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Patients and healthcare professionals' perspectives on the implementation of shared decision making in multiple myeloma: a multinational qualitative study.

BACKGROUND: Shared decision making (SDM) is highly relevant in oncology and cancer care, yet its application within multiple myeloma (MM) remains underexplored. This study aims to (1) investigate SDM implementation in MM clinical practice, (2) assess the role of various stakeholders next to haematologists in the SDM process, and (3) identify barriers and potential solutions to SDM implementation in MM care. METHODS: This qualitative study consisted of semi-structured interviews with patients (n = 39), haematologists (n = 15), and haematology nurses (n = 5) from nine countries in Europe and Is

Prevalence, Attributes, and Risk Factors of QT-Interval-Prolonging Drugs and Potential Drug-Drug Interactions in Cancer Patients: A Prospective Study in a Tertiary Care Hospital.

Introduction Cancer chemotherapy regimens include multiple classes of adjuvant drugs as supportive therapy. Because of the concurrent intake of other drugs (like antiemetics, antidepressants, analgesics, and antimicrobials), there is a heightened risk for possible QT interval prolongation. There is a dearth of evidence in the literature regarding the usage of QT-prolonging anticancer drugs and associated risk factors that have the propensity to prolong QT interval. The purpose was to explore the extent of the use of QT-interval-prolonging drugs and potential QT-prolonging drug-drug interaction

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… Oncologists, cardiologists, and general practitioners should be mindful of this hazard. Proactive cardiotoxicity monitoring with ECG (concurrently with echocardiogram and/or stress testing in suspected cases) during treatment is advocated [ 55 ]. … An integrative and algorithmic surveillance mechanism with the inclusion of oncologists, cardiologists, general practitioners, and clinical pharmacologists/pharmacists is imperative to optimize drug therapy and minimize detrimental medication effects in patients afflicted with cancer. …

Artificial intelligence-derived left ventricular strain in echocardiography in patients treated with chemotherapy.

Global longitudinal strain (GLS) is an echocardiographic measure to detect chemotherapy-related cardiovascular dysfunction. However, its limited availability and the needed expertise may restrict its generalization. Artificial intelligence (AI)-based GLS might overcome these challenges. Our aims are to explore the agreements between AI-based GLS and conventional GLS, and to assess whether the agreements were influenced by expertise levels, cardiac remodeling and cardiovascular diseases/risks. Echocardiographic images in the apical four-chamber view of left ventricle were retrospectively analyz

The importance of pathways to facilitate early diagnosis and treatment of patients with cardiac amyloidosis.

Cardiac amyloidosis (CA) is a condition caused by extracellular deposition of amyloid fibrils in the heart. It is an underdiagnosed disease entity which can present with a variety of cardiac and non-cardiac manifestations. Diagnosis usually follows an initial suspicion based on clinical evaluation or imaging findings before confirmation with subsequent imaging (echocardiography, cardiac magnetic resonance imaging, 3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy) in combination with biochemical screening for monoclonal dyscrasia (serum free light chains and serum and urine electrophor

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… initially been referred with heart failure or a suspicion of hypertrophic cardiomyopathy, as well as patients presenting with incidental findings. 42 These types of studies are important as they provide a framework for constructing clinical pathway decision tools that can be used to potentially aid cardiologists …

CAR-T cell therapy for multiple myeloma: a practical toolkit for treatment in Brazil.

IntroductionChimeric antigen receptor T (CAR-T) cell therapy is an emerging treatment option for relapsed/refractory multiple myeloma (RRMM) that is a multi-step process involving various stakeholders. Appropriate education on the practical logistics is therefore paramount to ensure treatment success.MethodsA group of key opinion leaders met to explore the key elements of setting up and running a CAR-T center in Brazil. For each step in the CAR-T cell therapy process, the experts agreed on basic requirements, gave their key recommendations from practical experience, and considered any remainin

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… It can be useful to include cardiologists. Overcoming common challenges The accreditation process can be lengthy (18–24 months), so centers should prepare for this step in advance. Alt-text: Unlabelled box 2. …

Показатели качества в системном склерозе

Повышение качества - это новая область, в которой применяются принципы совершенствования науки и используются методы измерения в целях улучшения ухода за пациентами. Системный склероз (SSc) — системное аутоиммунное ревматическое заболевание, связанное с увеличением нагрузки на здравоохранение, расходов, заболеваемости и смертности. Неоднократно отмечаются пробелы в оказании медицинской помощи пациентам, страдающим SSc. В этой статье мы введем дисциплину повышения качества и использования показателей качества. Мы резюмируем и сравнительно оцениваем three - наборы качественных показателей, котор

Clusters of Comorbidities in the Short-Term Prognosis of Acute Heart Failure among Elderly Patients: A Retrospective Cohort Study.

