WorldWideScience

Sample records for acute non-surgical cancer

  1. Non-surgical treatment of primary female urethral cancer

    Directory of Open Access Journals (Sweden)

    Bernard F. Schneider

    2010-09-01

    Full Text Available Primary carcinomas of the female urethra are extremely rare, with an annual incidence of less than ten in one million. Currently, there is no consensus regarding management of this malignancy. However, there have been several case reports demonstrating the efficacy of chemoradiation in the treatment of female urethral cancer. In this report we present two cases of female primary urethral adenocar­cinoma that were treated by concomitant chemotherapy and external beam radiother­apy, followed by interstitial brachytherapy.

  2. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis.

    Science.gov (United States)

    Burton, Martin J; Glasziou, Paul P; Chong, Lee Yee; Venekamp, Roderick P

    2014-11-19

    Surgical removal of the tonsils, with or without adenoidectomy (adeno-/tonsillectomy), is a common ENT operation, but the indications for surgery are controversial. This is an update of a Cochrane review first published in The Cochrane Library in Issue 3, 1999 and previously updated in 2009. To assess the effectiveness of tonsillectomy (with and without adenoidectomy) in children and adults with chronic/recurrent acute tonsillitis in reducing the number and severity of episodes of tonsillitis or sore throat. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 30 June 2014. Randomised controlled trials comparing tonsillectomy (with or without adenoidectomy) with non-surgical treatment in adults and children with chronic/recurrent acute tonsillitis. We used the standard methodological procedures expected by The Cochrane Collaboration. This review includes seven trials with low to moderate risk of bias: five undertaken in children (987 participants) and two in adults (156 participants). An eighth trial in adults (40 participants) was at high risk of bias and did not provide any data for analysis. Good information about the effectiveness of adeno-/tonsillectomy is only available for the first year following surgery in children and for a shorter period (five to six months) in adults.We combined data from five trials in children; these trials included children who were 'severely affected' (based on the specific 'Paradise' criteria) and less severely affected. Children who had an adeno-/tonsillectomy had an average of three episodes of sore throats (of any severity) in the first postoperative year, compared to 3.6 episodes in the control group; a difference of 0.6 episodes (95% confidence interval (CI) -1 to

  3. The lived experience of dysphagia following non-surgical treatment for head and neck cancer.

    Science.gov (United States)

    Nund, Rebecca L; Ward, Elizabeth C; Scarinci, Nerina A; Cartmill, Bena; Kuipers, Pim; Porceddu, Sandro V

    2014-06-01

    The prevalence and severity of dysphagia in people treated non-surgically for primary head and neck cancer (HNC) is well documented. However, few studies have looked beyond the physiological impairment to explore the lived experience of dysphagia in the post-treatment period of HNC. The current study adopted a person-centred, qualitative approach to describe the experiences of people living with dysphagia in the months and years following non-surgical treatment for HNC. Using maximum variation sampling, 24 participants who had undergone radiotherapy treatment for HNC were recruited. Individual interviews were conducted to explore the impact of dysphagia on participants' everyday lives. The themes identified included: (1) physical changes related to swallowing; (2) emotions evoked by living with dysphagia; (3) altered perceptions and changes in appreciation of food; and (4) personal and lifestyle impacts. The data revealed the breadth and significance of the impact of dysphagia on the lives of people treated curatively for HNC. Assessment and management in the post-treatment period must be sufficiently holistic to address both the changing physical states and the psychosocial needs of people with dysphagia following HNC. Rehabilitation services which focus only on impairment-based management will fail to fully meet the support needs of this clinical population.

  4. Non-surgical factors influencing lymph node yield in colon cancer

    Institute of Scientific and Technical Information of China (English)

    Patrick Wood; Colin Peirce; Jurgen Mulsow

    2016-01-01

    There are numerous factors which can affect the lymph node(LN) yield in colon cancer specimens.The aim of this paper was to identify both modifiable and nonmodifiable factors that have been demonstrated toaffect colonic resection specimen LN yield and to summarise the pertinent literature on these topics.A literature review of Pub Med was performed to identify the potential factors which may influence the LN yield in colon cancer resection specimens.The terms used for the search were:LN,lymphadenectomy,LN yield,LN harvest,LN number,colon cancer and colorectal cancer.Both nonmodifiable and modifiable factors were identified.The review identified fifteen non-surgical factors:(13 nonmodifiable,2 modifiable) which may influence LN yield.LN yield is frequently reduced in older,obese patients and those with male sex and increased in patients with right sided,large,and poorly differentiated tumours.Patient ethnicity and lower socioeconomic class may negatively influence LN yield.Pre-operative tumour tattooing appears to increase LN yield.There are many factors that potentially influence the LN yield,although the strength of the association between the two varies greatly.Perfecting oncological resection and pathological analysis remain the cornerstones to achieving good quality and quantity LN yields in patients with colon cancer.

  5. Acute prevertebral calcific tendinitis: a source of non-surgical acute cervical pain.

    Science.gov (United States)

    Silva, Claudio F; Soffia, Pablo S; Pruzzo, Edda

    2014-02-01

    Prevertebral calcific tendinitis results from calcium hydroxyapatite crystal deposits in the longus colli muscles, which induce symptoms similar to some surgically-treated conditions, such as retropharyngeal abscesses. Imaging techniques are critical for accurate diagnosis. To describe the computed tomography (CT) findings associated with prevertebral calcific tendinitis. Retrospective analysis performed in an 18-month period, searching for patients with neck CT and reports with diagnosis of "calcific longus collis tendinitis" or "prevertebral calcific tendinitis". CT images and clinical data available in the medical records were analyzed. One hundred and thirty-four examinations were performed in the period studied. Nine patients who fulfilled inclusion criteria were identified and their CT imaging characteristics are presented. Six presented with calcific deposits in the right longus colli muscle. CT matched the clinical pain lateralization in all cases. Eight patients had no significant enhancement post injection of contrast media. Prevertebral calcific tendinitis is a cause of acute cervical pain that clinically mimics a retropharyngeal abscess, however on neck CT has a characteristic appearance. Correct identification of this pathologic condition will help avoiding unnecessary invasive procedures.

  6. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis.

    Science.gov (United States)

    Burton, Martin J; Glasziou, Paul P

    2009-01-21

    Surgical removal of the tonsils, with or without adenoidectomy (adeno-/tonsillectomy), is a common ENT operation but the indications for surgery are controversial. To determine the effects of tonsillectomy, with and without adenoidectomy, in patients with chronic/recurrent acute tonsillitis. The Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, issue 2), MEDLINE (1966 to 2008), EMBASE (1974 to 2008), bibliographies, and additional sources were searched for published and unpublished trials. The date of the last search was 11 April 2008. Randomised controlled trials comparing tonsillectomy, with or without adenoidectomy, with non-surgical treatment in adults and children with chronic/recurrent acute tonsillitis. We included trials which used reduction in the number and severity of tonsillitis and sore throat as main outcome measures. Two authors applied the inclusion/exclusion criteria independently. This review includes five studies: four undertaken in children (719 participants) and one in adults (70 participants). Good information about the effects of tonsillectomy is only available for children and for effects in the first year following surgery.Children were divided into two subgroups: those who are severely affected (based on specific criteria which are often referred to as the 'Paradise criteria') and those less severely affected.For more severely affected children adeno-/tonsillectomy will avoid three unpredictable episodes of any type of sore throat, including one episode of moderate or severe sore throat in the next year. The cost of this is a predictable episode of pain in the immediate postoperative period.Less severely affected children may never have had another severe sore throat anyway and the chance of them so doing is modestly reduced by adeno-/tonsillectomy. For them, surgery will mean having an average of two rather than three unpredictable

  7. Is surgical intervention more effective than non-surgical treatment for acute Achilles tendon rupture? A systematic review of overlapping meta-analyses.

    Science.gov (United States)

    Wu, Yaohong; Lin, Linghan; Li, Hao; Zhao, Yachao; Liu, Longgang; Jia, Zhiwei; Wang, Deli; He, Qing; Ruan, Dike

    2016-12-01

    There is discordance in the results from meta-analyses on surgical versus non-surgical treatment for acute Achilles tendon rupture. We systematically reviewed the overlapping meta-analyses on this topic to provide information that will be helpful to decision makers when selecting treatments based on the current best available evidence. We comprehensively searched multiple databases for systematic reviews that compared surgical and non-surgical treatments for acute Achilles tendon rupture. We only included meta-analyses that comprised randomized controlled trials (RCTs). The methodological quality and extracted data were assessed. The meta-analysis that offered the best evidence was ascertained with the Jadad decision algorithm. Nine meta-analyses were included in our study and all of them included RCTs with Level-II evidence. Assessment of Multiple Systematic Reviews (AMSTAR) scores ranged from 5 to 10 (median 7). The Jadad decision algorithm was used to select a high-quality meta-analysis with more RCTs. The results from this study showed that when functional rehabilitation was used, non-surgical intervention was similar to surgical treatment regarding the incidence of range of motion, rerupture, calf circumference and functional outcomes, and the incidence of other complications was reduced. Non-surgical intervention significantly increased the rerupture rate if functional rehabilitation was not considered. The findings of meta-analyses regarding surgical versus non-surgical treatment for acute Achilles tendon rupture are inconsistent. According to this systematic review of overlapping meta-analyses, the current best available evidence suggests that centers offering functional rehabilitation may prefer non-surgical intervention. Surgical treatment may be preferred at centers that do not have functional rehabilitation. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Quality of survival in patients treated for malignant biliar y obstruction caused by unresectable pancreatic head cancer:surgical versus non-surgical palliation

    Institute of Scientific and Technical Information of China (English)

    Hyung Ook Kim; Sang Il Hwang; Hungdai Kim; Jun Ho Shin

    2008-01-01

    BACKGROUND:Appropriate palliation for unresectable pancreatic head cancer is most important. This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. METHODS:We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer. Fifty-two patients with locally advanced disease (local vascular invasion) and 17 with distant metastatic disease were included. The patients were divided into two groups, surgical and non-surgical palliation. RESULTS:Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage (PTBD). There was no signiifcant difference in the early complications, successful biliary drainage, recurrent jaundice, and 30-day mortality between surgical palliation and PTBD. However, in 52 patients whose tumor was unresectable secondary to local vascular invasion, the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non-surgical palliation (P CONCLUSIONS:In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions, surgical exploration should be performed. Thus, in patients who have unresectable cancer or limited metastatic disease on exploration, surgical palliation should be performed for longer survival and better quality of survival.

  9. Acute pain treatment on postoperative and medical non-surgical wards [Akutschmerztherapie auf operativen und konservativen Stationen

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2013-05-01

    Full Text Available [english] The effectiveness of acute pain treatment in hospitals is examined. An efficient therapy of acute pain is efficient and cost-effective. Although every patient is entitled for the relief of pain, many hospitals do not treat acute pain in an optimal manner.[german] Es wird die Effektivität der Akutschmerztherapie in Krankenhäusern untersucht. Eine effiziente Behandlung akuter Schmerzen ist wirksam und spart Kosten. Obwohl jeder Patient Anspruch auf Linderung seiner Schmerzen hat, behandeln viele Krankenhäuser akute Schmerzen noch nicht optimal.

  10. The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: a systematic review protocol.

    Science.gov (United States)

    Pope, Nicole; Tallon, Mary; McConigley, Ruth; Wilson, Sally

    2015-10-01

    The qualitative objective of this systematic review is to identify and synthesize the best available evidence on experiences of acute non-surgical pain, including pain management, of children (between four to 18 years) when they present to a healthcare facility for treatment.The specific objectives are to identify: The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". The pain experience is multifaceted and complex, extending beyond the physiological interpretation of a noxious stimulus, encompassing other dimensions, including; psychological, cognitive, sociocultural, affective and emotional factors. Pain can be described as chronic (persisting for three months or more) or acute (a time limited response to a noxious stimuli). Over the past 50 years clinical research has made revolutionary contributions to better understanding pediatric pain. The once pervasive erroneous notion that infants do not experience pain the same way as adults has been firmly dispelled. We now know that nervous system structures associated with the physiological interpretation of pain are functional as early as fetal development. Despite this critical knowledge and the growing global commitment to improving pediatric pain management in clinical practice, evidence repeatedly suggests that pain management remains suboptimal and inconsistent, a phenomenon commonly referred to as oligoanalgesia. Research evidence has linked poorly managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Effective pain management is therefore a priority area for health care professionals. Improved understanding of children's experiences of acute non-surgical pain may lead to improved pain management and a reduction in oligoanalgesia.In the 1970s and 1980s, studies began exploring the subjective experiences of

  11. Safety of elective colorectal cancer surgery : Non-surgical complications and colectomies are targets for quality improvement

    NARCIS (Netherlands)

    Henneman, Daniel; Ten Berge, Martijn G.; Snijders, Heleen S.; Van Leersum, Nicoline J.; Fiocco, Marta; Wiggers, Theo; Tollenaar, Rob A. E. M.; Wouters, Michel W. J. M.

    2014-01-01

    Background Mortality following severe complications (failure-to-rescue, FTR) is targeted in surgical quality improvement projects. Rates may differ between colon- and rectal cancer resections. Methods Analysis of patients undergoing elective colon and rectal cancer resections registered in the Dutch

  12. Non-Surgical Breast-Conserving Treatment (KORTUC-BCT Using a New Radiosensitization Method (KORTUC II for Patients with Stage I or II Breast Cancer

    Directory of Open Access Journals (Sweden)

    Yasuhiro Ogawa

    2015-11-01

    Full Text Available The purpose of the present study was to establish a non-surgical breast-conserving treatment (BCT using KORTUC II radiosensitization treatment. A new radiosensitizing agent containing 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (a CD44 ligand has been developed for intra-tumoral injection into various tumors. This new method, named KORTUC II, was approved by our local ethics committee for the treatment of breast cancer and metastatic lymph nodes. A total of 72 early-stage breast cancer patients (stage 0, 1 patient; stage I, 23; stage II, 48 were enrolled in the KORTUC II trial after providing fully informed consent. The mean age of the patients was 59.7 years. A maximum of 6 mL (usually 3 mL for tumors of less than approximately 3 cm in diameter of the agent was injected into breast tumor tissue twice a week under ultrasonographic guidance. For radiotherapy, hypofraction radiotherapy was administered using a tangential fields approach including an ipsilateral axillary region and field-in-field method; the energy level was 4 MV, and the total radiation dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added three times. Treatment was well tolerated with minimal adverse effects in all 72 patients. No patients showed any significant complications other than mild dermatitis. A total of 24 patients under 75 years old with stage II breast cancer underwent induction chemotherapy (EC and/or taxane prior to KORTUC II treatment, and 58 patients with estrogen receptor-positive tumors also received hormonal therapy following KORTUC II. The mean duration of follow-up as of the end of September 2014 was 51.1 months, at which time 68 patients were alive without any distant metastases. Only one patient had local recurrence and died of cardiac failure at 6.5 years. Another one patient had bone metastases. For two of the 72 patients, follow-up ended after several months following KORTUC II treatment. In conclusion, non-surgical

  13. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Lara, Christine Tunon de, E-mail: c.tunondelara@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Ferron, Stéphane, E-mail: s.ferron@bordeaux.unicancer.fr; Hurtevent, Gabrielle, E-mail: g.hurtevent@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Fournier, Marion, E-mail: m.fournier@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Debled, Marc, E-mail: m.debled@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Oncology (France); Palussière, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France)

    2015-10-15

    AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.

  14. Application of the International Classification of Functioning, Disability and Health (ICF) to people with dysphagia following non-surgical head and neck cancer management.

    Science.gov (United States)

    Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

    2014-12-01

    The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 individuals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the diverse impact of dysphagia associated with HNC on the individual, can be used to guide more holistic assessment and management for this population.

  15. Non-surgical therapy of Peyronie's disease

    Institute of Scientific and Technical Information of China (English)

    Frederick L. Taylor; Laurence A. Levine

    2008-01-01

    The present paper provides a review of the available non-surgical treatments for Peyronie's disease (PD). A review of published literature on oral, intralesional, external energy and iontophoresis therapies for PD was performed,and the published results of available treatment options reviewed. The authors' recommendations for appropriate non-surgical management of PD are provided. Although there are many published reports that show the efficacy of non-surgical therapies for PD, there is a lack of large scale, multicenter controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments, which might do harm, and misses the opportunity to do some good. Clearly further work is necessary to develop safe and effective non-surgical treatments for PD.

  16. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: J.Palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Interventional Radiology (France); Lagarde, Philippe, E-mail: P.Lagarde@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Radiation Oncology Department (France); Aupérin, Anne, E-mail: auperin@igr.fr [Institut Gustave-Roussy, Unit of Biostatistics and Epidemiology (France); Deschamps, Frédéric, E-mail: frederic.deschamps@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France); Chomy, François, E-mail: F.Chomy@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Department of medical oncology (France); Baere, Thierry de, E-mail: debaere@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France)

    2015-02-15

    PurposeTo evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.Materials and MethodsEighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analysesResultsMedian follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.ConclusionsOversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression.

  17. ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology.

    Science.gov (United States)

    Bozzetti, F; Arends, J; Lundholm, K; Micklewright, A; Zurcher, G; Muscaritoli, M

    2009-08-01

    Parenteral nutrition offers the possibility of increasing or ensuring nutrient intake in patients in whom normal food intake is inadequate and enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. These guidelines are intended to provide evidence-based recommendations for the use of parenteral nutrition in cancer patients. They were developed by an interdisciplinary expert group in accordance with accepted standards, are based on the most relevant publications of the last 30 years and share many of the conclusions of the ESPEN guidelines on enteral nutrition in oncology. Under-nutrition and cachexia occur frequently in cancer patients and are indicators of poor prognosis and, per se, responsible for excess morbidity and mortality. Many indications for parenteral nutrition parallel those for enteral nutrition (weight loss or reduction in food intake for more than 7-10 days), but only those who, for whatever reason cannot be fed orally or enterally, are candidates to receive parenteral nutrition. A standard nutritional regimen may be recommended for short-term parenteral nutrition, while in cachectic patients receiving intravenous feeding for several weeks a high fat-to-glucose ratio may be advised because these patients maintain a high capacity to metabolize fats. The limited nutritional response to the parenteral nutrition reflects more the presence of metabolic derangements which are characteristic of the cachexia syndrome (or merely the short duration of the nutritional support) rather than the inadequacy of the nutritional regimen. Perioperative parenteral nutrition is only recommended in malnourished patients if enteral nutrition is not feasible. In non-surgical well-nourished oncologic patients routine parenteral nutrition is not recommended because it has proved to offer no advantage and is associated with increased morbidity. A benefit, however, is reported in patients undergoing hematopoietic stem cell transplantation

  18. Non-surgical embryo transfer in pigs

    NARCIS (Netherlands)

    Hazeleger, W.

    1999-01-01

    Embryo transfer in pigs has been performed surgically for a long time. However, a less invasive, non-surgical, procedure of embryo transfer could be a valuable tool for research (to study embryo survival and embryo-uterus interactions) and practical applications (export, prevention of

  19. Non-surgical treatment of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Vito Annese; Gabrio Bassotti

    2006-01-01

    Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration,weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

  20. Irrigants in non-surgical endodontic treatment.

    Science.gov (United States)

    Regan, John D; Fleury, Alex A P

    2006-01-01

    This paper highlights that one of the main goals of root canal treatment is the elimination of microorganisms from the contaminated root canal system. Instrumentation alone will not allow for adequate debridement and disinfection of the complex and diverse root canal system. Chemomechanical debridement is required. The importance of the use of irrigants during non-surgical root canal treatment has frequently been neglected both during instruction of dental students and later in the clinical practice of endodontics. The article highlights 'shape, clean and fill' vs. 'clean, shape and fill' to enable chemomechanical debridement. Our protocol advises mechanical debridement and copious irrigation for a minimum of twenty minutes with 2.5% to 6% solutions of sodium hypochlorite, followed by a rinse with a 17% solution of ethylenediaminetetraacetic acid and a final rinse with 2% chlorhexidine. The canals are dried with high volume aspirators and sterile paper points.

  1. Non-surgical periodontal management in scleroderma disease patients.

    Science.gov (United States)

    Laforgia, A; Corsalini, M; Stefanachi, G; Tafuri, S; Ballini, A; Pettini, F; Di Venere, D

    2016-01-01

    The aim of the present study is to investigate the periodontal status of people with scleroderma and their response to non-surgical treatment protocol aimed at controlling the evolution of the disease. The response to non-surgical periodontal treatment was tested on patients belonging to a scleroderma group and a control group: the data show an improvement of the periodontal conditions of all these patients in response to treatment. When compared on the same diagram, a slight remission of the periodontal disease was obtained in both scleroderma and healthy patients. This highlights the benefit to soft tissues produced by non-surgical periodontal treatment also in patients affected by systemic diseases.

  2. Usefulness of gadolinium in MRI evaluation of non surgically treated herniated disk.

    Science.gov (United States)

    Motta, E; Boniotti, V; Miserocchi, L; Caudana, R

    2005-01-01

    The rationale for the use of Gadolinium (Gd) in the MRI evaluation of non surgically treated herniated disk is based on the known presence of inflammatory granulation tissue and neoangiogenesis which plays an important role in both pain and the spontaneous resorption of the hernia. of this study was to determine the usefulness of Gd in MRI examination for detecting the inflammatory reaction around the discal hernia. Thirty-eight patients (mean age 45 years; range 20-70 years) with non surgically treated herniated disk were evaluated with MRI between January 2000 and July 2004. T2w-FAST-SE sagittal and T1w-SE transaxial and sagittal images were acquired before and after the administration of Gd. Twenty out of 22 patients with acute sciatic pain (symptoms =/discal hernia in the spinal canal. In the remaining 16 with chronic sciatic pain (symptoms > 6 months) the discal hernia did not show peri-hernial enhancement. In MRI evaluation of the herniated disk, peri-hernial enhancement is correlated with inflammatory reaction around the hernia which is associated with acute symptoms. The absence of peri-hernial enhancement in chronic herniated disk is due to the poorly vascular fibrotic tissue. Therefore, peri-hernial enhancement facilitates the differential diagnosis in uncertain cases and represents a reliable prognostic index of response to non-surgical therapy and of the possible spontaneous resorption of discal hernia.

  3. Non-surgical management of multicystic dysplastic kidney.

    Science.gov (United States)

    Cambio, Angelo J; Evans, Christopher P; Kurzrock, Eric A

    2008-04-01

    To better define the outcome and association of multicystic dysplastic kidney (MCDK) with hypertension, vesico-ureteric reflux (VUR), infection and cancer, as there is no consensus on the management of patients born with MCDK. The risk of cancer has dictated the surgical management of the disease in the past. The Medline database was searched for articles published between 1965 and 2006 and written in the English language, and containing the keywords 'multicystic dysplastic kidney'. The inclusion criteria were met by 105 reports that were subsequently analysed. Of MCDK, 60% regress or involute within 3 years. About 25% of patients will have VUR into the contralateral kidney, of which 90% is grade non-surgical management of MCDK. Common practice has been to remove palpable or growing MCDKs, although these represent a very small fraction of MCDKs. In theory, ultrasonographic surveillance until 4 years old might allow the earlier detection of a Wilms' tumour, and decrease the intensity of chemotherapy and improve prognosis. Previous reports do not prove or disprove this concept, and the appropriate frequency of surveillance is not evident.

  4. [Acute appendicitis. Surgical and non-surgical treatment].

    Science.gov (United States)

    Souza-Gallardo, Luis Manuel; Martínez-Ordaz, José Luis

    2017-01-01

    Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment. It is known that traditional management of appendicitis is appendectomy with a complication rate of 2.5% to 48%. Nowadays, laparoscopy is the approach of choice by many surgeons and there have proposed new invasive techniques such as endoscopic treatment with the use of prosthesis and ambulatory surgery. Antibiotic use is essential in the management of appendicitis. Its use as the only strategy to treat this disease has the purpose of lowering costs and diminishing complications related to surgery or the resection of the organ. We conclude that the ideal management of appendicitis remains controversial and it will depend of the clinical characteristics of each patient and the resources available.

  5. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  6. The clinical feature and countermeasures of hospital-acquired pneumonia in non-surgical treatment elderly inpatients with lung cancer%老年肺癌非手术治疗医院内获得性肺炎的临床特点分析及对策

    Institute of Scientific and Technical Information of China (English)

    黄虎威; 周建英

    2009-01-01

    Objective To analyze the clinical feature and treatment strategy of Hospital-acquired pneumonia (HAP) in old age patients with lung cancer. Method 275 cases of HAP in non-surgically treated elderly inpatients with lung cancer during January 2006 to December 2008 were included and analyzed retrospectively. Result Among these patients, 165 cases occurred Central-type lung cancer, squamous cell carcinoma were prone to develop HAP; HAP caused by gram-negative bacteria was significantly higher than that caused by gram-positive bacteria and fungi; HAP infection rate in radiotherapy plus chemotherapy group was higher than that in chemotherapy or radiotherapy alone group; Along with the decrease of neutrophilic leukocyte, the infection rate was significantly higher, especially when the neutrophilic leukocyte < 1.0 × 10~9/L. Conclusion According to the clinical feature of HAP in non-surgically treated elderly inpatients with lung cancer, the prevention of HAP should be a fundamental measure, and treatment should be given in time once the infection occurs.%目的 探讨老年肺癌非手术治疗患者医院内获得性肺炎的临床特点及对策.方法 对2006年1月至2008年12月住院的275例非手术治疗老年肺癌的医院内获得性肺炎(Hospital-acquired pneumonia,HAP)情况进行回顾性分析.结果 本组病例发生院内获得性肺炎165例.以中央型肺癌、鳞癌易发院内获得性肺炎;由革兰阴性菌导致的HAP明显高于革兰阳性菌与真菌;放疗加化疗HAP感染率高于单纯放疗或化疗;随着白细胞下降,感染率明显增高,特别是粒细胞<1.0×10~9/L者感染率最高.结论 根据老年肺癌非手术治疗院内获得性肺炎的临床特点把HAP的预防作为根本措施,一旦出现感染应及时治疗.

  7. Prevalence of deep vein thrombosis (DVT) in non-surgical patients at hospital admission.

    Science.gov (United States)

    Lawall, Holger; Hoffmanns, Wibke; Hoffmanns, Phillip; Rapp, Uli; Ames, Michael; Pira, Alessandro; Paar, W Dieter; Bramlage, Peter; Diehm, Curt

    2007-10-01

    Venous thromboembolism (VTE) is known as a common complication in surgical and non-surgical patients. We hypothesized that according to the underlying risk factors and the acute illness, the prevalence ofVTE in non-surgical patients admitted to hospital is widely underestimated. For three months each patient admitted to the department of internal medicine with an acute illness, but without known deep venous thrombosis (DVT) was investigated by ultrasound compression sonography. Patients' history, risk factors and extent of immobilisation were documented. In patients with newly detected DVT D-dimer and fibrinogen were measured as well as computer tomography scans performed. Follow-up investigations of the DVT population were performed at four weeks and three months. Six hundred seventeen patients (49.3% men) were included. In 16 patients (men = 7) a previously unknown thrombosis (2.6%) was detected, mainly in patients with acute cardio-pulmonary disease (56%) and the elderly (mean age 75.6 years). Eight patients had femoro-popliteal (50.0%), four a femoral (25.0%), and four a popliteal vein thrombosis (25.0%). Five had pulmonary embolism (31.3%). In patients with DVT D-dimer was 875 +/- 1,228 mg/l, fibrinogen 568 +/- 215 mg/dl and C-reactive-protein 58.54 +/- 73.65 mg/dl. One patient died from sepsis during hospitalisation, one died from sudden cardiac death at home. None of the other 14 surviving patients relapsed. The study shows a 2.6% risk for DVT in outpatients with acute illness admitted to the department of internal medicine. These data demonstrate the high risk of DVT is in non-surgical patients. Early prophylaxis has to be considered in internal medicine patients especially in the elderly.

  8. Non-surgical and non-chemical attempts to treat echinococcosis: do they work?

    Directory of Open Access Journals (Sweden)

    Tamarozzi Francesca

    2014-01-01

    Full Text Available Cystic echinococcosis (CE and alveolar echinococcosis (AE are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the lesion, setting and patient. We performed a literature review of curative or palliative non-surgical, non-chemical interventions in CE and AE. In CE, some of these techniques, like radiofrequency thermal ablation (RFA, were shelved after initial attempts, while others, such as High-Intensity Focused Ultrasound, appear promising but are still in a pre-clinical phase. In AE, RFA has never been tested, however, radiotherapy or heavy-ion therapies have been attempted in experimental models. Still, application to humans is questionable. In CE, although prospective clinical studies are still lacking, therapeutic, non-surgical drainage techniques, such as PAIR (puncture, aspiration, injection, re-aspiration and its derivatives, are now considered a useful option in selected cases. Finally, palliative, non-surgical drainage techniques such as US- or CT-guided percutaneous biliary drainage, centro-parasitic abscesses drainage, or vascular stenting were performed successfully. Recently, endoscopic retrograde cholangiopancreatography (ERCP-associated techniques have become increasingly used to manage biliary fistulas in CE and biliary obstructions in AE. Development of pre-clinical animal models would allow testing for AE techniques developed for other indications, e.g. cancer. Prospective trials are required to determine the best use of PAIR, and associated procedures, and the indications and techniques of palliative drainage.

  9. Review of acute cancer beds.

    LENUS (Irish Health Repository)

    Evans, D S

    2012-01-01

    A review of admissions to cancer services at University Hospital Galway (UHG) was undertaken to assess the appropriateness of hospital usage. All cancer specialty patients admitted from 26-28 May 2009 were reviewed (n = 82). Chi square tests, Exact tests, and One-way ANOVA were utilised to analyse key issues emerging from the data. Fifty (61%) were classified as emergencies. Twenty three (67%) occupied a designated cancer bed with 24 (30%) in outlying non-oncology wards. The mean length of stay was 29.3 days. Possible alternatives to admission were identified for 15 (19%) patients. There was no evidence of discharge planning for 50 (60%) admissions. There is considerable potential to make more appropriate utilisation of UHG for cancer patients, particularly in terms of reducing bed days and length of stay and the proportion of emergency cancer admissions, and further developing integrated systems of discharge planning.

  10. Review of acute cancer beds.

    LENUS (Irish Health Repository)

    Evans, D S

    2012-01-01

    A review of admissions to cancer services at University Hospital Galway (UHG) was undertaken to assess the appropriateness of hospital usage. All cancer specialty patients admitted from 26-28 May 2009 were reviewed (n = 82). Chi square tests, Exact tests, and One-way ANOVA were utilised to analyse key issues emerging from the data. Fifty (61%) were classified as emergencies. Twenty three (67%) occupied a designated cancer bed with 24 (30%) in outlying non-oncology wards. The mean length of stay was 29.3 days. Possible alternatives to admission were identified for 15 (19%) patients. There was no evidence of discharge planning for 50 (60%) admissions. There is considerable potential to make more appropriate utilisation of UHG for cancer patients, particularly in terms of reducing bed days and length of stay and the proportion of emergency cancer admissions, and further developing integrated systems of discharge planning.

  11. The Prevention and Non-surgical Treatment for Postsurgical Gastroparesis Syndrome in Esophageal Cancer or Cardiac Cancer Patients%食管癌、贲门癌术后胃瘫综合征的预防与非手术治疗

    Institute of Scientific and Technical Information of China (English)

    胡彬; 庄翔; 杨晓军; 谢天鹏; 肖平; 荣昊; 李强

    2014-01-01

    Objective: To investigate the prevention and non-surgical treatment for postsurgical gastroparesis syn-drome in esophageal cancer or cardiac cancer patients. Methods:Between April 2010 and June 2013, the systematic pre-ventive measures were given to 867 patients ( observation group) who accepted operation for esophageal cancer or cardiac cancer in our hospital, which included intraoperative protection for the stomach, chest gastric fixation, gastrointestinal de-compression, acid suppression to reduce tension of stomach, enteral nutrition support, prevention from the inhibition of gas-trointestinal smooth muscle contraction, keeping balance for internal environment. Between May 2007 to March 2010, the systematic preventive measures were not given to the 573 patients ( control group) . The non-operative comprehensive treat-ment measures were given to gastric paralysis cases in observation group, which included fasting water, continuous gastroin-testinal decompression, prevention of regurgitation and aspiration, warm saline lavage, enteral nutrition, total parenteral nutrition in enteral nutrition failed cases, gastric dynamic drugs, maintaining internal environment balance, monitoring the blood sugar level, pyloric expansion under gastroscope, traditional Chinese medicine ( TCM) tube feeding, etc. The con-trol group did not accept comprehensive treatment measures. The clinical curative efficacy of gastric paralysis in the two groups were reviewed. Results:Twenty-seven cases of gastric paralysis occurred in the control group ( 4. 71%) , and 22 cases (2. 53%) in observing group. The incidence of gastric paralysis significantly decreased after systematic preventive measures was conducted (P =0. 04). The symptoms of 22 cases in observation group were control effectively. No death occured in this group. The average time of nutrition tube in-dwelling was 48. 35 ( 17 ~69 ) days; The average length of hospital stay was 53. 23 (19~71) days. In control group, 2 patients died

  12. Endometrial and acute myeloid leukemia cancer genomes characterized

    Science.gov (United States)

    Two studies from The Cancer Genome Atlas (TCGA) program reveal details about the genomic landscapes of acute myeloid leukemia (AML) and endometrial cancer. Both provide new insights into the molecular underpinnings of these cancers.

  13. Esthesioneuroblastoma with intracranial extension: A non-surgical approach.

    Science.gov (United States)

    Thomas, Sarah Boby; Balasubramaniam, Deepak; Hiran, K R; Dinesh, M; Pavithran, K

    2016-01-01

    Esthesioneuroblastoma is a rare tumor arising from the olfactory mucosa of upper respiratory tract. The primary modality of treatment has been surgery with craniofacial resection followed by post-operative radiotherapy. There are only a few reported cases of non-surgical approaches. We report a case of esthesioneuroblastoma with intracranial extension treated with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide, Etoposide protocol followed by radiation with 5 years of follow-up. This is the first reported case using this chemotherapy schedule.

  14. Effect of non-surgical periodontal treatment on transferrin serum levels in patients with chronic periodontitis.

    Science.gov (United States)

    Shirmohamadi, Adileh; Chitsazi, Mohamad Taghi; Faramarzi, Masoumeh; Salari, Ashkan; Naser Alavi, Fereshteh; Pashazadeh, Nazila

    2016-01-01

    Background. Transferrin is a negative acute phase protein, which decreases during inflammation and infection. The aim of the present investigation was to evaluate changes in the transferrin serum levels subsequent to non-surgical treatment of chronic periodontal disease. Methods. Twenty patients with chronic periodontitis and 20 systemically healthy subjects without periodontal disease, who had referred to Tabriz Faculty of Dentistry, were selected. Transferrin serum levels and clinical periodontal parameters (pocket depth, clinical attachment level, gingival index, bleeding index and plaque index) were measured at baseline and 3 months after non-surgical periodontal treatment. Data were analyzed with descriptive statistical methods (means ± standard deviations). Independent samples t-test was used to compare transferrin serum levels and clinical variables between the test and control groups. Paired samples t-test was used in the test group for comparisons before and after treatment. Statistical significance was set at P < 0.05. Results. The mean transferrin serum level in patients with chronic periodontitis (213.1 ± 9.2 mg/dL) was significantly less than that in periodontally healthy subjects (307.8 ± 11.7 mg/dL). Three months after periodontal treatment, the transferrin serum level increased significantly (298.3 ± 7.6 mg/dL) and approached the levels in periodontally healthy subjects (P < 0.05). Conclusion. The decrease and increase in transferrin serum levels with periodontal disease and periodontal treatment, respectively, indicated an inverse relationship between transferrin serum levels and chronic periodontitis.

  15. Effect of non-surgical periodontal therapy on serum ferritin levels: an interventional study.

    Science.gov (United States)

    Chakraborty, Souvik; Tewari, Shikha; Sharma, Rajinder Kumar; Narula, Satish Chander

    2014-05-01

    Ferritin, an acute-phase reactant, has been found to be elevated in many chronic inflammation-related diseases. The aim of the present study is to investigate differences in concentrations of serum ferritin in patients with and without periodontal disease before and after non-surgical periodontal therapy and correlate these values with clinical variables associated with periodontal disease. Forty-two individuals were included in this study, 20 with chronic periodontitis (CP) and 22 classified as periodontally healthy. Serum ferritin concentrations, hemoglobin levels, and periodontal parameters (probing depth [PD], clinical attachment level, gingival index, bleeding on probing, and plaque index) were recorded at baseline and 3 months after non-surgical periodontal therapy. Patients with CP showed higher concentrations of serum ferritin than periodontally healthy controls (P serum ferritin levels and the number of sites with PD ≥ 6 mm at baseline (P serum ferritin levels at baseline (R(2) = 0.823). Significant reductions in serum ferritin levels were observed at the 3-month assessment after periodontal treatment (P serum ferritin values were comparable to those of controls (P >0.05). Furthermore, the post-treatment degree of change in the serum ferritin level was positively and significantly associated with improvement in PD (R(2) = 0.213, P Serum ferritin levels are raised in patients with CP and decrease to control levels post-treatment.

  16. Non-surgical treatment of skeletal class III malocclusion.

    Science.gov (United States)

    Kapadia, Romina M; Shah, Adit P; Diyora, Shamil D; Rathva, Vandana J

    2014-04-10

    The incidence of skeletal class III malocclusion has a mean of 3% in the Caucasian population, 5% in African-American adolescents and about 14% in the Asian population. In India, the incidence of class III malocclusion is reported to be 3.4%. A patient having class III malocclusion shows findings ranging from edge-to-edge bite to large reverse overjet, with extreme variations of underlying skeletal jaw bases and craniofacial form. This is a case report of a 20-year-old man having skeletal class III malocclusion with concave profile, anterior crossbite and a negative overjet of 3 mm treated non-surgically with extraction of only one lower left first premolar.

  17. Surgical versus non-surgical management for pleural empyema.

    Science.gov (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

    2017-03-17

    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  18. Acute leukaemia: making sense of a complex blood cancer.

    LENUS (Irish Health Repository)

    Meenaghan, Teresa

    2012-01-01

    Acute leukaemia represents a diverse group of blood cancers that affect both children and adults. Treatment schedules for these haematology cancers are often prolonged, with many associated side effects and complications. Nurses caring for patients with acute leukaemia require an anticipatory approach, where care is aimed at minimizing the side effects of treatment and being constantly vigilant for any impending adverse effects. Moreover, patients require support for the psychosocial issues that can arise for patients during their illness. This article provides an overview of acute lymphoblastic leukaemia and acute myeloid leukaemia. Nursing considerations in the care of patients being treated for acute leukaemia are also explored.

  19. The study of clinical target volume motion of radical intensity-modulated radiotherapy for non-surgical cer-vical cancer patients by cone beam computed tomography%锥形束CT评价根治性宫颈癌调强放疗患者肿瘤临床靶区运动度的研究∗

    Institute of Scientific and Technical Information of China (English)

    丁嘉佩; 袁君; 朱红; 吴苏日娜; 严思奇; 马觉

    2016-01-01

    Objective To investigate the motion of clinical target volume(CTV)by using cone beam computed tomography ( CBCT) on linear accelerator and to determine a internal margin( IM) value for the internal target volume( ITV) during intensity-modula-ted radiotherapy( IMRT) for non-surgical cervical cancer. Methods One hundred and forty CBCT images from 20 non-surgical cervical cancer patients who underwent radical IMRT from Dec 2013 to Oct 2014 were selected for this study. The deformation and displacement between the simulation CT and CBCTs were measured. Results The volume reductions of CTV1 between the simulation CT and CBCTs were(33. 56±22. 52) cm3(range from 1. 04-110. 22 cm3) and the percentages of the volume reductions were(10. 19±6. 32)%(range from 0. 37%-32. 01%). The motion between the simulation CT and CBCTs were(1. 19±0. 82)cm,(0. 80±0. 55)cm,(0. 16±0. 25)cm,(0. 23± 0. 29) cm, ( 0. 27 ± 0. 42) cm, ( 0. 18 ± 0. 24) cm and ( 0. 78 ± 1. 09) cm in the anterio-posterior directions of uterus, anterio-posterior directions of cervix, superior directions of uterus, lateral directions of the same side, the opposite side of the bottom of uterus, respective-ly. If the IM was set less than 2 cm, the CTV of 85% CBCTs could be covered completely. 95% patients showed greater uterus motions than cervical motions in all directions. The motion of CTV1 had great individual difference. Conclusion The strategies of target outline for different IM size at three dimensional direction obtained by CBCT and different IM size of uterus and cervix, in combination with indi-vidualized image guided radiotherapy may be a good clinical form for realizing precise radiotherapy in cervical cancer.%目的:探讨采用锥形束 CT ( CBCT )评价未手术宫颈癌患者适形调强放射治疗( IMRT )中肿瘤临床靶区(CTV)内界值的移动度,以期为未手术宫颈癌根治性放疗患者肿瘤CTV-ITV扩界值(IM)的设定提供参考。方法收集2013年12

  20. Cancer risk of patients discharged with acute myocardial infarct

    DEFF Research Database (Denmark)

    Dreyer, L; Olsen, J H

    1998-01-01

    in acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early......We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977...... and 1989. We calculated the incidence of cancer in this group by linking it to the Danish Cancer Registry for the period 1978-1993. There was no consistent excess over the expected figures for any of the categories of cancer not related to tobacco smoking. Specifically, the rates of colorectal cancer...

