Context. Although several studies have evaluated the frequency of adverse drug reactions (ADRs) and drug-drug interactions (DDIs) in general medicine, few studies have looked at the epidemiology of adverse drug events (ADEs) in oncology. Objectives. We sought to investigate how many hospital admissions in oncology are related to a DDI or an ADR. Methods. All cancer patients admitted to an oncology ward during an eight-month period had their charts retrospectively evaluated for reasons of hospitalization, using a 4-point scale (definitely, probably, possibly, or unlikely associated) to classify admissions by their probability of being associated with either a DDI or an ADR. Results. From September 2007 to May 2008, there were 550 hospital admissions and 458 were eligible. Among unplanned admissions (n = 298), 39 (13.0%, 95% confidence interval [CI] 9.4%-17.4%) were considered to be associated with an ADE, 33 (11.0%, 95% CI 7.7%-15.2%) with an ADR, and six (2.0%, 95% CI 0.7%-4.3%) with a DDI. The most common DDIs involved warfarin, captopril, and anti-inflammatory agents, and the most frequent ADR was neutropenic fever post-chemotherapy. Most patients were discharged completely recovered, but two patients died. Conclusion. Approximately one in 10 unplanned hospitalizations of cancer patients is associated with an ADE. Prospective and population-based studies are warranted to evaluate their magnitude in oncology. J Pain Symptom Manage 2011;42:342-353. (C) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Foi realizada uma revisão integrativa da literatura com o objetivo de caracterizar as pesquisas na área de enfermagem oncológica. O levantamento bibliográfico abrangeu as publicações nacionais em enfermagem oncológica, de 1980 a 2004, disponível nos bancos de dados Lilacs e BDENF. Foram identificados 91 artigos, dos quais 84 compuseram a amostra final do estudo. A análise dos estudos permitiu identificar que os mesmos foram publicados com maior freqüência na Revista Brasileira de Cancerologia e que as publicações se intensificaram após o ano 2000. Em relação à identificação dos autores, a maioria é docente (41,5%); 85,3% dos pesquisadores são enfermeiros; 33,4% procedem da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo e da Universidade Federal de São Paulo. Os estudos, em sua maioria, foram desenvolvidos na região Sudeste e 52,4% deles foram localizados na base de dados Lilacs; as palavras-chave mais utilizadas foram enfermagem e câncer (72,6%); 66,7% dos estudos apresentaram os objetivos de forma clara, 23,8% não apresentaram objetivos, 9,5% não apresentaram adequadamente os objetivos e 19,0% eram derivados de dissertação ou tese. Entre os desenhos de pesquisa, 36,9% utilizaram a abordagem metodológica qualitativa e 21...

Atualmente o câncer e a terceira causa de óbitos em ambos os sexos e em todas as faixas de idade. O Ministério da Saúde relata que a alta complexidade da atenção ontológica demanda alto custo financeiro e alta tecnologia. Cada vez mais, as atividades de pesquisa, prevenção, diagnóstico e tratamento do câncer são realizadas sobre um domínio multidisciplinar envolvendo medicina, química, genética, bioinformática e engenharia. Estas atividades são responsáveis por gerar e manipular grandes quantidades de dados que são geograficamente distribuídos entre as unidades de tratamento deste país. Estes dados necessitam ser integrados e processados, a sua utilização é empregada para melhorar a gestão e viabilizar colaborações de pesquisa entre as instituições do setor. O processamento destas informações demandaria grande capacidade computacional. Particularmente, verificamos que a bioinformática manipula uma grande quantidade de dados, e tem cada vez mais contribuído para a pesquisa e no diagnóstico de várias doenças, principalmente do câncer. A proposta desta dissertação consiste na pesquisa e desenvolvimento de uma infra-estrutura computacional baseada na tecnologia de grades computacionais para atender as demandas de alto processamento computacional...

