Quality of life and psychosocial impacts of the different restrictive measures during one year into the COVID-19 pandemic on patients with cancer in Italy: An ecological study

Background: The aim of the study was to assess the perceived quality of life and the psychosocial impact of the various restrictive measures due to COVID-19 pandemic on cancer patients in Italy, as well as their perception of the relationship with doctors and caregivers. Methods: This study compares three population-based observational studies of patients with cancer carried out in three consecutive time periods characterized by different restrictive measures using a self-administered online questionnaire. Results: Among the basic needs, psychological and medical support appeared to be prevalent; so did the need for safe transportation to reach the treatment facilities. Internet was the main source of information on the coronavirus. Although 74.6% of the total number of patients did not give up hospital therapies, 34.8% complained about variations in the continuity of treatment, with different percentages in the three samples. The majority of the sample (73.8%) was worried of being infected, but 21.9% did not share their anxieties and worries with others. The multivariate regression analysis showed that a pessimistic perception of quality of life was influenced by living in extra-urban areas and alone (OR = 1.4; OR = 2.1); while a perception of a reduced physical function result affected by the state of anxiety and stress (OR = 1.9) and the difficulties in continuity of medical assistance (OR = 2.2). The scoring of the SF-12 in the Physical Component Summary and Mental Component Summary scores showed a fluctuating trend throughout the three periods investigated. Conclusions: It is important for health professionals, caregivers and social workers to identify the new needs in order to enhance home care interventions, personalize and optimize care, ensure continuity of care and guarantee a high quality of life even in a health emergency situation

Distress Evaluation during Chemotherapy: The Real-time Assessment Strategies for Oncology Nurses among Asian Population in Outpatient Clinics

Background: Routine oncology visits failed to identify 50-94% of patient’s distress, which creates a considerable burden, impairs emotional well-being and reduces patients’ quality of life. Limited in-person visits during the COVID-19 pandemic have reduced access to care for many patients, further adding to their emotional distress. Untreated distress also leads to elevated stress levels, systemic inflammation, non-compliance with treatment, and higher mortality rates. Early distress screening and multidisciplinary care are recommended to reduce the impacts of distress. Objectives: To identify the best outpatient practices to address newly diagnosed cancer patients’ unique needs due to distress. Methods: Databases searched including CINAHL® Complete, Joanna Briggs Institute EBP Database, APA PsycINFO®, PubMed, and Cochrane Database of Systematic Reviews. Studies had to be written in English or Chinese, published in a peer-reviewed journal, and included individuals aged 18 years or older. The initial search yielded 371 articles. Findings: Research highlighted the need to assess patients’ pre-existing life events, culture, beliefs, and other personal characteristics for optimal distress management. The screening should identify high-risk patients and provide early intervention. Investing in telehealth practice and psycho-oncology education is more cost-effective compared to face-to-face interventions

Implement exercise in the oncological setting

Over the past 20 years, the understanding of the role of physical activity in cancer has been increased. Traditionally, patients were advised to rest, recovery, and save energy during and after anticancer treatments. Nevertheless, it is now clear that physical activity may help alleviate some side effects caused by therapies and a sedentary lifestyle; consequently, cancer patients should be encouraged to perform exercise. Epidemiological evidence shows that post-diagnosis physical activity is associated with enhancing patients \u2018survival, especially in breast, colon, and prostate cancer. In cancer patients, exercise acts by improving health-related skills, particularly cardiorespiratory fitness, strength, and body composition. Moreover, several trials demonstrated that a regular exercise program effectively relieves some cancer and treatments \u2018side effects, such as fatigue, nausea, and vomiting, thereby improving patients\u2019 quality of life. The last update of the American College of Sports Medicine\u2019 guidelines recommends that patients perform 90 minutes per week of aerobic exercise at moderate intensity, with strength activities twice a week. Despite these important benefits, in Italy, the spread of exercise-oncology programs and the research in the exercise oncology field are still poor, negatively impacting patients and producing a gap in the literature. The purpose of this thesis is trying to fill this gap, increasing the available literature, and proposing an exercise program based on patients\u2019 needs and the current guidelines. Chapter one is dedicated to a brief introduction about physical activity in cancer. In chapters two, three, four, and five, the experimental studies that led to the development of patient-centred exercise program are presented. Chapters six and seven report two other studies investigating exercise as part of the multimodal approach in counteracting cancer cachexia. The last chapter is dedicated to a summary of the main thesis results

