Senses and Sciences

Accidental exposure to hazardous drugs, reproductive toxicity risk and proper use of PPE in the hospital setting evidence from an observational study

2025-03-02T16:49:32+00:00

Background: Workplace safety in healthcare is crucial, especially regarding the handling of hazardous drugs, which pose significant risks due to their carcinogenic and teratogenic properties. This study focuses on the risks of reproductive toxicity associated with accidental exposure to hazardous drugs and assesses the effectiveness of personal protective equipment (PPE) in mitigating these risks. The COVID-19 pandemic has highlighted vulnerabilities in healthcare safety protocols.
Methods: This observational cross-sectional study was conducted at the Azienda Ospedaliera Universitaria Policlinico di Palermo, involving healthcare personnel across various departments. Data were collected via an anonymous questionnaire administered through the hospital's intranet, focusing on demographics, exposure to hazardous drugs, PPE use, and health outcomes. The survey spanned six months, and statistical analyses, including Pearson Chi-square tests and multivariable logistic regressions, were employed, with a significance level set at 0.05.
Results: The study revealed a significant lack of awareness among healthcare workers about non-antineoplastic hazardous drugs, with 61.7% of respondents unaware of these risks. The correct use of PPE was reported by 90.8% of participants, with nurses showing higher compliance than other categories. Despite these precautions, 6.45% of exposed workers reported difficulties in conception, though this association was not statistically significant (OR = 1.25, p = 0.802).
Conclusion: The findings highlight the need for improved training and stricter enforcement of safety protocols regarding hazardous drug handling. While PPE use is widespread, the lack of awareness about non-antineoplastic drugs and reported reproductive issues suggest current measures may be insufficient. The study advocates for implementing advanced protective technologies and continuous education to better protect healthcare workers and meet evolving safety standards.

Immune Checkpoint Inhibitors In Pediatric Malignancies, Efficacy And Adverse Events In Alexandria University

2025-03-02T17:26:47+00:00

Background: Pediatric malignancies are the most fatal childhood diseases in developed countries, with survival rates reaching over 80% in high-income countries and 15-45% in low- and middle-income countries. Immune checkpoint inhibitors (ICI), including monoclonal antibodies against negative regulators of T-cell function, such as CTLA-4, Programmed Death-1 (PD-1), and PD-L1, have improved outcomes in adult cancer. Results of ICI in pediatric malignancies were all disappointing which highlight the need to improve outcomes by further studies. Methods: This retrospective study included 31 eligible patients from 1-20 years old to discusses the experience of Alexandria clinical oncology department and Borg el Arab pediatric oncology center, in using immune checkpoint inhibitors (ICI) in pediatric patients, with the primary goal of assessing efficacy and the secondary is evaluating the safety profile. Results: Thirty one eligible patients aged 1-20 from May 2018 to May 2023, with a male-to-female ratio of 1.38:1, and the average age at diagnosis was 14.39 years old. The majority of cases (19 patients) were diagnosed with classical Hodgkin lymphoma, followed by Xeroderma pigmentosa. Pembrolizumab was the most commonly used drug. The mean PFS was 25.5 months, while the mean OS was 27 months. Side effects of ICI was found and documented in 11 patients (35.5%). Thyroiditis was found in nearly half of the patients, followed by colitis and dermatitis, all of which were grade II. Hodgkin lymphoma and Xeroderma pigmentosa showed the highest response to ICI compared to other diagnoses. Conclusions: immune checkpoint inhibitors are effective in pediatric malignancies, especially in Hodgkin disease and Xeroderma pigmentosa, with a very good safety profile and response rate. Further studies should be applied to verify predictive markers to know the best responders among patients.

Impact of single vs. multiple GnRH-agonist doses for luteal phase support in antagonist ICSI cycles: a three-arm randomized controlled trial

2025-03-02T17:40:36+00:00

Abstract. Background: All stimulated ART cycles had inadequate luteal phase (LP), according to many studies. Current LPS regimens utilizing progesterone alone may not always be enough to promote implantation. The novel use of gonadotropin-releasing hormone agonists (GnRH-a) is increasing, aiming to enhance reproductive outcomes. Most studies evaluating the efficacy of GnRH-a for LPS used the long GnRH-a protocol with conflicting results. This study was conducted to assess whether administration of single or multiple doses of GnRH-agonists in the luteal phase improves clinical outcomes in intracytoplasmic sperm injection cycles (ICSI) using the GnRH antagonist protocol. Methods: In a single-centre, parallel, open-label, three-arm randomized controlled trial, 75 infertile women undergoing ICSI cycles were randomized into three groups according to luteal phase support (LPS) regimens. The study involved adding a single subcutaneous injection of 0.1 mg triptorelin on the 6^th day after oocyte retrieval (group I; n = 25), multiple doses of triptorelin on the 5^th, 7^th, and 9^th days after oocyte retrieval (group II; n = 25), or a control group with no added triptorelin (group III; n = 25) to routine LPS with progesterone. Results: No statistical differences were detected between the groups regarding clinical pregnancy, implantation, multiple pregnancy rates or β-hCG concentration. The clinical pregnancy rate (CPR) was slightly higher in the multiple-dose group (72%), vs. 60% and 52% for the single-dose group and control group, respectively (p = 0.334). Conclusions: Compared to progesterone alone, the addition of mid-luteal GnRH agonists did not significantly improve implantation or CPR. However, the multiple-dose addition showed promisingly higher CPR, warranting further research.