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Clinical Index of Stable Febrile Neutropenia

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1. Validation of the Clinical Index of Stable Febrile Neutropenia (CISNE) model in febrile neutropenia patients visiting the emergency department. Can it guide emergency physicians to a reasonable decision on outpatient vs. inpatient treatment? Full Text available with Trip Pro

Validation of the Clinical Index of Stable Febrile Neutropenia (CISNE) model in febrile neutropenia patients visiting the emergency department. Can it guide emergency physicians to a reasonable decision on outpatient vs. inpatient treatment? Advances in oncology have enabled physicians to treat low-risk febrile neutropenia (FN) in outpatient settings. This study was aimed to explore the usefulness of the CISNE model and identify better triage in the emergency setting. This is a retrospective (...) cohort study on 400 adult FN patients presenting to the Emergency Department of National Cancer Center, Korea from January 2010 to December 2016. All had been treated with cytotoxic chemotherapy for solid tumors in the previous 30 days. The primary outcome was the frequency of any serious complications during the duration of illness. Apparently stable patients numbered 299 (74.8%) of 400, and the remainder comprised clinically unstable patients. The stable patients fell into three cohorts according

2018 PLoS ONE

2. Prognostic accuracy of the Multinational Association of Supportive Care of Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for identifying low-risk adult patients with febrile neutropenia

Prognostic accuracy of the Multinational Association of Supportive Care of Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for identifying low-risk adult patients with febrile neutropenia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete (...) . Not an original full research paper (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures

2019 PROSPERO

3. Prediction of Serious Complications in Patients With Seemingly Stable Febrile Neutropenia: Validation of the Clinical Index of Stable Febrile Neutropenia in a Prospective Cohort of Patients From the FINITE Study (Abstract)

Prediction of Serious Complications in Patients With Seemingly Stable Febrile Neutropenia: Validation of the Clinical Index of Stable Febrile Neutropenia in a Prospective Cohort of Patients From the FINITE Study To validate a prognostic score predicting major complications in patients with solid tumors and seemingly stable episodes of febrile neutropenia (FN). The definition of clinical stability implies the absence of organ dysfunction, abnormalities in vital signs, and major infections.We (...) developed the Clinical Index of Stable Febrile Neutropenia (CISNE), with six explanatory variables associated with serious complications: Eastern Cooperative Oncology Group performance status ≥ 2 (2 points), chronic obstructive pulmonary disease (1 point), chronic cardiovascular disease (1 point), mucositis of grade ≥ 2 (National Cancer Institute Common Toxicity Criteria; 1 point), monocytes < 200 per μL (1 point), and stress-induced hyperglycemia (2 points). We integrated these factors into a score

2015 EvidenceUpdates

4. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy Full Text available with Trip Pro

identification of candidate patients for outpatient treatment. (¶)See Recommendation 3.1 regarding evaluation of patients for hospital admission. CISNE, Clinical Index of Stable Febrile Neutropenia; MASCC, Multinational Association for Supportive Care in Cancer. Guideline Questions What is the recommended initial diagnostic approach for patients with fever who are seeking emergency medical care within 6 weeks of receiving chemotherapy? Which patients with FN are at low risk of medical complications (...) /cephalosporins should be treated as inpatients with a carbapenem-based regimen that likely requires multiple doses per day. Patients colonized with or suspected of having MRSA, VRE, or Stenotrophomonas maltophilia infection should be considered as candidates for inpatient management. Patients undergoing HSCT or induction therapy for acute leukemia are unlikely to be appropriate candidates for outpatient therapy. Recommendation 2.2. The Clinical Index of Stable Febrile Neutropenia (CISNE; ) may be used

2018 Infectious Diseases Society of America

5. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update.

? Recommendations : In patients who are responding to initial empirical antibiotic therapy, discontinue double coverage for gram-negative infection or empirical glycopeptide (if initiated) after 24 to 72 hours if there is no specific microbiologic indication to continue combination therapy ( Strong recommendation; Moderate-quality evidence ). Do not modify the initial empirical antibacterial regimen based solely on persistent fever in children who are clinically stable ( Strong recommendation; Low-quality (...) be closely matched or there may be considerable uncertainty about the magnitude of the benefits and risks. In formulating recommendations, costs were explicitly considered in addition to benefits and risks. None provided Fever and neutropenia (FN) Diagnosis Evaluation Management Risk Assessment Treatment Family Practice Infectious Diseases Internal Medicine Oncology Pediatrics Advanced Practice Nurses Physician Assistants Physicians To update a clinical practice guideline (CPG) for the empirical