Trata-se de um estudo qualitativo, com a utilização da perspectiva sociológica do conhecimento e da educação, que teve como objetivo interpretar os significados de ser Enfermeiro Especialista em Oncologia, entre os egressos do Curso de Especialização em Enfermagem em Oncologia, da Escola de Enfermagem de Ribeirão Preto, da Universidade de São Paulo. Foram entrevistados 20 profissionais atuantes na área de enfermagem oncológica, egressos da primeira, segunda e terceira turmas da especialização. A cole ta de dados ocorreu no período de março/2008 a janeiro/2009, no ambiente de trabalho de cada participante. Utilizamos o referencial metodológico do estudo de caso instrumental, do método do relato oral pontual, e da técnica de entrevista semi-estruturada. Para apreender os significados analisamos os dados por meio da análise de conteúdo indutivo. Primeiramente, os dados foram organizados e codificados em núcleos de sentidos; a seguir, construímos os três núcleos temáticos: a trajetória do enfermeiro em busca da especialização em oncologia, a prática do especialista em oncologia: o universo novo e ser enfermeiro especialista em oncologia: a construção da nova identidade, pelos quais obtivemos a compreensão do fenômeno. No primeiro núcleo temático...

Introdução: Os ambulatórios de oncologia vêm atendendo, a cada dia, um número crescente de pacientes que necessitam de cuidados clínicos complexos; todavia, boa parte desses serviços não possui informações que possam dar suporte às decisões relativas ao dimensionamento de profissionais de enfermagem. Objetivos: Identificar e analisar as intervenções / atividades realizadas pelos profissionais de enfermagem e definir parâmetros para dimensionar o quadro de pessoal de enfermagem em ambulatório especializado em oncologia e hematologia. Método: Pesquisa metodológica de campo que utiliza a técnica de amostragem de trabalho realizada em um ambulatório de oncologia e hematologia de uma organização de saúde privada localizada na cidade de São Paulo. Os dados foram coletados de 15 a 19 de abril de 2013 e foram organizados nas etapas seguintes: (1) Construção do instrumento de medida da frequência e do tempo despendido em intervenções de enfermagem; (2) Validação das intervenções / atividades do instrumento; (3) Identificação da frequência e do tempo despendido pelos profissionais de enfermagem em intervenções / atividades; (4) Dimensionamento de profissionais de enfermagem em ambulatório de oncologia e hematologia. Resultados: O instrumento construído e validado englobou 34 intervenções e três atividades. Foram registradas pelos observadores de campo 3694 observações dos profissionais de cada categoria na execução das intervenções / atividades de enfermagem. A documentação foi a intervenção que despendeu maior tempo da equipe (24...

Introdução: O trabalhador de enfermagem que passa por afastamento de trabalho por transtorno mental enfrenta preconceitos e dificuldades, desde seu adoecimento e afastamento até o momento que retorna ao trabalho. As dificuldades e limitações sentidas para realizar as atividades e se reinserir na equipe de trabalho, ainda, são pouco estudadas, evidenciando a necessidade de uma maior compreensão sobre a problemática. Objetivo: O presente estudo teve por objetivo analisar a percepção dos trabalhadores de enfermagem oncológica afastados por transtornos mentais, sobre o retorno ao trabalho e elaborar propostas de intervenção que facilitem este retorno. Metodologia: O estudo foi desenvolvido na linha compreensiva e na abordagem qualitativa. A população foi de 564 trabalhadores de enfermagem de um hospital especializado em oncologia no Estado de São Paulo. A amostra intencional foi constituída por oito trabalhadores de enfermagem, sendo seis mulheres e dois homens, incluindo as categorias profissionais de técnicos de enfermagem e enfermeiros, que atenderam ao critério de inclusão, ou seja, que retornaram de afastamento por transtorno mental há, no máximo, seis meses. Após aprovação do projeto pelo Comitê de Ética...

Objective: several studies have examined the academic production of the researchers at the CNPq, in several areas of knowledge. The aim of this study was to evaluate the scientific production of researchers in Hematology/Oncology who hold scientific productivity grants from the Brazilian Council for Scientific and Technological Development. Methods: the Academic CVs of 28 researchers in Hematology/Oncology with active grants in the three-year period from 2006 to 2008 were included in the analysis. The variables of interest were: institution, researchers’ time after doctorate, tutoring of undergraduate students, masters and PhD degree, scientific production and its impact. Results: from a total of 411 researchers in Medicine, 28 (7%) were identified as being in the area of Hematology/Oncology. There was a slight predominance of males (53.6%) and grant holders in category 1. Three Brazilian states are responsible for approximately 90% of the researchers: São Paulo (21...

