Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi-Italian experience.

Autor: Al-Jadiry MF; Department of Pediatrics, College of Medicine, University of Baghdad, Oncology Unit-Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Uccini S; Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Testi AM; Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy., Moleti ML; Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy., Alsaadawi AR; Central Teaching Laboratory, Medical City, Pathology, Baghdad, Iraq., Al-Darraji AF; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Al-Saeed RM; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Faraj Al-Badri SA; College of Medicine- Wasit University, Children's Welfare Teaching Hospital-Pediatric Oncology Unit, Medical City, Baghdad, Iraq., Sabhan AH; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Ghali HH; Department of Pediatrics, College of Medicine, University of Baghdad, Oncology Unit-Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Fadhil SA; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Abed WM; Hematology Laboratory Department, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Ameen NA; Hematology Laboratory Department, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Abed YS; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Yousif FS; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Abed AR; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Hussein HM; Oncology Unit, Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq., Shkara AM; Department of Pharmaceutics-College of Pharmacy, University of Baghdad, Baghdad, Iraq., Piciocchi A; GIMEMA Data Center, GIMEMA Foundation, Rome, Italy., Mohamed S; Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy., Ruco L; Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Qaddoumi I; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Al-Hadad SA; Department of Pediatrics, College of Medicine, University of Baghdad, Oncology Unit-Children Welfare Teaching Hospital-Medical City, Baghdad, Iraq.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Jan; Vol. 12 (1), pp. 256-265. Date of Electronic Publication: 2022 Jun 03.
DOI: 10.1002/cam4.4892
Abstrakt: Background: Iraq's health care system has gradually declined after several decades of wars, terrorism, and UN economic sanctions. The Oncology Unit at Children's Welfare Teaching Hospital (CWTH) in Baghdad was lacking basic facilities and support. To address this shortcoming, a humanitarian and educational partnership was established between CWTH and Sapienza University of Rome (SUR).
Methods: We investigated the outcomes of 80 online and 16 onsite educational sessions and 142 teleconsultation sessions from 2006 to 2014. We also determined the outcomes of pathology reviews by SUR of 1216 tissue specimens submitted by CWTH from 2007 until 2019 for second opinions. The primary outcomes were discordance, concordance, and changes among clinical diagnoses and pathology review findings. The measures included the frequency of teleconsultation and tele-education sessions, the topics discussed in these sessions, and the number of pathology samples requiring second opinions.
Findings: A total of 500 cases were discussed via teleconsultations during the study period. The median patient age was 7 years (range, 24 days to 16·4 years), and the cases comprised 79 benign tumors, 299 leukemias, 120 lymphomas, and 97 solid tumors. The teleconsultation sessions yielded 27 diagnostic changes, 123 confirmed diagnoses, and 13 equivocal impacts. The pathology reviews by SUR were concordant for 996 (81·9%) cases, discordant for 186 (15·3%), and inconclusive for 34 (2·8%). The major cause of discordance was inadequate immunohistochemical staining. The percentage of discordance markedly decreased over time (from 40% to 10%). The cause of the improvement is multifactorial: training of two CWTH pathologists at SUR, better immunohistochemical staining, and the ongoing clinical and pathologic telemedicine activities. The partnership yielded 12 publications, six posters, and three oral presentations by CWTH investigators.
Interpretation: The exchange of knowledge and expertise across continental boundaries meaningfully improved the diagnoses and management of pediatric cancer at CWTH.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje