Experience With the Use of an Online Community on Facebook for Brazilian Patients With Gestational Trophoblastic Disease: Netnography Study

Diniz, Marisa Victória; Sun, Sue Yazaki; Barsottini, Claudia; Viggiano, Maurício; Filho, Roney Cesar Signorini; Pimenta, Bruna Sanches Ozane; Elias, Kevin M.; Horowitz, Neil S.; Braga, Antônio; Berkowitz, Ross S.

doi:10.2196/10897

Cited by 15 publications

(3 citation statements)

References 27 publications

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“…Nesse sentido, três experiências gerenciais em saúde exitosas podem ser aplicadas onde há longas distâncias entre a residência da paciente e o CR em NTG. A primeira está relacionada às informações clínicas disponibilizadas aos profissionais de saúde e pacientes por meio de redes sociais, capazes de compartilhar informações gerais sobre NTG de forma rápida e simples 28,29 . A segunda é a possibilidade de manter a vigilância clínica de pacientes com NTG por meio da telemedicina, seja por meio de consultas ponta a ponta com médicos (um especialista em NTG atende remotamente as pacientes com essa doença ao lado do seu médico de atenção primária e do oncologista local), ou por meio de consultas remotas intercaladas com atendimento presencial [30][31][32] .…”

Section: Discussionunclassified

Impacto da distância entre a residência da paciente e o centro de referência nos indicadores clínicos e de qualidade da assistência à saúde prestada às mulheres com neoplasia trofoblástica gestacional no Estado do Rio de Janeiro

Braga

França

2023

J bras Ginec

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Introdução: É a neoplasia trofoblástica gestacional doença rara e amplamente curável, mesmo em casos quimiorresistentes e multimetastáticos, em especial, se a paciente for tratada em centros de referência. Objetivo: Analisar a distância percorrida da residência da paciente até o centro de referência (CR) de neoplasia trofoblástica gestacional (NTG) e a ocorrência de desfechos clínicos desfavoráveis. Métodos: Estudo retrospectivo de coorte histórica de pacientes com NTG acompanhadas no CR-NTG do Estado do Rio de Janeiro, de 1º de janeiro de 2000 a 31 de dezembro de 2017. Resultados: Foram avaliados 462 casos de NTG tratados no CR-NTG do Estado do Rio de Janeiro. A distância mediana percorrida entre a residência da paciente e o CR no Estado do Rio de Janeiro foi de 50 quilômetros (KM). Nessa distância, houve associação significativa com desfechos mais desfavoráveis, incluindo atraso significativo no início da quimioterapia (3 versus 2 meses, p<0,01), maior ocorrência de início de tratamento fora do CR (10 versus 7%, p<0,01), tratamento em desacordo com os critérios da Federação Internacional de Ginecologia e Obstetrícia (FIGO) (7 versus 2%), ocorrência de doença metastática à apresentação (22 versus 7%, p<0, 01), escore FIGO 7–12 (23 versus 14%, p<0,01) e ≥13 (5 versus 1%, p<0,01), maior ocorrência de abandono do seguimento durante a quimioterapia (6 versus 2%, p<0,01), assim como de quimiorresistência (26% versus 6%, p<0,01), maior número de pacientes que receberam número incompleto de ciclos de quimioterapia de consolidação (71 versus 47%, p<0,01), maior ocorrência de recidiva (5,6 versus 0,4%, p<0,01) e óbito por NTG (4,6 versus 1,2, p<0,01), em relação aos que residiam <50 KM do CR-NTG no Estado do Rio de Janeiro, respectivamente. Conclusão: A distância entre a residência da paciente e o CR-NTG no Estado do Rio de Janeiro está associada com desfechos desfavoráveis, inclusive óbito por essa doença.

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Section: Discussionunclassified

Impacto da distância entre a residência da paciente e o centro de referência nos indicadores clínicos e de qualidade da assistência à saúde prestada às mulheres com neoplasia trofoblástica gestacional no Estado do Rio de Janeiro

Braga

França

2023

J bras Ginec

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“…We believe that this is mostly due to the creation of an online community on Facebook by the Brazilian Association of Gestational Trophoblastic Disease in 2013. This tool contributes to patient assistance by directing patients to treatment at a reference center, which acts as an access facilitator 17. Recently, the COVID-19 pandemic has promoted scientific advances in the use of telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine in post-molar follow-up: is it a useful tool?