Objective Construct and to validate an instrument for measuring the time spent by nursing staff in the interventions/activities in Outpatient Oncology and Hematology, interventions based on Nursing Interventions Classification (NIC), for key areas of Pediatric Oncology and Oncology Nursing. Methods Cross-sectional study divided into two steps: (1) construction of an instrument to measure the interventions/Nursing activities and (2) validation of this instrument. Results We selected 32 essential interventions from NIC for Pediatric Oncology and Oncology Nursing areas. The judges agreed with removing 13 and including 6 interventions in the instrument, beyond personal activity. Conclusion The choice of essential interventions from NIC is justified by the gain time on research.

Several challenging and often controversial issues arise in oncology trials with the use of the end point progression-free survival (PFS), defined to be the time to detection of progressive disease or death. While this end point does not directly measure how a patient feels, functions, or survives, it does provide insights about whether an intervention affects the tumor burden process, the intended mechanism through which it is hoped that most anticancer agents will provide benefit. However, simply achieving statistically significant effects on PFS is insufficient to obtaining reliable evidence of important clinical benefit, and even is insufficient to justifying the conclusion that the experimental intervention is “reasonably likely to provide clinical benefit.” The magnitude of the effect on PFS in addition to the statistical strength of evidence is of great importance in interpreting the reliability of the evidence regarding clinical efficacy. PFS has several important properties, including being a direct measure of the effect of treatment on the tumor burden process, being sensitive to cytostatic as well as cytotoxic mechanisms of interventions, and incorporating the clinically relevant event of death, increasing its sensitivity to influential harmful mechanisms and avoiding substantial bias that arises when deaths are censored. To obtain reliable evidence about the effect of an intervention on PFS and patient survival...

Productivity measurement for physician assistants and nurse practitioners can be challenging. This study quantifies their productivity in oncology according to economic indicators such as charges and work relative value units.

Most large academic radiation oncology practices have incorporated electronic health record systems into practice and plan to meet meaningful use requirements. Further work should focus on needs of smaller practices, and specific guidelines may improve widespread adoption.

In this, the seventh iteration of the National Practice Benchmark, the authors made significant changes in the approach and analysis of the survey, including restructuring and shortening the survey instrument to facilitate the participation of hospital and academic oncology practices, in recognition of the ongoing changes in the oncology industry.

A United Kingdom–wide appreciation of the systemic failings of emergency cancer care led to the creation of a new subspecialty, acute oncology. It was meant to bridge the gap between admitting teams, oncology, and palliative care, providing support to manage the symptoms of cancer, the side effects of cancer treatment, and people presenting with cancer of unknown primary origin. This article identifies the reasons for the creation of acute oncology and explores various models for this aspect of cancer care worldwide. With health care budgets static and demand increasing, the article also identifies ways in which acute oncology can contribute to an efficient and caring health system.

Cardio-oncology is a relatively new discipline that focuses on the cardiovascular sequelae of anti-tumour drugs. As any other young adolescent discipline, cardio-oncology struggles to define its scientific boundaries and to identify best standards of care for cancer patients or survivors at risk of cardiovascular events. The International Colloquium on Cardio-Oncology was held in Rome, Italy, 12–14 March 2014, with the aim of illuminating controversial issues and unmet needs in modern cardio-oncology. This colloquium embraced contributions from different kind of disciplines (oncology and cardiology but also paediatrics, geriatrics, genetics, and translational research); in fact, cardio-oncology goes way beyond the merging of cardiology with oncology. Moreover, the colloquium programme did not review cardiovascular toxicity from one drug or the other, rather it looked at patients as we see them in their fight against cancer and eventually returning to everyday life. This represents the melting pot in which anti-cancer therapies, genetic backgrounds, and risk factors conspire in producing cardiovascular sequelae, and this calls for screening programmes and well-designed platforms of collaboration between one key professional figure and another. The International Colloquium on Cardio-Oncology was promoted by the Menarini International Foundation and co-chaired by Giorgio Minotti (Rome)...

