations. Eighty-six percent of transfers were to urban teaching hospitals. The most common transfer diagnoses to all hospitals nationally were mood disorder (8.9%), other perinatal conditions (8.7%), prematurity (4.8%), asthma (4.2%), and bronchiolitis (3.8%). In adjusted analysis, factors associated with higher odds of being admitted by transfer included having a neonatal principal diagnosis, male gender, white race, nonprivate insurance, rural residence, higher illness severity, and weekend admission. Interfacility transfers are relatively common among hospitalized pediatric patients. Higher odds of admission by transfer are associated not only with higher illness severity but also with principal diagnosis, insurance status, and race. Further studies are needed to identify the etiologies and clinical impacts of identified transfer differences. Copyright © 2016 by the American Academy of Pediatrics.

  9. Breast cancer in a multi-ethnic Asian setting : Results from the Singapore-Malaysia hospital-based breast cancer registry

    NARCIS (Netherlands)

    Pathy, Nirmala Bhoo; Yip, Cheng Har; Taib, Nur Aishah; Hartman, Mikael; Saxena, Nakul; Lau, Philip; Bulgiba, Awang M.; Lee, Soo Chin; Lim, Siew Eng; Wong, John E. L.; Verkooijen, Helena M.

    2011-01-01

    Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnos

  10. Medicare Hospital Spending Per Patient - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  11. Medicare Hospital Spending Per Patient - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  12. Clinical Characteristics of Patients with Sporadic Colorectal Cancer and Primary Cancers of Other Organs

    Directory of Open Access Journals (Sweden)

    Jung-Yu Kan

    2006-11-01

    Full Text Available Most cancer patients often neglect the possibility of secondary cancer. Colorectal cancer (CRC is the third leading cause of cancer death in Taiwan. It is important to be aware of the clinical characteristics of double cancer in CRC patients for early diagnosis and treatment. We retrospectively analyzed 1,031 CRC patients who underwent surgical treatment at the Department of Surgery of Kaohsiung Medical University Hospital between January 1998 and December 2004. Among these patients, CRC was accompanied by cancer of other organs in 17 patients (1.65%, either synchronously or metachronously. Therefore, we describe our experience regarding the location of CRC, the clinical symptoms and signs of these patients, the TNM stage, histology, phase, association with other malignancies, interval between cancers and clinical outcomes. Of the 17 patients in whom CRC was accompanied by primary cancer of other organs, there were four synchronous and 13 metachronous multiple cancer patients. Our patient group comprised six men and 11 women with ages ranging from 47 to 88 years (median age, 66 years. The most common location of CRC was the sigmoid colon. Six gastric cancers (35.2% and six breast cancers (35.2% were associated with primary CRC. The remaining six second primary cancers were one lung cancer, one thyroid cancer, one cervical cancer, one ovarian cancer, one skin cancer, and one urinary bladder cancer. Of the 13 metachronous multiple cancer patients, eight patients developed subsequent CRC after primary cancers of other organs, whereas two patients developed a subsequent second primary cancer after CRC. The intervals between the development of metachronous multiple cancers ranged from 2 to 19 years. In this retrospective analysis, breast and gastric cancer patients were at increased risk of developing subsequent secondary CRC. Careful attention should always be paid to the possibility of secondary CRC in treating these cancer patients. Cancer

  13. Clinical Analysis of Hospital Acquired Infection in 295 Patients with Cancer Treated by Chemotherapy%295例恶性肿瘤化疗患者院内感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    邓玉洁; 林学德; 施烯; 曾乌查

    2014-01-01

    目的:了解恶性肿瘤接受化疗患者合并医院内获得性感染的发病特点,指导临床有效防治。方法回顾性分析295例院内感染的恶性肿瘤化疗患者的临床资料。结果3 a 内院内感染率分别为7.04%、6.01%和5.78%,呈逐年下降趋势;院内感染与年龄、性别、住院时间、糖皮质激素的使用、白细胞减少有关(P <0.05),感染病原菌以真菌及革兰氏阴性菌居多。结论恶性肿瘤患者合并院内感染的发生率较高,积极采取预防措施,减少易感因素,合理使用抗生素是关键。%Objective To study the characteristics of hospital acquired infections in patients with cancer treated by chemotherapy,and to provide the guidance for clinical prevention and treatments. Methods The clinical data of 295 cases of hospital acquired infections in patients with cancer treated by chemotherapy were analyzed retrospec-tively. Results In the recent three years,the incidences of hospital acquired infections were 7. 04% ,6. 01% and 5. 78% ,respectively. The trend was decreasing year by year. Hospital acquired infections were related with age,gen-der,length of hospitalization,use of glucocorticoid,leucopenia(P < 0. 05). The pathogens were mainly fungi and Gram negative bacteria. Conclusion There is a relatively higher incidence of hospital acquired infections in pa-tients with cancer and the key points of prevention lie in reducing the predisposing factors,rational use of antibiotics and taking actively prophylactic measures.

  14. Failure-to-Rescue After Colorectal Cancer Surgery and the Association with Three Structural Hospital Factors

    NARCIS (Netherlands)

    Henneman, D.; van Leersum, N. J.; ten Berge, M.; Snijders, H. S.; Fiocco, M.; Wiggers, T.; Tollenaar, R. A. E. M.; Wouters, M. W. J. M.

    2013-01-01

    This study was designed to evaluate the association between structural hospital characteristics and failure-to-rescue (FTR) after colorectal cancer surgery. A growing body of evidence suggests a large hospital variation concerning mortality rates in patients with a severe complication (FTR) in color

  15. [Physiotherapy of cancer patients].

    Science.gov (United States)

    Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

    2016-07-01

    Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

  16. Prevalence of Lynch syndrome and Lynch-like syndrome among patients with colorectal cancer in a Japanese hospital-based population.

    Science.gov (United States)

    Chika, Noriyasu; Eguchi, Hidetaka; Kumamoto, Kensuke; Suzuki, Okihide; Ishibashi, Keiichiro; Tachikawa, Tetsuhiko; Akagi, Kiwamu; Tamaru, Jun-Ichi; Okazaki, Yasushi; Ishida, Hideyuki

    2017-02-09

    We investigated the prevalence of Lynch syndrome and Lynch-like syndrome among Japanese colorectal cancer patients, as there have been no credible data from Japan. Immunohistochemical analyses for mismatch repair proteins (MLH1, MSH2, MSH6 and PMS2) were carried out in surgically resected, formalin-fixed paraffin-embedded specimens obtained from 1,234 newly diagnosed colorectal cancer patients between March 2005 and April 2014. The presence/absence of the BRAF V600E mutation and hypermethylation of the MLH1 promoter was analyzed where necessary. Genetic testing was finally undertaken in patients suspected as having Lynch syndrome. By the universal screening approach with immunohistochemical analysis for mismatch repair proteins followed by analyses for the BRAF V600E mutation and MLH1 promoter methylation status, 11 (0.9%) of the 1,234 patients were identified as candidates for genetic testing. Out of the 11 patients, 9 (0.7%) were finally diagnosed as having Lynch syndrome; the responsible genes included MLH1 (n = 1), MSH2 (n = 4), EPCAM (n = 1) and MSH6 (n = 3). The remaining two patients (0.2%) were regarded as having Lynch-like syndrome, since biallelic somatic deletion of the relevant mismatch repair genes was detected in the absence of germline mismatch repair alterations. None of the cases was identified as having germline MLH1 epimutation. The prevalence of Lynch syndrome among all newly diagnosed cases of colorectal cancer in Japan is in the same range as that recently reported by studies in Western population. The prevalence of Lynch-like syndrome seems to be extremely low.

  17. Factors that influence minority use of high-volume hospitals for colorectal cancer care.

    Science.gov (United States)

    Huang, Lyen C; Tran, Thuy B; Ma, Yifei; Ngo, Justine V; Rhoads, Kim F

    2015-05-01

    Previous studies suggest that minorities cluster in low-quality hospitals despite living close to better performing hospitals. This may contribute to persistent disparities in cancer outcomes. The purpose of this work was to examine how travel distance, insurance status, and neighborhood socioeconomic factors influenced minority underuse of high-volume hospitals for colorectal cancer. The study was a retrospective, cross-sectional, population-based study. All hospitals in California from 1996 to 2006 were included. Patients with colorectal cancer diagnosed and treated in California between 1996 and 2006 were identified using California Cancer Registry data. Multivariable logistic regression models predicting high-volume hospital use were adjusted for age, sex, race, stage, comorbidities, insurance status, and neighborhood socioeconomic factors. A total of 79,231 patients treated in 417 hospitals were included in the study. High-volume hospitals were independently associated with an 8% decrease in the hazard of death compared with other settings. A lower proportion of minorities used high-volume hospitals despite a higher proportion living nearby. Although insurance status and socioeconomic factors were independently associated with high-volume hospital use, only socioeconomic factors attenuated differences in high-volume hospital use of black and Hispanic patients compared with white patients. The use of cross-sectional data and racial and ethnic misclassifications were limitations in this study. Minority patients do not use high-volume hospitals despite improved outcomes and geographic access. Low socioeconomic status predicts low use of high-volume settings in select minority groups. Our results provide a roadmap for developing interventions to increase the use of and access to higher quality care and outcomes. Increasing minority use of high-volume hospitals may require community outreach programs and changes in physician referral practices.

  18. Teamwork culture and patient satisfaction in hospitals.

    Science.gov (United States)

    Meterko, Mark; Mohr, David C; Young, Gary J

    2004-05-01

    A growing line of research indicates a positive relationship between a healthcare organization's culture and various performance measures. In these studies, a key cultural characteristic is the emphasis placed on teamwork. None of the studies, however, have examined teamwork culture relative to patient satisfaction, which is now 1 of the most widely used performance measures for healthcare organizations. This study investigated the relationship between teamwork culture of hospitals and patient reports of their satisfaction with the care they received. The study setting was the Veterans Health Administration (VHA), Department of Veterans Affairs. The study sample consisted of 125 VHA hospitals for which independent and valid sources of data for culture and patient satisfaction were obtained. Each hospital's culture was assessed relative to 4 dimensions: teamwork, entrepreneurial, bureaucratic, and rational. Patient satisfaction data were available for both inpatient and outpatient settings. Results from multivariate regression analyses indicated a significant and positive relation between teamwork culture and patient satisfaction for inpatient care, and a significant and negative relation between bureaucratic culture and patient satisfaction for inpatient care. Additional analyses revealed an almost 1 standard deviation difference in patient satisfaction scores between hospitals in the top third and bottom third of the distribution for the teamwork culture measure. Study results suggest that hospitals and possibly other healthcare organizations should strive to develop a culture emphasizing teamwork and deemphasizing those aspects of bureaucracy that are not essential to assuring efficiency and quality care.

  19. Análise do atraso no diagnóstico e tratamento do câncer de mama em um hospital público Analysis of delays in diagnosis and treatment of breast cancer patients at a public hospital

    Directory of Open Access Journals (Sweden)

    Damila Cristina Trufelli

    2008-02-01

    Full Text Available OBJETIVO: Identificar as possíveis fases de atraso na condução de pacientes com câncer de mama atendidas em um hospital público, desde a suspeita até o diagnóstico e o início do tratamento. MÉTODOS: Estudo retrospectivo, no qual foram analisados em pacientes com câncer de mama atendidas consecutivamente no Serviço de Oncologia do Hospital Estadual Mário Covas, durante o ano de 2006, os dados relativos aos intervalos de tempo transcorrido entre a suspeita, o diagnóstico e o início do tratamento adjuvante sistêmico. RESULTADOS: Sessenta e oito mulheres foram incluídas. A média de idade foi de 56,3 anos (desvio padrão: 12,2 anos. Entre os intervalos analisados, o maior atraso ocorreu entre a suspeita mamográfica de câncer e a realização da biópsia (mediana de 72 dias, variação de 4 a 1095 dias, sendo este significativamente maior (pBACKGROUND: To identify potential delays in the management of patients with breast cancer examined at a public hospital, from time of suspicion until diagnosis and beginning of treatment. METHODS: Retrospective study which analyzed data related to time elapsed in different intervals between suspicion, diagnosis and onset of systemic cancer-directed treatments, of consecutive breast cancer patients cared for at the medical oncology clinic of the Mario Covas Hospital during 2006. RESULTS: Sixty-eight women, with a mean age of 56.3 years (standard deviation: 12.2 years, were included. Of all the intervals, the longest delay occurred between the mammographic suspicion of cancer and performance of biopsy (median of 72 days, range: 4 - 1095 days; this was significantly longer (P<0.001 than in the other intervals analyzed. Furthermore, this interval in particular, was significantly longer in patients with advanced stage breast cancer when compared to those at the initial stage (P=0.014. CONCLUSION: Breast cancer patients treated in a public hospital in Brazil suffer delays, especially during the

  20. A 13-year follow-up of patients with breast cancer presenting to a District General Hospital breast unit in southeast England.

    Science.gov (United States)

    Robinson, David; Bell, Janine; Møller, Henrik; Salman, Asad

    2006-04-01

    The purpose of this clinical cohort study was to examine long-term survival in groups of screen-detected and symptomatic breast cancer patients attending a specialist breast unit, and to determine the factors affecting this survival. A total of 3239 breast cancer cases (1252 screen-detected and 1987 symptomatic) diagnosed between 1989 and 2002 were followed up until the end of 2002, and breast cancer-specific survival was examined in the screened and symptomatic groups, in relation to patient age, tumour size, nodal status and histological grade. Long-term survival in this clinical cohort was high. Relative survival values in the symptomatic group were similar to population-based estimates for southeast England derived from data held at the Thames Cancer Registry, whilst survival values in the screening group were 11-12 percentage points higher at 4 years after diagnosis and onwards. Ten-year relative survival estimates were 88% in the screening group and 77% in symptomatic cases. In groups of comparable age, the difference in breast cancer-specific survival at 10 years was 19 percentage points. Survival was significantly related to tumour characteristics (size, nodal status and grade), but not to morphological tumour type or deprivation score of the subject. After adjustment for other factors, the difference in survival between the two groups was much attenuated and became statistically non-significant. The higher survival seen in the screening group can be almost entirely accounted for in terms of the detection of early stage and lower grade tumours which screening provides.

  1. Nutritional support of the hospitalized patient

    African Journals Online (AJOL)

    1983-04-23

    Apr 23, 1983 ... Improve- ment in the nutritional status of cancer patients by oral feeding .... Ambulatory home care using total parenteral nutrition is a novel and ... major burns treated with aggressive nutritional support have a ... phase.56.

  2. EGFR mutation testing in patients with advanced non-small cell lung cancer: a comprehensive evaluation of real-world practice in an East Asian tertiary hospital.

    Directory of Open Access Journals (Sweden)

    Yoon-La Choi

    Full Text Available INTRODUCTION: Guidelines for management of non-small cell lung cancer (NSCLC strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. METHODS: Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. RESULTS: This cohort had a mean age (SD of 59.6 (11.1 years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5% and squamous cell carcinoma (18.0%. Overall, 39.5% of patients were tested for EGFR mutations. The proportion of patients undergoing EGFR testing during January 2007 through July 2008, August 2008 through September 2009, and October 2009 through July 2010 were 23.3%, 38.3%, and 63.5%, respectively (P<0.001. The median time elapsed between cancer diagnoses and receiving EGFR testing results was 21 days. EGFR testing was most frequently ordered by oncologists (57.7%, pulmonologists (31.9%, and thoracic surgeons (6.6%. EGFR testing was more commonly requested for women, younger patients, stage IV disease, non-smokers, and adenocarcinoma histology. Of 586 cases successfully tested for EGFR mutations, 209 (35.7% were positive, including 118 cases with exon 19 deletions and 62 with L858R mutations. EGFR mutation positive patients were more likely to be female, never-smokers, never-drinkers and to have adenocarcinoma. CONCLUSIONS: In a large cancer center in Korea, the proportion of EGFR testing increased from 2007 through 2010. The high frequency of EGFR mutation positive

  3. 关于住院癌症患者疼痛调查及健康教育体会%Pain investigation and health education experience of hospitalized cancer patients

    Institute of Scientific and Technical Information of China (English)

    朱燕双; 李彩霞; 张旭绚

    2014-01-01

    Objective To understand the effect of pain control for cancer patients hospitalized in the region and summarize health education experience to further promote the therapeutic work of “three steps of cancer analgesic”.Methods Comprehensively assessing the incidence of pain, medication, pain control satisfaction of 300 cancer patients by questionnaire and linear visual analog scale assessment.Results Completed a total cancer pain survey of 300 patients, of which 96.33% cancer patients had pain treatment, the choice of drug treatment accounted for 92.7%, the analgesic effect was most satisfied with the use of intravenous analgesia pump, pain relief rate was 91.7%.Conclusion Hospitalized patients with cancer pain control in the region is acceptable, pain health education should be further deepened.%目的:了解本地区住院癌症患者的疼痛控制情况,总结健康教育体会,进一步推动“癌症镇痛三阶梯”治疗工作。方法通过调查问卷及采用线性视觉模拟评估尺,对300例癌症患者的疼痛发生率、用药、疼痛控制满意度等情况进行全面评估。结果共完成300例癌痛患者的调查,其中96.33%的癌症患者接受过止痛治疗,选用药物治疗的占92.7%,镇痛效果最满意的是使用静脉止痛泵,疼痛缓解率达91.7%。结论本地区住院癌症患者癌痛控制的效果尚可,癌痛健康教育需进一步深化。

  4. Psychometric Evaluation of Cancer Patients

    Directory of Open Access Journals (Sweden)

    S B Bansal, Sanjay Dixit, Geeta Shivram

    2012-01-01

    Full Text Available Background: Mental health is the balanced development of the individual’s personality and the emotional attitude which will enable him or her to live harmoniously with his or her Fellow citizens. Mental health is not exclusively a matter of relation between persons It is also a matter of relation of individuals towards the community in which they live, towards the society of which the community is a part, and towards the social institutions which for a large part guide their life, determine their way of living, working, leisure, and the way they spends and earns the money, the way they sees happiness, stability and security. Objective: To asses and quantify the prevalence of psychological morbidity in cancer patients of government cancer hospital MGM Medical College Indore, M.P. Material and Methods: 100 cancer patients were chosen randomly all of them were interviewed through a questionnaire survey in ward and OPD of cancer hospital in November and December 2009. Data on demographics, and duration of diagnosis were collected. Results: Gender wise prevalence of psychological morbidity Grade II &III; were 94% in males and 86% in females. Chi square test was not significant. According to age the Grade II & III psychological morbidity were 41(46% in 15-45 years age group and 49 (54% in 46-75 years age group which is significantly higher than previous age group .Chi square test (x2 = 7.54 p value < 0.05 Grade II & III psychological morbidity were 52% in 0-6 months duration while it was 38% in more than 6 months duration Chi square test (x2= 8.04, P value < 0.05 statistically significant Conclusion: the prevalence of psychological morbidity was slightly higher in males and older age group, and also high psychological morbidity was seen in recently diagnosed cancer patients. A good counseling, stress relaxation and life style modification program is required to make such patients live their life in a positive and better way.

  5. Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland

    Directory of Open Access Journals (Sweden)

    Rutkowski Stefan

    2008-05-01

    Full Text Available Abstract Background Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI. To date, no prospective multicenter studies have been published on this topic. Methods Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO with specific case definitions and standardized surveillance methods. Results 7 pediatric oncology centers (university facilities participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36% were HAIs in 181 patients, for an incidence density (ID (number of events per 1,000 inpatient days of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P Conclusion Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

  6. Poor adhesion of fentanyl transdermal patches may mimic end-of-dosage failure after 48 hours and prompt early patch replacement in hospitalized cancer pain patients

    Science.gov (United States)

    Arnet, Isabelle; Schacher, Sabrina; Balmer, Eva; Koeberle, Dieter; Hersberger, Kurt E

    2016-01-01

    Context Renewal of fentanyl transdermal patch (transdermal therapeutic system [TTS]) should occur every 3 days (72 hours) according to manufacturer’s guidelines. Some studies mentioned patients reporting end-of-dose failure, and thus, some authors recommend shortening the interval of application to 2 days (48 hours). However, reasons for early replacement are mostly unknown. Objectives The objectives of this study were to assess the prevalence of early replacement of fentanyl TTS in a cancer center in Basel, Switzerland, and to assess the reasons for early replacement in stationary patients. Methods We retrieved all fentanyl TTS administered in a cancer center in Basel, Switzerland, between November 11, 2011, and January 31, 2015, from the electronic medical database. Results A total of 739 patients (mean age 71.4±11.5 years, 55% women) were administered 2,250 fentanyl TTS (dosage 6–500 µg/hour). Most replacements occurred after 72 hours (61.6%) and a few after 48 hours (7.4%). Patients with early replacement after 48 hours were significantly younger (63.8 years versus 71.5 years, ppharmacists, the most often reasons for early TTS replacement were end-of-dosage pain (41.4%) and poor adhesion (31.4%). Conclusion In the absence of any physiological, pharmacological, or environmental reasons recorded in the database to explain an early replacement of fentanyl TTS, skin adhesion problems may point practical reasons and mimic end-of-dosage failure. PMID:27877065

  7. Cancer Patients' Informational Needs: Qualitative Content Analysis.

    Science.gov (United States)

    Heidari, Haydeh; Mardani-Hamooleh, Marjan

    2016-12-01

    Understanding the informational needs of cancer patients is a requirement to plan any educative care program for them. The aim of this study was to identify Iranian cancer patients' perceptions of informational needs. The study took a qualitative approach. Semi-structured interviews were held with 25 cancer patients in two teaching hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories were extracted. The results came under two main categories: disease-related informational needs and information needs related to daily life. Disease-related informational needs had two subcategories: obtaining information about the nature of disease and obtaining information about disease prognosis. Information needs related to daily life also had two subcategories: obtaining information about healthy lifestyle and obtaining information about regular activities of daily life. The findings provide deep understanding of cancer patients' informational needs in Iran.

  8. Hip fracture in hospitalized medical patients.

    Science.gov (United States)

    Zapatero, Antonio; Barba, Raquel; Canora, Jesús; Losa, Juan E; Plaza, Susana; San Roman, Jesús; Marco, Javier

    2013-01-08

    The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost. A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p patients with a hip fracture (20.7 days vs 9.8 days; p patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  9. Rehabilitation of cancer patients.

    Directory of Open Access Journals (Sweden)

    Pandey M

    2001-01-01

    Full Text Available With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.

  10. Epidemiology of hospitalized burns patients in Taiwan.

    Science.gov (United States)

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang

    2003-09-01

    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children.

  11. Prevalence and Risk Factors of Gastric Adenoma and Gastric Cancer in Colorectal Cancer Patients

    OpenAIRE

    Dae Hyun Tak; Hee Seok Moon; Sun Hyung Kang; Jae Kyu Sung; Hyun Yong Jeong

    2016-01-01

    Background/Aims. To evaluate the incidence of gastric adenoma and gastric cancer in colorectal cancer patients, as well as the clinicopathological features that affect their incidence. Methods. Among patients who underwent surgery after being diagnosed with colorectal cancer between January 2004 and December 2013 at Chungnam National University Hospital, 142 patients who underwent follow-up upper gastrointestinal endoscopy were assigned to the patient group. The control group included 426 sub...

  12. Knowledge, attitude and practice about breast cancer and breast self-examination among women seeking out-patient care in a teaching hospital in central India

    Directory of Open Access Journals (Sweden)

    Rao Siddharth

    2016-01-01

    Full Text Available Background: Breast cancer (BC continues to be a major cause of morbidity and mortality throughout the world. Early detection of BC and early treatment increases the chance of survival. According to Breast Health Global Initiative guidelines for low and middle income countries, diagnosing BCs early by promoting breast self-awareness; clinical breast examination (CBE and resource adapted mammographic screening will reduce BC mortality. There is a paucity of data on the knowledge and awareness of BC and self-breast examination in India. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge, awareness and practices related to BC and breast self-examination in the female rural population attending a teaching hospital. Materials and Methods: We did a random sampling to identify and enroll 360 women and their female relatives. We excluded a participant from the study if she had already undergone a screening mammography or had had a BC. The data was collected by a self-administered questionnaire in vernacular language. Results: Our study population included 360 women with a mean age of 45.81 (±10.9 years. Only 5 (1.38% females had a family history of BC. A whopping 81% of women did not have any knowledge about BC. All the women thought that CBE by doctors was the only way for screening BC. Conclusions: We concluded that with the results of this study, it is imperative to increase awareness about BC and its detection methods in the community through health education campaigns. We should have major policy changes to increase future screening programs and health education programs which would have an overall positive impact on reducing the disease burden.

  13. Inpatient Hospitalization of Oncology Patients: Are We Missing an Opportunity for End-of-Life Care?

    Science.gov (United States)

    Rocque, Gabrielle B.; Barnett, Anne E.; Illig, Lisa C.; Eickhoff, Jens C.; Bailey, Howard H.; Campbell, Toby C.; Stewart, James A.; Cleary, James F.

    2013-01-01

    Introduction: Despite advances in the care of patients with cancer over the last 10 years, cancer remains the second leading cause of death in the United States. Many patients receive aggressive, in-hospital end-of-life care at high cost. There are few data on outcomes after unplanned hospitalization of patients with metastatic cancer. Methods: In 2000 and 2010, data were collected on admissions, interventions, and survival for patients admitted to an academic inpatient medical oncology service. Results: The 2000 survey included 191 admissions of 151 unique patients. The 2010 survey assessed 149 admissions of 119 patients. Lung, GI, and breast cancers were the most common cancer diagnoses. In the 2010 assessment, pain was the most common chief complaint, accounting for 28%. Although symptoms were the dominant reason for admission in 2010, procedures and imaging were common in both surveys. The median survival of patients after discharge was 4.7 months in 2000 and 3.4 months in 2010. Despite poor survival in this patient population, hospice was recommended in only 23% and 24% of patients in 2000 and 2010, respectively. Seventy percent of patients were discharged home without additional services. Conclusion: On the basis of our data, an unscheduled hospitalization for a patient with advanced cancer strongly predicts a median survival of fewer than 6 months. We believe that hospital admission represents an opportunity to commence and/or consolidate appropriate palliative care services and end-of-life care. PMID:23633971

  14. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Tom Edward N. Lo

    2016-03-01

    Full Text Available BackgroundWell-differentiated thyroid cancer (WDTC is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.MethodsWe performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular, evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.ResultsThe mean age at diagnosis was 44±13 years (range, 18 to 82, with a majority of cases occurring in the younger age group (<45 years. Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2% and follicular thyroid cancers (FTCs, 54.4% initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7% presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.ConclusionOverall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  15. Inappropriate hospital admissions: patient participation in research.