Assis

Morais

Freitas

et al. 2022

Int J Gynecol Cancer

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BackgroundTelemonitoring is an alternative to in-person appointments and overcomes geographic distance barriers.ObjectiveThe primary objective of this study was to evaluate adherence to post-molar follow-up using both WhatsApp and in-person appointments compared with standard care. The secondary objective was to evaluate the rate of completion of post-molar follow-up of complete moles, considering 6 and 3 months of duration.MethodsThis retrospective cohort study was conducted at the Gestational Trophoblastic Disease Center, São Paulo Hospital. Patients with complete or partial mole treatment between January 1, 2009 and December 31, 2018 were included in two groups: group 1 (patients from 2009 to 2013) and group 2 (from 2014 to 2018), before and after telemonitoring implementation, respectively. Complete follow-up was considered if after the first normal human chorionic gonadotropin (hCG) level (<5 mIU/mL), the patient was followed up for an additional 30 days (partial mole) or 180 days (complete mole). Loss to post-molar follow-up with positive hCG was also evaluated. Statistical analysis was performed using Pearson’s Χ2 test, 5% significance level (p=0.05), and R version 4.0.2.ResultsA total of 308 patients were included in the study, 92 of them were assessed in group 1 and 216 patients in group 2. There was no difference between the rates of complete follow-up after telemonitoring implementation (complete mole: 42/72=58.3% group 1 vs 85/163=52.1% group 2; p=0.38; partial mole: 16/20=80% group 1 vs 37/53=69.8 group 2; p=0.3), and no increase of loss to post-molar follow-up with positive hCG (8/92=8.7% group 1 vs 14/216=6.5% group 2; p=0.49). The shortening of follow-up of complete moles to 90 days increased the rate of complete post-molar follow-up (from 127/235=54.0% to 189/235=80.4%, p<0.001).ConclusionsThe association of telemonitoring with in-person appointments could have had an advantage in post-molar follow-up since it did not reduce adherence to hormonal surveillance. Shortening post-molar follow-up after complete mole to 90 days after the first normal hCG level increased the rate of complete post-molar follow-up.

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“…Gestational trophoblastic diseases (GTDs), originated from trophoblast cells, are pregnancy-related diseases, including benign, partial, and complete hydatidiform moles (HM), and malignant moles [gestational trophoblastic neoplasia (GTN)] (Victoria Diniz and Sun, 2018;Silva et al, 2021). GTN is a member of GTDs and can be developed from partial or complete HM (Golfier et al, 2007;Lurain, 2010;Sun et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Gut Microbial Diversity in Female Patients With Invasive Mole and Choriocarcinoma and Its Differences Versus Healthy Controls

Liu

Pan

Líu

et al. 2021

Front. Cell. Infect. Microbiol.

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ObjectiveTo investigate variation in gut microbiome in female patients with invasive mole (IM) and choriocarcinoma (CC) and compare it with healthy controls.MethodsFecal microbiome of 12 female patients with IM, 9 female patients with CC, and 24 healthy females were analyzed based on 16s rDNA sequencing. Alpha (α) diversity was evaluated using Shannon diversity index and Pielou evenness index, while beta (β) diversity was assessed using principle coordinate analysis (PCoA) of unweighted Unifrac distances. The potential functional changes of microbiomes were predicted using Tax4Fun. The relative abundance of microbial taxa was compared using Welch’s t test. The role of varied gut microbiota was analyzed via receiver operating characteristic (ROC) curve.ResultsThe α diversity and β diversity were significantly different between IM patients and controls, but not between CC patients and controls. In addition, the abundance of cancer-related genes was significantly increased in IM and CC patients. Notably, a total of 19 families and 39 genera were found to have significant differences in bacterial abundance. ROC analysis indicated that Prevotella_7 may be a potential biomarker among IM, CC, and controls.ConclusionOur study demonstrated that the diversity and composition of gut microbiota among IM patients, CC patients, and healthy females were significantly different, which provides rationale for using gut microbiota as diagnostic markers and treatment targets, as well as for further study of gut microbiota in gestational trophoblastic neoplasia (GTN).

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Experience With the Use of an Online Community on Facebook for Brazilian Patients With Gestational Trophoblastic Disease: Netnography Study

Cited by 15 publications

References 27 publications

Impacto da distância entre a residência da paciente e o centro de referência nos indicadores clínicos e de qualidade da assistência à saúde prestada às mulheres com neoplasia trofoblástica gestacional no Estado do Rio de Janeiro

Impacto da distância entre a residência da paciente e o centro de referência nos indicadores clínicos e de qualidade da assistência à saúde prestada às mulheres com neoplasia trofoblástica gestacional no Estado do Rio de Janeiro

Telemedicine in post-molar follow-up: is it a useful tool?

Gut Microbial Diversity in Female Patients With Invasive Mole and Choriocarcinoma and Its Differences Versus Healthy Controls

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