Journal of Oncology Medicine & Practice

ISSN: 2576-3857

Open Access

Articles in press and Articles in process

      Research Article Pages: 1 - 10

      Central Line Associated Thrombosis in Pediatric Oncology Patients: Single Center Experience

      Fatimah Almoaraj*, Hala Omer, Esraa AlQasem, Badriah Alomari, Ashraf Khairy, Qasim Alharbi, Omar Chamdine, Saad ALdaama and Maher El Doussouki

      DOI: 10.37421/2576-3857.2023.08.206

      Background: Central venous lines are important part in management of pediatric oncology patients, in spite of that, obtaining these access carry risk of complication. Central Venous Catheter-related Thrombosis (CVCT) is one of the major complications.

      Methods: This is a single-center retrospective study; we analyzed all pediatric oncology patients with a Central Venous Catheter (CVC) over 3 years period, focused on the CVCT risk factor and its outcome. Data were retrieved from patients’ hard and electronic medical records and collected in the Redcap system.

      Results: A total of 323 CVCs were inserted in 266 pediatric oncology patients, 14 CVCT episodes were discover (4.33%) which was occurred in 13 patients. The incidence of CVCT was highest among hematological malignancy 10 out of 13 patients. Using steroid as part of chemotherapy was recognized as significant risk for CVCT (P value: 0.019), having a peripherally inserted central catheter PICC or femoral line compared with an implantable port Cath were associated with increased risk of CVCT (P value <.001) besides of that the risk of thrombosis increased with subsequent insertions of the central line compared with a single central line insertion (P value: .004). 50% of CVCT were asymptomatic, LMWH was used in 9 episodes and line removed in 7, complete resolution occurred in 10 episodes.

      Conclusion: The use of CVC is a crucial corner in managing pediatric oncology patients and improves their quality of life, yet it is associated with significant complications, such as infection, thrombosis, and dysfunction.

      The pediatric oncologists and pediatric surgeons should pay special attention to ensure optimal and appropriate CVC placement methods and post-insertion care which may play an essential role in minimizing CVC-associated complications.

      Prospective studies are crucial to evaluate the clinical significance of CVC-dysfunction and its impact on the development of thrombosis, infection, or outcome of children with cancer. And to provide recommendations to improve the preventive strategies for such events.

      Research Article Pages: 1 - 5

      Improving Clinical Response to Cancer Symptom Screening: Leveraging Over Four Thousand Chart Audits for Actionable Person Centred Care

      Gillian Hurwitz*, Lesley Moody, Zahra Ismail, Monika Duddy and Lisa Barbera

      DOI: 10.37421/2576-3857.2023.08.206

      Introduction: Routine symptom screening for cancer patients using Patient Reported Outcome Measures (PROMs) is standard practice in Ontario to identify physical and emotional symptoms that can go undetected by clinicians. However, provider response to PROMs is essential to addressing symptom burden. To measure clinician response, a Regional Cancer Centre (RCC) chart audit process was developed to determine whether clinical teams acknowledged, assessed and/or addressed commonly experienced oncology symptoms outlined in the Edmonton Symptom Assessment System (ESAS).

      Methods: Annually, RCCs received a chart audit tool with preset options. Sites audited charts for seven of the ESAS symptoms using a business intelligence tool to access patient charts based on sampling parameters. RCCs were required to audit charts of patients whose ESAS symptom scores were moderate to severe (4-10), with at least five charts in the moderate range (4-6).

      Results: Overall, 4,679 charts from all 14 RCCs were examined in the FY 2016/17 and FY2017/18 audits (2,377 charts and 2,302 charts, respectively). Depression (45.5%) and anxiety (49.0%) were the least likely to be recorded in the patient’s chart, whereas pain (75.1%) was the most likely to be noted. Patients reporting depression and anxiety were the least likely to be offered assessments (49.8% and 51.1%, respectively) and interventions (47.0%, 46.5%, respectively). Patients reporting pain were the most likely to receive assessments (72.2%) and interventions (64.3%).

      Conclusion: Chart audits help measure clinical response to PROMs, providing useful information on the gaps in care, including response to emotional symptoms and can inform local quality improvement initiatives.

        Mini Review Pages: 1 - 3

        Cancer biology\'s functional implications of tetraspanin proteins

        Seeram Ramakrishna

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        A core of several tetraspanin proteins organizes other membrane proteins like growth factor receptors, integrins, and Human Leukocyte Antigen (HLA) antigens in these complexes. Albeit most tetraspanin proteins have been concentrated separately, tetraspanin proteins and their edifices can affect cell grip and motility, associations with stroma or influence announcing development factors, and for the greater part of them no ligand has been distinguished. Although they are found in all cell types, these proteins have primarily been studied functionally in lymphoid cells. Tetraspanins have been identified as metastasis suppressors in some tumors, but their significance is still unclear. Data are also available for these tumors. They are outlined, along with some of their implications for tumor biology and areas that require additional research. The biological properties of tumor cells, particularly those pertaining to tumor adhesion and dissemination, can be significantly affected by membrane proteins that are involved in cellular interactions with other cells or the stroma as well as signaling pathways. The tetraspanins, a brand-new class of membrane proteins, are beginning to gain importance in cell biology but have received very little attention in the context of cancer biology up until this point.

        Mini Review Pages: 1 - 3

        Heterochromatin protein 1?: a characteristic of cell proliferation that is pertinent to clinical oncology

        Wenbin Lin

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        Heterochromatin Protein 1α (HP1α) is a critical player in chromatin organization and gene regulation, and its dysregulation has been implicated in various cellular processes, including cell proliferation and cancer development. This review focuses on the role of HP1α as a characteristic of cell proliferation that is pertinent to clinical oncology. Extensive research has demonstrated that HP1α plays a dual role in regulating cell proliferation. On one hand, it functions as a transcriptional repressor, modulating the expression of genes involved in cell cycle control and DNA replication. On the other hand, HP1α has also been found to interact with numerous signaling pathways and transcription factors, thereby promoting cell proliferation under certain conditions. Aberrant expression and localization of HP1α have been observed in various types of cancer, including breast, prostate, lung, and colorectal cancer. Furthermore, studies have shown that altered HP1α expression is associated with poor prognosis and resistance to conventional therapies in cancer patients. Understanding the molecular mechanisms underlying HP1α's involvement in cell proliferation is of significant interest in clinical oncology. Targeting HP1α and its associated pathways may offer promising therapeutic opportunities for cancer treatment. In addition, HP1α expression levels and subcellular localization can potentially serve as diagnostic and prognostic biomarkers in clinical practice.

        Opinion Pages: 1 - 3

        In oncology, population pharmacokinetic?pharmacodynamic modelling

        Cancer Biology

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        Overall Survival (OS) is regarded as the most trustworthy and preferred endpoint in oncology trials to evaluate drug treatment benefits. In order to speed up and streamline the development of clinical oncology drugs, it is critical to identify the dynamic effects and connections between the various variables collected from patients for a given drug and its indication. Due to temporal differences, drug-induced effects and causal relationships can be difficult to interpret. Parametric time-to-event models and population pharmacokinetic– pharmacodynamic modeling are increasingly being used to address this issue.

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