    Science.gov (United States)

    Glasby, J; Littlechild, R

    Although political interest in reducing the number of inappropriate hospital admissions is mounting, methods for researching the rate of inappropriate admissions have several major limitations. Whereas traditional studies have tended to be predominantly subjective, more recent studies using clinical review instruments also have a number of limitations. Chief among these is the failure to consider the potential input of the individual patient. To illustrate some of the possible benefits of patient participation, this article cites findings from a study in Birmingham, which sought to involve individual older people in a research study into emergency hospital admissions.

  16. Cancer patients and characteristics of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Hasenberg, U.; Paul, T. [Department of Radiology, University Hospital Essen (Germany); Feuersenger, A. [Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen (Germany); Goyen, M. [Department of Radiology, University Medical Center Hamburg-Eppendorf (Germany); Kroeger, K. [Department of Angiology, University Hospital Essen (Germany)], E-mail: knut.kroeger@uk-essen.de

    2009-03-15

    Objective: To check the hypothesis that cancer patients suffer from extended pulmonary embolism (PE) more frequently than patients without cancer we analysed PEs proved by computed tomography (CT)-imaging. Patients and methods: One hundred and fifty consecutive CT scans at the University Hospital of Essen from March 2002 until December 2004 which proved a definite case of pulmonary embolism were retrospectively reviewed (79 men, 71 women; mean age 57 {+-} 15 years). Underlying disease and blood parameters were included (haemoglobin, haematocrit, fibrinogen and total protein, if determined within 48 h before the CT scans). Results: Patients with malignant disease were older (59 {+-} 12 years vs. 54 {+-} 19 years, p = 0.05) and tend to have a higher rate of central PEs (52% vs. 34%, p = 0.08) than patients without malignancies. The odds of a central PE in cancer patients was about twice as high as in patients without a malignant disease (Odds ratio: 2.08, 95%-confidence interval: 1.06-4.10; age-adjusted Odds ratio 1.88, 95%-confidence interval: 0.92-3.84). Additional adjustment for the clinical information dyspnoea, inhospital patient and clinically expected PE did not deteriorate the odds. Thrombus density determined in patients with central PE only shows a trend towards a lower density in patients with malignant disease (52 {+-} 13 HE vs. 45 {+-} 15 HE, p = 0.13). There is no statistical evidence that thrombus density is related to one of the blood parameters or even blood density measured in the pulmonary artery. Conclusion: Although this is a retrospective study including a small number of patients it shows that cancer patients are at a higher risk for central PE than patients without cancer. Characteristics of the intrapulmonal thrombus in cancer and non-cancer patients seem to be different.

  17. Clinicopathological, therapeutic and prognostic features of the triple-negative tumors in moroccan breast cancer patients (experience of Hassan II university hospital in Fez

    Directory of Open Access Journals (Sweden)

    Akasbi Yousra

    2011-11-01

    Full Text Available Abstract Introduction Triple-negative breast cancer (TNBC is defined as a group of breast carcinomas that are negative for expression of hormone receptors (ER, PR and Her2, we can distinguish between two groups: basal-like (ER-, PR-, Her2-, cytokeratin (CK 5/6+ and/or Her1+ and unclassified subtype (ER-, PR-, Her2-, Her1- and CK5/6-. The aim of this study is to determine the clinicopathological, histological, therapeutic and prognostic features associated with this type of breast cancer. Methods This is a retrospective study of 366 female breast cancer patients, diagnosed between January 2007 and June 2010 at the Department of Pathology. Epidemiological, clinical, histological, therapeutic and evolutive data were analyzed. OS and DFS rates were estimated by Kaplan-Meier analysis and a log-rank test to estimate outcome. Results A total of 64 women were identified as having TNBC (17.5% of all female breast cancer patients, 12.6% were basal-like, 4.9% were unclassified subtype, with a median age of 45 years. The median histological tumor diameter was 4.3 cm. TNBC were most often associated with a high grade, 49.2% grade III (53% for unclassified subtype, 47.6% for basal-like. Vascular invasion was found in 26.6% of cases (22% for unclassified subtype and 28.3% for basal-like. For the lymph node involvement: 51% had positive lymph nodes, and 22.4% had distant metastases. Neoadjuvant chemotherapy was administered to 18% patients with 26% of complete pathologic response; therefore adjuvant chemotherapy was given to 82%. 98% received anthracycline based regimen and only 30% received taxanes. The Kaplan-Meier curves based showed the lowest survival probability at 3-years (49% of OS, and 39% of DFS. Conclusion TNBC is associated with young age, high grade tumors, advanced stage at diagnosis, difference chemo response compared to other subtypes, and shortest survival. Critical to optimal future management is accurate identification of truly triple

  18. Overexpression of MMP-3 and uPA with Diminished PAI-1 Related to Metastasis in Ductal Breast Cancer Patients Attending a Public Hospital in Mexico City

    Science.gov (United States)

    Barajas-Castañeda, Luis Miguel; Cortés-Gutiérrez, Evelin; García-Rodríguez, Francisco Mario; Campos-Rodríguez, Rafael; Lara-Padilla, Eleazar; Enríquez-Rincón, Fernando; Figueroa-Arredondo, Paula

    2016-01-01

    Extracellular matrix metalloproteases and the fibrinolytic system are important protease systems interacting with each other in charge of remodeling and recycling of tissues. Their role in tumor invasion and metastasis is often discussed. In this study several metalloproteases such as MMP-1, MMP-3, MMP-9, and TIMP-1 together with molecules from the fibrinolytic system like uPA, its receptor uPAR, and its inhibitor, PAI-1, were studied by immune-histochemistry to establish a comparison with and without metastasis. From the (118) primary tumors of Mexican patients with ductal breast cancer studied, 56% were grade II and 69% were size T2; the group with metastatic ganglia included 64 samples (54.3%). In patients with metastasis the estimated expression of MMP-3 and uPA (resp., 28% and 45%) was higher than that from no metastatic tumors; it means there is higher expression of both markers in metastatic tumors (p < 0.05). At the same time, metastatic tumors showed statistically significant lower signal of PAI-1 (24%) than tumors without metastasis (p < 0.05). We concluded that overexpression of MMP-3 and uPA, altogether with diminished expression of PAI-1 from metastatic tumors, might be a crucial step towards metastasis in ductal breast cancer. Nevertheless, additional studies in different populations are necessary to establish a pattern. PMID:27975070

  19. Oral Candidiasis among Cancer Patients Attending a Tertiary Care Hospital in Chennai, South India: An Evaluation of Clinicomycological Association and Antifungal Susceptibility Pattern.

    Science.gov (United States)

    Jayachandran, Abirami Lakshmy; Katragadda, Radhika; Thyagarajan, Ravinder; Vajravelu, Leela; Manikesi, Suganthi; Kaliappan, Shanmugam; Jayachandran, Balaji

    2016-01-01

    Oropharyngeal candidiasis is one of the common manifestations seen in cancer patients on cytotoxic therapy and invasion into deeper tissues can occur if not treated promptly. Emergence of antifungal drug resistance is of serious concern owing to the associated morbidity and mortality. The present study aims at evaluation of clinicomycological association and antifungal drug susceptibility among the 180 recruited patients with cancer on chemotherapy and/or radiotherapy with signs or symptoms suggestive of oral candidiasis. Speciation and antifungal susceptibility was done by Microbroth dilution method for fluconazole, Itraconazole, and Amphotericin B as per standard microbiological techniques. Chi-square test was used for statistical analysis (p < 0.05 was considered statistically significant). Candida albicans was the predominant species isolated (94) (58%) followed by Candida tropicalis (34) (20.9%). Fluconazole and Itraconazole showed an overall resistance rate of 14% and 14.8%, respectively. All the isolates were susceptible to Amphotericin B. There was a significant association between the presence of dry mouth and isolation of Candida (p < 0.001). Such clinicomicrobiological associations can help in associating certain symptoms with the isolation of Candida. Species level identification with in vitro antifungal susceptibility pattern is essential to choose the appropriate drug and to predict the outcome of therapy.

  20. Overexpression of MMP-3 and uPA with Diminished PAI-1 Related to Metastasis in Ductal Breast Cancer Patients Attending a Public Hospital in Mexico City

    Directory of Open Access Journals (Sweden)

    Luis Miguel Barajas-Castañeda

    2016-01-01

    Full Text Available Extracellular matrix metalloproteases and the fibrinolytic system are important protease systems interacting with each other in charge of remodeling and recycling of tissues. Their role in tumor invasion and metastasis is often discussed. In this study several metalloproteases such as MMP-1, MMP-3, MMP-9, and TIMP-1 together with molecules from the fibrinolytic system like uPA, its receptor uPAR, and its inhibitor, PAI-1, were studied by immune-histochemistry to establish a comparison with and without metastasis. From the (118 primary tumors of Mexican patients with ductal breast cancer studied, 56% were grade II and 69% were size T2; the group with metastatic ganglia included 64 samples (54.3%. In patients with metastasis the estimated expression of MMP-3 and uPA (resp., 28% and 45% was higher than that from no metastatic tumors; it means there is higher expression of both markers in metastatic tumors (p<0.05. At the same time, metastatic tumors showed statistically significant lower signal of PAI-1 (24% than tumors without metastasis (p<0.05. We concluded that overexpression of MMP-3 and uPA, altogether with diminished expression of PAI-1 from metastatic tumors, might be a crucial step towards metastasis in ductal breast cancer. Nevertheless, additional studies in different populations are necessary to establish a pattern.

  1. Model construction of nursing service satisfaction in hospitalized tumor patients.

    Science.gov (United States)

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  2. Pegfilgrastim prophylaxis is associated with a lower risk of hospitalization of cancer patients than filgrastim prophylaxis: a retrospective United States claims analysis of granulocyte colony-stimulating factors (G-CSF

    Directory of Open Access Journals (Sweden)

    Naeim Arash

    2013-01-01

    Full Text Available Abstract Background Myelosuppressive chemotherapy can lead to dose-limiting febrile neutropenia. Prophylactic use of recombinant human G-CSF such as daily filgrastim and once-per-cycle pegfilgrastim may reduce the incidence of febrile neutropenia. This comparative study examined the effect of pegfilgrastim versus daily filgrastim on the risk of hospitalization. Methods This retrospective United States claims analysis utilized 2004–2009 data for filgrastim- and pegfilgrastim-treated patients receiving chemotherapy for non-Hodgkin’s lymphoma (NHL or breast, lung, ovarian, or colorectal cancers. Cycles in which pegfilgrastim or filgrastim was administered within 5 days from initiation of chemotherapy (considered to represent prophylaxis were pooled for analysis. Neutropenia-related hospitalization and other healthcare encounters were defined with a “narrow” criterion for claims with an ICD-9 code for neutropenia and with a “broad” criterion for claims with an ICD-9 code for neutropenia, fever, or infection. Odds ratios (OR for hospitalization and 95% confidence intervals (CI were estimated by generalized estimating equation (GEE models and adjusted for patient, tumor, and treatment characteristics. Per-cycle healthcare utilization and costs were examined for cycles with pegfilgrastim or filgrastim prophylaxis. Results We identified 3,535 patients receiving G-CSF prophylaxis, representing 12,056 chemotherapy cycles (11,683 pegfilgrastim, 373 filgrastim. The mean duration of filgrastim prophylaxis in the sample was 4.8 days. The mean duration of pegfilgrastim prophylaxis in the sample was 1.0 day, consistent with the recommended dosage of pegfilgrastim - a single injection once per chemotherapy cycle. Cycles with prophylactic pegfilgrastim were associated with a decreased risk of neutropenia-related hospitalization (narrow definition: OR = 0.43, 95% CI: 0.16–1.13; broad definition: OR = 0.38, 95% CI: 0.24–0.59 and all

  3. Lung Cancer Survival Improvement through Surgical Intervention in PUMCH Hospital

    Institute of Scientific and Technical Information of China (English)

    GUO Feng; ZHANG Zhiyong; CUI Yushang; LI Shanqing; LI Li; XU Xiaohui; GE Feng; GUO Huiqin; LI Zejian

    2006-01-01

    Objective: To investigate and evaluate improvement of lung cancer survival after surgical intervention in PUMC hospital during the last 15 years. Methods: From January 1989 to December 2003, 1574 lung cancer cases underwent surgical treatment and followed up. All cases in this series were divided into two groups according to time period: group A (1999-2003) and group B (1989-1998). The difference in the survival rate between groups A and B was compared. Results: The morbidity and mortality in group A was decreased significantly in comparison to group B (11.2% vs. 19.2%, 1.06% vs. 1.93%, respectively).However, the 3-year and 5-year survival rate was increased from 42.35% to 56.07%, and from 28.46% to38.99%, respectively. A significant improvement in survival was observed in patients with stage Ⅰ, Ⅱ and ⅢA, but not in those with stage ⅢB and Ⅳ. Also, patients with lobectomy had more satisfactory results than those receiving exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection. Conclusion: Lobectomy plus systematic mediastinal lymph nodes dissection has become the standard mode for resectable lung cancer. Combination of complete resection along with lymph nodal dissection, and postoperative adjuvant chemotherapy based on platinum/3rd generation chemotherapy medicine, has preliminarily been justified, proving an important approach for effective improvement in long-term survival of non-small cell lung carcinoma.

  4. QUALITY OF LIFE IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AT THE GENERAL ENDOCRINOLOGY CLINICS OF THE UNIVERSITY HOSPITAL OF PUERTO RICO

    Science.gov (United States)

    Vega-Vázquez, Mónica A.; González-Rodríguez, Loida; Santiago-Rodríguez, Eduardo J.; Garcés-Domínguez, Anette; Shum, Lee-Ming; Tirado-Gómez, Maribel; Ramírez-Vick, Margarita

    2016-01-01

    Background Differentiated thyroid cancer (DTC) can comprise the quality of life of patients. Our purpose is to investigate if the quality of life, in a cohort of patients in Puerto Rico, is affected by the diagnosis and/or treatment modalities received for DTC. Methods This is a cross-sectional study of 75 subjects with DTC. A Spanish version of the University Of Washington Quality Of Life Questionnaire was used, including multiple aspects of physical and social functioning. Descriptive and bivariate analysis between domain scores and variables of interest were performed. Results 82.7% of the patients reported that their health was the same or better than it was before treatment. The mean composite score obtained was 82.3, reflecting an overall little effect on quality of life. Patients diagnosed with DTC at an age of ≥45 years reported a significantly better score on the pain domain when compared with those diagnosed earlier (p150 mCi of radioiodine had a tendency towards a worse score on the same domain (p=0.05). Conclusions Our cohort reported an overall minimal effect on their quality of life. Future treatment strategies should include periodic quality of life evaluations, in order to tailor therapy in this growing population. PMID:26035981

  5. 中国和加拿大两所医院乳腺癌病人术后生存分析比较%Comparison of survival among patients with breast cancer treate d at First Teaching Hospital,Changchun,China and at Saint-Sacrement Hospital,Q uebec,Canada

    Institute of Scientific and Technical Information of China (English)

    范志民; 付彤; 辛志泳; 孙淑滨; 司序

    2001-01-01

    Objective:To explore th five year survivals and some prognostic factors for bres at cancer patients in the north areas of China,and the indentification or differ e nces on these variables among breast cancer patients between in China and in Can ada.Methods:All Data were collected from the hospital records of 1 002 breast cancer patients who were initially treated at the First Hospital of Jilin Uni versity (116 cases FTH,Changchun China) and the Sain t-Sacrement Hospital (886 cases in SSH,Quebec Canada) respectively by use of Historical Cohort survey,and the survival propotions were calculated and comp ared stradly by use of Kaplan-Meier method.Results:Age at diagnosis was substantially lower (average of age about 10 years less) among breast cancer patients seen at FTH compared to those treated at SSH (P<0.0001).Patients in the two hospitals differed in respect to tumor size at pathology (P=0.036).The proportion of women with lymph node involvement was greater at FTH (61.1%) than that at HSS(37.3%)(P<0.0001).Surgical treat ment of breats cancer was varied considerably:the radical mastectomy was frequen tly performed for andy stage of breast cancer patients in Changchun,but the part ial mastectomy was mainly used for patients with stage Ⅰ or Ⅱ in Quebec.The fi ve year survival was 74.2% among breast cacer patients seen at FTH compared to 7 6.3% among women treated at HSS,and there was no singnificant differrence (P =0.302). Conclusion:Five year survival of breast cancer patients treated surgically in C hangchun,China,was similar to that of patients treated surgically in Quebec,Can ada except for differences in age at diagnosis,tumor size and lymph node involve ment%目的:探讨我国北方地区乳腺癌病人的5年生存率、主要预后因素及其与加拿大类似气候地 区的异同。方法:收集吉林大学第一医院(中国长春,简称FTH)和拉瓦尔大学圣萨可门医 院(加拿大魁北克,简称SSH)1 002例乳腺癌病人的资料

  6. Cancer patients' evaluation of communication

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2013-01-01

    The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication.......The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication....

  7. Hospital patient loyalty: causes and correlates.

    Science.gov (United States)

    MacStravic, R S

    1994-01-01

    This study was designed to test whether factors associated with customer and employee loyalty are linked to hospital loyalty, and to measure the relative strength of the associations between traditional patient satisfaction factors and loyalty as compared to non-traditional factors.

  8. [Respect of patient's dignity in the hospital].

    Science.gov (United States)

    Duguet, A-M

    2010-12-01

    Every code of ethics of health professionals in France considers the respect of dignity as a fundamental duty. The French 2002 Law on patient rights says that the person has the right to respect of dignity and of private life. After a presentation of the articles of ethics codes regarding dignity, this paper presents recommendations to deliver medical care in situations where dignity might be endangered such as for patients hospitalized in psychiatric services without consent, or for medical examination of prisoners or medical care to vulnerable patients unable to express their will, especially in palliative care or at the end of life. Respect of dignity after death is illustrated by the reflection conducted by the Espace Ethique de l'AP-HP (Paris area hospitals) and in the Chart of the mortuary yard. A survey of the patients' letters of complaint received by the emergency service of the Toulouse University Hospital showed that, in five years, there were 188 letters and 18 pointed out infringements to the dignity of the person. The health professional team is now aware of this obligation, and in the accreditation of the hospitals, the respect of dignity is one of the indicators of the quality of medical care.

  9. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  10. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  11. Epidemiologic factors of colorectal cancer in a county hospital in Romania

    Directory of Open Access Journals (Sweden)

    Mihaela Leşe

    2013-03-01

    Full Text Available Colorectal cancer is the most common digestive cancer. The aim of this study is to determine the colorectal cancer’s frequency relatedto age, gender, personal or family history, and also to blood group of the patients operated in the County Emergency Hospital of BaiaMare, Romania. Material and methods: The records of 512 patients with cancer of the colon, rectal cancer and synchronous colorectal cancerwere studied retrospectively in a period of 15 years, admitted to The Department of Surgery in The County Emergency Hospital of Baia Mare,Romania. Results: Colorectal cancers have been found to be more frequent in women under the age of 50 and in men above this age (p=0.004.In urban environments the right colon cancer (59.62% and rectal cancer (55.87% were more frequently encountered. Tumor location had analmost even distribution: 30% right colon, 35.45% left colon, 34.96% rectal cancer and 0.78% synchronous cancers. The association with personaland family history was statistically insignificant, except asthma which was considered a protective factor (p<0.001 for colorectal cancer.The abidance in blood groups shows proportional distribution with their representation in the population of our country, but family historyof colorectal cancer was found only in O and A groups. Conclusions: The study ascertains the left to right shift of the large bowel cancers, theincreasing of medium age of patients and high incidence of colorectal cancer in women under the age of 50 years. Asthma may be a protectivefactor for colorectal cancer, especially for right colon cancer, and genetic factors are present only in patients with O and A blood groups .

  12. Impact of health care reform on the cancer patient: a view from cancer executives.

    Science.gov (United States)

    Ferris, Linda W; Farber, Matthew; Guidi, Teri Ursin; Laffey, William J

    2010-01-01

    Cancer leaders assess the impact on the cancer patient of the historic passage of Patient Protection and Affordable Care Act (HR 3590) (PPACA). The Association of Cancer Executives, a national organization for leadership development of oncology executives and improvements in patient care delivery, and the Association of Community Cancer Centers, a leading education and advocacy organization for the cancer team, weigh in on the impact of PPACA. Oncology leaders assess the impact of PPACA on cancer patients and families, cancer programs in the United States, and provider relations. The provisions of PPACA most impacting cancer patients are reviewed, including reimbursement changes, expansion of prevention and screening services, the development of accountable care organizations, physician relations, and the implementation of integrated electronic health records. Cancer executives prepare their programs for PPACA by changing the care delivery model to ensure the economic survival of private practices and hospital-based programs.

  13. Predictors of in-hospital mortality among older patients

    Directory of Open Access Journals (Sweden)

    Thiago J. A. Silva

    2009-01-01

    Full Text Available OBJECTIVE: The objective of this study was to determine predictors of in-hospital mortality among older patients admitted to a geriatric care unit. INTRODUCTION: The growing number of older individuals among hospitalized patients demands a thorough investigation of the factors that contribute to their mortality. METHODS: This was a prospective observational study implemented from February 2004 to October 2007 in a tertiary university hospital. A consecutive sample of 922 patients was evaluated for possible inclusion in this study. Patients hospitalized for palliative care, those who declined to participate, and those with incomplete data were excluded, resulting in a group of 856 patients aged 60 to 104 years. Bivariate and multivariate analyses were performed to determine associations between in-patient mortality and gender, age, length of stay, number of prescribed medications and diagnoses at admission, history of heart failure, neoplastic disease, immobility syndrome, delirium, infectious disease, and laboratory tests at admission (serum albumin and creatinine. RESULTS: The overall mortality rate was 16.4%. The following factors were associated with higher in-hospital mortality: delirium (OR=4.13, CI=2.65-6.44, P1.3mg/dL (OR=2.39, CI=1.53-3.72, P<.001, history of heart failure (OR=1.97, CI=1.20-3.22, P=.007, immobility (OR=1.84, CI=1.16-2.92, P =.009, and advanced age (OR=1.03, CI=1.01-1.06, P=.019. CONCLUSIONS: This study strengthens the perception of delirium as a mortality predictor among older inpatients. Cancer, immobility, low albumin levels, elevated creatinine levels, history of heart failure and advanced age were also related to higher mortality rates in this population.

  14. 我院2011-2014年结直肠癌患者化疗用药分析%Analysis of the Application of Antineoplastic Drugs in Patients with Colorectal Cancer in Our Hospital during 2011-2014

    Institute of Scientific and Technical Information of China (English)

    邰宵辉; 张玲芳; 张旭霞; 刘乐; 彭艳艳; 杨静; 李红玲

    2015-01-01

    目的:为结直肠癌患者化疗提供方案以及用药参考。方法:查阅我院2011-2014年化疗的结直肠癌住院患者的病历及医嘱,对化疗方案和药物的使用及用药不合理现象进行回顾性统计、分析。结果:共纳入结直肠癌患者593例,化疗频次1940次,主要从化疗的适应证、方案的选择、化疗过程、化疗的时间及周期等方面对化疗方案选择进行分析;用药不合理409例,主要从药物剂量、溶剂选择、药物浓度等方面进行统计分析,不合格率为21.08%。结论:我院结直肠癌患者抗肿瘤药的使用以及化疗方案的选择基本合理,但仍存在一定的不足,在今后的临床应用中,有待进一步改进。%OBJECTIVE:To provide reference for medication and chemotherapy in patients with colorectal cancer. METH-ODS:Through retrospective study,case histories and doctor’s advice of the colorectal cancer patients receiving chemotherapy in our hospital during 2011-2014 were consulted to analyze the chemotherapy,medication and irrational drug use. RESULTS:A total of 593 cases of colorectal cancer patients with chemotherapy frequency of 1 940 times were collected to analyze the choice of che-motherapy regimen mainly from the following aspects:indications of chemotherapy,choice of chemotherapy regimen,chemothera-py process and chemotherapy period. There was 409 cases of irrational drug use according to the analysis of drug dosage,selection of solvents and drug concentration,the unqualified rate was 21.08% . CONCLUSIONS:The medication and chemotherapy in pa-tients with colorectal cancer in our hospital are basically rational,but there are still certain problems and shortcomings. In future clinical applications,the medication and chemotherapy need to be improved.

