Background Skin rash remains one of the most prevalent and troublesome clinical problems experienced by patients on chemotherapy and targeted therapy. To ensure high-quality care, guidelines are seen as the best guidance. Considering the quality of guidelines varies greatly, a systematical appraisal of the methodological quality of guidelines for the management of skin rash in patients on chemotherapeutic drugs and targeted anticancer therapies was undertaken, in order to identify appropriate ones for healthcare professionals. Methods A systematic search of databases and Internet was conducted to obtain pertinent guidelines. Two reviewers independently assessed the eligibility of guidelines according to the inclusion criteria. Then the guidelines included were appraised by three researchers with the methodological quality of eligible guideline using Appraisal of Guidelines for Research and Evaluation II (AGREEII). Results Totally nineteen guidelines met the inclusion criteria. The quality ranged from good to acceptable in scope and purpose (mean: 78.80%, range: 66.67–94.44%) and clarity of presentation domains (mean: 85.38%, 75.00–91.67%), but not in stakeholder involvement (mean: 50.15%, range: 36.11–75.00%), rigor of development (mean: 23.65%, range: 6.25–70.83%), applicability (mean: 23.96%, range: 4.17–52.08%), and editorial independence domains (mean: 45.18%, range: 0.00–87.50%). Overall, two guidelines were classified as “recommended”. Conclusions Only two guidelines were recommended to manage skin rash in patients on chemotherapy and targeted therapies, most guidelines issued were of low to moderate quality. Thus, more attention should be paid to the methodological quality of guideline development in this field.
Background: Multiple myeloma (MM) extramedullary disease (EMD) is an invasive growth of-clonal plasma cells that, is characterized by myeloma cells escaping from the bone marrow microenvironment, entering the blood circulation and infiltrating and growing in other organs. Soft-tissue involvement was associated with significantly shorter progression-free survival and overall survival, with a poor prognosis and a median survival of 8.5 months. Among the sites involved in extramedullary lesions, the abdomen and back are rare. The prognosis of soft tissue masses located in extramedullary organs is the worst, and the treatment of soft tissue masses with enlargement of extramedullary lesions is still difficult because the poor effects of radio-chemotherapy. Case Presentation: We present an MM patient who experienced multiple skeletal-related events with EMD in the neck, chest, abdomen, and back after four surgical interventions, multiple cycles of chemotherapy and autologous peripheral blood stem cell transplantation, and surgical resection. Conclusions: MM with a large extramedullary plasma cell tumour often is not responsive to chemotherapy and radiotherapy. For continuously growing masses, surgical resection is recommended to reduce the tumour load, relieve pain, and relieve secondary vascular and nerve compression.
Purpose: The aims of this study were to understand the experiences of oncology nurses caring for patients with solid-tumor bone metastases and provide a theoretical basis for oncology nurses to formulate a standardized training and management system for patients with bone metastases,so as to improve the ability of patients to care for their own bone health. Methods: A phenomenological, qualitative study design with objective sampling was used. Semi-structured interviews were conducted with 12 oncology nurses in a third-grade a cancer hospital in Hebei Province from March to June 2022. Data collection and analysis proceeded simultaneously until data saturation was reached. The Colaizzi seven-step method of data analysis was used to analyze the data and refine the themes. Results: The experiences of oncology nurses caring for patients with solid-tumor bone metastases could be summarized into five themes: the oncology nurses have insufficient knowledge of the diseases of patients with solid-tumor bone metastases; Oncology nurses have a sense of weakness in managing patients with solid-tumor bone metastases; oncology nurses only pay attention to the primary disease and individual symptoms of patients with solid-tumor bone metastasis; oncology nurses hope to acquire more knowledge related to bone metastasis; and the role of oncology nurses in managing patients with solid-tumor bone metastases is ambiguous. Conclusion: The experiences of oncology nurses caring for patients with solid-tumor bone metastases are multi-dimensional. The interview results suggest that nursing managers need to strengthen nurse training related to bone metastases, formulate comprehensive and standardized nursing protocols for patients with bone metastases, and provide evidence-based support for nurses of patients with bone metastases. These changes could improve the self-management ability of bone health, delay the occurrence of skeletal-related events, and improve patient’ quality life.
Purpose: To compare the effects of peripherally inserted central catheters (PICC) and totally implantable venous access devices (port) in terms of complications and shoulder function in patients with malignant bone and soft tissue tumors of the lower limbs. Patients and methods: We analyzed 65 cases of port and 65 cases of PICC at the orthopedic department of the Fourth Hospital of Hebei Medical University. The two groups were compared in terms of catheter indwelling time, catheter-related complications, Constant-Murley shoulder function score, and displacement of the position of the catheter end on the catheterization side. Results: Compared to the PICC group, at six months after catheterization the port group showed better outcomes for catheter indwelling time, catheter-related complications, and Constant-Murley score for the catheterization-side shoulder joint (p < 0.05). The port group also showed less displacement of the catheter end position after 180° abduction of the catheterization-side shoulder joint (p < 0.05). Conclusion: Compared with PICC, port can prolong catheter indwelling time, reduce catheter-related complications, and maintain shoulder joint function, which makes it an ideal venous-access approach when providing chemotherapy to patients with malignant bone and soft tissue tumors of the lower limbs.
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