1
|
Yasmara D, Tam SH, Fang SY. Caring for Patients With Malignant Fungating Wounds: A Scoping Literature Review. J Wound Ostomy Continence Nurs 2024; 51:19-25. [PMID: 38215293 DOI: 10.1097/won.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
PURPOSE The aim of this scoping literature review was to identify current knowledge related to management of malignant fungating wounds (MFWs), gaps in this knowledge, and areas for future research. METHODS This was a scoping literature review. SEARCH STRATEGY Six electronic databases (Embase, MEDLINE, Cochrane (CENTRAL), CINAHL, Scopus, and Web of Science) were searched spanning the years 1987 and 2022. The initial electronic database search retrieved 6041 studies. The search is based on 60 articles published between 1987 and 2022, along with 14 additional studies were based on search of reference lists of key articles. FINDINGS Studies were divided into 2 main domains; the vast majority (65 of 72, 87.8%) focused on symptom impact, measurement, and management. The remaining articles (n = 9, 12.2%) focused on caring for patients with MFW; these studies focused on nursing care experiences and competencies, along with lay caregiver experiences. Findings indicated that instruments have been developed to evaluate symptoms of MFW but only a few have been validated. Most of the studies reviewed evaluated the influence of MFW on physical and psychosocial function. Local and systematic symptom managements such as modern dressings, wound care strategies, surgery, and radiotherapy as well as chemotherapy were found to be effective in alleviating symptoms. Findings also indicated that families and nurses encounter obstacles and burdens when caring for patients with MFW; limited studies were retrieved that investigated the competence and needs of nurses in their caring journey. IMPLICATIONS Future studies should focus on: (1) using better designs to evaluate and compare topical agents and dressings to control odor, (2) validating assessment tools specific to MFW, (3) qualitative studies designed to enhance understanding family and nurses' experiences, and (4) improving the nurse's ability to care for patients with MFWs and their responses to managing these challenging patients.
Collapse
Affiliation(s)
- Deni Yasmara
- Deni Yasmara, MN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Sin-Hang Tam, MSN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Su-Ying Fang, PhD, RN, Department of Nursing, College of Medicine, National Cheng Kung University and Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sin-Hang Tam
- Deni Yasmara, MN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Sin-Hang Tam, MSN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Su-Ying Fang, PhD, RN, Department of Nursing, College of Medicine, National Cheng Kung University and Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Su-Ying Fang
- Deni Yasmara, MN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Sin-Hang Tam, MSN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Su-Ying Fang, PhD, RN, Department of Nursing, College of Medicine, National Cheng Kung University and Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
2
|
Gupta M, Rao SR, Salins N, Singhai P, Rao KS. Maggots in the Intercostal Drain: Case Report of a Rare Presentation with a Brief Review of Literature. Indian J Palliat Care 2021; 27:439-441. [PMID: 34898938 PMCID: PMC8655648 DOI: 10.25259/ijpc_428_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/15/2021] [Indexed: 11/07/2022] Open
Abstract
Maggots are dipterous larvae of flies. Infestation of vertebrate animals (including humans) by maggots is termed as Myiasis. Warm and Humid climate, low socio-economic status, lack of knowledge and poor living conditions, malignant wounds predispose the cancer patients to maggot infestation in India. Apart from infestation in the wounds; oral, ophthalmic, nasal, aural, enteric, urogenital, trachea-pulmonary and rectal myiasis have been reported. Maggot infestation of the Intercostal drain (ICD) container without associated pleural myiasis is an extremely rare entity. We describe a rare case report of maggots in the ICD in a patient with metastatic chondrosarcoma femur with ICD in situ for malignant pleural effusion. Early detection and management are the keys to prevent the catastrophic complication of pleural myiasis.