  15. Proton treatment facility at National Cancer Center Hospital East

    Energy Technology Data Exchange (ETDEWEB)

    Nishio, Teiji [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East

    2002-06-01

    In 1997, the proton- treatment facility that has the therapeutic Azimuthally Varying Field (AVF) cyclotron accelerator (C235) is constructed at National Cancer Center Hospital East. The facility has 3-irradiation ports (rooms) that are 2-rotationg gantry ports and 1-horizontal fixed port. The C235 can accelerate proton to 235 MeV with the beam intensity of 300 nA. The external diameter is a very compact with about 4 m. The radio frequency is 106 MHz, the accelerating voltage is about 60 kV, and the harmonic number is 4. A beam stability of the C235 has an important relation with the uniformity of an irradiation field and is a very difficulty. The measured result indicated that the incident beam position against the 2.5-% dose uniformity must be into the 0.5- and 6.6-mm{phi} circles with the double-scattering and wobbler methods, respectively. The proton beam therapy began at the end of November 1998. It has been curing 97 patients by the present. Also, the proton therapy system at our hospital got an approval as medical equipment from the Japanese government in April 2001. And the proton therapy at our hospital was approved as a high advanced medical technology from the Japanese government in July 2001. The treatment expenses are 2883,000 yen uniformly. (author)

  16. Fungal agents isolated from cancer patients.

    Science.gov (United States)

    Alvarez Gasca, M A; Argüero Licea, B; Pliego Castañeda, A; García Tena, S

    1998-01-01

    With the aim to know the frequency of mycotic agents in patients with different types of cancer, samples were obtained from 81 patients from the Hospital de Oncología, Centro Médico Nacional Siglo XXI, IMSS from May 1995 through May 1996. In a conventional grouping seven (7) ambulatory patients were found in early stages, twenty seven (27) occasionally hospitalized patients were found in intermediate stage and forty seven (47) hospitalized patients in terminal stage of cancer. The different samples were processed through routine mycologycal methods and the following fungi species were isolated and identified: fifty four strains (58%) of Candida albicans followed by eleven strains (11.8%) of Candida tropicalis, six strains (6.45%) of Candida parapsilosis, five strains (5.37%) of Candida krusei, four strains (4.3%) of Candida humicola and five strains (5.37%) of Rodothorula rubra. From medical devices like catheter tips, drainage catheters (Pen rouse, Foley) and gallbladder catheters; four (4) strains of C. albicans, three (3) strains of Rodothorula rubra and two (2) strains of Aspergillus sp were isolated. Of the Candida non albicans it was relevant to find C. krusei more frequently than Rodothorula rubra, Aspergillus sp and Penicillum sp. The frequency of the presence of fungi increases commensurately to the advancement of the clincal stage of the cancer.

  17. Profile of Cancer Cases at a Tertiary Care Level Teaching Hospital in Rural Western Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Jayant D Deshpande , Kailash K Singh , Deepak B Phalke

    2012-01-01

    Full Text Available Background: Cancer is one of the major public health problems worldwide. Prevalence and pattern of cancer is known to vary from region to region. Epidemiological information on cancer including the pattern is an important basis for determining the priorities for cancer control in any population group. Objective: Present work is an attempt to study magnitude, profile and some epidemiological aspects in relation to cancer cases at a tertiary care level teaching hospital in rural area. Method: All records were studied and analyzed. A total of 1106 patients were treated during the period studied. A proforma was used to collect data such as age, sex, place of residence, type of cancers and treatment given. The data collected were entered into MS-Excel sheets and analysis was carried out. The information obtained was tabulated analyzed using the software GraphPad Instat demo version. Results: A total of 1106 cancer patients were treated during the January 2010 to December 2010. Among these, 626(56.60 were females and 480(43.39 were females. In males, the common cancers were oral cavity cancers, lung cancers and GIT cancers. The most common cancers among females were the cervical carcinomas, which constituted 32.10% of the total number of cancers cases followed by cancers of breast. Almost 2/3rd of cases occurred in the age group of 41 to 70 years. Maximum frequency was observed in 51–60 year age group in both sexes. Maximum numbers (74.59% of the cases were from rural area. The main methods of cancer treatment were surgery, chemotherapy and radiotherapy, used alone or in combination. Conclusion: Tobacco and alcohol related cancers predominated in males. In females, cervical cancer predominated over breast cancer. Human behavior is a major determinant in the successful control of cancer. Understanding cancer magnitude, risk and trends will be of help in cancer control.

  18. Cancer Treatment Measures – PPS-Exempt Cancer Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Program currently uses three cancer specific measures. The resulting PPS-Exempt...

  19. Analysis of the factors influencing lung cancer hospitalization expenses using data mining.

    Science.gov (United States)

    Yu, Tianzhi; He, Zhen; Zhou, Qinghua; Ma, Jun; Wei, Lihui

    2015-05-01

    Hospitalization expenses for the therapy of lung cancer are not only a direct economic burden on patients, but also the focus of medical insurance departments. Therefore, the method for classifying and analyzing lung cancer hospitalization expenses so as to predict reasonable medical cost has become an issue of common interest for both hospitals and insurance institutions. A C5.0 algorithm is adopted to analyze factors influencing hospitalization expenses of 731 lung cancer patients. A C5.0 algorithm is a data mining method used to classify calculation. Increasing the number of input variables leads to variation in the importance of different variables, but length of stay (LOS), major therapy, and medicine cost are the three variables of greater importance. They are important factors that affect the hospitalization cost of lung cancer patients. In all three calculations, the classification accuracy rate of training and testing partition sets reached 84% and above. The classification accuracy rate reached over 95% after addition of the cost variables. The classification rules are proven to be in accordance with actual clinical practice. The model established by the research can also be applied to other diseases in the screening and analysis of disease hospitalization costs according to selected feature variables.

  20. Investigation of different types of carcinomas among differentiated thyroid cancer patients managed in the Department of Nuclear Medicine at Dr George Mukhari Academic Hospital, South Africa: A five year retrospective study

    Directory of Open Access Journals (Sweden)

    Mpumelelo Nyathi

    2017-09-01

    Full Text Available Background Differentiated thyroid cancers (DTC are abnormal tissues growing around the thyroid gland manifesting in various forms, they vary according to geographic locations and life style. Knowledge of different types of DTC is important in order to implement cost effective treatment strategies. Aims This study was aimed at establishing the types of thyroid cancers among DTC patients managed with radioiodine post-surgery in the Department of Nuclear Medicine at Dr George Mukhari Academic Hospital (DGMAH in South Africa. Methods A retrospective five year (2007–2013 review of patient files managed post-surgery in the Nuclear Medicine Department for various thyroid diseases. A total of 51 patient files were examined. Males and females who received at least a single treatment dose of radioiodine (I-131 qualified for the study thus excluding 26 patients treated for grave’s disease and 9 DTC patients who did not receive a dose of radioiodine. A pie chart was used for categorical variables of the subtypes of carcinomas. Results The follicular carcinoma was the leading malignancy: 8 /16; (50 per cent; followed by the papillary carcinomas amounting to 6/16; (37.5; only one patient was managed for the Hurtle cell carcinoma; 1/16 (6.25 per cent and also one patient for poorly differentiated follicular carcinoma, 1/16; (6.25 per cent. Conclusion Follicular carcinoma was found to be the most common type of DTC managed at DGMAH followed by papillary carcinoma. However, the Hurtle cell carcinoma and the poorly differentiated follicular carcinomas were found to be rare.

  1. Pain in patients with cancer

    NARCIS (Netherlands)

    Vissers, K.C.P.; Besse, K.; Wagemans, M.; Zuurmond, W.; Giezeman, M.J.; Lataster, A.; Mekhail, N.; Burton, A.W.; Kleef, M. van; Huygen, F.

    2011-01-01

    Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate

  2. Coping with cancer and adversity. Hospital ethnography in Kenya

    NARCIS (Netherlands)

    Mulemi, B.A.

    2010-01-01

    Many people associate hospital treatment with 'getting better', the restoration to health and normal life. The onset of a life-threatening disease such as cancer, however, can transform the hospital into a place of constant struggle and suffering. Hospitalisation in this sense coincides with the

  3. Managing patients for zoonotic disease in hospitals

    Science.gov (United States)

    Warwick, Clifford; Corning, Susan

    2013-01-01

    Zoonoses involve infections and infestations transmissible from animals to humans. Zoonoses are a major global threat. Exposure to zoonotic pathogens exists in various settings including encroachment on nature; foreign travel; pet keeping; bushmeat consumption; attendance at zoological parks, petting zoos, school ‘animal contact experiences’, wildlife markets, circuses, and domesticated and exotic animal farms. Under-ascertainment is believed to be common and the frequency of some zoonotic disease appears to be increasing. Zoonoses include direct, indirect and aerosolized transmission. Improved awareness of zoonoses in the hospital environment may be important to the growing need for prevention and control. We reviewed relevant literature for the years 2000 to present and identified a significant need for the promotion of awareness and management of zoonoses in the hospital environment. This article provides a new decision-tree, as well as staff and patient guidance on the prevention and control of zoonoses associated with hospitals. PMID:24040497

  4. [Assessment of nutritional status in patients with primary lung cancer].

    Science.gov (United States)

    Chermiti Ben Abdallah, Fatma; Ben Saïd, Hanène; Chamkhi, Najiba; Ferchichi, Marwa; Chtourou, Amel; Taktak, Sofia; Ben Kheder, Ali

    2013-10-01

    Lung cancer is the leading cause of cancer-related mortality worldwide. Malnutrition is a common problem among patients with cancer, affecting up to 85% of patients with certain cancers and represents a risk factor for poor prognosis. aim: evaluate nutritional status in patients with lung cancer before and during treatment using nutritional risk index. it's a prospective study conducted in pneumology IV department in Abderahman Mami hospital, from January to May 2011. 30 male patients with a lung cancer were included. Nutritional status was assessed before and during treatment based on anthropometric measures, biological markers and nutritional risk index (NRI). Mean age of patients was 58 ± 12 years, ranging from 19 to 82 years. 29 patients had non small cell lung cancer and one patient had small cell cancer. Malnutrition was noted in 14 patients (47%) before treatment according to the NRI. It was noted in 23 patients (77%) after three cycles of chemotherapy with severe malnutrition in 8 patients. Relationship between body mass index (BMI) and the NRI was linear, but NRI tends to evaluate more objectively risk of malnutrition in patients with lung cancer. Nutritional assessment in patient with lung cancer should be performed systematically, early and repeatedly. Several markers can be used such as BMI and NRI. Nutritional support will reduce morbidity and improve quality of life in patients with lung cancer.

  5. Influence factors of hospital infections of patients with cancer after radiotherapy%癌症患者放疗后医院感染的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    鲁广; 张永伟; 柴枫; 任凤

    2015-01-01

    OBJECTIVE To analyze influencing factors of nosocomial infections in cancer patients after undergoing radiotherapy so as to provide the basis for the prevention of nosocomial infections after radiotherapy .METHODS From Aug .2012 to Feb .2015 ,960 cases of cancer patients who received radiotherapy were chosen as study ob‐jects .Their clinical data were analyzed to find out the hospital infection related factors .SPSS 15 .0 was adopted for statistical analysis .RESULTS Among 960 cases of cancer patients with radiotherapy ,62 cases were found to appear hospital infections ,accounting for 6 .46% .Respiratory tract was the main infected site ,accounting for 53 .22% .Patients with myelosuppression grade of Ⅳ got the highest infection rate of 29 .03% .Age greater than or equal to 60 years old ,poor nutrition ,stage Ⅳ ,hospitalization stay longer than or equal to 30 days ,invasive op‐eration ,radiotherapy + chemotherapy ,the use of antimicrobial agents were found to be risk factors for nosocomi‐al infections and the differences were significant (P<0 .05) .CONCLUSION A lot of risk factors can cause infec‐tions in cancer patients after radiotherapy .Hence the prevention and control measures should be taken correspond‐ingly to decrease the hospital infection rate .%目的:分析癌症患者放疗后医院感染的影响因素,为预防放疗后医院感染提供依据。方法选择2012年8月-2015年2月医院960例癌症放疗患者临床资料,分析发生医院感染的相关影响因素,并采用SPSS 15.0软件对数据进行统计分析。结果960例癌症放疗患者发生医院感染62例,感染率为6.46%;感染部位以呼吸道为主占53.22%;骨髓抑制程度为Ⅳ级的感染率最高29.03%;年龄≥60岁、营养状况不良、病期为Ⅳ期、住院时间≥30 d、有侵入性操作、行放疗+化疗治疗方式、使用抗菌药物的患者医院感染率,高于同组的其他数据,差

  6. The impact of the hospital work environment on social support from physicians in breast cancer care.

    Science.gov (United States)

    Ansmann, Lena; Wirtz, Markus; Kowalski, Christoph; Pfaff, Holger; Visser, Adriaan; Ernstmann, Nicole

    2014-09-01

    Research on determinants of a good patient-physician interaction mainly disregards systemic factors, such as the work environment in healthcare. This study aims to identify stressors and resources within the work environment of hospital physicians that enable or hinder the physicians' provision of social support to patients. Four data sources on 35 German breast cancer center hospitals were matched: structured hospital quality reports and surveys of 348 physicians, 108 persons in hospital leadership, and 1844 patients. Associations between hospital structures, physicians' social resources as well as job demands and control and patients' perceived support from physicians have been studied in multilevel models. Patients feel better supported by their physicians in hospitals with high social capital, a high percentage of permanently employed physicians, and less physically strained physicians. The results highlight the importance of the work environment for a good patient-physician interaction. They can be used to develop interventions for redesigning the hospital work environment, which in turn may improve physician satisfaction, well-being, and performance and consequently the quality of care. Health policy and hospital management could create conditions conducive to better patient-physician interaction by strengthening the social capital and by increasing job security for physicians. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Knowledge about breast cancer and hereditary breast cancer among nurses in a public hospital

    Directory of Open Access Journals (Sweden)

    Carmen Maria Dornelles Prolla

    2015-02-01

    Full Text Available OBJECTIVE: To assess the knowledge of nurses involved in the care of oncology patients in a public university hospital, regarding breast cancer and hereditary breast cancer, and to verify the use of such knowledge in their daily practice.METHODS: This is a descriptive cross-sectional study. Data were obtained through a structured, self-administered questionnaire. Out of 154 nurses, 137 (88.9% agreed to participate in the study. Two questionnaires were excluded such that 135 questionnaires were analyzed.RESULTS: The global percentage of correct answers was not associated with age (p=0.173 or degree/specialization (p=0.815. Questions were classified into categories. In categories involving knowledge of established breast cancer risk factors and indicators of hereditary breast cancer, the rate of correct answers was 65.8% and 66.4%, respectively. On the practice of genetic counseling, 40.7% of those interviewed were not sure about the definition of genetic counseling and 78.5% reported never having identified or referred a patient at genetic risk for specialized risk assessment. Practice of educational actions regarding this subject was reported by 48.5% of those interviewed.CONCLUSION: This study reinforces the need to develop qualifying actions for nurses, so that strategies to control breast cancer become effective in their health care practice.

  8. Knowledge about breast cancer and hereditary breast cancer among nurses in a public hospital 1

    Science.gov (United States)

    Prolla, Carmen Maria Dornelles; da Silva, Patrícia Santos; Netto, Cristina Brinckmann Oliveira; Goldim, José Roberto; Ashton-Prolla, Patricia

    2015-01-01

    OBJECTIVE: To assess the knowledge of nurses involved in the care of oncology patients in a public university hospital, regarding breast cancer and hereditary breast cancer, and to verify the use of such knowledge in their daily practice. METHODS: This is a descriptive cross-sectional study. Data were obtained through a structured, self-administered questionnaire. Out of 154 nurses, 137 (88.9%) agreed to participate in the study. Two questionnaires were excluded such that 135 questionnaires were analyzed. RESULTS: The global percentage of correct answers was not associated with age (p=0.173) or degree/specialization (p=0.815). Questions were classified into categories. In categories involving knowledge of established breast cancer risk factors and indicators of hereditary breast cancer, the rate of correct answers was 65.8% and 66.4%, respectively. On the practice of genetic counseling, 40.7% of those interviewed were not sure about the definition of genetic counseling and 78.5% reported never having identified or referred a patient at genetic risk for specialized risk assessment. Practice of educational actions regarding this subject was reported by 48.5% of those interviewed. CONCLUSION: This study reinforces the need to develop qualifying actions for nurses, so that strategies to control breast cancer become effective in their health care practice. PMID:25806636

  9. Epidemiological and clinical profile of triple negative breast cancer at a cancer hospital in North India

    Directory of Open Access Journals (Sweden)

    P Suresh

    2013-01-01

    Full Text Available Background: Triple negative breast cancer (TNBC is a recent concept and the burning topic of research today. Various studies have been reported in western literature on TNBCs or the similar group of basal like cancers, all highlighting the poor prognostic features of this molecular subtype in comparison to the other types of breast cancers. However extensive data from India is lacking. The aim of this study was to analyze the epidemiological and clinical profile of TNBcs at our institute. Materials and Methods: Data on 171 patients of TNBCs registered at this hospital between 2005 and 2008 and followed up until December 2010 was collected and reviewed for epidemiological and clinical features. Results: The median age at presentation was 49 years (22-75 years. Sixty eight patients (40% had lump in the breast of less than 1 month duration. Fourteen (8% were nulliparous and 10 (7% patients had crossed the age of 30 years at first full-term pregnancy, 89 (52% were pre or peri-menopausal at presentation. Only 8 (5% patients had a family history of breast or ovarian cancer. One hundred and six (62% patients were stage II, 26 (15% stage III, 21 (12% stage I and 18 (10% stage IV at presentation. One hundred and twenty eight patients (75% had early breast cancer eligible for surgery at presentation, 25 (15% were locally advanced and received neoadjuvant chemotherapy (NACT and 18 (10% were found to be metastatic. Modified radical mastectomy was the preferred surgical option by most patients (76% who underwent upfront surgery in our study. The pathological overall response rates (complete and partial response after NACT was 75% with complete response rate of 25% and there were no relapses in the complete responders. The median follow-up was 30 months (9-70 months. One hundred and twenty two patients (71% were alive at last follow-up, 34 (22% had relapsed, 18 (11% had died due to progressive disease. Thirty one patients (18% were lost to follow-up. Most of

  10. Triceps skinfold compressibility in hospitalized patients

    Science.gov (United States)

    Sousa, Ana Sofia; Pichel, Fernando; Amaral, Teresa F

    2017-06-05

    To explore triceps skinfold (TSF) compressibility and its associated factors among hospitalized patients. A cross-sectional study was conducted among hospitalized adult patients. Evolution of tissue compressibility during two seconds was registered and 120 TSF values were obtained using a digital calliper. Compressibility was determined according to the difference between the initial value and the final value (TSF difference) and according to time (τ). Multivariable linear regression models were performed in order to identify factors associated with TSF compressibility. One hundred and six patients (30.2% aged ≥ 65 years) composed the study sample. Compressibility based on TSF difference was independently associated with TSF thickness (regression coefficient, 95% confidence interval [CI] = 0.38, 0.01-0.05, p = 0.002) and nutritional risk (regression coefficient, 95% CI = 0.23, 0.12-1.23, p = 0.018), but time of compressibility (τ) was not significantly associated with any of the studied variables. Among a sample of hospitalized patients, undernutrition risk and higher TSF thickness were factors independently associated with higher compressibility assessed by the difference between the initial and final TSF value. Time of compressibility (τ) was not affected by any of the studied factors.

  11. Acute Hospitalization of the Older Patient

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Pedersen, Mette Merete; Petersen, Janne

    2013-01-01

    OBJECTIVE: Acute hospitalization of older patients may be associated with loss of muscle strength and functional performance. The aim of this study was to investigate the effect of acute hospitalization as a result of medical disease on muscle strength and functional performance in older medical...... patients. DESIGN: Isometric knee-extension strength; handgrip strength; and functional performance, that is, the Timed Up and Go test, were assessed at admission, at discharge, and 30 days after discharge. Twenty-four-hour mobility was measured during hospitalization. RESULTS: The mean (SD) age was 82.7 (8...... hospitalization, from 17.3 secs at admission to 13.3 secs at discharge (P = 0.003), but with no improvement at the 30-day follow-up (12.4 secs, P = 0.064). The median times spent in lying, sitting, and standing/walking were 17.4 hrs per day, 4.8 hrs per day, and 0.8 hrs per day, respectively. CONCLUSIONS: Muscle...

  12. Real-world hospital costs for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer in Chinese patients: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Chen JH

    2016-04-01

    Full Text Available Jianhua Chen,1 Shengqi Wu,2 Chenping Hu,3 Yicheng Yang,4 Narayan Rajan,5 Yun Chen,4 Canjuan Yang,6 Jianfeng Li,6 Wendong Chen7 1Department of Medical Oncology, 2Department of Research and Education, Hunan Province Tumor Hospital, 3Department of Respiratory, Xiangya Hospital, Central South University, Changsha, Hunan, 4Lilly Suzhou Pharmaceutical Co., Ltd. Shanghai Branch, Shanghai, People's Republic of China; 5Global Health Outcomes Research, Eli Lilly and Co, Indianapolis, IN, USA; 6Division of Health Outcome Research, Normin Health Changsha Representative Office, Changsha, Hunan, People's Republic of China; 7Normin Health, Toronto, ON, Canada Objective: The objective of this study was to compare hospital costs per treatment cycle (HCTC for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer (AdvNS-NSCLC in Chinese patients. Methods: Patients receiving platinum-based doublets in the first-line setting for AdvNS-NSCLC from 2010 to 2012 in two Chinese tertiary hospitals were identified to create the retrospective study cohort. Propensity score methods were used to create matched treatment groups for head-to-head comparisons on HCTC between pemetrexed–platinum and other platinum-based doublets. Multiple linear regression analyses were performed to rank studied platinum-based doublets for their associations with the log10 scale of HCTC for nonchemotherapy drugs and nondrug care. Results: Propensity score methods created matched treatment groups for pemetrexed–platinum versus docetaxel–platinum (61 pairs, paclitaxel–platinum (39 pairs, gemcitabine–platinum (93 pairs, and vinorelbine–platinum (73 pairs, respectively. Even though the log10 scale of HCTC for nonchemotherapy drugs and nondrug care associated with pemetrexed–platinum was ranked lowest in all patients (coefficient –0.174, P=0.015, which included patients experiencing

  13. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...... dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented...

  14. 肿瘤患者感染病原菌的分布及耐药性分析%The distribution and drug resistance of pathogens specttum in cancer patients during hospitalization

    Institute of Scientific and Technical Information of China (English)

    慕玉东; 楚雍烈; 王永兴

    2011-01-01

    目的:了解肿瘤患者感染病原菌的分布及耐药性分析,为合理用药提供依据.方法:对本院肿瘤患者送检的合格标本分离菌株进行培养鉴定和耐药性分析.结果: 405株病原菌中G- 杆菌228株,占56.3%;G+球菌67株,占16.5%;真菌110株,占27.2%;药敏试验结果提示G-杆菌对亚胺培南、美罗培南高度敏感,对氨苄西林、哌拉西林耐药率很高.结论:肿瘤患者易发生院内感染且易产生耐药株,在选择抗生素时应依据药敏实验结果合理选用药物,控制病原菌的耐药性.%Objective :To study the distribution and drug resistance of pathogens spectrum in cancer patients and provide the basis of rational use of medecines. Methods ; Qualified samples of cancer patients in our hospital were cultered isolated identification and analyzed drug resistance. Results : Of 405 pathogens spectrum the G - bacilli were 228 ( 56. 3 % ) , and C+ coccis were 67 ( 16. 5% ) , and fungi were 110( 27. 2% ) . The results of susceptibility test suggested : the G- bacilli had a highly senstive to imipenem and meropenem, and had a highly resiatant againat ampicillin ang piperacillin. Conclusions : Cancer patients prone to nosoconual infection with resistant strains easily, so the selection of antibiotics should be based on the results of sensitivity tests, to control drug resistance.

  15. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    Science.gov (United States)

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  16. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  17. Model construction of nursing service satisfaction in hospitalized tumor patients

    OpenAIRE

    Chen, Yongyi; LIU, JINGSHI; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient s...

  18. Population versus hospital controls for case-control studies on cancers in Chinese hospitals

    Directory of Open Access Journals (Sweden)

    Li Lin

    2011-12-01

    Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  19. Organochlorine pesticides accumulation and breast cancer: A hospital-based case-control study.

    Science.gov (United States)

    He, Ting-Ting; Zuo, An-Jun; Wang, Ji-Gang; Zhao, Peng

    2017-05-01

    The aim of this study is to detect the accumulation status of organochlorine pesticides in breast cancer patients and to explore the relationship between organochlorine pesticides contamination and breast cancer development. We conducted a hospital-based case-control study in 56 patients with breast cancer and 46 patients with benign breast disease. We detected the accumulation level of several organochlorine pesticides products (β-hexachlorocyclohexane, γ-hexachlorocyclohexane, polychlorinated biphenyls-28, polychlorinated biphenyls-52, pentachlorothioanisole, and pp'-dichlorodiphenyldichloroethane) in breast adipose tissues of all 102 patients using gas chromatography. Thereafter, we examined the expression status of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 (HER2), and Ki-67 in 56 breast cancer cases by immunohistochemistry. In addition, we analyzed the risk of breast cancer in those patients with organochlorine pesticides contamination using a logistic regression model. Our data showed that breast cancer patients suffered high accumulation levels of pp'-dichlorodiphenyldichloroethane and polychlorinated biphenyls-52. However, the concentrations of pp'-dichlorodiphenyldichloroethane and polychlorinated biphenyls-52 were not related to clinicopathologic parameters of breast cancer. Further logistic regression analysis showed polychlorinated biphenyls-52 and pp'-dichlorodiphenyldichloroethane were risk factors for breast cancer. Our results provide new evidence on etiology of breast cancer.

  20. Home versus hospital mortality from cancer in Mexico (1999-2009).

    Science.gov (United States)

    Castillo-Guzmán, Sandra; Palacios-Ríos, Dionicio; Nava-Obregón, Teresa Adriana; Torres-Pérez, Juan Francisco; González-Santiago, Omar

    2013-05-01

    To analyze the place of death from cancer in México from 1999 to 2009 and find the associated factors. We collected data on mortality by cancer from the national database including age, gender, area of residence, level of education, place of death, and type of cancer. The proportion of deaths at home and hospital was 55.67% and 39%, respectively. Factors associated with home deaths were old age, female gender, rural area of residence, and lack of formal education. There was a short but significant decrease in home deaths for cervical cancer and leukemia. In México, mortality in home is greater than in hospital for patients with cancer. Our results have important implications for palliative care professionals and health services of México.

  1. [Prevention of fungal infections in hospitalized patients].

