ABSTRACT
BACKGROUND: Healthcare professionals have fought hard to restrain the COVID-19 pandemic by providing high-quality care for their infected patients, but in doing so they have developed fears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratory therapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation. The study sought to describe the experiences and coping strategies of Saudi RT managing patients with COVID-19. MATERIALS AND METHODS: The study utilized qualitative research methods, specifically employing a phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact with COVID-19 patients were selected after they agreed to participate in this study. The study followed a one-on-one semi-structured interview process using the Zoom platform. This qualitative data collection technique focuses on the participants' lived experiences and feelings to discover shared patterns. The data were analyzed via an inductive approach. RESULTS: Six themes were found in the RT perceptions including stress while treating COVID patients, managing the fear of catching of Covid 19, feelings towards COVID-19 patients, challenges faced by female RTs, workplace experiences, and excessive workload. CONCLUSIONS: RTs feelings dramatically changed throughout the COVID-19 pandemic. All the RTs have developed a self-copying style that has helped them improve their psychosocial behavior to face the pandemic. During the outbreak, frontline RTs' positive and negative emotions intertwined and coexisted. Negative emotions predominated in the beginning, while good feelings emerged gradually. Self-coping methods and psychosocial development were significant factors in RTs mental health while caring for COVID-19 patients.
ABSTRACT
AIMS: Cutaneous melanoma is one of the most immunogenic tumours. Immunotherapy with checkpoint inhibitors, such as anti-PD-1 antibodies, has significantly improved the prognosis in metastatic melanoma. However, only half of the patients respond to this therapy and have a favourable outcome. Identifying factors associated with treatment failure and early identification of responders are both important to select the best treatment approach for each patient. The aim of our study was to investigate clinical biomarkers of response to treatment with anti-PD-1 antibodies. MATERIALS AND METHODS: We selected all patients with stage IV melanoma (n = 147), subjected to first-line treatment with anti-PD-1 in the last 10 years. We investigated the associations between patients' different clinical features and progression-free survival, using the Cox proportional hazards models. RESULTS: In the multivariate analysis, an increased risk of disease progression was observed among patients with stage M1d metastases (hazard ratio 3.30; 95% confidence interval 1.58-6.91), compared with patients with stage M1a-M1b. Moreover, the risk of progression was greater in patients with the Eastern Cooperative Oncology Group Performance Status (ECOG PS) 1 (hazard ratio 2.04; 95% confidence interval 1.02-4.06) and in patients with ECOG PS ≥ 2 (hazard ratio 2.19; 95% confidence interval 1.05-4.55) compared with ECOG PS 0. High levels of lactate dehydrogenase (hazard ratio 2.06; 95% confidence interval 1.18-3.59) and the presence of respiratory diseases (hazard ratio 4.14; 95% confidence interval 1.42-12.0) at the beginning of anti-PD-1 treatment were also associated with an increased risk of disease progression. In a subgroup analysis, neutrophil count and neutrophil/lymphocyte ratio before anti-PD-1 treatment were higher in patients who underwent disease progression. CONCLUSION: In our study population, independent predictors of disease progression among patients treated with first-line anti-PD-1 were as follows: ECOG PS, staging, lactate dehydrogenase and the presence of respiratory diseases.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Immunotherapy , Melanoma/drug therapy , Prognosis , Progression-Free Survival , Retrospective Studies , Skin Neoplasms/drug therapyABSTRACT
The acute metabolic abnormalities associated with cancer may cause symptoms that require urgent medical treatment and may constitute a more dangerous threat to life than the cancer itself. Hypercalcaemia is probably the most common metabolic complication of neoplastic disease (occurring in up to 30% of cancer patients) and its timely treatment may often save the patient and may permit subsequent chemotherapy. In this communication we focused our attention on the pathogenetic mechanism (part 1), diagnosis and subsequent treatment of this metabolic disorder (part 2).
Subject(s)
Hypercalcemia/etiology , Neoplasms/complications , Diagnosis, Differential , Emergencies , Humans , Hypercalcemia/diagnosis , Hypercalcemia/therapyABSTRACT
The acute metabolic abnormalities associated with cancer may cause symptoms that require urgent medical treatment and may constitute a more dangerous threat to life than the cancer itself. Hypercalcaemia is probably the most common metabolic complication of neoplastic disease (occurring in up to 30% of cancer patients) and its timely treatment may often save the patient and may permit subsequent chemotherapy. In this communication we focused our attention on the pathogenetic mechanism (part 1), diagnosis and subsequent treatment of this metabolic disorder (part 2).
