Intestinal protozoan infections among Egyptian neutropenic patients with acute leukemia

@#Several enteric protozoan species are linked to diarrhea in humans, with some causing debilitating illnesses, essentially in immunocompromised and neutropenic patients as in acute leukemias. The aim of this study was to detect intestinal protozoa in Egyptian neutropenic patients with acute leukemia. The study comprised two groups; 40 newly diagnosed neutropenic acute leukemia patients and 30 controls. Stool samples were collected from all participants and subjected to routine microscopic examination, special staining and detection of copro-antigen using rapid diagnostic test (RDT) RIDA®QUICK Entamoeba/ Giardia/ Cryptosporidium Combi. Cases were tested post-chemotherapy at the nadir of neutropenia (absolute neutrophil count ANC< 0.5x109/L) and 19 cases were also tested initially prior to chemotherapy. Of examined patients, 15/40 (37%) were positive for Blastocystis hominis by wet mount, 10/40 (25%) had microsporidia using modified trichrome stain and only 2 cases (5%) of Cryptosporidium spp. by Ziehl-Neelsen stain. By RDT, 8/40 cases (20%) were positive compared to entirely negative controls. The positive cases included 4 patients with G. intestinalis 2 with Entamoeba and 2 with Cryptosporidium.19/40 cases were tested both pre- and post-chemotherapy. microsporidian spp. was diagnosed in 6/19 cases at the nadir of neutropenia compared to none of the cases pre-chemotherapy and the difference was statistically significant (p= 0.031*). Intestinal protozoa in acute leukemia patients post-chemotherapy are common especially B. hominis. Furthermore, RDT might be helpful for diagnosing intestinal protozoa in acute leukemia. Attention is highly required as intestinal protozoa infection can emerge after chemotherapy such as microsporidia.

Systematic review and Meta-analysis on chemotherapy-induced bone marrow suppression treated with acupuncture / 中国针灸

OBJECTIVE@#To review systematically the effectiveness of acupuncture in treatment of chemotherapy-induced bone marrow suppression.@*METHODS@#From the date of database establishment to April 1, 2020, the articles on randomized controlled trials of chemotherapy-induced bone marrow suppression were retrieved by computer from the following databases, i.e. PubMed, Cochrane central register of controlled trials (CENTRAL), EMbase, cumulative index to nursing & allied health literature (CINAHL), JBI database of systematic reviews and implementation reports, CNKI, Wanfang, VIP and SinoMed. Using RevMan5.3, Meta-analysis was conducted. With GRADEpro GDT, the evidence quality was evaluated.@*RESULTS@#A total of 12 articles were included, 10 articles of which were analyzed by quantitative Meta-analysis. Compared with the control group, the improvements in the decrease of post-chemotherapy leukocyte (@*CONCLUSION@#Acupuncture alleviates the decrease of leukocyte, platelet, neutrophile granulocyte and erythrocyte counts and improves the survival quality of patients with chemotherapy-induced bone marrow suppression.

Post therapy Wilms tumour or ectopic immature renal tissue: A pathologist's diagnostic dilemma

Post chemotherapy Wilms Tumour (PCWT) is a diagnostic conundrum both for the clinician and the pathologist, in view of its morphological similarity with ectopic immature renal tissue (EIRT). However, due to their varying prognoses and different lines of management, it is important to distinguish between the two. Here, we discuss clinical presentation and pathology of a case of PCWT, arising in a horse shoe deformity of the kidney in a 5 year old girl. The discussion focuses on the pathogenesis of Extra Renal Wilms Tumour (ERWT) as well as its distinguishing morphological features and chemotherapy induced changes in Wilms tumour.

Intervention of Progressive Stage of Radiation Pneumonia with Tibetan Medicine Flos Saussureae Plus Glucocorticoid / 广州中医药大学学报