  1. Reactive positioning of pathologically migrated tooth following non-surgical periodontal therapy

    Directory of Open Access Journals (Sweden)

    Neeraj Agrawal

    2011-01-01

    Full Text Available While contemporary periodontics has witnessed the continued emergence of sophisticated techniques to resolve esthetic concerns through various periodontal procedures, frequently the early stages of periodontal diseases are best treated with non-surgical periodontal therapy. This short communication presents a case of reactive positioning of pathologically migrated anterior tooth following non-surgical periodontal therapy.

  2. Penile Cancer Presenting With Acute Urinary Retantion: Case Report

    Directory of Open Access Journals (Sweden)

    Ercan KAZAN

    2015-06-01

    Full Text Available Penile cancer is a rare malignancy in our country. Phimosis, , poor hygiene and smoking are major risk factors for penile cancer. Penile cancer in men have a strong correlation with human papilloma virus (HPV infection. Penile cancer is rare in circumcised men, particularly if they are circumcised as newborns. Penile cancer is usually asymptomatic and physical examination is essential for diagnosis. We report a case of penile cancer whose first symptom was acute urinary retention (AUR and review of the literature. [J Contemp Med 2015; 5(2.000: 131-134

  3. Leptin role in advanced lung cancer. A mediator of the acute phase response or a marker of the status of nutrition?

    Science.gov (United States)

    Alemán, María Remedios; Santolaria, Francisco; Batista, Norberto; de La Vega, María; González-Reimers, Emilio; Milena, Antonio; Llanos, Marta; Gómez-Sirvent, Juan Luis

    2002-07-07

    Leptin is an anorexia inductor peptide produced by adipocytes and related to fat mass. Leptin is also produced by fat under proinflammatory cytokine action. Our objective is to study serum leptin levels in relation to nutritional status and acute phase response in advanced-stage non-small cell lung cancer.Seventy-six patients newly diagnosed of non surgical non-small cell lung cancer before chemotherapy treatment and 30 healthy controls were included. BMI, serum leptin and cholesterol levels and lymphocyte count were decreased in lung cancer patients. Cytokine IL-6, TNF-alpha, sTNF-RII, sIL-2R, IL-12, IL-10 and IFN-gamma, and other acute phase reactants as alpha1 antitrypsin, ferritin, CRP and platelets were all raised in patients, whereas the IL-2 was decreased. We found a direct relationship between leptin and other indicators of the status of nutrition, especially total fat mass. We also found a close relationship between the status of nutrition and the performance status (Karnofsky index). However, serum leptin and nutritional status were inversely correlated with acute phase proteins and proinflammatory cytokines, suggesting a stress-type malnutrition. Although serum leptin levels, nutritional status and Karnofsky index are related to survival, at multivariate analysis they all were displaced by the acute phase reaction markers. These results suggest that cancer anorexia and cachexia are not due to a dysregulation of leptin production. Circulating leptin concentrations are not elevated in weight-losing cancer patients and are inversely related to the intensity of the inflammatory response. In advanced lung cancer patients serum leptin concentrations only depend on the total amount of fat.

  4. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  5. Taking Control: Non-Surgical Treatment Options for Urinary Incontinence in Women

    Science.gov (United States)

    ... Home > Decision Aids > Urinary Incontinence > What is UI? Taking Control: Non-surgical Treatment Options for Urinary Incontinence in ... 0 Page 2 What is urinary incontinence (UI)? Taking Control (5-minute video) Click on the video above ...

  6. Acute pancreatitis in patients with pancreatic cancer

    Science.gov (United States)

    Li, Shaojun; Tian, Bole

    2017-01-01

    Abstract Acute pancreatitis (AP) is a rare manifestation of pancreatic cancer (PC). The relationship between AP and PC remains less distinct. From January 2009 to November 2015, 47consecutive patients with PC who presented with AP were reviewed for this study. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were documented in detail from our database. In order to identify cutoff threshold time for surgery, receiver operating curve (ROC) was built according to patients with or without postoperative complications. Cumulative rate of survival was calculated by using the Kaplan–Meier method. The study was conducted in accordance with the principles of the Declaration of Helsinki and the guidelines of West China Hospital. This study included 35 men (74.5%) and 12 women (25.5%) (mean age: 52 years), with a median follow-up of 40 months. AP was clinically mild in 45 (95.7%) and severe in 2 (4.3%). The diagnosis of PC was delayed by 2 to 660 days (median 101 days). Thirty-nine (83.0%) cases underwent surgery. Eight (17.0%) cases performed biopsies only. Of 39 patients, radical surgery was performed in 32 (82.1%) cases and palliative in 7 (19.9%) cases. Two (8.0%) patients were needed for vascular resection and reconstruction. Postoperative complications occurred in 12 (30.8%) patients. About 24.5 days was the best cutoff point, with an area under curve (AUC) of 0.727 (P = 0.025, 95% confidence interval: 0.555–0.8999). The survival rate of patients at 1 year was 23.4%. The median survival in patients with vascular resection and reconstruction was 18 months, compared with 10 months in patients without vascular resection (P = 0.042). For the primary stage (T), Tix was identified in 3 patients, the survival of whom were 5, 28, 50 months, respectively. And 2 of them were still alive at the follow-up period. The severity of AP was mainly mild. Surgical intervention after 24.5 days may benefit for

  7. Acute Recurrent Pancreatitis: A Possible Clinical Manifestation of Ampullary Cancer

    Directory of Open Access Journals (Sweden)

    Athanasios Petrou

    2011-11-01

    Full Text Available Context Acute recurrent pancreatitis still poses diagnostic difficulties. The coexistence or moreover the causative relationship of carcinoma of the ampulla of Vater and acute recurrent pancreatitis is fairly rare. Case report We present a case of carcinoma of the ampulla of Vater that presented with acute recurrent necrotizing pancreatitis complicated with pseudocysts. A diagnosis of malignancy in the ampulla was only made after several ERCP attempts due to residual inflammation at the periampullary area. Conclusion Malignancy at the ampulla of Vater causing recurrent episodes of pancreatitis represents a realistic risk and attempts to diagnose the underlying cause should always take into account the possibility of cancer.

  8. The effectiveness of non-surgical interventions in the treatment of Charcot foot.

    Science.gov (United States)

    Smith, Caroline; Kumar, Saravana; Causby, Ryan

    2007-12-01

    Background  Charcot neuropathic osteoarthropathy is commonly known as 'Charcot foot'. It is a serious foot complication of diabetes mellitus that can frequently lead to foot ulceration, gangrene, hospital admission and foot amputation. A multidisciplinary approach to the management of Charcot foot is taken involving medical and allied health professionals. The management approach may also differ between different countries. To date, there is no systematic review of the literature undertaken to identify the clinical effectiveness of non-operative interventions in the treatment of acute Charcot foot. Objective  The objective of this review was to identify the effectiveness of non-surgical interventions with reducing lesions, ulceration, the rate of surgical intervention, reducing hospital admissions and improve the quality of life of subjects with Charcot foot. Search strategy  A comprehensive search strategy was undertaken on databases available from University of South Australia from their inception to November 2006. Selection criteria  Randomised controlled trials or clinical controlled trials were primarily sought. Critical appraisal of study quality and data extraction was undertaken using Joanna Briggs Institute instruments. Review Manager software was used to calculate comparative statistics. Results  This review identified 11 trials and five trials were included in the review. Three trials involved the use of bisphosphonate, a pharmacological agent. Two experimental treatments were also included, evaluating palliative radiology and magnetic fields. No trials were found using immobilisation and off-loading interventions for acute Charcot foot. The overall methodological quality score of the five studies was moderate. Owing to heterogeneous data, meta-analysis could not be performed. The trials did not report on reducing lesions, ulceration, rate of surgical intervention, hospital admissions and the quality of life of subjects with Charcot foot. The

  9. [Diverticular bleeding. Diagnostics, non-surgical treatment, indications for surgery].

    Science.gov (United States)

    Labenz, J

    2014-04-01

    Diverticular bleeding is the most common cause of acute severe lower gastrointestinal bleeding. Diagnostic and therapeutic approaches have not been standardized. Development of an evidence-based management algorithm. A systematic search of the literature (PubMed 1998-2013) was carried out and a review with consideration of current guidelines is given. The lifetime risk of clinically relevant bleeding is estimated to be 5 % in persons with colonic diverticula. Patients with clinically suspected diverticular hemorrhage should be admitted to hospital. Diverticular bleeding will cease spontaneously in around 70-90 % of the cases. In patients with severe lower gastrointestinal tract bleeding, defined as instability of the circulation, persistent bleeding after 24 h, drop of the hemoglobin level to ≥ 2 g/dl or the necessity for transfusion, endoscopy of the upper and lower gastrointestinal tract within the first 12-24 h is recommended. In patients with active diverticular bleeding or signs of recent hemorrhage (e.g. visible vessel or adherent clot) endoscopic therapy is strongly recommended because it significantly decreases the rate of early and late rebleeding. Angiography with superselective embolization is a therapeutic option in patients where endoscopy failed. Surgery should be considered in patients with ongoing bleeding and failure of interventional treatment and in patients who suffered from recurrent severe diverticular bleeding. Diverticulosis coli remains the most common cause of lower gastrointestinal bleeding. Colonoscopy is recommended as first-line diagnostic and therapeutic approach. In the vast majority of patients diverticular hemorrhage can be readily managed either conventionally or by interventional therapy.

  10. Acute Liver Failure Secondary to Metastatic Medullary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Emmanuel C. Gorospe

    2011-01-01

    Full Text Available Acute liver failure (ALF is a rare presentation of liver metastases. Although cases of ALF from metastatic disease have been reported, etiologies have been largely confined to lymphoma, metastatic breast, lung, and gastric cancers. ALF from medullary thyroid cancer (MTC has never been reported. We present a 59-year-old male with newly diagnosed MTC, who was admitted with ALF. He presented with jaundice, hepatic encephalopathy, and synthetic dysfunction. His clinical course was marked by rapid decompensation within 6 days from initial presentation of jaundice to development of hepatic coma. Although liver metastases from medullary thyroid cancer have been reported, to our knowledge, this is the first described case of MTC resulting in acute liver failure.

  11. Acute and late toxicity in radical radiotherapy of prostate cancer

    Directory of Open Access Journals (Sweden)

    Josifovski Tatjana

    2009-01-01

    Full Text Available Introduction. Although radical radiotherapy has proved to be a successful method in prostate cancer treatment, the conventional (box technique can result in significant adverse events. Objective. The objective of our study was to estimate the frequency, type and severity of acute and late toxicity in radical radiotherapy of prostate cancer. Methods. In a clinical retrospective study, we included 283 patients with histologically confirmed prostate cancer. All our patients received radical, conventional radiotherapy using the four-field technique. The study was performed at the Radiotherapy Department of the Institute for Oncology and Radiology of Serbia between January 1991 and December 2005. During regular follow-up, we analyzed the frequency, type and severity of acute and late toxicity. Results. Two thirds (71% of our patients had acute toxicity of at least one organ within the radiation field. Most frequent complication was radiation dermatitis (10.5%, and enteritis (9%, cystitis (6% and proctitis (2.5%. Acute adverse events were mostly low grade (I and II, 28-61%. Late complications were registered in 20.5% of patients. Skin fibrosis was most frequent (12%. Chronic proctitis was detected in 4% and urethral stricture in 4.5% of our patients. All late complications were low grade. Conclusion. Treatment tolerance of radical radiotherapy is relatively good. Although most patients develop acute toxicity, it is commonly low grade and requires the interruption of radiotherapy treatment in 20% of patients only. Late toxicity is rarer than acute and, in most cases, it does not affect the quality of life.

  12. Lentigo maligna - anatomic location as a potential risk factor for recurrences after non-surgical treatment

    NARCIS (Netherlands)

    K. Greveling (Karin); van der Klok, T. (Th.); M.B.A. van Doorn (Martijn); V. Noordhoek Hegt (Vincent); E.P. Prens (Errol)

    2016-01-01

    textabstractBackground: A higher incidence of lentigo maligna (LM) recurrences on the nose was previously observed in our cohort after non-surgical treatment. Objectives: To determine histological parameters that might be related to the previously observed higher incidence of LM recurrences on the n

  13. MR imaging of idiopathic trigeminal neuralgia. Correlation with non-surgical therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kuroiwa, Toshiro; Matsumoto, Shunichi; Kato, Akira; Harano, Kiyoshi; Totoki, Tadahide; Tabuchi, Kazuo; Kudo, Sho [Saga Medical School (Japan)

    1996-09-01

    Magnetic resonance (MR) findings in patients with idiopathic trigeminal neuralgia were evaluated and correlated with the effectiveness of non-surgical treatments. Thirty-four patients with idiopathic trigeminal neuralgia (ITN) were examined using T{sub 1}-and T{sub 2}-weighted spin-echo (SE) pulse sequence techniques to evaluate their trigeminal root-entry zones and the vessels contacted prior to non-surgical treatment (retrogasserian glycerol injection, peripheral nerve block, or only oral analgesics). Vascular contact at the proximal portion of the preganglionic segment (PGS) of the trigeminal nerve and deformity of the PGS on the affected side were observed in 97% and 47% of the patients, respectively. Non-surgical treatments were curative in 12 (67%) but failed in two (11%) of the 18 patients without deformed PGS. However, among 16 patients with deformed PGS, they were curative in only six (37.5%) and failed in four (25%). Results of this study suggest that MR imaging could be useful in the clinical assessment of trigeminal neuralgia prior to instituting non-surgical treatment. (author)

  14. Breast cancer acute radiotherapy morbidity evaluated by different scoring systems.

    Science.gov (United States)

    López, Escarlata; Núñez, M Isabel; Guerrero, M Rosario; del Moral, Rosario; de Dios Luna, Juan; del Mar Rodríguez, M; Valenzuela, M Teresa; Villalobos, Mercedes; Ruiz de Almodóvar, José Mariano

    2002-05-01

    Reporting of the outcome of radiotherapy is not satisfactory without a description of the treatment-related side effects. The purposes of this paper were: (1) to evaluate the frequency and the severity of collateral skin reactions in a group of breast cancer patients; (2) to report the acute reactions using some current scoring systems and to compare the application of them, and (3) to investigate the variation between intra- and interobservers using these different scales. We studied 108 breast cancer patients who, after surgical treatment, received adjuvant radiotherapy. Clinical skin evaluation was always performed by the same radiotherapist the last day of treatment, and the collateral radiation effects were photographed at that moment to facilitate later evaluations by another two expert doctors. Normal tissue damage was scored according to the Radiation Therapy Oncology Group/The European Organisation for Research, and Treatment of Cancer/ (RTOG/EORTC), the Danish, the European, and the Biomed2 side-effect scales. The most frequent acute complications found were erythema (91.7%), dry desquamation (29.6%) and moist desquamation (35.2%). The reactions were classified as severe in 13.9, 23, 18.5 and 13% of the patients with each of the different systems used, respectively. The concordance between the scoring of radiation-induced side effects on the skin assessed by direct observation of the patients or by examination of the photographic document was sufficient. This is a warrant of accuracy in the evaluation of acute normal tissue lesions. Our results allow us to state the advantage of the RTOG system over the others in terms of evaluating the acute effects produced by radiotherapy of women with breast cancer.

  15. Salivary Visfatin Concentration in Response to Non-surgical Periodontal Therapy

    Science.gov (United States)

    Tabari, Zahra Alizadeh; Azadmehr, Abbas; Nohekhan, Ali; Tabrizi, Mohammad Amir Alizadeh; Ardakani, Mohammad Reza Talebi; Naddafpour, Nima

    2015-01-01

    Introduction: Visfatin is a pro-inflammatory cytokine that has been associated with several immunomodulating processes. The relationship between visfatin and periodontitis has been the subject of a few studies that have described visfatin as an inflammatory marker for periodontitis. However, studies on visfatin as a potential therapeutic target in periodontal diseases are scarce. In the present study, we evaluated the alterations in salivary visfatin levels in response to non-surgical periodontal treatment. Materials and Methods: Twenty individuals with moderate to severe chronic periodontitis and twenty periodontally healthy individuals were selected for this study according to clinical parameters. Patients with chronic periodontitis were treated by non-surgical periodontal therapy. Clinical parameters were recorded and saliva samples were obtained from the control group and test group before (T1 group) and one month after periodontal treatment (T2 group). Salivary visfatin concentrations were measured by standard enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed with the statistical software SPSS, version 18. Results: Visfatin was detectable in all samples. T1 and control groups were significantly different in terms of clinical parameters and visfatin levels. Visfatin concentrations were reduced significantly after non-surgical periodontal therapy. Periodontal treatment also resulted in significant reductions of all clinical parameters with the exception of clinical attachment level. Conclusion: The results demonstrated that salivary levels of visfatin are reduced after non-surgical periodontal therapy to the levels comparable with those found in healthy individuals. Therefore, the salivary visfatin level may have the potential to be a target marker for assessment of responses to non-surgical periodontal therapy. However, more studies with larger sample sizes are necessary to validate these findings. PMID:26023633

  16. Effect of acute exercise on prostate cancer cell growth.

    Science.gov (United States)

    Rundqvist, Helene; Augsten, Martin; Strömberg, Anna; Rullman, Eric; Mijwel, Sara; Kharaziha, Pedram; Panaretakis, Theocharis; Gustafsson, Thomas; Östman, Arne

    2013-01-01

    Physical activity is associated with reduced risk of several cancers, including aggressive prostate cancer. The mechanisms mediating the effects are not yet understood; among the candidates are modifications of endogenous hormone levels. Long-term exercise is known to reduce serum levels of growth stimulating hormones. In contrast, the endocrine effects of acute endurance exercise include increased levels of mitogenic factors such as GH and IGF-1. It can be speculated that the elevation of serum growth factors may be detrimental to prostate cancer progression into malignancy. The incentive of the current study is to evaluate the effect of acute exercise serum on prostate cancer cell growth. We designed an exercise intervention where 10 male individuals performed 60 minutes of bicycle exercise at increasing intensity. Serum samples were obtained before (rest serum) and after completed exercise (exercise serum). The established prostate cancer cell line LNCaP was exposed to exercise or rest serum. Exercise serum from 9 out of 10 individuals had a growth inhibitory effect on LNCaP cells. Incubation with pooled exercise serum resulted in a 31% inhibition of LNCaP growth and pre-incubation before subcutaneous injection into SCID mice caused a delay in tumor formation. Serum analyses indicated two possible candidates for the effect; increased levels of IGFBP-1 and reduced levels of EGF. In conclusion, despite the fear of possible detrimental effects of acute exercise serum on tumor cell growth, we show that even the short-term effects seem to add to the overall beneficial influence of exercise on neoplasia.

  17. Effect of acute exercise on prostate cancer cell growth.

    Directory of Open Access Journals (Sweden)

    Helene Rundqvist

    Full Text Available Physical activity is associated with reduced risk of several cancers, including aggressive prostate cancer. The mechanisms mediating the effects are not yet understood; among the candidates are modifications of endogenous hormone levels. Long-term exercise is known to reduce serum levels of growth stimulating hormones. In contrast, the endocrine effects of acute endurance exercise include increased levels of mitogenic factors such as GH and IGF-1. It can be speculated that the elevation of serum growth factors may be detrimental to prostate cancer progression into malignancy. The incentive of the current study is to evaluate the effect of acute exercise serum on prostate cancer cell growth. We designed an exercise intervention where 10 male individuals performed 60 minutes of bicycle exercise at increasing intensity. Serum samples were obtained before (rest serum and after completed exercise (exercise serum. The established prostate cancer cell line LNCaP was exposed to exercise or rest serum. Exercise serum from 9 out of 10 individuals had a growth inhibitory effect on LNCaP cells. Incubation with pooled exercise serum resulted in a 31% inhibition of LNCaP growth and pre-incubation before subcutaneous injection into SCID mice caused a delay in tumor formation. Serum analyses indicated two possible candidates for the effect; increased levels of IGFBP-1 and reduced levels of EGF. In conclusion, despite the fear of possible detrimental effects of acute exercise serum on tumor cell growth, we show that even the short-term effects seem to add to the overall beneficial influence of exercise on neoplasia.

  18. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis

    NARCIS (Netherlands)

    Burton, M.J.; Glasziou, P.P.; Chong, L.Y.; Venekamp, R.P.

    2014-01-01

    Background Surgical removal of the tonsils, with or without adenoidectomy (adeno-/tonsillectomy), is a common ENT operation, but th e indicationsfor surgery are controversial. This is an update of a Cochrane re view first published in The Cochrane Library in Issue 3, 1999 andpreviously updated in 200

  19. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis

    NARCIS (Netherlands)

    Burton, M.J.; Glasziou, P.P.; Chong, L.Y.; Venekamp, R.P.

    2014-01-01

    Background Surgical removal of the tonsils, with or without adenoidectomy (adeno-/tonsillectomy), is a common ENT operation, but th e indicationsfor surgery are controversial. This is an update of a Cochrane re view first published in The Cochrane Library in Issue 3, 1999 andpreviously updated in 200

  20. Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

    Science.gov (United States)

    Płaszewski, Maciej; Bettany-Saltikov, Josette

    2014-01-01

    Background Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Objectives Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Design Systematic overview of systematic reviews. Methods Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews. Results From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Conclusions Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers

  1. Non-surgical synovectomy in rheumatoid arthritis. Results obtained by radio-synoviorthesis

    Energy Technology Data Exchange (ETDEWEB)

    Delbarre, F.; Menkes, J.C.

    1974-01-01

    The different radioactive isotopes used in the treatment of rheumatoid arthritis by non-surgical synovectomy are discussed. The results of ..beta.. irradiation on the synovium are compared in a double blind trial using yttrium isotopes. Some cases of polyarticular rheumatoid arthritis and their therapy with ..beta.. emitters are described. Histological and biological changes after synoviorthesis and the results of this therapy are compared with surgical synovectomy.

  2. Effect of non-surgical periodontal treatment on chronic kidney disease patients

    OpenAIRE

    Hilana Paula Carillo Artese; Celso Oliveira de Sousa; Ronir Raggio Luiz; Carmelo Sansone; Maria Cynésia Medeiros Barros Torres

    2010-01-01

    Chronic kidney disease (CKD) is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1) and 19 individuals without clinical evidence of kidney disease (group 2) with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated ...

  3. Retrospective study of teeth with a poor prognosis following non-surgical periodontal treatment.

    Science.gov (United States)

    Ekuni, Daisuke; Yamamoto, Tatsuo; Takeuchi, Noriko

    2009-04-01

    The aim of this retrospective study was to assess teeth with a poor prognosis and the proximal periodontium of adjacent teeth, and to identify the risk factors associated with the loss of teeth with a poor prognosis following non-surgical periodontal treatment. Teeth with a poor prognosis (n=113), teeth adjacent to those of poor prognosis (n=105) and non-adjacent teeth (n=51) were evaluated in 25 non-smoking patients who had received supportive periodontal treatment for 5-16 years following non-surgical periodontal treatment at a university hospital. Probing pocket depth (PPD), percentage of alveolar bone loss, presence of tooth mobility and bleeding on probing in all teeth improved significantly after treatment. Logistic regression analysis showed that loss of teeth with a poor prognosis depended on the initial deepest PPD, tooth mobility and multi-rooted tooth. Teeth with a poor prognosis did not affect the proximal periodontium of the adjacent teeth, and progression of periodontal disease in these teeth and adjacent teeth can be prevented by non-surgical periodontal treatment in non-smokers. The risk factors for loss of teeth with a poor prognosis were the initial deepest PPD, tooth mobility and multi-rooted tooth.

  4. Effect of non-surgical periodontal treatment on chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2010-12-01

    Full Text Available Chronic kidney disease (CKD is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1 and 19 individuals without clinical evidence of kidney disease (group 2 with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002. Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

  5. Effect of non-surgical periodontal treatment on chronic kidney disease patients.

    Science.gov (United States)

    Artese, Hilana Paula Carillo; Sousa, Celso Oliveira de; Luiz, Ronir Raggio; Sansone, Carmelo; Torres, Maria Cynésia Medeiros de Barros

    2010-01-01

    Chronic kidney disease (CKD) is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1) and 19 individuals without clinical evidence of kidney disease (group 2) with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002). Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

  6. Non-surgical sterilisation methods may offer a sustainable solution to feral horse (Equus caballus) overpopulation.

    Science.gov (United States)

    Hall, Sally Elizabeth; Nixon, Brett; Aitken, R John

    2016-10-05

    Feral horses are a significant pest species in many parts of the world, contributing to land erosion, weed dispersal and the loss of native flora and fauna. There is an urgent need to modify feral horse management strategies to achieve public acceptance and long-term population control. One way to achieve this is by using non-surgical methods of sterilisation, which are suitable in the context of this mobile and long-lived species. In this review we consider the benefits of implementing novel mechanisms designed to elicit a state of permanent sterility (including redox cycling to generate oxidative stress in the gonad, random peptide phage display to target non-renewable germ cells and the generation of autoantibodies against proteins essential for conception via covalent modification) compared with that of traditional immunocontraceptive approaches. The need for a better understanding of mare folliculogenesis and conception factors, including maternal recognition of pregnancy, is also reviewed because they hold considerable potential in providing a non-surgical mechanism for sterilisation. In conclusion, the authors contend that non-surgical measures that are single shot and irreversible may provide a sustainable and effective strategy for feral horse control.

  7. [Non-surgical periodontal treatment in uncontrolled type 2 diabetes mellitus patients].

    Science.gov (United States)

    Garzón-Sanabria, Verónica; Olmos-Bringas, Marisol; Mota-Sanhu, Vanessa; Enríquez-Bárcenas, Luis Fernando; García-Ruiz, Erika; Rivas-Ayala, Lourdes; Rojas-Jiménez, José Alberto

    2013-01-01

    To evaluate the effect of non-surgical periodontal treatment on the metabolic control, measured by HbA1c in uncontrolled type 2 diabetes mellitus patients with periodontal disease treated with the ADA-EASD algorithm. The study group consisted of 38 patients diagnosed with type 2 diabetes mellitus and periodontal disease, attending a benefit clinic. HbA1c measures were obtained before and after 3 months of the non-surgical periodontal treatment. T student test for dependent samples was applied with a p value less than 0.05 for statistical significance. From the total sample, 79% was female, and mean age was of 51 +/- 9.8 years old. Mean HbA1c at baseline was of 8.6 and 8% at exit. The mean reduction was statistically significant (p = 0.026). After non-surgical periodontal treatment, the prevalence of periodontal disease was of 8%. The mean of personal plaque control before and after the treatment decreased from 82.6% to 35.5% (p periodontal disease and improved personal plaque control.

  8. THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

    Institute of Scientific and Technical Information of China (English)

    YANG Yun-zhu(杨芸珠); SUN Zhe(孙喆); HU Chun-zhen(胡纯贞); YANG Yu-guo(杨裕国); JIN Li-jian(金力坚); LEUNG Hui-qiang(梁惠强); Esmond F Corbet

    2004-01-01

    Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese with chronic periodontitis. Methods Moderate to advanced chronic periodontitis (CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fiuctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PH), gingival index (Gl), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (AL)of all patients were recorded at 6 sites on each tooth at the baseline and 1,3 and 6 months after oral hygiene instruction ( OHI) , scaling and root planing. Results It was found that the short-term effect of non-surgical periodontal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

  9. Surgical treatment of colorectal cancer complicated with acute intestinal obstruction

    Directory of Open Access Journals (Sweden)

    S. N. Schaeva

    2016-01-01

    Full Text Available Background. The main reason for urgent complications of colon cancer is an acute intestinal obstruction (AIO. This is complex pathological condition in 90 % of cases caused by colorectal cancer (CRC.Objective – to evaluate radicality of the performed operations in complicated colorectal cancer in general surgical hospitals. Dependence of the severity of intestinal obstruction by tumor localization, its morphological characteristics, determine dependence of the type of the surgical operation performed on the severity of intestinal obstruction.Materials and methods. We have studied the data on 667 patients with colorectal cancer complicated by acute intestinal obstruction. These patients were treated in the period from 2001 to 2013 in general surgical hospital in the territory of Smolensk and Smolensk region. For the processing of the obtained results we have used software Statistica 6.1. Differences were considered statistically at p ≤ 0.05.Results. All the patients were divided into 3 groups by the expression of intestinal obstruction. Group 1 (n = 279 consisted of patients with the presence of decompensated intestinal obstruction (DIO, group 2 (n = 313 consisted of patients with subcompensated intestinal obstruction (SIO, group 3 (n = 75 included patients with compensated intestinal obstruction (CIO. In case of tumor localization in right halfof the colon we most commonly observed clinical picture of acute development of decompensated intestinal obstruction (p = 0.041. Subcompensated intestinal obstruction prevailed in case of tumor localization in left half of the colon and rectal localization. In general surgical hospitals it is not always possible to speak about radicality of surgical treatment, as in a large number of cases (62.5 % the number of examined lymph nodes was less than 4. When DIO patients are admitted in the clinic, the percentage of singlestage operations is equal to 7.5 % (n = 21. In case of DIO and SIO there was a high

  10. Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Eliana C.A. Benites

    2014-07-01

    Full Text Available OBJECTIVE: to estimate the prevalence of infection by respiratory viruses in pediatric patients with cancer and acute respiratory infection (ARI and/or fever. METHODS: cross-sectional study, from January 2011 to December 2012. The secretions of nasopharyngeal aspirates were analyzed in children younger than 21 years with acute respiratory infections. Patients were treated at the Grupo em Defesa da Criança Com Câncer (Grendacc and University Hospital (HU, Jundiaí, SP. The rapid test was used for detection of influenza virus (Kit Biotrin, Inc. Ireland, and real-time multiplex polymerase chain reaction (FTD, Respiratory pathogens, multiplex Fast Trade Kit, Malta for detection of influenza virus (H1N1, B, rhinovirus, parainfluenza virus, adenovirus, respiratory syncytial virus, human parechovirus, bocavirus, metapneumovirus, and human coronavirus. The prevalence of viral infection was estimated and association tests were used (χ2 or Fisher's exact test. RESULTS: 104 samples of nasopharyngeal aspirate and blood were analyzed. The median age was 12 ± 5.2 years, 51% males, 68% whites, 32% had repeated ARIs, 32% prior antibiotic use, 19.8% cough, and 8% contact with ARIs. A total of 94.3% were in good general status. Acute lymphocytic leukemia (42.3% was the most prevalent neoplasia. Respiratory viruses were detected in 50 samples: rhinoviruses (23.1%, respiratory syncytial virus AB (8.7%, and coronavirus (6.8%. Co-detection occurred in 19% of cases with 2 viruses and in 3% of those with 3 viruses, and was more frequent between rhinovirus and coronavirus 43. Fever in neutropenic patients was observed in 13%, of which four (30.7 were positive for viruses. There were no deaths. CONCLUSIONS: the prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co-detection was frequent in patients with cancer and ARIs.

  11. Non-Surgical Therapy for Peri-Implant Diseases: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Fernando Suárez-López del Amo

    2016-09-01

    Full Text Available Objectives: The purpose of this paper was to systematically evaluate the effectiveness of non-surgical therapy for the treatment of peri-implant diseases including both, mucositis and peri-implantitis lesions. Material and Methods: An electronic search in two different databases was performed including MEDLINE (PubMed and EMBASE from 2011 to 2016. Human studies reporting non-surgical treatment of peri-implant mucositis and peri-implantitis with more than 10 implants and at least 6 months follow up published in English language were evaluated. A systematic review was performed to evaluate the effectiveness of the different methods of decontamination employed in the included investigations. Risk of bias assessment was elaborated for included investigations. Results: Twenty-five articles were identified of which 14 were further evaluated and included in the analysis. Due to significant heterogeneity in between included studies, a meta-analysis could not be performed. Instead, a systematic descriptive review was performed. Included investigations reported the used of different methods for implant decontamination, including self-performed cleaning techniques, and professionally delivered treatment such as laser, photodynamic therapy, supra-/sub-mucosal mechanical debridement, and air-abrasive devices. Follow-up periods ranged from 6 to 60 months. Conclusions: Non-surgical treatment for peri-implant mucositis seems to be effective while modest and not-predictable outcomes are expected for peri-implantitis lesions. Limitations include different peri-implant diseases definitions, treatment approaches, as well as different implant designs/surfaces and defect characteristics.

  12. Production of piglets from in vitro-produced embryos following non-surgical transfer.

    Science.gov (United States)

    Yoshioka, Koji; Noguchi, Michiko; Suzuki, Chie

    2012-03-01

    The objective of this study was to enhance procedures for producing piglets derived from in vitro-produced (IVP) pig embryos by non-surgical embryo transfer (ET). The effects of insertion length for the catheter, asynchrony between the age of donor IVP blastocysts and the recipient estrous cycle, and volume of transfer medium were investigated. The IVP blastocysts at 5 days after in vitro fertilization were placed into porcine zygote medium (PZM)-5 supplemented with 10% (v/v) fetal bovine serum (PZM+FBS) in a 0.25 mL plastic straw (21-40 blastocysts per straw) and then transferred into one uterine horn of recipients using the Takumi(®) catheter for deep intrauterine insertion. Successful production of piglets derived from IVP embryos was achieved following non-surgical ET when the catheter was inserted at more than 30 cm anterior to the spiral guide spirette. The efficiency of piglet production (percentage number of piglet(s) born based on the number of embryos transferred) was greater (P<0.05) in recipients whose estrous cycle was asynchronous to that of donors with a 1-day delay (8.3%) than in those with a 2-day (1.5%) or 3-day (0.9%) delay, while pregnancy and farrowing rates (10-40%) did not differ among treatments. When blastocysts were transferred into recipients with 1.0 or 2.5 mL PZM+FBS, there were no significant differences in farrowing rate (30-40%) or average litter size (4.5-6.7) between treatments. The results of the present study indicate that the insertion length of the deep intrauterine catheter and the degree of asynchrony between donor embryos and recipient estrous cycle influenced on pregnancy and birth outcome following non-surgical transfer of IVP blastocysts.

  13. Antioxidative status of saliva before and after non-surgical periodontal treatment

    Directory of Open Access Journals (Sweden)

    Novaković Nada

    2013-01-01

    Full Text Available Introduction. Oxidative stress and antioxidants play an important role in the pathogenesis of inflammatory disease, including chronic periodontitis (CP. Saliva contains enzymatic (glutathione peroxidase - GPx, superoxide dismutase - SOD, etc. and non-enzymatic (albumin - ALB, uric acid - UA, glutathione, etc. antioxidants. Objective. The aims of this study were to investigate: a level of SOD, GPx, UA, ALB and total antioxidative status (TAS of saliva in CP patients before and after non-surgical treatment, and b correlations between clinical periodontal parameters and levels of salivary antioxidants. Methods. Saliva was collected from 21 CP patients before and after non-surgical treatment. The condition of periodontium was assessed by plaque index, gingival index, bleeding on probing, probing depth and clinical attachment loss. Level of investigated antioxidants (except GPx and TAS was determined using colorimetric method and commercial kits. GPx activity was determined using UV method and commercial kits. Results. After the treatment significant increase of UA, ALB, Gpx, TAS was detected (p0.05. A significant correlation was observed between GPx and PI (r=0.575, p=0.008, SOD and GI (r=0.525, p=0.017 before therapy, and SOD and bleeding on probing (BP (r=0.59, p=0.006, TAS and BP (r=0.453, p=0.045 after therapy. Conclusion. These data suggest that levels of salivary antioxidants generally increase after non-surgical periodontal treatment. Correlation between some clinical periodontal parameters and level of salivary antioxidants was found. [Projekat Ministarstva nauke Republike Srbije, br. 41008

  14. The effects of total knee replacement and non-surgical treatment on pain sensitization and clinical pain

    DEFF Research Database (Denmark)

    Skou, S. T.; Roos, E. M.; Simonsen, O.;

    2016-01-01

    BACKGROUND: The objective was to compare the effect of total knee replacement (TKR) followed by a 3-month non-surgical treatment with the non-surgical treatment alone in reducing pain sensitization and other pain-related measures in patients with knee osteoarthritis. METHODS: One hundred patients...... were randomized to (1) TKR followed by a non-surgical treatment of neuromuscular exercise, education, diet, insoles and pain medication or (2) the non-surgical treatment alone. Outcomes assessed at baseline and after 3 months were as follows: (1) pain sensitization assessed as pressure-pain thresholds...... no significant between-group differences in change in the pain-related measures from baseline to 3 months (p = 0.15-0.27). Both groups improved in most of the pain-related measures (p treatment is more effective in reducing localized and spreading...

  15. Acute myelogenous leukemia following chemotherapy and radiation for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Aso, Teijiro; Hirota, Yuichi; Kondou, Seiji; Matsumoto, Isao; Matsuzaka, Toshimitsu; Iwashita, Akinori

    1989-03-01

    In August 1982, a 44-year-old man was diagnosed as having rectal cancer, histologically diagnosed as well differentiated adenocarcinoma, and abdominoperineal resection and colostomy were performed. Postoperatively, he received chemotherapy with mitomycin C up to a total dose of 100 mg. In September 1986, lung metastasis occurred and he was treated with a combination chemotherapy consisting of cisplatin, pirarubicin and 5-fluorouracil. In the following year, radiation treatment (total: 6900 rad) was given for a recurrent pelvic lesion. Peripheral blood on April 30, 1988, showed anemia, thrombocytopenia and appearance of myeloblasts, and a diagnosis of acute myelogenous leukemia (FAB: M1) was made. Combination chemotherapy (including aclarubicin, vincristine, behenoyl ara-C, daunorubicin, 6-mercaptopurine, cytarabine, etoposide and prednisolone) failed to induce remission and the patient died in June 1988. This case was thought to be one of secondary leukemia occurring after chemotherapy and radiation treatment for rectal cancer. This case clearly indicates the need for a careful follow-up of long-term survivors who have received cancer therapy. (author).

  16. Radio-diagnosis of fecoliths and its non-surgical management in dogs

    Directory of Open Access Journals (Sweden)

    Arif Khan

    2014-03-01

    Full Text Available Two cases with a history of cessation of feces for 2 weeks, depression, lethargy and anorexia in two different dogs; a Labrador male and a Doberman female, were presented. On physical examination, abdominal distension along with intense pain was observed. Blood samples were collected from the dogs for hematological and biochemical analyses. The examination revealed an increased percentage of packed cell volume (PCV. By radiological examination, radiopaque material was seen in the large intestinal tract. The condition was suggestive of fecolith. The cases were managed by means of non-surgical management. Through an 11-day long medicinal treatment, the dogs recovered uneventfully.

  17. Non-surgical management of hepatocellular carcinoma; Prise en charge non chirurgicale du carcinome hepatocellulaire

    Energy Technology Data Exchange (ETDEWEB)

    Merle, P. [Service d' hepato-gastroenterologie, hopital de l' Hotel-Dieu, 69 - Lyon (France); Inserm U871 -Oncogenese hepatique et hepatites virales-, 69 - Lyon (France); IFR62 Lyon-Est, universite Lyon 1, 69 - Lyon (France); Mornex, F. [Departement de radiotherapie-oncologie, centre hospitalier Lyon-Sud, 69 - Pierre-Benite (France)

    2010-10-15

    Most of patients with hepatocellular carcinoma (HCC) cannot benefit from surgical therapies. Among non-surgical options, only radiofrequency can challenge surgery for small size tumours. Conformal radiotherapy is likely highly efficient on solitary tumours, but controlled studies are warranted to conclude. Other options are purely palliative. Trans-arterial hepatic chemo-embolization is the goal-standard for multifocal hepatocellular carcinoma and Sorafenib for hepatocellular carcinoma with portal vein invasion, leading to modest but significant benefit on survival rates. Yttrium-90 radio-embolization is under evaluation through controlled studies, and could be of major interest for multifocal hepatocellular carcinoma with or without portal venous invasion. (authors)

  18. In vitro cleaning potential of three implant debridement methods. Simulation of the non-surgical approach

    OpenAIRE

    Ronay, Valerie; Merlini, Andrea; ATTIN, Thomas; Schmidlin, Patrick R.; Sahrmann, Philipp

    2017-01-01

    OBJECTIVES To assess the cleaning potential of commonly used implant debridement methods, simulating non-surgical peri-implantitis therapy in vitro. MATERIALS AND METHODS One-hundred-and-eighty dental implants were ink-stained and mounted in combined soft and hard tissue models, representing peri-implantitis defects with angulations of 30, 60, and 90° covered by a custom-made artificial mucosa. Implants were treated by a dental school graduate and a board-certified periodontist for 120 s w...

