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1.
Support Care Cancer ; 17(5): 471-8, 2009 May.
Article in English | MEDLINE | ID: mdl-19089459

ABSTRACT

GOALS OF WORK: This study aimed to use an integrated system (Medical Care Continuity (MCC) system) consisting of computer, video telephone, and a high-definition camera to monitor at home chemotherapy side effects in cancer outpatients. PATIENTS AND METHODS: The system allowed 24 h/day video consultation with an intermediate medical call center with possible connection to a specialized hospital if necessary. All patients were provided with internationally validated and project-oriented questionnaires exploring patients' health status and opinions on usefulness and complexity of study devices. The content of each call was recorded on a computer database. An approximate estimate of avoided hospital admissions was calculated. MAIN RESULTS: Median duration of experimentation and frequency of patient/doctor contacts were 2.1 months and 4.2 contact per week, respectively. Overall, a 98% positive opinions on the experimental system was reported at the end of the study by all participants, with a 21% conversion rate with respect to the opinions gathered at study entry. Changes in patient management after a medical call were made in 32% of cases. It was calculated that approximately 2.2 per month unnecessary hospital admissions were avoided. CONCLUSIONS: The MCC system was well managed by both patients and caregivers. These results show that it has the potential to improve medical assistance by virtue of a constant access to medical advice and reduce unnecessary hospital admissions.


Subject(s)
Antineoplastic Agents/adverse effects , Drug Monitoring/methods , Remote Consultation/methods , Videoconferencing , Adult , Aged , Antineoplastic Agents/therapeutic use , Computers , Continuity of Patient Care/organization & administration , Female , Home Care Services , Hospitalization/statistics & numerical data , Humans , Italy , Male , Middle Aged , Neoplasms/drug therapy , Patient Satisfaction , Pilot Projects
2.
J Chemother ; 14(4): 412-6, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12420861

ABSTRACT

We describe a novel method for detecting micrometastasis in the blood stream of cancer patients based on RT-PCR amplification of tumor-associated carcinoembryonic antigen (CEA) mRNA. To increase sensitivity and specificity of RT-PCR, CEA transcript was selectively up-regulated in cancer cells by exposure of peripheral blood to non-toxic concentrations of staurosporine (ST). Thereafter, polyA(+) RNA was extracted from tumor cells captured by means of magnetic beads coated with a monoclonal antibody against a common human epithelial antigen. Finally, RNA was subjected to RT-PCR analysis of CEA transcript. Using this approach, we demonstrated an ST-mediated increase in CEA transcript in blood specimens collected from a patient with metastatic colon cancer before receiving treatment with 5-fluorouracil/leucovorin. After a few cycles of chemotherapy, CEA-positive tumor cells were no longer detected. Clinical follow-up of this patient indicated that treatment with chemotherapy induced a dramatic reduction in liver metastasis. Therefore, it can be hypothesized that lack of CEA transcript detection might be consistent with disappearance or at least marked reduction of circulating tumor cells.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoembryonic Antigen/genetics , Colonic Neoplasms/drug therapy , Liver Neoplasms/drug therapy , Neoplastic Cells, Circulating , RNA, Messenger/analysis , Adenocarcinoma/blood , Adenocarcinoma/secondary , Carcinoembryonic Antigen/metabolism , Colonic Neoplasms/blood , Colonic Neoplasms/pathology , DNA Primers/chemistry , Female , Fluorouracil/administration & dosage , Humans , Immunomagnetic Separation , Leucovorin/administration & dosage , Liver Neoplasms/blood , Liver Neoplasms/secondary , Middle Aged , Prognosis , RNA, Neoplasm/blood , Reverse Transcriptase Polymerase Chain Reaction/methods , Sensitivity and Specificity
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