Clinical Oncology

[Treatment of anemia in cancer patients]

NAGYKÁLNAI Tamás

DECEMBER 10, 2016

Clinical Oncology - 2016;3(04)

[Anemia in cancer can be resulted by the underlying malignant disease or related to the chemotherapy. Cancer-related anemia adversely effects quality of life and is associated with reduced survival. Clinical studies demonstrate that blood transfusions, ESAs, and correction of iron defi ciency are therapeutic options for anemic cancer patients.]

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Clinical Oncology

[Side-effects of immunotherapy]

LANDHERR László

[The immune system has an important role in controlling and eradicating cancer cells. Antibody therapy against several negative immunologic regulators (checkpoints) has demonstrated promise in a variety of malignancies. The immune checkpoint blockade with antibodies against cytotoxic T lymphocyte- associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathway (PD-1/PD-L1) and its ligand have a unique and distinct pattern of adverse events. Immune-related adverse events are most commonly observed in the skin, gastrointestinal tract, liver and the endocrine system. Early recognition and treatment are believed to be important in mitigating severity of such adverse effects.]

Clinical Oncology

[Long-term central venous access devices in oncology]

PAJKOS Gábor

[Long-term central venous access devices are essential in the management of oncology patients, as they minimize the discomfort caused by frequent venipuncture and cannulation. Indications of application of central venous accesses, possibilities of implantations, immediate and long term complications, they prevention and obviation has been reported based on guidelines and relevant publications. Long term implantable central venous accesses handled by well-trained and exercised team, working with principles of maintenance, these manipulations are effective and safe, therefore suitable in oncological practice.]

Clinical Oncology

[Defi ciency of DNA-repair]

KOPPER László

[The cell uses the DNA to keep those information, which are vital to function properly. It is essential to maintain the integrity of the DNA, the stability of the genome. Since DNA damages, caused by external or internal factors, are continuously produced, DNA-repair mechanisms should be ready to identify and eliminate the damages. Either the repair system is successful and the cell can continue its duty, or, if the damages are unrepaired, the programed cell death (apoptosis) is activated according to the rule, that it is prohibited to transfer genomic/epigenomic damages into the daughter cells. It is true that the severness of the damages are not the same. The most important is the identifi cation and repair of those damages which can make genomic instability increasing the risk of cancer development. This may happen when the repair system is insuffi cient, sometimes due to inherited mutations (e.g. BRCA1 mutations can increase the risk of breast cancer, ovarian cancer etc.). Among the damages the DNA double strand breaks are rather common, and also, that the breaks are intended to be repaired in most cases. However, if such repair fails, the cell, here the cancer cell, due to the overhelming damages will dye. This phenomenon is the synthetic lethality. An example: „cooperation” of inherited BRCA1 mutation and PARP-inhibition, can lead to clinical response using PARP inhibitors, as oliparib. New agents and clinical trials intend to take advantage from synthetic lethality.]

Clinical Oncology

[Foreword]

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Clinical Oncology

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Clinical Neuroscience

[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

Lege Artis Medicinae

[ASSESSMENT OF THE QUALITY OF LIFE AND THE ATTITUDES TO AGEING OF ELDERLY PEOPLE]

TRÓZNAI Tibor, KULLMANN Lajos

[BACKGROUND - The WHOQOL-OLD questionnaire was developed in a multicultural way. The authors were involved in this work as members of the international task force. In order to improve services for the elderly by learning their attitudes to ageing, an Attitudes to Ageing Questionnaire (AAQ) was also developed by the working group. In the present study the authors assessed a sample of Hungarian elderly people by these two methods. Answers by elderly persons related to their quality of life, social and health conditions, as well as their attitude to ageing were analysed. PERSONS AND METHOD - A total of 333 (190 unhealthy and 143 healthy) persons over sixty years of age filled in the questionnaires either by themselves or through verbal interview. The participants’ compliance with the research was generally good. The study sample reflected the general features of the Hungarian elderly population. For statistical analysis the Microsoft SPSS for Windows version 11.0 programme was used. RESULTS - Better health condition, better mood, and a better ability for self-care improve the quality of life. Better attitudes to ageing are associated with better quality of life. CONCLUSIONS - The use of the WHOQOLOLD questionnaire is recommended in the daily practice to assess elderly Hungarians’ quality of life. The results highlight the significance of mental health in the development of the elderly persons’ attitude to ageing. The use of the new questionnaires may help change negative stereotypes related to ageing.]

