Frequency of venous thromboembolism events during acute inpatient rehabilitation in a comprehensive cancer centre

Cognitive rehabilitation is advantageous in terms of fatigue and independence in pediatric cancer treatment: a randomized-controlled study

This study aimed to investigate the effect of task-oriented inpatient cognitive rehabilitation on fatigue perception and independence in daily activities. Forty (22 males, 18 females) children with pediatric cancer were randomized to either study [n = 22; 10.81 (1.33) years] or control [n = 18; 10.16 (1.24) years] groups. The study group received a cognitive rehabilitation intervention in addition to a routine therapy program, and the control group received a routine therapy program for 15 sessions. Cognitive status, fatigue, and daily life activity outcomes were assessed by blinded assessors in before and after interventions in the hospital setting. The study group showed a significant decrease in fatigue (P values for fatigue before, during, and after activity: P < 0.001) and in the control group (P values for fatigue only in during and post activity: P < 0.05). A statistically significant improvement was found in functional independence for the study group in all activities of daily living areas areas (P < 0.001), whereas no differences were found in the control group. Cognitive rehabilitation appears to provide beneficial effects in decreasing fatigue, improving functional status in activities of daily living, and increasing cognitive skills at the early stages in inpatient rehabilitation of pediatric cancer.

Calf measurements screening for deep vein thrombosis in acute inpatient cancer rehabilitation

Background/Aims:

Cancer patients have a fourfold increase in the frequency of thrombosis and it is a common cause of death. The purpose of this study was to review the impact of calf measurements during initial admission to an inpatient rehabilitation unit to detect deep vein thrombosis.

Methods:

During inpatient admission to a rehabilitation unit, calf measurement assessments were performed by nursing staff. The nurses were instructed to notify clinicians for an order for a venous Doppler ultrasound if the difference between the two calves was greater than 3 cm.

Findings:

A total of 374 patients were admitted to the inpatient cancer rehabilitation unit over 12 months. Only six patients (2%) did not have their calves measured, with a 98% compliance of measurement. Only two patients (0.5%) had a difference in calf measurement and clinical exam significant to warrant a venous Doppler ultrasound. Both cases were negative for thrombosis. Venous Doppler ultrasounds were performed in 63 (17%) patients before admission to the rehabilitation unit. During the rehabilitation stay, venous Doppler ultrasounds were performed on 44 (12%) patients, with 10 (3%) patients identified with having deep vein thrombosis.

Conclusions:

This study suggests that calf measurements at admission to a rehabilitation unit were unable to detect deep vein thrombosis in this cancer population. Venous Doppler ultrasounds were ordered and identified additional patients who had deep vein thrombosis.