Collapse
Affiliation(s)
- Mayank Gupta
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Seema Rajesh Rao
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Naveen Salins
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pankaj Singhai
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Krithika S Rao
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
3
|
Lu JE, Mohan S, Pfeiffer ML, Clark BS, Chang JR. Aspiration as a Novel Technique to Address Facial and Periocular Myiasis. Ophthalmic Plast Reconstr Surg 2021; 37:e172-e173. [PMID: 33795608 DOI: 10.1097/iop.0000000000001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suction aspiration, which has not yet been described in the treatment for myiasis in the periorbital and facial regions, was used to achieve rapid resolution of maggot burden in a 78-year-old patient who presented with a large ulcerated squamous cell carcinoma of the face. This technique also facilitates submission of parasite samples for further analysis. Suction aspiration had no complications, such as significant residual ruptured maggots in the wound or eye injury. Suction aspiration is a safe and efficient technique to reduce maggot burden that has advantages over classic myiasis treatments, especially near the eyes and airway.
Collapse
Affiliation(s)
- Jonathan E Lu
- Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | | | | | | | | |
Collapse
|
4
|
Ashopa V, Verma U, Nareda P, Gupta E, Prakash P. Postpartum genital myiasis - Dermatobia hominis infestation with giant uterine fibroid: A rare case with review of literature. Trop Parasitol 2021; 10:142-146. [PMID: 33747883 PMCID: PMC7951076 DOI: 10.4103/tp.tp_65_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/01/2019] [Accepted: 12/24/2019] [Indexed: 11/11/2022] Open
Abstract
A 32-year-old multiparous rural woman having 26 weeks of pregnancy with giant uterine fibroid extending up to the cervix had stillbirth 2 weeks back and left hospital against medical advice. She was readmitted in emergency with necrotic prolapsed uterine fibroid with offensive vaginal bleeding. On examination, the patient had necrotic prolapsed fibroid with very offensive bloody discharge and a large number of larvae of Dermatobia hominis (human botfly) were crawling in necrotic tissue. The location of this infestation at genital region is an extremely rare occurrence in postdelivery patients.
Collapse
Affiliation(s)
- Vishakha Ashopa
- Department of Microbioloby, Dr S.N Medical College, Jodhpur, Rajasthan, India
| | - Usha Verma
- Department of Microbioloby, Dr S.N Medical College, Jodhpur, Rajasthan, India
| | - Pooja Nareda
- Department of Microbioloby, Dr S.N Medical College, Jodhpur, Rajasthan, India
| | - Eshank Gupta
- Department of Microbioloby, Dr S.N Medical College, Jodhpur, Rajasthan, India
| | - Prabhu Prakash
- Department of Microbioloby, Dr S.N Medical College, Jodhpur, Rajasthan, India
| |
Collapse
|
5
|
Osorio-Pinzon J, Palencia A, Cruz-Calderon S, Rodriguez-Morales AJ. Myiasis and Tungiasis. CURRENT TROPICAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40475-021-00233-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
6
|
Morales Godínez LC, Sangines EGG. Skin Myasis Associated with High-Risk Epidermoid Carcinoma in a Possible Lung Metastasis Patient. Indian J Dermatol 2021; 66:576. [PMID: 35068539 PMCID: PMC8751689 DOI: 10.4103/ijd.ijd_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
7
|
Waidyaratne G, Zhou S, O'Neil T, Marks A. Management of Wound Myiasis in the Hospice and Palliative Medicine Setting. J Palliat Med 2020; 24:797-800. [PMID: 33121325 DOI: 10.1089/jpm.2020.0441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Complex wounds are common complications in hospice and palliative medicine (HPM), especially in patients with aggressive malignancies. Myiasis, or an infestation of maggots, is a rare but significant complication of such wounds. While uncommon in the United States, many HPM patients have multiple risk factors and comorbidities that increase their vulnerability to this condition. Currently, there are no standard diagnostic or treatment guidelines for wound myiasis. In addition, common management strategies may not be easily accessible in HPM settings. We present this case of a patient with malignant squamous cell carcinoma of the neck complicated by myiasis while in hospice, and our experience diagnosing and managing her infestation. We also reflect on special considerations for HPM patients when addressing the physical and psychological symptoms of wound myiasis.