The work has as study object the relation between the public sector and private in oncology care and their implications for strengthening the capital project, and as general aim to review how the private sector has benefited from the oncology care policy in Brazil .There was, initially, a study about the relation State and Capital, explaining the changes in the capitalist mode of production, in the political and economic structures from the contemporary crisis of the capital, identifying the conflict relationship between these two sectors. For Research Development, it was used as methodological resource the literature search and the documentary research. The documentary research and the analysis were developed from primary sources data, official sources and organs of the nationally disseminate press. The period for gathering quantitative data side has been from 1998 to 2007. The historical-critical dialectic perspective is the referential used for research and for the exposure of the object studied. To qualify the public and private terms, it was taken as starting point the writings of classic authors such as Hannah Arendt, Habermas and Norberto Bobbio, and as analyzing reference the writings of contemporary Marxists authors, especially the theoretical contribution of Antonio Gramsci. It was then described the relation between public and private sectors in Brazilian healthy policy...

AIM: Colorectal cancer (CRC) is one of the most common malignancies worldwide and adjuvant chemotherapy is proven to improve survival in patients with Dukes' C CRC. The purpose of this study was to analyze factors influencing referral to medical oncology in patients with Dukes' C colonic cancer in our institutions. METHODS: Patients who underwent resection for Dukes' C colonic cancer were assessed for factors that influence the pattern of postoperative referral to the medical oncology department, including demographic and perioperative data. RESULTS: Overall, 466 patients were identified to have Dukes' C colonic cancer, with 53.9% of these being female. Referral to medical oncology occurred for 58.4% patients. Multivariable logistic regression modeling identified age, elective admission and resection in private hospitals as factors. The likelihood of medical oncology referral in patients who had elective resection was 63% versus 41% in those who had emergency resection and resection in private hospitals was 69% versus 50% in public hospitals. CONCLUSION: Referral to a postoperative medical oncology clinic for adjuvant chemotherapy in Dukes' C colonic cancer was more likely in younger patients, those who underwent elective resection and those treated in private hospitals.; Cu-Tai Lu...

The authors revise last year's predictions and project for the next 3 years, outlining a conceptual framework for contemplating the data based on an ecological model of the oncology delivery system.

The authors demonstrate through the example of single brain metastases in Ontario that it is feasible to perform explicit needs-based resource planning in radiation oncology.

Purpose: Rehabilitation is increasingly recognized as an important therapeutic intervention for people with cancer. The main objective of this study was to explore the current practice pattern and provision of oncology rehabilitation in Canada. Methods: A descriptive cross-sectional online survey was administered to Canadian facilities offering cancer treatment and/or listed as offering rehabilitation services during or after cancer treatment (cancer centres, rehabilitation hospitals, community centres, and private clinics). Results: Of the 116 sites contacted, 62 completed the questionnaire, 20 of which reported having an oncology rehabilitation programme. The majority of respondents indicated that they are not meeting their clients' rehabilitation needs. Rehabilitation programmes were provided by multidisciplinary health care teams, the majority of which included a physiotherapist. Funding and availability of resources were identified as the main barriers to the development of oncology rehabilitation programmes. Conclusions: Formal oncology rehabilitation programmes appear to be scarce, despite growing evidence that rehabilitation offers benefits across the cancer survivorship continuum.

Background and Objectives: Work on the oncology department has proved to be very stressful, so the medical staff indirectly copes with it by trying to escape it through the ego-defense mechanisms. On the other hand, working on the physical medicine department does not seem to be so stressful. The objective of this study was to determine the main ego- defense mechanisms at oncology and physical medicine department and to explain the differences between their frequencies. The other part was to obtain data about socio- demographic status and working environment of the participants. Methods: General structural interview for collecting data on socio-demographic status and working environment and Life Style Questionnaire and Defense Mechanisms for obtaining data about ego-defense mechanisms were carried out among a random sample of 40 medical staff members at each department. Results: A significantly higher level (p≤.05) of the following ego-defense mechanisms has been found at the oncology department: regression, intellectualization, projection and dislocation. Also, statistically significant difference (p≤.05), showing higher score on oncology department is observed in following variables: death of patients, facing the patient or his family with possible death...