  19. Are diaphyseal clavicular fractures still treated traditionally in a non-surgical way?

    Science.gov (United States)

    Labronici, Pedro José; Santos Filho, Fernando Claudino Dos; Reis, Tales Bregalda; Pires, Robinson Esteves Santos; Junior, Adriano Fernando Mendes; Kojima, Kodi Edson

    2017-01-01

    To evaluate the decision of orthopedics surgeons regarding which cases they would indicate surgery or non-surgical treatment. 20 images of radiographs with fracture in the middle third of the collar bone (AO/OTA 15-B) in anteroposterior view were analyzed, and divided into four groups: group 1 - fracture type AO/OTA 15-B1 without displacement; group 2 - fracture type AO/OTA 15-B1 with displacement; group 3 - fracture type AO/OTA 15-B2; group 4 - fracture type AO/OTA 15-B3. The evaluator was requested to indicate the choice of treatment, surgical or non-surgical. There was no strong correlation between the amount of surgical indications and the working experience or age of the medical evaluator. It was observed that the average of surgical indications in the total sample was 52%. When indications were studied in different areas of Brazil, there was no significant difference among them. No pattern for the Brazilian regions studied was observed in the case analysis. Even within a group (cases of the same complexity), no specific pattern of surgical indication was observed. No association between surgical indication and the length of professional experience was found. The Southern and Southeastern regions were those that most recommended surgeries in groups 2, 3, and 4. In no region the same level of surgical indication for cases of the same complexity rate was kept.

  20. Breast cancer as second malignant neoplasm after acute myeloid leukemia: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Govind Babu

    2016-01-01

    Full Text Available Cancer survivors after successful treatment of hematological and lymphoid malignancies are at an increased risk for second malignant neoplasms. As the overall survival has increased in these cancers, solid tumors are emerging as a serious long-term complication. In this article, we describe such a rare occurrence, in literature, of breast cancer after the treatment of acute myeloid leukemia.

  1. Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures

    Directory of Open Access Journals (Sweden)

    Anna Maria Fleury

    2011-01-01

    Full Text Available INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically. Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20% for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively. The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%. CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance.

  2. Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements

    Directory of Open Access Journals (Sweden)

    Érica del Peloso Ribeiro

    2010-12-01

    Full Text Available OBJECTIVE: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I used as an adjunct to non-surgical treatment of interproximal class II furcation involvements. MATERIAL AND METHODS: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD >5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10% as the cooling liquid (test group or identical treatment using distilled water as the cooling liquid (control group. The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP, position of the gingival margin, relative attachment level (RAL, PPD and relative horizontal attachment level (RHAL. BAPNA (N-benzoyl-L-arginine-p-nitroanilide testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>0.05. These variables were, respectively, 2.20±1.10 mm, 1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm and 1.56±0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain >2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD >5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group. CONCLUSION: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits.

  3. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

    Directory of Open Access Journals (Sweden)

    Vasconcelos Belmiro CE

    2008-09-01

    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  4. Radiation Techniques for Increasing Local Control in the Non-Surgical Management of Rectal Cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L.; Jakobsen, Anders

    2015-01-01

    , particularly in cases with small tumours and limited local disease. This report discusses several radiotherapy techniques for tumour boosting, focusing on technical challenges and clinical experiences with each technique. Specifically, external beam radiotherapy, brachytherapy and contact X-ray treatment...... for dose escalation are considered. Ultimately, no technique provides definitive advantage over others, and the choice in clinical practice will have to depend on the patient population treated as well as the technical capabilities of the treating department....

  5. Monoclonal Antibody Therapy in Treating Patients With Ovarian Epithelial Cancer, Melanoma, Acute Myeloid Leukemia, Myelodysplastic Syndrome, or Non-Small Cell Lung Cancer

    Science.gov (United States)

    2013-01-09

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Myeloid Leukemia; Recurrent Melanoma; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Stage IV Melanoma; Stage IV Non-small Cell Lung Cancer

  6. Effect of smoking cessation on non-surgical periodontal therapy: Results after 24 months

    DEFF Research Database (Denmark)

    Francisca Rosa, Ecinele; Corraini, Priscila; Inoue, Gislene

    2014-01-01

    AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were...... extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every three months. A calibrated examined, blinded to smoking status, performed full-mouth periodontal examination in six sites per...... continued smoking (NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ(p≤ 0...

  7. A non-surgical approach for male germ cell mediated gene transmission through transgenesis.

    Science.gov (United States)

    Usmani, Abul; Ganguli, Nirmalya; Sarkar, Hironmoy; Dhup, Suveera; Batta, Suryaprakash R; Vimal, Manoj; Ganguli, Nilanjana; Basu, Sayon; Nagarajan, P; Majumdar, Subeer S

    2013-01-01

    Microinjection of foreign DNA in male pronucleus by in-vitro embryo manipulation is difficult but remains the method of choice for generating transgenic animals. Other procedures, including retroviral and embryonic stem cell mediated transgenesis are equally complicated and have limitations. Although our previously reported technique of testicular transgenesis circumvented several limitations, it involved many steps, including surgery and hemicastration, which carried risk of infection and impotency. We improved this technique further, into a two step non-surgical electroporation procedure, for making transgenic mice. In this approach, transgene was delivered inside both testes by injection and modified parameters of electroporation were used for in-vivo gene integration in germ cells. Using variety of constructs, germ cell integration of the gene and its transmission in progeny was confirmed by PCR, slot blot and immunohistochemical analysis. This improved technique is efficient, requires substantially less time and can be easily adopted by various biomedical researchers.

  8. Clinical effect of ibuprofen as an adjunct to non-surgical periodontal disease treatment

    Directory of Open Access Journals (Sweden)

    Đurić Milanko Đ.

    2002-01-01

    Full Text Available Twenty five patients with progresive periodontal disease entered this study in order to examine clinical effects of a non-steroidal anti-inflammatory drug - ibuprofen, used as an adjunct to non-surgical periodontal treatment. After scaling and root planning, patients were randomly assigned to either receive orally 200 mg of ibuprofen per day for one month (group A, or not receive the drug (group B. The obtained results show that the mechanical periodontal treatment brought to resolution the gingival inflammation with both group of patients. Although the mean values of the used indices were lower in group A than in group B, those differences were neither statistically nor clinically significant. We may conclude that systemic ibuprofen had no significant effect on plaque, gingival or bleeding index scores.

  9. Acute onset paraneoplastic cerebellar degeneration in a patient with small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Bhatia R

    2003-04-01

    Full Text Available A patient with small cell lung cancer presented with a rare presentation of an acute onset pancerebellar dysfunction. His clinical condition markedly improved following the surgical removal of the tumor and chemo- and radiotherapy.

  10. New approaches to non-surgical sterilization for dogs and cats: Opportunities and challenges.

    Science.gov (United States)

    Rhodes, Linda

    2016-11-28

    Over the last 40 years, researchers have explored methods to non-surgically suppress fertility in animals. Immunocontraception has been used to control wildlife populations but does not confer long-term immunity. The gonadotropin-releasing hormone (GnRH) agonist deslorelin, formulated as an implant to provide 6-month to 1-year suppression of fertility in male dogs, is available commercially in some countries. Neither of these approaches provide permanent sterility. A single-dose, permanent treatment would be a valuable tool in dog and cat population control. The Michelson Prize and Grants (MPG) programme was initiated "to eliminate shelter euthanasia of healthy, adoptable companion animals and reduce populations of feral and free-roaming cats and dogs" offering a $25 million US prize for a non-surgical sterilant that is effective as a single treatment in both male and female dogs and cats. Michelson Prize and Grants programme has offered US $50 million in grant money for research and has attracted scientists worldwide. Approaches under study include gene therapy, small interfering RNA to inhibit reproductive targets and delivery of cytotoxins to pituitary gonadotrophs or GnRH producing neurons in the hypothalamus. Research in implant technology that could deliver compounds over an animal's lifetime is also underway. Details of funded grants and results to date can be found at: http://www.michelsonprizeandgrants.org/michelson-grants/research-findings. The next steps are translating the most promising research into products. The Alliance for Contraception of Cats and Dogs (ACC&D) is helping to research practical methods of marking sterilized animals to avoid costly retreatment and population modelling that will help guide field workers in use of resources for sterilization programmes.

  11. Non surgical laser and light in the treatment of chronic diseases: a review based on personal experiences

    Science.gov (United States)

    Longo, L.

    2010-11-01

    Since many years some effects of non surgical laser and light on biological tissue have been demonstrated, in vitro and in vivo. This review is based on the results obtained by me and my colleagues/follower in Italy. Aim of our study is to verify the anti-inflammatory and regenerative effects of non surgical laser and light therapy on patients with chronic diseases not good treatable with traditional therapies, as diabetes, and central nervous system injuries. In addition, many clinical data have emerged from double-blind trials on laser treatment of rheumatic diseases and in sports medicine. So, we would like to do a review on the state of the art of non surgical laser treatment in medicine, included aesthetic laser and light therapy field. We discuss the indications and limitations of aesthetic laser medicine, as concluded from the data analysis of the published literature and from over thirty years of personal experiences.

  12. Variation in use of non-surgical treatments among osteoarthritis patients in orthopaedic practice in the Netherlands

    Science.gov (United States)

    Hofstede, Stefanie N; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M; Nelissen, Rob G H H; Marang-van de Mheen, Perla J; van Bodegom-Vos, Leti

    2015-01-01

    Objectives National and international evidence-based guidelines for hip and knee osteoarthritis (OA) recommend to start with non-surgical treatments, followed by surgical intervention if a patient does not respond sufficiently to non-surgical treatments, but there are indications that these are not optimally used. The aim of this study was to assess the extent to which all recommended non-surgical treatments were used by patients with hip or knee OA who receive(d) a total hip or knee replacement, as reported by patients and orthopaedic surgeons. Setting We performed two cross-sectional internet-based surveys among patients and orthopaedic surgeons throughout the Netherlands. Participants 195 OA patients either have undergone total knee arthroplasty or total hip arthroplasty no longer than 12 months ago or being on the waiting list for surgery with a confirmed date within 3 months and 482 orthopaedic surgeons were invited to participate. Primary and secondary outcome measures The use of recommended non-surgical treatments including education about OA/treatment options, lifestyle advice, dietary therapy, physical therapy, acetaminophen, NSAIDs and glucocorticoid injections. Results 174 OA patients (93%) and 172 orthopaedic surgeons (36%) completed the surveys. Most recommended non-surgical treatments were given to the majority of patients (eg, 80% education about OA, 73% physical therapy, 72% acetaminophen, 80% NSAIDs). However, only 6% of patients and 10% of orthopaedic surgeons reported using a combination of all recommended treatments. Dietary therapy was used least frequently. Only 11% of overweight and 30% of obese participants reported having received dietary therapy and 28% of orthopaedic surgeons reported to prescribe dietary therapy to overweight patients. Conclusions While most recommended non-surgical treatments were used frequently as single therapy, the combination is used in only a small percentage of OA patients. Especially, use of dietary therapy

  13. The patient's experience with non-surgical treatment for lumbar spinal stenosis: a qualitative study.

    Science.gov (United States)

    Bove, Allyn M; Lynch, Andrew D; Ammendolia, Carlo; Schneider, Michael

    2017-09-01

    Lumbar spinal stenosis (LSS) is a highly prevalent disease in older adults that causes significant limitations in walking and other daily activities. There is a lack of research into optimal nonsurgical treatment approaches for LSS. The purpose of this qualitative study is to assess the opinions of participants in a randomized clinical trial of non-surgical LSS treatments regarding the interventions they received, factors contributing to adherence to the interventions, and methods of outcomes assessment. Qualitative focus group study; academic research center PATIENT SAMPLE: Individuals participating in a randomized clinical trial (RCT) for non-surgical LSS treatment were invited to discuss their study treatments and general experiences with LSS. The three treatment arms in the study were medical care, community-based group exercise, and clinic-based manual therapy and individual exercise. Following coding of qualitative data, kappa statistic was used to calculate agreement between observers. Themes were identified and agreed upon by both coders. This study was funded by the Patient-Centered Outcomes Research Institute (PCORI). Fifty individuals (28 female, mean age 73 ± 7.7 years) participated in a focus group. Two focus groups based on modified grounded theory were held for participants of each of the three treatment arms, for a total of six focus groups. Discussion topics included perceived effectiveness of the assigned treatment, suggestions for improvement, barriers and facilitators to completing treatment, and opinions of research outcome measures. Several themes were evident across all treatment groups. First, patients prefer individualized treatment that is tailored to their specific impairments and functional limitations. They also want to learn self-management strategies to rely less upon formal health care providers. Participants consistently stated that exercise improved their pain levels and physical function. However, they noted that these effects

  14. Acute pancreatitis induced by paclitaxel and carboplatin therapy in an ovarian cancer patient.

    Science.gov (United States)

    Shintani, D; Yoshida, H; Imai, Y; Fujiwara, K

    2016-01-01

    A 46-year-old female was treated with a regimen of paclitaxel and carboplatin (TC therapy) as adjuvant chemotherapy for Stage IC ovarian adenocarcinoma. There was no severe toxicity except for grade 3 neutropenia during the first four cycles of TC therapy. However, she developed acute pancreatitis at 14 days after fifth cycle. TC therapy is commonly associated with adverse effects such as myelosuppression, hypersensitivity, alopecia, and peripheral neuropathy, but acute pancreatitis has rarely been reported. Ovarian cancer patients often present with nausea and abdominal pain, which are the same symptoms of pancreatitis. It is very important to keep in mind that acute pancreatitis may be concealed in these common symptoms of ovarian cancer during and after TC therapy. Because acute pancreatitis is fatal complication and quitting the drug usually leads to complete cure. The authors report an uncommon case in which TC therapy may have caused acute pancreatitis.

  15. A systematic review of thrust manipulation for non-surgical shoulder conditions.

    Science.gov (United States)

    Minkalis, Amy L; Vining, Robert D; Long, Cynthia R; Hawk, Cheryl; de Luca, Katie

    2017-01-01

    Although many conservative management options are available for patients with non-surgical shoulder conditions, there is little evidence of their effectiveness. This review investigated one manual therapy approach, thrust manipulation, as a treatment option. A systematic search was conducted of the electronic databases from inception to March 2016: PubMed, PEDro, ICL, CINAHL, and AMED. Two independent reviewers conducted the screening process to determine article eligibility. Inclusion criteria were manuscripts published in peer-reviewed journals with human participants of any age. The intervention included was thrust, or high-velocity low-amplitude, manipulative therapy directed to the shoulder and/or the regions of the cervical or thoracic spine. Studies investigating secondary shoulder pain or lacking diagnostic confirmation procedures were excluded. Methodological quality was assessed using the PEDro scale and the Cochrane risk-of-bias tool. The initial search rendered 5041 articles. After screening titles and abstracts, 36 articles remained for full-text review. Six articles studying subacromial impingement syndrome met inclusion criteria. Four studies were randomized controlled trials (RCTs) and 2 were uncontrolled clinical studies. Five studies included 1 application of a thoracic spine thrust manipulation and 1 applied 8 treatments incorporating a shoulder joint thrust manipulation. Statistically significant improvements in pain scores were reported in all studies. Three of 4 RCTs compared a thrust manipulation to a sham, and statistical significance in pain reduction was found within the groups but not between them. Clinically meaningful changes in pain were inconsistent; 3 studies reported that scores met minimum clinically important difference, 1 reported scores did not, and 2 were unclear. Four studies found statistically significant improvements in disability; however, 2 were RCTs and did not find statistical significance between the active and sham

  16. Coronary ectasia in a man on breast cancer therapy presenting with acute coronary syndrome

    OpenAIRE

    2016-01-01

    Limited data exist on the association between breast cancer treatments and coronary artery disease anatomy, particularly in males. We describe an unusual case of diffuse coronary ectasia in a man with breast cancer presenting with acute coronary syndrome (ACS). A 66-year-old man with breast cancer on paclitaxel, tamoxifen, and carboplatin chemotherapy regimen, presents with new onset chest pain. Electrocardiogram reveals anterolateral ST-segment depressions and elevated troponin I level. Emer...

  17. The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Rasmussen, Sten; Laursen, Mogens Berg

    2015-01-01

    secondary care with knee OA, confirmed by radiography (Kellgren-Lawrence grade ≥1), but not eligible for a TKR. The 12-week non-surgical treatment program consisted of individualized progressed neuromuscular exercise, patient education, insoles, dietary advice and prescription of pain medication...

  18. Efficacy of multimodal, systematic non-surgical treatment of knee osteoarthritis for patients not eligible for a total knee replacement

    DEFF Research Database (Denmark)

    Skou, Soren Thorgaard; Roos, Ewa M.; Laursen, Mogens Berg

    2012-01-01

    in a randomised controlled study. The purpose of this randomised controlled study is to examine if an optimised, combined non-surgical treatment programme results in greater improvements in pain, function and quality of life in comparison with usual care in patients with KOA who are not eligible for total knee...

  19. Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis.

    Science.gov (United States)

    Zheng, Xiaozuo; Kang, Kai; Li, Tong; Lu, Bo; Dong, Jiangtao; Gao, Shijun

    2014-12-01

    The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P 0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.

  20. Tratamiento no quirúrgico de la litiasis biliar Non-Surgical treatment of biliary calculi

    Directory of Open Access Journals (Sweden)

    Felipe Franco

    1992-01-01

    Full Text Available

    Se describen diversos procedimientos para el tratamiento no quirúrgico de la colelitiasis: la administración de ácidos billares orales, la litotripsia extracorpórea, la colecistostomía percutánea, la escleroterapia de la vesícula y la litotripsia mecánica; se consignan las indicaciones, ventajas, desventajas y limitaciones de cada uno de ellos.

    Several procedures are described for non-surgical treatment of biliary calculi, namely: oral administration of bile acids, extracorporeal shock-wave lithotrypsy I percutaneous cholecystostomy I gallbladder sclerotherapy

    and mechanicallithotrypsy. lndications, advantages, disadvantages and limitations of each procedure are discussed.

  1. RANKL and OPG mRNA level after non-surgical periodontal treatment.

    Science.gov (United States)

    Dereka, Xanthippi E; Markopoulou, Cleopatra E; Fanourakis, Galinos; Tseleni-Balafouta, Sofia; Vrotsos, Ioannis A

    2010-06-01

    Recent research evidence shows that the receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) play an important role in osteoclastogenesis and the inflammatory bone loss during periodontitis. Bone remodeling process is dependent on the balance of these two proteins while a high ratio of RANKL/OPG characterizes the increased osteolytic process and it has been reported in inflammatory diseases including the periodontal disease. The purpose of this study was to determine the OPG and RANKL mRNA levels in periodontal tissues derived from patients with advanced chronic periodontitis after non-surgical periodontal therapy (SRP) and to compare the RANKL/OPG ration with that in healthy persons. Gingival biopsies were obtained from subjects with clinically healthy periodontium (H) (N = 11) and patients with advanced chronic periodontitis (CP) (N = 14). Total RNA was isolated from the gingival samples and 1 microg RNA was reverse transcribed to cDNA, followed by polymerase chain reaction (PCR) using specific primers for OPG and RANKL. The efficiency of reverse transcription was verified by the amplification of the GAPDH gene. The intensity of RT-PCR products was analyzed by a densitometer and was normalized to the intensity of the band for the housekeeping gene GAPDH. Immunohistochemical evaluation of the RANKL and OPG expression was also performed. The expression of RANKL as well as of OPG was reduced in CP specimens in comparison to that of healthy persons in a statistical significant way. However, the RANKL/OPG ratio showed to be slightly elevated in CP compared to H specimens but this finding was not of statistical significance. The immunohistochemical analysis revealed a non-uniform expression pattern for both proteins. Although further investigation is needed to identify the specific role of RANKL and OPG protein in periodontitis progression, our data after SRP might indicate the possible involvement of these proteins in the activation of

  2. In vitro cleaning potential of three implant debridement methods. Simulation of the non-surgical approach.

    Science.gov (United States)

    Ronay, Valerie; Merlini, Andrea; Attin, Thomas; Schmidlin, Patrick R; Sahrmann, Philipp

    2017-02-01

    To assess the cleaning potential of commonly used implant debridement methods, simulating non-surgical peri-implantitis therapy in vitro. One-hundred-and-eighty dental implants were ink-stained and mounted in combined soft and hard tissue models, representing peri-implantitis defects with angulations of 30, 60, and 90° covered by a custom-made artificial mucosa. Implants were treated by a dental school graduate and a board-certified periodontist for 120 s with following instruments: Gracey curette, ultrasonic scaler, and an air powder abrasive device with a nozzle for sub-mucosal use utilizing glycine powder. All procedures were repeated 10 times for each instrumentation and defect morphology respectively. Images of the implant surface were taken. Areas with color remnants were planimetrically determined and their cumulative surface area was calculated. Results were tested for statistical differences using two-way anova and Bonferroni correction. Micro-morphologic surface changes were analyzed on scanning electron microscope (SEM) images. The areas of uncleaned surfaces (%, mean ± standard deviations) for curettes, ultrasonic tips, and air abrasion accounted for 74.70 ± 4.89%, 66.95 ± 8.69% and 33.87 ± 12.59% respectively. The air powder abrasive device showed significantly better results for all defect angulations (P instrumentation with Gracey curettes and ultrasonic devices, whereas glycine powder did not result in any surface alterations. A complete surface cleaning could not be achieved regardless of the instrumentation method applied. The air powder abrasive device showed a superior cleaning potential for all defect angulations with better results at wide defects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Non-oncogenic Acute Viral Infections Disrupt Anti-cancer Responses and Lead to Accelerated Cancer-Specific Host Death

    Directory of Open Access Journals (Sweden)

    Frederick J. Kohlhapp

    2016-10-01

    Full Text Available In light of increased cancer prevalence and cancer-specific deaths in patients with infections, we investigated whether infections alter anti-tumor immune responses. We report that acute influenza infection of the lung promotes distal melanoma growth in the dermis and leads to accelerated cancer-specific host death. Furthermore, we show that during influenza infection, anti-melanoma CD8+ T cells are shunted from the tumor to the infection site, where they express high levels of the inhibitory receptor programmed cell death protein 1 (PD-1. Immunotherapy to block PD-1 reverses this loss of anti-tumor CD8+ T cells from the tumor and decreases infection-induced tumor growth. Our findings show that acute non-oncogenic infection can promote cancer growth, raising concerns regarding acute viral illness sequelae. They also suggest an unexpected role for PD-1 blockade in cancer immunotherapy and provide insight into the immune response when faced with concomitant challenges.

  4. Drinking Hydrogen-Rich Water Has Additive Effects on Non-Surgical Periodontal Treatment of Improving Periodontitis: A Pilot Study

    OpenAIRE

    Tetsuji Azuma; Mayu Yamane; Daisuke Ekuni; Yuya Kawabata; Kota Kataoka; Kenta Kasuyama; Takayuki Maruyama; Takaaki Tomofuji; Manabu Morita

    2015-01-01

    Oxidative stress is involved in the pathogenesis of periodontitis. A reduction of oxidative stress by drinking hydrogen-rich water (HW) might be beneficial to periodontal health. In this pilot study, we compared the effects of non-surgical periodontal treatment with or without drinking HW on periodontitis. Thirteen patients (3 women, 10 men) with periodontitis were divided into two groups: The control group (n = 6) or the HW group (n = 7). In the HW group, participants consumed HW 4–5 times/...

  5. Quantitative evaluaiton of porphyromonas gingivalis before and after non- surgical periodontal treatment in deep pockets of patients with aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Kadkhoda Z.

    2004-08-01

    Full Text Available Statement of Problem: Elimination of porphyromonas gingivalis (p.g from subgingival area in order to successfully treatment out comes in patients with Aggressive periodntitis AP is necessary. Purpose: The aim of this study was the evaluation of non-surgical treatment efficacy in reduction of bacterial population in deep pockets. Materials and Methods: In this randomized clinical trial study we evaluated the result of non- surgical therapy on reduction of p.g count from deep pockets of patients with aggressive periodontitis that had at least one (p.g plus deep pocket (>5mm in each quadrant. At first stage of non-surgical treatment intra pocket irrigation with chlorhexidin was done after scaling and root planning for all patients. In second stage (one week later antibiotics including amoxicillin- metronidazol prescribed for ten days. At base line, one, six and twelve weeks after beginning of therapy, microbial samples, plaque index, bleeding on probing index and probing pocket index were recorded. Result: There was statistically important difference between one and six weeks after treatment with base line in colony count of p.g and all of clinical indices. But in 12 weeks after therapy just, PI and PPD had statistical difference with base line. In this stage, colony count and BOP was reduced but this reduction had not statistically important difference with base line. Conclusion: Thus in present study our non- surgical strategy in elimination of p.g and clinical improvement was successful in short time but three month after therapy recurrence of disease happened in some patients.

  6. Acute renal failure secondary to ingestion of alternative medication in a patient with breast cancer.

    Science.gov (United States)

    Gulia, S; Gota, V; Kumar, Sangita D; Gupta, Sudeep

    2015-01-01

    Complementary and alternative medicine (CAM) use among cancer patients is widely prevalent and often underreported. Advanced stage of disease is significantly associated with CAM use. The concurrent use of alternative medicines and chemotherapy drugs has the potential to lead to toxicities as well as altered therapeutic activity due to unknown interactions. We report a case of early breast cancer who presented to us with non-oliguric acute renal failure related concurrent use of Ayurvedic medicines and adjuvant anthracycline based.

  7. Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser

    Directory of Open Access Journals (Sweden)

    Marisa Roncati

    2013-01-01

    Full Text Available An 810-nm diode laser was used to non-surgically treat a 7-mm pocket around an implant that had five threads of bone loss, BoP+, and exudate, and the patient was followed up for 5 years. Non-surgical treatment, home care reinforcement, clinical indices records, and radiographic examination were completed in two consecutive 1-h appointments within 24 h. The patient was monitored frequently for the first 3 months. Subsequently, maintenance debridement visits were scheduled at 3-month intervals. The patient had a decreased probing pocket depth and a negative BoP index compared to initial clinical data, and the results were stable after 1 year. After 5 years of follow-up visits, there appeared to be rebound of the bone level radiographically. Within the limits of this case report, conventional non-surgical periodontal therapy with the adjunctive use of an 810-nm diode laser may be a feasible alternative approach for the management of peri-implantitis. The 5-year clinical and radiographic outcomes indicated maintenance of the clinical improvement.

  8. The effect of systemic metronidazole after non-surgical treatment in moderate and advanced periodontitis in young adults.

    Science.gov (United States)

    Söder, P O; Frithiof, L; Wikner, S; Wouters, F; Engström, P E; Rubin, B; Nedlich, U; Söder, B

    1990-05-01

    The effect of adjunctive systemic metronidazole was studied in patients with moderate and advanced periodontitis recalcitrant to comprehensive non-surgical treatment. The material originated from a randomly selected part of the population aged 31 to 40 years. After non-surgical treatment of 149 patients, 98 with persisting pathological pockets greater than or equal to 5 mm (52 men and 46 women) became the subjects for the study. Clinical parameters were registered and pocket contents subjected to laboratory analysis. The subjects were randomized into two groups according to a code list known only by the manufacturer and the statistician. The test group took three 400 mg metronidazole tablets daily for 1 week and the control group took placebo tablets. Reassessment 6 months later showed statistically significant clinical improvement, with a reduction in the number of sites greater than or equal to 5 mm in both test and control groups. Complete healing, with no pockets greater than or equal to 5 mm, was noted in 30% of the test group and 9% of the control group. The difference is statistically significant and shows the supplementary effect of adjunctive metronidazole in non-surgical treatment of moderate and advanced periodontitis.

  9. Evaluation of serum anti-cardiolipin antibodies after non-surgical periodontal treatment in chronic periodontitis patients.

    Science.gov (United States)

    Kiany, Farin; Hedayati, Azita

    2015-05-01

    The present study investigated the effect of non-surgical periodontal therapy on serum level of anti-cardiolipin antibodies (aCLA), which are potentially involved in the pathogenesis of cardiovascular diseases in periodontal patients. Twenty volunteers (11 females and 9 males) with the mean age of 40.55 years participated in this study. Generalized chronic periodontitis was diagnosed through clinical periodontal examination at baseline visit. This examination included measuring the probing pocket depth and clinical attachment loss. Plaque index and gingival index were also recorded. After baseline examination, all the subjects received full-mouth non-surgical periodontal treatment. Subjects returned for a final visit 6 weeks after the last session of scaling for reevaluation of the periodontal parameters. At baseline and final visits 2 ml of venous blood was collected from each patient and an available commercially enzyme-linked immunosorbent assay was used for analyzing aCLA (IgM and IgG). The collected data were analyzed using the paired sample t test. Mean levels of both forms of aCLA, before and after treatment, showed statistically significant difference (P = 0.003 for IgM and P = 0.001 for IgG). In addition, study results showed significant reductions in periodontal parameters after non-surgical periodontal therapy (P < 0.001). The results of this study suggested that successful periodontal therapy can improve the serum level of one of the inflammatory biomarkers involved in the cardiovascular problems.

  10. Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser

    Science.gov (United States)

    Roncati, Marisa; Lucchese, Alessandra; Carinci, Francesco

    2013-01-01

    An 810-nm diode laser was used to non-surgically treat a 7-mm pocket around an implant that had five threads of bone loss, BoP+, and exudate, and the patient was followed up for 5 years. Non-surgical treatment, home care reinforcement, clinical indices records, and radiographic examination were completed in two consecutive 1-h appointments within 24 h. The patient was monitored frequently for the first 3 months. Subsequently, maintenance debridement visits were scheduled at 3-month intervals. The patient had a decreased probing pocket depth and a negative BoP index compared to initial clinical data, and the results were stable after 1 year. After 5 years of follow-up visits, there appeared to be rebound of the bone level radiographically. Within the limits of this case report, conventional non-surgical periodontal therapy with the adjunctive use of an 810-nm diode laser may be a feasible alternative approach for the management of peri-implantitis. The 5-year clinical and radiographic outcomes indicated maintenance of the clinical improvement. PMID:24554897

  11. Effect of Non-surgical Periodontal Therapy on Serum and Salivary Concentrations of Visfatin in Patients with Chronic Periodontitis

    Science.gov (United States)

    Abolfazli, Nader; Jabali, Sahar; Saleh Saber, Fariba; Babaloo, Zohreh; Shirmohammadi, Adileh

    2015-01-01

    Background and aims. Visfatin, mainly secreted by visceral adipose tissue, especially by macrophages, plays an important role in regulating the defense and immune functions, and functions as a growth factor, a cytokine, an enzyme and more importantly as a proinflammatory mediator. The aim of the present study was to evaluate the effect of non-surgical periodontal treatment on serum and salivary levels of visfatin in patients with generalized moderate-to-severe chronic periodontitis. Materials and methods. Eighteen patients with generalized moderate-to-severe chronic periodontitis were selected based on periodontal parameters of gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and radiographic parameters. Serum and salivary samples were collected at baseline and one month following non-surgical periodontal therapy (scaling and root planing ([SRP]). Visfatin levels were measured using an ELISA kit. Data were analyzed by SPSS 15, using paired t-test and Pearson's correlation coefficient. Results. Mean salivary and serum levels of visfatin significantly decreased after non-surgical periodontal treatment (P<0.05). Changes in salivary visfatin levels were more prominent. Conclusion. According to the findings of this study it seems that there is a direct relationship between periodontal tissue inflammation and disease activity with salivary and serum visfatin levels. PMID:25973148

  12. Effect of Non-surgical Periodontal Therapy on Serum and Salivary Concentrations of Visfatin in Patients with Chronic Periodontitis.

    Science.gov (United States)

    Abolfazli, Nader; Jabali, Sahar; Saleh Saber, Fariba; Babaloo, Zohreh; Shirmohammadi, Adileh

    2015-01-01

    Background and aims. Visfatin, mainly secreted by visceral adipose tissue, especially by macrophages, plays an important role in regulating the defense and immune functions, and functions as a growth factor, a cytokine, an enzyme and more importantly as a proinflammatory mediator. The aim of the present study was to evaluate the effect of non-surgical periodontal treatment on serum and salivary levels of visfatin in patients with generalized moderate-to-severe chronic periodontitis. Materials and methods. Eighteen patients with generalized moderate-to-severe chronic periodontitis were selected based on periodontal parameters of gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and radiographic parameters. Serum and salivary samples were collected at baseline and one month following non-surgical periodontal therapy (scaling and root planing ([SRP]). Visfatin levels were measured using an ELISA kit. Data were analyzed by SPSS 15, using paired t-test and Pearson's correlation coefficient. Results. Mean salivary and serum levels of visfatin significantly decreased after non-surgical periodontal treatment (P<0.05). Changes in salivary visfatin levels were more prominent. Conclusion. According to the findings of this study it seems that there is a direct relationship between periodontal tissue inflammation and disease activity with salivary and serum visfatin levels.

  13. Drinking Hydrogen-Rich Water Has Additive Effects on Non-Surgical Periodontal Treatment of Improving Periodontitis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Tetsuji Azuma

    2015-07-01

    Full Text Available Oxidative stress is involved in the pathogenesis of periodontitis. A reduction of oxidative stress by drinking hydrogen-rich water (HW might be beneficial to periodontal health. In this pilot study, we compared the effects of non-surgical periodontal treatment with or without drinking HW on periodontitis. Thirteen patients (3 women, 10 men with periodontitis were divided into two groups: The control group (n = 6 or the HW group (n = 7. In the HW group, participants consumed HW 4–5 times/day for eight weeks. At two to four weeks, all participants received non-surgical periodontal treatment. Oral examinations were performed at baseline, two, four and eight weeks, and serum was obtained at these time points to evaluate oxidative stress. At baseline, there were no significant differences in periodontal status between the control and HW groups. The HW group showed greater improvements in probing pocket depth and clinical attachment level than the control group at two, four and eight weeks (p < 0.05. The HW group also exhibited an increased serum level of total antioxidant capacity at four weeks, compared to baseline (p < 0.05. Drinking HW enhanced the effects of non-surgical periodontal treatment, thus improving periodontitis.

  14. Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media?

    Directory of Open Access Journals (Sweden)

    Daniel Dwain M

    2007-05-01

    Full Text Available Abstract Background Traction therapy has been utilized in the treatment of low back pain for decades. The most recent incarnation of traction therapy is non-surgical spinal decompression therapy which can cost over $100,000. This form of therapy has been heavily marketed to manual therapy professions and subsequently to the consumer. The purpose of this paper is to initiate a debate pertaining to the relationship between marketing claims and the scientific literature on non-surgical spinal decompression. Discussion Only one small randomized controlled trial and several lower level efficacy studies have been performed on spinal decompression therapy. In general the quality of these studies is questionable. Many of the studies were performed using the VAX-D® unit which places the patient in a prone position. Often companies utilize this research for their marketing although their units place the patient in the supine position. Summary Only limited evidence is available to warrant the routine use of non-surgical spinal decompression, particularly when many other well investigated, less expensive alternatives are available.

  15. Adjuvant chemotherapy and acute toxicity in hypofractionated radiotherapy for early breast cancer

    Science.gov (United States)

    Kouloulias, Vassilis; Zygogianni, Anna; Kypraiou, Efrosini; Georgakopoulos, John; Thrapsanioti, Zoi; Beli, Ivelina; Mosa, Eftychia; Psyrri, Amanta; Antypas, Christos; Armbilia, Christina; Tolia, Maria; Platoni, Kalliopi; Papadimitriou, Christos; Arkadopoulos, Nikolaos; Gennatas, Costas; Zografos, George; Kyrgias, George; Dilvoi, Maria; Patatoucas, George; Kelekis, Nikolaos; Kouvaris, John

    2014-01-01

    AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy (HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0Mx. The patients received 3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity. RESULTS: The acute radiation induced skin toxicity was as following: grade I 27.6%, grade II 7.8% and grade III 2.6%. No significant correlation was noted between toxicity grading and chemotherapy (P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively (P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions (P = 0.47, χ2 test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse. CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions. PMID:25405195

  16. INCIDENCE OF ACUTE MYELOID LEUKEMIA AFTER BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Caterina Giovanna Valentini

    2011-12-01

    Full Text Available Breast cancer is the most frequent cancer among women and the leading cause of death among middle-aged women. Early detection by mammography screening and improvement of therapeutic options have increased breast cancer survival rates, with the consequence that late side effects of cancer treatment become increasingly important. In particular, patients treated with adjuvant chemotherapy regimens, commonly including alkylating agents and anthracyclines, are at increased risk of developing leukemia, further enhanced by the use of radiotherapy. In the last few years also the use of growth factors seems to increase the risk of secondary leukemia. The purpose of this review is to update epidemiology of therapy-related myeloid neoplasms occurring in breast cancer patients

  17. Acute chemotherapy-induced cardiovascular changes in patients with testicular cancer

    NARCIS (Netherlands)

    Nuver, J; Smit, AJ; van der Meer, J; van den Berg, MP; van der Graaf, WTA; Meinardi, MT; Sleijfer, DT; Hoekstra, HJ; van Gessel, AI; van Roon, AM; Gietema, JA

    2005-01-01

    Purpose; After cisplatin- and bleomycin-containing chemotherapy for testicular cancer, part of the patient population will develop acute or long-term cardiovascular toxicity. It is largely unknown whether standard tests can be used to assess chemotherapy-induced cardiovascular changes. Patients and

  18. Which is best for osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty or non-surgical treatment? A study protocol for a Bayesian network meta-analysis

    Science.gov (United States)

    Kan, Shun-Li; Yuan, Zhi-Fang; Chen, Ling-Xiao; Sun, Jing-Cheng; Ning, Guang-Zhi; Feng, Shi-Qing

    2017-01-01

    Introduction Osteoporotic vertebral compression fractures (OVCFs) commonly cause both acute and chronic back pain, substantial spinal deformity, functional disability and decreased quality of life and increase the risk of future vertebral fractures and mortality. Percutaneous vertebroplasty (PVP), balloon kyphoplasty (BK) and non-surgical treatment (NST) are mostly used for the treatment of OVCFs. However, which treatment is preferred is unknown. The purpose of this study is to comprehensively review the literature and ascertain the relative efficacy and safety of BK, PVP and NST for patients with OVCFs using a Bayesian network meta-analysis. Methods and analysis We will comprehensively search PubMed, EMBASE and the Cochrane Central Register of Controlled Trials, to include randomided controlled trials that compare BK, PVP or NST for treating OVCFs. The risk of bias for individual studies will be assessed according to the Cochrane Handbook. Bayesian network meta-analysis will be performed to compare the efficacy and safety of BK, PVP and NST. The quality of evidence will be evaluated by GRADE. Ethics and dissemination Ethical approval and patient consent are not required since this study is a meta-analysis based on published studies. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication. PROSPERO registration number CRD42016039452; Pre-results. PMID:28093431

  19. The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients.

    Directory of Open Access Journals (Sweden)

    Isabel C T Almeida

    Full Text Available INTRODUCTION: Delirium and coma are a frequent source of morbidity for ICU patients. Several factors are associated with the prognosis of mechanically ventilated (MV cancer patients, but no studies evaluated delirium and coma (acute brain dysfunction. The present study evaluated the frequency and impact of acute brain dysfunction on mortality. METHODS: The study was performed at National Cancer Institute, Rio de Janeiro, Brazil. We prospectively enrolled patients ventilated >48 h with a diagnosis of cancer. Acute brain dysfunction was assessed during the first 14 days of ICU using RASS/CAM-ICU. Patients were followed until hospital discharge. Univariate and multivariable analysis were performed to evaluate factors associated with hospital mortality. RESULTS: 170 patients were included. 73% had solid tumors, age 65 [53-72 (median, IQR 25%-75%] years. SAPS II score was 54[46-63] points and SOFA score was (7 [6-9] points. Median duration of MV was 13 (6-21 days and ICU stay was 14 (7.5-22 days. ICU mortality was 54% and hospital mortality was 66%. Acute brain dysfunction was diagnosed in 161 patients (95%. Survivors had more delirium/coma-free days [4(1,5-6 vs 1(0-2, p<0.001]. In multivariable analysis the number of days of delirium/coma-free days were associated with better outcomes as they were independent predictors of lower hospital mortality [0.771 (0.681 to 0.873, p<0.001]. CONCLUSIONS: Acute brain dysfunction in MV cancer patients is frequent and independently associated with increased hospital mortality. Future studies should investigate means of preventing or mitigating acute brain dysfunction as they may have a significant impact on clinical outcomes.