Collapse
Affiliation(s)
| | - Shiwei Zhou
- Division of Infectious Diseases, Department of Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Thomas O'Neil
- Arbor Hospice and Northstar Palliative Care, Ann Arbor, Michigan, USA
| | - Adam Marks
- Division of Geriatrics and Palliative Care, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
8
|
Astekar M, Gujjar SV, Upadhyay H, Upadhyay H. Grub in the mouth: an unusual case with review of literature. BMJ Case Rep 2020; 13:13/9/e234818. [PMID: 32895252 DOI: 10.1136/bcr-2020-234818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral myiasis is a rare disease, identified primarily in non-industrialised nations. It is caused fundamentally by the attack of larvae from Dipteran flies on the human tissues. Predisposing factors for oral myiasis are extraction wounds, destitute oral cleanliness, meagreness, mouth breathing amid rest, suppurative injuries, necrotic tissues, diabetes and perivascular infections primarily within the elderly, extreme halitosis, alcohol addiction, cerebral paralysis and components that favour prolonged mouth opening. Myiasis may have predilection to patients with mental challenges, cerebral palsy and hemiplegia due to unfortunate physical agility. The present case reports an oral myiasis in a 25-year-old woman who was mentally challenged. This condition was treated by topical application of turpentine oil with manual expulsion of hatchlings, taken after by surgical debridement and wide range antimicrobials.
Collapse
Affiliation(s)
- Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, India
| | | | - Himanshu Upadhyay
- Department of Oral and Maxillofacial Surgery, Dental Implant and Maxillofacial Surgery Centre, Etah, India
| | - Himani Upadhyay
- Department of Periodontology, Dental Implant and Maxillofacial Surgery Centre, Etah, India
| |
Collapse
|
9
|
Li N, Zhan X. Anti-parasite drug ivermectin can suppress ovarian cancer by regulating lncRNA-EIF4A3-mRNA axes. EPMA J 2020; 11:289-309. [PMID: 32549918 PMCID: PMC7272521 DOI: 10.1007/s13167-020-00209-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/07/2020] [Indexed: 12/16/2022]
Abstract
RELEVANCE Ivermectin, as an old anti-parasite drug, can suppress almost completely the growth of various human cancers, including ovarian cancer (OC). However, its anticancer mechanism remained to be further studied at the molecular levels. Ivermectin-related molecule-panel changes will serve a useful tool for its personalized drug therapy and prognostic assessment in OCs. PURPOSE To explore the functional significance of ivermectin-mediated lncRNA-EIF4A3-mRNA axes in OCs and ivermectin-related molecule-panel for its personalized drug therapy monitoring. METHODS Based on our previous study, a total of 16 lncRNA expression patterns were analyzed using qRT-PCR before and after ivermectin-treated different OC cell lines (TOV-21G and A2780). Stable isotope labeling with amino acids in cell culture (SILAC)-based quantitative proteomics was used to analyze the protein expressions of EIF4A3 and EIF4A3-binding mRNAs in ovarian cancer cells treated with and without ivermectin. A total of 411 OC patients from the Cancer Genome Atlas (TCGA) database with the selected lncRNA expressions and the corresponding clinical data were included. Lasso regression was constructed to examine the relationship between lncRNA signature and OC survival risk. The overall survival analysis between high-risk and low-risk groups used the Kaplan-Meier method. Heatmap showed the correlation between risk groups and clinical characteristics. The univariate and multivariate models were established with Cox regression. RESULTS SILAC-based quantitative proteomics found the protein expression levels of EIF4A3 and 116 EIF4A3-binding mRNAs were inhibited by ivermectin in OC cells. Among the analyzed 16 lncRNAs (HCG15, KIF9-AS1, PDCD4-AS1, ZNF674-AS1, ZNRF3-AS1, SOS1-IT1, LINC00565, SNHG3, PLCH1-AS1, WWTR1-AS1, LINC00517, AL109767.1, STARD13-IT1, LBX2-AS1, LEMD1-AS1, and HOXC-AS3), only 7 lncRNAs (HCG15, KIF9-AS1, PDCD4-AS1, ZNF674-AS1, ZNRF3-AS1, SOS1-IT1, and LINC00565) were obtained for further lasso regression when combined with the results of drug testing and overall survival analysis. Lasso regression identified the prognostic model of ivermectin-related three-lncRNA signature (ZNRF3-AS1, SOS1-IT1, and LINC00565). The high-risk and low-risk groups based on the prognostic model were significantly related to overall survival and clinicopathologic characteristics (survival status, lymphatic invasion, cancer status, and clinical stage) in OC patients and remained independent risk factors according to multivariate COX analysis (p < 0.05). CONCLUSION Those findings provided the potential targeted lncRNA-EIF4A3-mRNA pathways of ivermectin in OC, and constructed the effective prognostic model, which benefits discovery of novel mechanism of ivermectin to suppress ovarian cancer cells, and the ivermectin-related molecule-panel changes benefit for its personalized drug therapy and prognostic assessment towards its predictive, preventive, and personalized medicine (PPPM) in OCs.
