Older cancer survivors' perspectives and use of telehealth in their cancer survivorship care in the United States: A ResearchMatch® sample

INTRODUCTION

COVID-19 has resulted in reliance on telecommunication technologies for the provision of supportive cancer care. However, research on the use of these resources among older adults, who are the majority of cancer survivors, is limited. The objective of this study was to gather information on older cancer survivors' perspectives and use of telehealth their cancer survivorship care in the United States.

MATERIALS AND METHODS

Potential participants were recruited through ResearchMatch® from December 2020-January 2021. Online semi-structured interviews were conducted. Descriptive statistics were used to analyze the participants' demographic and health characteristics. Content analysis were conducted by two independent coders for identification of common themes. Coding agreement was reached through consensus, and count comparisons of participant responses were made.

RESULTS

The majority of respondents (n = 21; mean age = 73.5 ± 4.9) were female (57%), White (90%), and had a variety of cancer diagnoses. Participants reported using a variety of technology devices and telehealth products. Older cancer survivors (n = 10) endorsed telehealth video use for physical health concerns and basic check-ups, but some (n = 4) preferred in-person visits for major concerns and sensitive issues (e.g., mental health). Half of participants reported mobile health app use; however, ten participants did not use these apps as they felt the technology was not useful. Barriers to health technology use included missing face-to-face connections with providers, lack of familiarity with the technology, and perceived lack of utility and personalized telehealth platforms. Lastly, video-based conferencing and social media site use among seventeen participants was reported for social interaction during the COVID-19 pandemic.

DISCUSSION

These findings suggest that older cancer survivors utilize online platforms for their general health; however, they prefer in-person visits for serious issues and value personalization with telehealth. Despite from a highly educated sample of ResearchMatch® participants, these results can be used to inform clinicians and researchers about the appropriateness and provision of telehealth-based supportive care among older cancer survivors.

Mullerian adenosarcoma of the uterus associated with tamoxifen therapy

Mullerian adenosarcoma of the uterus is a biphasic tumor exhibiting benign epithelial and malignant stromal component. This tumor may occasionally be associated with tamoxifen therapy which is used as an adjuvant drug for breast carcinoma. Reviewing the literature, we found only 12 adenosarcoma cases associated with tamoxifen therapy Thus, the clinical and pathological findings in a 58 years old postmenopausal woman who developed uterine adenosarcoma, following low dose tamoxifen therapy after 8 years, was discussed in this report.

Relationship between FIGO grade and AgNOR, S100-positive langerhans cells in endometrial adenocarcinoma

Cell kinetic information is an important adjuvant to histological grading in some malignant tumors. In the current study, 20 endometrial adenocarcinomas were graded according to the 1988 International Federation of Gynecology and Obstetrics (FIGO) and nuclear grading system and the expression of silver-stained nucleolar organizer regions (AgNOR) and S100-positive Langerhans cells were determined. According to the FIGO grade, eight patients were in grade 1, seven were in grade 2 and five were in grade 3. Nuclear grade 1, 2 and 3 was determined in six, eight and six cases, respectively. Although an overlap was seen in some grade 2 and 3 cases, AgNOR counts were the highest in grade 3. S100-positive Langerhans cells were depleted when the grades elevated. It is concluded that AgNOR and Langerhans cells can be correlated with grades. Further studies, including survival data of the patients, could be performed and AgNOR and Langerhans cells can be correlated with prognosis.

Effect of conjunctival structure and inflammatory cell counts on intraocular pressure after trabeculectomy

PURPOSE

To evaluate the conjunctival structure and inflammatory cell counts and to determine the predictive value of these histological parameters for postoperative intraocular pressure (IOP) levels after trabeculectomy.

METHODS

A clinical and histological study was performed on consecutive patients. Postoperative (mean 32. 8 +/- 18.4 months; range 6-60 months) conjunctival biopsies of 36 eyes of 28 primary open-angle glaucoma patients who had trabeculectomy between 1992 and 1995 were included in the study. According to postoperative pressure control, patients with < or = 16 mm Hg and those with >16 mm Hg were taken as groups 1 and 2, respectively. The control group (group 3) consisted of 15 age-matched patients without glaucoma, who had received no topical therapy. We compared the conjunctival structure and cell counts within these groups. Goblet cells, acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharides and collagen compositions were determined in groups 1, 2 and 3.

