Dutch Oncology COVID-19 consortium:Outcome of COVID-19 in patients with cancer in a nationwide cohort study

Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible. Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years). Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered

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Prehospital administered fascia iliaca compartment block by emergency medical service nurses, a feasibility study Dochez et al

Optical spectra and the corresponding blood similarity parameters.

<p>Spectra acquired from one volunteer for subcutaneous needle (upper panes) and intravascular needle positioning (lower panes), as confirmed by positive blood aspiration. Left: full spectra, indicating the intensity of light received by the stylet (linear arbitrary units, a.u.) as a function of the wavelength (nanometers, nm). Center: an enlarged image of the spectrum that is used to determine the blood similarity parameter B (dashed lines indicate the wavelengths that are used for the calculation). Right: Ln (natural logarithm) of the blood similarity parameter as calculated for these two acquisitions.</p

Consort flowchart of the study.

<p>Consort flowchart of the study.</p

All blood similarity parameters.

<p>Overview of all blood similarity parameters (B) determined for the different measurement locations in all volunteers. Results are plotted as the average natural logarithm Ln (B) (crosses), with standard deviations determined for the set of spectra acquired at each measurement location in each subject. Volunteer 14 was excluded. Because of the considerable differences in blood similarity parameters (B) between the two groups, more details in the data are visible by plotting Ln(B) instead of B directly.</p

Picture of the console and needle tip.

<p>Picture of the console (upper part) and needle tip with optical stylet (lower part). The drawing demonstrates the needle, which is connected to the console. The console is just a drawing and not an accurate image of the real one. The picture of the needle tip shows the two fibers and indicates the measuring volume.</p

Nerve detection with optical spectroscopy for regional anesthesia procedures

BACKGROUND: Regional anesthesia has several advantages over general anesthesia but requires accurate needle placement to be effective. To achieve accurate placement, a needle equipped with optical fibers that allows tissue discrimination at the needle tip based on optical spectroscopy is proposed. This study investigates the sensitivity and specificity with which this optical needle can discriminate nerves from the surrounding tissues making use of different classification methods. METHODS: Diffuse reflectance spectra were acquired from 1563 different locations from 19 human cadavers in the wavelength range of 400–1710 nm; measured tissue types included fascicular tissue of the nerve, muscle, sliding fat and subcutaneous fat. Physiological parameters of the tissues were derived from the measured spectra and part of the data was directly compared to histology. Various classification methods were then applied to the derived parameter dataset to determine the accuracy with which fascicular tissue of the nerve can be discriminated from the surrounding tissues. RESULTS: From the parameters determined from the measured spectra of the various tissues surrounding the nerve, fat content, blood content, beta-carotene content and scattering were most distinctive when comparing fascicular and non-fascicular tissue. Support Vector Machine classification with a combination of feature selections performed best in discriminating fascicular nerve tissue from the surrounding tissues with a sensitivity and specificity around 90 %. CONCLUSIONS: This study showed that spectral tissue sensing, based on diffuse reflectance spectroscopy at the needle tip, is a promising technique to discriminate fascicular tissue of the nerve from the surrounding tissues. The technique may therefore improve accurate needle placement near the nerve which is necessary for effective nerve blocks in regional anesthesia