Background and Objectives: Elderly patients affected by acute heart failure (AHF) often show different patterns of comorbidities. In this paper, we aimed to evaluate how chronic comorbidities cluster and which pattern of comorbidities is more strongly related to in-hospital death in AHF. Materials and Methods: All patients admitted for AHF to an Internal Medicine Department (01/2015−01/2019) were retrospectively evaluated; the main outcome of this study was in-hospital death during an admission for AHF; age, sex, the Charlson comorbidity index (CCI), and 17 different chronic pathologies were i

Diagnostic and Prognostic Values of Cardiopulmonary Exercise Testing in Cardiac Amyloidosis.

Cardiac amyloidosis (CA) is a myocardial disease characterized by extracellular amyloid infiltration throughout the heart, resulting in increased myocardial stiffness, and restrictive heart wall chamber behavior. Its diagnosis among patients hospitalized for cardiovascular diseases is becoming increasingly frequent, suggesting improved disease awareness, and higher diagnostic capacities. One predominant functional manifestation of patients with CA is exercise intolerance, objectified by reduced peak oxygen uptake (VO2 peak), and assessed by metabolic cart during cardiopulmonary exercise testin

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… The aim of the present review, addressed to clinicians and cardiologists, is to describe the utility of cardiopulmonary exercise testing (CPET) as an aid to patient orientation and clinical decision-making in CA management. …

Stress cardiomyopathy in hospitalized patients with cancer: machine learning analysis by primary malignancy type.

AimsPrevious studies have shown that patients with stress (Takotsubo) cardiomyopathy (SC) and cancer have higher in-hospital mortality than patients with SC alone. No studies have examined outcomes in patients with active cancer and SC compared to patients with active cancer without SC. We aimed to assess the potential association between primary malignancy type and SC and their shared interaction with inpatient mortality.Methods and resultsWe analysed SC by primary malignancy type with propensity score adjusted multivariable regression and machine learning analysis using the 2016 United State

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… In our study, we placed special focus on patients with cancer in general, from the perspective of internists, cardiologists, and oncologists who regularly encounter a patient population with malignancy. …

Structured benefit-risk evaluation for medicinal products: review of quantitative benefit-risk assessment findings in the literature.

A favorable benefit-risk profile remains an essential requirement for marketing authorization of medicinal drugs and devices. Furthermore, prior subjective, implicit and inconsistent ad hoc benefit-risk assessment methods have rightly evolved towards more systematic, explicit or "structured" approaches. Contemporary structured benefit-risk evaluation aims at providing an objective assessment of the benefit-risk profile of medicinal products and a higher transparency for decision making purposes. The use of a descriptive framework should be the preferred starting point for a structured benefit-

Anthracycline-Induced Cardiotoxicity in Breast Cancer Patients from Southern Sri Lanka: An Echocardiographic Analysis.

Anthracycline-induced cardiotoxicity has never been investigated in Sri Lanka. Therefore, this study was conducted to determine the prevalence of anthracycline-induced cardiotoxicity in breast cancer patients using echocardiographic findings. A prospective cohort study was performed. All newly diagnosed breast cancer patients who were administered with anthracycline and cyclophosphamide (AC schedule) for the first time were enrolled in the study. In the hospital setting, anthracycline is administered only as a combination therapy, and only this combination was selected to limit the effect of o

High levels of serum β2-microglobulin predict severity of coronary artery disease.

BackgroundThe identification of new risk factors for coronary artery disease (CAD) is increasingly sought in an effort to tackle this threatening disease. β2-microglobulin (B2M) is reported to associate with peripheral arterial disease and adverse cardiovascular outcomes. However, the association between B2M and cardiovascular disease remains under-researched. This study evaluated the effects of B2M on CAD without renal dysfunction.MethodsOne thousand seven hundred sixty-two subjects (403 non-CAD subjects and 1,359 CAD subjects) were investigated. Fasting samples were collected to determine B2

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… Coronary angiography Two experienced interventional cardiologists (M.D. and M.G.K.) measured quantitative coronary angiography using the standard Judkins approach. Both had no knowledge of subjects’ clinical information. …

Abstracts from the World Congress of Cardiology/Brazilian Congress of Cardiology 2022

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… All echocardiograms were independently reviewed by an adjudication panel which consisted of four expert pediatric cardiologists to determine maximum MR jet length and diagnosis (RHD positive or not). Among 95 cases, 29 were normal and 66 had RHD. … Conclusion: Our automatic method has the potential to reliably detect RHD as accurately as expert cardiologists. …

Interdisciplinary Multidimensional Assessment of Transthyretin Amyloidosis before and after Tafamidis.