    Science.gov (United States)

    Seeliger, H P; Schröter, G

    1984-06-01

    Hospital acquired infections due to fungi are primarily caused by yeast species of the genus Candida and mould species of the genus Aspergillus. Underlying disease with severely impaired defence mechanisms as well as certain forms of immunosuppressive and aggressive chemotherapy are the most important prerequisites for such secondary fungal infections. Aspergillus spec. usually infect man via exogenous routes, whereas Candida spec. mostly originate from the patient's own microbial flora. Under certain circumstances invasion of tissues follows (endomycosis). Exogenous Candida infections may likewise occur through contaminated hands of personnel and medical devices. The density of yeast cell distribution in hospital wards decreases with the distance from the primary source: the Candida infected human patient. Preventive measures protecting the patient at risk include: Permanent surveillance by routine cultural and serological examinations for the detection of an early infection of the skin, mouth, oesophagus, urinary tract, vagina and the bowel. Monitoring of patients is essential for early detection of dissemination and contributes to the control of fungal decontamination measures. Selective local decontamination is effected by the use of nonabsorbable compounds such as nystatin and amphotericin B in the gastrointestinal tract, and in oral and genital mucous membranes. Oral administration of ketoconazole has also been recommended. For the disinfection of skin appropriate chemicals are available. In the control of the environment of the endangered patient special attention must be paid to meticulous management of catheters. These measures are to be supported by careful disinfection policy concerning the hands of personnel and medical equipment.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. [Health literacy in patients attending a University Hospital].

    Science.gov (United States)

    Konfino, Jonatan; Mejía, Raúl; Majdalani, María Pía; Pérez-Stable, Eliseo J

    2009-01-01

    Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during 2007. Health literacy was assessed through the Short Assessment of Health Literacy for Spanish-speaking Adults. Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during 2007. There were a total of 2345 patients potentially eligible during the time of the study, 234 were approached after random selection and 229 patients were interviewed (98% response); 54.6% of respondents were women and 62% were recruited from the ambulatory clinic. The respondents had a median age of 56 years. The prevalence of inadequate health literacy was 30.1% (69 patients). Patients with literacy compared with those with > 12 years of education OR = 45.1 (IC 9.6-211.6). We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences.

  3. Disclosing discourses: biomedical and hospitality discourses in patient education materials.

    Science.gov (United States)

    Öresland, Stina; Friberg, Febe; Määttä, Sylvia; Öhlen, Joakim

    2015-09-01

    Patient education materials have the potential to strengthen the health literacy of patients. Previous studies indicate that readability and suitability may be improved. The aim of this study was to explore and analyze discourses inherent in patient education materials since analysis of discourses could illuminate values and norms inherent in them. Clinics in Sweden that provided colorectal cancer surgery allowed access to written information and 'welcome letters' sent to patients. The material was analysed by means of discourse analysis, embedded in Derrida's approach of deconstruction. The analysis revealed a biomedical discourse and a hospitality discourse. In the biomedical discourse, the subject position of the personnel was interpreted as the messenger of medical information while that of the patients as the carrier of diagnoses and recipients of biomedical information. In the hospitality discourse, the subject position of the personnel was interpreted as hosts who invite and welcome the patients as guests. The study highlights the need to eliminate paternalism and fosters a critical reflective stance among professionals regarding power and paternalism inherent in health care communication. © 2015 John Wiley & Sons Ltd.

  4. Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States.

    Science.gov (United States)

    Schwartzberg, Lee; Morrow, Gary; Balu, Sanjeev; Craver, Chris; Gayle, Julie; Cox, David

    2011-08-01

    The incidence of overall (acute and delayed) chemotherapy-induced nausea and vomiting (CINV) events among patients treated with single- and multi-day low emetogenic chemotherapy (LEC) is not well established. We studied a cohort of patients receiving LEC and antiemetic prophylaxis with palonosetron (Group 1) versus other 5-HT(3) receptor antagonists (5-HT(3)-RAs) (Group 2), to determine the overall rate of CINV and the proportion of patients experiencing delayed CINV (days 2-7 of a CT cycle) in a hospital outpatient setting. Patients aged ≥18 years with cancer diagnosis initiating single-day and multi-day LEC for the first time between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective database. CINV events (ICD-9-CM codes for nausea, vomiting, or volume depletion or CINV-related rescue medications) were assessed descriptively. A generalized linear multivariate regression model was developed, estimating the overall CINV event rate among Group 1 and 2 patients in the follow-up period (first of eight chemotherapy [CT] cycles or 6 months). In the follow-up period, out of a total of 10,137 overall CINV events (single-day and multi-day LEC), 8783 events (86.6%) were identified in single-day LEC treated patients. Within single-day LEC treated events, in the first cycle, of 3184 events, 2996 (94.1%) events were delayed. Average number of delayed events per patient remained consistent throughout the eight cycles (3.1 [1st cycle] vs. 2.9 [8th cycle]; P = 0.842]). Among 2439 patients on antiemetic prophylaxis with a 5-HT(3)-RA, 10.1% (n = 247) initiated palonosetron. Regression analysis indicated that Group 1 patients (versus Group 2) had a 15.2% reduction in CINV event rate per CT cycle; P = 0.0403. Study limitations include potential lack of generalizability, absence of data on certain confounders including alcohol consumption and prior history of motion sickness, potential underestimation of incidence of uncontrolled CINV, and inability to

  5. Variation in neoadjuvant chemotherapy utilization for epithelial ovarian cancer at high volume hospitals in the United States and associated survival.

    Science.gov (United States)

    Barber, Emma L; Dusetzina, Stacie B; Stitzenberg, Karyn B; Rossi, Emma C; Gehrig, Paola A; Boggess, John F; Garrett, Joanne M

    2017-06-01

    To estimate variation in the use of neoadjuvant chemotherapy by high volume hospitals and to determine the association between hospital utilization of neoadjuvant chemotherapy and survival. We identified incident cases of stage IIIC or IV epithelial ovarian cancer in the National Cancer Database from 2006 to 2012. Inclusion criteria were treatment at a high volume hospital (>20 cases/year) and treatment with both chemotherapy and surgery. A logistic regression model was used to predict receipt of neoadjuvant chemotherapy based on case-mix predictors (age, comorbidities, stage etc). Hospitals were categorized by the observed-to-expected ratio for neoadjuvant chemotherapy use as low, average, or high utilization hospitals. Survival analysis was performed. We identified 11,574 patients treated at 55 high volume hospitals. Neoadjuvant chemotherapy was used for 21.6% (n=2494) of patients and use varied widely by hospital, from 5%-55%. High utilization hospitals (n=1910, 10 hospitals) had a median neoadjuvant chemotherapy rate of 39% (range 23-55%), while low utilization hospitals (n=2671, 14 hospitals) had a median rate of 10% (range 5-17%). For all ovarian cancer patients adjusting for clinical and socio-demographic factors, treatment at a hospital with average or high neoadjuvant chemotherapy utilization was associated with a decreased rate of death compared to treatment at a low utilization hospital (HR 0.90 95% CI 0.83-0.97 and HR 0.85 95% CI 0.75-0.95). Wide variation exists in the utilization of neoadjuvant chemotherapy to treat stage IIIC and IV epithelial ovarian cancer even among high volume hospitals. Patients treated at hospitals with low rates of neoadjuvant chemotherapy utilization experience decreased survival. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Dentinal candidiasis in cancer patients.

    Science.gov (United States)

    Damm, D D; Neville, B W; Geissler, R H; White, D K; Drummond, J F; Ferretti, G A

    1988-01-01

    Two examples of an unusual presentation of oropharyngeal candidiasis in cancer patients are offered. The light and scanning electron microscopic appearances of candidiasis involving the dentin of teeth are described. The potential significance of recognition of this form of candidiasis in cancer patients is discussed.

  7. Rural-urban disparities of breast cancer patients in China.

    Science.gov (United States)

    Zhang, Yan; Bu, Yulan; Gao, Hua

    2013-03-01

    The purpose of this study was to examine the rural-urban disparities in breast cancer patients in China. The retrospective study was performed with a total of 2,139 breast cancer patients hospitalized in Qilu Hospital of Shandong University between the years 1997 and 2011. We applied Chi-square analysis to identify significant disparities between rural and urban populations. Logistic regression model was used to estimate factors associated with the adjuvant chemotherapy treatment. Two-fifths of patients were considered rural dwellers. Significant disparities were found in marriage age (p rural-urban differences were also shown in the choice of neo-adjuvant chemotherapy (p = 0.0050) and surgical procedures (p rural-urban breast cancer patients exist in China. Interventions to increase early diagnosis of breast cancer among rural area are in need. Further research is needed to investigate potential attitude and perception differences between rural and urban populations with respect to breast cancer preventions and treatments.

  8. Long-term Outcomes After Bladder-preserving Tri-modality Therapy for Patients with Muscle-invasive Bladder Cancer: An Updated Analysis of the Massachusetts General Hospital Experience.

    Science.gov (United States)

    Giacalone, Nicholas J; Shipley, William U; Clayman, Rebecca H; Niemierko, Andrzej; Drumm, Michael; Heney, Niall M; Michaelson, Marc D; Lee, Richard J; Saylor, Philip J; Wszolek, Matthew F; Feldman, Adam S; Dahl, Douglas M; Zietman, Anthony L; Efstathiou, Jason A

    2017-06-01

    Tri-modality therapy (TMT) is a recognized treatment strategy for selected patients with muscle-invasive bladder cancer (MIBC). Report long-term outcomes of patients with MIBC treated by TMT. Four hundred and seventy-five patients with cT2-T4a MIBC were enrolled on protocols or treated as per protocol at the Massachusetts General Hospital between 1986 and 2013. Patients underwent transurethral resection of bladder tumor followed by concurrent radiation and chemotherapy. Patients with less than a complete response (CR) to chemoradiation or with an invasive recurrence were recommended to undergo salvage radical cystectomy. Disease-specific survival (DSS) and overall survival (OS) were calculated using the Kaplan-Meier method. Median follow-up for surviving patients was 7.21 yr. Five- and 10-yr DSS rates were 66% and 59%, respectively. Five- and 10-yr OS rates were 57% and 39%, respectively. The risk of salvage cystectomy at 5 yr was 29%. In multivariate analyses, T2 disease (OS hazard ratio [HR]: 0.57, 95% confidence interval [CI]: 0.44-0.75, DSS HR: 0.51, 95% CI: 0.36-0.73), CR to chemoradiation (OS HR: 0.61, 95% CI: 0.46-0.81, DSS HR: 0.49, 95% CI: 0.34-0.71), and presence of tumor-associated carcinoma in situ (OS HR: 1.56, 95% CI: 1.17-2.08, DSS HR: 1.50, 95% CI: 1.03-2.17) were significant predictors for OS and DSS. When evaluating our cohort over treatment eras, rates of CR improved from 66% to 88% and 5-yr DSS improved from 60% to 84% during the eras of 1986-1995 to 2005-2013, while the 5-yr risk of salvage radical cystectomy rate decreased from 42% to 16%. These data demonstrate high rates of CR and bladder preservation in patients receiving TMT, and confirm DSS rates similar to modern cystectomy series. Contemporary results are particularly encouraging, and therefore TMT should be discussed and offered as a treatment option for selected patients. Tri-modality therapy is an alternative to radical cystectomy for patients with muscle-invasive bladder cancer, and

  9. Intensify standardized therapy for esophageal and stomach cancer in tumor hospitals

    Institute of Scientific and Technical Information of China (English)

    Shi Jie Wang; Deng Gui Wen; Jing Zhang; Xin Man; Hui Liu

    2001-01-01

    @@ INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal and stomach cancer[1-5], the number ofcancer patients waiting for admission isinconceivably large.

  10. Hospitalization costs of lung cancer diagnosis in Turkey: Is there a difference between histological types and stages?

    Science.gov (United States)

    Türk, Murat; Yıldırım, Fatma; Yurdakul, Ahmet Selim; Öztürk, Can

    2016-12-01

    To establish the direct costs of diagnosing lung cancer in hospitalized patients. Hospital data of patients who were hospitalized and diagnosed as lung cancer between September 2013 and August 2014 were retrospectively analyzed. Patients who underwent surgery for diagnosis and who were initiated with cancer treatment during the same hospital stay were excluded from study. Histological types and stages of lung cancer were determined. Expenses were grouped as laboratory costs, pathology costs, diagnostic imaging costs, overnight room charges, medication costs, blood center costs, consumable expenditures' costs and inpatient service charges (including consultants' service, electrocardiogram, follow-up, nursing services, diagnostic interventions). Of the 68 patients, 55 (81%) had non-small cell lung cancer (NSCLC), 13 (19%) had small cell lung cancer (SCLC). 47% of patients with NSCLC had stage 4 disease and 86% of patients with SCLC had extensive stage disease. Median total cost per patient was 910 (95% CI= 832-1291) Euros (€). Of all costs, 37% were due to inpatient service charges and 22% were medication costs. Median total cost per patient was 912 (95% CI= 783-1213) € in NSCLC patients and 908 (95% CI= 456-2203) € in SCLC patients (p> 0.05). In NSCLC group, total cost per patient was 873 (95% CI= 591-1143) € in stage 1-2-3 diseases and 975 (95% CI= 847-1536) € in stage 4 disease (p> 0.05). In SCLC group total cost per patient was 937 € in limited stage and 502 (95% CI= 452-2508) € in extensive stage (p> 0.05). There is no significant difference between costs related to diagnosis of different lung cancer types and stages in patients hospitalized in a university hospital.

  11. Neuritic Patient at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Ni Putu Dita-Rinjani

    2012-05-01

    Full Text Available Objective: Treatment of optic neuritic as recommended by the Optic Neuritic Treatment Trial (ONTT was intravenous methylprednisolon followed by oral prednisone. This study aims to describe  characteristics and response to intravenous methylprednisolon followed by oral prednisone treatment of optic neuritic patient in Sanglah General Hospital Denpasar. Method: This report is an analytical cross sectional study. Data were collected retrospectively from medical report of optic neuritic patient who came to Sanglah General Hospital during a period of January 1st 2010 until December 31st 2011. Patient characteristics were analyzed with descriptive analyses and presented as frequency, percentage, mean and standar deviation. Visual acuity and contrast sensitivity improvement after intravenous methylprednisolon followed by oral prednisone treatment were statistically analyzed with Wilcoxon test Results:  Optic neuritic were found in twenty-three patients (33 eyes, majority was in age group of 15-40 years (56.5% with female predominance (65.2% and unilateral involvement was 56.3%. Mean onset patient presented to the hospital was 21.7±2.21 days and the most common symptom was decreasing vision (87.9%.  The majority of patient presented with papillitis (54.5%, totally color blindness found in 39.4% eyes, and the type of visual field defect at presentation was central scotoma (18.2%. All cases show lesion of optic nerve from visual evoked potential (VEP examination and magnetic resonance imaging (MRI shows normal results (39.1% patient. The mean of pretreatment logMAR visual acuity and contrast sensitivity were significant improve after treatment from 1.59±0.47 to 0.59±0.62 (p=0.0001 and 0.31±0.56 to 1.25±0.56 (p=0.0001, respectively. All cases in this study were idiopathic. Recurrences were seen in 2 eyes and none of patient had clinical features suggestive of multiple sclerosis. Conclusions: Visual acuity and contrast sensitivity improvement

  12. Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

    Institute of Scientific and Technical Information of China (English)

    Jennifer Y Wang; Jonathan P Terdiman; Eric Vittinghoff; Tracy Minichiello; Madhulika G Varma

    2009-01-01

    AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have significantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer. CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.

  13. Racial and Socio-Economic Disparities in Breast Cancer Hospitalization Outcomes by Insurance Status

    Science.gov (United States)

    Akinyemiju, Tomi; Sakhuja, Swati; Raviv, Neomi Vin

    2017-01-01

    Background Breast cancer remains a major cause of morbidity and mortality among women in the US, and despite numerous studies documenting racial disparities in outcomes, the survival difference between Black and White women diagnosed with breast cancer continues to widen. Few studies have assessed whether observed racial disparities in outcomes vary by insurance type e.g. Medicare/Medicaid versus private insurance. Differences in coverage, availability of networked physicians, or cost-sharing policies may influence choice of treatment and treatment outcomes, even after patients have been hospitalized, effects of which may be differential by race. Purpose The aim of this analysis was to examine hospitalization outcomes among patients with a primary diagnosis of breast cancer and assess whether differences in outcome exist by insurance status after adjusting for age, race/ethnicity and socio-economic status. Methods We obtained data on over 67,000 breast cancer patients with a primary diagnosis of breast cancer for this cross-sectional study from the 2007-2011 Healthcare Cost and Utilization project Nationwide Inpatient Sample (HCUP-NIS), and examined breast cancer surgery type (mastectomy vs. breast conserving surgery or BCS), post-surgical complications and in-hospital mortality. Multivariable regression models were used to compute estimates, odds ratios and 95% confidence intervals. Results Black patients were less likely to receive mastectomies compared with White women (OR: 0.80, 95% CI: 0.71 - 0.90), regardless of whether they had Medicare/Medicaid or Private insurance. Black patients were also more likely to experience post-surgical complications (OR: 1.41, 95% CI: 1.12-1.78) and higher in-hospital mortality (OR: 1.57, 95%: 1.21-2.03) compared with White patients, associations that were strongest among women with Private insurance. Women residing outside of large metropolitan areas were significantly more likely to receive mastectomies (OR: 1.89, 95% CI: 1

  14. Custo do tratamento de pacientes com histórico de tabagismo em hospital especializado em câncer Costo del tratamiento de pacientes con historia de tabaquismo en hospital especializado en cáncer Cost of treating patients with smoking history in a specialized cancer hospital

    Directory of Open Access Journals (Sweden)

    Márcia Pinto

    2011-06-01

    tabaquismo en un hospital especializado en la ciudad de Rio de Janeiro, Sureste de Brasil, entre 2000 y 2006. La muestra fue compuesta por 127 casos de cáncer de pulmón, 80 de cáncer de laringe y 35 de cáncer de esófago. La selección de los cánceres fue realizada por medio del análisis de la frecuencia y del valor monetario de las hospitalizaciones, ponderados por la fracción atribuible al tabaco en la población. Los datos fueron colectados de los prontuarios. Los pacientes fueron clasificados conforme el perfil de tabaquismo, el diagnóstico principal, la fase y las comorbilidades. El análisis estadístico incluyó la distribución log-normal para ajustar los valores del costo y la correlación de Spearman. RESULTADOS: Los pacientes eran fumadores pesados y fueron diagnosticados en fases avanzadas. La carga tabáquica fue elevada y 92% de los pacientes con cáncer de pulmón, 72% con cáncer de laringe y 94% con cáncer de esófago fueron diagnosticados en fases avanzadas. Las comorbilidades más frecuentes fueron las enfermedades cardíacas y las respiratorias. El costo promedio fue de R$ 28.901, R$ 37.529 y R$ 33.164 para cáncer de pulmón, laringe y esófago, respectivamente. Los principales responsables por el costo fueron la radioterapia y la hospitalización. Se observó asociación entre fases avanzadas y menor costo para cáncer de pulmón y de esófago. CONCLUSIONES: Siendo la radioterapia y hospitalización los principales responsables por el costo total, los pacientes en fases más graves presentaron costos menores probablemente por la reducción de las opciones terapéuticas.OBJECTIVE: To describe the costs of treating lung, laryngeal and esophageal cancer among patients with histories of smoking. METHODS: A longitudinal non-concurrent study on three cohorts with histories of smoking at a specialized hospital was carried out in the city of Rio de Janeiro, Southeastern Brazil, between 2000 and 2006. The sample was composed of 127 cases of lung cancer

  15. Suicidal behaviour among terminally ill cancer patients in India

    OpenAIRE

    Latha, K. S.; Bhat, S.M.

    2005-01-01

    Background: Passive suicidal thoughts are relatively common in patients with terminal cancer. There is a need for more information about the factors that influence these patients to desire death. Aim: To examine the prevalence of suicidal ideation among terminally ill cancer patients. Methods: Fifty-four terminally ill inpatients (27 men and 27 women) from the palliative care unit of the Oncology department of Kasturba Hospital, Manipal were evaluated on various rating scales for depression, ...

  16. The Difference of Kidney, Heart and Blood Function on Cervical Cancer Patients with Chemotherapy, Bleomycin, Oncovin®, Mitomycin and Carboplatin (Case Study in Sanglah General Hospital, Denpasar in 2015

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    Rini Noviyani

    2016-12-01

    Full Text Available Oncovin® bleomycin mitomycin-carboplatin (BOM-carboplatin regimen as chemotherapy is inseparable from the side effects it can caused which is toxicity to organs including the kidneys, liver, and blood where the toxicity in the kidneys can be indicated by the parameter of Serum Creatinine and Blood Urea Nitrogen (BUN, the occurrence of toxicity in the liver can be measured by the parameters of SGOT and SGPT, and toxicity to blood function can be indicated by the value of hemoglobin, platelets, leukocytes. The absence of data on the toxic effects of chemotherapy BOM-carboplatin in patients with squamous cell cervical cancer stage IIB–IIIB in Sanglah General Hospital in Denpasar, had made this research conducted through monitoring of kidney, liver and blood function. This study is an observational case study of nine patients who were followed for three rounds of chemotherapy from February to August 2015. Data of creatinine serum, BUN, SGOT, SGPT, hemoglobin, platelets, and leukocytes were analyzed using paired t-test for the data that were normally distributed and Wilcoxon test for the data that were not normally distributed with a confidence level of 95% and was said to be significantly different when p<0.05. The results of this case study demonstrated the value of serum creatinine (p=0.530, BUN (p=0.553, SGOT (p=0.162, SGPT (p=0.054, hemoglobin (p=0.034, platelets (p=0.028, and leukocytes (p=0.011 so it could be concluded that there was a significant decrease of blood function which could be characterized by a significant decrease in the parameters of hemoglobin, platelets and leucocytes before chemotherapy I and after chemotherapy III BOM-carboplatin, so it required strict monitoring of the blood function of the patients who received chemotherapy BOM-carboplatin in Sanglah General Hospital in Denpasar.

  17. Refeeding syndrome in hospitalized pediatric patients.

    Science.gov (United States)

    Dunn, Rebecca L; Stettler, Nicolas; Mascarenhas, Maria R

    2003-08-01

    Refeeding syndrome has been well documented over the years, primarily through case reports and literature reviews. Awareness of refeeding syndrome is crucial in preventing the occurrence of, and the metabolic and physiologic complications associated with, aggressive nutrition support in malnourished populations. Once compromised patients have been identified to be at risk of refeeding syndrome, nutrition rehabilitation should be cautiously initiated. We have found a lack of clinical validation for instituting nutrition support in high-risk pediatric patients who may develop refeeding syndrome. The purposes of our investigation were to determine the incidence of refeeding syndrome in pediatric hospitalized patients beginning on parenteral nutrition and to determine how consistently the Department of Clinical Nutrition standards of care for screening and prevention were followed at our institution.

  18. Social Network Analysis of Patient Sharing Among Hospitals in Orange County, California

    Science.gov (United States)

    McGlone, Sarah M.; Song, Yeohan; Avery, Taliser R.; Eubank, Stephen; Chang, Chung-Chou; Bailey, Rachel R.; Wagener, Diane K.; Burke, Donald S.; Platt, Richard; Huang, Susan S.

    2011-01-01

    Objectives. We applied social network analyses to determine how hospitals within Orange County, California, are interconnected by patient sharing, a system which may have numerous public health implications. Methods. Our analyses considered 2 general patient-sharing networks: uninterrupted patient sharing (UPS; i.e., direct interhospital transfers) and total patient sharing (TPS; i.e., all interhospital patient sharing, including patients with intervening nonhospital stays). We considered these networks at 3 thresholds of patient sharing: at least 1, at least 10, and at least 100 patients shared. Results. Geographically proximate hospitals were somewhat more likely to share patients, but many hospitals shared patients with distant hospitals. Number of patient admissions and percentage of cancer patients were associated with greater connectivity across the system. The TPS network revealed numerous connections not seen in the UPS network, meaning that direct transfers only accounted for a fraction of total patient sharing. Conclusions. Our analysis demonstrated that Orange County's 32 hospitals were highly and heterogeneously interconnected by patient sharing. Different hospital populations had different levels of influence over the patient-sharing network. PMID:21330578

  19. Clinical diagnosis of hyposalivation in hospitalized patients

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    Soraya de Azambuja Berti-Couto

    2012-04-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. MATERIAL AND METHODS: A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years. Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom, chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. RESULTS: Results obtained with Chi-square tests showed that 71 patients (48.9% presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p <0.05. Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05. CONCLUSION: Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.

  20. Not just bricks and mortar: planning hospital cancer services for Aboriginal people

    Directory of Open Access Journals (Sweden)

    Durey Angela

    2011-03-01

    Full Text Available Abstract Background Aboriginal people in Australia experience higher mortality from cancer compared with non-Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i being alone and lost in a big, alien and inflexible system; (ii failure of open communication, delays and inefficiency in the system; (iii practicalities: costs, transportation, community and family responsibilities; (iv the need for Aboriginal support persons; and (v connection to the community. Conclusions Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes.

  1. Quality of Life in Cancer Patients with Pain in Beijing

    Institute of Scientific and Technical Information of China (English)

    Ping Yang; Li-qiu Sun; Qian lu; Dong Pang; Yue Ding

    2012-01-01

    Objective:To investigate the quality of life (QOL) of cancer pain patients in Beijing,and explore the effect of cancer pain control on patients' QOL.Methods:Self-developed demographic questionnaire,numeric rating scale and SF-36 questionnaire were used together among 643 cancer pain patients in 28 Grade 2nd to 3rd general hospitals and 2 Grade 3rd cancer hospitals.Results:The SF-36 eight dimensions scores ranged from 31.75 to 57.22 in these cancer pain patients.The t test and Wilcoxon rank sum test were used to compare the QOL between pain controlled (PC) group and pain uncontrolled (PUC) group,and the results showed that patients in PC group had the higher QOL scores in 6 areas of SF-36 (P<0.05).Binary logistic regression results found that pain management satisfaction scores (P<0.001),family average personal monthly income (P=0.029),current receiving chemotherapy (P=0.009) and cancer stage (P<0.001) were the predictors to cancer pain controlled results.Conclusion:Cancer patients with pain in Beijing had poor QOL.Pain control will improve the QOL of cancer pain patients.