2017 National Guideline Clearinghouse (partial archive)

6. Clinical Index of Stable Febrile Neutropenia

Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Aka: Clinical Index of Stable Febrile Neutropenia , CISNE Score II. Indications Assess risk in III. Contraindications Age <18 years old Hospitalization for other reason (e.g. PE, arrhythmia) Acute organ failure or decompensation of chronic insufficiency (e.g. , , CHF) or with systolic <90 mmHg Severe infection IV. Criteria Score 2: ( ) >2 Score 2: Stress induced Score 1: Score 1: Chronic cardiovascular

2018 FP Notebook

7. Clinical Index of Stable Febrile Neutropenia

Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Aka: Clinical Index of Stable Febrile Neutropenia , CISNE Score II. Indications Assess risk in III. Contraindications Age <18 years old Hospitalization for other reason (e.g. PE, arrhythmia) Acute organ failure or decompensation of chronic insufficiency (e.g. , , CHF) or with systolic <90 mmHg Severe infection IV. Criteria Score 2: ( ) >2 Score 2: Stress induced Score 1: Score 1: Chronic cardiovascular

2017 FP Notebook

8. Management of Febrile Neutropaenia

with neutropenia during cancer chemotherapy. N Engl J Med 1999; 341: 305–311. 17. Innes H, Lim SL, Hall A et al. Management of febrile neutropenia in solid tumours and lymphomas using the Multinational Association for Supportive Care in Cancer (MASCC) risk index: feasibility and safety in routine clinical practice. Support Care Cancer 2008; 16: 485–491. 18. Kern WV, Marchetti O, Drgona L et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer: a double-blind, multicenter trial comparing (...) . Support Care Cancer 2015; 23: 3131–3140. 12. Mitchell S, Li X, Woods M et al. Comparative effectiveness of granulocyte colony- stimulating factors to prevent febrile neutropenia and related complications in cancer patients in clinical practice: a systematic review. J Oncol Pharm Pract 2016; 22: 702–716. 13. Hämäläinen S, Kuittinen T, Matinlauri I et al. Neutropenic fever and severe sepsis in adult acute myeloid leukemia (AML) patients receiving intensive chemotherapy: causes and consequences. Leuk

2017 European Society for Medical Oncology

9. International Guideline for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation

: Empirical antifungal therapy in neutropaenic cancer patients with persistent fever. EJC 5:32-42, 2007 (suppl) 6. National Comprehensive Cancer Network: NCCN Guidelines TM for Supportive Care: Prevention and Treatment of Cancer-Related Infections (Version 2.2011), Fort Washington, PA: National Comprehensive Cancer Network, 2011 (http://www.nccn.org/professionals/physician_gls/f_guidelines.asp) 7. de Naurois J, Novitzky-Basso I, Gill MJ, et al: Management of febrile neutropenia: ESMO Clinical Practice (...) chest radiography in children with cancer hospitalized for fever and neutropenia. Cancer 68:940-3, 1991 55. Phillips R, Wade R, Riley R, et al: Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people. J Paediatr Child Health, 2011 56. Furno P, Bucaneve G, Del Favero A: Monotherapy or aminoglycoside-containing combinations for empirical antibiotic treatment of febrile neutropenic patients

2012 SickKids Supportive Care Guidelines

10. A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia. Full Text available with Trip Pro

A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia. We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN).The data from the FINITE study (n=1133) and University of Salamanca Hospital (USH) FN registry (n=296) were used to develop and validate (...) this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups.The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status ⩾2, chronic

2016 British Journal of Cancer

11. Short vs Prolonged Antibiotic Treatment for Hospitalized Hemato-oncology Patients With Febrile Neutropenia

infusion therapy in patients with hematologic diseases with neutropenic fever. Research goals: The main goal is to compare between two groups of hematologic patients with neutropenic fever, The first group will receive antibiotic therapy in extended infusion, and the second (control) group will receive the treatment in a fixed time. Condition or disease Intervention/treatment Phase Fever Febrile Neutropenia Drug: Piperacillin/tazobactam Drug: Ceftazidim Drug: Meropenem Drug: Vancomycin Phase 4 Detailed (...) Description: METHODS: Each patient who will be hospitalized in the Department of Bone Marrow Transplantation and which meets the Inclusion criteria for, will be offered to participate in the study. If fever appears during hospitalization empirical treatment of neutropenia will be initiated performed in accordance with the allocation of the patient in the study. Therapeutic success is defined as a combination of several clinical parameters, including: a decline in Fever, the recurrence of fever