  20. Breast cancer resistance protein (BCRP) in acute leukemia

    NARCIS (Netherlands)

    Plasschaert, SLA; van der Kolk, Dorina M.; De Bont, ESJM; Vellenga, E; Kamps, WA; De Vries, EGE

    Multidrug resistance, cross- resistance to structurally and functionally unrelated drugs, is an important cause of treatment failure in acute leukemia. Multidrug resistance can result from the overexpression of ATP- dependent efflux pumps, such as P- glycoprotein and members of the multidrug

  1. The role of acute trigemino-cardiac reflex in unusual, non-surgical cases: A mini-review

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2016-10-01

    Full Text Available Trigemino-cardiac reflex is a well established phenomenon that is mainly reported in the various surgical specialities. However, the role of this unique reflex is entirely unknown in other medicine domains. Therefore, the present mini-review aims to explore the role of TCR in such unusual cases and also highlights the importance of case reports for knowledge creation in such context.

  2. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general Venous thromboembolism prevention in non-surgical adult patients admitted in a general hospital

    Directory of Open Access Journals (Sweden)

    Marcelo J. Melero

    2012-10-01

    Full Text Available Los pacientes adultos internados por una enfermedad no quirúrgica tienen un riesgo alto de padecer una tromboembolia venosa y pueden desarrollar alguna forma de esta enfermedad cuando no reciben un tratamiento preventivo adecuado. Los objetivos de este estudio prospectivo, analítico, observacional y transversal, fueron: 1 determinar cuál es el porcentaje de pacientes adultos internados por una enfermedad aguda no quirúrgica en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, que tienen indicación de tromboprofilaxis, 2 establecer cuántos de ellos reciben un tratamiento preventivo para la tromboembolia venosa, y 3 comprobar cuántos estaban medicados con alguna forma de tromboprofilaxis sin tener causas que justificaran este tratamiento. Se estudiaron 93 pacientes durante un lapso de 72 horas consecutivas. Se encontró que el 90.3% de ellos necesitaba un tratamiento preventivo para la tromboembolia venosa y el 76.2% de estos enfermos recibían tromboprofilaxis farmacológica. Un 33.3% de los pacientes internados tenía indicado un tratamiento farmacológico preventivo sin tener una causa que justificara esta prescripción. El porcentaje encontrado de pacientes tratados con tromboprofilaxis es más alto que el comunicado en otros estudios observacionales.Adult patients hospitalized for a non-surgical condition, usually have a high risk of venous thromboembolism and may develop some form of this disease when they do not receive appropriate preventive treatment. The objectives of this prospective, analytical, observational and cross-sectional study were: 1 to determine what percentage of adult patients hospitalized for a non-surgical acute condition at the Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, had indication for preventive thromboprophylaxis, 2 to establish how many of them had been prescribed a preventive treatment of venous thromboembolism, 3 to establish how many of them had been

  3. Risk of acute myelogenous leukaemia and myelodysplasia following cancer treatment.

    Science.gov (United States)

    van Leeuwen, F E

    1996-03-01

    Now that a substantial group of cancer patients has such a favourable prognosis, it has become increasingly important to evaluate the long-term complications of treatment. Of all late effects of treatment, secondary leukaemia is one of the most serious. Increased risk of AML has been observed both after RT and after CT; however, several types of CT have much stronger leukaemogenic properties than RT. Limited field radiation in the therapeutic dose range is associated with very little or no increased risk of leukaemia, which has been attributed to cell killing at the higher radiation doses. With respect to CT, two different syndromes of treatment-related AML have been recognized. Risk of alkylating agent-related AML is highest in the 5-10 year follow-up period and seems to decrease afterwards. This type of leukaemia is often preceded by MDS, and is characterized by deletions of chromosomes 5 and 7. Leukaemias related to treatment with the topoisomerase II inhibitors are characterized by a short induction period, presentation as myelomonocytic or monocytic leukaemia (rather than MDS) and balanced chromosomal translocations involving bands 11q23 and 21q22. This review addresses the risk of secondary AML and MDS following treatment of HD, NHL, testicular cancer, ovarian cancer, breast cancer and paediatric malignancies. In patients with HD, the risk of AML is higher with an increasing number of mechlorethamine-procarbazine-containing cycles, a greater number of CT episodes, and after splenectomy. The majority of data shows that RT does not add to the leukaemia risk from CT, but this issue is still surrounded by some controversy. ABV(D)-treated patients have a very low risk of AML. Generally, patients with NHL, testicular cancer and breast cancer experience much lower risk of AML than patients with HD. NHL and breast cancer treatment regimens with cumulative cyclophosphamide doses of 20 g or less do not confer an appreciable increase of AML. Recently, strongly increased

  4. Association of XRCC1 variants with acute skin reaction after radiotherapy in breast cancer patients.

    Science.gov (United States)

    Zhou, Liqing; Xia, Jianhong; Li, Hongliang; Dai, Jianrong; Hu, Yimin

    2010-12-01

    After irradiation results in cytotoxic effects by DNA damage, base excision repair (BER) pathway is involved in the repair of single-strand breaks and nonhomologous end joining and homologous repair of double-strand breaks caused by radiotherapy. Alterations in the function of BER DNA repair genes may affect DNA repair proficiency and influence the response of patients with cancer to radiotherapy. The association of single nucleotide polymorphisms of BER DNA repair X-ray repair cross-complementing group 1 protein (XRCC1) and risk of radiotherapy-induced ≥grade 2 acute skin reaction in patients with breast cancer was examined. It was found that the risk of ≥grade 2 acute skin toxicity after radiotherapy could be increased by 2.86-fold in patients carrying the XRCC1 -77TC and CC genotypes (p = 0.016). However, the other three coding XRCC1 variants did not influence the risk of ≥grade 2 acute skin toxicity for patients with breast cancer after radiotherapy. Our results suggested that the XRCC1 polymorphism is associated with increased risk of radiation-induced acute skin reaction in a Chinese population.

  5. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Non-surgical Methods

    Science.gov (United States)

    Valderrama, Pilar; Blansett, Jonathan A; Gonzalez, Mayra G; Cantu, Myrna G; Wilson, Thomas G

    2014-01-01

    Objective: The aim of this review is to summarize the findings of studies that have evaluated non-surgical approaches for detoxification of implant body surfaces in vitro and in vivo, and to evaluate clinical trials on the use of these methodologies for treating peri-implant disease. Materials and methods: A literature search was conducted using MEDLINE (Pubmed) from 1966 to 2013. In vitro and in vivo studies as well as clinical trials on non-surgical therapy were evaluated. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters including probing depth, clinical attachment levels, bleeding on probing; radiographic bone fill and histological re-osseointegration. Results: From 134 articles found 35 were analyzed. The findings, advantages and disadvantages of using lasers as well as mechanical and chemical methods are discussed. Most of the in vivo and human studies used combination therapies which makes determining the efficacy of one specific method difficult. Most human studies are case series with short term longitudinal analysis without survival or failure reports. Conclusion: Complete elimination of the biofilms is difficult to achieve using these approaches. All therapies induce changes of the chemical and physical properties of the implant surface. Re-osseointegration may be difficult to achieve if not impossible without surgical access to ensure thorough debridement of the defect and detoxification of the implant surface. Combination protocols for non-surgical treatment of peri-implantitis in humans have shown some positive clinical results but long-term evaluation to evaluate the validity and reliability of the techniques is needed. PMID:24894571

  6. Selective decontamination of the oral and digestive tract in surgical versus non-surgical patients in intensive care in a cluster-randomized trial.

    NARCIS (Netherlands)

    Melsen, W.G.; Smet, A.M. de; Kluytmans, J.A.; Bonten, M.J.; Pickkers, P.

    2012-01-01

    BACKGROUND: Selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) are effective in improving survival in patients under intensive care. In this study possible differential effects in surgical and non-surgical patients were investigated. METHODS: This was a post

  7. Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

    OpenAIRE

    Chang, Hee-Yung; Park, Shin-Young; Kim, Jin-Ah; Kim, Young-Kyun; Lee, Hyo-Jung

    2015-01-01

    Purpose This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance...

  8. Autopsy report of acute necrotizing opticomyelopathy associated with thyroid cancer.

    Science.gov (United States)

    Kuroda, Y; Miyahara, M; Sakemi, T; Matsui, M; Ryu, T; Yamaguchi, M; Sasadomi, E; Sugihara, H

    1993-12-01

    We report an autopsied case of paraneoplastic necrotizing myelopathy. The patient had bilateral blindness, quadriplegia, and dyspnea of acute onset and died without remission 7 weeks later. The severe tissue necrosis and demyelination were found in the optic chiasm and from the medulla oblongata throughout the whole length of spinal cord. A papillary carcinoma was found in the thyroid gland at autopsy. In the present case IgG, myelin basic protein and activated helper T cells were increased in the CSF at onset, suggesting a mechanism of autoimmune demyelination for the condition.

  9. Transcatheter arterial embolization in gastric cancer patients with acute bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Joo; Shin, Ji Hoon; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Song, Ho-Young; Sung, Kyu-Bo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea)

    2009-04-15

    The safety and clinical effectiveness of transcatheter arterial embolization for bleeding associated with unresectable gastric cancer was evaluated. Twenty-three patients with bleeding from unresectable gastric cancer underwent transcatheter arterial embolization. Of the 23 patients, eight showed signs of active bleeding, such as contrast extravasation or pseudoaneurysm, seven showed only tumor staining, and the remaining eight patients showed negative angiographic findings. All embolization procedures were successful without procedure-related complications. In all eight active bleeding patients, immediate hemostasis was achieved. The overall clinical success rate was 52% (12/23). Recurrent bleeding within 1 month occurred in one (8%) in 12 patients with initial clinical success. One patient showed partial splenic infarction after embolization of the splenic artery for active bleeding from the short gastric artery. Overall 30-day mortality rate was 43% (10/23). The median overall survival period was 38 days. In patients with bleeding from unresectable gastric cancer, transcatheter arterial embolization was found to be safe and effective for achieving immediate hemostasis for active bleeding. Although the clinical success rate was not high, the recurrent bleeding rate was low at 1 month post procedure. (orig.)

  10. Put a label (claim) on it: Getting non-surgical contraceptives approved for use in cats and dogs.

    Science.gov (United States)

    Rhodes, Linda

    2015-09-01

    Non-surgical contraceptives or sterilants need regulatory approval to be sold for that use. This approval process gives veterinarians the information required to assess the benefits and risks of each product, and to provide comprehensive information on the required dose, method and duration of use, safety and effectiveness. This article reviews the information that must be developed and provided to regulatory agencies worldwide, with a focus on the European Union and the United States, in order to achieve regulatory approval. The main components of developing a drug include developing extensive information on the safety and effectiveness of the product, and also the safety to the environment and to humans handling and administering the drug. Most importantly, a robust method of manufacturing both the drug itself and the formulated drug product (pill, liquid implant or injection) must be developed to assure quality and consistency in each batch. This information is then compiled and submitted to regulatory agencies; in the United States, this includes the Food and Drug Administration, the United States Department of Agriculture and the Environmental Protection Agency, and, in Europe, the European Medicines Agency. Because of the unique nature of non-surgical contraceptives for use in cats and dogs, particularly the desire to have these products last over multiple years, there are special challenges to their regulatory approval that are discussed in this review. © The Author(s) 2015.

  11. Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial.

    Science.gov (United States)

    De Micheli, Giorgio; de Andrade, Ana Karina Pinto; Alves, Vanessa Tubero Euzebio; Seto, Marcio; Pannuti, Cláudio Mendes; Cai, Silvana

    2011-01-01

    The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.

  12. Drinking Hydrogen-Rich Water Has Additive Effects on Non-Surgical Periodontal Treatment of Improving Periodontitis: A Pilot Study.

    Science.gov (United States)

    Azuma, Tetsuji; Yamane, Mayu; Ekuni, Daisuke; Kawabata, Yuya; Kataoka, Kota; Kasuyama, Kenta; Maruyama, Takayuki; Tomofuji, Takaaki; Morita, Manabu

    2015-07-09

    Oxidative stress is involved in the pathogenesis of periodontitis. A reduction of oxidative stress by drinking hydrogen-rich water (HW) might be beneficial to periodontal health. In this pilot study, we compared the effects of non-surgical periodontal treatment with or without drinking HW on periodontitis. Thirteen patients (3 women, 10 men) with periodontitis were divided into two groups: The control group (n = 6) or the HW group (n = 7). In the HW group, participants consumed HW 4-5 times/day for eight weeks. At two to four weeks, all participants received non-surgical periodontal treatment. Oral examinations were performed at baseline, two, four and eight weeks, and serum was obtained at these time points to evaluate oxidative stress. At baseline, there were no significant differences in periodontal status between the control and HW groups. The HW group showed greater improvements in probing pocket depth and clinical attachment level than the control group at two, four and eight weeks (p surgical periodontal treatment, thus improving periodontitis.

  13. Defining and predicting outcomes of non-surgical periodontal treatment: a 1-yr follow-up study.

    Science.gov (United States)

    Baelum, Vibeke; López, Rodrigo

    2016-02-01

    This study reports on 1-yr outcomes of non-surgical periodontal therapy and compares predictive models resulting from different definitions of treatment success. A total of 149 participants, 30-70 yr of age, provided clinical periodontal data and data on sociodemographic status, health status, symptoms, and oral health-care behaviors at baseline. One week later, clinical attachment level and probing pocket depth were recorded again in 148 patients. Participants underwent non-surgical periodontal therapy, including scaling and root planing, during three to four clinical sessions. Three and 12 months later, clinical attachment level, probing pocket depth, and bleeding on probing (BOP) were recorded in 141 and 137 participants, respectively. Using test-retest data, patients were classified as having 'downhill', 'stable', or 'improved' results on three clinical attachment level and three probing pocket depth outcomes, and their classification was found to vary considerably according to outcome. Although the predictors of treatment outcome varied depending on the variable chosen to represent the treatment outcome, some predictors were more commonly noted as predicting improvement, namely a high baseline percentage of sites with subgingival calculus and the presence of suppuration at baseline. The latter was, however, also predictive for tooth loss during the study. Our findings underline the need for uniformity in defining the outcomes in trials of periodontal therapy.

  14. Characterization of the release profile of doxycycline by PLGA microspheres adjunct to non-surgical periodontal therapy.

    Science.gov (United States)

    Moura, Lucas Alves; Ribeiro, Fernanda Vieira; Aiello, Talita Bianchi; Duek, Eliana Ap De Rezende; Sallum, Enilson Antonio; Nociti Junior, Francisco Humberto; Casati, Márcio Zaffalon; Sallum, Antonio Wilson

    2015-01-01

    The aim of this pilot study was to assess the release of locally delivered doxycycline by poly (l-lactide-co-glycolide) (PLGA) microspheres in the periodontal pocket of patients with chronic periodontitis, treated by non-surgical periodontal therapy. Nineteen sites of non-adjacent teeth of four different patients were evaluated. Five milligram of PLGA microspheres loaded with 16 doxycycline hyclate (DOX) was administered per periodontal site. To quantify DOX released into the periodontal pocket, gingival crevicular fluid (GCF) was collected from the sites on days 2, 5, 7, 10, 15, and 20 after DOX application, and high-performance liquid chromatography was performed. Data were statistically assessed by ANOVA/Tukey test. At days 2, 5, and 7, the DOX concentration was stably sustained (23.33 ± 1.38, 23.4 ± 1.82, and 22.75 ± 1.33 μg/mL, respectively), with no significant differences over these assessment times (p > 0.05). At days 10 and 15, a tendency was observed toward a decrease in DOX concentration (21.74 ± 0.91 and 20.53 ± 4.88 μg/mL, respectively), but a significant decrease in GCF drug concentration (19.69 ± 4.70 μg/mL) was observed only on day 20. The DOX delivery system developed demonstrated a successful sustained release after local administration, as an adjunct to non-surgical periodontal therapy.

  15. Adjuvant radiotherapy for endometrial cancer--a comparative review of radiotherapy technique with acute toxicity.

    Science.gov (United States)

    Koh, Y V; Tang, J I; Choo, B A; Koh, M S; Lee, K M

    2014-01-01

    The addition of pelvic radiotherapy to brachytherapy (EBRT-BT) in early-stage endometrial cancer is controversial and may cause unnecessary toxicity. The incidence of acute toxicity of EBRT-BT will have an impact on clinical decision and patient compliance but is currently poorly understood. This study compares the acute toxicities of EBRT-BT versus BT alone. Seventy-nine patients with FIGO Stage IA-II endometrial cancer who underwent adjuvant radiotherapy, (EBRT-BT or BT alone) from 2001 to 2011 were included in the study. Medical records of these patients were reviewed retrospectively and toxicity graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Patients were followed up for at least three months post-treatment to assess resolution of toxicity. The mean age of the study group was 60.6 years. Median follow-up was four years. Forty patients received EBRT-BT. There was a 37% increase in Grade 1-3 diarrhea with the addition of pelvic radiotherapy (OR 18.67, p < 0.0005) and a 34% increase in lethargy (p < 0.0005). There was also an increased occurrence of genitourinary and skin toxicities. Two patients in the EBRT-BT group required hospitalisation for severe diarrhea and three patients were unable to complete the treatment. All acute toxicities had resolved by three months post treatment. EBRT-BT causes significantly more acute toxicities compared to BT alone. Patients should be informed of this during counselling.

  16. The acute oncologist’s role in managing patients with cancer and other comorbidities

    Directory of Open Access Journals (Sweden)

    Kate Shankland

    2015-08-01

    Full Text Available Background: An Acute Oncology Service (AOS is paramount to providing timely and improved pathways of care for patients who are admitted to hospital with cancer-related problems or suspected cancer. Objective: To establish an AOS pilot study to decide how best to implement such a service locally. Methods: The AOS, which included collaboration between the oncology and palliative care teams at the Northern General Hospital in Sheffield, UK, ensured that the majority of oncology patients in the region received timely assessment by an oncologist if they became acutely unwell as a result of their cancer or its treatment. The AOS consisted of a thrice-weekly ward round, and daily telephone advice service. Results: We report on patient data during the first 12 months of the pilot study. Delivery of the AOS enhanced communication between the services and provided inter-professional education and support, resulting in earlier oncological team involvement in the management of patients with cancer admitted under other teams, as well as provision of advice to patients and their caregivers and families. Provision of the AOS shortened the mean length of hospital stay by 6 days. Two case studies are presented to illustrate the typical challenges faced when managing these patients. Conclusions: Establishment of the AOS enabled effective collaboration between the oncology and other clinical teams to provide a rapid and streamlined referral pathway of patients to the AOS. Locally, this process has been supported by the development of acute oncology protocols, which are now in use across the local cancer network.

  17. Secondary acute promyelocytic leukemia following chemotherapy for gastric cancer: a case report.

    Science.gov (United States)

    Zhang, Ying-Cheng; Zhou, Yu-Qi; Yan, Bing; Shi, Jun; Xiu, Li-Juan; Sun, Yu-Wei; Liu, Xuan; Qin, Zhi-Feng; Wei, Pin-Kang; Li, Yong-Jin

    2015-04-14

    Therapy-related acute myeloid leukemia (t-AML) refers to a heterogeneous group of myeloid neoplasms that develop in patients following extensive exposure to either cytotoxic agents or radiation. The development of t-AML has been reported following treatment of cancers ranging from hematological malignancies to solid tumors; however, to our knowledge, t-AML has never been reported following treatment of gastric cancer. In this study, we report the development of t-acute promyelocytic leukemia in a cT4N1M0 gastric cancer patient after an approximate 44 mo latency period following treatment with 4 cycles of oxaliplatin (OXP) (85 mg/m(2) on day 1) plus capecitabine (1250 mg/m(2) orally twice daily on days 1-14) in combination with recombinant human granulocyte-colony stimulating factor treatment. Karyotype analysis of the patient revealed 46,XY,t(15;17)(q22;q21)[15]/46,idem,-9,+add(9)(p22)[2]/46,XY[3], which, according to previous studies, includes some "favorable" genetic abnormalities. The patient was then treated with all-trans retinoic acid (ATRA, 25 mg/m(2)/d) plus arsenic trioxide (ATO, 10 mg/d) and attained complete remission. Our case illuminated the role of certain cytotoxic agents in the induction of t-AML following gastric cancer treatment. We recommend instituting a mandatory additional evaluation for patients undergoing these therapies in the future.

  18. A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study

    Directory of Open Access Journals (Sweden)

    Hurwitz Eric L

    2006-02-01

    Full Text Available Abstract Background While it is widely held that non-surgical management should be the first line of approach in patients with lumbar spinal stenosis (LSS, little is known about the efficacy of non-surgical treatments for this condition. Data are needed to determine the most efficacious and safe non-surgical treatment options for patients with LSS. The purpose of this paper is to describe the clinical outcomes of a novel approach to patients with LSS that focuses on distraction manipulation (DM and neural mobilization (NM. Methods This is a prospective consecutive case series with long term follow up (FU of fifty-seven consecutive patients who were diagnosed with LSS. Two were excluded because of absence of baseline data or failure to remain in treatment to FU. Disability was measured using the Roland Morris Disability Questionnaire (RM and pain intensity was measured using the Three Level Numerical Rating Scale (NRS. Patients were also asked to rate their perceived percentage improvement. Results The mean patient-rated percentage improvement from baseline to the end to treatment was 65.1%. The mean improvement in disability from baseline to the end of treatment was 5.1 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability from baseline to the end of treatment was seen in 66.7% of patients. The mean improvement in "on average" pain intensity was 1.6 points. This did not reach the threshold for clinical meaningfulness. The mean improvement in "at worst" pain was 3.1 points. This was considered to be clinically meaningful. The mean duration of FU was 16.5 months. The mean patient-rated percentage improvement from baseline to long term FU was 75.6%. The mean improvement in disability was 5.2 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability was seen in 73.2% of patients. The mean improvement in "on average" pain intensity from baseline to long

  19. Oral health-related quality of life following non-surgical (routine tooth extraction: A pilot study

    Directory of Open Access Journals (Sweden)

    Wasiu L Adeyemo

    2012-01-01

    Full Text Available Aim: The study was designed to explore the changes in oral health-related quality of life (QoL in the immediate postoperative period following routine (non-surgical dental extraction. Setting and Design: A prospective study carried out at the Oral and Maxillofacial Surgery clinic of the Lagos University Teaching Hospital, Nigeria. Materials and Methods: Subjects attending who required non-surgical removal of one or two teeth under local anesthesia were included in the study. A baseline QoL questionnaire (oral health impact profile-14 [OHIP-14] was filled by each patient just before surgery, and only those who were considered to have their QoL "not affected" (total score 14 or less were included in the study. After the extraction, each subject was given a modified form of "health related QoL" [OHIP-14]-instrument to be completed by the 3 rd day-after surgery, and were given the opportunity to review the questionnaire on the 7 th day postoperative review. Results: Total OHIP-14 scores ranged between 14 and 48 (mean ± SD, 26.2 ± 8.3. Majority of the subjects (60% reported, "a little affected." Only few subjects (5.8% reported, "not at all affected," and about 32% reported, "quite a lot." Summation of OHIP-14 scores revealed that QoL was "affected" in 41 subjects (34.2% and "not affected" in 79 subjects (65.8%. More than 30% of subjects reported that their ability to chew, ability to open the mouth and enjoyment of food were affected following tooth extraction. Few subjects (14-34% reported deterioration in their speech and less than 20% of subjects reported that change in their appearance was "affected." Only few subjects (12.5-15.1% reported sleep and duty impairment. Thirty-percent of subjects reported their inability to keep social activities, and 41% were not able to continue with their favorite sports and hobbies. Multiple regression analysis revealed no significant association between age, sex, indications for extraction, duration of

  20. Expression and activity of breast cancer resistance protein (BCRP) in de novo and relapsed acute myeloid leukemia

    NARCIS (Netherlands)

    Vellenga, E; Scheffer, GL; Muller, M; Bates, SE; Scheper, RJ; de Vries, EGE

    2002-01-01

    Overexpression of the breast cancer resistance protein (BCRP) efflux pump In human cancer cell lines results in resistance to a variety of cytostatic agents. The aim of this study was to analyze BCRP protein expression and activity In acute myeloid leukemia (AML) samples and to determine whether it

  1. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    Science.gov (United States)

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  2. Evaluation of non-surgical causes of cardiac tamponade in children at a cardiac surgery center.

    Science.gov (United States)

    Ozturk, Erkut; Tanidir, Ibrahim Cansaran; Saygi, Murat; Ergul, Yakup; Guzeltas, Alper; Odemis, Ender

    2014-02-01

    The aim of this study was to examine the causes of cardiac tamponade in children undergoing percutaneous pericardiocentesis. Patients who presented with other complaints but were diagnosed with cardiac tamponade based on clinical and echocardiographic findings between January 2010 and January 2013 were retrospectively investigated. Electrocardiography, telecardiography and transthoracic echocardiography were performed. Pericardiocentesis was performed percutaneously under continuous blood pressure and rhythm monitoring with echocardiography and fluoroscopy. Pericardial fluid was analyzed on hemography and biochemistry. Fourteen patients (six boys, eight girls; median age, 7 years) underwent pericardiocentesis for cardiac tamponade. At presentation, 78% had dyspnea, 56% chest pain, and 49% fever. All had cardiomegaly, and their cardiothoracic index was 0.56-0.72. Also, all patients had sinus tachycardia; 78%, low QRS voltage; 70%, ST-T changes; and 50% QRS alternans. On echocardiography the widest diameter of pericardial effusion was between 12 mm and 36 mm depth around the heart. The pericardial fluid was purulent in one, serohemorrhagic in seven, serofibrinous in two, and serous in four cases. Pericardiocentesis was unsuccessful in two patients, who underwent open surgical drainage, with no complications. Based on pericardial fluid characteristics and additional tests, cardiac tamponade was caused by an infection in five patients, hypothyroidism in two, familial Mediterranean fever in two, malignancy in one, acute rheumatic fever in one, collagen tissue disease (systemic lupus erythematosus) in one, catheter placement-associated damage in one, and idiopathic pulmonary arterial hypertension in one patient. Pericardial effusion and cardiac tamponade in children have varied causes, and early treatment is life saving. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  3. Efficacy of injections of phosphatidylcholine into fat deposits-a non-surgical alternative to liposuction in body-contouring

    Directory of Open Access Journals (Sweden)

    Karl-G Heinrich

    2005-01-01

    Full Text Available Injecting phosphatidylcholine has been used in South America as a non-surgical treatment in body contouring. The objective of this study was to demonstrate the efficacy of injecting phosphatidylcholine in the reduction of localised fat deposits. 86 patients were included in the study. Patients received 1-3 treatments in localised fat deposits in various areas of the body using phosphatidylcholine. After treatment with phosphatidylcholine (250 mg / 5 ml, fat deposits show an average circumferential reduction per application of 2.70 cm. No patient showed irregularities, dimples or any serious side effect after treatment. Results remained stable during the time of follow up. All patients showed remarkable reductions of the fat deposits treated with phosphatidylcholine. Using the correct technique, injecting phosphatidylcholine may be a safe and efficacious alternative to liposuction in patients objecting to surgery.

  4. Embryo retrieval after hormonal treatment to control ovarian function and non-surgical artificial insemination in African lions (Panthera leo).

    Science.gov (United States)

    Goeritz, F; Painer, J; Jewgenow, K; Hermes, R; Rasmussen, K; Dehnhard, M; Hildebrandt, T B

    2012-12-01

    Assisted reproduction technologies are essential for propagating endangered wild felids. Artificial insemination (AI) has been reported in several wild feline species, but pregnancy rates are low, partially owing to failures of current hormonal stimulation protocols. Therefore, this study describes the application of reliable methods to monitor ovarian activity and the development of an effective hormonal protocol to induce oestrus and ovulation in African lions. Application of porcine FSH and porcine LH was shown to be effective for inducing follicular growth and ovulation, and this regimen appeared to be superior to protocols described earlier in terms of ovulation and fertilization rates. Furthermore, non-surgical AI was performed successfully in lions, and uterine-stage embryos were collected and cryopreserved. African lions may serve as a valuable model to develop assisted reproduction for propagation of relic zoo populations in the critically endangered Asian lion or Barbary lion. © 2012 Blackwell Verlag GmbH.

  5. Non-surgical prevention and management of scoliosis for children with Duchenne muscular dystrophy: what is the evidence?

    Science.gov (United States)

    Harvey, Adrienne; Baker, Louise; Williams, Katrina

    2014-10-01

    A review was performed to examine the evidence for non-surgical interventions for preventing scoliosis and the need for scoliosis surgery in children with Duchenne muscular dystrophy. Medline and Embase databases and reference lists from key articles were searched. After the inclusion and exclusion criteria were applied, 13 studies were critically appraised independently by two reviewers. The included studies examined spinal orthoses and steroid therapy. There were no studies with high levels of evidence (randomised or other controlled trials). The studies with the highest level of evidence were non-randomised experimental trials. There is some evidence that children with Duchenne muscular dystrophy who receive steroid therapy might have delayed onset of scoliosis, but more evidence is required about the long-term risks versus benefits of this intervention. There is weak evidence that spinal orthoses do not prevent and only minimally delay the onset of scoliosis.

  6. 慢性盆腔痛的非手术治疗%Non-surgical management of chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    武昕; 钟艳芬

    2013-01-01

    The etiology of chronic pelvic pain (CPP) is complicated. The aim of treatment is improved function and alleviated pain. We summarized the methods of non-surgical treatments for CPP. First, Chinese and Western medical therapies, Second, ladder analgesics. Third, ultrasound and interventional as well as Physiotherapy. Fourth, psychotherapy including medicine and psychological persuasion.%慢性盆腔痛的病因复杂,治疗的目标在于改善功能,并尽可能缓解疼痛.文章就非手术治疗的中西药物治疗,阶梯性镇痛,超声、介入、理疗等物理治疗,药物及心理疏导的心理治疗进行归纳与概括.

  7. Reduced Acute Bowel Toxicity in Patients Treated With Intensity-Modulated Radiotherapy for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Samuelian, Jason M. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Callister, Matthew D., E-mail: Callister.matthew@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Ashman, Jonathan B. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Young-Fadok, Tonia M. [Division of Colorectal Surgery, Mayo Clinic, Scottsdale, AZ (United States); Borad, Mitesh J. [Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ (United States); Gunderson, Leonard L. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)

    2012-04-01

    Purpose: We have previously shown that intensity-modulated radiotherapy (IMRT) can reduce dose to small bowel, bladder, and bone marrow compared with three-field conventional radiotherapy (CRT) technique in the treatment of rectal cancer. The purpose of this study was to review our experience using IMRT to treat rectal cancer and report patient clinical outcomes. Methods and Materials: A retrospective review was conducted of patients with rectal cancer who were treated at Mayo Clinic Arizona with pelvic radiotherapy (RT). Data regarding patient and tumor characteristics, treatment, acute toxicity according to the Common Terminology Criteria for Adverse Events v 3.0, tumor response, and perioperative morbidity were collected. Results: From 2004 to August 2009, 92 consecutive patients were treated. Sixty-one (66%) patients were treated with CRT, and 31 (34%) patients were treated with IMRT. All but 2 patients received concurrent chemotherapy. There was no significant difference in median dose (50.4 Gy, CRT; 50 Gy, IMRT), preoperative vs. postoperative treatment, type of concurrent chemotherapy, or history of previous pelvic RT between the CRT and IMRT patient groups. Patients who received IMRT had significantly less gastrointestinal (GI) toxicity. Sixty-two percent of patients undergoing CRT experienced {>=}Grade 2 acute GI side effects, compared with 32% among IMRT patients (p = 0.006). The reduction in overall GI toxicity was attributable to fewer symptoms from the lower GI tract. Among CRT patients, {>=}Grade 2 diarrhea and enteritis was experienced among 48% and 30% of patients, respectively, compared with 23% (p = 0.02) and 10% (p = 0.015) among IMRT patients. There was no significant difference in hematologic or genitourinary acute toxicity between groups. In addition, pathologic complete response rates and postoperative morbidity between treatment groups did not differ significantly. Conclusions: In the management of rectal cancer, IMRT is associated with a

  8. Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

    Institute of Scientific and Technical Information of China (English)

    Deepak N Amarapurkar; Sundeep J Punamiya; Nikhil D Patel

    2008-01-01

    AIM: To evaluate patterns of obstruction, etiological spectrum and non-surgical treatment in patients with Budd-Chiari syndrome in India.METHODS: Forty-nine consecutive cases of Budd-Chiari syndrome (BCS) were prospectively evaluated.All patients with refractory ascites or deteriorating liver function were, depending on morphology of inferior vena cava (IVC) and/or hepatic vein (HV) obstruction,triaged for radiological intervention, in addition to anticoagulation therapy. Asymptomatic patients, patients with diuretic-responsive ascites and stable liver function,and patients unwilling for surgical intervention were treated symptomatically with anticoagulation.RESULTS: Mean duration of symptoms was 41.5±11.2 (range = 1-240) mo. HV thrombosis (HVT) was present in 29 (59.1%), IVC thrombosis in eight (16.3%),membranous obstruction of IVC in two (4%) and both IVC-HV thrombosis in 10 (20.4%) cases. Of 35 cases tested for hypercoagulability, 27 (77.1%) were positive for one or more hypercoagulable states. Radiological intervention was technically successful in 37/38 (97.3%):IVC stenting in seven (18.9%), IVC balloon angioplasty in two (5.4%), combined IVC-HV stenting in two (5.4%),HV stenting in 11 (29.7%), transjugular intrahepatic portosystemic shunt (TIPS) in 13 (35.1%) and combined TIPS-IVC stenting in two (5.4%). Complications encountered in follow-up: death in five, re-stenosis of the stent in five (17.1%), hepatic encephalopathy in two and hepatocellular carcinoma in one patient. Of nine patients treated medically, two showed complete resolution of HVT.CONCLUSION: In our series, HVT was the predominant cause of BCS. In the last five years with the availability of sophisticated tests for hypercoagulability, etiologies were defined in 85.7% of cases. Non-surgical management was successful in most cases.

  9. The Recipients' Parity Does Not Influence Their Reproductive Performance Following Non-Surgical Deep Uterine Porcine Embryo Transfer.

    Science.gov (United States)

    Martinez, E A; Nohalez, A; Martinez, C A; Parrilla, I; Vila, J; Colina, I; Diaz, M; Reixach, J; Vazquez, J L; Roca, J; Cuello, C; Gil, M A

    2016-02-01

    With the development of the non-surgical deep uterine (NsDU) embryo transfer (ET) technology, the commercial applicability of ET in pigs is now possible. There are, nevertheless, many factors that influence NsDU-ET effectiveness that need to be addressed. The aim of this study was to evaluate the effects of the weaned recipients' parity on fertility and prolificacy following NsDU-ET. The recipients (n = 120) were selected based on their reproductive history and body condition and grouped into three categories according to their parity: primiparous sows, sows of parity 2 and sows of parities from 3 to 5. Thirty fresh embryos (morulae and unhatched blastocysts) were non-surgically transferred into one uterine horn of each recipient. It was possible to insert the NsDU-ET catheter through the cervix along a uterine horn in 98.3% of the recipients. The parity had no influence on the difficulty grade of the insertions or on the percentage of correct insertions. The cervix and uterine wall were not perforated during the insertions, and vaginal discharge was not observed after transfer in any of the recipients. There were no differences in the pregnancy rates (74.8%), farrowing rates (71.2%) or litter sizes (9.6 ± 3.3) between groups. Also, there were no differences between groups regarding to the piglets' birthweights or piglet production efficiency. In conclusion, these results demonstrate that weaned sows from parity 1 to 5 are appropriate to be used as recipients in NsDU-ET programs, which increase the possibilities for the utilization of ET in the recipient farms.

  10. Effect of Intensive Non-Surgical Treatment on the Level of Serum Inflammatory Markers in Advanced Periodontitis

    Directory of Open Access Journals (Sweden)

    G. Radafshar

    2010-03-01

    Full Text Available Objective: To assess whether non-surgical periodontal treatment is associated with changes in serological markers of systemic inflammation.Materials and Methods: Thirty-five systemically healthy subjects with severe generalized periodontitis meeting the inclusion criteria participated in a four-month single blind interventional trial of which thirty-two completed the study. Periodontal parameters andinflammatory markers [C-reactive protein (CRP and plasma fibrinogen] and also the white blood cell count (WBC were evaluated prior to and four months after delivery of intensive non-surgical periodontal therapy with simultaneous lavage of chlorhexidine0.1% from the tip of the ultrasonic instrument into the pockets.Results: Significant differences in serum CRP levels were observed four months after treatment compared to the baseline (1.85, SD=1.93 vs 2.46, SD=2.32, respectively,P<0.0001. Periodontal treatment also resulted in a significant difference in WBC and neutrophilcounts compared to the baseline (P<0.0001. The reduction in fibrinogen levels was not significant at the end of the research period. Significant improvement in the pocket probing depth and clinical attachment level for pockets with initially 4-6 mm and thenmore than 7 mm depth was observed. Changes in plaque and bleeding scores were also statistically significant (82.75 vs. 35.84 and 19.03 vs. 1.81, respectively.Conclusion: Periodontal treatment is effective in reducing CRP levels and white blood cell count, while fibrinogen levels are not influenced by periodontal therapy. Periodontal treatment may therefore decrease the systemic inflammatory burden in patients with advanced periodontitis.

  11. Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study

    Science.gov (United States)

    Fitchett, Joseph R; Bhatta, Surya; Sherpa, Tenzing Y; Malla, Bishwo S; A Fitchett, Elizabeth J; Samen, Arlene

    2015-01-01

    Objectives Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. Design Prospective monitoring and evaluation study of a new public health programme. Setting Baglung district, rural Nepal. Participants Women with gynaecological symptoms of POP. Main outcome measures Risk factors for disease progression were assessed using Fisher’s exact test, Pearson’s χ2-test and logistic regression analysis. Results Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. Conclusions Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal. PMID:26664731

  12. Non-surgical oncology – Guidelines on Parenteral Nutrition, Chapter 19

    Directory of Open Access Journals (Sweden)

    Zander, A.

    2009-11-01

    Full Text Available Reduced nutritional state is associated with unfavourable outcomes and a lower quality of life in patients with malignancies. Patients with active tumour disease frequently have insufficient food intake. The resting energy expenditure in cancer patients can be increased, decreased, or remain unchanged compared to predicted values. Tumours may result in varying degrees of systemic pro-inflammatory processes with secondary effects on all significant metabolic pathways. Therapeutic objectives are to stabilise nutritional state with oral/enteral nutrition and parenteral nutrition (PN and thus to prevent or reduce progressive weight loss. The maintenance or improvement of quality of life, and the increase in the effectiveness and a reduction in the side-effects of antitumor therapy are further objectives. Indications for PN in tumour patients are essentially identical to those in patients with benign illnesses, with preference given to oral or enteral nutrition when feasible. A combined nutritional concept is preferred if oral or enteral nutrition are possible but not sufficient. There are generally no accepted standards for ideal energy and nutrient intakes in oncological patients, particularly when exclusive artificial nutrition is administered. The use of PN as a general accompaniment to radiotherapy or chemotherapy is not indicated, but PN is indicated in chronic severe radiogenic enteritis or after allogenic transplantation with pronounced mucositis or GvH-related gastrointestinal damage for prolonged periods, with particular attention to increased risk of bleeding and infection. No PN is necessary in the terminal phase.

  13. Cancer Events After Acute or Chronic Exposure to Sulfur Mustard: A Review of the Literature

    Science.gov (United States)

    Razavi, Seyed Mansour; Abdollahi, Mohammad; Salamati, Payman

    2016-01-01

    Background: Sulfur mustard (SM) has been considered as a carcinogen in the laboratory studies. However, its carcinogenic effects on human beings were not well discussed. The main purpose of our study is to assess carcinogenesis of SM following acute and/or chronic exposures in human beings. Methods: The valid scientific English and Persian databases including PubMed, Web of Science, Scopus, IranMedex, and Irandoc were searched and the collected papers reviewed. The used keywords were in two languages: English and Persian. The inclusion criteria were the published original articles indexed in above-mentioned databases. Eleven full-texts out of 296 articles were found relevant and then assessed. Results: Studies on the workers of the SM factories during the World Wars showed that the long-term chronic exposure to mustards can cause a variety of cancers in the organs such as oral cavity, larynx, lung, and skin. Respiratory system was the most important affected system. Acute single exposure to SM was assumed as the carcinogenic inducer in the lung and blood and for few cancers including basal cell carcinoma and squamous cell carcinoma. Conclusions: SM is a proven carcinogen in chronic situations although data are not enough to strongly conclude in acute exposure. PMID:27280012

  14. Rates of clinically apparent heparin-induced thrombocytopenia for unfractionated heparin vs. low molecular weight heparin in non-surgical patients are low and similar

    Directory of Open Access Journals (Sweden)

    Gerber Jonathan

    2005-04-01

    Full Text Available Abstract With the growing use of low-molecular-weight heparins (LMWH for the treatment and prevention of venous thromboembolism (VTE, it is important to provide an evidence-based comparison with unfractionated heparin (UFH concerning rates of heparin-induced thrombocytopenia (HIT. Such comparisons are essential in clinical decision-making and cost-modeling. In this paper we review data regarding non-surgical (medical patients. We conclude that the lack of uniform evaluation and standardized testing for HIT in the current literature precludes making a reliable estimate of the relative risk of HIT in UFH vs. LMWH in either the treatment or prevention of VTE in non-surgical patients. However, current data suggest that the risk of thrombocytopenia and HIT is low and similar for non-surgical patients who receive either LMWH or UFH.