  2. Commercial insurance triples chances of breast cancer survival in a public hospital.

    Science.gov (United States)

    Shi, Runhua; Mills, Glenn; McLarty, Jerry; Burton, Gary; Shi, Zhenzhen; Glass, Jonathan

    2013-01-01

    Breast cancer survival is affected both by endogenous factors and exogenous factors such as socioeconomic status. This study explored the relationship between insurance status and overall survival of 987 female breast cancer patients in a population served by a public hospital. All patients were offered the same level of care regardless of ability to pay. Of the 987 breast cancer patients investigated, 54.6% were African-American. 54.1% of patients were insured (commercial insurance or Medicare), 27.1% with Medicaid, and 18.8% who were uninsured. Overall median survival was 15.5 years and was not statistically significant between Caucasian and African-American women. Median survival times were 15.8, 11.3, and 8.2 years for insured, Medicaid, and uninsured groups, respectively. Uninsured patients had worse overall survival rates compared with insured patients (p insurance was a significant factor affecting survival with hazard ratios of 2.24 and 3.22 for Medicaid and uninsured patients, respectively, compared with insured patients. Even in a public hospital, after adjusting for potential risk factors, insurance status still proved to be an important factor in the survival of breast cancer patients. Further research is necessary to identify causal factors related to the survival disparities associated with insurance status. © 2013 Wiley Periodicals, Inc.

  3. Autopsy study of very old hospitalized patients.

    Science.gov (United States)

    Bauco, C; Arabia, A; Salza, M C; Golosio, F; Cinti, A M; Cicconetti, P; Cacciafesta, M; Marigliano, V

    1996-01-01

    All autopsies (n = 63) performed over the period from January 1, 1989 to December 31, 1990 on patients older than 85 years who died at the Policlinico Umberto I of Rome were reviewed retrospectively. The purpose of the study was to determine the autopsy rate, to ascertain accordance between clinical and pathological diagnoses and to clarify problems in diagnosis and complications of geriatric management in our University Hospital. The autopsy rate was 12.1%. The diagnostic error was particularly high for pulmonary embolism. In 26% of cases both the causes of death and the major clinical diagnoses were confirmed.

  4. Clinicopathologic characteristics of young patients with gallbladder cancer.

    Science.gov (United States)

    Do, Sung-Im; Lee, Hyoun Wook; Sohn, Jin Hee; Kim, Kyungeun

    2017-03-01

    Gallbladder cancer is the most common biliary tract cancer and the fifth most common cancer of the digestive system. However, the clinicopathologic features of gallbladder cancer in young Korean patients have not been studied. This study included 101 consecutive cases of gallbladder cancer that underwent cholecystectomy at Kangbuk Samsung Hospital from December 1990 to March 2011. The patients were divided into two groups by age at initial diagnosis of gallbladder cancer: a young patient group aged less than 45 years and an old patient group aged 45 or older. The young patient group included 10 patients with mean age of 38 (range, 29-44 years). Compared with the old patient group, the young patient group showed polypoid tumor appearance (p=0.014), lower pT stage (p=0.023), more frequent adenoma background (p=0.009), and less frequent dysplasia in remaining mucosa (p=0.001). The disease-related survival rate after 13.5 months was significantly more favorable for the young patients. Gallbladder cancers in young Korean patients have distinct clinicopathologic features of a high frequency of cancer arising in adenoma, rare association with intestinal metaplasia and dysplasia, and a favorable patient's prognosis. These findings suggest that the adenoma-carcinoma pathway could contribute more to gallbladder cancer carcinogenesis in young Korean patients than the metaplasia-dysplasia-carcinoma pathway.

  5. 胃癌住院患者营养风险及临床营养支持现状调查%Research on Nutritional Risk and Application of Nutrition Support in Hospitalized Patients with Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    杨平; 陈博; 伍晓汀

    2011-01-01

    Objective To investigate the nutritional risk, incidence of malnutrition, and clinical application of nutrition support in hospitalized patients with gastric cancer by the nutritional risk screening (NRS) 2002 score summary table. Methods From June 2009 to February 2010, nutritional risk screen and application of clinical nutritional support were carried out in the hospitalized patients with gastric cancer in this hospital. Nutritional risk was assessed case-by-case according to the severity of illness, nutritional status 〔including body mass index (BMI), recent changes in body weight and eating〕 and patients' age. NRS ≥3 was accepted as nutritionally at-risk, while NRS <3 no nutritional risk; BMI < 18.5 kg/m2 (or albumin <30 g/L) combined with clinical conditions was judged to be malnourished. Results Three hundreds and eighty-six patients were included, 329 of which completed the NRS2002 screening. One hundred and sixty-five patients (50. 15%) were at nutritional risk, while another 164 (49. 85 %) were no nutritional risk. Malnutrition was found in 57 patients (17.33 %). By gender, male malnourished patients and nutritionally at-risk patients were accounting for 16. 45% (38/231) and 48. 05% (111/231)respectively, while female nutritionally at-risk patients and malnourished patients were accounting for 55. 1%(54/98) and 19.39% (19/98) respectively, 72.04% (237/329) of the screened patients accepted clinical nutrition support, among which, 115 patients were at nutritional risk, accounting for 69.70% in that group, and 122 patients were no nutritional risk, accounting for 74.39% in that group. Conclusions The incidences of malnutrition and nutritionally at-risk in hospitalized gastric cancer patients are high. And irrationality of clinical nutrition support exists. Evidence-based guidelines are required to improve the nutritional status of support.%目的 应用营养风险筛查(NRS)2002方法对胃癌住院患者营养风险状况

  6. Marijuana use and inpatient outcomes among hospitalized patients: analysis of the nationwide inpatient sample database.

    Science.gov (United States)

    Vin-Raviv, Neomi; Akinyemiju, Tomi; Meng, Qingrui; Sakhuja, Swati; Hayward, Reid

    2017-01-01

    The purpose of this paper is to examine the relationship between marijuana use and health outcomes among hospitalized patients, including those hospitalized with a diagnosis of cancer. A total of 387,608 current marijuana users were identified based on ICD-9 codes for marijuana use among hospitalized patients in the Nationwide Inpatient Sample database between 2007 and 2011. Logistic regression analysis was performed to determine the association between marijuana use and heart failure, cardiac disease, stroke, and in-hospital mortality. All models were adjusted for age, gender, race, residential income, insurance, residential region, pain, and number of comorbidities. Among hospitalized patients, marijuana use was associated with a 60% increased odds of stroke (OR: 1.60, 95% CI: 1.44-1.77) compared with non-users, but significantly reduced odds of heart failure (OR: 0.78, 95% CI: 0.75-0.82), cardiac disease (OR: 0.86, 95% CI: 0.82-0.91), or in-hospital mortality (OR: 0.41, 95% CI: 0.38-0.44). Among cancer patients, odds of in-hospital mortality was significantly reduced among marijuana users compared with non-users (OR: 0.44, 95% CI: 0.35-0.55). Hospitalized marijuana users were more likely to experience a stroke compared with non-users, but less likely to experience in-hospital mortality. Prospective studies will be needed to better characterize the health effects of marijuana use, especially among older, sicker, and/or hospitalized patients. In the meantime, conversations regarding marijuana use/misuse may be warranted in the clinical setting in order for patients and healthcare providers to adequately weigh the anticipated benefits of marijuana use with potentially significant health risks. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  7. Family caregivers' involvement in caring for a hospitalized patient with cancer and their quality of life in a country with strong family bonds

    NARCIS (Netherlands)

    Effendy, C.; Vernooij-Dassen, M.; Setiyarini, S.; Kristanti, M.S.; Tejawinata, S.; Vissers, K.; Engels, Y.M.

    2015-01-01

    BACKGROUND: Being involved in caring for family members during illness is part of the Indonesian culture, even during hospitalization. It is unknown which factors influence the quality of life (QoL) of family members taking care of their loved ones. The present study aims to identify factors influen

  8. The First Children's Cancer Hospital, Egypt International Scientific Conference.

    Science.gov (United States)

    Zaghloul, Mohamed S

    2009-10-01

    A wide gathering of scientists, clinicians, pharmacists and nurses specialized in pediatric oncology practice met to celebrate the second anniversary of Children's Cancer Hospital, Egypt (CCHE). The celebration was in the form of high-brow teaching lectures and reports presented by international experts in the fields of pediatric CNS tumors, solid tumors (neuroblastoma, nephroblastoma, soft tissue and bone tumors, lymphoma, leukemia and pediatric oncology nursing. The conference extends its activities to hospital management, clinical pharmacy and telemedicine. Furthermore, CCHE experts presented the efforts performed to establish a state-of-the-art pediatric oncology hospital equipped with all needed facilities to raise the standard of care to the highest levels.

  9. Survey of Enteric Pathogens Causing Bacteremia in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Enayatollah Kalantar

    2014-05-01

    Full Text Available Background: Symptomatic bacteraemia, is a frequent condition among cancer patients with a significant morbidity and mortality all over the world. Objectives: The aim of this study was to determine the burden of enteric pathogens causing bacteremia among cancer patients. Patients and Methods: Ten ml blood samples were withdrawn from the cancer patients under aseptic conditions. The blood specimens were added to the blood culture bottles and incubated at 37°C. The bacterial isolates from these samples were identified by routine biochemical reactions. Results: During the study period, 68 blood samples from cancer patients were analyzed for bacteremia. Of these patients, six were female (08/82% and 62 were male (91.18%; with age ranging from under 40 years to 85 years old (mean, 63 years. Gastro-intestinal cancer and cancers of head and neck were the most frequent cancer types in the studied group, accounting for 51 (75% and 15 (22.1% cases, respectively. The mean weight of patients was 69.18 Kg (range: 49-100 Kg. Similarly, the mean length of hospital stay was 8 days (range: 4-12 days. Positive blood cultures were detected in only 12 (17.65% and 11 (91.7% blood specimens from the Cancer Institute, Tehran, compared with one (08.33% from Shahid Kamali hospital, Karaj. From these patients, 15 bacteria were isolated; E. coli alone outnumbered other species and accounted for 33.33% of the episodes of bacteremia. Conclusions: In conclusion, our investigation revealed that cancers of GI tract are the most common cancer types causing bacteremia and also we identified that most common bacteria causing bacteremia in Cancer Institute, Tehran and Shahid Kamali Hospital, Karaj, are E. coli and S. aureus

  10. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

    2012-01-01

    . Our study highlights the importance of providing hospital-based home care with consideration for the family members' need for the sense of security achieved by home care by experienced paediatric oncology nurses and regular contact with the doctor. In future studies, interviews with children......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

  11. Do patients "like" good care? measuring hospital quality via Facebook.

    Science.gov (United States)

    Timian, Alex; Rupcic, Sonia; Kachnowski, Stan; Luisi, Paloma

    2013-01-01

    With the growth of Facebook, public health researchers are exploring the platform's uses in health care. However, little research has examined the relationship between Facebook and traditional hospital quality measures. The authors conducted an exploratory quantitative analysis of hospitals' Facebook pages to assess whether Facebook "Likes" were associated with hospital quality and patient satisfaction. The 30-day mortality rates and patient recommendation rates were used to quantify hospital quality and patient satisfaction; these variables were correlated with Facebook data for 40 hospitals near New York, NY. The results showed that Facebook "Likes" have a strong negative association with 30-day mortality rates and are positively associated with patient recommendation. These exploratory findings suggest that the number of Facebook "Likes" for a hospital may serve as an indicator of hospital quality and patient satisfaction. These findings have implications for researchers and hospitals looking for a quick and widely available measure of these traditional indicators.

  12. Cancer

    Science.gov (United States)

    ... cancer Non-Hodgkin lymphoma Ovarian cancer Pancreatic cancer Testicular cancer Thyroid cancer Uterine cancer Symptoms Symptoms of cancer ... tumor Obesity Pancreatic cancer Prostate cancer Stomach cancer Testicular cancer Throat or larynx cancer Thyroid cancer Patient Instructions ...

  13. Clinical Analysis of Lung Cancer Patients Younger Than 30 Years

    Directory of Open Access Journals (Sweden)

    Guangjie HOU

    2011-05-01

    Full Text Available Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth. In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years. This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients. Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total. In this group, there were 34 non-small cell lung cancer (NSCLC patients and 19 small cell lung cacer (SCLC patients. The male/female ratio was 1.5:1. In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved. In these patients, 12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment. Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection. Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis. The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.

  14. Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals

    Directory of Open Access Journals (Sweden)

    Vaughan-Sarrazin Mary S

    2007-09-01

    Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.

  15. Evaluation and Treatment of Colorectal Cancer in Shahid Rahnemoon and Afshar Hospitals, Yazd-Iran

    Directory of Open Access Journals (Sweden)

    HR Dehghan

    2007-12-01

    Full Text Available Introduction: Colorectal cancer is the most common cancer of the alimentary system. In women, it is the second leading cause of mortality after breast cancer while in men, it is the third leading cause of death after lung and prostate carcinoma. Prevalence is more in population older than 50 years and increases in older people. Therefore, best treatment and prognosis is early diagnosis of disease. Methods: This study was a retrospective, cross-sectional study that included files of 191 patients of Shahid Rahnemoon and Afshar hospitals (two main hospitals in Yazd, Iran from 1992 till 1999. The aim was to evaluate the abundance and distribution of colorectal cancer with respect to staging, age, occupation, residence, clinical signs and method of treatment. All of the patients had a cancer pathology report. Results: Of the total of 191 patients with colorectal cancer, 186 cases were adenocarcinoma and 5 cases were lymphoma. Prevalence rate in men was more than women and their age range was between 28 and 94 years. 127 patients (67% were in the 60 – 69 years age group , while 7.3% were in the 20 -39 years age group. 106 patients (55.5% were men and 85 patients (44.5% were women. 64.9% were urban dwellers and 35.1% were rural. Surgical treatment included; abdominoperinneal resection (A.P.R in 55 patients (28.8%, anterior resection (A.R and anastomosis in 40 patients (20.9%, right and left hemicolectomy, each in 25 patients and rectosigmoiedectomy and anastomosis in 18 patients(19.4%. Results of treatment were as follows:177 patients (92.76% had relative recovery post operation, 5 cases (2.6% were discharged from the hospital against medical advice, 3 cases (1.6% died and 6 cases (3.1% were discharged with poor condition after laparotomy. Conclusion: Most of the patients with colorectal cancer referred with rectorrhagia, main type of cancer was adenocarcinoma (97.4% and the most frequent surgical procedure performed was A.P.R. Further research

  16. Cancer risk of patients discharged with acute myocardial infarct

    DEFF Research Database (Denmark)

    Dreyer, L; Olsen, J H

    1998-01-01

    in acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early......We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977...... and 1989. We calculated the incidence of cancer in this group by linking it to the Danish Cancer Registry for the period 1978-1993. There was no consistent excess over the expected figures for any of the categories of cancer not related to tobacco smoking. Specifically, the rates of colorectal cancer...

  17. Awareness and practice of patients' rights among hospitalized patients at Wad-Medani Teaching Hospital, Sudan.

    Science.gov (United States)

    Younis, Abobaker A H; Hassan, Amal H A; Dmyatti, Eylaph M E H; Elmubarak, Mehad A H; Alterife, Rahma A A; Salim, Rawan E O; Mohamed, Samar A B; Ahmed, Wefag S A M

    2017-03-30

    Patients' rights are a fundamental human right and an important part of modern health care practice. This is a cross-sectional descriptive analytic study, conducted amongst 263 patients at Wadi-Medani Teaching Hospital, Sudan, in March-April 2015. Most patients (95.2%) did not know about the Bill of Rights and most of them (92.8%) were not able to mention any of the patients' rights. The most practiced rights were: the right to be asked for permission before examination (88.1%), proper handling (87.8%), safety of the hospital (87%), presence of a third person when examining a female by a male doctor (85.6%), and admission file confidentiality (75.5%). The awareness of Sudan FMOH Patients' Bill of Rights was very low among patients at Wad-Medani Teaching Hospital, yet they showed a high satisfaction rate probably due to their low socioeconomic status, educational level and expectations. Therefore, awareness of patients' rights must be increased.

  18. Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

    Science.gov (United States)

    Ismail, A.; Hassan, Noor I.

    2013-09-01

    Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

  19. Alternate Level of Care Patients in Public General Hospital Psychiatry.

    Science.gov (United States)

    Marcos, Luis R.; Gil, Rosa M.

    1984-01-01

    Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

  20. Self-perceived risk and barriers to cervical cancer screening among patients seeking care at a tertiary care teaching hospital in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    Lokeshwari Jayaraman

    2016-03-01

    Conclusions: self-perception of not being at risk is documented to be associated with low uptake of screening. Concerned health education programs need to bring clearly to the end user the difference between precancerous lesions and invasive cervical cancer and the treatment options available. [Int J Res Med Sci 2016; 4(3.000: 766-769

  1. Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977-1993 in Denmark

    DEFF Research Database (Denmark)

    Øgard, Christina G; Engholm, Gerda; Almdal, Thomas P

    2004-01-01

    The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977-1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population. In a ra......The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977-1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population...

  2. Prevalence of pain in elderly hospitalized patients.

    Science.gov (United States)

    Gianni, W; Madaio, R A; Di Cioccio, L; D'Amico, F; Policicchio, D; Postacchini, D; Franchi, F; Ceci, M; Benincasa, E; Gentili, M; Zuccaro, S M

    2010-01-01

    Several studies indicate that pain, although very common in the elderly, is under-treated, because it is considered as a concomitant effect of aging. This study aimed to evaluate the prevalence of pain among patients in eight Italian geriatric hospital departments, correlated to prescribed therapy. We enrolled 387 patients in the study, 367 of whom were evaluated. Each patient's recovery, co-morbidity, pain intensity, prescribed therapy, side effects, duration of pain, and efficacy of therapy were monitored during two 15-day periods from 15 July to end of August 2008, and from 1 October to 15 November 2008. The results of this study confirmed that hypertension, cardiopathic disease, diabetes, and chronic obstructive pulmonary disease (COPD) are common pathologies, and that pain is present in 67.3% of those recovered in geriatric departments. In general, however, pain is not treated. Indeed only 49% of those with pain had any type of treatment, which was adequate for the pain intensity. In fact 74.5% of patients considered the therapy to be of low or no efficacy. These data demonstrate the presence of pain in a high percentage of elderly patients, which is either not treated, or treated inadequately. Controlling pain is essential in elderly patients in order to allow a normal life and an active role in family and society. The main conclusion is that pain is often poorly considered in the elderly, thus leading to a dangerous under-treatment. We want to underline the crucial clinical impact of such under-treatment in elderly patients.

  3. Integrated Patient Education on U.S. Hospital Web Sites.

    Science.gov (United States)

    Huang, Edgar; Wu, Kerong; Edwards, Kelsey

    2016-01-01

    Based on a census of the 2015 Most Wired Hospitals, this content analysis aimed to find out how patient education has been integrated on these best IT hospitals' Web sites to serve the purposes of marketing and meeting online visitors' needs. This study will help hospitals to understand where the weaknesses are in their interactive patient education implementation and come up with a smart integration strategy. The study found that 70% of these hospitals had adopted interactive patient education contents, 76.6% of such contents were from a third-party developer, and only 20% of the hospitals linked their patient education contents to one or more of the hospital's resources while 26% cross-references such contents. The authors concluded that more hospitals should take advantage of modern information communication technology to cross-reference their patient education contents and to integrate such contents into their overall online marketing strategy to benefit patients and themselves.

  4. Urotherapy for patients with cancer.

    Science.gov (United States)

    Eldor, J

    1997-04-01

    Cancer cells release various antigens, some of which appear in the urine. Oral autourotherapy is suggested as a new treatment modality for cancer patients. It will provide the intestinal lymphatic system with the many tumor antigens against which antibodies may be produced. These antibodies may be pierced through the blood stream and attack the tumor and its cells.

  5. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

    2011-01-01

    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...... for children with cancer....

  6. Epidemiology of hospitalized burn patients in Taleghani Hospital during 2003-2007.

    Science.gov (United States)

    Ekrami, A; Hemadi, A; Latifi, M; Kalantar, E

    2010-01-01

    The objective of this study was to describe the epidemiology of burn injuries refered to Taleghani Burn hospital, Ahvaz and to provide information necessary for planning and implementing an effective prevention program. The medical records of 6082 consecutive admissions for burn injury treated at Taleghani burn hospital over a five-year period (August 2003 to August 2007) were reviewed. Our results shows that hospital stay in female was significantly longer than in male (p hospital stay and %TBSA (chi2, p patients, 486 deaths were recorded. The overall mortality rate of hospitalized burns patients was 8%. Mortality rate in female was higher than in male (p hospitalized burn patients at Taleghani burn hospital. Prevention programs for reducing the risk of burns are needed. Furthermore, high %TBSA and mortality and the presence of multi-drugs resistant bacteria are major worrying problems in our hospital (Tab. 5, Fig. 2, Ref. 27).

  7. Prevalence and Risk Factors of Gastric Adenoma and Gastric Cancer in Colorectal Cancer Patients

    Directory of Open Access Journals (Sweden)

    Dae Hyun Tak

    2016-01-01

    Full Text Available Background/Aims. To evaluate the incidence of gastric adenoma and gastric cancer in colorectal cancer patients, as well as the clinicopathological features that affect their incidence. Methods. Among patients who underwent surgery after being diagnosed with colorectal cancer between January 2004 and December 2013 at Chungnam National University Hospital, 142 patients who underwent follow-up upper gastrointestinal endoscopy were assigned to the patient group. The control group included 426 subjects randomly selected. The patient group was subdivided into two: one that developed gastric adenoma or cancer and one that did not. Clinicopathological characteristics were compared between these groups. Results. In total, 35 (24.6% colorectal cancer patients developed a gastric adenoma or gastric cancer, which was higher than the number in the control group (20 [4.7%] patients; p<0.001. Age, alcohol history, and differentiation of colorectal cancer were associated with higher risks of gastric adenoma or gastric cancer, with odds ratios of 1.062, 6.506, and 5.901, respectively. Conclusions. In colorectal cancer patients, screening with upper gastrointestinal endoscopy is important, even if no lesions are noted in the upper gastrointestinal tract at colorectal cancer diagnosis. Endoscopic screening is particularly important with increasing age, history of alcohol consumption, and poor cancer differentiation.

  8. Improving stroke care for patients at Cavan hospital [poster

    LENUS (Irish Health Repository)

    Murugasu, G Dr.

    2013-07-01

    Under the Quality and Continuing Care Directorate (QCCD) in stroke care Cavan General Hospital was identified as a hospital that received a large number of stroke and TIA patients. A programme was established to improve services to this population.

  9. On Hospital Wards, Patient Crises May Have 'Domino Effect'

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162758.html On Hospital Wards, Patient Crises May Have 'Domino Effect' When ... should serve as a wake-up call for hospital-based physicians," study author Dr. Matthew Churpek, an ...

  10. Highlighting Hospital and Patient Concerns this Election Year.

    Science.gov (United States)

    Nickels, Tom

    2016-03-01

    Campaign 2016 is in full swing, and the American Hospital Association is seizing the opportunity to make sure the concerns of patients and hospitals are heard. On the front burner: escalating drug prices.

  11. Cancer Screening in Older Patients.

    Science.gov (United States)

    Salzman, Brooke; Beldowski, Kathryn; de la Paz, Amanda

    2016-04-15

    Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these patients should not be based on age alone. Studies suggest that a life expectancy of at least 10 years is necessary to derive a survival benefit from screening for breast and colorectal cancers; therefore, screening for these cancers is not recommended in those with a life expectancy of less than 10 years. Prostate cancer screening, if performed at all, should not be performed after 69 years of age. Cervical cancer screening may be stopped after 65 years of age if the patient has an adequate history of negative screening results. An individualized approach to cancer screening decisions involves estimating life expectancy, determining the potential benefits and harms of screenings, and weighing those benefits and harms in relation to the patient's values and preferences.

  12. Patients Light Preferences in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone; Bjerrum, H. S.; Kirkegaard, Poul Henning;

    2011-01-01

    it can have a positive influence on the recovery process. The present paper introduces the human perspective and the Danish cultural approach in illuminating homes and how it can contribute to innovative lighting design at hospitals. The importance of having a holistic approach to lighting design...... is introduced based on the theory by Gernot Böhmes i.e. “concept of atmosphere” dealing with the effect of experiencing atmosphere. The aim of this study for design of a lighting concept for wards is to get qualified information on patients light preferences for light atmosphere by studying the everyday use...... of light in homes. This explorative study displays the preferred light atmosphere in Danish homes in the age group of 60-85 years old people. With an anthropologically approach to the subject using semi structured interviews, the goal is to explore preferences for light atmosphere when the user...