Journal of Nursing Theory and Practice

[Focus on quality of life: Reconstruction in Vascular Surgery ]

AGÓCS Gábor, VÁRADYNÉ HORVÁTH Ágnes, SZEBENI-KOVÁCS Gyula, ROZMANN Nóra, PAKAI Annamária

[The aims of the study: The aim of our research was to gain deeper insight into the quality of life of patients after reconstructive vascular surgery of the lower limb. Material and method: The Vascuqol questionnaire survey was performed at the PTE KK Vascular Surgery Clinic on the day before the surgery and 3-6 weeks after surgery (N=54). Statistical analysis was carried out with Microsoft Office Excel 2013. Results: In summary it can be stated that following surgical intervention the quality of life of patients significantly improved, this finding ephasises the importance of invasise therapy. As the extent of pain decreased after surgery, patients’ ability to walk started to improve, as well as their overall physical state and ability to carry out certain household activities. There was also an improvement in their social life, more time was spent with family and friends. Conclusions: Although the VascuQoL-25 questionaire is senstivie device to measure quality of life, it is difficult to apply in clinical practice beacause of its length.]

Clinical Neuroscience

[Examining the psychometric properties of a new quality of life questionnaire in migraineurs]

MANHALTER Nóra, PALÁSTI Ágnes, BOZSIK György, ÁFRA Judit, ERTSEY Csaba

[Background - The deleterious effect of primary headaches on the sufferers’ quality of life (QOL) has been abundantly documented using both generic and headache-specific instruments. The currently used questionnaires focus on a limited number of factors and therefore may not be sensitive enough to detect the effect of headache type and headache characteristics on QOL, despite the obvious clinical differences. We have devised a comprehensive questionnaire that may be more sensitive to the burden of headache. Objective - To assess the psychometric properties of the new questionnaire on a group of migraineurs. Patients and method - We studied 117 migraineurs who completed the validated Hungarian version of the SF-36 generic QOL measure and our new, 25-item questionnaire. Reliability was assessed by internal consistency, measured by Cronbach’s a of all items. Content validity was exam- ined by calculating the correlation of the items with subscales of the SF-36 measure. The correlation of the patients’ migraine characteristics with the questionnaire’s items was used to assess criterion validity. Results - The questionnaire was quick and easy to administer. The questionnaire demonstrated good reliability, with Cronbach’s alpha being 0.893. Content validity was adequate; most “physical” items of the new questionnaire showed significant correlations with the bodily pain and role physical SF-36 subscales and most “psychical” and “social” items were correlated with mental health and social functioning SF-36 subscales. Criterion validity was adequate, with headache severity being correlated with most of the items. Discussion - In this study the new headache-specific quality of life instrument showed adequate psychometric properties.]

Journal of Nursing Theory and Practice

[Quality of Life of Cancer Patients’]

PATÓ Edit

[Aim of the study: This research is the part of an extended examination. It’s aim is to assess the cancer patients’ quality of life, how the diseas effects in the way of life, and also the psychologycal burden of the patients. Furthermore to assess the patient’s knowledge of their desease. Material and Methods: The research is descriptive, empirical, supplemenary, which in nurses and patients in oncology departments of Hondvéd Hospital in Budapest and Bács-Kiskun County Hospital in Kecskemét were attend. The method of the survey was an individual questionnaire. The evaulation of the results made with MS Excel and SPSS. The complete evaluable questionnaire’s rate is 74,9% (N=131). Results: the patients judge their own health and quality of life to low in a rate of 56,6%, and 75% of them stated that their way of life and their daily routin has changed in a significant extent. 50% of the responders described their actual emotional condition with a negative indicative, and also occur different psychic disfunctions amuong them. For example the depression in a rate of 17,5%, anxiety is in 18,5%, and reduced self-evaluation in 14,1%. A significant majority (76,3%) of respondents don’t possess the appropriate knowledge. Conclusions: The disease effect on cancer patients’ way of life and quality of life in a significant way. Patients are exposed to a significant psycholigycal burden. ]