Objective To study the therapeutic effect of Tibetan medicine Flos Saussureae combined with glucocorticoid for progressive stage of radiation pneumonia.Methods A total of 65 post-chemotherapy radiation pneumonia patients with esophageal carcinoma were randomized into western medicine group(20 cases),combined group (21 cases) and Flos Saussureae group (24 cases),which were treated with prednisone (1 mg/kg,orally),prednisone (0.5 mg/kg,orally) plus Flos Saussureae Injection (2 mL/d,by intramuscular injection),and Flos Saussureae Injection (4 mL/d,by intramuscular injection) respectively.The medication lasted for 6 weeks.Before and after treatment,we investigated the scores of chest high resolution CT(HRCT),Leicester Cough Questionnaire (LCQ) scores,6-minute walk distance,pulmonary function indexes of vital capacity (VC),total lung capacity (TLC) and diffusion function DLco,and arterial oxygen partial pressure(PO2).Results (1) The scores of HRCT,6-minute walk distance and LCQ scores of the combined group were improved as compared with those of western medicine group and Flos Saussureae group (P ＜ 0.05).The improvement of psychological scores,social function scores and overall socres of LCQ in Flos Saussureae group was superior to that in western medicine group (P ＜0.05).(2)After treatment,pulmonary function indexes and PO2 of the combined group and Flos Saussureae group were improved compared with those of western medicine group (P ＜ 0.05),and the improvement of DLco and PO2 of the combined group was superior to that of Flos Saussureae group (P＜ 0.05).Conclusion Flos Saussureae Injection combined with glucocorticoid exerts certain therapeutic effect for progressive stage of radiation pneumonia,and large-dose Flos Saussureae Injection is beneficial to the improvement of symptoms and imaging features of the patients.

Clinical outcome of postchemotherapy retroperitoneal lymph node dissection and predicting retroperitoneal histology in advanced nonseminomatous germ cell tumours of the testis / 中华外科杂志

Objective@#To explore the clinical outcome of advanced testicular nonseminomatous germ cell cancer patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND), and to analyze the relevant prognostic factors of lymph node pathological.@*Methods@#A total of 43 consecutive testicular nonseminomatous germ cell cancer patients underwent PC-RPLND between March 2001 and December 2014 in Department of Urology at Sun Yat-sen University Cancer Center were retrospectively reviewed. The average age of the patients was (29.0±11.5) years (ranging from 12 to 58 years). Before PC-RPLND, 22 patients were classified as phase Ⅱ, while 21 were phase Ⅲ. Primary tumor histology revealed seminomatous elements in 19 cases, embryonal cell carcinoma in 22 cases, yolk sac tumor in 13 cases, chorionic carcinoma in 3 cases, mature teratomatous elements in 11 and immature teratomatous elements in 2 cases. Patients were treated with cisplatin-based chemotherapy after orchectomy and then underwent surgical resection of retroperitoneal lymph nodes.After PC-RPLND, all patients underwent a periodic review including the blood routine, biochemistry routine and computed tomography or ultrasonograph of the chest, the abdomen and the pelvis. The association of pathological data with patient′s clinic features and the correlations between molecular features detected with each other were assessed by the t test, χ2 and Fisher′s exact test. Multivariate logistic regression were used to assess prognostic factors.@*Results@#The median operative time was 278 minutes (ranging from 50 to 715 minutes). Median blood loss was 425 ml (ranging from 50 to 5 000 ml). Eight patients received blood transfusion intra-operatively, 2 patients underwent adjunctive surgical procedures, 4 patients developed ileus and 4 had an ascites chylosus following PC-RPLND, 1 patient had a postoperative hyperthermia and retrograde ejaculation was present in 10 patients. The transverse diameter of the residual tumor in patients ranged from 0.8 to 18.2 cm. Necrosis, teratoma and viable germ cell tumors were found in 15, 17 and 11 of all patients. The median follow-up time was 46 months (ranging from 6 to 169 months). There were 39 patients had no tumor recurrence, 7 patients were found recurrence after PC-RPLND, 5 died of malignant germ cell tumor. The normal serum lactate dehydrogenase (LDH) level before chemotherapy (HR=25.811, 95%CI: 0.678 to 982.624, P=0.017) and relative changes more than 50% in retroperitoneal lymph node size (HR=0.016, 95%CI: 0 to 0.698, P=0.032) were statistically significant prognostic factors of the presence of necrosis.@*Conclusions@#Since most residual masses are not sensitive to chemotherapy, PC-RPLND is still an essential part of the treatment of metastatic testicular nonseminomatous germ cell cancer. Patients with the normal serum LDH level before chemotherapy and a shrinkage of 50% or more in retroperitoneal mass have a considerably chance of having necrosis in the retroperitoneum resection. This may help to refine the selection of candidates for PC-RPLND.