RESULTS

The number of goblet cells was significantly higher in group 1 (6.74 +/- 7.23) than group 2 (3. 09 +/- 2.77; p = 0.017). No statistical difference was observed in the number of acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharide or collagen compositions between groups 1 and 2 (p > 0.05). In addition, when groups 1 and 2 were compared with the control group, there was a significant decrease in goblet cells (p < 0.001), an increase in acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness and vascular density (p < 0.001), but there was no significant difference in mucopolysaccharide and collagen compositions (p > 0.05).

CONCLUSIONS

This study suggests that at the time of surgery a high number of goblet cells may be a predictor of lowered IOP (< or = 16 mm Hg) following trabeculectomy without antimetabolite.

Lung mass due to amniotic fluid embolism--an intrathoracic complication of pregnancy

A 29-year-old woman with right chest pain was admitted for radiographic investigation and found to have a round mass in the right lower zone. This was initially suspected to be a hydatid lung cyst but was confirmed as a cystic mass by computed tomography and duly excised. Histologic examination revealed an amniotic fluid embolism. The patient had had a stillbirth three months earlier.

Utility of CD15, CD30 & CD45 in the immunohistochemical diagnosis of Hodgkin's disease by antigen retrieval method

The utility of staining Reed-Sternberg (RS) cells with CD30, CD15 and CD45 as a diagnostic aid in Hodgkin's disease (HD) and the value of microwave citrate antigen retrieval (AR) method in improving the results of immunohistochemical (IHC) studies were evaluated. Histological and immunohistological studies were carried out on 21 patients with HD seen from January 1987 to December 1996 in the Pathology Department of the Cumhuriyet University, School of Medicine. Avidin biotin peroxidase complex (ABC) was used in IHC study as a method for detection of RS cells. Monoclonal antibodies CD30, CD15 and CD45 were applied on formalin fixed paraffin embedded tissue sections. In order to enhance the immunoreactivity, microwave citrate AR method and proteolytic pretreatment were used. The reactivity of RS cells and staining patterns were determined. In 14 (70%) of the 20 patients, RS cells stained positively with CD30, in 16 (80%) CD15 staining was positive and only 1 (5%) was positively stained with CD45. A combination of cytoplasmic with cell surface staining was common with CD30, while paranuclear deposit with cell surface and cytoplasmic staining was common with CD15. In conclusion, to facilitate the detection of RS cells in formalin fixed paraffin embedded tissues, the application of a panel of markers appears to be necessary. Also AR method seems to be helpful in obtaining optimal results on formalin fixed paraffin embedded tissue.

Detection and genotyping of Epstein-Barr virus by polymerase chain reaction in tissues obtained from cases with Hodgkin's disease in Turkey

In order to determine the positivity rate and genotype of Epstein-Barr virus (EBV) in cases with Hodgkin's disease (HD) in Turkey, 40 tissue specimens from HD patients were analysed. Ten non-lymphoid tissue samples from individuals without any evidence for lymphoma were used as controls. The cases with HD included 33 males and 7 females with a mean age of 28 years. Nodular sclerosis was the most prevalent histological subtype (16/40) followed by mixed cellularity (10/40), lymphocyte predominance (9/40), and lymphocyte depletion (5/40). After histopathological evaluation, deparafinisation and lysis of the specimens, one-stage polymerase chain reaction (PCR) and two-stage (nested) PCR assays were performed with the primers common for both EBV genotypes and the primers specific for EBV types 1 and 2, respectively. EBV DNA was detected in 22 of 40 (55%) cases with HD and in 1 of 10 (10%) control specimens. The distribution of EBV DNA positivity according to the histological subtypes was as follows: 10 of 16 (62.5%) for nodular sclerosis, 3 of 5 (60%) for lymphocyte depletion, 5 of 9 (55.6%) for lymphocyte predominance, and 4 of 10 (40%) for mixed cellularity. Although most of the HD patients were males of 15-34 years of age, there were no significant differences between EBV positivities obtained from different sex and age groups. The rates of EBV genotypes were 82% for type 1, 9% for type 2, and 9% for both types, respectively.

Placental teratoma. A case report

We present a rare case of a placental teratoma found within the fetal membranes of an otherwise normal placenta. Lack of a recognizable umbilical cord and no recognizable skeletal development are used as differential diagnostic criteria for a placental teratoma. In our case, an umbilical cord was absent; nevertheless, the tumor contained two vascular channels covered only by fetal membranes without Wharton's jelly.