Advanced breast, cervical and prostate cancer- Patient needs: systematic review.

BACKGROUND: There are high rates registered globally of breast cancer, cervical and prostate. People going through have needs that cause an impact in their life's quality, especially in the final stages of the illness. GOAL: To characterise the most evaluated and afflicted physical, emotional, roll, cognitive, social and spiritual needs of patients in the final stages of breast, cervical and prostate cancer. INTERVENTIONS/METHODS: A thorough systematic search of databases such as Medline (Ovid) and Embase, from databases' creation throughout 31 December 2021. Quantitative studies were included to evaluate, from the adoption of tools, the dimensions or needs of people going under three types of cancer on final stages. RESULTS: Twelve studies were included. More common symptoms such as nausea/vomiting and pain were the most evaluated with 83%. Fifty-eight per cent of papers studied the emotional function of people with breast and prostate cancer. Other 42% included roll, cognitive and social appreciations. Sexual, cognitive and physical, in that line, were the most affected. The most common questionnaires used to measure oncological patients on final stages were those from European Organisation for Research and Treatment of Cancer on its C-30, BR-23, C-15 PAL and CR-25 versions. CONCLUSIONS: On breast and prostate cancer, the most affected aspect was the sexual dysfunction, while for cervical cancer, the physical function was the most altered one. Spiritual dimension was not included in any of the evaluated literature.

Capsule endoscopy capture rate: has 4 frames-per-second any impact over 2 frames-per-second?

AIM: To compare the current capsule and a new prototype at 2 and 4 frames-per-second, respectively, in terms of clinical and therapeutic impact. METHODS: One hundred patients with an indication for capsule endoscopy were included in the study. All procedures were performed with the new device (SB24). After an exhaustive evaluation of the SB24 videos, they were then converted to "SB2-like" videos for their evaluation. Findings, frames per finding, and clinical and therapeutic impact derived from video visualization were analyzed. Kappa index for interobserver agreement and χ (2) and Student's t tests for qualitative/quantitative variables, respectively, were used. Values of P under 0.05 were considered statistically significant. RESULTS: Eighty-nine out of 100 cases included in the study were ultimately included in the analysis. The SB24 videos detected the anatomical landmarks (Z-line and duodenal papilla) and lesions in more patients than the "SB2-like" videos. On the other hand, the SB24 videos detected more frames per landmark/lesion than the "SB2-like" videos. However, these differences were not statistically significant (P > 0.05). Both clinical and therapeutic impacts were similar between SB24 and "SB2-like" videos (K = 0.954). The time spent by readers was significantly higher for SB24 videos visualization (P < 0.05) than for "SB2-like" videos when all images captured by the capsule were considered. However, these differences become non-significant if we only take into account small bowel images (P > 0.05). CONCLUSION: More frames-per-second detect more landmarks, lesions, and frames per landmark/lesion, but is time consuming and has a very low impact on clinical and therapeutic management.

EchoBrush may be superior to standard EUS-guided FNA in the evaluation of cystic lesions of the pancreas: preliminary experience.

BACKGROUND: Cystic lesions of the pancreas are being detected with increasing frequency. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is one of the most precise methods of diagnosis but still has limited accuracy. A new, through-the-needle cytologic brush system (EchoBrush; Cook Medical, Bloomington, Ind) has been approved for use during EUS evaluation of cystic pancreatic lesions. METHODS: Data from 127 EUS-FNAs of pancreatic cystic lesions were analyzed to compare the cytologic yield of EchoBrush with conventional EUS-FNA. An attending cytopathologist was present on site to assess specimen adequacy in all the cases. Diagnostic yields of both procedures, as well as related adverse events, were recorded. Statistical analysis was performed with the SPSS 15.0 version software (SPSS, Chicago, Ill). RESULTS: A total of 127 cystic lesions of the pancreas from 120 patients (42 men and 78 women, mean age of 62.17 ± 12.17 years) were included in the study. Mean size of lesions was 23.58 ± 21.69 mm. Adequacy of the samples and diagnostic yield were higher using EchoBrush. In 80 (63 %) cases, conventional EUS-FNA was performed, whereas in 47 (37%), we used EchoBrush. Diagnostic material was obtained in 85.1% (40 of 47) of cases using EchoBrush and in 66.3% (53 of 80) with conventional EUS-FNA. (P < .05). There were very few clinically relevant complications related to EUS-FNA and EUS-EchoBrush techniques. CONCLUSIONS: This study suggests that cytological specimens from pancreatic cystic lesions obtained using EchoBrush at the time of EUS are superior to conventional EUS-FNA mainly because of the higher yield of epithelial cells. Larger studies are needed to compare both methods.