BackgroundClinically, there is considerable heterogeneity in the presentation of transthyretin amyloidosis (ATTR), which ranges from primarily cardiac and primarily neurologic to mixed disease, among other manifestations. Because of this complex presentation, the diagnosis and management of patients with ATTR are often challenging and should be performed in interdisciplinary centers specialized in amyloidosis. Here, we aimed to increase awareness of ATTR detection and pathophysiology through a multidimensional multiorgan approach.Case reportWe reported on a 60-year-old man with wild-type ATTR

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… In this context, the Amyloidosis Expertise Center Utrecht has implemented an efficacious multidisciplinary clinical pathway: first, suspected patients are evaluated by a specialized team of cardiologists, hematologists, and neurologists. …

Real world data on light chain cardiac amyloidosis: Still a delayed diagnosis.

Cardiac amyloidosis (CA) represents a myocardial disorder developed by fibril deposition of a heterogeneous group of misfolding proteins. Despite being rare, a high clinical index of suspicion and novel advanced diagnostic methods seem to facilitate its early recognition. Currently nine types of cardiac amyloidosis have been described with AL and ATTR being the most common. Light chain amyloidosis (AL) is a life-threatening disease, resulting from clonal plasma cells that produce amyloidogenic light chain fragments causing organ damage including the heart. Morbidity and mortality of these pati

Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families.

BackgroundDespite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization. This study aims to synthesize knowledge on

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… D., et al., 2002 [ 89 ] To identify physicians’ characteristics associated to referral to PC Quantitative - Cross-sectional study 231 physicians (internists, family physicians, oncologists, pulmonologists, and cardiologists) - USA Questionnaire 7 Broom, A., Kirby, E. et al., 2012 [ 25 ] To examine the … D., et al., 2002 [ 89 ] | To identify physicians’ characteristics associated to referral to PC | Quantitative - Cross-sectional study | 231 physicians (internists, family physicians, oncologists, pulmonologists, and cardiologists) - USA | Questionnaire 7 | Broom, A., Kirby, E. et al., 2012 [ 25 ] | To …

Применение цифровых технологий для лечения хронических заболеваний: систематический обзор.

С учетом того, что на хронические заболевания приходится значительная доля предотвратимых смертей во всем мире, решающее значение имеет внедрение новаторских технологий для лечения и профилактики заболеваний. Цифровые близнецы (ДТ), представляющие one Наиболее передовые технологические решения позволяют в реальном масштабе времени осуществлять моделирование и мониторинг развития хронических заболеваний, облегчая индивидуализированные стратегии лечения и раннее вмешательство. В рамках этого систематического обзора изучаются текущие исследования по применению DT в области борьбы с хроническими з

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… patients (VPs), which are interactive, computer‐based simulations | Pilot/feasibility ( n < 50) 16 | Larkin A et al. [ 37 ] | 2020 | Prototype development and evaluation | Medical Education | Medical training and education | The aim was to evaluate whether a virtual patient simulation (VPS) can improve cardiologists … Among healthcare professionals, physicians were the most frequently targeted group, including specialists such as intensivists, transplant physicians, cardiologists, and radiologists. …

Efficacy and Safety of Low-Frequency Daratumumab Regimen in Systemic Light-Chain Amyloidosis.

In recent years, daratumumab has been increasingly applied in the treatment of systemic light-chain (AL) amyloidosis, significantly improving the prognosis of patients. Currently, the internationally recognized daratumumab treatment regimen comes from the ANDROMEDA trial. Given the low tumor burden and poor tolerance of patients with amyloidosis, in this study, we modified the ANDROMEDA-based protocol by administering daratumumab at half the original frequency. We enrolled 48 patients with AL amyloidosis who received low-frequency daratumumab in multiple hospitals from July 2021 to May 2024 (C

Cardiovascular risk in cancer patients: initial experience from a cardio-oncology clinic in Mexico.

OBJECTIVE: To describe the cardiovascular risk from Mexican patients scheduled to initiate cancer treatment and to compare the risk between oncological and hematological malignancies. METHODS: We enrolled patients referred for echocardiography before initiating cancer therapies. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) was evaluated. To estimate the risk for developing cancer therapy-related cardiovascular toxicity (CTR-CVT) we used the Heart Failure Association-International Cardio-Oncology Society risk score (HFA-ICOS). RESULTS: 106 patients were studi

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… A multidisciplinary team discussion between oncologists and cardiologists to balance the risk/benefit of cardiotoxic anticancer treatment before starting treatment in high and very-high-risk patients is recommended. …

Evaluation of Subclinical Cancer Therapy-Related Cardiac Dysfunction in Patients Undergoing Hematopoietic Stem Cell Transplantation: An Echocardiography Study.

Background: Hematopoietic stem cell transplantation (HSCT) is a potentially curative procedure that is used in various hematological malignancies. However, among an increasing number of HSCT, the amount of cancer therapy-related cardiac dysfunction (CTRCD) is increasing as well. This study aimed to determine the prevalence of subclinical CTRCD in HSCT patients 12 months after HSCT and to assess the impact of clinical factors on the development of CTRCD. Material and Methods: We included 55 patients who underwent autologous or allogeneic HSCT. The patients were assessed using an echocardiograph