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3 results

  • Chapter 37 - Treatment-Related Adverse Effects

  • Edited by Angela Bray Lindsay, Virginia Commonwealth University, Monica Kathleen Wattana, University of Texas, MD Anderson Cancer Center
  • Book:
    Oncologic Emergency Medicine
    Published online:
    24 April 2026
    Print publication:
    07 May 2026, pp 185-203

  • Summary

    1. Radiation therapy is a crucial treatment method for various cancers, used alone or with chemotherapy and surgery.

    2. Radiation-Induced Oral Mucositis (RIOM) is the most common and significant side effect, which worsens with higher doses delivered over a shorter period of time.

    3. Radiation Proctitis is a common side effect, characterized by inflammation of the rectal mucosa due to radiation. Acute proctitis usually appears within three months of starting therapy and can last up to six months, potentially progressing to chronic proctitis after therapy.

    4. Acute Radiation-Induced Esophagitis (ARIE) symptoms usually arise within the first two months of radiotherapy and adversely affect the quality of life, often causing unplanned pauses in treatment and lessening therapy effectiveness.

    5. Radiation-induced pneumonitis is a significant concern in patients receiving radiation for lung, breast, and lymphoma cancers, and in those undergoing total body irradiation for bone marrow transplants with systemic glucocorticoids being the preferred treatment that can lead to symptom relief and radiographic improvement although relapse is possible post-treatment.

  • Chapter 40 - Hematuria

  • Edited by Angela Bray Lindsay, Virginia Commonwealth University, Monica Kathleen Wattana, University of Texas, MD Anderson Cancer Center
  • Book:
    Oncologic Emergency Medicine
    Published online:
    24 April 2026
    Print publication:
    07 May 2026, pp 212-215

  • Summary

    1. Hemorrhagic cystitis (HC) is a condition characterized by inflammation and bleeding of the bladder lining.

    2. It is important to have a high index of suspicion for HC in patients who complain of urinary changes after starting chemotherapy or who have previously undergone pelvic radiation therapy.

    3. Symptoms commonly include blood in the urine, increased urinary frequency and urgency, pain with urination and lower abdominal pain.

    4. HC can present as mild non-infectious hematuria, but in more severe cases as gross hematuria with hemorrhage and clots causing acute urinary retention.

    5. The best treatment is prevention and supportive care with saline diuresis and mesna.

  • Adherence to guideline recommendations for urinary tract infections in adult women: a cross-sectional study

  • Rian Lelie- van der Zande, Marcel Bouvy, Martina Teichert
  • Journal:
    Primary Health Care Research & Development / Volume 22 / 2021
    Published online by Cambridge University Press:
    05 April 2021, e11
    • Article
      • You have access
      • Open access
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  • Aim:

    To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing.

    Background:

    For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice.

    Methods:

    In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI.

    Findings:

    Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.