Validación de una guía de cuidados para el manejo y control de los efectos secundarios post quimioterapia según la opinión de enfermeros Servicio de Especialidades Médicas y Quimioterapia Hospital Alberto Sabogal Sologuren - EsSalud / Validation of a care guide for the management and control of the side effects post chemotherapy according to opinion of nurses, Service of Medical Specialties and Chemotherapy, Hospital Alberto Sabogal Sologuren - EsSalud

El presente estudio titulado: "Validación de una Guía de cuidados para el manejo y control de los efectos secundarios post quimioterapia según la opinión de enfermeros en el Servicio de Especialidades Médicas y Quimioterapia", tuvo como objetivo determinar la Validación de una guía de cuidados para el manejo y control de los efectos secundarios post quimioterapia según la opinión de enfermeros. Material y Método: El estudio es de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo conformado por 20 enfermeros, la técnica fue la encuesta y el instrumento fue la guía de cuidados y un opinionario aplicado previo consentimiento informado Resultados: Del 100 por ciento (20), 70 por ciento (14) tienen una opinión favorable y 30 por ciento (6) no favorable. Conclusión: La Validación de la guía de cuidados según la opinión de la mayoría de enfermeros es favorable, en cuanto al contenido y estructura, lo cual permitirá brindar información importante del paciente oncológico en tratamiento con quimioterapia sobre los efectos secundarios post quimioterapia...

This study entitled: "Validation of a care guide for the management and control of the side effects post chemotherapy according to nurses at the service of medical specialties and chemotherapy", aimed to determine the validation of a care guide for the management and control of side effects post chemotherapy according to nurses. Material and method: The study is application level, quantitative, descriptive cross-sectional method. The population was comprised of 20 nurses, the technique was the survey and instruments a care guide and an opinionario applied prior informed consent results: 100 per cent (20), 70 per cent (14) have a favorable opinion and 30 per cent (6) not favorable. Conclusion: The validation of the care guide according to the opinion of the majority of nurses is favorable, in terms of content and structure, enabling you to provide important information for the cancer patient in treatment with chemotherapy side effects post chemotherapy...

Estimulação medular espinhal para tratamento da polineuropatia dolorosa refratária induzida por quimioterapia / Spinal cord stimulation in the treatment of refractory painful polineuropathy induced by chemotherapy

JUSTIFICATIVAS E OBJETIVOS: Polineuropatia dolorosa pós-quimioterapia tem sido muitas vezes uma condição refratária ao tratamento clínico conservador. O objetivo deste relato de caso foi mostrar o uso da estimulação medular como técnica alternativa aos métodos convencionais para tratar paciente com quadro doloroso de difícil controle. RELATO DO CASO: Paciente de 72 anos, com polineuropatia dolorosa pós-quimioterapia há mais ou menos dez anos, apresentava dor de forte intensidade (escala analógica visual = 10) em membros inferiores, contínua e diária, apesar do uso de várias medicações específicas para dor neuropática. Foi submetido a implante de eletrodo peridural apresentando melhora significativa das dores (escala analógica visual = 3) e diminuição do uso de medicação. CONCLUSÃO: A estimulação da medula espinhal constitui uma opção terapêutica em pacientes com neuropatia periférica refratária ao tratamento médico convencional quando bem indicada e realizada dentro de critérios estabelecidos.

BACKGROUND AND OBJECTIVES: Painful polyneuropathy after chemotherapy is often refractory to conservative clinical treatment. The objective of this report was to demonstrate that spinal cord stimulation is an alternative to conventional methods used in the treatment of patients with pain that is difficult to control. CASE REPORT: A 72 year old patient with painful polyneuropathy after chemotherapy approximately 10 years ago, presented severe, continuous, daily pain (visual analog scale = 10) in the lower limbs despite the use of several drugs specific for neuropathic pain. An epidural electrode was implanted, with significant improvement in pain (visual analog scale = 3) and reduction in the consumption of medication. CONCLUSION: Spinal cord stimulation constitutes a therapeutic option in patients with peripheral neuropathy refractory to conventional clinical management when properly indicated and within established criteria.

JUSTIFICATIVAS Y OBJETIVOS: La polineuropatía dolorosa posquimioterapia ha sido en muchas ocasiones una condición refractaria al tratamiento clínico conservador. El objetivo de este relato de caso fue mostrar el uso de la estimulación medular como técnica alternativa a los métodos convencionales para tratar paciente con cuadro doloroso de difícil control. RELATO DEL CASO: Paciente de 72 años, con polineuropatía dolorosa pos-quimioterapia hace más o menos 10 años, presentaba dolor de fuerte intensidad (escala analógica visual = 10) en miembros inferiores, continua y diaria, a pesar del uso de varias medicaciones específicas para dolor neuropático. Se sometió a implante de electrodo peridural presentando una mejoría significativa de los dolores (escala analógica visual = 3) y una disminución del uso de medicación. CONCLUSION: La estimulación de la médula espinal constituye una opción terapéutica en pacientes con neuropatía periférica refractaria al tratamiento médico convencional cuando se indica y se realiza dentro de criterios establecidos.