ABSTRACT
BACKGROUND: Patients diagnosed with cancer are at higher risk of anxiety, depression, and overall distress. These mood disturbances are risk factors for non-adherence to cancer treatment, increased length of stay during hospital admissions, increased number of visits to the emergency department, and also impact survival. Although paper handouts about the potential side effects are widely used in the oncology practice studies have shown that digital educational material is known to work better when compared to traditional methods. However, the impact of video education on anxiety, depression, and distress have not been previously evaluated. Our study aimed to assess whether video education about potential chemotherapy and immunotherapy can reduce anxiety, depression, and distress levels. METHODS: After IRB approval, we enrolled patients who were fluent in English, younger than 80 years of age, and who were able to provide informed consent. The Hospital Anxiety and Depression Scale and Distress Thermometer were used to assess distress, as well as depression and anxiety before and after watching video educational material. Paired t-test was used to compare the differences between the scores before and after watching educational videos. The statistical software GraphPad Prism 9, San Diego, California, was used to perform the statistical analysis. RESULTS: We enrolled 29 patients, of whom 20 completed the study, six withdrew, two were lost to follow-up, and one did not complete the initial questionnaire. Of all patients that completed the study 85% of the patient found videos helpful, and they were 7/10 likely to recommend them to other patients who may experience symptoms. The mean depression score changed from 4.75 before to 4.9 after watching the videos (p 0.77), distress score from 2.3 to 2.65 (p 0.52), and anxiety scores changed from 4.85 to 6.15 (p 0.03). The feedback provided by the patients indicated that they were more willing to watch the videos related to the side effects they experienced at their free time and convenience. CONCLUSIONS: Our study suggests that patients were open to video education and found it helpful and worth watching. However, the exposure of the patients to the videos about potential side effects of cancer treatment, including those patients do not experience, may lead to increased anxiety.
Subject(s)
Depression , Neoplasms , Humans , Depression/diagnosis , Anxiety/diagnosis , Anxiety Disorders , Immunotherapy , Neoplasms/drug therapyABSTRACT
A commonly seen phenomenon in the hospital and critical care setting is anaphylaxis. This acute systemic inflammatory reaction can lead to anaphylactic shock in severe cases and potentially be fatal. The role of platelets in anaphylactic reactions is not well established; however, platelets, among other mediators such as platelet-activating factor, have been shown to promote a prothrombotic state shortly after an acute hypersensitivity reaction. In addition, the aggregation of platelets promoted by platelet-activating factor and other mediators can also lead to thrombocytopenia. We present a case of a 57-year-old woman who developed severe anaphylaxis while receiving chemotherapy with paclitaxel suspended in Cremophor, a well-known allergen. She was profoundly thrombocytopenic following the reaction and was treated with therapeutic anticoagulation, with no thrombus formation.
ABSTRACT
Hyper-eosinophilic syndrome (HES) can be fatal if left untreated; and it is difficult to make a diagnosis early on due to the symptoms overlapping with many other conditions. For patients presenting with eosinophilia and end-organ damage, clinicians should have a high degree of suspicion for HES. Treatment with steroids can prevent further progression or can lead to complete resolution of the symptoms.
ABSTRACT
Amiodarone is associated with a wide variety of side effects, but unusual presentations can make it difficult to diagnose and treat. This case report describes amiodarone causing nodular changes in the lung, as opposed to diffuse interstitial disease. After cessation of the medication, there was marked radiographic improvement in the nodules.
ABSTRACT
Small cell carcinoma of the bladder is a rare type of bladder malignancy. Based on most of the existing studies, there is an observed male predominance, usually in their sixties or seventies, and they are more likely to have a history of smoking. Additionally, there is a higher predilection for Caucasians (versus non-Caucasians). The most common presenting complaint is painless macroscopic hematuria. However, other presenting symptoms also include dysuria, difficulty voiding, weight loss, abdominal pain, nocturia, and urinary frequency. It is not uncommon to have a history of frequent urinary tract infections, ureteral obstruction, and paraneoplastic syndromes. Cystoscopy is the "gold standard" for evaluation of urinary tract lining, especially in conjunction with narrow-band imaging and biopsy. Transurethral resection of the bladder tumor (TURBT) is the next step in diagnosis and treatment that allows to precisely evaluate pathology and the extent of bladder wall involvement, and is a sufficient surgical approach for the treatment of non-muscle invasive tumors. Once tumor pathology is confirmed, a treatment plan is determined based on the staging. Although both lung and bladder small cell carcinoma have similarities in pathogenesis, genomic alterations in small cell carcinoma of the bladder are more similar to that of urothelial cancer rather than small cell lung cancer. As this is a rare subtype and only a few reported cases are available, no standard treatment regimen has been established. In localized disease, neo-adjuvant platinum-based chemotherapy with cystectomy has been shown to provide the best result in retrospective studies. As this type of cancer has a poor prognosis, in metastatic disease, palliative chemotherapy is offered. Here we present one such case of small cell carcinoma of the bladder and review the current literature.
