ABSTRACT

PURPOSE: Breast cancer survivors may experience a variety of disabilities that could potentially compromise their independent functioning. This study aimed to examine their perspectives and experts on their functioning and interpret concepts with the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework (IPF).

METHODS: Interpretive descriptive methods were used with in-depth interviewing with 16 breast cancer survivors and 22 experts using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis. The extracted data were linked to the ICF Core Set for Breast cancer and were interpreted by the IPF.

RESULTS: Four main themes emerged to define the functioning of breast cancer survivors: body functioning, physical functioning, social functioning, and mental functioning. Three other factors were also categorized as modifiers of functioning personal, emotional, and environmental. The 592 extracted meaningful concepts were linked to 38 (47%) categories from the ICF: 16 Body Functions, 14 Activities and Participation, and 8 Environmental Factors. The IPF classified all the extracted concepts, and most rational appraisals fell in the biological (B) domain. The concepts that required emotional appraisal were classified in Psychology (P).

CONCLUSION: Psychological and emotional factors were pivotal in defining functioning in patients with BC.

PMID:37237439 | DOI:10.1080/09638288.2023.2212915

C

19:19

Cardiotoxicity News

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

In reply to this message

PubMed articles on: Cancer & VTE/PE

COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period

Arch Clin Cases. 2023 Jun 7;10(2):78-85. doi: 10.22551/2023.39.1002.10246. eCollection 2023.

ABSTRACT

Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgA), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory.

PMID:37293685 | PMC:PMC10246599 | DOI:10.22551/2023.39.1002.10246

19:19

In reply to this message

PubMed articles on: Cancer & VTE/PE

Incidence and risk factors for venous thromboembolism in patients with ovarian cancer during neoadjuvant chemotherapy: a meta-analysis

Am J Cancer Res. 2023 May 15;13(5):2126-2134. eCollection 2023.

ABSTRACT

In recent years, there has been increasing recognition of the relationship between neoadjuvant chemotherapy (NACT) in ovarian cancer and the incidence rate of venous thromboembolism (VTE). Some studies have suggested that NACT may be associated with a high risk of VTE in patients with ovarian cancer. To investigate this, we conducted a systematic review and meta-analysis of the incidence of VTE during NACT and its associated risk factors. We searched PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the International Standard Randomized Controlled Trial Number Register (ISRCTN) from their inception to September 15, 2022. We calculated the incidence of VTE as the event rate (%) and used logistic regression analysis to investigate pooled VTE rates. Risk factors for VTE were presented as odds ratios (ORs), and pooled ORs was estimated using the inverse variance method. We reported pooled effect estimates with 95% confidence intervals (CIs). Our review included 7 cohort studies with 1244 participants. Meta-analysis of these studies revealed a pooled VTE rate of 13% during NACT (1224 participants; 95% CI, 9%-17%), with body mass index identified as a risk factor for VTE during NACT in 3 of the included studies (633 participants; OR, 1.76; 95% CI, 1.13-2.76).

PMID:37293158 | PMC:PMC10244120

19:19

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

In reply to this message

PubMed articles on: Cancer & VTE/PE

Causal relationships between risk of venous thromboembolism and 18 cancers: a bidirectional Mendelian randomisation analysis

medRxiv. 2023 May 18:2023.05.16.23289792. doi: 10.1101/2023.05.16.23289792. Preprint.

ABSTRACT

Background:People with cancer experience high rates of venous thromboembolism (VTE). Additionally, risk of subsequent cancer is increased in people experiencing their first VTE. The causal mechanisms underlying this association are not completely understood, and it is unknown whether VTE is itself a risk factor for cancer. Methods:We used data from large genome-wide association study meta-analyses to perform bi-directional Mendelian randomisation analyses to estimate causal associations between genetically-proxied lifetime risk of VTE and risk of 18 different cancers. Results:We found no conclusive evidence that genetically-proxied lifetime risk of VTE was causally associated with an increased incidence of cancer, or vice-versa. We observed an association between VTE and pancreatic cancer risk (odds ratio for pancreatic cancer 1.23 (95% confidence interval 1.08 - 1.40) per log-odds increase in risk of VTE, P =0.002). However, sensitivity analyses revealed this association was predominantly driven by a variant proxying non-O blood group, with inadequate evidence from Mendelian randomisation to suggest a causal relationship. Conclusions:These findings do not support the hypothesis that genetically-proxied lifetime risk of VTE is a cause of cancer. Existing observational epidemiological associations between VTE and cancer are therefore more likely to be driven by pathophysiological changes which occur in the setting of active cancer and anti-cancer treatments. Further work is required to explore and synthesise evidence for these mechanisms.

KEY MESSAGES: 1) There is strong observational evidence that active cancer is associated with venous thromboembolism.2) It is currently unknown whether venous thromboembolism is a risk factor for cancer.3) We applied a bi-directional Mendelian randomisation framework to appraise the causal relationships between genetically-proxied risk of venous thromboembolism and 18 different cancers.4) Overall, there was no clear evidence from Mendelian randomisation that lifetime-elevated risk of venous thromboembolism is causally associated with an increased risk of cancer, or visa versa.

PMID:37292802 | PMC:PMC10246038 | DOI:10.1101/2023.05.16.23289792

19:19

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

19:19

In reply to this message

PubMed articles on: Cancer & VTE/PE

Stroke Recurrence in Embolic Stroke of Undetermined Source Without Atrial Fibrillation on Invasive Cardiac Monitoring

Heart Lung Circ. 2023 Jun 6:S1443-9506(23)00514-0. doi: 10.1016/j.hlc.2023.05.010. Online ahead of print.