Qvida+: Development of a Clinical Decision Support System

In these last few decades, there has been a significant increase in the average life expectancy due to improved general life conditions as well as to several advances in the medicine field. Contrary to what happened then, people with chronic conditions live more now, and so it's essential to ensure their quality of life. Furthermore, in addition to prolonging their life, another goal of medical treatment is to maintain or increase the quality of life of patients. Health Related Quality of Life (HRQOL) can be defined as the individuals' perception of their own health status (physical, functional, emotional and social) and the impact of their condition or treatment in their daily life (job, family, friends). The QVida+ project, based on recent scientific and technological advances in the HRQOL fields and mobile devices, intends to create an innovative paradigm when it comes to the assessment and application of HRQOL. The following step to this project, and the aim of the current dissertation would be the development of a clinical support system that would gather all the data collected in previous steps of this project such as biometric data (e.g., sleep, heart rate variability) and physical activity( e.g., number of daily steps) collected through smartbands, responses to self-report questionnaires and clinical data from cancer patients and provide health care professionals with more and better information about their patients. This system, with the help of machine learning (ML) techniques, would focus particularly on patients' evolution regarding their health status and HRQOL, and consequently assist health care professionals on future decisions with greater quantity and quality of information

A disastrous complication of colonephrocutaneous fistula: brain abscess

A rare case of colonephrocutaneous fistula complicated with a brain abscess is a lifethreatening clinical condition. We report a case of a 35-year-old lady with a history of partial left nephrectomy complicated with left colonic injury who presented with persistent vomiting associated with headache and blurry vision for 5 days. Clinically, she was confused and restless with Glasgow Coma Scale (GCS) of 12/15, however her pupils were equal and reactive bilaterally. Other neurological examinations were unremarkable. Abdominal examination noted functioning ileostomy with a skin opening at left lumbar with pus discharge. Diagnosis of brain abscess was made after contrasted computed tomography (CT) scan of brain. Urgent open drainage surgery was done followed by long course of antibiotic. Contrasted CT abdomen and fistulogram revealed a left colo-psoas and left nephrocutaneous fistula, hence, she was subjected for surgery. Intraoperatively, there was a fistula tract connecting the descending colon, remaining of left kidney, and the skin. Thus, left hemicolectomy, completion of left nephrectomy, and fistulectomy was done. The long-standing infective foci can lead to septic emboli and causes formation of abscess at distant site. Its management is challenging involving both medical and surgical therapy

An experimental model of induction of osteoarthritis in New Zealand white rabbit

Introduction: Historically, animal models for osteoarthritis have been established to facilitate the study of the pathogenesis of osteoarthritis and the potential medical treatment. The anterior cruciate ligament transection (ACTL) and partial meniscal resection model in rabbits have been widely used. The aim of the study was to establish a more effective surgical approach to induce knee osteoarthritis in New Zealand White Rabbits. Materials and Methods: This descriptive study was approved by the Institutional Animal Care and Use Committee (I-ACUC) ethical committee. The surgical approach of induction of osteoarthritis was done in Advanced Orthopedics Research Laboratory, International Islamic University Malaysia. Eight rabbits underwent lateral and medial meniscectomies at bilateral foreleg knees to induce osteoarthritis. The models were examined through physical and radiographic analysis. Results: Physical exams showed that all model animal daily food and water intakes were normal. Animal model knee motion in passive range showed limitation and instability. Radiographic imaging analysis showed osteoarthritic changes in all models. Moreover, no mortality was recorded during the study. The approach requires less surgery time and easier access. The analgesia was more humane and showed faster recovery. Conclusion: These outcomes suggested an effective and feasible technique of inducing knee osteoarthritis in New Zealand White rabbit models