  15. Acute and chronic cadmium exposure promotes E-cadherin degradation in MCF7 breast cancer cells.

    Science.gov (United States)

    Ponce, Esmeralda; Louie, Maggie C; Sevigny, Mary B

    2015-10-01

    Cadmium is an environmental carcinogen that usually enters the body at minute concentrations through diet or cigarette smoke and bioaccumulates in soft tissues. In past studies, cadmium has been shown to contribute to the development of more aggressive cancer phenotypes including increased cell migration and invasion. This study aims to determine if cadmium exposure-both acute and chronic-contributes to breast cancer progression by interfering with the normal functional relationship between E-cadherin and β-catenin. An MCF7 breast cancer cell line (MCF7-Cd) chronically exposed to 10(-7)  M CdCl2 was previously developed and used as a model system to study chronic exposures, whereas parental MCF7 cells exposed to 10(-6)  M CdCl2 for short periods of time were used to study acute exposures. Cadmium exposure of MCF7 cells led to the degradation of the E-cadherin protein via the ubiquitination pathway. This resulted in fewer E-cadherin/β-catenin complexes and the relocation of active β-catenin to the nucleus, where it interacted with transcription factor TCF-4 to modulate gene expression. Interestingly, only cells chronically exposed to cadmium showed a significant decrease in the localization of β-catenin to the plasma membrane and an increased distance between cells. Our data suggest that cadmium exposure promotes breast cancer progression by (1) down-regulating E-cadherin, thus decreasing the number of E-cadherin/β-catenin adhesion complexes, and (2) enhancing the nuclear translocation of β-catenin to increase expression of cancer-promoting proteins (i.e., c-Jun and cyclin D1).

  16. MYST3/CREBBP Rearranged Acute Myeloid Leukemia after Adjuvant Chemotherapy for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Arjun Gupta

    2014-01-01

    Full Text Available Although rare, clinicians and patients must be aware that therapy related malignancies, specifically acute myeloid leukemia (AML, can occur as a complication of adjuvant chemotherapy for breast cancer. Vigilance for signs and symptoms is appropriate. AML with t (8;16 is a specific translocation leading to formation of a fusion protein (MYST3/CREBBP. The MYST3/CREBBP AML tends to develop within 2 years of adjuvant chemotherapy, especially for breast cancer, without preceding myelodysplasia. It usually presents with disseminated intravascular coagulation and osteolytic lesions and has a poor prognosis despite aggressive resuscitation and therapy. With the increasing use of adjuvant chemotherapy for breast cancer, we are seeing a definite increase in the incidence of therapy related myelodysplastic syndromes and AML. One must keep this complication in mind while counseling and following up breast cancer patients who have received adjuvant chemotherapy. New osteolytic bone lesions in a patient with history of breast cancer do not necessarily mean metastatic disease and should be fully evaluated.

  17. Cyclophosphamide-Induced Severe Acute Hyponatremic Encephalopathy in Patients with Breast Cancer: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Michelle Baker

    2014-07-01

    Full Text Available Background: Cyclophosphamide is an alkylating agent widely used in antineoplastic and immunosuppressive therapies. Symptomatic hyponatremia can be a rare but life-threatening complication in patients treated with cyclophosphamide. Case Presentations: We report 2 patients who presented with severe acute hyponatremic encephalopathy after receiving their first cycles of a low-dose cyclophosphamide-containing regimen for breast cancer. In case 1, a 58-year-old female received the combination of docetaxel and cyclophosphamide, and in case 2, a 56-year-old female received the combination of doxorubicin and cyclophosphamide. Both patients recovered after correction of their serum sodium concentration without neurological deficits. Future cycles of chemotherapy were well tolerated without recurrence of hyponatremia after cyclophosphamide was discontinued from the respective regimens. Conclusion: Clinicians must always keep in mind that acute hyponatremic encephalopathy can be induced by low-dose cyclophosphamide.

  18. Myelodysplastic Syndromes and Acute Myeloid Leukemia After Radiotherapy for Prostate Cancer: A Population-Based Study.

    Science.gov (United States)

    Wang, Rong; Zeidan, Amer M; Yu, James B; Soulos, Pamela R; Davidoff, Amy J; Gore, Steven D; Huntington, Scott F; Gross, Cary P; Ma, Xiaomei

    2017-04-01

    To understand the impact of radiotherapy on the development of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) among elderly prostate cancer patients. We performed a retrospective cohort study of elderly prostate cancer patients diagnosed during 1999-2011 by using the National Cancer Institute's Surveillance, Epidemiology and End Results-Medicare linked database. Competing risk analyses adjusting for patient characteristics were conducted to assess the impact of radiotherapy on the development of subsequent MDS/AML, compared with surgery. Of 32,112 prostate cancer patients, 14,672 underwent radiotherapy, and 17,440 received surgery only. The median follow-up was 4.68 years. A total of 157 (0.47%) prostate cancer patients developed subsequent MDS or AML, and the median time to develop MDS/AML was 3.30 (range: 0.16-9.48) years. Compared with prostate cancer patients who received surgery only, patients who underwent radiotherapy had a significantly increased risk of developing MDS/AML (hazard ratio [HR] =1.51, 95% confidence interval [CI]: 1.07-2.13). When radiotherapy was further categorized by modalities (brachytherapy, conventional conformal radiotherapy, and intensity-modulated radiotherapy [IMRT]), increased risk of second MDS/AML was only observed in the IMRT group (HR = 1.66, 95% CI: 1.09-2.54). Our findings suggest that radiotherapy for prostate cancer increases the risk of MDS/AML, and the impact may differ by modality. Additional studies with longer follow-up are needed to further clarify the role of radiotherapy in the development of subsequent myeloid malignancies. A better understanding may help patients, physicians, and other stakeholders make more informed treatment decisions. Prostate 77:437-445, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults

    Directory of Open Access Journals (Sweden)

    Maffulli Nicola

    2009-11-01

    Full Text Available Abstract Background Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory. In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision. Methods/Design We aim to undertake a pragmatic UK-based multi-centre randomised controlled trial evaluating the effectiveness and cost-effectiveness of surgical versus standard non-surgical treatment for adults with an acute closed displaced fracture of the proximal humerus with involvement of the surgical neck. The choice of surgical intervention is left to the surgeon, who must use techniques that they are fully experienced with. This will avoid 'learning curve' problems. We will promote good standards of non-surgical care, similarly insisting on care-provider competence, and emphasize the need for comparable provision of rehabilitation for both groups of patients. We aim to recruit 250 patients from a minimum of 18 NHS trauma centres throughout the UK. These patients will be followed-up for 2 years. The primary outcome is the Oxford Shoulder Score, which will be collected via questionnaires completed by the trial participants at 6, 12 and 24 months. This is a 12-item condition-specific questionnaire providing a total score based on the person's subjective assessment of pain and activities of daily living impairment. We will also collect data for other outcomes, including general health measures and complications, and for an economic evaluation. Additionally, we plan a systematic collection of reasons for non-inclusion of eligible patients who were not recruited into the trial, and their baseline

  20. The Impact of Obesity on Gallstone Disease, Acute Pancreatitis, and Pancreatic Cancer.

    Science.gov (United States)

    Cruz-Monserrate, Zobeida; Conwell, Darwin L; Krishna, Somashekar G

    2016-12-01

    Obesity is a well-recognized risk factor for gallstone formation and increases the risk for gallstone-related complications. Pancreatic diseases are impacted adversely by obesity. Although weight loss surgery increases the risk of gallstone disease, evidence suggests that bariatric surgery mitigates the obesity-associated adverse prognostication in acute pancreatitis. Obesity is also a significant risk factor for pancreatic cancer. Obesity is a global epidemic and is increasing worldwide and among all age groups. There is an urgent need for focused health policies aimed at reducing the incidence and prevalence of obesity. This article summarizes the current literature highlighting the association between obesity and the pathophysiology and outcome of gallstone disease, pancreatitis, and pancreatic cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. EFFICACY OF THE ANTERIOR RESECTION IN MANAGMENT OF ACUTE COLONIC OBSTRUCTION IN PATIENTS WITH RECTAL CANCER.

    Science.gov (United States)

    Minasyan, A; Sargsyan, R

    2016-10-01

    The aim of this study is to improve the results of surgical treatment of acute bowel obstruction caused by rectal cancer and to reduce the period of full recovery of patients. The presented research included 73 patients (study group) with rectal cancer who underwent emergent anterior resection of rectum with loop ileostomy and intra-operative decompression of colon. Patients of this group were compared to a group of 68 patients (control group) with the same diagnosis who underwent Hartmann's procedure. There was no essential difference between the two groups in the quantity of postoperative complications. However the results indicate significant difference in reversal rates and time to reversal. Thus, the technique of low anterior resection with intraoperative decompression and ileostomy that we used improves outcomes, significantly reduces the period of full recovery.

  2. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jia-Bao Guo

    Full Text Available Surgical and non-surgical interventions are the two categories for treatment of vertebral compression fractures (VCFs. However, there is clinical uncertainty over optimal management. This study aimed to examine the safety and effectiveness of surgical management for treatment of VCFs with osteopenia compared with non-surgical treatment.We conducted a systematic search through electronic databases from inception to June 2014, with no limits on study data or language. Randomized controlled trials (RCTs evaluating surgical versus non-surgical interventions for treatment of patients with VCFs due to osteopenia were considered. Primary outcomes were pain and adverse effects. A random-effects model was used to calculate the pooled mean difference (MD or risk ratios with 95% confidence interval (CI.Sixteen reports (11 studies met the inclusion criteria, and provided data for the meta-analysis with a total of 1,401 participants. Compared with conservative treatment, surgical treatment was more effective in reducing pain (short-term: MD -2.05, 95% CI -3.55 to -0.56, P=0.007; mid-term: MD -1.70, 95% CI -2.78 to -0.62, P=0.002; long-term: MD -1.24, 95% CI -2.20 to -0.29, P=0.01 and disability on the Roland-Morris Disability score (short-term: MD -4.97, 95% CI -8.71 to -1.23, P=0.009, as well as improving quality of life on the Short-Form 36 Physical Component Summary score (short-term: MD 5.53, 95% CI 1.45 to 9.61, P=0.008 and the Quality of Life Questionnaire of the European Foundation for Osteoporosis score (short-term: MD -5.01, 95% CI -8.11 to -1.91, P=0.002. Indirect comparisons between vertebroplasty and kyphoplasty found no evidence that the treatment effect differed across the two interventions for any outcomes assessed. Compared with the sham procedure, surgical treatment showed no evidence of improvement in pain relief and physical function. Based on these two comparisons, no significant difference between groups was noted in the pooled results

  3. Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial.

    Science.gov (United States)

    Blasimann, Angela; Eichelberger, Patric; Brülhart, Yvonne; El-Masri, Isam; Flückiger, Gerhard; Frauchiger, Lars; Huber, Martin; Weber, Martin; Krause, Fabian G; Baur, Heiner

    2015-01-01

    Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis posterior muscle and its tendon can lead to a flattening of the longitudinal arch of the foot. Those affected can experience functional impairment and pain. Less severe cases at an early stage are eligible for non-surgical treatment and foot orthoses are considered to be the first line approach. Furthermore, strengthening of arch and ankle stabilising muscles are thought to contribute to active compensation of the deformity leading to stress relief of soft tissue structures. There is only limited evidence concerning the numerous therapy approaches, and so far, no data are available showing functional benefits that accompany these interventions. After clinical diagnosis and clarification of inclusion criteria (e.g., age 40-70, current complaint of foot and ankle pain more than three months, posterior tibial tendon dysfunction stage I & II, longitudinal arch flattening verified by radiography), sixty participants with posterior tibial tendon dysfunction associated complaints will be included in the study and will be randomly assigned to one of three different intervention groups: (i) foot orthoses only (FOO), (ii) foot orthoses and eccentric exercise (FOE), or (iii) sham foot orthoses only (FOS). Participants in the FOO and FOE groups will be allocated individualised foot orthoses, the latter combined with eccentric exercise for ankle stabilisation and strengthening of the tibialis posterior muscle. Participants in the FOS group will be allocated sham foot orthoses only. During the intervention period of 12 weeks, all participants will be encouraged to follow an educational program for dosed foot load management (e.g., to stop activity if they experience increasing pain). Functional

  4. Training or non-surgical factors-what determines a good surgical performance? A randomised controlled trial.

    Science.gov (United States)

    Lindlohr, Cornelia; Lefering, R; Saad, S; Heiss, M M; Pape-Köhler, C

    2017-06-01

    Acquiring laparoscopic skills is a necessity for every young surgeon. Whether it is a talent or a non-surgical skill that determines the surgical performance of an endoscopic operation has been discussed for years. In other disciplines aptitude testing has become the norm. Airlines, for example, have implemented assessments to test the natural aptitude of future pilots to predict their performance later on. In the medical field, especially surgery, there are no similar comparable tests implemented or even available. This study investigates the influence of potential factors that may predict the successful performance of a complex laparoscopic operation, such as the surgeon's age, gender or learning method. This study focussed 70 surgical trainees. It was designed as a secondary analysis of data derived from a 2 × 2 factorial randomised controlled trial of practical training and/or multimedia training (four groups) in an experimental exercise. Both before and then after the training sessions, the participating trainees performed a laparoscopic cholecystectomy in a pelvitrainer. Surgical performance was then evaluated using a modified objective structured assessment of technical skills (OSATS). Participants were classified as 'Skilled' (high score in the pre-test), 'Good Learner' (increase from pre- to post-test) or 'Others' based on the OSATS results. Based on the results of the recorded performance, the training methods as well as non-surgical skills were eventually evaluated in a univariate and in a multivariate analysis. In the pre-training performance 11 candidates were categorised as 'Skilled' (15.7%), 35 participants as 'Good Learners' (50.0%) and 24 participants were classified as 'Others'. The univariate analysis showed that the age, a residency in visceral surgery, and participation in a multimedia training were significantly associated with this grouping. Multivariate analyses revealed that residency in visceral surgery was the most predictive factor

  5. Non-surgical periodontal treatment of peri-implant diseases with the adjunctive use of diode laser: preliminary clinical study.

    Science.gov (United States)

    Lerario, Francesco; Roncati, Marisa; Gariffo, Annalisa; Attorresi, Enrica; Lucchese, Alessandra; Galanakis, Alexandros; Palaia, Gaspare; Romeo, Umberto

    2016-01-01

    Peri-implant diseases present in two forms: peri-implant mucositis and peri-implantitis. The prevalence of peri-implant complications is significantly rising. The aim of this study was to compare conventional treatment of inflamed peri-implant tissues with conventional treatment together with diode laser application. Twenty-seven patients (age 36 to 67, 15 women and 12 men, 12 smokers and 15 non-smokers) requiring treatment for mucositis or peri-implantitis were taken into account for this preliminary study. Plaque index (PI), pocket depth (PD), and bleeding on probing (BoP) were recorded at baseline evaluation. Patients in control group (CG) received conventional non-surgical periodontal treatment. Patients in test group received conventional non-surgical periodontal treatment together with diode laser application (810 nm, 30 s, 1 W, 50 Hz, t on = 100 ms, t off = 100 ms, energy density = 24.87 J/cm(2)). Paired t test was used to evaluate the difference in repeated measurements of considered indexes at T 0 and T 1 (1 year) in both groups. A total of 606 sites were taken into account in the test group (TG) and 144 in the CG. PD mean variation in the TG was 2.66 mm ± 1.07, while mean PD variation in the CG was 0.94 ± 1.13 mm. Paired t testing of the variation in PD in CG and TG revealed a statistically significant difference between the two groups (p < 0.0001). A reduction of pathological sites from 89 % (T 0) to 14.35 % (T 1) was achieved in the TG, while reduction obtained in the CG was from 75.69 % (T 0) to 50 % (T 1); BoP scores at time T 1 had fallen below 5 % in the TG and decreased to 59.7 %, in the CG. Within the limitations of this study, diode laser seems to be an additional valuable tool for peri-implant disease treatment.

  6. Effect Of Non- Surgical Periodontal Treatment On Glycemic Control Among Type 2 Diabetes Mellitus Patients With Periodontitis.

    Science.gov (United States)

    Salman, Sadia; Khan, Khurshid; Salman, Fariha; Hameed, Maliha

    2016-01-01

    Periodontitis and Diabetes Mellitus are two closely, bidirectional linked disease where periodontitis is a well-known complication of diabetes it is also considered to be a cause for poor glycaemic control. The present study objective was to evaluate the glycaemic control in patients suffering from both Diabetes Mellitus and Periodontitis after non-surgical periodontal treatment. A comparative cross-sectional study was conducted with two groups of patients attending Diabetic Clinic, Jinnah Hospital, Lahore, during six months from September 2013 to February 2014. Forty-six diabetes mellitus subjects who were undergoing non-surgical treatment of periodontal disease that includes mechanical removal of supra- and sub gingival bacterial plaque with scalers, antibiotics and or root canal if required while 46 subjects with diabetic mellitus having periodontal disease did not had treatment for periodontal disease. HbA1c was compared at base line and at three months. Data was compiled and analysed through SPSS version 16. Quantitative variables like HbA1c was presented as mean±SD. Qualitative variables like gender, education status, economic status, treatment for diabetes mellitus and periodontal disease were described by using frequency percentages. The t-test was applied to assess statistical significance in mean difference HbA1c between two groups. p-value periodontitis 43 (93.5%) received scaling only while 3 (6.5%) received scaling plus antibiotics. Fall in the level of HbA1c was observed among subjects with treatment of periodontal disease indicating a good control of diabetes while in group without treatment there was either no change or increase in HbA1c. Mean HbA1c at baseline in group with treatment of periodontitis at baseline was 7.672±.6414 and without treatment was 6.957±.3494. (t= -1.008, pperiodontitis was 6.867±.6168, and in group without treatment was 6.983±.3678. (t=6.641, pperiodontal treatment is associated with improved glycaemic control (reduced

  7. Acute Respiratory Distress Syndrome after Treatment of Metastatic Prostate Cancer with Taxotere: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ali Raufi

    2015-01-01

    Full Text Available Prostate cancer is the most common cancer in men. Docetaxel is a common chemotherapeutic agent that has proven its efficacy in the treatment of patients with both castration sensitive and resistant metastatic prostate cancer. We report a case of acute respiratory distress syndrome (ARDS in a patient with metastatic prostate cancer treated with docetaxel (Taxotere. ARDS is very rare but life threatening complication of docetaxel which requires aggressive supportive care and close monitoring. Better awareness and prompt diagnosis of this treatment related ARDS will improve the effectiveness and outcome of its management.

  8. Role of markers for acute kidney injury in surgical management of patients with renal cancer

    Directory of Open Access Journals (Sweden)

    O. I. Kit

    2015-01-01

    Full Text Available The paper gives the results of studying the urinary levels of markers of acute kidney injury (AKI in 46 patients with renal cancer during separate ureteral catheterization before the surgery and 24 hours after laparoscopic partial nephrectomy performed due to elective indications under warm ischemia. The levels of cystatin C, neutrophil gelatinase-associated lipocalin (NGAL, liver-type fatty acid-binding protein (L-FABP, and interleukin-18 were examined by enzyme immunoassay. It has been established that the risk of early postoperative AKI may be predicted from the baseline urinary levels of cystatin C and LFABP in patients with renal cancer resulting from 15-20-min warm ischemia time during the partial nephrectomy. An approach based on estimation of the baseline urinary levels of cystatin C and L-FABP to be incorporated into a preoperative examination scheme is proposed for surgical treatment policy choosing in patients with renal cancer. A scheme for examining patients with renal cancer is also suggested for the risk of complications and the degree of AKI assessing in the early post-operative period.

  9. Non-surgical interventions after mild traumatic brain injury: A systematic review. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Nygren-de Boussard, Catharina; Holm, Lena W; Cancelliere, Carol

    2014-01-01

    Objective: To synthesize the best available evidence regarding the impact of non-surgical interventions on persistent symptoms after mild traumatic brain injury (MTBI). Data sources: MEDLINE and other databases were searched (2001–2012) with terms including ‘rehabilitation’. Inclusion criteria we...

  10. The health-related quality of life of obese persons seeking or not seeking surgical or non-surgical treatment: a meta-analysis

    NARCIS (Netherlands)

    Nunen, Annemieke van; Wouters, Eveline; Vingerhoets, Ad; Hox, Joop; Geenen, Rinie

    2007-01-01

    Background: A meta-analysis examined differences in health-related quality of life (HRQoL) between seekers of surgical and non-surgical treatment, and non-treatment seekers, over and above differences that are explained by weight, age, and gender. Methods: Our literature search focused on the 'Impa

  11. Impact of Oral Health Education and a Non-Surgical Periodontal Therapy on the Quality of Life of Patients with Diabetes Mellitus*

    Directory of Open Access Journals (Sweden)

    Oanta Cornelia

    2015-11-01

    Full Text Available Aim: The aim of the study was to evaluate the impact of oral health education and non-surgical periodontal therapy on the quality of life for a group of patients with type I diabetes mellitus, in Iasi, Romania.

  12. Effect of non-surgical periodontal treatment on visfatin concentrations in serum and gingival crevicular fluid of patients with chronic periodontitis and type 2 diabetes mellitus.

    Science.gov (United States)

    Wu, Yun; Chen, Ling; Wei, Bin; Luo, Kai; Yan, Fuhua

    2015-06-01

    This study aims to assess visfatin concentrations in serum and gingival crevicular fluid (GCF) and investigate this relationship in patients with type 2 diabetes mellitus (T2DM) and chronic periodontitis (CP) before and after non-surgical periodontal treatment. Fifty-four patients with T2DM and CP were recruited. The patients were randomly divided into two groups: treatment and control. Serum and GCF visfatin concentrations and glycated hemoglobin (HbA1c) levels were measured by enzyme-linked immunosorbent assay at different time points (at baseline and 3 and 6 months after non-surgical periodontal treatment). Serum and GCF visfatin concentrations showed no significant differences between the groups at baseline (t test, P >0.05). A significant decline of visfatin in the treatment group was found in serum and GCF 3 months after non-surgical periodontal treatment (t test, P 0.05). The data suggest that non-surgical periodontal treatment is helpful for glucose control, an effect that may be associated with reduced visfatin in patients with T2DM and periodontitis. Furthermore, the data suggest that visfatin may be considered an inflammatory marker for periodontal diseases.

  13. Effect of Topical Tetracycline Gel with Non Surgical Periodontal Therapy on Hba1c and Lipid Profile in Type 2 Diabetic Patients: A Clinico- Biochemical Study

    Directory of Open Access Journals (Sweden)

    A Haerian-Ardakani

    2014-11-01

    Full Text Available Introduction: The present study aimed to evaluate the Effect of topical tetracycline gel application with non surgical periodontal therapy on HbA1c and lipid profile in type 2 diabetic patients. Methods: A total of 30 type 2 diabetic patients were randomly divided into two groups. The first group received scaling and root planning, whereas the second group received scaling and root planning with topically applied tetracycline gel. Clinical factors such as GI, PI, PPD and biochemical factors such as HbA1c and lipid profile were assessed in beginning of study and 3 months later. Results: Comparing the clinical factors between the two groups revealed that periodontal pocket depth significantly reduced in tetracycline-received group. Regarding the biochemical factors, triglyceride levels decreased significantly in tetracycline-received group. No significant difference was observed between the two groups in regard with other clinical and biochemical factors. Conclusion: The study findings demonstrated that clinical and biochemical parameters have been improved after non surgical periodontal treatment in both groups. Although it seems that application of topical tetracycline gel combined with non-surgical periodontal therapy is effective in improvement of some clinical and biochemical factors like PPD and TG, it doesn’t offer any superiority in regard with other factors compared to mere non surgical periodontal therapy.

  14. Interpretation of chest radiographs in both cancer and other critical care patients with acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Sema Yilmaz

    2013-04-01

    Full Text Available Acute respiratory distress syndrome is a clinical, pathophysiological and radiographic pattern that has signs of pulmonary edema occur without elevated pulmonary venous pressures. Clinical presentation and progression of acute respiratory distress syndrome are followed by frequently ordered portable chest X-ray in critically ill patients. We evaluated chest radiographs of ten cancer and other six critical care pediatric patients. The parenchymal imaging of lung in patients with cancer was reported the same as that of other critically ill children despite underlying pathophysiological variations in our investigation. [Cukurova Med J 2013; 38(2.000: 270-273

  15. Acute inferior ST segment elevation myocardial infarction due to chemotherapy in a young man with testicular cancer

    Directory of Open Access Journals (Sweden)

    Veysel Tosun

    2016-12-01

    Full Text Available Testicular cancer is the most common malignancy in men between 15 and 29 years of age. cisplatin, etoposide and bleomycin combination chemotherapy remains the mainstay of testicular cancer treatment. Acute myocardial infarction is a rare complication of these chemotherapeutics. In this case report, we present a case of 36-year-old male with acute inferior ST-segment elevation myocardial infarction after bleomycin injection. Because the patient had no significant risk factors for coronary artery disease, the infarction was likely caused by the chemotherapy regimen.

  16. Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer.

    Science.gov (United States)

    Oluwasanjo, Adetokunbo; Pathak, Ranjan; Ukaigwe, Anene; Alese, Olatunji

    2016-01-01

    Therapy-related acute myeloid leukemia (t-AML) associated with radioiodine treatment (RAI) is emerging as an important clinical entity with the rise in incidence of thyroid cancer. We conducted an electronic search of MEDLINE and EMBASE, and also searched reference lists of articles and abstracts from conference proceedings for case reports and review articles on t-AML following radioiodine therapy. A total of 37 patients with acute myeloid neoplasms following radioiodine treatment were analyzed. The median RAI dose was 324 mCi, and median age was 47.5 years with M/F ratio of 1:3. Latency period was 1-4 years, and the median time from RAI exposure to diagnosis of t-AML was 2.9 years. FAB M2 and M3 were the two most common t-AML subtypes reported. Seventy-one percent of the cases that reported cytogenetic abnormalities were classified as unfavorable. The most commonly reported abnormalities were del 5q and t(15:17). Survival outcomes were not reported due to lack of patient-level data. T-AML following radioiodine therapy for thyroid cancer appears to have a shorter latency period than other types of t-AML, which is an important consideration for post-therapy surveillance. Reporting of cases and outcomes will help provide data for further research. Identifying biomarkers that help risk-stratify patients prior to therapy and specific genetic-guided therapies may help improve outcomes.

  17. Gallbladder Metastasis of Non-small Cell Lung Cancer Presenting as Acute Cholecystitis

    Institute of Scientific and Technical Information of China (English)

    Yu-Sook Jeong; Seung-Taik Kim; Hye-Suk Han; Sung-Nam Lim; Mi-Jin Kim; Joung-Ho Han; Min-Ho Kang; Dong-Hee Ryu; Ok-Jun Lee; Ki-Hyeong Lee

    2012-01-01

    Although non-small cell lung cancer (NSCLC) can metastasize to almost any organ,metastasis to the gallbladder with significant clinical manifestation is relatively rare.Here,we report a case of gallbladder metastasis of NSCLC presenting as acute cholecystitis.A 79-year-old man presented with pain in the right upper quadrant and fever.A computed tomography (CT) scan of the chest and abdomen showed a cavitary mass in the right lower lobe of the lung and irregular wall thickening of the gallbladder.Open cholecystectomy and needle biopsy of the lung mass were performed.Histological examination of the gallbladder revealed a moderately-differentiated squamous cell carcinoma displaying the same morphology as the lung mass assessed by needle biopsy.Subsequent immunohistochemical examination of the gallbladder and lung tissue showed that the tumor cells were positive for P63 but negative for cytokeratin 7,cytokeratin 20 and thyroid transcription factor-1.A second primary tumor of the gallbladder was excluded by immunohistochemical methods,and the final pathological diagnosis was gallbladder metastasis of NSCLC.Although the incidence is extremely rare,acute cholecystitis can occur in association with lung cancer metastasis to the gallbladder.

  18. THE EFFECTS OF POOR GLYCEMIC CONTROL AND OF NON-SURGICAL PERIODONTAL THERAPY IN PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Cornelia OANȚĂ

    2015-09-01

    Full Text Available Aim: The aim of the study was to evaluate the relationship between the diabetic status and severity of the periodontal involvement, and also of the non-surgical periodontal therapy on the periodontal status of patients with diabetes mellitus. Materials and method: The study was conducted on 21 patients with type 1 diabetes mellitus (study group and 10 systemically healthy subjects (control group. We examined: the degree of glycemic control (by measuring the glycated hemoglobin, the periodontal and oral hygiene parameters at the baseline and 4 weeks, 6 months and 12 months after the periodontal treatment (scaling and root planning. Results and discussion: Subjects with a poor glycemic control presented a higher percentage of sites with attachment loss, significantly higher amounts of bacterial plaque, sub-gingival calculus and gingival bleeding - when compared with the control group or with subjects with good or moderated glycemic control. In the same group, a rapid recurrence of the deep periodontal pockets was observed after 12 months. Conclusions: A prolonged poor control of glycemia and the time elapsed from the debut of diabetes were closely related with its complications. The comparison between the diabetes and the control groups demonstrated that diabetes mellitus is a risk factor for the periodontal disease.

  19. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease.

    Science.gov (United States)

    Artese, Hilana Paula Carillo; de Sousa, Celso Oliveira; Torres, Maria Cynésia Medeiros de Barros; Silva-Boghossian, Carina Maciel; Colombo, Ana Paula Vieira

    2012-01-01

    This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD). Sixteen CKD pre-dialysis individuals (CKD) and 14 individuals without clinical evidence of kidney disease (C) presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05). After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05) were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05) than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  20. Efect of periodontal disease and non surgical periodontal treatment on C-reactive protein. Evaluation of type 1 diabetic patients

    Science.gov (United States)

    Llambés, Fernando; Hernández-Mijares, Antonio; Guiha, Rami; Bautista, Daniel; Caffesse, Raúl

    2012-01-01

    Objectives: The purpose of this study was to analyze how anti-infectious periodontal treatment affects C reactive protein (CRP) values in patients with type 1 diabetes, and correlate baseline CRP levels with periodontal disease severity. Study Design: A cohort of fifty three subjects with type 1 diabetes and moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate high-sensitivity C-reactive protein (hs-CRP). Group 1 was treated with scaling, root planning, and systemic administration of doxycycline. Group 2 received only scaling and root planning. Results: Hs-CRP was reduced after periodontal treatment in group 1 (-0.22 mg/l) and 2 (-0.21 mg/l ) but this reduction was not statistically significant, even in the patients with the best response to periodontal treatment. However, significant correlation appeared between hs-CRP and mean probing pocket depth (PPD) (p=0, 01) and mean clinical attachment level (CAL) (p=0,03). Conclusions: Non-surgical periodontal treatment couldn’t reduce hs-CRP values, however, it was found an association between advanced periodontitis and elevated blood hs-CRP levels in patients with type 1 diabetes. It can be speculated that periodontal disease increases production of pro-inflammatory mediators in patients with type 1 diabetes, but other producing sources of these pro-inflammatory substances may exist. Key words:Periodontal disease, periodontitis, diabetes mellitus type 1, periodontal therapy, C reactive protein. PMID:22322513

  1. Effect of Non Surgical Periodontal Therapy on Gingival Crevicular Fluid and Serum Visfatin Concentration in Periodontal Health and Disease

    Directory of Open Access Journals (Sweden)

    N.M. Raghavendra

    2012-01-01

    Full Text Available Visfatin is a pleiotropic mediator which acts as growth factor, cytokine, enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and has been recently demonstrated to exert several pro-inflammatory functions. The purpose of this study is to evaluate the Visfatin concentration in gingival crevicular fluid (GCF and serum in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the GCF and serum visfatin concentration. 30 subjects (age range: 25 to 52 years were selected and divided into two groups based on the gingival index, probing depth, periodontal attachment level, and radiologic parameters (bone loss: group 1 (15 subjects with healthy periodontium, group 2 (15 subjects with chronic periodontitis, while, Group 2 patients after 8 weeks of the treatment (scaling and root planning, SRP constituted group 3. GCF samples (by microcapillary pipettes and serum samples (by venipuncture were collected to estimate the levels of Visfatin using enzyme linked immunosorbent assay kit. The mean Visfatin concentration in GCF and serum was observed to be the highest in group 2 and lowest in group 1. While concentration in group 3 was similar to group 1. The concentration of Visfatin in GCF and serum decreased after SRP. The Visfatin concentration in GCF and serum found to be highest in chronic periodontitis group and decreases after treatment. Hence Visfatin values can be considered as an “inflammatory marker” can be explored in future as a potential therapeutic target in the treatment of periodontal disease.

  2. Cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer.

    Science.gov (United States)

    Kono, Tomoyuki; Ohtsuki, Toshiho; Hosomi, Naohisa; Takeda, Ikuko; Aoki, Shiro; Sueda, Yoshimasa; Ishihara, Kayoko; Nakamura, Takeshi; Yamawaki, Takemori; Matsumoto, Masayasu

    2012-07-01

    Although several studies have reported various causes of ischemic stroke in patients with cancer, only a few have evaluated the clinical relevance of ischemic stroke pathogenesis to cancer. The aim of the present study was to elucidate the clinical characteristics of cancer-associated ischemic stroke. We evaluated 154 ischemic stroke patients without cancer and 57 ischemic stroke patients with cancer who had either received continuous treatment for cancer within 5 years before to the onset of ischemic stroke, or who had been diagnosed with cancer within 1 year after the onset of ischemic stroke. Cancer patients were grouped into "cancer-associated ischemic stroke," the "conventional ischemic stroke," or "other." A total of 15 patients (26%) were classified into the cancer-associated ischemic stroke in cancer patients. In univariate analysis of the cancer-associated ischemic stroke and the others, there were significant differences in the prevalence of hypertension, hyperlipidemia and advanced cancer (clinical stage IV), and the levels of d-dimer, fibrin degradation product and hemoglobin. With multivariate regression analysis of those factors, the prevalence of hypertension, hyperlipidemia and advanced cancer (clinical stage IV), and the levels of D-dimer and fibrin degradation product remained as statistically independent factors, which were associated with cancer-associated ischemic stroke (n = 111, χ(2) =67.21, P acute ischemic stroke, the cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation products, even after controlling hypertension, hyperlipidemia and advanced cancer (clinical stage IV). © 2012 Japan Geriatrics Society.

  3. Helical tomotherapy in cervical cancer patients. Simultaneous integrated boost concept: technique and acute toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone; Stromberger, Carmen; Kawgan-Kagan, Michael; Wlodarczyk, Waldemar; Jahn, Ulrich; Budach, Volker [Dept. of Radiooncology, Charite - Univ. Medicine, Berlin (Germany); Schneider, Achim; Koehler, Christhardt [Dept. of Gynecology Charite - Univ. Medicine, Berlin (Germany); Ulrich, Uwe [Dept. of Gynecology and Obstetrics, Martin Luther Hospital, Berlin (Germany)

    2010-10-15

    Purpose: To evaluate the acute toxicity of simultaneous integrated boost (SIB) technique for dose escalation with helical tomotherapy (HT) in patients with locally advanced cervical cancer. Patients and Methods: 20 patients (FIGO IB1 pN1-IIIB) underwent primary chemoradiation. Prior to chemoradiation, a laparoscopic pelvic and para-aortic lymphadenectomy was performed. A boost region was defined using titanium clips during staging for planning target volume (PTV-B). Patients were treated with five weekly fractions of 1.8 Gy to a total dose of 50.4 Gy to the tumor region and the pelvic (para-aortic) lymph node region (PTV-A), and five weekly fractions of 2.12 Gy to a total dose of 59.36 Gy to the PTV-B. Chemotherapy consisted of weekly cisplatin 40 mg/m{sup 2}. 19 patients underwent brachytherapy. Dose-volume histograms were evaluated and acute gastrointestinal (GI), genitourinary (GU), and hematologic toxicity were documented (CTCAE v3.0). Results: Pelvic and para-aortic lymph node metastases were confirmed in nine and four patients, respectively. Five patients refused laparoscopic staging. The mean volume of PTV-A and PTV-B was 1,570 {+-} 404 cm{sup 3} and 341 {+-} 125 cm{sup 3}, respectively. The mean dose to the bladder, rectum, and small bowel was 47.85 Gy, 45.76 Gy, and 29.71 Gy, respectively. No grade 4/5 toxicity was observed. Grade 2/3 hematologic toxicity occurred in 50% of patients and 5% experienced grade 3 diarrhea. There was no grade 3 GU toxicity. 19 patients underwent curettage 6-9 weeks after chemoradiation without any evidence of tumor. Conclusion: The concept of SIB for dose escalation in patients with locally advanced cervical cancer is feasible with a low rate of acute toxicity. Whether dose escalation can translate into improved outcome will be assessed after a longer follow-up. (orig.)

  4. Intensity modulated whole pelvic radiotherapy in patients with cervix cancer: analysis of acute toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Min; Lee, Hyung Sik; Hur, Won Joo; Cha, Moon Seok; Kim, Hyun Ho [School of Medicine, Dong-A University, Busan (Korea, Republic of)

    2006-12-15

    To evaluate acute toxicities in cervix cancer patients receiving intensity modulated whole pelvic radiation therapy (IM-WPRT). Between August 2004 and April 2006, 17 patients who underwent IM-WPRT were analysed. An intravenous contrast agent was used for radiotherapy planning computed tomography (CT). The central clinical target volume (CTV) included the primary tumor, uterus, vagina, and parametrium. The nodal CTV was defined as the lymph nodes larger than 1 cm seen on CT and the contrased-enhanced pelvic vessels. The planning target volume (PTV) was the 1-cm expanded volume around the central CTV, except for a 5-mm expansion from the posterior vagina, and the nodal PTV was defined as the nodal CTV plus a 1.5 cm margin. IM-WPRT was prescribed to deliver a dose of 50 Gy to more than 95% of the PTV. Acute toxicity was assessed with common toxicity criteria up to 60 days after radiotherapy. Grade 1 nausea developed in 10 (58.9%) patients, and grade 1 and 2 diarrhea developed in 11 (64.7%) and 1 (5.9%) patients, respectively. No grade 3 or higher gastrointestinal toxicity was seen. Leukopenia, anemia, and thrombocytopenia occurred in 15 (88.2%). 7 (41.2%), and 2 (11.8%) patients, respectively, as hematologic toxicities. Grade 3 leukopenia developed in 2 patients who were treated with concurrent chemoradiotherapy. IM-WPRT can be a useful treatment for cervix cancer patients with decreased severe acute toxicities and a resultant improved compliance to whole pelvic irradiation.

  5. Differential diagnosis of acute miliary pulmonary tuberculosis from widespread-metastatic cancer for postoperative lung cancer patients: two cases

    Science.gov (United States)

    Zhao, Wei; Tian, Yuke; Peng, Feng; Long, Jianlin; Liu, Lan; Lu, You

    2017-01-01

    Pulmonary infections and lung cancer can resemble each other on radiographic images, which makes it difficult to diagnosis accurately and apply an appropriate therapy. Here we report two cases that two postoperative patients with lung adenocarcinoma developed diffuse nodules in bilateral lungs in a month which needed to be distinguished between metastatic malignancies and infectious diseases. Although there are much similarities in disease characteristics of two cases, patient in case one was diagnosed as acute miliary pulmonary tuberculosis (TB) while patient in case two was diagnosed as metastatic disease. The symptoms and pulmonary foci on CT scan of patient in case one improved distinctly after the immediate anti-TB treatment, but the disease of patient in case two progressed after chemotherapy. These findings caution us that differential diagnosis is crucial and have significance in guiding clinical work.