  13. Rhabdomyolysis: an evaluation of 475 hospitalized patients.

    Science.gov (United States)

    Melli, Giorgia; Chaudhry, Vinay; Cornblath, David R

    2005-11-01

    Rhabdomyolysis is a common and potentially lethal clinical syndrome that results from acute muscle fiber necrosis with leakage of muscle constituents into blood. Myoglobinuria is the most significant consequence, leading to acute renal failure (ARF) in 15%-33% of patients with rhabdomyolysis. Rhabdomyolysis occurs from inherited diseases, toxins, muscle compression or overexertion, or inflammatory processes, among other disorders. In some cases, no cause is found. We describe 475 patients from the Johns Hopkins Hospital inpatient records between January 1993 and December 2001 for the following discharge diagnosis codes: myoglobinuria, rhabdomyolysis, myopathy, toxic myopathy, malignant hyperthermia, neuroleptic malignant syndrome, and polymyositis. Of 1362 patients, 475 patients with an acute neuromuscular illness with serum creatine kinase (CK) more than 5 times the upper limit of normal (>975 IU/L) were included. Patients with recent myocardial infarction or stroke were excluded. The etiology was assigned by chart review. For all, the highest values of serum CK, serum creatinine and urine myoglobin, hemoglobin, and red blood cells were recorded. Forty-one patients had muscle biopsy within at least 2 months from the onset of rhabdomyolysis.Of the 475 patients, 151 were female and 324 were male (median age, 47 yr; range, 4-95 yr). Exogenous toxins were the most common cause of rhabdomyolysis, with illicit drugs, alcohol, and prescribed drugs responsible for 46%. Among the medical drugs, antipsychotics, statins, zidovudine, colchicine, selective serotonin reuptake inhibitors, and lithium were the most frequently involved. In 60% of all cases, multiple factors were present. In 11% of all cases, rhabdomyolysis was recurrent. Underlying myopathy or muscle metabolic defects were responsible for 10% of cases, in which there was a high percentage of recurrence, only 1 etiologic factor, and a low incidence of ARF. In 7%, no cause was found. ARF was present in 218 (46

  14. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... in the metastatic processes required for cancer dissemination, and there are emerging data showing that, at least in some clinical situations, the use of bone-targeted treatments can reduce metastasis to bone and has potential impact on patient survival....

  15. Practice of palliative care for hospitalized patients with advanced cancer%晚期肿瘤住院患者姑息护理实践

    Institute of Scientific and Technical Information of China (English)

    张慧芝; 商丽艳; 黄喆

    2016-01-01

    Our hospital was one of the ifrst group of tertiary Grade A hospitals which established palliative care agency. After eight years of exploration, we have initially formed a complete model of palliative nursing practice. In this paper, we introduced the professional training, the construction of palliative care team, the service object, service content and the concrete implementation, and put forward the corresponding thinking and outlook.%我院作为首批成立姑息治疗机构的三级甲等医院,经过8年的探索,已初步形成较完善的姑息护理实践模式。本文对我院专业人员的培训,姑息护理团队的建设,姑息护理服务对象、服务内容及具体实施等方面进行相应介绍,并对此提出相应的思考与展望。

  16. Cardiac changes in hospitalized patients of trauma.

    Science.gov (United States)

    Gawande, Ninad B; Tumram, Nilesh Keshav; Dongre, Anand Paikuji

    2014-09-01

    Modern clinical management of the patients sustaining traumatic injuries and thermal burns has resulted in their longer survival, but the clinical and pathological effects of these traumatic injuries over the myocardium have been largely neglected. It is speculated that certain factors such as the inflammatory and degenerative lesions of the heart, prolonged clinical course, and the subsequent stress and strain may play role in hastening the death. In the present study, 125 hospitalized cases of traumatic injuries and thermal burns brought for medicolegal autopsy were examined, with the purpose to find out the incidence, its significance, and the extent of the myocardial lesions due to stress and strain following trauma. About 20% patients had myocardial lesions recognized at gross and histological examination at autopsy. A myocardial lesion does develop in the cases of traumatic injuries and thermal burns. No significant sex difference is seen in the cases showing positive myocardial lesions. However, a relationship exists between these myocardial lesions and the after-effects developing in the cases of trauma. These myocardial lesions seen in the cases of traumatic injuries can be termed as early ischemic or anoxic lesions in the absence of any specific coronary pathology. The intensity of myocardial lesions increases with increase in the survival period of the patient. The findings in the study support the concept of human stress cardiomyopathy and demonstrate the potential significance of stress in precipitating death.

  17. Malnutrition prevalence in hospitalized elderly diabetic patients

    Directory of Open Access Journals (Sweden)

    Alejandro Sanz París

    2013-06-01

    Full Text Available Background & aims: Malnutrition prevalence is unknown among elderly patients with diabetes mellitus. Our objectives were to determine malnutrition prevalence in elderly in patients with diabetes, and to describe their impact on prognosis. Methods: An observational multicenter study was conducted in 35 Spanish hospitals. Malnutrition was assessed with the Mini Nutritional Assessment (MNA tool. Patients were followed until discharge. Results: 1,090 subjects were included (78 ± 7.1 years; 50% males. 39.1% had risk of malnutrition, and 21.2% malnutrition. A 15.5% of the malnourished subjects and 31.9 % of those at risk had a BMI ≥ 30 kg/m². In multivariate analysis, female gender (OR = 1.38; 95% CI: 1.19-1.11, age (OR = 1.04; 95% CI: 1.02-1.06 and presence of diabetic complications (OR = 1.97; 95% CI: 1.52-2.56 were associated with malnutrition. Length of stay (LOS was longer in at-risk and malnourished patients than in well-nourished (12.7 ± 9.9 and 15.7 ± 12.8 days vs 10.7 ± 9.9 days; p < 0.0001. After adjustment by age and gender, MNA score (OR = 0.895; 95% CI 0.814-0.985 and albumin (OR = 0.441; 95% CI 0.212-0.915 were associated with mortality. MNA score was associated with the probability of home discharge (OR = 1.150; 95% CI 1.084-1.219. Conclusion: A high prevalence of malnutrition among elderly in patients with diabetes was observed, regardless of BMI. Malnutrition, albumin, and MNA score were related to LOS, mortality and home discharge.

  18. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer

    2013-01-01

    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety, an...... and the psychosocial burden on the family does not increase. Pediatr Blood Cancer © 2013 Wiley Periodicals, Inc.......BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety......, and cost. A controlled trial was conducted to assess children's health-related quality of life (HRQOL) using the parent-reported and self-reported PedsQL Generic Core Scale and PedsQL Cancer Module, and the psychosocial impact on the family by PedsQL Family Impact Module comprising a subsample of 28...

  19. The recurrence rate of breast cancer conserving operation in Yokohama Citizen's Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Ishiyama, Akira; Chishima, Takashi; Hayashi, Kazushige; Kito, Fumihiko; Fukushima, Tumeo [Yokohama Municipal Citizen' s Hospital (Japan)

    2000-05-01

    During the last nine year period from Jan. 1991 to Dec. 1999, a total of 615 patients with primary breast cancer were experienced at our hospital. Eighty-eight patients underwent breast conserving therapy, 9 out of 88 patients received radiation therapy after surgical procedures. Recurrence were observed in five patients (5.7%). One of them had skin metastasis which looked like inflammatory breast cancer. This case was treated by postoperative 50 Gy radiation therapy to the remnant breast tissue but was unsuccessful in this case. We believe that postoperative radiation therapy is indicated for breast cancer patients with cancer-positive surgical margin or massive lymph node metastases. The other recurrent cases included one patient with supraclavicular lymph node metastases and three patients with local recurrence of remnant breast tissue cancer as a result of multicentricity. Our five recurrent patients are now alive after the various salvage therapies. Breast conserving therapy without radiation is thought to be useful in certain indicated cases. (author)

  20. Psychological aspects of cancer patients

    Directory of Open Access Journals (Sweden)

    Graça Cardoso

    2014-06-01

    Full Text Available Cancer is accompanied by important psychological distress experienced by both patient and family. From the moment of the diagnosis on, the patient has to develop a great number of mechanisms and tasks of adjustment to the illness and its circumstances. The high prevalence of anxiety and depressive disorders during the course of cancer increases in the end stage disea‐ se. Therefore, a global plan of intervention integrating somatic and psychological/ psychiatric care throughout all the phases of the illness is crucial in the treatment of these patients. Health professionals working on this field can also experience emotional reactions to their patients’ suffering. They should be aware of the emotional aspects involved and develop training to help them intervene adequately with the patient and the family. The articulation between oncologists, palliative care professionals, and mental health care teams can be of great help in providing good quality of care to cancer patients.

  1. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

    DEFF Research Database (Denmark)

    Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S

    2015-01-01

    OBJECTIVES: Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes...... are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect......-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management...

  2. EGFR mutation testing in patients with advanced non-small cell lung cancer: a comprehensive evaluation of real-world practice in an East Asian tertiary hospital

    National Research Council Canada - National Science Library

    Choi, Yoon-La; Sun, Jong-Mu; Cho, Juhee; Rampal, Sanjay; Han, Joungho; Parasuraman, Bhash; Guallar, Eliseo; Lee, Genehee; Lee, Jeeyun; Shim, Young Mog

    2013-01-01

    .... Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010...

  3. [Sharing space/time among hospitalized patients].

    Science.gov (United States)

    Bellato, Roseney; de Carvalho, Emília Campos

    2002-01-01

    By means of a comprehensive approach and based on the theoretical framework stemming from the studies of Michel Maffesoli, we attempted to understand the sharing dimension existing among ill people during hospitalization. Through interviews and observation, we were able to apprehend that, in spite of all the standardization of hospitalization, people weave a relational web and engender a "destination community" within the hospital.

  4. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

    OpenAIRE

    Kourosh Parsapour; Kon, Alexander A.; Madan Dharmar; McCarthy, Amy K.; Hsuan-Hui Yang; Smith, Anthony C; Janice Carpenter; Sadorra, Candace K.; Farbstein, Aron D.; Hojman, Nayla M.; Gary L. Wold; Marcin, James P.

    2011-01-01

    The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six case...

  5. Outcomes in Critically Ill Patients with Cancer-Related Complications

    Science.gov (United States)

    Torres, Viviane B. L.; Vassalo, Juliana; Silva, Ulysses V. A.; Caruso, Pedro; Torelly, André P.; Silva, Eliezer; Teles, José M. M.; Knibel, Marcos; Rezende, Ederlon; Netto, José J. S.; Piras, Claudio; Azevedo, Luciano C. P.; Bozza, Fernando A.; Spector, Nelson; Salluh, Jorge I. F.; Soares, Marcio

    2016-01-01

    Introduction Cancer patients are at risk for severe complications related to the underlying malignancy or its treatment and, therefore, usually require admission to intensive care units (ICU). Here, we evaluated the clinical characteristics and outcomes in this subgroup of patients. Materials and Methods Secondary analysis of two prospective cohorts of cancer patients admitted to ICUs. We used multivariable logistic regression to identify variables associated with hospital mortality. Results Out of 2,028 patients, 456 (23%) had cancer-related complications. Compared to those without cancer-related complications, they more frequently had worse performance status (PS) (57% vs 36% with PS≥2), active malignancy (95% vs 58%), need for vasopressors (45% vs 34%), mechanical ventilation (70% vs 51%) and dialysis (12% vs 8%) (P<0.001 for all analyses). ICU (47% vs. 27%) and hospital (63% vs. 38%) mortality rates were also higher in patients with cancer-related complications (P<0.001). Chemo/radiation therapy-induced toxicity (6%), venous thromboembolism (5%), respiratory failure (4%), gastrointestinal involvement (3%) and vena cava syndrome (VCS) (2%) were the most frequent cancer-related complications. In multivariable analysis, the presence of cancer-related complications per se was not associated with mortality [odds ratio (OR) = 1.25 (95% confidence interval, 0.94–1.66), P = 0.131]. However, among the individual cancer-related complications, VCS [OR = 3.79 (1.11–12.92), P = 0.033], gastrointestinal involvement [OR = 3.05 (1.57–5.91), P = <0.001] and respiratory failure [OR = 1.96(1.04–3.71), P = 0.038] were independently associated with in-hospital mortality. Conclusions The prognostic impact of cancer-related complications was variable. Although some complications were associated with worse outcomes, the presence of an acute cancer-related complication per se should not guide decisions to admit a patient to ICU. PMID:27764143

  6. Hospital Rating Systems and Implications For Patient Travel to Better-rated Hospitals.

    Science.gov (United States)

    Subramanian, Arun; Adler, Joel T; Shah, Nilay D; Hyder, Joseph A

    2017-03-01

    Publicly reported hospital ratings aim to encourage transparency, spur quality improvement, and empower patient choice. Travel burdens may limit patient choice, particularly for older adults (aged 65 years and more) who receive most medical care. For 3 major hospital ratings systems, we estimated travel burden as the additional 1-way travel distance to receive care at a better-rated hospital.Distances were estimated from publicly available data from the US Census, US News Top Hospitals, Society of Thoracic Surgeons composite rating for coronary artery bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS).Hospitals were rated for HCAHPS (n = 4656), STS-CABG (n = 470), and US News Top Hospitals (n = 15). Older adults were commonly located within 25 miles of their closest HCAHPS hospital (89.6%), but less commonly for STS-CABG (62.9%). To receive care at a better-rated hospital, travel distances commonly exceeded 25 miles: HCAHPS (39.2%), STS-CABG (62.7%), and US News Top Hospital (85.2%). Additional 1-way travel distances exceeded 25 miles commonly: HCAHPS (23.7%), STS-CABG (36.7%), US News Top Hospitals (81.8%).Significant travel burden is common for older adults seeking "better" care and is an important limitation of current hospital ratings for empowering patient choice.

  7. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Directory of Open Access Journals (Sweden)

    Waseem Khaliq

    Full Text Available Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89, current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67, and history of stroke (OR = 2.83, 95%CI; 1.21-6.60. By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34.Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  8. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Science.gov (United States)

    Khaliq, Waseem; Aamar, Ali; Wright, Scott M

    2015-01-01

    Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women. A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography. Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89), current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67), and history of stroke (OR = 2.83, 95%CI; 1.21-6.60). By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34). Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  9. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  10. Breaking Bad News in Cancer Patients

    Science.gov (United States)

    Konstantis, Apostolos; Exiara, Triada

    2015-01-01

    Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines. PMID:25709183

  11. Dietary tyramine restriction for hospitalized patients on linezolid: an update.

    Science.gov (United States)

    Rumore, Martha M; Roth, Marc; Orfanos, Areti

    2010-06-01

    Linezolid is a weak, reversible monoamine oxidase inhibitor. The current practice at most hospitals is to place patients receiving linezolid on a tyramine-restricted diet. This process typically involves both the hospital's pharmacy department and the food and nutrition department. A literature search assessing the interaction between linezolid and tyramine was conducted, and the amount of tyramine in a typical unrestricted diet for a hospitalized patient was reviewed. Although patients receiving linezolid should avoid consuming large amounts of foods containing high concentrations of tyramine, such foods in large amounts are not components of meals for inpatients. Therefore, dietary tyramine restriction in hospitalized patients is not generally required.

  12. Management of the hospitalized diabetes patient with an insulin pump.

    Science.gov (United States)

    McCrea, Deborah

    2013-03-01

    More than 375,000 Americans manage their diabetes with an insulin pump, and this number continues to increase. Many of these patients will want to remain on their insulin pump while hospitalized, so the nurse needs to know about how to care for the hospitalized patient wearing an insulin pump. This article discusses the benefits of intensive insulin therapy, how the insulin pump works, initial insulin-pump dosing, candidate selection, advantages and disadvantages of using an insulin pump, troubleshooting the pump, nursing care of the hospitalized patient wearing an insulin pump, and development of hospital protocols for the care of such patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Lung cancer in HIV-infected patients

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    R Palacios

    2012-11-01

    Full Text Available Purpose: Several studies have shown that HIV patients are at higher risk of lung cancer. Our aim is to analyse the prevalence and features of lung cancer in HIV-infected patients. Methods: The clinical charts of 4,721 HIV-infected patients seen in three hospitals of southeast Spain (study period 1992–2012 were reviewed, and all patients with a lung cancer were analysed. Results: There were 61 lung cancers, giving a prevalence of 1.2%. There was a predominance of men (82.0%, and smokers (96.6%; mean pack-years 35.2, with a median age of 48.0 (41.7–52.9 years, and their distribution according to risk group for HIV was: intravenous drug use 58.3%, homosexual 20.0%, and heterosexual 16.7%. Thirty-four (56.7% patients were Aids cases, and 29 (47.5% had prior pulmonar events: tuberculosis 16, bacterial pneumonia 9, and P. jiroveci pneumonia 4. The median nadir CD4 count was 149/mm3 (42–232, the median CD4 count at the time of diagnosis of the lung cancer was 237/mm3 (85–397, and 66.1%<350/mm3. 66.7% were on ART, and 70% of them had undetectable HIV viral load. The most common histological types of lung cancer were adenocarcinoma and epidermoid, with 24 (40.0% and 23 (38.3% cases, respectively. There were 49 (80.3% cases with advanced stages (III and IV at diagnosis. The distribution of treatments was: only palliative 23 (39.7%, chemotherapy 14 (24.1%, surgery and chemotherapy 8 (13.8%, radiotherapy 7 (12.1%, surgery 4 (6.9%, and other combined treatments 2 (3.4%. Forty-six (76.7% patients died, with a median survival time of 3 months. The Kaplan-Meier survival rate at 6 months was 42.7% (at 12 months 28.5%. Conclusions: The prevalence of lung cancer in this cohort of HIV-patients is high. People affected are mainly men, smokers, with transmission of HIV by intravenous drug use, and around half of them with prior opportunistic pulmonary events. Most patients had low nadir CD4 count, and were immunosuppressed at the time of diagnosis

  14. Private and public patients in public hospitals in Australia.

    Science.gov (United States)

    Shmueli, Amir; Savage, Elizabeth

    2014-04-01

    The nature of the private-public mix in health insurance and in health care is a major issue in most health systems. To compare the hospitalization characteristics of private and public patients hospitalized in public hospitals. We focused on planned, overnight and same-day admissions, discharged during 2004-2005 from the public New South Wales hospitals, and run fixed-effects regressions in order to identify the effect of accommodation status (private/public) on the hospitalization characteristics. Private patients have one third less waiting days than public patients, and they are assigned higher urgency of admission. Length of stay and length of visit are both unrelated to the accommodation status, however, private patients tend to have more hours in ICU and more procedures performed during the hospitalization. In-hospital mortality and the number of transfers (wards) are not affected by the accommodation status. Private patients are treated differently than public patients in public hospitals, reinforcing the private health insurance-related inequity in inpatient care identified by others. Two health policy issues emerge from the findings: the role of private health insurance in the Australian socialized medicine system, and in particular, in the public hospitals; and the way public hospitals are reimbursed for private patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.

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    Tjibbe Donker

    Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.

  16. A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team.

    Science.gov (United States)

    Rowlands, S; Callen, J

    2013-01-01

    The aim of the study was to explore how patient information is communicated between health professionals within a multidisciplinary hospital-based lung cancer team and to identify mechanisms to improve these communications. A qualitative method was employed using semi-structured in-depth interviews with a representative sample (n = 22) of members of a multidisciplinary hospital-based lung cancer team including medical, nursing and allied health professionals. Analysis was undertaken using a thematic grounded theory approach to derive key themes to describe communication patterns within the team and how communication could be improved. Two themes with sub-themes were identified: (1) characteristics of communication between team members including the impact of role on direction of communications, and doctors' dominance in communications; and (2) channels of communication including, preference for face-to-face and the suboptimal roles of the Multidisciplinary Team Meeting and the hospital medical record as mediums for communication. Traditional influences of role delineation and the dominance of doctors were found to impact on communication within the multidisciplinary hospital-based lung cancer team. Existing guidelines on implementation of multidisciplinary cancer care fail to address barriers to effective team communication. The paper-based medical record does not support team communications and alternative electronic solutions need to be used. © 2012 Blackwell Publishing Ltd.

  17. Randomized trial of a patient-centered hospital unit.

    Science.gov (United States)

    Martin, D P; Diehr, P; Conrad, D A; Davis, J H; Leickly, R; Perrin, E B

    1998-06-01

    Patient-centered hospital units have grown out of the national trend to greater consumerism, but few of these units have been evaluated rigorously. We used a randomized controlled trial to compare patient outcomes on the Planetree Model Hospital Unit with other medical-surgical units in the hospital. Planetree patients were significantly more satisfied than controls with their hospital stay, the unit's environment and nursing care, but did not differ in ratings of physician care. Planetree patients reported more involvement in their care while hospitalized and higher satisfaction with the education they received. There were few differences between Planetree and controls in health behaviors. While Planetree patients reported better mental health status and role functioning after discharge, their health status was similar to controls after 3 to 6 months. There were no differences in length of stay and charges for the index hospitalization, readmissions or outpatient care during the following year.

  18. Patient experiences of inpatient hospital care: a department matter and a hospital matter.

    NARCIS (Netherlands)

    Krol, M.W.; Boer, D. de; Sixma, H.; Hoek, L. van der; Rademakers, J.J.D.J.M.; Delnoij, D.M.

    2015-01-01

    Objective: To examine the added value of measuring and possibly presenting patient experiences at the department level, in addition to the hospital level, and to explore the possibility that patient experiences differ according to the ‘type’ of hospital department. Design: Secondary analysis of data

  19. Risk Factors for Thyroid Cancer: A Hospital-Based Case-Control Study in Korean Adults

    Science.gov (United States)

    Myung, Seung-Kwon; Lee, Chan Wha; Lee, Jeonghee; Kim, Jeongseon; Kim, Hyeon Suk

    2017-01-01

    Purpose Although the incidence of thyroid cancer in Korea has rapidly increased over the past decade, few studies have investigated its risk factors. This study examined the risk factors for thyroid cancer in Korean adults. Materials and Methods The study design was a hospital-based case-control study. Between August 2002 and December 2011, a total of 802 thyroid cancer cases out of 34,211 patients screened from the Cancer Screenee. Cohort of the National Cancer Center in South Korea were included in the analysis. A total of 802 control cases were selected from the same cohort, and matched individually (1:1) by age (±2 years) and area of residence for control group 1 and additionally by sex for control group 2. Results Multivariate conditional logistic regression analysis using the control group 1 showed that females and those with a family history of thyroid cancer had an increased risk of thyroid cancer, whereas ever-smokers and those with a higher monthly household income had a decreased risk of thyroid cancer. On the other hand, the analysis using control group 2 showed that a family history of cancer and alcohol consumption were associated with a decreased risk of thyroid cancer, whereas higher body mass index (BMI) and family history of thyroid cancer were associated with an increased risk of thyroid cancer. Conclusion These findings suggest that females, those with a family history of thyroid cancer, those with a higher BMI, non-smokers, non-drinkers, and those with a lower monthly household income have an increased risk of developing thyroid cancer. PMID:27338034

  20. The Relation between Awareness of Cancer Diagnosis and Spiritual Health among Cancer Patients

    Directory of Open Access Journals (Sweden)

    Shima Sadat Aghahosseini

    2012-05-01

    Full Text Available Introduction: Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. Methods: This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. Results: Results showed the mean (SD of spiritual health among aware and unaware patients to be 75.1 (3.8 and 75.4 (3.9, respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96. Conclusion: These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies.

  1. Perceptions of Hospital-Dependent Patients on Their Needs for Hospitalization.

    Science.gov (United States)

    Liu, Tao; Kiwak, Eliza; Tinetti, Mary E

    2017-06-01

    In the United States, older adults account for a significant proportion of hospitalizations, and a subset become hospital-dependent, for reasons that are unclear. We conducted a qualitative study to explore these individuals' perspectives on their need for hospitalizations. Twenty patients hospitalized at an academic medical center underwent semistructured qualitative interviews. Criteria for selection included age 65 and older, at least three hospitalizations over six months, admission to the medical service at the time of the study, did not meet criteria for chronic critical illness, was not comfort measures only, and did not have a conservator. Interviews were audiotaped, transcribed, and inductively analyzed. The major themes derived were the necessity and inevitability of hospitalizations ("You have to bring me in here"), feeling safe in the hospital ("It makes me feel more secure"), patients hospitalized despite having outside medical and social support ("I have everything"), and inadequate goals-of-care discussions ("It just doesn't occur to me"). Results suggested that candid discussions about health trajectories are needed to ensure hospitalization is consistent with the patient's realistic health priorities. Journal of Hospital Medicine 2017;12:450-453. © 2017 Society of Hospital Medicine.

  2. Survival of patients with breast cancer attending Bristol Cancer Help Centre.

    Science.gov (United States)

    Bagenal, F S; Easton, D F; Harris, E; Chilvers, C E; McElwain, T J

    1990-09-08

    The Bristol Cancer Help Centre (BCHC) was set up in 1979 to offer various alternative therapies and treatments for patients with cancer. It attracted much public interest and a high demand for its services--and profound medical scepticism. In a study beginning in 1986 of 334 women with breast cancer attending the centre for the first time between June, 1986, and October, 1987, information about the diagnosis was obtained from case notes. Controls were a sample of 461 women with breast cancer attending a specialist cancer hospital or two district general hospitals. The same information was obtained for the control group as for the BCHC group. All patients have been followed up to June, 1988. 85% of patients with breast cancer attending the BCHC were aged under 55 at diagnosis. More than half had experienced recurrence of their disease before entry. For patients metastasis-free at entry, metastasis-free survival in the BCHC group was significantly poorer than in the controls (relapse rate ratio 2.85). Survival in relapsed cases was significantly inferior to that in the control group (hazard ratio 1.81). For cases metastasis-free at entry to the BCHC there was a significant difference in survival between cases and controls, confirming the difference in metastasis-free survival. There was no significant difference in survival or disease-free survival between the cancer hospital controls and other controls.

  3. Incidence and risk factor analysis for sarcopenia in patients with cancer

    OpenAIRE

    ZHANG, GUOXING; LI, XIUJIANG; SUI, CHANGPING; Hui ZHAO; Zhao, Jihong; Hou, Yue; Du, Yujun

    2015-01-01

    The objective of the present study was to investigate the incidence of and possible risk factors associated with sarcopenia among cancer patients. Patients with cancer were examined through the use of lumbar magnetic resonance imaging, and clinical data was collected between September and December, 2012, at Jilin Province Tumor Hospital (Changchun, China). The data was subsequently compared between patients with and without sarcopenia. Of the 113 treated cancer patients, 96 patients [39 males...

  4. Hacking the hospital environment: young adults designing youth-friendly hospital rooms together with young people with cancer experiences.

    Science.gov (United States)

    Boisen, Kirsten A; Boisen, Anne; Thomsen, Stine Legarth; Matthiesen, Simon Meggers; Hjerming, Maiken; Hertz, Pernille Grarup

    2015-12-09

    There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. To involve young people in designing youth-friendly ward environment. We arranged a design competition lasting 42 h (Hackathon). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups presented their products to a jury and relevant stakeholders. The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. A hackathon event was an effective mode of youth participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients.