2015 Clinical Trials

12. Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline

: low, bene?t outweighs harm; Strength of recommendation: moderate). Recommendation 6.5. It is recommended that patients be monitored closely with consideration of dose modi?cations based on levels of toxicity, neutropenia, fever/infection, tolerability of adverse effects, per- formance status, liver and kidney function, and in keeping with the goals of treatment. (Type: informal consensus; Evidence quality: low, bene?t outweighs harm; Strength of recommendation: moderate). Relapsed Disease (...) Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline ASCO special article Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline Joseph Mikhael,MD 1,2 ; No?sat Ismaila,MD 3 ; Matthew C. Cheung, MD, SM 4 ; Caitlin Costello,MD 5 ; Madhav V. Dhodapkar,MD 6 ; Shaji Kumar,MD 7 ; Martha Lacy,MD 7 ; Brea Lipe,MD 8 ; Richard F. Little,MD 9 ; Anna Nikonova, MD, CM 10 ; James Omel,MD 11 ; NamrataPeswani,MD 12 ;AncaPrica,MD 13 ;NoopurRaje,MD 14 ;RahulSeth,DO

2019 Cancer Care Ontario

13. Guidance for the clinical management of children admitted to hospital with suspected COVID-19

appraisal is not complete, but all evidence is low quality. Web of Science You searched for: TOPIC: (co-vid or covid or coronavirus or MERS-CoV) AND TOPIC: (clinic* or radiolog* or manage* or treat* or therapy*) Refined by: PUBLICATION YEARS: ( 2020 ) Timespan: All years. Indexes: SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, BKCI-S, BKCI-SSH, ESCI, CCR- EXPANDED, IC. Handsearching (daily) of: General medical journals NEJM BMJ Lancet PLoS Medicine JAMA BMC Open access journals BMJ Open BMJ Open (...) /62 (32%) had pre-existing comorbidity 21/62 (34%) were associated with familial clusters Median duration of symptoms 4 days Commonest clinical features: fever (77%), cough (81%) myalgia/fatigue (52%) Respiratory: 2/62 (3%) developed shortness of breath 1/62 (1.6%) ventilated Bloods: FBC: 19/62 (31%) leucopenic Renal: not reported LFT: AST increased in 10/62 (16%) 8 MANAGEMENT OF CHILDREN ADMITTED TO HOSPITAL WITH COVID-19 INFE CTION (VERSION 2) Huang Lancet (9) Wuhan 41 adults (no children were

2020 British Thoracic Society

14. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

circumstances. DOI:10.4158/GL-2019-0406 © 2019 AACE. 7 ABBREVIATIONS A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ABCD = adiposity-based chronic disease; ABOM = American Board of Obesity Medicine; ACE = American College of Endocrinology; ADA = American Diabetes Association; AGA = American Gastroenterological Association; AHI = Apnea-Hypopnea Index; ASA = American Society of Anesthesiologists; ASMBS = American Society of Metabolic and Bariatric Surgery; BMI = body mass (...) index; BPD = biliopancreatic diversion; BPD/DS = biliopancreatic diversion with duodenal switch; CI = confidence interval; CPAP = continuous positive airway pressure; CPG = clinical practice guideline; CRP = C-reactive protein; CVD = cardiovascular disease; DBCD = dysglycemia-based chronic disease; DS = duodenal switch; DVT = deep venous thrombosis; DXA = dual- energy X-ray absorptiometry; EL = evidence level; EN = enteral nutrition; ERABS = enhanced recovery after bariatric surgery; ESG

2019 American Association of Clinical Endocrinologists

15. Neutropenia (Diagnosis)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) for antibacterial prophylaxis is an oral fluoroquinolone, while that for antifungal prophylaxis is an oral triazole or parenteral echinocandin. [ ] A companion ASCO/IDSA guideline contains recommendations on outpatient management of fever and neutropenia in patients with cancer. The guideline recommends using clinical judgment and the Multinational Association for Supportive Care in Cancer (MASCC) scoring system or Talcott's rules to identify patients who may be candidates for outpatient management. In patients

2014 eMedicine.com

16. Neutropenia (Overview)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) for antibacterial prophylaxis is an oral fluoroquinolone, while that for antifungal prophylaxis is an oral triazole or parenteral echinocandin. [ ] A companion ASCO/IDSA guideline contains recommendations on outpatient management of fever and neutropenia in patients with cancer. The guideline recommends using clinical judgment and the Multinational Association for Supportive Care in Cancer (MASCC) scoring system or Talcott's rules to identify patients who may be candidates for outpatient management. In patients