  6. Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sanguineti, Giuseppe; Bicquart, Celine; Little, Michael; Chen, George; Berilgen, Jason (Dept. of Radiation Oncology, Univ. of Texas Medical Branch, Galveston, TX (US)); Endres, Eugene J.; Parker, Brent C. (Dept. of Physics, Univ. of Texas Medical Branch, Galveston, TX (US))

    2008-02-15

    Purpose. To assess the acute toxicity profile of whole pelvis IMRT (WP-IMRT) for localized prostate cancer. Materials. Eighty seven patients treated with definitive WP-IMRT at UTMB from May 2002 to November 2006 were retrospectively reviewed. Treatment consisted of two sequential phases, WP-IMRT to 54 Gy at 1.8 Gy per fraction to the pelvic nodes and seminal vesicles and 60 Gy at 2 Gy to the prostate, and a separate external beam boost, 3DCRT or IMRT, to bring the dose to the prostate to 76 Gy. Acute toxicity was prospectively scored weekly during treatment and at 3 month follow-up according to CTC v2.0 for 10 genitourinary (GU) and gastrointestinal (GI) domains. The proportion of patients experiencing a given level of peak acute toxicity at a given point is reported. Results. Treatment was feasible with delivered doses to PTVs not significantly lower than planned ones and with only two patients experiencing treatment gaps longer than 5 days. About 2/3 and 1/10 of the patients experienced peak grade 2 and grade 3 reactions at least once during RT, respectively. Frequency/urgency (Grade 2+: 37.9%) and diarrhea (36.7%) were the most prevalent symptoms followed by proctitis (21.8%) and dysuria (16.1%). GI reactions were generally shorter lasting compared to GU ones which accumulated progressively during treatment. At 3 months, almost half of the patients were asymptomatic and most of observed reactions (89.2%) were mild, with GI ones more likely to be fully resolved (92.5%) than GU ones (68.7%, 2, p=0.001). Conclusion. Our approach is dosimetrically and clinically feasible with intense, but transient, acute toxicity

  7. In vivo dosimetry and acute toxicity in breast cancer patients undergoing intraoperative radiotherapy as boost

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jason Joon Bock; Choi, Jin Hyun; Lee, Ik Jae; Park, Kwang Woo; Kim, Kang Pyo; Kim, Jun Won [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ahn, Sung Gwe; Jeong, Joon [Dept. of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-06-15

    To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.

  8. Comparison of acute toxicities of two chemotherapy schedules for head and neck cancers

    Directory of Open Access Journals (Sweden)

    Geeta S

    2006-01-01

    Full Text Available Background: Chemo-radiotherapy has become the standard of care for loco-regionally advanced head and neck cancers. Platinum based regimens are the most effective. Although benefits are proven with chemo-radiation, acute toxicities are markedly increased. The dose and delivery schedules of Cisplatin have ranged from intermittent higher dose [100 mg/m2] every 3 weeks to low dose [6 mg/m2] daily administration. At present there is no data indicating which regimen is superior. Purpose: To compare acute toxicities of two chemotherapy schedules for head and neck cancers. Materials and Methods: A total of 83 head and neck cancer patients treated with two schedules of concurrent chemo RT were analyzed, retrospectively, for treatment toxicity. In group A [51 patients], chemotherapy [CT] was administered on week 1, 4 and 7 [cisplatin 100 mg/m2] over a period of 2-3 days. In group B [32 patients], CT was delivered weekly [cisplatin 40 mg/m2]. Radiotherapy dose was 7000 cGy in 35 fractions for definitive concurrent chemo-radiation and 6600 cGy in 33 fractions for adjuvant treatment. Results: Group B patients had increased grade III skin and hematological toxicity, where as patients in group A had more pharyngeal toxicity. Treatment interruptions and percentage of weight loss were higher in group B. Weekly CT schedule had higher rate of severe mucositis, which was statistically significant on both univariate [ P =0.005] and multivariate [ P =0.007] analysis. Conclusions: Three weekly CT is less toxic than weekly. Weekly CT can be made more acceptable by reducing the dose and using feeding tubes for nutrition.

  9. Joint effects of febrile acute infection and an interferon-γ polymorphism on breast cancer risk.

    Directory of Open Access Journals (Sweden)

    Yi Su

    Full Text Available BACKGROUND: There is an inverse relationship between febrile infection and the risk of malignancies. Interferon gamma (IFN-γ plays an important role in fever induction and its expression increases with incubation at fever-range temperatures. Therefore, the genetic polymorphism of IFN-γ may modify the association of febrile infection with breast cancer risk. METHODOLOGY AND PRINCIPAL FINDINGS: Information on potential breast cancer risk factors, history of fever during the last 10 years, and blood specimens were collected from 839 incident breast cancer cases and 863 age-matched controls between October 2008 and June 2010 in Guangzhou, China. IFN-γ (rs2069705 was genotyped using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry platform. Odds ratios (OR and 95% confidence intervals (CIs were calculated using multivariate logistic regression. We found that women who had experienced ≥1 fever per year had a decreased risk of breast cancer [ORs and 95% CI: 0.77 (0.61-0.99] compared to those with less than one fever a year. This association only occurred in women with CT/TT genotypes [0.54 (0.37-0.77] but not in those with the CC genotype [1.09 (0.77-1.55]. The association of IFN-γ rs2069705 with the risk of breast cancer was not significant among all participants, while the CT/TT genotypes were significantly related to an elevated risk of breast cancer [1.32 (1.03-1.70] among the women with <1 fever per year and to a reduced risk of breast cancer [0.63 (0.40-0.99] among women with ≥1 fever per year compared to the CC genotype. A marked interaction between fever frequencies and the IFN-γ genotypes was observed (P for multiplicative and additive interactions were 0.005 and 0.058, respectively. CONCLUSIONS: Our findings indicate a possible link between febrile acute infection and a decreased risk of breast cancer, and this association was modified by IFN-γ rs2069705.

  10. Acute inhibition of myostatin-family proteins preserves skeletal muscle in mouse models of cancer cachexia

    Energy Technology Data Exchange (ETDEWEB)

    Benny Klimek, Margaret E.; Aydogdu, Tufan [Department of Cell Biology and Anatomy, University of Miami Miller School of Medicine, Miami, FL (United States); Link, Majik J.; Pons, Marianne [Molecular Oncology Program, Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL (United States); Koniaris, Leonidas G. [Department of Cell Biology and Anatomy, University of Miami Miller School of Medicine, Miami, FL (United States); Molecular Oncology Program, Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL (United States); Molecular Oncology and Experimental Therapeutics Program, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL (United States); Zimmers, Teresa A., E-mail: tzimmers@med.miami.edu [Department of Cell Biology and Anatomy, University of Miami Miller School of Medicine, Miami, FL (United States); Molecular Oncology Program, Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL (United States); Molecular Oncology and Experimental Therapeutics Program, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL (United States)

    2010-01-15

    Cachexia, progressive loss of fat and muscle mass despite adequate nutrition, is a devastating complication of cancer associated with poor quality of life and increased mortality. Myostatin is a potent tonic muscle growth inhibitor. We tested how myostatin inhibition might influence cancer cachexia using genetic and pharmacological approaches. First, hypermuscular myostatin null mice were injected with Lewis lung carcinoma or B16F10 melanoma cells. Myostatin null mice were more sensitive to tumor-induced cachexia, losing more absolute mass and proportionately more muscle mass than wild-type mice. Because myostatin null mice lack expression from development, however, we also sought to manipulate myostatin acutely. The histone deacetylase inhibitor Trichostatin A has been shown to increase muscle mass in normal and dystrophic mice by inducing the myostatin inhibitor, follistatin. Although Trichostatin A administration induced muscle growth in normal mice, it failed to preserve muscle in colon-26 cancer cachexia. Finally we sought to inhibit myostatin and related ligands by administration of the Activin receptor extracellular domain/Fc fusion protein, ACVR2B-Fc. Systemic administration of ACVR2B-Fc potently inhibited muscle wasting and protected adipose stores in both colon-26 and Lewis lung carcinoma cachexia, without affecting tumor growth. Enhanced cachexia in myostatin knockouts indicates that host-derived myostatin is not the sole mediator of muscle wasting in cancer. More importantly, skeletal muscle preservation with ACVR2B-Fc establishes that targeting myostatin-family ligands using ACVR2B-Fc or related molecules is an important and potent therapeutic avenue in cancer cachexia.

  11. The effect of multidisciplinary team care on cancer management

    OpenAIRE

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical o...

  12. Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer

    NARCIS (Netherlands)

    Maduro, JH; Pras, E; Willemse, PHB; de Vries, EGE

    2003-01-01

    Randomised studies in locally advanced cervical cancer patients showed that cisplatin should be given concurrently with radiotherapy, because of a better long-term survival compared to radiotherapy alone. This increases the relevance of treatment related toxicity. This review summarises the acute an

  13. Effects of non-surgical periodontal treatment on the L-arginine-nitric oxide pathway and oxidative status in platelets.

    Science.gov (United States)

    Siqueira, Mariana Alves de Sá; Fischer, Ricardo Guimarães; Pereira, Natália Rodrigues; Martins, Marcela Anjos; Moss, Monique Bandeira; Mendes-Ribeiro, Antônio Cláudio; Figueredo, Carlos Marcelo da Silva; Brunini, Tatiana Marlowe Cunha

    2013-06-01

    Several studies have suggested an increase of cardiovascular disease (CVD) risk on periodontitis patients. An enhancement has been demonstrated on both platelet activation and oxidative stress on periodontitis patients, which may contribute for this association. Therefore, the aim of this study was to evaluate the effects of non-surgical periodontal treatment on the l-arginine-nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) pathway and oxidative status in platelets. A total of eight periodontitis patients and eight controls were included in this study. Clinical, laboratory and experimental evaluations were performed on baseline and 90 days after periodontal treatment (except for western blot analysis). The clinical periodontal evaluation included measurements of probing pocket depth (PPD), clinical attachment loss (CAL), % of sites with plaque and % of sites with bleeding on probing. We evaluated: l-[(3)H]arginine influx; nitric oxide synthase (NOS) and arginase enzymes activity and expression; expression of guanylate cyclase and phosphodiesterase-5 enzymes; cGMP levels; platelet aggregation; oxidative status through superoxide dismutase (SOD) and catalase activities, and measurement of reactive oxygen species (ROS) levels and C-reactive protein (CRP) levels. The initial results showed an activation of both l-arginine influx and via system y (+ )L associated with reduced intraplatelet cGMP levels in periodontitis patients and increased systemic levels of CRP. After periodontal treatment, there was a significant reduction of the % of sites with PPD 4-5mm, % of sites with CAL 4-5 mm, and an enhancement in cGMP levels and SOD activity. Moreover, CRP levels were reduced after treatment. Therefore, alterations in the intraplatelet l-arginine-NO-cGMP pathway and oxidant-antioxidant balance associated with a systemic inflammatory response may lead to platelet dysfunction, which may contribute to a higher risk of CVD in periodontitis.

  14. Efficacy of adjunctive laser in non-surgical periodontal treatment: a systematic review and meta-analysis.

    Science.gov (United States)

    Cheng, Y; Chen, J W; Ge, M K; Zhou, Z Y; Yin, X; Zou, S J

    2016-01-01

    To evaluate the efficacy of the adjunctive laser therapy in conventional non-surgical treatment of chronic periodontitis, an electronic search was performed through the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, EMBASE, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), and China Biology Medicine (CBM) Disc, for relevant randomized controlled trials (RCTs) or quasi-RCTs. All the 12 included studies (11 RCTs and 1 quasi-RCT) were qualified for descriptive and quantitative analysis. Outcomes were divided into two groups according to the length of follow-ups (long term and short term). Subgroup analyses were performed based on the mode of laser (inside and outside mode). Among all included researches, reduction in probing depth (PD) and gain in clinical attachment level (CAL) were presented with the mean value and 95 % confidence interval, while bleeding on probing (BOP) was assessed descriptively. Meta-analysis suggested that adjunctive laser therapy reduced PD at 3 months [mean difference (MD) = -0.26, 95 % confidence interval (CI) range = -0.43 to -0.09, p = 0.003] but did not demonstrate significant effect on the CAL at either 3 months (MD = -0.03, 95 % CI range = -0.25 to 0.19, p = 0.79) or 6 months (MD = -0.11, 95 % CI range = -0.38 to 0.16, p = 0.43). Subgroup analyses indicated that laser therapy would be more effective when the probes were set up outside the periodontal pockets.

  15. Surgical patients travel longer distances than non-surgical patients to receive care at a rural hospital in Mozambique.

    Science.gov (United States)

    Faierman, Michelle L; Anderson, Jamie E; Assane, Americo; Bendix, Peter; Vaz, Fernando; Rose, John A; Funzamo, Carlos; Bickler, Stephen W; Noormahomed, Emilia V

    2015-01-01

    Surgical care is increasingly recognised as an important component of global health delivery. However, there are still major gaps in knowledge related to access to surgical care in low-income countries. In this study, we compare distances travelled by surgical patients with patients seeking other medical services at a first-level hospital in rural Mozambique. Data were collected on all inpatients at Hospital Rural de Chókwè in rural Mozambique between 20 June 2012 and 3 August 2012. Euclidean distances travelled by surgical versus non-surgical patients using coordinates of each patient's city of residence were compared. Data were analysed using ArcGIS 10 and STATA. In total, 500 patients were included. Almost one-half (47.6%) lived in the city where the hospital is based. By hospital ward, the majority (62.0%) of maternity patients came from within the hospital's city compared with only 35.2% of surgical patients. The average distance travelled was longest for surgical patients (42 km) compared with an average of 17 km for patients on all other wards. Patients seeking surgical care at this first-level hospital travel farther than patients seeking other services. While other patients may have access to at community clinics, surgical patients depend more heavily on the services available at first-level hospitals. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2012-08-01

    Full Text Available This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD. Sixteen CKD pre-dialysis individuals (CKD and 14 individuals without clinical evidence of kidney disease (C presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05. After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05 were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05 than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  17. Acute fulminant colon cancer metastasis after renal transplantation Metástasis agudas fulminantes de cáncer de colon tras el trasplante renal

    Directory of Open Access Journals (Sweden)

    C. T. Lin

    2010-07-01

    Full Text Available We report a 52-year-old male with no family history of colonic cancer, who was found to have advanced colonic cancer with metastases two months post renal transplantation. With this case, we highlight the possibility of acute fulminant cancer metastases within short period after renal transplantation and the importance of periodic colorectal cancer screening pre-transplant. To our knowledge, this case is not yet reported in the literature, especially with such presentation of acute fulminant colonic cancer metastases post renal transplantation.

  18. Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy

    Directory of Open Access Journals (Sweden)

    Williams Scott

    2011-10-01

    Full Text Available Abstract Background Image-guided radiotherapy (IGRT increases the accuracy of treatment delivery through daily target localisation. We report on toxicity symptoms experienced during radiotherapy treatment, with and without IGRT in prostate cancer patients treated radically. Methods Between 2006 and 2009, acute toxicity data for ten symptoms were collected prospectively onto standardized assessment forms. Toxicity was scored during radiotherapy, according to the Common Terminology Criteria Adverse Events V3.0, for 275 prostate cancer patients before and after the implementation of a fiducial marker IGRT program and dose escalation from 74Gy in 37 fractions, to 78Gy in 39 fractions. Margins and planning constraints were maintained the same during the study period. The symptoms scored were urinary frequency, cystitis, bladder spasm, urinary incontinence, urinary retention, diarrhoea, haemorrhoids, proctitis, anal skin discomfort and fatigue. Analysis was conducted for the maximum grade of toxicity and the median number of days from the onset of that toxicity to the end of treatment. Results In the IGRT group, 14228 toxicity scores were analysed from 249 patients. In the non-IGRT group, 1893 toxicity scores were analysed from 26 patients. Urinary frequency ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188. Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174. Fatigue ≥G2 affected 23% and 8% of patients in the non-IGRT and IGRT groups (p = 0.0271. The median number of days with a toxicity was higher for ≥G2 (p = 0.0179 and ≥G3 frequency (p = 0.0027, ≥G2 diarrhoea (p = 0.0033 and ≥G2 fatigue (p = 0.0088 in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference. Conclusions In this study, prostate cancer patients treated radically with IGRT had less severe urinary frequency, diarrhoea and fatigue during treatment

  19. Acute respiratory distress syndrome due to Strongyloides stercoralis infection in a patient with cervical cancer.

    Science.gov (United States)

    Kinjo, Takeshi; Nabeya, Daijiro; Nakamura, Hideta; Haranaga, Shusaku; Hirata, Tetsuo; Nakamoto, Tomoko; Atsumi, Eriko; Fuchigami, Tatsuya; Aoki, Yoichi; Fujita, Jiro

    2015-01-01

    A 62-year-old woman complained of diarrhea and vomiting after receiving chemotherapy for cervical cancer in association with high doses of corticosteroids. Two months later, the patient developed acute respiratory distress syndrome, and numerous Strongyloides stercoralis parasites were found in the intrabronchial discharge. Ivermectin was administered daily until nematodes were no longer detected in the sputum, and the patient's condition was successfully rescued. Antibodies for human T-cell lymphotropic virus-1 (HTLV-1) were positive. HTLV-1 infection and the administration of corticosteroids are known risk factors for strongyloides hyperinfection syndrome. Therefore, physicians should consider this disease in the differential diagnosis of patients from endemic areas who present with gastrointestinal symptoms under these risk factors.

  20. Acute inpatient palliative medicine in a cancer center: clinical problems and medical interventions--a prospective study.

    Science.gov (United States)

    Lagman, Ruth; Rivera, Nilo; Walsh, Declan; LeGrand, Susan; Davis, Mellar P

    2007-01-01

    The clinical characteristics and medical interventions of the 100 consecutive cancer admissions to the acute care inpatient palliative medicine unit at the Cleveland Clinic for 2 months are described. Median age was 62 years (range, 31 to 92 years). The male-female ratio was 1:1. Most admissions were referred by hematology-oncology and had prior antineoplastic therapy. Reasons for admission were symptom control and cancer-related complications. Patients underwent invasive diagnostic and therapeutic procedures, hydration, transfusions, radiation, or chemotherapy, or a combination, during their admission. Most were discharged home with hospice care or had outpatient clinic follow-up. The mortality rate was 20%. Aggressive multidisciplinary management of symptoms, disease complications, comorbid conditions, and psychosocial problems were provided. Palliative medicine physicians provided continuity of care in the outpatient clinic and at home. An acute inpatient palliative medicine unit within a tertiary level medical center has a definable and important role in comprehensive cancer care.

  1. Acute urinary morbidity after a permanent 125I implantation for localized prostate cancer.

    Science.gov (United States)

    Ohga, Saiji; Nakamura, Katsumasa; Shioyama, Yoshiyuki; Tatsugami, Katsunori; Sasaki, Tomonari; Nonoshita, Takeshi; Yoshitake, Tadamasa; Asai, Kaori; Hirata, Hideki; Naito, Seiji; Honda, Hiroshi

    2014-11-01

    We evaluated the predictive factors of acute urinary morbidity (AUM) after prostate brachytherapy. From November 2005 to January 2007, 62 patients with localized prostate cancer were treated using brachytherapy. The (125)Iodine ((125)I) seed-delivering method was a modified peripheral pattern. The prescribed dose was 144 Gy. Urinary morbidity was scored at 3 months after implantation. The clinical and treatment parameters were analysed for correlation with AUM. In particular, in this study, Du90 (the minimal dose received by 90% of the urethra), Dup90 (the minimal dose received by 90% of the proximal half of the urethra on the bladder side) and Dud90 (the minimal dose received by 90% of the distal half of the urethra on the penile side) were analysed. We found that 43 patients (69.4%) experienced acute urinary symptoms at 3 months after implantation. Of them, 40 patients had Grade 1 AUM, one patient had Grade 2 pain, and two patients had Grade 2 urinary frequency. None of the patients had ≥Grade 3. Univariate and multivariate analysis revealed that Du90 and Dup90 were significantly correlated with AUM. In this study, Du90 and Dup90 were the most significant predictors of AUM after prostate brachytherapy.

  2. Acute toxicity of combined photon IMRT and carbon ion boost for intermediate-risk prostate cancer - Acute toxicity of 12C for PC

    Energy Technology Data Exchange (ETDEWEB)

    Nikoghosyan, Anna V.; Herfarth, Klaus; Didinger, Bernd; Muenter, Marc W.; Jensen, Alexandra D.; Debus, Juergen (Dept. of Radiation Oncology, Univ. of Heidelberg (Germany)), e-mail: a.nikoghosyan@med.uni-heidelberg.de; Schulz-Ertner, Daniela (Radiological Inst. (Medical Care Unit), Markus Hospital, Frankfurt/Main (Germany)); Jaekel, Oliver (Dept. of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ) Heidelberg (Germany); Heidelberg Ion Beam Therapy Centre of the Univ. Hospital Heidelberg (Germany)); Hoess, Angelika; Haberer, Thomas (Heidelberg Ion Beam Therapy Centre of the Univ. Hospital Heidelberg (Germany))

    2011-08-15

    Background. Carbon ion (12C) therapy in the treatment of prostate cancer (PC) might result in an improved outcome as compared to low linear energy transfer irradiation techniques. In this study, we present the first interim report of acute side effects of the first intermediate-risk PC patients treated at the GSI (Gesellschaft fuer Schwerionenforschung) and the Univ. of Heidelberg in an ongoing clinical phase I/II trial using combined photon intensity modulated radiation therapy (IMRT) and 12C carbon ion boost. Material and methods. Fourteen patients (planned accrual: 31 pts) have been treated within this trial so far. IMRT is prescribed to the median PTV at a dose of 30 x 2 Gy; 12C boost is applied to the prostate (GTV) at a dose of 6 x 3 GyE using raster scan technique. Safety margins added to the clinical target volume were determined individually for each patient based on five independent planning computed tomography (CT)-scans. Acute gastrointestinal (GI) and genitourinary (GU) toxicity was assessed and documented according to the CTCAE Version 3.0. Results. Radiotherapy was very well tolerated without any grade 3 or higher toxicity. Acute anal bleeding grade 2 was observed in 2/14 patients. Rectal tenesmus grade 1 was reported by three other patients. No further GI symptoms have been observed. Most common acute symptoms during radiotherapy were nocturia and dysuria CTC grade 1 and 2 (12/14). There was no severe acute GU toxicity. Conclusion. The combination of photon IMRT and carbon ion boost is feasible in patients with intermediate-risk PC. So far, the treatment has been well tolerated. Acute toxicity rates were in good accordance with data reported for high dose IMRT alone

  3. Effect of non-surgical periodontal therapy on the concentration of volatile sulfur compound in mouth air of a group of nigerian young adults.

    Science.gov (United States)

    Ehizele, Ao; Akhionbare, O

    2013-07-01

    The major goal of non-surgical periodontal therapy is to reduce or eliminate the subgingival pathogenic microbial flora that is known to be associated with volatile sulfur compounds (VSC). The aim of this study was, therefore, to determine the effect of non-surgical periodontal therapy on the concentration of VSC in mouth air of young adults. Four hundred subjects, grouped into two based on the absence or presence of periodontal diseases, were involved in this study. Basic periodontal examination was used for the grouping. The measurement of the concentration of the VSC in the mouth air of the subjects was done objectively, using the Halimeter, before and after the therapy, and at recall visits 2 weeks and 6 weeks after therapy. Chi-square and Paired t-test were used to find statistical significance. The results revealed that at baseline, 78.7% (48/61) of the subjects who had VSC concentration more than 250 parts per billion (ppb) were from the group with periodontal disease. Immediately after non-surgical periodontal therapy, only 8.5% (17/200) of the subjects with periodontal disease had VSC concentration of more than 250 ppb while all the subjects with no periodontal disease had VSC concentration less than 181 ppb. The same pattern of reduction in the concentration of the VSC and improvement in oral hygiene was also obtained 2 weeks and 6 weeks after therapy. It can be concluded that non-surgical periodontal therapy brought about reduction in the concentration of volatile sulfur compounds in mouth air of young adults.

  4. Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Richmond Charlotte

    2010-07-01

    Full Text Available Abstract Background Because previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP due to disc degeneration (discogenic low back pain and disc herniation, it has accordingly been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration. The goal of this study was to determine if changes in LBP, as measured on a verbal rating scale, before and after a 6-week treatment period with non-surgical spinal decompression, correlate with changes in lumbar disc height, as measured on computed tomography (CT scans. Methods A retrospective cohort study of adults with chronic LBP attributed to disc herniation and/or discogenic LBP who underwent a 6-week treatment protocol of motorized non-surgical spinal decompression via the DRX9000 with CT scans before and after treatment. The main outcomes were changes in pain as measured on a verbal rating scale from 0 to 10 during a flexion-extension range of motion evaluation and changes in disc height as measured on CT scans. Paired t-test or linear regression was used as appropriate with p Results We identified 30 patients with lumbar disc herniation with an average age of 65 years, body mass index of 29 kg/m2, 21 females and 9 males, and an average duration of LBP of 12.5 weeks. During treatment, low back pain decreased from 6.2 (SD 2.2 to 1.6 (2.3, p Conclusions Non-surgical spinal decompression was associated with a reduction in pain and an increase in disc height. The correlation of these variables suggests that pain reduction may be mediated, at least in part, through a restoration of disc height. A randomized controlled trial is needed to confirm these promising results. Clinical trial registration number NCT00828880

  5. Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial.

    Science.gov (United States)

    Chondros, Panos; Nikolidakis, Dimitris; Christodoulides, Nicos; Rössler, Ralf; Gutknecht, Norbert; Sculean, Anton

    2009-09-01

    Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following parameters were evaluated at baseline and at 3 months and 6 months after therapy: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC), and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At 3 months after therapy

  6. Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? a systematic review

    Directory of Open Access Journals (Sweden)

    Shi Qiyun

    2011-04-01

    Full Text Available Abstract Background Carpal tunnel syndrome is a common disorder in hand surgery practice. Both surgical and conservative interventions are utilized for the carpal tunnel syndrome. Although certain indications would specifically indicate the need for surgery, there is a spectrum of patients for whom either treatment option might be selected. The purpose of this systematic review was to compare the efficacy of surgical treatment of carpal tunnel syndrome with conservative treatment Methods We included all controlled trials written in English, attempting to compare any surgical interventions with any conservative therapies. We searched Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2010, MEDLINE (1980 to June 2010, EMBASE (1980 to June 2010, PEDro (searched in June 2010, international guidelines, computer searches based on key words and reference lists of articles. Two reviewers performed study selection, assessment of methodological quality and data extraction independently of each other. Weighted mean differences and 95% confidence intervals for patient self-reported functional and symptom questionnaires were calculated. Relative risk (RR and 95% confidence intervals for electrophysiological studies and complication were also calculated. Results We assessed seven studies in this review including 5 RCTs and 2 controlled trials. The methodological quality of the trials ranged from moderate to high. The weighted mean difference demonstrated a larger treatment benefit for surgical intervention compared to non surgical intervention at six months for functional status 0.35( 95% CI 0.22, 0.47 and symptom severity 0.43 (95% CI 0.29, 0.57. There were no statistically significant difference between the intervention options at 3 months but there was a benefit in favor of surgery in terms of function and symptom relief at 12 months ( 0.35, 95% CI 0.15, 0.55 and 0.37, 95% CI 0.19 to 0.56. The RR for secondary outcomes of normal

  7. The effect of non-surgical periodontal therapy on systemic immune response and blood glucose level of NIDDM patients

    Directory of Open Access Journals (Sweden)

    Oedijani Santoso

    2008-03-01

    Full Text Available Periodontal inflammation is a periodontal disorder of high prevalence in the population. Chronic periodontitis is associated with the accumulation of plaque and calculus as local factors, and systemic factors such an diabetes mellitus (DM and HIV infection. Cytokine, especially IL-1β as inflammatory mediator for periodontal disease, may directly stimulated iNOS (inducible nitric oxide synthase expression and NO (nitric oxide production by β-cells, resulting in NO-mediated β-cell damage. The leucotoxin and proteases produced by periodontal pathogens will induce chemotactic and phagocytotic defect; therefore causing decreased PMN phagocytotic function. Hyperglicemia which occurs in diabetic patients increases calcium influx to the cell, resulting in the increased cytosol’s calcium ([Ca 2+]i level and; therefore, resulting in dysfunction of PMN and impaired PMN phagocytotic function. Advanced glycosilation endproduct in NIDDM binds to monocytes resulting in the increase of pro-inflammatory cytokines (IL-1, TNFα and produces activation of macrophages and osteoclasts. Hyperglicemia activates diacyl glycerol (DAG-protein kinase C (PKC, thus increasing PGE2 and cytokine expression that induce inflammation and periodontal tissue destruction processes. Studies on the effect of scaling to remove calculus disposition on blood glucose control and cellular immune response in DM patient has never been carried out. The aim of the study was to analyze the effect of scaling as non-surgical periodontal therapy on immune response (IL-1β level and PMN phagocytotic function and blood glucose level of type 2 diabetic patients. Subjects were diabetic patients, 60 controlled-DM (CDM and 60 uncontrolled-DM (UCDM, in Metabolic-Endocrinology Clinic of Ciptomangunkusumo Hospital, aged 40-60 years. The subjects were divided into treatment (scaling and control group, and cellular immune response and diabetic status, before and 6 weeks after treatment were evaluated

  8. Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review.

    Science.gov (United States)

    Tieu, Long D; Saltaji, Humam; Normando, David; Flores-Mir, Carlos

    2014-07-23

    This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

  9. A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients.

    Science.gov (United States)

    Schnur, Julie B; Ouellette, Suzanne C; Dilorenzo, Terry A; Green, Sheryl; Montgomery, Guy H

    2011-03-01

    One of the most common acute side effects of breast cancer radiotherapy is treatment-induced skin changes, referred to as skin toxicity. Yet no research to date has focused expressly on skin toxicity-related quality of life (QOL) in breast cancer radiotherapy patients. Therefore, our aim was to use qualitative approaches to better understand the impact of skin toxicity on QOL. Semistructured interviews were conducted with 20 women (Stage 0-III breast cancer), during their last week of external beam radiotherapy. Each interview was transcribed verbatim, and thematic analysis was performed. Three themes were identified based on the interview responses: First, skin changes affect multiple dimensions of QOL. They cause physical discomfort, body image disturbance, emotional distress, and impair both day-to-day functioning and satisfaction with radiation treatment. Second, individual differences affect women's experiences. Generally African American women, younger women, women who are not currently in a relationship, women who are being treated during the summer, and women who are more invested in their appearance are more distressed by skin toxicity. Third, women use a variety of symptom management strategies including self-medication, complementary/alternative medicine approaches, and psychological strategies. Implications of results are as follows: (1) skin toxicity affects numerous dimensions of QOL, and assessment approaches and psychosocial interventions should address this; (2) individual differences may affect the experience of skin toxicity and should be considered in treatment and education approaches; and (3) participants' own creativity and problem-solving should be used to improve the treatment experience. Copyright © 2010 John Wiley & Sons, Ltd.

  10. A new hospice consulting system for terminal cancer patients in transferring to post-acute care options in Taiwan.

    Science.gov (United States)

    Chang, P M-H; Liu, Y-Y L; Chao, T-C; Lin, H-L; Chen, M-B; Chen, P-M; Chiou, T-J

    2010-03-01

    The terminal cancer patients increase needs for hospice care day by day. A new hospice consulting system has been developed in Taiwan to provide options for terminal cancer patients in choosing a suitable post-acute hospice care while a combined hospice care system is also given by the consulting team in the acute wards. Hereinafter is our report. From March 2005 to January 2006, 313 terminal cancer patients were analysed. These patients had signed consent forms for palliative treatment and had received consultations from the new hospice consulting system. Multivariate analysis showed that the home care patients had better performance status (P = 0.012), less shortness of breath (P = 0.006), less limbs swelling (P = 0.043), less flatulency (P = 0.000) and less constipation (P = 0.018). Among the 162 patients with regular follow-up, the symptoms/signs were significantly improved after intervention of consulting team in pain (P = 0.000), shortness of breath (P = 0.000), difficulty in sleeping (P = 0.002), nausea (P = 0.004), constipation (P = 0.008), changes in skin (P = 0.024) and adoption (P = 0.000). This new system had significant improvement in the terminal cancer patients' symptoms/signs control in acute wards and could contribute to the care quality of home care patients.

  11. Conformal radiotherapy for prostate cancer - Longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure

    Energy Technology Data Exchange (ETDEWEB)

    Odrazka, Karel; Vanasek, Jaroslav; Vaculikova, Miloslava; Petera, Jiri; Zouhar, Milan; Zoul, Zdenk; Stejskal, Jan; Skrabkova, Zuzana; Kadeka, David [Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic). Dept. of Radiotherapy and Oncology

    2001-11-01

    The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.

  12. 非手术综合治疗保留中晚期喉癌患者喉器官的效果分析%Effective analysis of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    颜芳; 张欣欣; 马林; 刘明波; 陈南翔; 王嘉陵; 武文明; 黄德亮

    2016-01-01

    Objective To evaluate the therapeutic effects,larynx preservation and adverse events of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal squamous cell carcinomas(SCCs).Methods Forty-six patients with locally advanced laryngeal carcinoma (T2-4,N0-N3) were treated individually with non-surgical combined treatments for larynx preservation (LP).These treatments included concurrent chemoradiotherapy (CCRT) (± epidermal growth factor receptor (EGFR)inhibitor),induction chemotherapy (ICT) followed by CCRT (± EGFR inhibitor),or concurrent radiotherapy and EGFR inhibitor.Radiation therapy was given to a total dose of 60-70 Gy.The KaplanMeier method was used to determine the overall survival.Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.Results The average follow-up time was 31.8 months (range 6-95 months).All patients completed the planned radiotherapywithout treatment breaks,and 45(97.8%) of 46 patients completed the planned chemotherapy.The 3-year and 5-year overall survival rates were 87.3% and 67.2%,respectively.The 5-year larynx preservation rate was 100.0%.The 3-year and 5-year progression free survival rates were 95.1% and 87.7%,respectively.The most common acute side effect in grade 3 was oropharyngeal mucositis.After treatment,tracheotomy was still required in 2 patients with glottis cancer for laryngeal edema or stenosis.No patient depended on a percutaneous gastrostomy and experienced speech impairment.Conclusion Patients with locally advanced laryngeal cancer can be offered non-surgical combined treatments for laryngeal preservation and the high quality of life,showing a higher laryngeal preservation survival rate with minimal toxicities.%目的 评估应用非手术综合治疗方法治疗中晚期喉癌患者的治疗效果.方法 回顾性分析2007年11月至2015年4月,解放军总医院耳鼻咽喉头颈外科46例应

  13. Hypofractionated radiotherapy after conservative surgery for breast cancer: analysis of acute and late toxicity

    Directory of Open Access Journals (Sweden)

    Tunesi Sara

    2010-11-01

    Full Text Available Abstract Background A variety of hypofractionated radiotherapy schedules has been proposed after breast conserving surgery in the attempt to shorten the overall treatment time. The aim of the present study is to assess acute and late toxicity of using daily fractionation of 2.25 Gy to a total dose of 45 Gy to the whole breast in a mono-institutional series. Methods Eighty-five women with early breast cancer were assigned to receive 45 Gy followed by a boost to the tumour bed. Early and late toxicity were scored according to the Radiation Therapy Oncology Group criteria. For comparison, a group of 70 patients with similar characteristics and treated with conventional fractionation of 2 Gy to a total dose of 50 Gy in 25 fractions followed by a boost, was retrospectively selected. Results Overall median treatment duration was 29 days for hypofractionated radiotherapy and 37 days for conventional radiotherapy. Early reactions were observed in 72/85 (85% patients treated with hypofractionation and in 67/70 (96% patients treated with conventional fractionation (p = 0.01. Late toxicity was observed in 8 patients (10% in the hypofractionation group and in 10 patients (15% in the conventional fractionation group, respectively (p = 0.4. Conclusions The hypofractionated schedule delivering 45 Gy in 20 fractions shortened the overall treatment time by 1 week with a reduction of skin acute toxicity and no increase of late effects compared to the conventional fractionation. Our results support the implementation of hypofractionated schedules in clinical practice.

  14. Isocitrate dehydrogenase mutation hot spots in acute lymphoblastic leukemia and oral cancer

    Directory of Open Access Journals (Sweden)

    Jen-Yang Tang

    2012-03-01

    Full Text Available Isocitrate dehydrogenase (IDH encodes a nicotinamide adenine dinucleotide phosphate+-dependent enzyme for oxidative decarboxylation of isocitrate and has an essential role in the tricarboxylic acid cycle. Mutations of IDH1 and IDH2 have been identified in patients with glioma, leukemia, and other cancers. However, the incidence of IDH mutations in acute myeloid leukemia in Taiwan is much lower than that reported in Western countries. The reason for the difference is unknown and its clinical implications remain unclear. Acute lymphoblastic leukemia (ALL is a heterogenous hematopoietic malignancy. Oral squamous cell carcinoma (OSCC results from chronic carcinogen exposures and is highly prevalent in trucking workers, especially in southern Taiwan. Subtypes of both diseases require specific treatments, and molecular markers for developing tailored treatments are limited. High-resolution melting (HRM analysis is now a widely used methodology for rapid, accurate, and low-cost mutation scanning. In this study, 90 adults with OSC and 31 children with ALL were scanned by HRM analysis for IDH1 and IDH2 mutation hot spots. In ALL, the allele frequency was 3.23% in both IDH1 and IDH2. In OSCC, the allele frequency was 2.22% in IDH2. A synonymous mutation over pG313 (c.939A > G of IDH2 was found in both pediatric ALL and adult OSCC. Therefore, we concluded that mutations of IDH are uncommon in ALL and OSCC and are apparently not a major consideration when selecting treatment modalities.

  15. The Study on Acute and Subacute Toxicity and Anti-Cancer Effects of cultivated wild ginseng Herbal acupuncture

    Directory of Open Access Journals (Sweden)

    Ki-Rok, Kwon

    2003-06-01

    Full Text Available Objectives : The purpose of this study was to investigate acute and subacute toxicity and sarcoma-180 anti-cancer effects of herbal acupuncture with cultivated wild ginseng (distilled in mice and rats. Methods : Balb/c mice were injected intravenous with cultivated wild ginseng herbal acupuncture for LD50 and acute toxicity test. Sprague-Dawley rats were injected intravenous with cultivated wild ginseng herbal acupuncture for subacute toxicity test. The cultivated wild ginseng herbal-acupuncture was injected at the tail vein of mice. Results : 1. In acute LD50 toxicity test, there was no mortality thus unable to attain the value. 2. Examining the toxic response in the acute toxicity test, there was no sign of toxication. 3. In acute toxic test, running biochemical serum test couldn't yield any differences between the control and experiment groups. 4. In subacute toxicity test, there was no sign of toxication in the experimental groups and didn't show any changes in weight compared to the normal group. 5. In subacute toxicity test, biochemical serum test showed significant increase of Total albumin, Albumin, and Glucose in the experimental group I compared with the control group. Significant decrease of GOT, ALP, GPT, and Triglyceride were shown. In experiment group II, only Glucose showed significant increase compared with the control group. 6. Measuring survival rate for anti-cancer effects of Sarcoma-180 cancer cell line, all the experimental groups showed significant increase in survival rate. 7. Measuring NK cell activity rate, no significant difference was shown throughout the groups. 8. Measuring Interleukin-2 productivity rate, all the experimental groups didn't show significant difference. 9. For manifestation of cytokine mRNA, significant decrease of interleukin-10 was witnessed in the experimental group compared to the control group. Conclusion : According to the results, we can conclude cultivated wild ginseng herbal acupuncture

  16. Acute myocardial infarction mimicking squamous cell lung cancer with bone metastases due to hypercalcemia: a case report

    Institute of Scientific and Technical Information of China (English)

    FANG Chong-feng; XU Geng; CHEN Yang-xin

    2010-01-01

    @@ Acute myocardial infarction (AMI), the most severe coronary artery disease, is one of the most frequent cardiac emergencies, and early diagnosis and treatment are very important to decrease the subsequent cardiac adverse events such as malignant arrhythmia and sudden cardiac death. But in fact, lots of diseases are similar to AMI in clinical practice, of which the most common are myocarditis, pulmonary embolism in department of cardiology. Here we report a case of AMI-like squamous cell lung cancer with bone metastases.

  17. Rectal planning risk volume correlation with acute and late toxicity in 3-dimensional conformal radiation therapy for prostate cancer.

    Science.gov (United States)

    Dias, R S; Giordani, A J; Souhami, L; Segreto, R A; Segreto, H R C

    2011-12-01

    The purpose of this study was to evaluate rectum motion during 3-Dimensional conformal radiation therapy (3D-CRT) in prostate cancer patients, to derive a planning volume at risk (PRV) and to correlate the PRV dose-volume histograms (DVH) with treatment complications.This study was conducted in two phases. Initially, the PRV was defined prospectively in 50 consecutive prostate cancer patients (Group 1) who received a radical course of 3-D CRT. Then, the obtained PRV was used in the radiotherapy planning of these same 50 patients plus another 59 prostate cancer patients (Group 2) previously treated between 2004 and 2008. All these patients' data, including the rectum and PRV DVHs, were correlated to acute and late complications, according to the Common Toxicity Criteria (CTC) v4.0.The largest displacement occurred in the anterior axis. Long-term gastrointestinal (GI) complications grade ≥ 2 were seen in 9.2% of the cases. Factors that influenced acute GI reactions were: doses at 25% (p 5 0.011) and 40% (p 5 0.005) of the rectum volume and at 40% of the PRV (p 5 0.012). The dose at 25% of the rectum volume (p 5 0.033) and acute complications ≥ grade 2 (p 5 0.018) were prognostic factors for long-term complications. The PRV DVH did not correlate with late toxicity. The rectum showed a significant inter-fraction motion during 3D-CRT for prostate cancer. PRV dose correlated with acute gastrointestinal complications and may be a useful tool to predict and reduce their occurrence.