  5. End-of-life care during and after an acute hospitalization in older patients with cancer, end-stage organ failure, or frailty : A sub-analysis of a prospective cohort study

    NARCIS (Netherlands)

    Huijberts, Sanne; Buurman, Bianca M.; de Rooij, Sophia E.

    Background: Many patients show deterioration in functioning and increased care needs in the last year of life. End-of-life care needs and health care utilization might differ between groups of acutely hospitalized older patients. Aim: To investigate differences in geriatric conditions, advance care

  6. [Radiotherapy in vulvar cancer. Experience in the Hospital de Oncología, CMN, SXXI, IMSS].

    Science.gov (United States)

    Huerta Bahena, J; Padilla Arrieta, P; Ayala Hernández, J R

    1995-11-01

    Between 1986 and 1992, 42 patients with carcinoma of the vulva diagnosis, were treated at the Hospital de Oncologia, CMN, SXXI. Mean age was 63 years. There was 1 case stage I, 5 stage II, 25 stage III, 4 stage IV, 2 with recurrent disease and 5 patients could not be classified. Local control was reached in 60% of patients however, 12 patients developed local recurrence after surgery and/or radiation therapy, finally 43% of patients remained disease free after a mean of 19 months of followup. In the subset of advanced disease patients treated with radical or preoperative radiation therapy (27 patients), 41% of them remained without disease. Mean radiation doses for patients treated only with radiation therapy was 6500 cGy. Late vulvar fibrosis and acute desquamative dermatitis, were the morbidity more frequently observed. New directions in the management of vulvar cancer must be developed to improve treatment results, in patients with advanced disease.

  7. Breaking bad news in cancer patients

    Directory of Open Access Journals (Sweden)

    Apostolos Konstantis

    2015-01-01

    Full Text Available Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59% had specific training on breaking bad news. 20 doctors (33.90% were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66% had a consistent plan for breaking bad news. 57 (96.61% delivered bad news in a quiet place, 53 (89.83% ensured no interruptions and enough time, 53 (89.83% used simple words and 54 (91.53% checked for understanding and did not rush through the news. 46 doctors (77.97% allowed relatives to determine patient′s knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician′s speech and their plan were according to current guidelines.

  8. Application of hospital preparations for cancer treatment, and an approach toward their commercialization.

    Science.gov (United States)

    Watanabe, Kyohei; Goto, Nobuyuki; Nakamura, Toshiaki; Masada, Mikio

    2013-01-01

    In Japan, pharmacists who are in consultation with doctors independently prepare medications in an attempt to meet the needs of patients in the hospital. In particular, the need for hospital preparations to treat cancer is high and diverse. However, unlike gov]ernment-approved medications, independently and individually prepared hospital preparations raise concerns about their effectiveness, safety, economic efficiency, quality control, etc. One way to address these concerns is to commercialize these preparations and to understand the difference between necessity and demand from various points of view. We have conducted nation-wide utilization surveys and evaluated the literature on hospital preparations. On the basis of the findings of this survey, we have concluded that pharmaceutical companies and the government need to implement the commercialization of hospital preparations in clinical practice. In this report, we discuss the significance of commercialization of hospital preparations, concerns regarding pharmaceutical preparations, and our recent efforts on cancer treatment. We hope to continuously contribute to society and to medical care by improving individualized care and by commercializing medications needed in clinical practice.

  9. Connecting hospitalized patients with their families: case series and commentary.

    Science.gov (United States)

    Parsapour, Kourosh; Kon, Alexander A; Dharmar, Madan; McCarthy, Amy K; Yang, Hsuan-Hui; Smith, Anthony C; Carpenter, Janice; Sadorra, Candace K; Farbstein, Aron D; Hojman, Nayla M; Wold, Gary L; Marcin, James P

    2011-01-01

    The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010). The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital-principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

  10. Clues to occult cancer in patients with ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Suk Jae Kim

    Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.

  11. Large variation between hospitals in immediate breast reconstruction rates after mastectomy for breast cancer in the Netherlands

    NARCIS (Netherlands)

    van Bommel, A C M; Mureau, M A M; Schreuder, K; van Dalen, T; Vrancken Peeters, M T F D; Schrieks, M; Maduro, J H; Siesling, S

    2016-01-01

    BACKGROUND: The present study aimed to describe the use of immediate breast reconstruction (IBR) after mastectomy for invasive breast cancer and ductal carcinoma in situ (DCIS) in hospitals in the Netherlands and determine whether patient and tumor factors account for the variation. METHODS: Patient

  12. Antibiotic resistance in cancer patients.

    Science.gov (United States)

    Gudiol, Carlota; Carratalà, Jordi

    2014-08-01

    Bacterial infection is one of the most frequent complications in cancer patients and hematopoietic stem cell transplant recipients. In recent years, the emergence of antimicrobial resistance has become a significant problem worldwide, and cancer patients are among those affected. Treatment of infections due to multidrug-resistant (MDR) bacteria represents a clinical challenge, especially in the case of Gram-negative bacilli, since the therapeutic options are often very limited. As the antibiotics active against MDR bacteria present several disadvantages (limited clinical experience, higher incidence of adverse effects, and less knowledge of the pharmacokinetics of the drug), a thorough acquaintance with the main characteristics of these drugs is mandatory in order to provide safe treatment to cancer patients with MDR bacterial infections. Nevertheless, the implementation of antibiotic stewardship programs and infection control measures is the cornerstone for controlling the development and spread of these MDR pathogens.

  13. Thromboembolism in Patients with Cancer.

    Science.gov (United States)

    Büyükçelik, Abdullah; Akbulut, Hakan

    2004-03-01

    One hundred and forty years ago, Armand Trousseau described phlegmasia alba dolens as a sign of internal malignancy. Nowadays, it is commonly believed that the presence malignant tumaor increases the risk of venous thromboembolism (i.e deep vein thrombosis and pulmonary embolism) However, cancer is usually associated with other factors such as old age, extensive surgery,immobility, etc., which may predispose to thromboembolism. The majority of thrombotic events occur in the venous system; the incidence of arterial thrombosis is much lower.Recurrent thromboembolism in cancer patients frequently and diminishes the quality of life of the patients.Furthermore, if the thromboembolism is massive, destipte of early and aggressive treatment, it may result in death. In this article, we review thromboembolic complications in cancer patients.

  14. Multi-modal intervention improved oral intake in hospitalized patients

    DEFF Research Database (Denmark)

    Holst, M; Beermann, T; Mortensen, M N

    2015-01-01

    : A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h......BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital. AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting. METHODS...

  15. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2015-03-15

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  16. Hypertension in Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Vinicius Barbosa de Souza

    2015-03-01

    Full Text Available There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib, corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  17. Prevalence of skin diseases in hospitalized geriatric patients : Association with gender, duration of hospitalization and geriatric assessment.

    Science.gov (United States)

    Makrantonaki, E; Steinhagen-Thiessen, E; Nieczaj, R; Zouboulis, C C; Eckardt, R

    2017-08-01

    Improvement of quality of life in old age and prevention of age-associated diseases have become the main focus of research into aging; however, information regarding the skin health status of geriatric patients still remains sparse. To investigate the extent of dermatological diseases in hospitalized geriatric patients, map the most prevalent ones, check for any gender differences and document any correlations with duration of hospitalization and results of geriatric assessments. A total of 110 hospitalized geriatric patients underwent a complete dermatological examination at the Evangelical Geriatric Hospital (Evangelisches Geriatriezentrum) Berlin. The collected information was stratified according to dermatological diagnosis, results of geriatric assessments, duration of hospitalization, age and gender of the patients. The average number of diagnosed skin diseases per patient was 3.7 ± 1.8 for the female population and 4.3 ± 2.0 for the male population. After categorizing all diagnosed skin diseases, infectious diseases were found to be most common in both female and male patients (55 % and 58 %, respectively) followed by vascular diseases (46.7 % and 54 %, respectively). Precancerous skin lesions and epithelial skin cancer were more frequent in men than in women (20 % vs. 6.7 %, p Tinetti score on the day of discharge, indicating that pruritus may have a significant impact on the physical condition of elderly multimorbid patients and on the static and dynamic balance abilities. Our results demonstrate that skin health in the elderly is compromised and disregarded and this should constitute one of the top priorities of healthcare specialists and physicians in the future.

  18. Subjective burden of family caregivers for hospitalized cancer patients and related factors%住院肿瘤患者亲属照顾者主观负担及相关因素

    Institute of Scientific and Technical Information of China (English)

    李文杰; 王峰; 李树秋; 吕丽; 王力; 薛艳; 张红静

    2011-01-01

    Objective To explore the state of subjective burden among family caregivers for cancer patients and its associations with the caregiver's family relationship and other sensitive factors. Methods 71 caregivers for hospitalized cancer patients were assessed by the general sociological survey, Caregiver Reaction Assessment( CRA), Index of Family Relations (IFR)and Family Assessment Device (FAD), and 45 caregivers for general medicine as the control group were studied by CRA. Results The burden in health (P<0. 05), scheduling (P<0.01) and finances (P<0.001) of caregivers for cancer was higher than that in the control group. Higher quality of family relationship was related to lower burden in caregiver's health ( P < 0.01 ), scheduling ( P < 0.05 ), finances ( P < 0.01 ) and family abandonment ( P < 0.05 ), while it was related to higher self-esteem ( P < 0.05 ). Affect intervention was related to lower burden in caregiver's health ( P < 0.05 ) and family abandonment ( P < 0.05 ), while it was related to higher self-esteem. The age, marriage state, job and care time of caregivers were related to burden outcomes. Conclusions Subjective burden of caregivers for cancer is higher than that of caregivers for general medicine. The burden is related to the caregiver's family relationship quality, age, marriage state, job, care time and family income.%目的 探讨肿瘤患者亲属照顾者主观负担现状及其与一般社会性因素、家庭关系质量的相关性.方法 用一般社会学指标、照顾者反应评估工具、家庭关系指数和家庭功能评定问卷对71名住院肿瘤患者照顾者和45名普通内科住院患者照顾者(对照组)进行测量.结果 肿瘤患者照顾者的健康问题(P<0.05)、时间受打扰(P<0.01)和经济压力(P<0.001)显著高于对照组.家庭关系指数与健康问题(P<0.01)、时间受打扰(P<0.05)、经济压力(P<0.01)、家庭支持缺乏(P<0.05)呈显

  19. Incidence and hospital mortality of vascular surgery patients with ...

    African Journals Online (AJOL)

    MINS in these patients was significantly associated with hospital mortality. MINS requires strict diagnostic ... of cardiovascular complications by explicitly excluding patients ..... the Ethics and Guidelines Standing Committee of the SA Heart.

  20. Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

    Directory of Open Access Journals (Sweden)

    Shafazand Masoud

    2012-03-01

    Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

  1. Does hospital need more hospice beds? Hospital charges and length of stays by lung cancer inpatients at their end of life: A retrospective cohort design of 2002-2012.

    Science.gov (United States)

    Kim, Sun Jung; Han, Kyu-Tae; Kim, Tae Hyun; Park, Eun-Cheol

    2015-10-01

    Previous studies found that hospice and palliative care reduces healthcare costs for end-of-life cancer patients. To investigate hospital inpatient charges and length-of-stay differences by availability of hospice care beds within hospitals using nationwide data from end-of-life inpatients with lung cancer. A retrospective cohort study was performed using nationwide lung cancer health insurance claims from 2002 to 2012 in Korea. Descriptive and multi-level (patient-level and hospital-level) mixed models were used to compare inpatient charges and lengths of stay. Using 673,122 inpatient health insurance claims, we obtained aggregated hospital inpatient charges and lengths of stay from a total of 114,828 inpatients and 866 hospital records. Hospital inpatient charges and length of stay drastically increased as patients approached death; a significant portion of hospital inpatient charges and lengths of stay occurred during the end-of-life period. According to our multi-level analysis, hospitals with hospice care beds tend to have significantly lower end-of-life hospital inpatient charges; however, length of stay did not differ. Hospitals with more hospice care beds were associated with reduction in hospital inpatient charges within 3 months before death. Higher end-of-life healthcare hospital charges were found for lung cancer inpatients who were admitted to hospitals without hospice care beds. This study suggests that health policy-makers and the National Health Insurance program need to consider expanding the use of hospice care beds within hospitals and hospice care facilities for end-of-life patients with lung cancer in South Korea, where very limited numbers of resources are currently available. © The Author(s) 2015.

  2. [Weight loss in cancer patients].

    Science.gov (United States)

    Lordick, Florian; Hacker, Ulrich

    2016-02-01

    Cancer patients are regularly affected by malnutrition which often leads to a worsened quality of life and activity in daily living, more side effects and complications during anticancer treatment and shorter survival times. The early diagnosis and treatment of malnutrition are therefore relevant components of oncological treatment. The assessment of the nutritional status and determination of the body-mass-index should be done in every patient with cancer. The clinical examination delivers important findings and indications for malnutrition. Bioimpedance analysis can deliver additional objective information. The treatment of malnutrition should start early and follows a step-wise escalation reaching from nutritional counseling to enteral nutritional support to parenteral nutrition.

  3. Assessing patient safety culture in hospitals across countries

    NARCIS (Netherlands)

    Wagner, C.; Smits, M.; Sorra, J.; Huang, C.C.

    2013-01-01

    OBJECTIVE: It is believed that in order to reduce the number of adverse events, hospitals have to stimulate a more open culture and reflective attitude towards errors and patient safety. The objective is to examine similarities and differences in hospital patient safety culture in three countries: t

  4. Assessing patient safety culture in hospitals across countries.

    NARCIS (Netherlands)

    Wagner, C.; Smits, M.; Sorra, J.; Huang, C.C.

    2013-01-01

    Objective: It is believed that in order to reduce the number of adverse events, hospitals have to stimulate a more open culture and reflective attitude towards errors and patient safety. The objective is to examine similarities and differences in hospital patient safety culture in three countries: t

  5. Disparities in oral cancer survival among mentally ill patients.

    Directory of Open Access Journals (Sweden)

    Ting-Shou Chang

    Full Text Available BACKGROUND: Many studies have reported excess cancer mortality in patients with mental illness. However, scant studies evaluated the differences in cancer treatment and its impact on survival rates among mentally ill patients. Oral cancer is one of the ten most common cancers in the world. We investigated differences in treatment type and survival rates between oral cancer patients with mental illness and without mental illness. METHODS: Using the National Health Insurance (NHI database, we compared the type of treatment and survival rates in 16687 oral cancer patients from 2002 to 2006. The utilization rate of surgery for oral cancer was compared between patients with mental illness and without mental illness using logistic regression. The Cox proportional hazards model was used for survival analysis. RESULTS: Oral cancer patients with mental disorder conferred a grave prognosis, compared with patients without mental illness (hazard ratios [HR] = 1.58; 95% confidence interval [CI] = 1.30-1.93; P<0.001. After adjusting for patients' characteristics and hospital characteristics, patients with mental illness were less likely to receive surgery with or without adjuvant therapy (odds ratio [OR] = 0.47; 95% CI = 0.34-0.65; P<0.001. In multivariate analysis, oral cancer patients with mental illness carried a 1.58-times risk of death (95% CI = 1.30-1.93; P<0.001. CONCLUSIONS: Oral cancer patients with mental illness were less likely to undergo surgery with or without adjuvant therapy than those without mental illness. Patients with mental illness have a poor prognosis compared to those without mental illness. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this vulnerable group.

  6. Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls

    Directory of Open Access Journals (Sweden)

    Sutradhar Rinku

    2012-10-01

    Full Text Available Abstract Background Over the past years, the incidence of colorectal cancer has been increasing among young adults. A large percentage of these patients live at least 5 years after diagnosis, but it is unknown whether their rate of hospitalizations after this 5-year mark is comparable to the general population. Methods This is a population-based cohort consisting of 917 young adult survivors diagnosed with colorectal cancer in Ontario from 1992–1999 and 4585 matched cancer-free controls. A multistate model is presented to reflect and compare trends in the hospitalization process among survivors and their matched controls. Results Analyses under a multistate model indicate that the risk of a subsequent hospital admission increases as the number of prior hospitalizations increases. Among patients who are yet to experience a hospitalization, the rate of admission is 3.47 times higher for YAS than controls (95% CI (2.79, 4.31. However, among patients that have experienced one and two hospitalizations, the relative rate of a subsequent admission decreases to 3.03 (95% CI (2.01, 4.56 and 1.90 (95% CI (1.19, 3.03, respectively. Conclusions Young adult survivors of colorectal cancer have an increased risk of experiencing hospitalizations compared to cancer-free controls. However this relative risk decreases as the number of prior hospitalizations increases. The multistate approach is able to use information on the timing of hospitalizations and answer questions that standard Poisson and Negative Binomial models are unable to address.

  7. Does implementation of ISO standards in hospitals improve patient satisfaction?

    Directory of Open Access Journals (Sweden)

    Vahid Keshtkar

    2017-01-01

    Full Text Available Introduction: Around the world, a large number of projects have been developed with the aim of assessing patient satisfaction especially in hospitals. As an important indicator of the quality of health care system, Patients’ perception of health care has been the center of attention over the recent 20 years. Method: 402 patients who were hospitalized in teaching hospitals affiliated to the Shiraz University of Medical Sciences were investigated. Patients’ satisfactions of the health care services were assessed using the translated and modified version of the KQCAH consisted of 44 questions divided to7 categories of Respect and Caring, Effectiveness and Continuity, Appropriateness, Information, Efficiency, Meals, First Impression, Staff Diversity. All of the patients were asked to fill out the questionnaire (with written informed consents at the time of discharge from the hospitals. Results: Regarding total score of patient satisfaction the ISO-certified hospitals did not show advantages over the uncertified hospitals. The total score of patients’ satisfaction ranged from 66.5 to 77.5 in. Overall, only in one ISO-certified hospital the total score of patient satisfaction representing all dimensions, was significantly higher comparing to other hospitals included in the study. Conclusion: It seems that solitary application of ISO standards could not improve patient satisfaction in hospitals affiliated to Shiraz University of Medical Sciences.

  8. Ethnic inequalities in patient safety in Dutch hospital care

    NARCIS (Netherlands)

    van Rosse, F.

    2015-01-01

    This thesis shows the first results of Dutch studies on the relation between ethnicity and patient safety. We used mixed methods to identify patient safety outcomes and patient safety risks in a cohort study in 4 urban hospitals among 763 Dutch patients and 576 ethnic minority patients. In a record

  9. Hospital reimbursement price cap for cancer drugs: the French experience in controlling hospital drug expenditures.

    Science.gov (United States)

    Degrassat-Théas, A; Bensadon, M; Rieu, C; Angalakuditi, M; Le Pen, C; Paubel, P

    2012-07-01

    In 2005, the French Government implemented a new way of financing high-cost drugs for hospitals in order to promote innovation. Such drugs are gathered on a positive list, established by the Ministry of Health, with a reimbursement price cap. Hospitals still negotiate with pharmaceutical firms, who set their prices freely, and then charge the national health insurance according to their consumption, without budgetary constraints, but on the condition of good use of care. They are not allowed to charge a price higher than this ceiling price, which is called the 'responsibility tariff' (RT). This measure is included in another, larger reform, which concerns hospital financing through allotted amounts at a specific diagnosis-based level. The purpose of this add-on payment on top of the health funds is firstly to avoid heterogeneity in costs per diagnostic-related group and secondly to avoid an uncontrolled increase of prices due to a lack of interest in negotiation from hospitals, as supplementary funding could reduce hospital price sensitivity. The aim of this work was to assess the bargaining power of hospitals with the pharmaceutical firms in the monopoly market of innovative cancer drugs since the implementation of this reimbursement price cap. This study used data from the French Technical Agency of Information on Hospitals (ATIH; Agence Technique de l'Information sur l'Hospitalisation) and included 487 hospitals, which were public and non-profit private. The analysis was conducted on the cancer drugs of the regulated list. An index representing the ratio of the purchase prices to the RT was built from 2004 to 2007 in order to make a 'before-and-after' comparison. Results showed a transient price decrease in 2005 before an alignment of patented drugs with regulated prices in the context of a dynamic market with a 22.5% yearly growth rate in value between 2004 and 2007. Hospitals are able to impose the RT for single-brand drugs. However, they are no longer able to

  10. Perfil dos pacientes portadores de câncer colorretal operados em um hospital geral: necessitamos de um programa de rastreamento acessível e efetivo Profile of patients with colorectal cancer operated in a general hospital: we need an accessible and effective screening program

    Directory of Open Access Journals (Sweden)

    Marcus Valadão

    2010-06-01

    study is to demonstrate the current panorama of colorectal cancer in a general hospital in Rio de Janeiro, focusing on aspects related to the clinical presentation and delayed diagnosis. This is a retrospective study that included patients followed at the outpatient section of colorectal cancer follow-up of the Segunda Clínica Cirúrgica do Hospital Federal Bonsucesso in the past five years (2004-2009. The most common symptoms were abdominal pain (60.1%, intestinal obstruction (41.1%, weight loss (36.7%, bleeding (33.5%, anemia (14.5%, perforation (6.3 % and fistula (1.2%. Patients with right colon tumors presented with weight loss (54.5%, pain (45.4%, obstruction (45.4% and anemia (27.2%. In patients with tumors of the left colon and sigmoid, the most common symptoms were pain (60.5%, obstruction (42.9%, weight loss (38.5%, bleeding (32.4% and anemia (16.6%. Patients with rectal tumors presented with bleeding (70%, obstruction (60%, pain (60%, weight loss (20% and perforation (10%. At surgery, 53 patients had distant metastases (33.5%, the liver being the organ most affected in 36 patients (67.9%, followed by the peritoneum in 11 cases (20.7% and ovaries with 4 cases (7.5%. Eighty-eight patients (55.6% had nodal metastasis. Regarding TNM staging, we found that the emergency group distribution was as follows: Stage I 0%, 28.2% Stage II, Stage III 30.4% and 41 3% Stage IV, whereas the elective group staging distribution was: 2.7% Stage I, Stage II 27.7%, 25% Stage III and Stage IV 44%. Conclusion: The profile of patients operated in our institution (which reflects the national reality is composed mainly with patients with advanced cancer stages. Based on the data presented, it is necessary to implement a national screening program for colorectal cancer.

  11. CLINICO-EPIDEMIOLOGICAL PROFILE OF ORAL CANCER: A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Kapil H Agrawal

    2012-07-01

    Full Text Available Background: India is heading towards various types of non-communicable diseases, which are also known as modern epidemics. Among these modern epidemics cancer is among the ten commonest cause of mortality in developing countries including India. Oral cancer is a major problem in India and accounts for 50-70% of all the cancers diagnosed. Ninety percent (90% of oral cancers in South East Asia including India are linked to tobacco chewing and tobacco smoking. Research question: What is the profile of Oral cancer (Oral cavity cases reported in the hospital? Objective: To study the clinico-epidemiological profile associated with Oral cancer cases. Methods: Study Design: Hospital based, Cross -sectional study. Settings: Shri Siddhivinayak Ganapati Cancer Hospital, Miraj, Maharashtra. Participants and Sample size: As it is a time bound study sample size comprised of all the confirmed cases of oral cancer reported in the hospital during the study period. The study was carried out from 1st March 2005 to 28th February 2006. Study variables included demographic factors, socioeconomic factors, enquiries regarding modifiable risk factors such as tobacco usage, alcohol consumption, site involved (within oral cavity, staging, histopathological examination, treatment modality used. Data entry and statistical analysis was done using Microsoft excel. Data presented in form of percentages and proportions. Results: Out of the total 160 cases, majority of the subjects were above 40 years age. 36 (22% of subjects were young adults (below 40 years age. 125 (78% subjects were male. Most of the subjects belonged to upper lower and lower middle socio-economic scale according to modified Kuppuswamy classification. It was observed that 139 (87% cases consumed tobacco in all forms. Out of these, ninety cases consumed tobacco in chewable form. Tobacco was chewed mainly in the form of gutka. Only ten (10 female subjects chewed tobacco. No female subjects smoked. The most

  12. The quality perception gap between employees and patients in hospitals.

    Science.gov (United States)

    Willems, Jurgen; Ingerfurth, Stefan

    2016-12-15

    To assess hospital performance, quality perceptions of various stakeholders are increasingly taken into account. However, because of substantial background differences, various stakeholder groups might have different and even contrasting quality perceptions. We test the hypothesis that an overall perception gap exists between employees and patients with respect to perceived hospital quality. We additionally elaborate on how various employee groups differ from each other and from patients. We use primary survey data on perceived hospital quality from 9,979 patients and 4,306 employees from 11 German hospitals. With a multilevel regression and variance analysis, we test the impact of respondent type (employee or patient) on quality perception scores and test the interaction with hospital size. We additionally contrast different employee groups and test differences for various quality dimensions. Hospital employees score hospital quality consistently lower than patients and are also more heterogeneous in their assessments. This makes it from a managerial point of view relevant to subdivide employees in more homogeneous subgroups. Hospital size has no clear effect on the perception gap. Doctors compared to patients and other employee groups have substantially different perceptions on hospital quality. Our findings fuel the practical and ethical debate on the extent that perception gaps could and should be allowed in the context of high-quality and transparent hospital performance. Furthermore, we recommend that the quality perception gap is a substantial part of the overall hospital evaluation for ethical reasons but also to enable managers to better understand the (mis)match between employees' priorities and patients' preferences. However, we do warn practitioners that perceptions are only to a limited extent related to the organizational level (in contrast to the individual level), and only minimal improvements can thus be reached by differentiating from other

  13. Estimated radiation exposure from medical imaging for patients of radiology service of Al Faraby Hospital, Oujda Morocco

    OpenAIRE

    2015-01-01

    Purpose: To evaluate the effective dose received per radiological examination per patient and the additional cancer risk factor in the Radiological Service of Al Faraby Hospital in 2012. Methods: From the number of radiological procedures (NX) made in 2012 in the radiology service of Al Faraby Hospital and the average effective dose DEX associated with each type of act exam X, it is possible to calculate the effective dose collective [S =∑ DEX * NX]. The additional cancer risk factor is calcu...

