Febrile neutropenia studies in Brazil - treatment and cost management based on analyses of cases

Bellesso, Marcelo

doi:10.5581/1516-8484.20130002

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Though it remains unclear how this pain originates, it is believed to result from the accumulation of sickle-shaped red blood cells in capillaries obstructing and restricting blood flow into organs thereby causing pain, ischaemia and organ damage 9 . Moreover, this obstructive capillary blockage induces the recruitment of neutrophils and monocytes thereby promoting chronic pro-inflammatory response 10 . Reactive oxygen species (ROS) are often released and present in chronic inflammation thus, there is a possibility that oxidative stress may influence VOC observed in SCA individuals.…”

Section: Discussionmentioning

confidence: 99%

“…One of such complications is the vaso-occlusive crisis (VOC), a condition caused by the accumulation of sickle-shaped RBCs in capillaries obstructing and restricting blood flow into organs, thereby resulting in pain, ischaemia and often leads to organ damage 9 . This blockage of capillaries induces the recruitment of neutrophils and monocytes thereby promoting chronic pro-inflammatory response 10 . Inflammatory responses are usually accompanied by the action of reactive oxygen species (ROS) and thus, there is a possibility that VOC may be influenced by oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

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Relationship of oxidative stress and antioxidant response with vaso-occlusive crisis in sickle cell anaemia

et al. 2021

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Background: Though sickle cell anaemia (SCA) is known to promote oxidative stress, there is paucity of information on the relationship between oxidative stress and vaso-occlusive crisis (VOC). Objective: This study was undertaken to evaluate the relationship of oxidative stress and antioxidant response with VOC in SCA. Methods: A cross-sectional case-control study was carried out at University of Nigeria Teaching Hospital (UNTH), Itu- ku-Ozalla, Enugu Nigeria involving 116 individuals which included 36 SCA subject, 40 sickle cell carriers (AS) and 40 healthy individuals (AA). Baseline information as well as the frequency of VOC was obtained from the participants and anaemia as well as oxidative stress and antioxidant indices were assessed in blood. Results: Anaemia was prevalent (88.9 %) in SCA individuals compared to AS (52.5%) and AA (47.5 %) individuals. Nitric oxide scavenging (NOS) and superoxide dismutase (SOD) activities as well as glutathione level were significantly (p<0.005) lower while catalase activity was higher in SCA individuals compared to controls (AA and AS). Higher malondialdehyde (MDA) level was associated with very severe VOC while low level of NOS activity was associated with severe VOC in SCA individuals. Conclusion: Sickle cell anaemia exhibited oxidative stress and alteration in the levels of antioxidant indices which was pos- sibly associated with vaso-occlusive crisis. Keywords: Sickle cell anaemia; oxidative stress; antioxidant; vaso-occlusive crisis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship of oxidative stress and antioxidant response with vaso-occlusive crisis in sickle cell anaemia

et al. 2021

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“…(9) In the pediatric population, studies have demonstrated a wide range of costs per FN event, ranging from $511 to $16,341. (10)(11)(12)(13)(14)(15) In most cases, inpatient care costs were double that of outpatient treatment, with hospitalization being the primary cost driver, accounting for 62-83% of the total treatment cost per FN episode (10,16) Given the economic challenges faced by the Mexican public health care system, it is crucial to gather information regarding the costs associated with FN management strategies. Such data can assist decision-makers in promoting cost-effective health strategies.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Economic Implications of Step-Down Outpatient Management for Fever and Neutropenia Episodes in Pediatric Cancer Patients: A Cost Minimization Analysis

