Implemented Interventions at the Naef K. Basile Cancer Institute to Protect Patients and Medical Personnel From COVID Infections: Effectiveness and Patient Satisfaction

BackgroundThe Coronavirus Disease 2019 (COVID-19) was declared a pandemic by WHO in March 2020. The first case of COVID-19 was identified in Lebanon on the 21st of February 2020, amid a national economic crisis. As the numbers of cases increased, ICU admissions and mortality rose, which led hospitals across Lebanon to take certain safety measures to contain the virus. The Naef K. Basile Cancer Institute (NKBCI) at the American University of Beirut Medical Center handles oncology outpatient visits and outpatient treatment protocol infusions. The aim of this study is to evaluate the efficacy of the safety measures put forth by the NKBCI early in the pandemic.MethodsOncology patients are amongst the immunosuppressed population, who are at greatest risk of contracting COVID-19 and consequently suffering its complications. In this manuscript, we evaluated the precautionary measures implemented at the NKBCI of AUBMC from March 1st to May 31st of 2020, by surveying oncology patients on the telephone who had live and virtual appointments in both the oncology outpatient clinics and infusion unit. We conducted a prospective study of 670 oncology patients who had appointments at the NKBCI during this period and used their answers to draw responses about patient satisfaction towards those safety measures.ResultsOur results involved 387 responses of oncology patients who visited the NKBCI during the period of March 1st to May 31st of 2020. 99% of our respondents gave a rating of good to excellent with these new measures. The option of online consultation was given to 35% in the hematology group compared to 19% in those with solid tumors (p=0.001). From the total, 15% of patients opted for the telemedicine experience as a new implemented strategy to provide patient-centered medical care. Of this group of patients, 22% faced problems with connectivity and 19% faced problems with online payment.ConclusionNKBCI was competent in following the WHO guidelines in protecting the oncology patient population. Feedback collected from the surveys will be taken into account by the committee of the NKBCI to develop new safety measures that can better control viral spread while providing patient-centered medical care

Développement d'une méthode d'extraction séquentielle de 36 composés phénoliques et 16 hydrocarbures aromatiques polycycliques à partir d'échantillons atmosphériques

Les hydrocarbures aromatiques polycycliques (HAP) sont des polluants organiques persistants émis dans l atmosphère par de nombreux processus de combustion. Ils sont particulièrement étudiés en raison de leur potentiel cancérigène et mutagène. Les phénols fonctionnalisés (chloro- et nitrophénols principalement) sont rejetés dans l atmosphère du fait de leur utilisation comme pesticides. Ils peuvent aussi provenir des combustions de déchets, du charbon, du bois et des émissions des véhicules diesel. Bien que certains d entre eux soient toxiques pour l homme et les végétaux, ils ne sont que très peu étudiés en France.Dans ce contexte, cette étude a pour objectif d élaborer une méthode séquentielle d extraction accélérée par solvant pressurisé à partir de la résine XAD-2 dopée. La première étape est l extraction de 36 composés phénoliques avec de l eau chaude alcaline à 150 C, ensuite, l extraction de 16 HAP se fait avec un mélange de n-hexane-acétone à 105 C. Les composés phénoliques sont concentrés par micro-extraction sur phase solide, suivie d une dérivation par silylation dans l injecteur d un chromatographe en phase gazeuse couplé à un spectromètre de masse pour l analyse. Les HAP sont quantifiés par chromatographie liquide à détection par fluorescence. L optimisation de la méthode d extraction a permis d obtenir des taux de recouvrement satisfaisants: 74-109% (chlorophénols), 60-101% (nitrophénols) et 85-114% (HAP). De plus, la méthode d analyse validée est rapide, sélective, fiable et sensible avec des limites de détection de 0,03-26 ng.mL-1. Grâce à une consommation minimale de solvants organiques, la méthode est également moins polluante de l environnement.Polycyclic aromatic hydrocarbons (PAH) are persistent organic pollutants. They are emitted into the atmosphere by many combustion processes and they have been particularly studied due to their potential carcinogenic and/or mutagenic properties. Functionalized phenols (e.g. chloro- and nitro-phenols) are released into the atmosphere because of their use as pesticides. They can also be emitted from diesel engines, waste incineration, coal and wood combustions. Some of them are known or suspected to be highly toxic to human health and plants. However, they are poorly studied in France.In this laboratory study, accelerated solvent extraction was used for the sequential extraction of 36 phenolic compounds and 16 PAH from spiked XAD-2 resin. The procedure is based on hot alkaline water extraction (150 C) of polar phenolic compounds, followed by acetone-n-hexane (1:1, v/v) extraction of PAH at 105 C. The phenolic compounds in the aqueous extract are preconcentrated onto solid-phase microextraction fiber, followed by desorption and injection-port derivatization prior to gas chromatography analysis with mass spectrometry detection. The PAH, included in the second fraction, are preconcentrated by rotary evaporator and analyzed by liquid chromatography with fluorescence detection.Optimization of the extraction method allowed achieving high recoveries: 74-109% (chlorophenols), 60-101% (nitrophenols) and 85-114% (PAH). The validated analytical procedure is fast, selective, reliable and sensitive with detection limits of 0.03-26 ng.mL-1. Furthermore, the method is environmentally friendly, as it consumes much less harmful organic solvents compared to conventional extraction methods.STRASBOURG-Sc. et Techniques (674822102) / SudocSudocFranceLebanonFRL