  18. Management and treatment of osteonecrosis in children and adolescents with acute lymphoblastic leukemia.

    Science.gov (United States)

    Te Winkel, Mariël L; Pieters, Rob; Wind, Ernst-Jan D; Bessems, J H J M Gert; van den Heuvel-Eibrink, Marry M

    2014-03-01

    There is no consensus regarding how to manage osteonecrosis in pediatric acute lymphoblastic leukemia patients. Therefore, we performed a quality assessment of the literature with the result of a search strategy using the MESH terms osteonecrosis, children, childhood cancer, surgery, bisphosphonates, 6 hydroxymethyl-glutaryl CoA reductase inhibitors, anticoagulants and hyperbaric oxygen, and terms related to these MESH terms. A randomized controlled trial showed that osteonecrosis can be prevented by intermittent, instead of continuous, corticosteroid administration. The studies on interventions after onset of osteonecrosis were of low-quality evidence. Seven pediatric acute lymphoblastic leukemia studies described non-surgical interventions; bisphosphonates (n=5), hyperbaric oxygen therapy (n=1), or prostacyclin analogs (n=1). Safety and efficacy studies are lacking. Five studies focused on surgical interventions; none was of sufficient quality to draw definite conclusions. In conclusion, preventing osteonecrosis is feasible in a proportion of the pediatric acute lymphoblastic leukemia patients by discontinuous, instead of continuous, steroid scheduling. The questions as to how to treat childhood acute lymphoblastic leukemia patients with osteonecrosis cannot be answered as good-quality studies are lacking.

  19. Impact of hypofractionation and tangential beam IMRT on the acute skin reaction in adjuvant breast cancer radiotherapy.

    Science.gov (United States)

    Rudat, Volker; Nour, Alaa; Ghaida, Salam Abou; Alaradi, Aziz

    2016-07-30

    The purpose of the study was to evaluate the impact of multiple prognostic factors on the acute skin reaction in adjuvant breast cancer radiotherapy, in particular the impact of hypofractionation (HF) compared to conventional fractionation (CF) and tangential beam (TB) IMRT compared to three-dimensional conformal radiotherapy (3DCRT). Two-hundred and sixty-six breast cancer patients with postoperative radiotherapy after breast conserving surgery or mastectomy were retrospectively evaluated. Patients were treated with HF (15 fractions of 2.67 Gy; n = 121) or CF (28 fractions of 1.8 Gy or 25 fractions of 2.0 Gy; n = 145) and TB-IMRT (n = 151) or 3DCRT (n = 115). The acute skin reactions were prospectively assessed using the CTCAE v4 grading scale. Ordinal regression analysis was used to assess the impact of possible prognostic factors on the maximal acute skin reaction. Grade 2 skin reactions were observed in 19 % of the patients treated with CF compared to 2 % treated with HF. On univariate analysis, the fractionation regimen, the PTV (breast versus chest wall), the volume of the PTV and the body mass index were significant prognostic factors for the maximum acute skin reaction. On multivariate analysis, the fractionation regimen (p skin reaction compared to CF.

  20. Predictors of Acute Gastrointestinal Toxicity During Pelvic Chemoradiotherapy in Patients With Rectal Cancer

    Science.gov (United States)

    Yang, T. Jonathan; Oh, Jung Hun; Son, Christina H.; Apte, Aditya; Deasy, Joseph O.; Wu, Abraham

    2013-01-01

    ABSTRACT BACKGROUND: This study was conducted to identify the factors associated with acute gastrointestinal (GI) toxicity during pelvic chemoradiotherapy (PCRT) in patients with rectal cancer. METHODS: We analyzed 177 patients with rectal cancer treated from 2007 through 2010. Clinical information, including weekly diarrhea and proctitis toxicity grade during PCRT, was recorded. GI structures including bowel and anal canal were contoured. The associations between toxicity and clinical and dosimetric predictors were tested. RESULTS: The median age was 60; 76 patients were women; 98 were treated with intensity-modulated radiotherapy (IMRT) and 79 with 3D conformal RT (3DCRT). A higher rate of grade 2+ diarrhea was observed in the women, starting at week 4 (24% women vs. 11% men, P = .01; week 5: 33% vs. 12%, P = .002), as well as in all the patients treated with 3DCRT (22% vs. 12% IMRT, P = .03; week 5: 32% vs. 11%, P = .001). On multivariate analysis, the normal tissue complication probability (NTCP) model including bowel V45 (bowel volume receiving ≥45 Gy) showed that being female, and use of 3DCRT, was most predictive of grade 2+ diarrhea (area under the curve [AUC] = 0.76; RS = 0.35; P < .001). A higher rate of grade 2+ proctitis was seen in patients <60 years of age starting at week 3 (21% vs. 9%, P = .02; week 4: 35% vs. 16%, P = .003). The NTCP model including anal canal V15 and younger age was most predictive of grade 2+ proctitis (AUC = 0.67; RS = 0.25; P < .001). CONCLUSIONS: Women and all patients who were treated with 3DCRT had higher rates of grade 2+ diarrhea, and the younger patients had a higher rate of grade 2+ proctitis during PCRT. The use of more stringent dosimetric constraints in higher risk patients is a strategy for minimizing toxicity. PMID:24312686

  1. Mutational analysis of NOTCH1, 2, 3 and 4 genes in common solid cancers and acute leukemias.

    Science.gov (United States)

    Lee, Sung Hak; Jeong, Eun Goo; Yoo, Nam Jin; Lee, Sug Hyung

    2007-12-01

    NOTCH proteins (NOTCH1, NOTCH2, NOTCH3 and NOTCH4) play crucial roles in embryonic development. Also, mounting evidence indicates that NOTCH contributes to the pathogenesis of hematopoietic and solid malignancies. Recent studies reported a high incidence of gain-of-function mutations of the NOTCH1 gene in T-cell acute lymphoblastic leukemias (ALL). To see whether NOTCH1 mutation occurs in other malignancies, we analyzed NOTCH1 for the detection of somatic mutations in 334 malignancies, including 48 lung, 48 breast, 48 colorectal and 48 gastric carcinomas, and 142 acute leukemias (105 acute myelogenous leukemias, 32 B-ALLs and 4 T-ALLs) by single-strand conformation polymorphism assay. Also, to see whether other NOTCH genes harbor somatic mutations, we analyzed NOTCH2, NOTCH3 and NOTCH4 genes in the same tissue samples. Overall, we detected three NOTCH mutations in the cancers, which consisted of one NOTCH1 mutation in the T-ALLs (25.0%), one NOTCH2 mutation in the breast carcinomas (2.1%), and one NOTCH3 mutation in the colorectal carcinomas (2.0%). There was no NOTCH mutation in other malignancies analyzed. Our data indicate that NOTCH1 is mutated in T-ALL, but not in other common human cancers, and that NOTCH2, NOTCH3 and NOTH4 genes are rarely mutated in common human cancers. Despite the importance of NOTCH activation in many types of human cancers, mutation of NOTCH genes, except for NOTCH1 mutation in T-ALL, may not play an important role in the tumorigenesis of common cancers.

  2. A case of lung cancer associated with acute respiratory distress syndrome after thoracic radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Enoki, Masafumi; Tojima, Hirokazu [Tokyo Rosai Hospital (Japan)

    1996-12-01

    A 73-year-old man presented with dyspnea, cough, fever, appetite loss and stridor due to bronchial stenosis. Fiber-optic bronchoscopy revealed an endobronchial lesion in the right main bronchus and biopsy specimens showed poorly differentiated squamous cell carcinoma. The clinical stage of lung cancer was IIIB (T4N2M0). The patient received 60 Gy in 30 fractions over 43 days to a field including the right hilum and mediastinum. The tumor decreased in size and stenosis of the bronchus disappeared. A week after completion of radiation the patient began to have high grade fever and dyspnea, and progressive hypoxia developed. A chest radiograph showed diffuse bilateral interstitial infiltrates. Despite mechanical ventilation with PEEP and the administration of steroids, he died of respiratory failure three weeks after completion of radiation. Necropsy specimens obtained from the left lung revealed massive deposition of fibrin in the alveolar airspaces associated with hyaline membranes and hyperplasia of type II cells indicating diffuse alveolar damage. The patient had mild pulmonary fibrosis on a CT scan taken before the start of radiotherapy. We conclude that care should be taken if the case has pulmonary fibrosis because radiation therapy can precipitate severe radiation pneumonitis and acute respiratory distress syndrome in such cases. (author)

  3. Cancer

    Science.gov (United States)

    ... cancer Non-Hodgkin lymphoma Ovarian cancer Pancreatic cancer Testicular cancer Thyroid cancer Uterine cancer Symptoms Symptoms of cancer ... tumor Obesity Pancreatic cancer Prostate cancer Stomach cancer Testicular cancer Throat or larynx cancer Thyroid cancer Patient Instructions ...

  4. Effect of Exposure to Portland Cement Dust on the Periodontal Status and on the Outcome of Non-Surgical Periodontal Therapy

    Science.gov (United States)

    Abdelhamid, Alaa

    2016-01-01

    Background Cement dust contains heavy metals like nickel, cobalt, lead and chromium, pollutants hazardous to the biotic environment, with adverse impact for vegetation, human and animal health and ecosystems. Objective To investigate if long term exposure to cement dust can affect the periodontal health and affect the outcome of non-surgical periodontal therapy. Methods A total of sixty subjects were included in this study. Forty patients with chronic periodontitis were grouped into; Group I comprised of 20 patients with chronic periodontitis working in the Portland Cement Company and Group II comprised of 20 patients with chronic periodontitis who does not work in cement factories nor live near any of them. Twenty healthy subjects were included in this study as healthy control group (Group III). Clinical parameters including gingival index (GI), plaque index (PI), pocket depth (PD) and clinical attachment loss (CLA) were scored for all patients before and after periodontal therapy. All patients received non-surgical periodontal therapy together with strict oral hygiene program for one month. Gingival crevicular fluid (GCF) samples were collected from both groups at baseline and one month after periodontal therapy. Real time PCR (RT-PCR) was used to analyze the GCF samples for detection and assessment of the levels of IL-1β and TNFα. Results The two studied groups responded well to non-surgical periodontal treatment and there was no significant difference between GI and GII (P>0.05). The levels of TNFα was higher in GI than in GII before and after periodontal therapy (P0.05), but represented with a highly significant difference between G1 and GII after periodontal therapy (Psurgical periodontal treatment but it affects the levels of the pro-inflammatory mediators leading to more periodontal tissue destruction. PMID:27610057

  5. Advance of non-surgical treatment for stress urinary incontinence%压力性尿失禁的非手术治疗进展

    Institute of Scientific and Technical Information of China (English)

    吕坚伟

    2016-01-01

    压力性尿失禁严重影响中老年女性患者的生活质量,容易导致心身疾病。随着我国国民经济的快速增长及人民生活水平的迅速提高,压力性尿失禁所带来的诸多问题正逐渐受到重视。压力性尿失禁的治疗可分为非手术治疗与手术治疗两种,非手术治疗是首选治疗,包括生活方式干预、盆底肌锻炼、药物治疗及中医治疗。本文复习压力性尿失禁非手术治疗的研究进展。%Stress urinary incontinence seriously affects the quality of life of senile female patients, and is easy to cause psychosomatic disease. With the rapid growth of national economy and the rapid improvement of people’s living standard, attentions have been gradually paid to many problems caused by the stress urinary incontinence. There are two kinds of therapy in the treatment of stress urinary incontinence, that is non-surgical treatment and surgical treatment. The non-surgical treatment is the preferred therapy which involves life style intervention, pelvic lfoor muscle exercise, drug therapy and Chinese medicine treatment. This paper reviews the research progress of non-surgical treatment for stress urinary incontinence.

  6. Association of susceptible genotypes to periodontal disease with the clinical outcome and tooth survival after non-surgical periodontal therapy: A systematic review and meta-analysis

    Science.gov (United States)

    Doufexi, Aikaterini-Ellisavet; Kalogirou, Fotini

    2016-01-01

    Background The real clinical utility of genetic testing is the prognostic value of genetic factors in the clinical outcome of periodontal treatment and the tooth survival. A meta-analysis was undertaken to estimate the effect of a susceptible genotype to periodontitis on the clinical outcomes of non-surgical periodontal therapy and the tooth survival. Material and Methods A systematic search of MEDLINE-Pubmed, Cochrane Library and Scopus was performed. Additionally, a hand search was done in three journals. No specific language restriction was applied. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. Results Initial screening of electronic databases resulted in 283 articles. Ten studies met the inclusion criteria, nine of them examined the clinical outcome, while the other one investigated the tooth survival in susceptible individuals after non-surgical periodontal therapy. Eight of included studies were selected for the meta-analysis. IL-1 positive genotypes increase the risk of tooth loss, while no association found between the bleeding on probing (BOP), clinical attachment loss (CAL) and plaque index (PI) with the genotype status. Probing pocket depth (PPD) reduction in the first three months and in long-term results found to have a significant association with the genotype. Conclusions There is no difference in the clinical measurements after non-surgical periodontal treatment, apart from PPD. More publications are needed to identify a cause-effect relationship. Key words:Periodontal disease, periodontitis, periodontal therapy, clinical outcome, tooth loss, susceptibility, polymorphism, genotype, meta-analysis, systematic review. PMID:26595831

  7. Acute and late toxicity in prostate cancer patients treated by dose escalated intensity modulated radiation therapy and organ tracking

    Directory of Open Access Journals (Sweden)

    Behrensmeier Frank

    2008-10-01

    Full Text Available Abstract Background To report acute and late toxicity in prostate cancer patients treated by dose escalated intensity-modulated radiation therapy (IMRT and organ tracking. Methods From 06/2004 to 12/2005 39 men were treated by 80 Gy IMRT along with organ tracking. Median age was 69 years, risk of recurrence was low 18%, intermediate 21% and high in 61% patients. Hormone therapy (HT was received by 74% of patients. Toxicity was scored according to the CTC scale version 3.0. Median follow-up (FU was 29 months. Results Acute and maximal late grade 2 gastrointestinal (GI toxicity was 3% and 8%, late grade 2 GI toxicity dropped to 0% at the end of FU. No acute or late grade 3 GI toxicity was observed. Grade 2 and 3 pre-treatment genitourinary (GU morbidity (PGUM was 20% and 5%. Acute and maximal late grade 2 GU toxicity was 56% and 28% and late grade 2 GU toxicity decreased to 15% of patients at the end of FU. Acute and maximal late grade 3 GU toxicity was 8% and 3%, respectively. Decreased late ≥ grade 2 GU toxicity free survival was associated with higher age (P = .025, absence of HT (P = .016 and higher PGUM (P Discussion GI toxicity rates after IMRT and organ tracking are excellent, GU toxicity rates are strongly related to PGUM.

  8. Characteristics and risk factors of major and clinically relevant non-major bleeding in cancer patients receiving anticoagulant treatment for acute venous thromboembolism-the CATCH study

    NARCIS (Netherlands)

    Kamphuisen, P.W.; Lee, A.Y.Y.; Meyer, Guy; Bauersachs, R.; Janas, M.S.; Jarner, M.F.; Khorana, A.A.

    2015-01-01

    Background: Cancer patients with acute venous thromboembolism (VTE) receiving anticoagulant treatment have a substantial risk of bleeding complications. Aims: To assess the rate, site and risk factors of clinically relevant bleeding (CRB; major or clinically relevant non-major bleeding) in cancer pa

  9. [Case of acute exacerbation of neuropathic cancer pain rapidly relieved by simultaneous oral intake of immediate release oxycodone and pregabalin].

    Science.gov (United States)

    Baba, Mika; Gomwo, Ikuo

    2012-10-01

    Cancer pain consists of continuous pain lasting almost all day and transient exacerbation of pain called breakthrough pain. Breakthrough pain is classified as somatic pain and visceral pain, neuropathic pain according to the character of pain. Although the immediate release opioid is used as the first treatment of choice to breakthrough pain, the effect is not enough when it shows the character of neuropathic pain. Pregabalin has become the first medicine for the treatment of neuropathic pain, and it sometimes reveals prompt analgesic effect based on its pharmacological profile. It has also been reported that pregabalin used with oxycodine reveals analgesic effect with smaller dosage than pregabalin alone. We experienced a young patient with lung cancer suffering from sudden exacerbation of symptomatic sciatica, whose pain was markedly reduced within 30 minutes by taking immediate release oxycodone 5 mg and pregabalin 75 mg simultaneously. Conclusions : Pregabalin with immediate release oxycodone simultaneously may be able to improve acute exacerbation of neuropathic cancer pain rapidly.

  10. Correlation between anthropometric parameters and acute skin toxicity in breast cancer radiotherapy patients: a pilot assessment study.

    Science.gov (United States)

    Méry, Benoîte; Vallard, Alexis; Trone, Jane-Chloé; Pacaut, Cécile; Guy, Jean-Baptiste; Espenel, Sophie; Langrand-Escure, Julien; Ollier, Edouard; Wang, Guoping; Diao, Peng; Bigot, Lise; Mengue Ndong, Sylvie; Bosacki, Claire; Ben Mrad, Majed; Magné, Nicolas

    2015-01-01

    The objective of the present study was to identify acute skin toxicity risk factors linked to the anthropometric characteristics of patients with breast cancer treated with radiation therapy. Consecutive patients with breast cancer were enrolled after breast-conserving surgery and before radiotherapy course. Acute skin toxicity was assessed weekly during the 7 weeks of radiotherapy with the International Classification from National Cancer Institute. Grade 2 defined acute skin toxicity. Patient characteristics and anthropometric measurements were collected. 54 patients were enrolled in 2013. Eight patients (14.8%) had grade ≥2 toxicity. The average weight and chest size were 65.5 kg and 93.6 cm, respectively. Bra cup size is significantly associated with a risk of grade 2 dermatitis [odds ratio (OR) 3.46, 95% confidence interval (CI) (1.29-11.92), p = 0.02]. Anthropometric breast fat mass measurements, such as thickness of left [OR 2.72, 95% CI (1.08-8.26), p = 0.04] and right [OR 2.45, 95% CI (0.99-7.27), p = 0.05] axillary fat, are correlated with an increased risk. Distance between the pectoral muscle and nipple is a reproducible measurement of breast size and is associated with acute skin toxicity with significant tendency (OR = 2.21, 95% CI (0.97-5.98), p = 0.07). Breast size and its different anthropometric measurements (thickness of left and right axillary fat, nipple-to-pectoral muscle distance) are correlated with the risk of skin toxicity. The present article analyses several characteristics and anthropomorphic measurements of breast in order to assess breast size. A standardized and reproducible protocol to measure breast volume is described.

  11. Comparative evaluation of plasma ROM levels in chronic periodontitis patients before and after non-surgical and surgical periodontal therapy: A clinical trial

    Science.gov (United States)

    Chaudhary, Sohini; Gowda, Triveni M.; Mehta, Dhoom S.; Kumar, Tarun A. B.

    2014-01-01

    Objective: Chronic periodontitis (CP) is associated with increased levels of blood reactive oxygen species (ROS). So, treatment of CP may lead to decrease in blood ROS. However, not much literature is available comparing the effect of surgical and non-surgical periodontal treatment on blood ROS levels. Reactive oxygen metabolites (ROMs) are a useful measure of blood ROS. The aim of this study was to investigate the effect of periodontal treatment on plasma ROM levels in CP patients. Materials and Methods: Thirty CP patients and 15 controls were monitored. Plasma samples were collected at baseline and the clinical parameters were recorded. The CP patients were randomly divided into two groups: Scaling and root planing (Group II) and periodontal flap surgery (Group III). Both groups were re-evaluated 1 and 2 months after therapy. Clinical parameters were reviewed, plasma samples collected, and ROM levels were determined using a spectrophotometric technique. Results: At baseline, the ROM levels for Group II and Group III were 519.8 ± 62.4 and 513.4 ± 74.7 CARR U, respectively, which were higher than Group I value (282.9 ± 23.9, P surgical periodontal treatment was more effective in lowering the plasma ROM levels than when non-surgical periodontal treatment was performed alone and, therefore, may be more beneficial in reducing systemic oxidative stress. PMID:24872618

  12. 腰椎间盘突出症的非手术治疗%Non-surgical Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    倪家骧

    2012-01-01

    腰椎间盘突出症是一种部分自限性疾病,随着放射介入技术的推广,微创介入治疗技术近年来得到广泛应用,显著降低了腰椎间盘突出症的手术治疗率,非手术治疗成为本病的基本治疗方法.本文主要论述腰椎间盘突出症的非手术治疗方法,为临床提供参考.%Lumbar disc herniation is a partly self - limited disease, and with the development of radiology intervention-al techniques, minimally invasive treatment techniques have been widely applied in recent years, which significantly reduced the rate of surgical treatment for lumbar disc herniation, turning non - surgical treatment into a basic therapy for the disease. This paper mainly reviewed non - surgical therapies of lumbar disc herniation in order to provide references for clinic.

  13. Frequency of abnormal findings in lumbar MRI in patients With non traumatic and non surgical low back pain referred to Imam-Khomeini Hospital

    Directory of Open Access Journals (Sweden)

    Leila Aghaghazvini

    2014-08-01

    Full Text Available Background: This study was conducted to determine the frequency of abnormal discal findings in lumbar MRI in patients with non traumatic non surgical low back pain who referred to Imam-Khomeini hospital Materials and methods: This study was conducted as a descriptive – analytical cross-sectional prospective survey among 280 consecutive patients who referred to Imam-Khomeini hospital in 2008 -2009. The data were collected by check list and analysis was done by SPSS 10 Results: The mean age of the patients was 40.98. 56.1% were female Abnormal MRI was seen in 83.2% and 72.9% had disc involvement including 40.7% central, 21.1% right and 36.3% left involvements, 25.75% had bulging, 62.85% protrusion, 11.05% extrusion and finally 0.35% had sequestration. Conclusion: It may be concluded that disc protrusion and bulging are the most common findings in MRI and according to excellent ability of MRI in diagnosis of herniation, MRI is recommended in patients with non surgical non traumatic low back pain.

  14. A prospective comparison of acute intestinal toxicity following whole pelvic versus small field intensity-modulated radiotherapy for prostate cancer

    Science.gov (United States)

    Kim, Yeon Joo; Park, Jin-hong; Yun, In-Ha; Kim, Young Seok

    2016-01-01

    Purpose To compare the acute intestinal toxicity of whole pelvic (WP) and small field (SF) intensity-modulated radiotherapy (IMRT) for prostate cancer using dosimetric and metabolic parameters as well as clinical findings. Methods Patients who received IMRT in either a definitive or postoperative setting were prospectively enrolled. Target volume and organs at risk including intestinal cavity (IC) were delineated in every patient by a single physician. The IC volume that received a 10–50 Gy dose at 5-Gy intervals (V10–V50) and the percentage of irradiated volume as a fraction of total IC volume were calculated. Plasma citrulline levels, as an objective biological marker, were checked at three time points: baseline and after exposure to 30 Gy and 60 Gy. Results Of the 41 patients, only six experienced grade 1 acute intestinal toxicity. Although all dose–volume parameters were significantly worse following WP than SF IMRT, there was no statistically significant relationship between these dosimetric parameters and clinical symptoms. Plasma citrulline levels did not show a serial decrease by radiotherapy volume difference (WP versus SF) and were not relevant to the irradiated doses. Conclusion Given that WP had comparable acute intestinal toxicities to those associated with SF, WP IMRT appears to be a feasible approach for the treatment of prostate cancer despite dosimetric disadvantages. PMID:27022287

  15. Acute Esophagus Toxicity in Lung Cancer Patients After Intensity Modulated Radiation Therapy and Concurrent Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kwint, Margriet [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Uyterlinde, Wilma [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Nijkamp, Jasper; Chen, Chun; Bois, Josien de; Sonke, Jan-Jakob [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Heuvel, Michel van den [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Knegjens, Joost; Herk, Marcel van [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Belderbos, Jose, E-mail: j.belderbos@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2012-10-01

    Purpose: The purpose of this study was to investigate the dose-effect relation between acute esophageal toxicity (AET) and the dose-volume parameters of the esophagus after intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with non-small cell lung cancer (NSCLC). Patients and Methods: One hundred thirty-nine patients with inoperable NSCLC treated with IMRT and concurrent chemotherapy were prospectively analyzed. The fractionation scheme was 66 Gy in 24 fractions. All patients received concurrently a daily dose of cisplatin (6 mg/m Superscript-Two ). Maximum AET was scored according to Common Toxicity Criteria 3.0. Dose-volume parameters V5 to V70, D{sub mean} and D{sub max} of the esophagus were calculated. A logistic regression analysis was performed to analyze the dose-effect relation between these parameters and grade {>=}2 and grade {>=}3 AET. The outcome was compared with the clinically used esophagus V35 prediction model for grade {>=}2 after radical 3-dimensional conformal radiation therapy (3DCRT) treatment. Results: In our patient group, 9% did not experience AET, and 31% experienced grade 1 AET, 38% grade 2 AET, and 22% grade 3 AET. The incidence of grade 2 and grade 3 AET was not different from that in patients treated with CCRT using 3DCRT. The V50 turned out to be the most significant dosimetric predictor for grade {>=}3 AET (P=.012). The derived V50 model was shown to predict grade {>=}2 AET significantly better than the clinical V35 model (P<.001). Conclusions: For NSCLC patients treated with IMRT and concurrent chemotherapy, the V50 was identified as most accurate predictor of grade {>=}3 AET. There was no difference in the incidence of grade {>=}2 AET between 3DCRT and IMRT in patients treated with concurrent chemoradiation therapy.

  16. Regulation of cancer stem cell properties by CD9 in human B-acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Hiroto [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Wilson Xu, C. [Drug Development Program, Nevada Cancer Institute, Las Vegas, NV (United States); Naito, Motohiko [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Nishida, Hiroko [Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo (Japan); Okamoto, Toshihiro; Ghani, Farhana Ishrat; Iwata, Satoshi [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Inukai, Takeshi; Sugita, Kanji [Department of Pediatrics, School of Medicine, University of Yamanashi, Yamanashi (Japan); Morimoto, Chikao, E-mail: morimoto@ims.u-tokyo.ac.jp [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Drug Development Program, Nevada Cancer Institute, Las Vegas, NV (United States)

    2011-05-27

    Highlights: {yields} We performed more detailed analysis of CD9 function for CSC properties in B-ALL. {yields} Leukemogenic fusion/Src family proteins were markedly regulated in the CD9{sup +} cells. {yields} Proliferation of B-ALL cells was inhibited by anti-CD9 monoclonal antibody. {yields} Knockdown of CD9 by RNAi remarkably reduced the leukemogenic potential. {yields} CD9-knockdown affected the expression and phosphorylation of Src family and USP22. -- Abstract: Although the prognosis of acute lymphoblastic leukemia (ALL) has improved considerably in recent years, some of the cases still exhibit therapy-resistant. We have previously reported that CD9 was expressed heterogeneously in B-ALL cell lines and CD9{sup +} cells exhibited an asymmetric cell division with greater tumorigenic potential than CD9{sup -} cells. CD9{sup +} cells were also serially transplantable in immunodeficient mice, indicating that CD9{sup +} cell possess self-renewal capacity. In the current study, we performed more detailed analysis of CD9 function for the cancer stem cell (CSC) properties. In patient sample, CD9 was expressed in the most cases of B-ALL cells with significant correlation of CD34-expression. Gene expression analysis revealed that leukemogenic fusion proteins and Src family proteins were significantly regulated in the CD9{sup +} population. Moreover, CD9{sup +} cells exhibited drug-resistance, but proliferation of bulk cells was inhibited by anti-CD9 monoclonal antibody. Knockdown of CD9 remarkably reduced the leukemogenic potential. Furthermore, gene ablation of CD9 affected the expression and tyrosine-phosphorylation of Src family proteins and reduced the expression of histone-deubiquitinase USP22. Taken together, our results suggest that CD9 links to several signaling pathways and epigenetic modification for regulating the CSC properties of B-ALL.

  17. Predictors of Severe Acute and Late Toxicities in Patients With Localized Head-and-Neck Cancer Treated With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Francois, E-mail: francois.meyer@chuq.qc.ca [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Fortin, Andre; Wang, Chang Shu [Radiation Therapy Department, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Liu, Geoffrey [Applied Molecular Oncology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto (Canada); Bairati, Isabelle [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada)

    2012-03-15

    Purpose: Radiation therapy (RT) causes acute and late toxicities that affect various organs and functions. In a large cohort of patients treated with RT for localized head and neck cancer (HNC), we prospectively assessed the occurrence of RT-induced acute and late toxicities and identified characteristics that predicted these toxicities. Methods and Materials: We conducted a randomized trial among 540 patients treated with RT for localized HNC to assess whether vitamin E supplementation could improve disease outcomes. Adverse effects of RT were assessed using the Radiation Therapy Oncology Group Acute Radiation Morbidity Criteria during RT and one month after RT, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme at six and 12 months after RT. The most severe adverse effect among the organs/tissues was selected as an overall measure of either acute or late toxicity. Grade 3 and 4 toxicities were considered as severe. Stepwise multivariate logistic regression models were used to identify all independent predictors (p < 0.05) of acute or late toxicity and to estimate odds ratios (OR) for severe toxicity with their 95% confidence intervals (CI). Results: Grade 3 or 4 toxicity was observed in 23% and 4% of patients, respectively, for acute and late toxicity. Four independent predictors of severe acute toxicity were identified: sex (female vs. male: OR = 1.72, 95% confidence interval [CI]: 1.06-2.80), Karnofsky Performance Status (OR = 0.67 for a 10-point increment, 95% CI: 0.52-0.88), body mass index (above 25 vs. below: OR = 1.88, 95% CI: 1.22-2.90), TNM stage (Stage II vs. I: OR = 1.91, 95% CI: 1.25-2.92). Two independent predictors were found for severe late toxicity: female sex (OR = 3.96, 95% CI: 1.41-11.08) and weight loss during RT (OR = 1.26 for a 1 kg increment, 95% CI: 1.12-1.41). Conclusions: Knowledge of these predictors easily collected in a clinical setting could help

  18. The Study on Acute.Subacute Toxicity and Anti-cancer Effect of H Herbal-acupuncture

    Directory of Open Access Journals (Sweden)

    Tae-Hui Kim

    2002-12-01

    Full Text Available Objectives : The purpose of this study is to investigate Acute and Subacute Toxicity, and Anti-cancer Effect of H Herbal-acupuncture on mice and rats. Methods : Balb/c mice were injected intraperitoneally with H Herbal-acupuncture for LD50 and acute toxicity test. Sprague-Dawley rats were experimented in the same way for subacute toxicity test. H Herbal-acupuncture was injected into abdomen of mice having S-180 cancer cell line. Result : 1. During the test, LD50 could not be counted since there was no expired subjects. 2. In an acute toxicity test, the loss of motility and reflex action was observed, but weight increased in the treatment group, compared with those in the normal group (P<0.05. 3. In an acute toxicity test of serum biochemical values of mice, glucose increased in the treatment group II while total cholesterol was increased in the all treatment groups (P<0.05. 4. In a subacute toxicity test, a little loss of motility and reflex action was observed in the treatment group. Weight of mice in the treatment group decreased on the 28th day. 5. In a subacute toxicity test, liver weight was decreased but lung weight of mice increased in the all treatment groups (P<0.05. 6. As a result of measuring Complete Blood Count test (CBC of rat, HCT was decreased in treatments even though it was not significant, compared with the normal group (P<0.05. 7. In a serum biochemical value test of subacute toxicity, total protein and albumin decreased in the all treatment groups. Creatinine, glucose, GOT increased in the treatment group I compared with the control group. Alkaline phos-phatase decreased in treatment II group, compared with the control group (P<0.05. 8. Median survival time that was measured in the rats treated with sarcoma-180 cancer cell Median decreased in the treatment group, compared with the control group (P<0.05. 9. Natural killer cell activity showed significant reduction at 100:1 and 10:1 E/T ratio while it increased at 50:1 E

  19. Impact of tumour bed boost integration on acute and late toxicity in patients with breast cancer: A systematic review.

    Science.gov (United States)

    Hamilton, Daniel George; Bale, Rebecca; Jones, Claire; Fitzgerald, Emma; Khor, Richard; Knight, Kellie; Wasiak, Jason

    2016-06-01

    The purpose of this systematic review was to summarise the evidence from studies investigating the integration of tumour bed boosts into whole breast irradiation for patients with Stage 0-III breast cancer, with a focus on its impact on acute and late toxicities. A comprehensive systematic electronic search through the Ovid MEDLINE, EMBASE and PubMed databases from January 2000 to January 2015 was conducted. Studies were considered eligible if they investigated the efficacy of hypo- or normofractionated whole breast irradiation with the inclusion of a daily concurrent boost. The primary outcomes of interest were the degree of observed acute and late toxicity following radiotherapy treatment. Methodological quality assessment was performed on all included studies using either the Newcastle-Ottawa Scale or a previously published investigator-derived quality instrument. The search identified 35 articles, of which 17 satisfied our eligibility criteria. Thirteen and eleven studies reported on acute and late toxicities respectively. Grade 3 acute skin toxicity ranged from 1 to 7% whilst moderate to severe fibrosis and telangiectasia were both limited to 9%. Reported toxicity profiles were comparable to historical data at similar time-points. Studies investigating the delivery of concurrent boosts with whole breast radiotherapy courses report safe short to medium-term toxicity profiles and cosmesis rates. Whilst the quality of evidence and length of follow-up supporting these findings is low, sufficient evidence has been generated to consider concurrent boost techniques as an alternative to conventional sequential techniques.

  20. [Endoscopic percutaneous gastrostomy. A non-surgical method of enteral alimentation in ORL patients unable to feed orally].

    Science.gov (United States)

    Girodet, J; Vedrenne, J B; Salmon, R J; Rodriguez, J; Esteve, M; Guillaume, A; Brugere, J

    1988-01-01

    Since surgical gastrostomy is not a risk-free operation in debilitated patients, a method of endoscopic percutaneous gastrostomy (EPG) is proposed. A thread is passed percutaneously into the gastric cavity and brought to the exterior through the mouth during fibroscopy. This thread allows removal of a gastrostomy tube by simple traction. Used in 18 patients with ENT cancer the EPG was simple to perform, postoperative complications being minor in 3 cases and serious in one patient. In the absence of any obstacle in the pharyngeal channel preventing the passage of a fibroscope, EPG is a simple procedure and is therefore an alternative to surgical gastrostomy.

  1. Metastasis-Induced Acute Pancreatitis Successfully Treated with Chemotherapy and Radiotherapy in a Patient with Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kerem Okutur

    2015-01-01

    Full Text Available Although involvement of pancreas is a common finding in small cell lung cancer (SCLC, metastasis-induced acute pancreatitis (MIAP is very rare. A 50-year-old female with SCLC who had limited disease and achieved full response after treatment presented with acute pancreatitis during her follow-up. The radiologic studies revealed a small area causing obliteration of the pancreatic duct without mass in the pancreatic neck, and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA confirmed the metastasis of SCLC. The patient was treated successfully with systemic chemotherapy and radiotherapy delivered to pancreatic field. In SCLC, cases of MIAP can be encountered with conventional computed tomography with no mass image, and positron emission tomography and EUS-FNA can be useful for diagnosis of such cases. Aggressive systemic and local treatment can prolong survival, especially in patients with good performance status.

  2. Metastasis-Induced Acute Pancreatitis Successfully Treated with Chemotherapy and Radiotherapy in a Patient with Small Cell Lung Cancer

    Science.gov (United States)

    Okutur, Kerem; Bozkurt, Mustafa; Korkmaz, Taner; Karaaslan, Ercan; Guner, Levent; Goksel, Suha; Demir, Gokhan

    2015-01-01

    Although involvement of pancreas is a common finding in small cell lung cancer (SCLC), metastasis-induced acute pancreatitis (MIAP) is very rare. A 50-year-old female with SCLC who had limited disease and achieved full response after treatment presented with acute pancreatitis during her follow-up. The radiologic studies revealed a small area causing obliteration of the pancreatic duct without mass in the pancreatic neck, and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) confirmed the metastasis of SCLC. The patient was treated successfully with systemic chemotherapy and radiotherapy delivered to pancreatic field. In SCLC, cases of MIAP can be encountered with conventional computed tomography with no mass image, and positron emission tomography and EUS-FNA can be useful for diagnosis of such cases. Aggressive systemic and local treatment can prolong survival, especially in patients with good performance status. PMID:26075124

  3. Sepsis-related acute respiratory distress syndrome in children with cancer: the respiratory dynamics of a devastating condition

    Science.gov (United States)

    Arduini, Rodrigo Genaro; de Araujo, Orlei Ribeiro; da Silva, Dafne Cardoso Bourguignon; Senerchia, Andreza Almeida; Petrilli, Antonio Sergio

    2016-01-01

    Objective To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome. Methods This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint. Results There were 17 deaths within 28 days of acute respiratory distress syndrome onset and another 7 between 29 - 60 days. Only 5 patients survived for more than 60 days. Nine (31%) patients died as a direct consequence of refractory hypoxemia, and the others died of multiple organ failure and catecholamine-refractory shock. In 66% of the measurements, the tidal volume required to obtain oxygen saturation equal to or above 90% was greater than 7mL/kg. The estimated means of dynamic compliance were low and were similar for survivors and non-survivors but with a negative slope between the first and final measurements, accompanied by a negative slope of the tidal volume for non-survivors. Non-survivors were significantly more hypoxemic, with PaO2/FiO2 ratios showing lower estimated means and a negative slope along the four measurements. Peak, expiratory and mean airway pressures showed positive slopes in the non-survivors, who also had more metabolic acidosis. Conclusions In most of our children with cancer, sepsis and acute respiratory distress syndrome progressed with deteriorating ventilation indexes and escalating organic dysfunction, making this triad nearly fatal in children. PMID:28099641

  4. A prospective comparison of acute intestinal toxicity following whole pelvic versus small field intensity-modulated radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Kim YJ

    2016-03-01

    Full Text Available Yeon Joo Kim, Jin-hong Park, In-Ha Yun, Young Seok KimDepartment of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of KoreaPurpose: To compare the acute intestinal toxicity of whole pelvic (WP and small field (SF intensity-modulated radiotherapy (IMRT for prostate cancer using dosimetric and metabolic parameters as well as clinical findings.Methods: Patients who received IMRT in either a definitive or postoperative setting were prospectively enrolled. Target volume and organs at risk including intestinal cavity (IC were delineated in every patient by a single physician. The IC volume that received a 10–50 Gy dose at 5-Gy intervals (V10–V50 and the percentage of irradiated volume as a fraction of total IC volume were calculated. Plasma citrulline levels, as an objective biological marker, were checked at three time points: baseline and after exposure to 30 Gy and 60 Gy.Results: Of the 41 patients, only six experienced grade 1 acute intestinal toxicity. Although all dose–volume parameters were significantly worse following WP than SF IMRT, there was no statistically significant relationship between these dosimetric parameters and clinical symptoms. Plasma citrulline levels did not show a serial decrease by radiotherapy volume difference (WP versus SF and were not relevant to the irradiated doses.Conclusion: Given that WP had comparable acute intestinal toxicities to those associated with SF, WP IMRT appears to be a feasible approach for the treatment of prostate cancer despite dosimetric disadvantages.Keywords: prostate cancer, intensity-modulated radiotherapy, intestinal toxicity, citrulline

  5. Prospective Evaluation of Acute Toxicity and Quality of Life After IMRT and Concurrent Chemotherapy for Anal Canal and Perianal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kathy; Cummings, Bernard J.; Lindsay, Patricia; Skliarenko, Julia; Craig, Tim [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Le, Lisa W. [Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Brierley, James; Wong, Rebecca; Dinniwell, Robert; Bayley, Andrew J.; Dawson, Laura A.; Ringash, Jolie [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Krzyzanowska, Monika K.; Moore, Malcolm J.; Chen, Eric X. [Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Easson, Alexandra M. [Department of Surgical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario (Canada); Kassam, Zahra; Cho, Charles [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Kim, John, E-mail: John.Kim@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada)

    2014-11-01

    Purpose: A prospective cohort study was conducted to evaluate toxicity, quality of life (QOL), and clinical outcomes in patients treated with intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for anal and perianal cancer. Methods and Materials: From June 2008 to November 2010, patients with anal or perianal cancer treated with IMRT were eligible. Radiation dose was 27 Gy in 15 fractions to 36 Gy in 20 fractions for elective targets and 45 Gy in 25 fractions to 63 Gy in 35 fractions for gross targets using standardized, institutional guidelines, with no planned treatment breaks. The chemotherapy regimen was 5-fluorouracil and mitomycin C. Toxicity was graded with the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR29 questionnaires. Correlations between dosimetric parameters and both physician-graded toxicities and patient-reported outcomes were evaluated by polyserial correlation. Results: Fifty-eight patients were enrolled. The median follow-up time was 34 months; the median age was 56 years; 52% of patients were female; and 19% were human immunodeficiency virus—positive. Stage I, II, III, and IV disease was found in 9%, 57%, 26%, and 9% of patients, respectively. Twenty-six patients (45%) required a treatment break because of acute toxicity, mainly dermatitis (23/26). Acute grade 3 + toxicities included skin 46%, hematologic 38%, gastrointestinal 9%, and genitourinary 0. The 2-year overall survival (OS), disease-free survival (DFS), colostomy-free survival (CFS), and cumulative locoregional failure (LRF) rates were 90%, 77%, 84%, and 16%, respectively. The global QOL/health status, skin, defecation, and pain scores were significantly worse at the end of treatment than at baseline, but they returned to baseline 3 months after treatment. Social functioning and appetite scores were

  6. Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

    Directory of Open Access Journals (Sweden)

    Rachel Cherian Koshy

    2010-01-01

    Full Text Available Pathological fractures in cancer patient cause severe pain that is difficult to control pharmacologically. Even with good pain relief at rest, breakthrough and incident pain can be unmanageable. Continuous regional nerve blocks have a definite role in controlling such intractable pain. We describe two such cases where severe pain was adequately relieved in the acute phase. Continuous femoral nerve block was used as an efficient, cheap and safe method of pain relief for two of our patients with pathological fracture femur. This method was proved to be quite efficient in decreasing the fracture-related pain and improving the level of well being.

