ABSTRACT
This study was specifically focused on para-professional healthcare workers (PHCWs) who handle cytotoxic drugs and contaminated wastes at the Public Teaching Hospitals of Marseille (AP-HM), France. It first aimed at evaluating the knowledge and professional practice of the PHCWs who belong to a personnel category among the less informed and protected in hospitals. In a second time, this study also proposed to raise awareness, educate and train the staff on protective measures to minimise the exposure of the PHCWs to the potential toxicity of anticancer chemotherapy agents (or metabolites) when cleaning and handling both cytotoxic drugs and wastes. Among the 11 oncology units evaluated, 82% completed an assessment survey, 63% of which were PHCWs. Out of nine oncology units assessed, 89% reported limited knowledge of the general risk and of the safe handling of cytotoxic drugs, 89% reported using vinyl gloves which are the less protective ones. Forty-four per cent of the units used wet sweeping techniques for cleaning the floors, and 11% of the units did not have specific procedures for cleaning the equipments used for collecting contaminated excreta. Protective outer apparel was not always worn and chemotherapy wastes were not managed consistently between all units. Standardized procedures and guidelines to prevent occupational exposure were not used by PHCWs. More education and training are needed to improve safety.
Subject(s)
Antineoplastic Agents/adverse effects , Cytotoxins/adverse effects , Medical Waste Disposal/standards , Occupational Exposure/prevention & control , Personnel, Hospital , Adult , Decontamination/standards , Education, Professional/standards , Equipment Contamination/prevention & control , Female , France , Gloves, Protective , Health Knowledge, Attitudes, Practice , Hospitals, Public , Hospitals, Teaching , Humans , Male , Middle Aged , Personnel, Hospital/education , Protective Clothing/statistics & numerical data , Young AdultABSTRACT
INTRODUCTION: Miltefosine (Hexadecylphosphocholine) is a chemotherapy, which when applied locally, has demonstrated efficacy in the treatment of cutaneous metastases of breast cancer. CASE REPORT: A 79 year-old woman developed recurrent in transit cutaneous metastases of a squamous cell carcinoma on her left leg. All lesions completely resolved after topical applications of miltefosine. Tolerance was excellent and the patient remained disease-free 24 months after the end of the treatment. DISCUSSION: Miltefosine, which might prove to be a simple and effective alternative for the usually heavy treatments proposed, warrants further assessment in this context.
Subject(s)
Antineoplastic Agents/administration & dosage , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/secondary , Neoplasm Recurrence, Local/drug therapy , Phosphorylcholine/analogs & derivatives , Skin Neoplasms/drug therapy , Skin Neoplasms/secondary , Administration, Topical , Aged , Female , Humans , Leg , Phosphorylcholine/administration & dosageABSTRACT
A 65-year-old female was admitted with leg edema by retroperitoneal fibrosis and tricuspid valve incompetence by fibrosis, cutaneous fibrosis, moderate flushing over the upper body without diarrhea. It revealed an ileal carcinoid tumor with hepatic metastases. Octreotide (Sandostatine), tumor excision and interferon alpha 2b treatment led to a regression of flushing and edema, a reduction of fibrosis and a stabilization of the metastatic carcinoid, with normal serotonin levels.