Paradoxical pulmonary artery systolic pressure response with catheter-directed therapies for pulmonary embolism

Background: Early data on use of catheter-directed therapies (CDT) for treatment of Intermediate or High-Risk pulmonary embolism (PE) show improvement in pulmonary artery systolic pressures (PAsP) and RV/LV ratios. Occasionally a paradoxical rise in PAsP was observed with CDT utilizing ultrasound-assisted thrombolysis (USAT). It is unclear whether this pattern is seen with CDT utilizing mechanical aspiration. Objectives: To investigate and compare the changes in PAsP between those who underwent CDT with USAT to those with mechanical aspiration. Methods: A retrospective analysis of those diagnosed with Intermediate or High-Risk PE who underwent CDT using USAT or mechanical aspiration from 7/2013 to 3/2023. The primary outcome was comparison of PAsP changes between the two modalities. Secondary outcomes include length of stay, mortality, and bleeding complications. Results: A total of 142 patients were analyzed, of which 93 underwent USAT and 49 underwent mechanical thrombectomy. The mechanical thrombectomy group had significantly lower post-intervention PAsP than the USAT group (42.2 ± 13.4 mmHg vs 54.5 ± 15.2 mmHg, p < 0.0001) and a greater adjusted mean reduction (−16.5 ± 2.7 vs. −7.7 ± 3.2 mmHg. p < 0.0001). A higher frequency of a paradoxical rise in PAsP was observed in the USAT group (22 % vs 4.1 %, p < 0.001). Conclusions: CDT utilizing mechanical thrombectomy was associated with lower post-interventional PAsP and greater mean negative change compared to USAT. Occasional paradoxical rises in PAsP were observed with both types of CDT, but they were more frequent with USAT. Hemodynamic monitoring should be considered after CDT. Condensed unstructured abstract: We report a retrospective comparison of changes to pulmonary artery systolic pressures (PAsPs) between catheter-directed ultrasound-assisted thrombolysis (USAT) and catheter-directed mechanical thrombectomy in Intermediate and High-Risk pulmonary embolism. Those treated with mechanical thrombectomy compared to USAT had significantly lower post-interventional PAsP (42.2 ± 13.4 mmHg vs 54.5 ± 15.2 mmHg, p < 0.0001) and a greater adjusted mean reduction (−16.2 ± 2.7 vs. −7.5 ± 3.2 mmHg, p < 0.0001). A paradoxical rise in PAsP was observed more frequently in the USAT group than the mechanical thrombectomy group (22 % vs 4.1 %, p < 0.001)

Impact of Adding Antithymocyte Globulin to Posttransplantation Cyclophosphamide in Haploidentical Stem-Cell Transplantation

International audienc

Effect of the Thiotepa Dose in the TBF Conditioning Regimen in Patients Undergoing Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia in Complete Remission: A Report From the EBMT Acute Leukemia Working Party

Allogeneic stem cell transplantation is a potentially curative therapy for patients with acute myeloid leukemia (AML) after achieving complete remission (CR). The aim of this study is to evaluate the optimal dose of thiotepa, administered as part of the thiotepa-busulfan-fludarabine (TBF) conditioning regimen for allogeneic stem cell transplantation in adults with AML in CR