Avilés-Robles

López

2023

Preprint

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Background The management of febrile neutropenia (FN) in pediatric cancer patients has traditionally been conducted in a hospital setting. However, recent evidence has indicated that outpatient management of FN can be equally effective compared to inpatient care. Based on this evidence, we conducted a cost-minimization analysis (CMA) specifically focused on pediatric cancer patients in Mexico Methods The CMA was performed from a societal perspective using patient-level data derived from a previous noninferiority clinical trial that compared outpatient treatment to inpatient treatment for FN in children with cancer. Direct and indirect costs were collected prospectively. The costs were adjusted for inflation and converted to US dollars, with values standardized to August 2022 costs. Statistical analysis using bootstrap methods was employed to obtain robust estimations for decision-making within the Mexican public health care system. Results A total of 117 FN episodes were analyzed, with 60 in the outpatient group and 57 in the inpatient group; however, complete cost data were available for only 115 FN episodes. The analysis revealed an average savings of $1,087 per FN event managed on an outpatient basis, representing a significant reduction of 92% compared to inpatient treatment. Length of hospital stay and inpatient consultations emerged as the primary cost drivers within the inpatient care group Conclusion This CMA demonstrates that the step-down outpatient management approach is not only cost-effective but also cost-saving when compared to inpatient management of FN in pediatric cancer patients. The mean difference observed between the treatment groups provides support for decision-making within the public health care system, as outpatient management of FN allows for substantial cost savings without compromising patient health.

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“…Para adaptar-se ao novo ambiente em que a criança está inserida, o familiar precisa ser informado sobre os cuidados a serem realizados com a criança de acordo com as alterações do sistema imunológico. A educação em saúde é uma forma de orientar e solucionar as dúvidas a respeito do isolamento protetor, pois entende-se que o familiar sem informações pode exercer grande influência sobre o paciente e o andamento do tratamento a ser realizado (Bellesso, 2013).…”

Section: Introductionunclassified

Cuidado de enfermagem às crianças com leucemia em um hospital de alta complexidade

Oliveira

Santana

Pereira

et al. 2021

RSD

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Introdução: O câncer infantil é considerado uma doença rara, sendo progressiva e de grande relevância à saúde pública no país. Quando associado aos tumores, a leucemia é considerada a segunda causa de mortalidade principalmente na faixa etária de cinco a nove anos. A atuação do enfermeiro tem papel primordial na recuperação e na manutenção das condições saudáveis de vida da criança. Objetivo: Conhecer os cuidados prestados pela enfermagem às crianças com leucemia no ambiente hospitalar. Metodologia: Trata-se de uma pesquisa qualitativa de abordagem descritiva. Foi realizada na clínica oncológica pediátrica de um hospital filantrópico em Teresina-PI. Os sujeitos da pesquisa foram todos os enfermeiros e sete técnicos em enfermagem. Os dados foram colhidos nos meses de setembro a novembro de 2017, por meio de um roteiro de entrevista semiestruturada. Resultado: Participaram do estudo três enfermeiros e sete técnicos em enfermagem e, a partir dos relatos emergiram duas categorias temáticas: O acolhimento de enfermagem à criança com leucemia durante a internação; O incentivo da enfermagem para que as crianças com leucemia permaneçam internadas até a recuperação. Evidencia-se a utilização de estratégias para proporcionar bem-estar do binômio criança/família por meio do acolhimento em conjunto com a assistência humanizada; orientações quanto aos procedimentos que terão de passar no ambiente hospitalar; apoio aos familiares e a promoção do lazer da criança, horário para brincar. Conclusão: Este estudo contribuiu na ampliação dos conhecimentos da enfermagem sobre os cuidados prestados às crianças com leucemia, bem como na discussão e implementação de ações que possam promover a melhoria da qualidade de vida dessas crianças.

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Febrile neutropenia studies in Brazil - treatment and cost management based on analyses of cases

Cited by 9 publications

References 16 publications

Relationship of oxidative stress and antioxidant response with vaso-occlusive crisis in sickle cell anaemia

Relationship of oxidative stress and antioxidant response with vaso-occlusive crisis in sickle cell anaemia

Assessing the Economic Implications of Step-Down Outpatient Management for Fever and Neutropenia Episodes in Pediatric Cancer Patients: A Cost Minimization Analysis

Cuidado de enfermagem às crianças com leucemia em um hospital de alta complexidade

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