  14. Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

    Directory of Open Access Journals (Sweden)

    Leonard K. Katalambula

    2016-01-01

    Full Text Available Background. Colorectal cancer (CRC is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2 tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06% and females (49.94%, although gender likelihood of diagnosis type (i.e., rectal or colon was significantly different (P=0.027. More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183 and time (P=0.004 but not gender (P=0.0864 were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405, age (P=0.0015, and time (P=0.0075 were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

  15. Measuring the Frailty Index of Multiple Myeloma Cancer Patients

    DEFF Research Database (Denmark)

    Corradini, Andrea; Hansen, Martin; Savic, Toma

    2016-01-01

    We report on a responsive web-based application that we have been developing for the cancer hospital in Vejle, Denmark. The application administers and handles systematic frailty scoring of patients with multiple myeloma and helps doctors make a more efficient and effective treatment choice....... The application is currently being tested with a small number of patients and is to replace the frailty measurement system used until now, which is done by the doctor on a per patient basis....

  16. Cancer-related false knowledge in relatives of cancer patients and the general public.

    Science.gov (United States)

    Turhal, N S; Dane, F; Ulus, C; Sari, S; Senturk, N; Bingol, D

    2010-01-01

    Although there are many myths about cancer in Turkey, there is no study evaluating Turkish public's knowledge about cancer. The goals of our research were to: 1) measure the extent of knowledge of cancer among the Turkish public; 2) determine the differences in extent of cancer-related knowledge between participants who have relatives with cancer and those who do not; and 3) determine the sources of knowledge possessed. Data were obtained from a total of 415 participants (244 female, 171 male), all of them sitting at the Marmara University Faculty of Medicine Hospital (MUFMH) outpatient clinic waiting area for non-cancer-related reasons. Each participant completed a 3-part questionnaire. Appropriate statistical tests were used for comparison. The mean age was 41 years. Of 415 participants, 65.3% stated that they had one or more cancer patient in their immediate family; 70.1% of the participants had a high-school education or greater. The questionnaire showed that, depending on the question, anywhere from 1.7% to 88.5% of the general public possesses some false information; furthermore, the difference in accuracy between relatives of cancer patients and non-relatives was marginal. Only 3 specific questions, related to the following ideas, rendered answers that were statistically significantly different between these 2 groups: breast cancer is only seen in females (p cancer (p cancer is always very painful (p knowledge about cancer was unacceptably high in our cohort. Broader efforts should be made to inform the Turkish public about cancer.

  17. Outcomes in hospitalized pediatric patients with systemic lupus erythematosus.

    Science.gov (United States)

    Son, Mary Beth F; Johnson, Victor M; Hersh, Aimee O; Lo, Mindy S; Costenbader, Karen H

    2014-01-01

    Disparities in outcomes among adults with systemic lupus erythematosus (SLE) have been documented. We investigated associations between sociodemographic factors and volume of annual inpatient hospital admissions with hospitalization characteristics and poor outcomes among patients with childhood-onset SLE. By using the Pediatric Health Information System, we analyzed admissions for patients aged 3 to <18 years at index admission with ≥ 1 International Classification of Diseases, Ninth Revision code for SLE from January 2006 to September 2011. Summary statistics and univariable analyses were used to examine demographic characteristics of hospital admissions, readmissions, and lengths of stay. We used multivariable logistic regression analyses, controlling for patient gender, age, race, ethnicity, insurance type, hospital volume, US census region, and severity of illness, to examine risk factors for poor outcomes. A total of 10,724 admissions occurred among 2775 patients over the study period. Hispanic patients had longer lengths of stay, more readmissions, and higher in-hospital mortality. In multivariable analysis, African American race was significantly associated with ICU admission. African American race and Hispanic ethnicity were associated with end-stage renal disease and death. Volume of patients with SLE per hospital and hospital location were not significantly associated with outcomes. In this cohort of hospitalized children with SLE, race and ethnicity were associated with outcomes. Further studies are needed to elucidate the relationship between sociodemographic factors and poor outcomes in patients with childhood-onset SLE.

  18. Hospitalization rates among dialysis patients during Hurricane Katrina.

    Science.gov (United States)

    Howard, David; Zhang, Rebecca; Huang, Yijian; Kutner, Nancy

    2012-08-01

    Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear. The impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated. Data from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations. The rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics. Hospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.

  19. Treatment of Pancreatic and Periampullary Cancers at a Community Hospital: Successful Application of Tertiary Care Treatment Standards

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    Robert C. Moesinger

    2011-01-01

    Full Text Available Background. The treatment of pancreatic cancer and other periampullary neoplasms is complex and challenging. Major high-volume cancer centers can provide excellent multidisciplinary care of these patients but almost two-thirds of pancreatic cancer patients are treated at low volume centers. There is very little published data from low volume community cancer programs in regards to the treatment of periampullary cancer. In this study, a review of comprehensive periampullary cancer care at two low volume hospitals with comparison to national standards is presented. Methods. This is a retrospective review of 70 consecutive patients with periampullary neoplasms who underwent surgery over a 5-year period (2006–2010 at two community hospitals. Results. There were 51 successful resections of 70 explorations (73% including 34 Whipple procedures. Mortality rate was 2.9%. Comparison of these patients to national standards was made in terms of operative mortality, resectability rate, administration of adjuvant therapy, clinical trial participation and overall survival. The results in these patients were comparable to national standards. Conclusions. With adequate commitment of resources and experienced surgical and oncologic practitioners, community cancer centers can meet national tertiary care standards in terms of pancreatic and periampullary cancer care.

  20. Measuring the Frailty Index of Multiple Myeloma Cancer Patients

    DEFF Research Database (Denmark)

    Corradini, Andrea; Hansen, Martin; Savic, Toma

    2016-01-01

    We report on a responsive web-based application that we have been developing for the cancer hospital in Vejle, Denmark. The application administers and handles systematic frailty scoring of patients with multiple myeloma and helps doctors make a more efficient and effective treatment choice...

  1. [Awareness about medical expenses and certifications of eligibility for limited health insurance payments for chemotherapy among clinicians at the Ehime Cancer Care Network Priority Hospitals (Ehime Cancer Kyoten Hospitals)].

    Science.gov (United States)

    Yakushijin, Yoshihiro; Morita, Junko; Yano, Takuya; Matsuhisa, Tetsuaki; Kawazoe, Hitoshi; Kojima, You; Okada, Kenzou; Kamei, Haruhito; Hara, Masamichi; Fujii, Motohiro; Matsuno, Takeshi; Tanimizu, Masahito; Shinkai, Tetsu

    2014-05-01

    The "Cancer Chemotherapy and its Management" subcommittee at the Ehime Cancer Care Network Priority Hospitals (Ehime Cancer Kyoten Hospitals)with a focus on medical expenses associated with chemotherapy, surveyed awareness among 98 clinicians regarding certifications of eligibility for Limited Health Insurance Payments during cancer treatment. This committee also lists social and clinical problems encountered at the Ehime Cancer Care Network Priority Hospitals. In our survey, 78% of clinicians were consulted about medical expenses associated with chemotherapy and were actively involved in resolving medical expense problems and resulting correspondences. However, only 38% of clinicians could explain the details of the Japanese guideline on the catastrophic cap and the certifications of eligibility for Limited Health Insurance Payments. This knowledge deficit was more pronounced in younger residents. From our analyses of the awareness about medical expenses among clinicians, we recommend the establishment of the following systems for the management of cancer patients. First, establish a reporting system and early consultation on the catastrophic cap and the certifications of eligibility before initiating cancer treatment. Second, education regarding medical expenses should be mandatory for clinicians, especially for young residents. Third, patients with cancer suffering in the interval of the medical expense and the social system should be relieved with new systems.

  2. Case-case study of factors associated to hMLH1, hMSH2, and hMSH6 protein expression among endometrial cancer patients of the University District Hospital of San Juan, Puerto Rico

    Science.gov (United States)

    González, Lorena; Ortiz, Ana P.; Suárez, Erick; Umpierre, Sharee; Marcos, Maria J.; Billoch, Jorge; Joy, Leilani; Charneco, Eileen; Lacourt, Mercedes Y.; Bernabe-Dones, Raúl D.; Cruz-Correa, Marcia

    2012-01-01

    Lynch syndrome (LS) is an autosomal dominant disorder caused by DNA mismatch repair (MMR) system deficiencies. Women affected by LS present a 40 to 60% lifetime risk of endometrial cancer (EC). Objective This case-case study aims to determine the frequency of the hMLH1, hMSH2, and hMSH6 MMR proteins and the factors (age, family history of cancer [FHC] related to LS, and body mass index [BMI]) associated to their absence in EC patients attending the University District Hospital of San Juan, Puerto Rico. Method/Materials Twenty cases were preliminary evaluated for the MMR protein expression by immunohistochemistry testing and classified as positive-cases (presence of protein) or negative-cases (absence of protein). The statistical analysis was based on the logistic regression model using the Maximum Likelihood estimation (MLE). The Bayesian approach was used to determine the posterior probability {posterior Pr[OR>1]}. Results Results showed absence for at least one MMR protein in 25% of the cases; 15% for hMLH1 and 10% for hMSH2. None of the cases showed an absence for hMSH6. The MLE demonstrated that women diagnosed with EC before the age of 50 (OR: 12.4; 95%CI = 0.5–322.7), having FHC related to LS (OR: 17.7; 95%CI = 0.6–534.6), and having lower BMI (OR: 2.38; 95%CI = 0.39–14.28) present higher odds than their counterparts of lacking an MMR protein, once adjusting for potential predictors (p > .05). The posterior probability that an excess risk of lacking an MMR protein occurs was ≥ 95% for each predictor. Conclusion Our study in this Hispanic population supports previous studies in that younger age, FHC, and lower BMI are associated with increased odds of having an absence of MMR protein expression. Further studies with larger sample sizes should be performed. PMID:22635031

  3. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  4. [Customer and patient satisfaction. An appropriate management tool in hospitals?].

    Science.gov (United States)

    Pawils, S; Trojan, A; Nickel, S; Bleich, C

    2012-09-01

    Recently, the concept of patient satisfaction has been established as an essential part of the quality management of hospitals. Despite the concept's lack of theoretical and methodological foundations, patient surveys on subjective hospital experiences contribute immensely to the improvement of hospitals. What needs to be considered critically in this context is the concept of customer satisfaction for patients, the theoretical integration of empirical results, the reduction of false satisfaction indications and the application of risk-adjusted versus naïve benchmarking of data. This paper aims to contribute to the theoretical discussion of the topic and to build a basis for planning methodologically sound patient surveys.

  5. Risk factors for prostate cancer: An hospital-based case-control study from Mumbai, India

    Directory of Open Access Journals (Sweden)

    B Ganesh

    2011-01-01

    Full Text Available Background : In India, prostate cancer is one of the five leading sites of cancers among males in all the registries. Very little is known about risk factors for prostate cancer among the Indian population. Objectives : The present study aims to study the association of lifestyle factors like chewing (betel leaf with or without tobacco, pan masala, gutka, smoking (bidi, cigarette, comorbid conditions, diet, body mass index (BMI, family history, vasectomy with prostate cancer. Materials and Methods : This an unmatched hospital-based case-control study, comprised of 123 histologically proven prostate ′cancer cases′ and 167 ′normal controls. Univariate and regression analysis were applied for obtaining the odds ratio for risk factors. Results : The study revealed that there was no significant excess risk for chewers, alcohol drinkers, tea and coffee drinkers, family history of cancer, diabetes, vasectomy and dietary factors. However, patients with BMI >25 (OR = 2.1, those with hypertension history (OR = 2.5 and age >55 years (OR = 19.3 had enhanced risk for prostate cancer. Conclusions : In the present study age, BMI and hypertension emerged as risk factors for prostate cancer. The findings of this study could be useful to conduct larger studies in a more detailed manner which in turn can be useful for public interest domain.

  6. Study On The Prevalence Of Various Forms Of Cancer In Diabetic Patients Hospitalized In The National Institute Of Diabetes, Nutrition And Metabolic Diseases “Prof. N.C. Paulescu”

    Directory of Open Access Journals (Sweden)

    Popescu-Vâlceanu Horaţiu-Cristian

    2015-06-01

    Full Text Available Background and aims: Epidemiological evidence suggests that people with diabetes have a significantly increased risk of developing various cancers. The aim of the study was to assess the frequency of various cancers in diabetic patients admitted in the National Institute of Diabetes Nutrition and Metabolic Diseases “Prof. N.C. Paulescu” between 01.01.2011 and 01.09.2014.

  7. Migration of patients between five urban teaching hospitals in Chicago.

    Science.gov (United States)

    Galanter, William L; Applebaum, Andrew; Boddipalli, Viveka; Kho, Abel; Lin, Michael; Meltzer, David; Roberts, Anna; Trick, Bill; Walton, Surrey M; Lambert, Bruce L

    2013-04-01

    To quantify the extent of patient sharing and inpatient care fragmentation among patients discharged from a cohort of Chicago hospitals. Admission and discharge dates and patient ZIP codes from 5 hospitals over 2 years were matched with an encryption algorithm. Admission to more than one hospital was considered fragmented care. The association between fragmentation and socio-economic variables using ZIP-code data from the 2000 US Census was measured. Using validation from one hospital, patient matching using encrypted identifiers had a sensitivity of 99.3 % and specificity of 100 %. The cohort contained 228,151 unique patients and 334,828 admissions. Roughly 2 % of the patients received fragmented care, accounting for 5.8 % of admissions and 6.4 % of hospital days. In 3 of 5 hospitals, and overall, the length of stay of patients with fragmented care was longer than those without. Fragmentation varied by hospital and was associated with the proportion of non-Caucasian persons, the proportion of residents whose income fell in the lowest quartile, and the proportion of residents with more children being raised by mothers alone in the zip code of the patient. Patients receiving fragmented care accounted for 6.4 % of hospital days. This percentage is a low estimate for our region, since not all regional hospitals participated, but high enough to suggest value in creating Health Information Exchange. Fragmentation varied by hospital, per capita income, race and proportion of single mother homes. This secure methodology and fragmentation analysis may prove useful for future analyses.

  8. [Reception in the hospital environment: perspectives of companions of hospitalized patients].

    Science.gov (United States)

    Prochnow, Adelina Giacomelli; dos Santos, José Luis Guedes; Pradebon, Vania Marta; Schimith, Maria Denise

    2009-03-01

    Reception procedures are one of the main guidelines concerning the health care production, even though the studies on this subject are focused upon primary health care. This paper aimed to understand the way reception is experienced by the companions of hospitalized patients and discuss their difficulties while accompanying the patients in a hospital environment. This is a qualitative study, conducted with 77 companions of patients hospitalized in a university hospital in the state of Rio Grande do Sul, Brazil. Data were collected through interviews and examined by the content analysis. According to the companions' perceptions, the reception procedure is associated to clarifying rules and routines, as well as meals delivery; the main difficulties were related to the physical structure and the noise in the hospital environment. A need for reconsidering the established models for health assistance is pointed, as well as the importance of improving health care practices based on light technology.

  9. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalen

  10. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  11. Pegfilgrastim in pediatric cancer patients

    NARCIS (Netherlands)

    te Poele, EM; Kamps, WA; Tamminga, RYJ; Leew, JA; Postma, A; de Bont, ESJM

    2005-01-01

    Chemotherapy-induced neutropenia is a major dose-limiting side effect of intensive chemotherapy in cancer patients. Recently, pegfilgrastim (a product with a long half-life, resulting in once-per-cycle dosage) was introduced to prevent neutropenia in adults. The authors report 32 episodes of pegfilg

  12. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

    Directory of Open Access Journals (Sweden)

    Oliver Groene

    Full Text Available Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures.We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ, a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level.Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1

  13. Nurses' perceptions of patient safety culture in Jordanian hospitals.

    Science.gov (United States)

    Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R

    2015-03-01

    Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between

  14. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Matheus, E-mail: matheus10miranda@gmail.com; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Juliano, Yara [Universidade de Santo Amaro, São Paulo, SP (Brazil); Buffolo, Enio [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-02-15

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.

  15. Guidelines for the Treatment of Smoking in Hospitalized Patients.

    Science.gov (United States)

    Jiménez Ruiz, Carlos A; de Granda Orive, Jose Ignacio; Solano Reina, Segismundo; Riesco Miranda, Juan Antonio; de Higes Martinez, Eva; Pascual Lledó, Jose Francisco; Garcia Rueda, Marcos; Lorza Blasco, Jose Javier; Signes Costa-Miñana, Jaime; Valencia Azcona, Borja; Villar Laguna, Cristina; Cristóbal Fernández, Maribel

    2017-07-01

    Between 15 and 27% of patients admitted to Spanish hospitals are smokers. Hospitalization is an ideal time for a smoker to decide to quit. We performed a MEDLINE search of controlled, randomized or observational studies associated with helping hospitalized patients quit smoking, published between January 1, 2002 and September 30, 2015. On the basis of the results of those studies, we have issued some recommendations for the treatment of smoking in hospitalized patients. The recommendations were drawn up according to the GRADE system. Offering the smoker psychological counselling and prolonging follow-up for at least 4 weeks after discharge is the most effective recommendation for helping hospitalized patients to quit. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. How do patients define "good" and "bad" doctors? - Qualitative approach to the representations of hospital patients

    NARCIS (Netherlands)

    Luthy, C; Cedraschi, C; Perrin, E; Allaz, AF

    2005-01-01

    Questions under study: Knowledge of hospital patients' perceptions of doctors' qualities is limited. The purpose of this study was to explore hospital patients' definitions of "good" and "bad" doctors. Methods: Semi-structured interviews conducted with 68 consecutive hospital patients. The questions

  17. Nursing-related Patient Safety Events in Hospitals

    Institute of Scientific and Technical Information of China (English)

    Yilan LIU; Guanghong ZHAO; Fen LI; Xingzhi HUANG; Deying HU; Juan XU; Shanglong YAO; Liang ZHANG

    2009-01-01

    To explore the method of identifying nursing-related patient safety events,types,contributing factors and evaluate consequences of these events in hospitals of China,incident report program was established and implemented in 15 patient units in two teaching hospitals of China to get the relevant information.Among 2935 hospitalized patients,141 nursing-related patient safety events were reported by nurses.Theses events were categorized into 15 types.Various factors contributed to the events and the consequence varied from no harm to patient death.Most of the events were preventable.It is concluded that incident reporting can provide more information about patient safety,and establishment of a program of voluntary incident reporting in hospitals of China is not only urgent but also feasible.

  18. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

    Directory of Open Access Journals (Sweden)

    Kourosh Parsapour

    2011-01-01

    Full Text Available The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010. The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

  19. Patients' Hand Washing and Reducing Hospital-Acquired Infection.

    Science.gov (United States)

    Haverstick, Stacy; Goodrich, Cara; Freeman, Regi; James, Shandra; Kullar, Rajkiran; Ahrens, Melissa

    2017-06-01

    Hand hygiene is important to prevent hospital-acquired infections. Patients' hand hygiene is just as important as hospital workers' hand hygiene. Hospital-acquired infection rates remain a concern across health centers. To improve patients' hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients' education to reduce hospital-acquired infections. In August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer. Nurses and nursing technicians provided hand hygiene education to each patient. Patients completed a 6-question survey before the intervention, at hospital discharge and 1, 2, and 3 months after the intervention. Hospital-acquired infection data were tracked monthly by infection prevention staff. Significant correlations were found between hand hygiene and rates of infection with vancomycin-resistant enterococci (P = .003) and methicillin-resistant Staphylococcus aureus (P = .01) after the intervention. After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene. This quality improvement project demonstrates that increased hand hygiene compliance by patients can influence infection rates in an adult cardiothoracic step-down unit. The decreased infection rates and increased compliance with hand hygiene among the patients may be attributed to the implementation of patient education and the increased accessibility and use of hand sanitizer. ©2017 American Association of Critical-Care Nurses.

  20. Is quality of colorectal cancer care good enough? Core measures development and its application for comparing hospitals in Taiwan

    Directory of Open Access Journals (Sweden)

    Cheng Skye H

    2010-01-01

    Full Text Available Abstract Background Although performance measurement for assessing care quality is an emerging area, a system for measuring the quality of cancer care at the hospital level has not been well developed. The purpose of this study was to develop organization-based core measures for colorectal cancer patient care and apply these measures to compare hospital performance. Methods The development of core measures for colorectal cancer has undergone three stages including a modified Delphi method. The study sample originated from 2004 data in the Taiwan Cancer Database, a national cancer data registry. Eighteen hospitals and 5585 newly diagnosed colorectal cancer patients were enrolled in this study. We used indicator-based and case-based approaches to examine adherences simultaneously. Results The final core measure set included seventeen indicators (1 pre-treatment, 11 treatment-related and 5 monitoring-related. There were data available for ten indicators. Indicator-based adherence possesses more meaningful application than case-based adherence for hospital comparisons. Mean adherence was 85.8% (79.8% to 91% for indicator-based and 82.8% (77.6% to 88.9% for case-based approaches. Hospitals performed well (>90% for five out of eleven indicators. Still, the performance across hospitals varied for many indicators. The best and poorest system performance was reflected in indicators T5-negative surgical margin (99.3%, 97.2% - 100.0% and T7-lymph nodes harvest more than twelve(62.7%, 27.6% - 92.2%, both of which related to surgical specimens. Conclusions In this nationwide study, quality of colorectal cancer care still shows room for improvement. These preliminary results indicate that core measures for cancer can be developed systematically and applied for internal quality improvement.

  1. Patient experience and hospital profitability: Is there a link?

    Science.gov (United States)

    Richter, Jason P; Muhlestein, David B

    Patient experience has had a direct financial impact on hospitals since value-based purchasing was instituted by the Centers for Medicare & Medicaid Services in 2013 as a method to reward or punish hospitals based on performance on various measures, including patient experience. Although other industries have shown an indirect impact of customer experience on overall profitability, that link has not been well established in the health care industry. Return-to-provider rate and perceptions of health quality have been associated with profitability in the health care industry. Our aims were to assess whether, independent of a direct financial impact, a more positive patient experience is associated with increased profitability and whether a more negative patient experience is associated with decreased profitability. We used a sample of 19,792 observations from 3767 hospitals over the 6-year period 2007-2012. The data were sourced from Centers for Medicare & Medicaid Services and Hospital Consumer Assessment of Healthcare Providers and Systems. Using generalized estimating equations to account for repeated measures, we fit four separate models for three dependent variables: net patient revenue, net income, and operating margin. Each model included one of the following independent variables of interest: percentage of patients who definitely recommend the hospital, percentage of patients who definitely would not recommend the hospital, percentage of patients who rated the hospital 9 or 10, and percentage of patients who rated the hospital 6 or lower. We identified that a positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability. Management should have greater justification for incurring costs associated with bolstering patient experience programs. Improvements in training, technology, and staffing can be justified as a way to improve not only quality but now

  2. Perception of nurses about falls of hospitalized patients

    OpenAIRE

    Rossi Rocha, Fernanda Ludmilla; Palucci Marziale, Maria Helena

    2008-01-01

    Patients falls represent a preoccupation to health professionals and administrators, since they compose one of the greatest categories of hospitalized patients incidents. This research had as objectives: explain the factors related to the falls of patients described by the literature and identify the causes of falls occurrences attributed by the nurses. The research was conducted at a University Hospital in the inner state of São Paulo, on the Medical, Surgical, Ear-nose-eye and Orthopaedic C...

  3. Family Participation in the Nursing Care of the Hospitalized Patients

    OpenAIRE

    Khosravan, Shahla; Mazlom, Behnam; Abdollahzade, Naiemeh; Jamali, Zeinab; Mansoorian, Mohammad Reza

    2014-01-01

    Background: Few studies, especially in Iran, have assessed the status of family participation in the care of the hospitalized patients. Objectives: This study was conducted to assess why family members partake in caregiving of their patients in hospitals, the type of care that family provide, and the outcomes of the participation in the opinions of nurses and family members. Patients and Methods: In this comparative-descriptive study, data was collected by a two- version researcher-developed ...

  4. COPD in primary lung cancer patients: prevalence and mortality

    Directory of Open Access Journals (Sweden)

    Ytterstad E

    2016-03-01

    Full Text Available Elinor Ytterstad,1 Per C Moe,2 Audhild Hjalmarsen3 1Department of Mathematics and Statistics, UiT The Arctic University of Norway, 2Department of Pulmonary Medicine, University Hospital of North Norway, 3Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway Background: Previous studies have relied on international spirometry criteria to diagnose COPD in patients with lung cancer without considering the effect lung cancer might have on spirometric results. The aim of this study was to examine the prevalence of COPD and emphysema at the time of primary lung cancer diagnosis and to examine factors associated with survival.  Materials and methods: Medical records, pulmonary function tests, and computed tomography scans were used to determine the presence of COPD and emphysema in patients diagnosed with primary lung cancer at the University Hospital of North Norway in 2008–2010.  Results: Among the 174 lung cancer patients, 69% had COPD or emphysema (39% with COPD, 59% with emphysema; male:female ratio 101:73. Neither COPD nor emphysema were significantly associated with lung cancer mortality, whereas patients with non-small-cell lung cancer other than adenocarcinoma and squamous cell carcinoma had a risk of lung cancer mortality that was more than four times higher than that of patients with small-cell lung cancer (hazard ratio [HR] 4.19, 95% confidence interval [CI] 1.56–11.25. Females had a lower risk of lung cancer mortality than males (HR 0.63, 95% CI 0.42–0.94, and patients aged ≥75 years had a risk that was twice that of patients aged <75 years (HR 2.48, 95% CI 1.59–3.87. Low partial arterial oxygen pressure (4.0–8.4 kPa increased the risk of lung