2014 eMedicine.com

17. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department. Full Text available with Trip Pro

Index of Stable Febrile Neutropenia (CISNE) scores for patients with chemotherapy-induced febrile neutropenia and presenting to the ED.We conducted a retrospective cohort study to evaluate all patients with febrile neutropenia (temperature ≥38°C [100.4°F], absolute neutrophil count <1,000 cells/μL) who presented to 2 academic EDs from June 2012 through January 2015. MASCC and CISNE scores were calculated for all subjects, and each visit was evaluated for several outcome variables, including (...) inpatient length of stay, upgrade in level of care, clinical deterioration, positive blood culture results, and death. Descriptive statistics are reported and continuous variables were analyzed with Wilcoxon rank sum.During our study period, 230 patients presented with chemotherapy-induced febrile neutropenia. The CISNE score identified 53 (23%) of these patients as low risk and was highly specific in the identification of a low-risk cohort for all outcome variables (98.3% specific, 95% confidence

2016 Annals of Emergency Medicine

18. Acne clinical guideline Full Text available with Trip Pro

Quality of Life Index (Acne-QOLI): development and validation of a brief instrument. Am J Clin Dermatol . 2006 ; 7 : 185–192 | | | , x 14 Dreno, B., Khammari, A., Orain, N. et al. ECCA grading scale: an original validated acne scar grading scale for clinical practice in dermatology. Dermatology . 2007 ; 214 : 46–51 | | | , x 15 Pochi, P.E., Shalita, A.R., Strauss, J.S. et al. Report of the Consensus Conference on Acne Classification. Washington, D.C., March 24 and 25, 1990. J Am Acad Dermatol . 1991 (...) Acne clinical guideline Guidelines of care for the management of acne vulgaris - Journal of the American Academy of Dermatology Email/Username: Password: Remember me Search JAAD & JAAD Case Reports Search Terms Search within Search Access provided by Volume 74, Issue 5, Pages 945–973.e33 Guidelines of care for the management of acne vulgaris Work Group:, x Andrea L. Zaenglein Affiliations Penn State Hershey Medical Center, Hershey, Pennsylvania , MD (Co-Chair) a , x Arun L. Pathy Affiliations

2016 American Academy of Dermatology

19. Clinical Trial for Post-marketing Evaluation of Sheng Bai Oral Liquid

of neutropenia The recovery time of neutropenia [ Time Frame: six weeks ] Comparison of the recovery time between two groups of Polymorphonuclear neutropenia Secondary Outcome Measures : The incidence of neutropenia associated with Fever (FN) in patients after chemotherapy [ Time Frame: six weeks ] Comparison of the incidence of fever with neutropenia in two chemotherapy cycles between two groups. The incidence of Peripheral blood thrombocytopenia disease [ Time Frame: six weeks ] Comparison of the incidence (...) by the abnormalities), decreased(After treatment than before treatment decreased ≥ 10%, or from normal to abnormal changes), stable(After treatment than before treatment, decreased less than 10% or maintained within the normal range). Other Outcome Measures: Genetic Testing [ Time Frame: six weeks ] The changes of body index before and after treatment were compared between two groups of subjects. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study

2018 Clinical Trials

20. Diagnosis, Risk Stratification, and Management of Pulmonary Hypertension of Sickle Cell Disease: An Official ATS Clinical Practice Guideline

. The TRV should be measured by Doppler echocardiography, using the same conditionsasthestudiesdescribedpreviously, because the TRV varies according to the clinicalstatusofthepatient(i.e.,theTRVmay beacutelyandtransientlyincreasedduringan acute illness such as a vaso-occlusive crisis [VOC] or acute chest syndrome [ACS]) (29). Therefore, Doppler echocardiography should be performed when the patient is in a stable clinical state, de?ned as more than 4 weeks after hospitalization for ACS and more than 2 (...) are clinically stable. Patients with an mPAP between 20 and 25 mm Hg need further study as they may be at increased mortality risk. Note: PAH therapy is to be considered on the basis of a weak recommendation and very low-quality evidence. AMERICAN THORACIC SOCIETY DOCUMENTS American Thoracic Society Documents 733 that prolonged therapy may be necessary to achieve a clinical bene?t (39, 40). Patients who received HU during the MSH trial also had improvement in some measures of quality of life (i.e., social

2014 American Thoracic Society

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