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Student nurses knowledge about the management of chemotherapy-induced neutropenia: Multi-national survey
دانش پرستاران دانشجویی در مورد مدیریت نوتروپنی ناشی از شیمی درمانی: مرور چند ملیتی-2021 Background: Chemotherapy-induced neutropenia is a serious global health concern. It is essential that student
nurses who are the future of healthcare are equipped with the right knowledge to care for the unique needs of
patients with neutropenia.
Objective: The study assesses student nurses’ knowledge of neutropenia management and examines the difference in their knowledge with regard to their demographics. Design: A descriptive cross-sectional survey design was used. Settings: Participants for this survey were recruited from four nursing schools from three countries: Jordan, Oman, and Saudi Arabia. Participants: The study sample comprised 230 student nurses representing all three countries. Methods: Online data collection was implemented. A message including the link to the study questionnaire was sent to students through their university portal. Demographic data and the neutropenia knowledge questionnaire were collected. Results: The student nurses showed poor knowledge of neutropenia and its management (mean = 10.1 out of 30). The bridging students (M = 12.6, SD = 9.8) had significantly higher mean total knowledge scores than the regular students (M = 9.8, SD = 5.5) (t = 2.9, df = 38.9, p = 0.006). However, students who had received previous education about neutropenia management (M = 11.6, SD = 5.0) had significantly higher mean knowledge scores than those who had not (M = 9.5, SD = 5.6) (t = − 2.73, df = 134.8, p = 0.007). Conclusions: The study findings underscore the overarching necessity to improve students’ knowledge of neutropenia and its management. However, addressing this concern is multifaceted and requires deliberate effort from various agencies. Developing innovative strategies to increase the coverage of oncology nursing in the curriculum, improving faculty expertise, enhancing staff nurses’ knowledge and skills, provision of funding, and adoption of oncology-related competencies in the nursing program need to be explored as key solutions. keywords: دانش | نوتروپنی | نوتروپنی ناشی از شیمی درمانی | دانش آموزان: پرستاری | پرستاری انکولوژی | نئوپلاسم | Knowledge | Neutropenia | Chemotherapy-induced febrile neutropenia | Students: nursing | Oncology nursing | Neoplasm |
مقاله انگلیسی |
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Prediction of irinotecan toxicity in metastatic colorectal cancer patients based on machine learning models with pharmacokinetic parameters
پیش بینی سمیت ایرینوتکان در بیماران مبتلا به سرطان روده بزرگ متاستاتیک بر اساس مدل های یادگیری ماشین با پارامترهای فارماکوکینتیک-2019 Irinotecan (CPT-11) is a drug used against a wide variety of tumors, which can cause severe toxicity,
possibly leading to the delay or suspension of the cycle, with the consequent impact on the prognosis of
survival. The main goal of this work is to predict the toxicities derived from CPT-11 using artificial intelligence
methods.
The data for this study is conformed of 53 cycles of FOLFIRINOX, corresponding to patients with
metastatic colorectal cancer. Supported by several demographic data, blood markers and pharmacokinetic
parameters resulting from a non-compartmental pharmacokinetic study of CPT-11 and its metabolites
(SN-38 and SN-38-G), we use machine learning techniques to predict high degrees of different
toxicities (leukopenia, neutropenia and diarrhea) in new patients.
We predict high degree of leukopenia with an accuracy of 76%, neutropenia with 75% and diarrhea
with 91%. Among other variables, this study shows that the areas under the curve of CPT-11, SN-38 and
SN-38-G play a relevant role in the prediction of the studied toxicities.
The presented models allow to predict the degree of toxicity for each cycle of treatment according to
the particularities of each patient. Keywords: Colorectal cancer | Irinotecan | Machine learning | Pharmacokinetics | Toxicity |
مقاله انگلیسی |
3 |
Infections after Transplantation of Bone Marrow or Peripheral Blood Stem Cells from Unrelated Donors
عفونت بعد از پیوند مغز استخوان و یا محیطی سلول های بنیادی خون از اهداکنندگان غیروابسته-2016 Infection is a major complication of hematopoietic cell transplantation. Prolonged neutropenia and graftversus-host disease are the 2 major complications with an associated risk for infection, and these complications differ according to the graft source. A phase 3, multicenter, randomized trial (Blood and Marrow
Transplant Clinical Trials Network [BMT CTN] 0201) of transplantation of bone marrow (BM) versus
peripheral blood stem cells (PBSC) from unrelated donors showed no significant differences in 2-year
survival between these graft sources. In an effort to provide data regarding whether BM or PBSC could
be used as a preferential graft source for transplantation, we report a detailed analysis of the infectious
complications for 2 years after transplantation from the BMT CTN 0201 trial. A total of 499 patients in this
study had full audits of infection data. A total of 1347 infection episodes of moderate or greater severity
were documented in 384 (77%) patients; 201 of 249 (81%) of the evaluable patients had received a BM graft
and 183 of 250 (73%) had received a PBSC graft. Of 1347 infection episodes, 373 were severe and 123 were
life-threatening and/or fatal; 710 (53%) of these episodes occurred on the BM arm and 637 (47%) on the
PBSC arm, resulting in a 2-year cumulative incidence 84.7% (95% confidence interval [CI], 79.6 to 89.8) for
BM versus 79.7% (95% CI, 73.9 to 85.5) for PBSC, P ¼ .013. The majority of these episodes, 810 (60%), were
due to bacteria, with a 2-year cumulative incidence of 72.1% and 62.9% in BM versus PBSC recipients,
respectively (P ¼ .003). The cumulative incidence of bloodstream bacterial infections during the first
100 days was 44.8% (95% CI, 38.5 to 51.1) for BM versus 35.0% (95% CI, 28.9 to 41.1) for PBSC (P ¼ .027). The
total infection density (number of infection events/100 patient days at risk) was .67 for BM and .60 for
PBSC. The overall infection density for bacterial infections was .4 in both arms; for viral infections, it was
.2 in both arms; and for fungal/parasitic infections, it was .04 and .05 for BM and PBSC, respectively. The
cumulative incidence of infection before engraftment was 47.9% (95% CI, 41.5 to 53.9) for BM versus 32.8%
(95% CI, 27.1 to 38.7) for PBSC (P ¼ .002), possibly related to quicker neutrophil engraftment using PBSC. Infections remain frequent after unrelated donor hematopoietic cell transplantation, particularly
after BM grafts.
Key Words: Infection | Unrelated donor | transplantation | Bacteremia | Cytomegalovirus | Aspergillosis | Pre-engraftment |
مقاله انگلیسی |