Collapse
Affiliation(s)
- Na Li
- University Creative Research Initiatives Center, Shandong First Medical University, 6699 Qingdao Road, Jinan, 250117 Shandong People’s Republic of China
- Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
- State Local Joint Engineering Laboratory for Anticancer Drugs, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
| | - Xianquan Zhan
- University Creative Research Initiatives Center, Shandong First Medical University, 6699 Qingdao Road, Jinan, 250117 Shandong People’s Republic of China
- Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
- State Local Joint Engineering Laboratory for Anticancer Drugs, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
- Department of Oncology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan People’s Republic of China
| |
Collapse
|
10
|
Treatment of facial myiasis in an elderly patient with oral squamous cell carcinoma: Case report. Int J Surg Case Rep 2020; 71:260-265. [PMID: 32492640 PMCID: PMC7264952 DOI: 10.1016/j.ijscr.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/12/2020] [Accepted: 05/11/2020] [Indexed: 02/01/2023] Open
Abstract
Myiasis may develop secondary to malignant neoplasms. Surgical treatment associated with administration of Ivermectin is effective in curing myiasis. The establishment of a multiprofessional team is fundamental in the treatment of myiasis.
Myiasis is caused by the infestation of fly larvae in human tissues and it presents immunodeficiency, poor hygiene, or malignant neoplasias as predisposing chronic diseases. Objective To describe a clinical case of myiasis associated with oral squamous cell carcinoma (OSCC) in an elderly patient. Case presentation A 60-year-old male, black, smoker, and alcoholic patient with OSCC, who refused initial cancer treatment and sought hospital care with an extensive facial lesion and approximately 150 larvae in the extraoral region. The treatment was given through the administration of 6 mg of Ivermectin associated with the surgical removal of the larvae. Subsequently, palliative chemotherapy began. Discussion Myiasis can sometimes be associated with OSCC and it commonly occurs in individuals who live in unhealthy locations and present poor hygiene and low immunity. In addition to medication, the surgical removal of the larvae is important in the treatment of myiasis. Conclusion Patient adherence to cancer treatment is essential to avoid the negative evolution of the tumor. The social component linked to the development of myiasis makes it an important public health topic, as it is related directly to the lack of primary care. Surgical and drug treatments are required to cure myiasis.
Collapse
|
11
|
Jain A. Myiasis in patients with oral squamous cell carcinoma-a systematic review and protocol for management. Oral Maxillofac Surg 2019; 23:265-269. [PMID: 31119420 DOI: 10.1007/s10006-019-00757-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Oral squamous cell carcinoma results in various morbidities like pain, bleeding on provocation, loss of function, facial disfigurement, extra oral fungation, and tissue necrosis. Other than these dreadful complications, sometimes in advanced and incurable stage, the wound gets infested with maggots. Oral myiasis in association with OSCC is rare, and a very few reports have been mentioned in the literature. MATERIAL AND METHODS A literature search was performed on PubMed, Medline, and Cochrane databases on 1st November 2018 for all the articles focusing on oral myiasis in patients with oral squamous cell carcinoma. RESULTS A total number of nine cases with oral myiasis in association with OSCC have been reported till date. Out of these nine cases, five cases have been reported from India and four from Brazil. CONCLUSION Oral myiasis is a possible risk for the patient with Oral squamous cell carcinoma. Good hygiene and general cleanliness along with educating the patients must be a practice to avoid this dreadful condition.
Collapse
Affiliation(s)
- Anuj Jain
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
| |
Collapse
|