Management of oral and gastrointestinal mucositis: ESMO Clinical Recommendations

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Management of febrile neutropenia: ESMO Clinical Practice Guidelines

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Analysis of Risk Factors Associated With Asymptomatic Colonization of Methicillin Resistant Staphylococcus aureus (MRSA) Among Community College Students

The bacterium Staphylococcus aureus has been an important human ailment for centuries, and with the overuse of antibiotics, methicillin resistant Staphylococcus aureus (MRSA) has emerged as a deadly, costly pathogen worldwide. Healthy carriers can become sick or can spread MRSA without symptoms. The amount of asymptomatic colonization among healthy college students and risk factors for colonization by MRSA are not well understood. According to the epidemiologic triangle model, the host (students who take antibiotics or have a history of skin infections), the infectious agent (MRSA) and the environment (direct contact with people, animals, or objects that may harbor MRSA) all play an important role in this disease. This study explored MRSA colonization rates among healthy students at a community college and explored the possibility that students exposed to sources of MRSA might have a higher colonization rate. Using a cross-sectional quantitative design with stratified sampling, risk factors to include student\u27s discipline, gender, race, work, and leisure exposure were surveyed. In tandem, Mannitol Salt Agar and MRSA Select Agar were inoculated from nasal swabs to identify students colonized by MRSA. The data were analyzed using contingency tables and Chi Squares. Significant risk factors identified included students who had a major that involved touching shared equipment and/or those who were in majors such as nursing, students who had close contact with animals, and students who had a skin infection. The implication for positive social change include improved awareness of MRSA colonization and risk factors which can lead to better prevention strategies and increased awareness among the student population

Five-years management of an emerging parasite risk (Eustrongylides sp., Nematoda) in a fishery supply chain located on Trasimeno Lake (Italy)

In the last few years, the widespread diffusion of potentially zoonotic parasitic nematodes of the genus Eustrongylides in the Trasimeno Lake, Central Italy, prompted Food Business Operators (FBOs) operating in the freshwater fish supply chain to define preventive measures to reduce or eliminate this new hazard from fishery products. The results of the self-checks for parasite risk management of a fishermen's cooperative over a five-year period (January 2016–April 2021) are presented. Nine freshwater commercial species, perch (Perca fluviatilis), largemouth black bass (Micropterus salmoides), big-scale sand smelt (Atherina boyeri), eel (Anguilla anguilla), black bullhead (Ictalurus melas), carp (Cyprinus carpio), tench (Tinca tinca), goldfish (Carassius auratus), and pumpkinseed sunfish (Lepomis gibbosus), differently processed (filleted, whole gutted or whole ungutted), were investigated. The presence of visible parasites was assessed by visual inspection during processing and recorded. Eustrongylides sp. were found in all species examined except for goldfish. Eustrongylides sp. occurrence was negligible in large mouth black bass, eel, carp, and tench, while increasing prevalence rates over the years were observed in fillets of perch <400 g (from 4.2% in 2016 to 68% in 2021), batches of sand smelt (<1%–40%) and pumpkinseed sunfish (6%–99%). Still low but slightly increasing prevalence rates were also observed for black bull head. The rising of the infection in perch, sand smelt, and pumpkinseed sunfish lead to a progressive implementation of preventive measures including the definition of a sampling plan for the visual inspection followed by trimming or removal of the parasites from the muscle or the application of a threshold value to define the marketability of fish batches. This is the first study describing an approach for the management of the emerging risk posed by nematodes of the genus Eustrongylides in a freshwater fishery supply chain. Besides providing an updated epidemiological scenario in Lake Trasimeno, where this parasite was described for the first time in Italy in 2015, it could support other FBOs in the implementation of preventive measures to safeguard consumers' health and trust

Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy

The role of dexamethasone to reduce delayed emesis following highly emetogenic chemotherapy is proven, but there is less evidence of benefit after mild–moderately emetogenic regimens. Here, we develop and evaluate a Dexamethasone Symptom Questionnaire (DSQ) to assess the side effects of dexamethasone in the week after patients receive moderately emetogenic chemotherapy. The DSQ was first optimised with the aid of a focus group. Sixty patients receiving oral dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy for cancer completed and then evaluated the DSQ. Patients reported that the DSQ was clearly worded and addressed items important to them. Patients receiving dexamethasone reported moderate–severe problems with insomnia (45%), indigestion/epigastric discomfort (27%), agitation (27%), increased appetite (19%), weight gain (16%) and acne (15%) in the week following chemotherapy. The side effects of dexamethasone may outweigh its benefits when used with moderately emetogenic chemotherapy. A randomised, double-blind crossover trial is underway to determine the effect of dexamethasone on nausea and vomiting, and the impact of side effects of dexamethasone and of nausea and vomiting on quality of life

Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines

Cardiovascular (CV) toxicity is a potential short- or long-term complication of various anticancer therapies. Some drugs, such as anthracyclines or other biological agents, have been implicated in causing potentially irreversible clinically important cardiac dysfunction. Although targeted therapies are considered less toxic and better tolerated by patients compared with classic chemotherapy agents, rare but serious complications have been described, and longer follow-up is needed to determine the exact profile and outcomes of related cardiac side-effects. Some of these side-effects are irreversible, leading to progressive CV disease, and some others induce reversible dysfunction with no long-term cardiac damage to the patient. Assessment of the prevalence, type and severity of cardiac toxicity caused by various cancer treatments is a breakthrough topic for patient management. Guidelines for preventing, monitoring and treating cardiac side-effects are a major medical need. Efforts are needed to promote strategies for cardiac risk prevention, detection and management, avoiding unintended consequences that can impede development, regulatory approval and patient access to novel therapy. These new ESMO Clinical Practice Guidelines are the result of a multidisciplinary cardio-oncology review of current evidence with the ultimate goal of providing strict criteria-based recommendations on CV risk prevention, assessment, monitoring and management during anticancer treatmen

Anti-nausea effects and pharmacokinetics of ondansetron, maropitant and metoclopramide in a low-dose cisplatin model of nausea and vomiting in the dog: a blinded crossover study

Nausea is a subjective sensation which is difficult to measure in non-verbal species. The aims of this study were to determine the efficacy of three classes of antiemetic drugs in a novel low dose cisplatin model of nausea and vomiting and measure change in potential nausea biomarkers arginine vasopressin (AVP) and cortisol. A four period cross-over blinded study was conducted in eight healthy beagle dogs of both genders. Dogs were administered 18 mg/m2 cisplatin intravenously, followed 45 min later by a 15 min infusion of either placebo (saline) or antiemetic treatment with ondansetron (0.5 mg/kg; 5-HT3 antagonist), maropitant (1 mg/kg; NK1 antagonist) or metoclopramide (0.5 mg/kg; D2 antagonist). The number of vomits and nausea associated behaviours, scored on a visual analogue scale, were recorded every 15 min for 8 h following cisplatin administration. Plasma samples were collected to measure AVP, cortisol and antiemetic drug concentrations