  7. Changes in acute response to radiation after implementation of new national guidelines for head and neck cancer

    DEFF Research Database (Denmark)

    Hansen, C. R.; Bertelsen, Anders; Zukauskaite, R.

    2015-01-01

    for simple glottic tumours. Acute skin and mucosal reactions were scored weekly during RT, and 2 and 8 weeks after (0 none, 1 erythema, 2 dry desquamation/patchy mucositis, 3 wet desquamation/confluent mucositis, 4 ulceration). Use of analgesics was recorded equivalently on a 5-point scale. Clinical......Purpose/Objective: New national guidelines (GL) for radiotherapy (RT) of head and neck cancer (HNC) were implemented at the beginning of 2013. One purpose of the new GL was to nationally standardise the expansion from GTV to high risk CTV (CTV1). This standardisation has resulted in change...

  8. Impact of Consumption of Chicory Leaf Extract in Adjunct with Non-surgical Periodontal Therapy on Serum Antioxidant and Lipid Status in Patients with Periodontal Disease: Preliminary Study

    Directory of Open Access Journals (Sweden)

    Ahmad Zare-Javid

    2016-04-01

    Full Text Available Background and Objectives: Periodontal disease is a chronic disorder with a high prevalence. There are few studies about the role of diet in prevention and treatment of periodontal disease. The aim of this study was to evaluate the effect of consumption of Chicory leaf extract in adjunct with non-surgical periodontal therapies on serum antioxidant and lipid status. Materials and Methods: This study was a double-blind, randomized controlled clinical trial conducted on 40 patients in Sina Hospital of Ahvaz Jundishapur University of Medical Sciences (Iran in 2014. The intervention (n=20 and control groups (n=20 were allocated using blocked randomization. The intervention group received 2 capsules (2 g of Chicory leaf extract daily for 8 weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric indices, 24-hour diet records, total antioxidant capacity, malate di-aldehyde (MDA, uric acid, total cholesterol, triglyceride (TG and HDL-c was measured before and after intervention. Results: The mean level of total antioxidant capacity (1.89 ± 0.49; 1.20 ± 0.25, respectively; P<0.001 and uric acid (7.15±1.98; 4.48±1.34, respectively; P<0.001 increased in the intervention group compared with the control group post intervention. The mean level of MDA decreased in the intervention group compared with the control group post-intervention (3.01±1.15; 3.97±1.19, respectively; P.d<0.001. Cholesterol difference was not significant pre- and post-intervention between the two groups (P=0.35. The mean level of serum triglyceride (TG was significantly lower in the intervention group compared with the control group post intervention (149.50±97.88; 109.35±58.00, respectively; P.d<0.001. The mean level of HDL-c was also significantly lower in the intervention group compared with the control group post treatment (42.25±8.47; 39.80±8.94, respectively; P.d<0.001. Conclusions: It seems that consumption of Chicory

  9. Comparison of healing rate in diabetes-related foot ulcers with low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised trial protocol

    Science.gov (United States)

    2014-01-01

    Background Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and best practice care, including debridement, offloading, dressings, management of infection, modified footwear and management of extrinsic factors. Ulcer debridement is a commonly applied management approach involving removal of non-viable tissue from the ulcer bed. Different methods of debridement have been reported in the literature including autolytic debridement via moist wound healing, mechanical debridement utilising wet to dry dressings, theatre based sharps debridement, biological debridement, non-surgical sharps debridement and newer technology such as low frequency ultrasonic debridement. Methods People with diabetes and a foot ulcer, referred to and treated by the Podiatry Department at Monash Health and who meet the inclusion criteria will be invited to participate in this randomised controlled trial. Participants will be randomly and equally allocated to either the non-surgical sharps debridement (control) or low frequency ultrasonic debridement (intervention) group (n = 322 ulcers/n = 108 participants). Where participants have more than one ulcer, only the participant will be randomised, not the ulcer. An investigator not involved in participant recruitment or assessment will be responsible for preparing the random allocation sequence and envelopes. Each participant will receive weekly treatment for six months including best practice podiatric management. Each ulcer will be measured on a weekly basis by calculating total area in centimetres squared. Measurement will be undertaken by a trained research assistant to ensure outcomes are blinded from the treating podiatrist. Another member of the research team will assess the final primary outcome. Discussion The primary aim of this study is to compare healing rates for diabetes-related foot ulcers

  10. Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition

    Directory of Open Access Journals (Sweden)

    Riccardo Caccialanza

    2015-03-01

    Full Text Available The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA and handgrip strength normalized for skeletal muscle mass (HG/SMM are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20, while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10. The mean adjusted difference and 95% CI were +1.4° (0.5–2.3 (p = 0.005 for PhA and +0.23 (0.20–0.43 (p = 0.033 for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23–0.77; p = 0.0023. PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of Ph

  11. A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts.

    Directory of Open Access Journals (Sweden)

    Tobias T Hägi

    Full Text Available There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a to establish a pocket model enabling mechanical removal of biofilm and b to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL fibroblasts.Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a hand-instrumentation with curettes (CUR, b ultrasonication (US, c subgingival air-polishing using erythritol (EAP and d subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX. The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz, the caused tooth substance-loss (thickness as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD.After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10. The lowest reduction was found after CUR (2 log10. Additionally, substance-loss was the highest when using CUR (128±40 µm in comparison with US (14±12 µm, EAP (6±7 µm and EAP-CHX (11±10 µm. Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts.The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results

  12. The non-surgical therapy of fungal cornea ulcer%真菌性角膜溃疡药物治疗体会

    Institute of Scientific and Technical Information of China (English)

    程昕; 谷树严

    2008-01-01

    Objective To summarize curative effect of the non-surgical operations cured the fungal cornea ulcer.Methods 68 inpatients (68 eyes) of the fungal cornea ulcer were treated with medicine locally and systemically.To analyze the curative effect of medication in fungal cornea ulcer.Result The cure rate of non-surgical operation treatment was 36.76%,the improvement rate is 27.94%,the inefficacious rate is 35.29%,2 cases were relapsed.Conclusions The non-surgical operation treatment is the effective method of cure the fungal cornea ulcer.Broad spectrum antifungal agents,especially the polyene and triazole,is efficacious drug to fungal cornea ulcer.The curative effect is conspicuous to the low-grade cases.The refractory cases should be treated with surgical operation.%目的 评价真菌性角膜溃疡非手术治疗的效果.方法 对68例68眼真菌性角膜溃疡患者,采用局部、全身药物治疗等方法的疗效进行回顾性分析,总结非手术方法治疗真菌性角膜溃疡的效果.结果 68例真菌性角膜溃疡患者经非手术治疗,治愈25只眼,好转19只眼,无效24只眼,复发2只眼.结论 非手术治疗方法是治疗真菌性角膜溃疡的一种有效的方法.广谱抗真菌药物多烯类与三唑类药物局部及全身联合治疗真菌性角膜溃疡有效,尤其对溃疡面积小、浸润浅者效果好,复发率低.对于非手术治疗无效的重症患者需行穿透性角膜移植手术治疗.

  13. Phase angle and handgrip strength are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition.

    Science.gov (United States)

    Caccialanza, Riccardo; Cereda, Emanuele; Klersy, Catherine; Bonardi, Chiara; Cappello, Silvia; Quarleri, Lara; Turri, Annalisa; Montagna, Elisabetta; Iacona, Isabella; Valentino, Francesco; Pedrazzoli, Paolo

    2015-03-11

    The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN) in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA) and handgrip strength normalized for skeletal muscle mass (HG/SMM) are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20), while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10). The mean adjusted difference and 95% CI were +1.4° (0.5-2.3) (p = 0.005) for PhA and +0.23 (0.20-0.43) (p = 0.033) for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23-0.77); p = 0.0023). PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of PhA variations as early

  14. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  15. Acute onset of ovarian dysfunction in young females after start of cancer treatment

    DEFF Research Database (Denmark)

    Mörse, Helena; Elfving, Maria; Lindgren, Anna

    2013-01-01

    Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors.......Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors....

  16. Differences in characteristics and patient-reported questionnaire responses in patients who choose non-surgical versus surgical treatment for severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Have, Mads; Overgaard, Søren; Jensen, Carsten

    Background: Preoperative patient characteristics may influence patient choice for participating in RCT’s. Purpose / Aim of Study: This study aimed to compare patient characteristics, level of pain, physical function and joint space width in patients with severe hip osteoarthritis (OA) who accepted...... or refused to participate in a RCT. Materials and Methods: In this prospective cohort study a total of 137 patients with primary hip OA were asked to choose between surgical or non- surgical treatment. We then compared the characteristics of each patient cohort (demographics, pain level and duration......, analgesic use, exercise habits), the radiographic hip OA state and their responses to Hip dysfunction and Osteoarthritis Outcome Score (HOOS, 0-100) and European Quality of Life Scale (EQ-5D-5L) questionnaires. Findings / Results: The between-group HOOS scores were significantly different in three out...

  17. Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

    DEFF Research Database (Denmark)

    Sander, P; Mouritsen, L; Andersen, J T

    2000-01-01

    Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non-surgical tr......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non....... The minimal care program and interdisciplinary structure in the incontinence clinic offer effective and low cost treatment for urinary incontinence. The open-access, interdisciplinary incontinence clinic model is recommended. Neurourol. Urodynam. 18:9-17, 2000....

  18. Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

    DEFF Research Database (Denmark)

    Sander, P; Mouritsen, L; Andersen, J T

    2000-01-01

    Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non-surgical tr......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non....... The minimal care program and interdisciplinary structure in the incontinence clinic offer effective and low cost treatment for urinary incontinence. The open-access, interdisciplinary incontinence clinic model is recommended. Neurourol. Urodynam. 18:9-17, 2000....

  19. The Kidney and Periodontal Disease (KAPD) study: A pilot randomized controlled trial testing the effect of non-surgical periodontal therapy on chronic kidney disease.

    Science.gov (United States)

    Grubbs, Vanessa; Garcia, Faviola; Jue, Bonnie L; Vittinghoff, Eric; Ryder, Mark; Lovett, David; Carrillo, Jacqueline; Offenbacher, Steven; Ganz, Peter; Bibbins-Domingo, Kirsten; Powe, Neil R

    2017-02-01

    Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects minorities and the poor, despite intense efforts targeting traditional risk factors. Periodontal diseases are common bacterial plaque-induced inflammatory conditions that can respond to treatment and have been implicated as a CKD risk factor. However there is limited evidence that treatment of periodontal disease slows the progression of CKD. We describe the protocol of the Kidney and Periodontal Disease (KAPD) study, a 12-month un-blinded, randomized, controlled pilot trial with two intent-to-treat treatment arms: 1. immediate intensive non-surgical periodontal treatment or 2. rescue treatment with delayed intensive treatment. The goals of this pilot study are to test the feasibility of conducting a larger trial in an ethnically and racially diverse, underserved population (mostly poor and/or low literacy) with both CKD and significant periodontal disease to determine the effect of intensive periodontal treatment on renal and inflammatory biomarkers over a 12-month period. To date, KAPD has identified 634 potentially eligible patients who were invited to in-person screening. Of the 83 (13.1%) of potentially eligible patients who attended in-person screening, 51 (61.4%) were eligible for participation and 46 enrolled in the study. The mean age of participants is 59.2years (range 34 to 73). Twenty of the participants (43.5%) are Black and 22 (47.8%) are Hispanic. Results from the KAPD study will provide needed preliminary evidence of the effectiveness of non-surgical periodontal treatment to slow CKD progression and inform the design future clinical research trials. Copyright © 2016. Published by Elsevier Inc.

  20. Comparative evaluation of plasma ROM levels in chronic periodontitis patients before and after non-surgical and surgical periodontal therapy: A clinical trial

    Directory of Open Access Journals (Sweden)

    Sohini Chaudhary

    2014-01-01

    Full Text Available Objective: Chronic periodontitis (CP is associated with increased levels of blood reactive oxygen species (ROS. So, treatment of CP may lead to decrease in blood ROS. However, not much literature is available comparing the effect of surgical and non-surgical periodontal treatment on blood ROS levels. Reactive oxygen metabolites (ROMs are a useful measure of blood ROS. The aim of this study was to investigate the effect of periodontal treatment on plasma ROM levels in CP patients. Materials and Methods: Thirty CP patients and 15 controls were monitored. Plasma samples were collected at baseline and the clinical parameters were recorded. The CP patients were randomly divided into two groups: Scaling and root planing (Group II and periodontal flap surgery (Group III. Both groups were re-evaluated 1 and 2 months after therapy. Clinical parameters were reviewed, plasma samples collected, and ROM levels were determined using a spectrophotometric technique. Results: At baseline, the ROM levels for Group II and Group III were 519.8 ± 62.4 and 513.4 ± 74.7 CARR U, respectively, which were higher than Group I value (282.9 ± 23.9, P < 0.001. Periodontal treatment in CP patients resulted in improvement of clinical parameters and a highly significant reduction in plasma ROM level (P < 0.001 after 2 months. Also, there was a more significant reduction in plasma ROM levels in Group III as compared to Group II (P < 0.05. Conclusions: In CP patients, surgical periodontal treatment was more effective in lowering the plasma ROM levels than when non-surgical periodontal treatment was performed alone and, therefore, may be more beneficial in reducing systemic oxidative stress.

  1. Effect of Non-Surgical Periodontal Therapy on Interleukin-29 Levels in Gingival Crevicular Fluid of Chronic Periodontitis and Aggressive Periodontitis Patients

    Directory of Open Access Journals (Sweden)

    B. M. Shivaprasad

    2013-01-01

    Full Text Available Recently discovered interleukin 29 (IL-29 has antiviral properties and its production is induced by herpes viruses. This study was aimed at analyzing the effect of non-surgical periodontal treatment on IL-29 levels in gingival crevicular fluid (GCF of chronic and aggressive periodontitis patients. A total of 60 participants were divided into healthy group (group 1; n = 20, chronic periodontitis group (group 2; n = 20, and aggressive periodontitis group (group 3; n = 20. GCF samples collected from each subject at baseline and 6–8 weeks after scaling and root planing were quantified for IL-29 levels using ELISA. The mean IL-29 concentration in GCF was found to be highest in group 3 (92.37 pg/μl. The mean IL-29 level in group 1 and group 2 was 36.88 pg/μl and 69.35 pg/μl respectively. After scaling and root planing, the mean concentration of IL-29 in GCF was increased to 85.99 pg/μl in group 2 and to 114.64 pg/μl in group 3. Results of the present study indicate that antiviral IL-29 level was highest in GCF of aggressive periodontitis patients and least in subjects with healthy periodontium, while that of chronic periodontitis lying in between. After non-surgical periodontal therapy, IL-29 levels increased both in chronic and aggressive periodontitis patients and deserve further investigation as a potential therapeutic agent in treating periodontitis.

  2. Evaluation of periodontal status and effectiveness of non-surgical treatment in patients with type 2 diabetes mellitus in Taiwan for a 1-year period.

    Science.gov (United States)

    Auyeung, Ling; Wang, Pei-Wen; Lin, Rue-Tsuan; Hsieh, Ching-Jung; Lee, Pei-Yu; Zhuang, Rui-Yeh; Chang, Hsueh-Wen

    2012-05-01

    The periodontal status and effects of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and periodontal disease are assessed. One-hundred patients with type 2 diabetes (mean ± SD hemoglobin (Hb)A1c level: 7.3% ± 0.94%) and periodontal disease were recruited for this study. The group with moderate-to-severe periodontal disease included patients with >1 tooth with a probing depth (PD) ≥5 mm and >2 teeth with a clinical attachment loss (AL) ≥ 6mm, and the group with mild periodontal disease included patients with 2 affected with a clinical AL ≥ 6mm. Patients (28 patients in the mild group and 72 patients in the moderate-to-severe group) underwent non-surgical periodontal treatments. We analyzed differences in serum concentrations of metabolic parameters (glycated hemoglobin and low-density lipoprotein), inflammatory parameters (interleukin [IL]-1β and C-reactive protein [CRP]), and periodontal parameters between the two groups before treatment and at 3, 6, 9, and 12 months post-therapy. Seventy-five patients with diabetes (21 patients in the mild group and 54 patients in the moderate-to-severe group) completed the study. Significant differences in the plaque index (PI), gingival index (GI), PD, and clinical AL at examination times were observed in the whole cohort (P periodontal treatment improved and maintained the periodontal health of patients with well-controlled diabetes, but no significant reduction of metabolic parameters was observed over a 1-year period.

  3. The Use of Magnetic Resonance Imaging to Predict the Clinical Outcome of Non-Surgical Treatment for Lumbar Interverterbal Disc Herniation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Kim, Chung Hwan; Shin, Myung Jin; Ryu, Dae Sik; Ahn, Jae Hong; Jung, Seung Moon; Park, Man Soo [GangNeung Asan Hospital, University of Ulsan College of Medicine, GangNeung, Seoul (Korea, Republic of); Song, Jae Seok [University of Kwandong College of Medicine, GangNeung (Korea, Republic of)

    2007-04-15

    We wanted to investigate the relationship between the magnetic resonance (MR) findings and the clinical outcome after treatment with non-surgical transforaminal epidural steroid injections (ESI) for lumbar herniated intervertebral disc (HIVD) patients. Transforaminal ESI were performed in 91 patients (50 males and 41 females, age range: 13 78 yrs) because of lumbosacral HIVD from March 2001 to August 2002. Sixty eight patients whose MRIs and clinical follow-ups were available were included in this study. The medical charts were retrospectively reviewed and the patients were divided into two groups; the successful (responders, n = 41) and unsatisfactory (non-responders, n = 27) outcome groups. A successful outcome required a patient satisfaction score greater than two and a pain reduction score greater than 50%. The MR findings were retrospectively analyzed and compared between the two groups with regard to the type (protrusion, extrusion or sequestration), hydration (the T2 signal intensity), location (central, right/left central, subarticular, foraminal or extraforaminal), and size (volume) of the HIVD, the grade of nerve root compression (grade 1 abutment, 2 displacement and 3 entrapment), and an association with spinal stenosis. There was no significant difference between the responders and nonresponders in terms of the type, hydration and size of the HIVD, or an association with spinal stenosis (p > 0.05). However, the location of the HIVD and the grade of nerve root compression were different between the two groups (p < 0.05). MRI could play an important role in predicting the clinical outcome of non-surgical transforaminal ESI treatment for patients with lumbar HIVD.

  4. The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Annie Kitty George

    2013-01-01

    Full Text Available Background: Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk. Aims: This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP in patients with severe chronic generalized periodontitis. Settings and Design: Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram. Materials and Methods: Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP was measured using latex turbidometric immunoassay. Statistical Analysis: Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS version 10. Results: The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment. Conclusions: In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers.

  5. Acute non-cancer mortality excess after polychlorinated biphenyls and polychlorinated dibenzofurans mixed exposure from contaminated rice oil: Yusho.

    Science.gov (United States)

    Kashima, Saori; Yorifuji, Takashi; Tsuda, Toshihide

    2011-08-15

    In Japan in 1968, rice-oil contaminated by polychlorinated biphenyls and polychlorinated dibenzofurans caused severe food poisoning, termed "Yusho" (oil disease). Several previous studies attempted to evaluate the effects targeting officially-certified Yusho patients. However, these studies have several limitations such as the left-truncated nature of the registry or residual confounding arising from the referent population selection. We thus conducted an area-based standardized mortality ratios (SMRs) study using vital statistics. A severely affected area (Tamanoura area) was adopted as the exposure group, with a reference population from Nagasaki prefecture in Kyushu, which included the Tamanoura. A large number of residents in Tamanoura were exposed to the rice-oil (28% of all the certified cases as of 2009). We estimated SMRs of non-cancer and cancer diseases for the years 1968-2002. Shortly after the exposure, SMRs of all causes, diabetes mellitus, cardiovascular disease, pneumonia/bronchitis, and bronchus/lung cancer were elevated. In particular, SMRs of heart disease were 1.97 [95% confidence intervals (CI): 1.09-3.56] in 1968, 2.05 (95% CI: 1.16-3.60) in 1969, and 1.89 (95% CI: 1.05-3.41) in 1975. However, we did not observe clear increase in SMRs more than 10 years after the exposure. This study provides further evidence in Yusho, especially on acute effects on non-cancer mortality. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Continuous renal replacement therapy for acute renal failure in patients with cancer: a well-tolerated adjunct treatment

    Directory of Open Access Journals (Sweden)

    Rebecca Fischler

    2016-08-01

    Full Text Available Abstract Introduction – Acute renal failure (ARF has a poor prognosis in patients with cancer requiring intensive care unit (ICU admission. Our aim is finding prognostic factors for hospital mortality in patients with cancer with ARF requiring renal replacement therapy (RRT. Methods – In this retrospective study, all patients with cancer with ARF treated with continuous venovenous filtration (CVVHDF in the ICU of the Institut Jules Bordet, between January 1st 2003 and December 31st 2012, were included in the study.Results – 103 patients are assessed: men/women 69/34, median age 62 years, solid/haematologic tumours 68/35, median SAPS II 56. Mortality rate was 63%. Seven patients required chronic renal dialysis. After multivariate analysis, two variables were statistically associated with hospital mortality : more than one organ failure (including kidney (OR 5.918 ; 95% CI 2.184 – 16.038 ; p<0,001 and low albumin level (OR 3.341; 95% CI 1.229 – 9.077; p=0,02. Only minor complications related to CVVHDF have been documented.Conclusions – Despite the poor prognosis associated with ARF, CVVHDF is an effective and tolerable renal replacement technique in patients with cancer admitted to the ICU. Multiple organ failure and hypoalbuminemia, two independent prognostic factors for hospital mortality have to be considered when deciding for introducing RRT.

  7. Dose-surface analysis for prediction of severe acute radio-induced skin toxicity in breast cancer patients.

    Science.gov (United States)

    Pastore, Francesco; Conson, Manuel; D'Avino, Vittoria; Palma, Giuseppe; Liuzzi, Raffaele; Solla, Raffaele; Farella, Antonio; Salvatore, Marco; Cella, Laura; Pacelli, Roberto

    2016-01-01

    Severe acute radiation-induced skin toxicity (RIST) after breast irradiation is a side effect impacting the quality of life in breast cancer (BC) patients. The aim of the present study was to develop normal tissue complication probability (NTCP) models of severe acute RIST in BC patients. We evaluated 140 consecutive BC patients undergoing conventional three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery in a prospective study assessing acute RIST. The acute RIST was classified according to the RTOG scoring system. Dose-surface histograms (DSHs) of the body structure in the breast region were extracted as representative of skin irradiation. Patient, disease, and treatment-related characteristics were analyzed along with DSHs. NTCP modeling by Lyman-Kutcher-Burman (LKB) and by multivariate logistic regression using bootstrap resampling techniques was performed. Models were evaluated by Spearman's Rs coefficient and ROC area. By the end of radiotherapy, 139 (99%) patients developed any degree of acute RIST. G3 RIST was found in 11 of 140 (8%) patients. Mild-moderate (G1-G2) RIST was still present at 40 days after treatment in six (4%) patients. Using DSHs for LKB modeling of acute RIST severity (RTOG G3 vs. G0-2), parameter estimates were TD50=39 Gy, n=0.38 and m=0.14 [Rs = 0.25, area under the curve (AUC) = 0.77, p = 0.003]. On multivariate analysis, the most predictive model of acute RIST severity was a two-variable model including the skin receiving ≥30 Gy (S30) and psoriasis [Rs = 0.32, AUC = 0.84, p skin dose, the LKB n parameter was consistent with a surface effect for the skin. A good prediction performance was obtained using a data-driven multivariate model including S30 and a pre-existing skin disease (psoriasis) as a clinical factor.

  8. Do comorbidity influences acute toxicity and outcome in elderly patients with endometrial cancer treated by adjuvant radiotherapy plus brachytherapy?

    Science.gov (United States)

    Fiorentino, A; Chiumento, C; Fusco, V

    2013-08-01

    To correlate comorbidity and acute radiation toxicity in elderly patients treated with adjuvant external beam radiotherapy (EBRT) plus brachytherapy-high dose rate (HDR-BRT) for endometrial cancer (EC). Endometrial cancer patients over 65 were treated and evaluated for comorbidity assessment with ACE-27 and Charlson comorbidity index (CCI). EBRT total dose was 45-50.4 Gy (1.8 Gy/day). The vault vagina boost of dose was performed by HDR-BRT with 2/3 fractions with a total dose of 10-15 Gy. From 2008 to 2011, 35 patients were analyzed. Eighteen patients (51.43 %) had not ACE-27 comorbidity; while 27 patients (77.14 %) had CCI lower than three. During treatment, acute toxicity was mild and not influenced by the comorbidity score. Two-year Progression Free and Overall Survival were 69 and 80 %. ACE-27 and CCI did not affect progression-free survival (p = 0.51, p = 0.3) and OS (p = 0.26, p = 0.5). External beam radiotherapy plus BRT-HDR are well tolerated in EC elderly with good performance status and low comorbidity profile.

  9. Low acute toxicity of radiotherapy and radiochemotherapy in patients with cancer of the anal canal and HIV-infection

    Energy Technology Data Exchange (ETDEWEB)

    Hoecht, S.; Wiegel, T.; Hinkelbein, W. [Abt. Strahlentherapie, Universitaetsklinikum Benjamin Franklin der Freien Univ. Berlin (Germany); Kroesen, A.J.; Runkel, N. [Abt. Allgemein- Thorax- und Gefaesschirurgie, Universitaetsklinikum Benjamin Franklin der Freien Univ. Berlin (Germany); Berdel, W.E. [Abt. Innere Medizin mit Schwerpunkt Haematologie und Onkologie, Universitaetsklinikum Benjamin Franklin der Freien Univ. Berlin (Germany)

    1997-12-31

    Although not an AIDS-defining malignancy, anal cancer is an evolving problem in HIV-infected patients. Treatment-tolerance to radiotherapy as well as to chemotherapy is supposed to be reduced in patients with HIV-infection. From January 1995 to January 1997, four patients with epidermoid cancer of the anal canal and a long history of HIV-infection but without symptoms of AIDS or repeated severe infections were treated with radiotherapy (n=1) or radiochemotherapy (n=3). External beam radiotherapy with 45 Gy to the tumor and pelvic as well as inguinal lymphatic drainage was administered. In tumors larger than T2 N0 lesions an additional boost of 9 Gy was given. Chemotherapy consisted of 5-fluorouracil 1000 mg/m{sup 2}/24 h, d 1-4 two cycles and Mitomycin C either 1 x 15 mg/m{sup 2}, d 1 in the first, or 2 x 10 mg/m{sup 2}, d 1, in the first and fifth week of radiotherapy. Acute reactions were mild to moderate in all patients and all but one treatment could be given as scheduled (1 patient with a delay of 4 days). No excessive acute reactions were seen. Because of the short follow-up, late reactions and local control are not yet evaluable. (orig.).

  10. Hypofractionation in non-small cell lung cancer (NSCLC): suggestions from modelling both acute and chronic hypoxia

    Energy Technology Data Exchange (ETDEWEB)

    Ruggieri, Ruggero [Department of Medical Physics, Az. Osp. Bianchi Melacrino Morelli, Via Melacrino, 89100 Reggio Calabria (Italy)

    2004-10-21

    Based on experimental estimates for acute and chronic tumour hypoxia, a speculative analysis of the therapeutic ratio dependence on the number of once-daily five-days-per-week fractions (n) for non-small cell lung cancer (NSCLC) radiotherapy is proposed. For this purpose an adapted formulation of the linear-quadratic model has been derived, including the effects of tumour repopulation, inter-tumour {alpha}-heterogeneity and oxygen enhancement ratio dependence on the dose per fraction. The relation between the curative dose D{sub 50}, assuring 50% tumour control probability, and n has been computed: for (n, D{sub 50}) fractionation schemes, the therapeutic ratios have been compared in terms of effective normalized total doses to the lungs (NTD{sup eff}{sub L}), estimated by a few supposed fractions of the normalized total dose to the tumour. Results suggest that D{sub 50} is dominated by chronic hypoxia for shortly hypofractionated treatments and by acute hypoxia for multifractionated treatments. Furthermore, the optimum number of fractions depends on the rapidity of the reoxygenation from chronically hypoxic cells, almost independently of the extent of both chronic and acute hypoxia. For NSCLC, both the reduction of n until about 20 fractions in hypofractionated dose-escalation trials, and the extension of extra-cranial stereotactic radiotherapy schedules to include at least 5-10 fractions, seem to be supported by this model.

  11. Protective effect of ulinastatin on acute lung injury after radiotherapy in patients with lung cancer and the related molecular mechanism

    Institute of Scientific and Technical Information of China (English)

    Guang-Ping Fan

    2016-01-01

    Objective:To analyze the protective effect of ulinastatin on acute lung injury after radiotherapy in patients with lung cancer and the related molecular mechanism.Methods:A total of 78 patients who received radiotherapy and developed acute lung injury in our hospital between December 2013 and December 2015 were randomly divided into observation group and control group, control group received symptomatic treatment, observation group received symptomatic + ulinastatin treatment, and the content of growth factors, inflammatory factors, disease-related proteins in serum as well as the expression of P38MAPK signaling pathway molecules in alveolar lavage fluid were compared between two groups of patients after treatment.Results:Ten days after treatment, HGF, KGF, VEGF, IL-1β, IL-8, IL-10, IL-18, IL-13, PCT, S100A8, S100A9 and SP-D content in serum of observation group were significantly lower than those of control group while Clara cell protein content was significantly higher than that of control group; phosphorylated p38MAPK, MAPK, MKK3/6 and ATF-2 protein expression levels in alveolar lavage fluid were significantly lower than those of control group.Conclusions:Ulinastatin can alleviate the overall condition in patients with acute lung injury after radiotherapy, and the specific mechanism is associated with P38MAPK signaling pathway.

  12. A biologically competitive 21 days hypofractionation scheme with weekly concomitant boost in breast cancer radiotherapy feasibility acute sub-acute and short term late effects

    Directory of Open Access Journals (Sweden)

    Garelli Stefania

    2010-11-01

    Full Text Available Abstract Background Radiation therapy after lumpectomy is a standard part of breast conserving therapy for invasive breast carcinoma. The most frequently used schedule worldwide is 60 Gy in 30 fractions in 6 weeks, a time commitment that sporadically may dissuade some otherwise eligible women from undertaking treatment. The purpose and primary endpoint of this perspective study is to evaluate feasibility and short-term late toxicity in a hypofractionated whole breast irradiation schedule. Methods Between February and October 2008 we treated 65 consecutive patients with operable invasive early-stage breast cancer with a hypofractionated schedule of external beam radiation therapy. All patients were assigned to 39 Gy in 13 fractions in 3 weeks to the whole breast plus a concomitant weekly boost dose to the lumpectomy cavity of 3 Gy in 3 fractions. Results All the patients had achieved a median follow up of 24 months (range 21-29 months. At the end of treatment 52% presented grade 0 acute toxicity 39% had grade 1 and 9% had grade 2. At 6 months with all the patients assessed there were 34% case of grade 1 subacute toxicity and 6% of grade 2. At 12 months 43% and 3% of patients presented with clinical grade 1 and grade 2 fibrosis respectively and 5% presented grade 1 hyperpigmentation. The remaining patients were free of side effects. At 24 months, with 56 assessed, just 2 patients (3% showed grade 2 of late fibrosis. Conclusions The clinical results observed showed a reasonably good feasibility of the accelerated hypofractionated schedule in terms of acute, subacute and short-term late toxicity. This useful 13 fractions with a concomitant boost schedule seems, in selected patients, a biologically acceptable alternative to the traditional 30 days regime.

  13. Acute High-Dose and Chronic Lifetime Exposure to Alcohol Consumption and Differentiated Thyroid Cancer: T-CALOS Korea.

    Directory of Open Access Journals (Sweden)

    Yunji Hwang

    Full Text Available This study evaluated the effects of acute high-dose and chronic lifetime exposure to alcohol and exposure patterns on the development of differentiated thyroid cancer (DTC.The Thyroid Cancer Longitudinal Study (T-CALOS included 2,258 DTC patients (449 men and 1,809 women and 22,580 healthy participants (4,490 men and 18,090 women who were individually matched by age, gender, and enrollment year. In-person interviews were conducted with a structured questionnaire to obtain epidemiologic data. Clinicopathologic features of the patients were obtained by chart reviews. Odds ratios (ORs and 95% confidence intervals (95%CI were estimated using conditional regression models.While light or moderate drinking behavior was related to a reduced risk of DTC, acute heavy alcohol consumption (151 g or more per event or on a single occasion was associated with increased risks in men (OR = 2.22, 95%CI = 1.27-3.87 and women (OR = 3.61, 95%CI = 1.52-8.58 compared with never-drinkers. The consumption of alcohol for 31 or more years was a significant risk factor for DTC for both men (31-40 years: OR = 1.58, 95%CI = 1.10-2.28; 41+ years: OR = 3.46, 95%CI = 2.06-5.80 and women (31-40 years: OR = 2.18, 95%CI = 1.62-2.92; 41+ years: OR = 2.71, 95%CI = 1.36-5.05 compared with never-drinkers. The consumption of a large amount of alcohol on a single occasion was also a significant risk factor, even after restricting DTC outcomes to tumor size, lymph node metastasis, extrathyroidal extension and TNM stage.The findings of this study suggest that the threshold effects of acute high-dose alcohol consumption and long-term alcohol consumption are linked to an increased risk of DTC.

  14. Dose-Volume Effects on Patient-Reported Acute Gastrointestinal Symptoms During Chemoradiation Therapy for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Ronald C. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Mamon, Harvey J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Killoran, Joseph H. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Crowley, Elizabeth M. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Blaszkowsky, Lawrence S. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Wo, Jennifer Y. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ryan, David P. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Hong, Theodore S., E-mail: tshong1@partners.org [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States)

    2012-07-15

    Purpose: Research on patient-reported outcomes (PROs) in rectal cancer is limited. We examined whether dose-volume parameters of the small bowel and large bowel were associated with patient-reported gastrointestinal (GI) symptoms during 5-fluorouracil (5-FU)-based chemoradiation treatment for rectal cancer. Methods and Materials: 66 patients treated at the Brigham and Women's Hospital or Massachusetts General Hospital between 2006 and 2008 were included. Weekly during treatment, patients completed a questionnaire assessing severity of diarrhea, urgency, pain, cramping, mucus, and tenesmus. The association between dosimetric parameters and changes in overall GI symptoms from baseline through treatment was examined by using Spearman's correlation. Potential associations between these parameters and individual GI symptoms were also explored. Results: The amount of small bowel receiving at least 15 Gy (V15) was significantly associated with acute symptoms (p = 0.01), and other dosimetric parameters ranging from V5 to V45 also trended toward association. For the large bowel, correlations between dosimetric parameters and overall GI symptoms at the higher dose levels from V25 to V45 did not reach statistical significance (p = 0.1), and a significant association was seen with rectal pain from V15 to V45 (p < 0.01). Other individual symptoms did not correlate with small bowel or large bowel dosimetric parameters. Conclusions: The results of this study using PROs are consistent with prior studies with physician-assessed acute toxicity, and they identify small bowel V15 as an important predictor of acute GI symptoms during 5-FU-based chemoradiation treatment. A better understanding of the relationship between radiation dosimetric parameters and PROs may allow physicians to improve radiation planning to optimize patient outcomes.

  15. Large volume unresectable locally advanced non-small cell lung cancer: acute toxicity and initial outcome results with rapid arc

    Directory of Open Access Journals (Sweden)

    Fogliata Antonella

    2010-10-01

    Full Text Available Abstract Background To report acute toxicity, initial outcome results and planning therapeutic parameters in radiation treatment of advanced lung cancer (stage III with volumetric modulated arcs using RapidArc (RA. Methods Twenty-four consecutive patients were treated with RA. All showed locally advanced non-small cell lung cancer with stage IIIA-IIIB and with large volumes (GTV:299 ± 175 cm3, PTV:818 ± 206 cm3. Dose prescription was 66Gy in 33 fractions to mean PTV. Delivery was performed with two partial arcs with a 6 MV photon beam. Results From a dosimetric point of view, RA allowed us to respect most planning objectives on target volumes and organs at risk. In particular: for GTV D1% = 105.6 ± 1.7%, D99% = 96.7 ± 1.8%, D5%-D95% = 6.3 ± 1.4%; contra-lateral lung mean dose resulted in 13.7 ± 3.9Gy, for spinal cord D1% = 39.5 ± 4.0Gy, for heart V45Gy = 9.0 ± 7.0Gy, for esophagus D1% = 67.4 ± 2.2Gy. Delivery time was 133 ± 7s. At three months partial remission > 50% was observed in 56% of patients. Acute toxicities at 3 months showed 91% with grade 1 and 9% with grade 2 esophageal toxicity; 18% presented grade 1 and 9% with grade 2 pneumonia; no grade 3 acute toxicity was observed. The short follow-up does not allow assessment of local control and progression free survival. Conclusions RA proved to be a safe and advantageous treatment modality for NSCLC with large volumes. Long term observation of patients is needed to assess outcome and late toxicity.

  16. Analysis of the clinical symptoms of patients complicated with acute intestinal obstruction after the surgery of colon cancer

    Institute of Scientific and Technical Information of China (English)

    Pei-Jun Ye

    2016-01-01

    Objective: To study the content of serum inflammatory medium of the patients complicated with acute intestinal obstruction after the surgery of colon cancer. Methods: A total of 150 patients with colon cancer received limited surgery treatment during the period of May 2012 to October 2015 were selected as the study objects. They were divided into postoperative ileus (POI) group and non-postoperative ileus (non-POI) group according to the presence or absence of intestinal obstruction. Then, the contents of serum procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-a) and interleukin-6 (IL-6) were detected at the 1st, 3rd, 5th and 7th days after the surgery. Results: The levels of serum PCT, CRP, TNF-a and IL-6 of two groups at the 1st day had no differences after the surgery. The level of serum PCT of POI group tended to increase and its levels of serum CRP, TNF-a and IL-6 tended to decrease at the 3rd, 5th and 7th days after the surgery, while the levels of serum PCT, CRP, TNF-a and IL-6 of non-POI group were decreased. The content of serum PCT of POI group and non-POI group at the 3rd day after the surgery had no differences (P > 0.05), and the level of serum PCT of POI group was higher than that of non-POI group at the 5th and 7th days after the surgery (P0.05). Conclusions: The raising of the content of serum PCT after the surgery can be used as the laboratory index to predict the incidence of acute intestinal obstruction after the surgery of colon cancer.

  17. Intermittent use of amifostine during postoperative radiochemotherapy and acute toxicity in rectal cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Dunst, J.; Semlin, S.; Pigorsch, S.; Mueller, A.C.; Reese, T. [Halle-Wittenberg Univ., Halle (Germany). Abt. fuer Radiotherapie

    2000-09-01

    From September 1997 through October 1998, 30 patients with stage II/III rectal cancer underwent postoperative radiochemotherapy at our department. All patients had undergone curative (R0) resection and received 50.4 Gy to the pelvis with a 3-field technique using a belly board followed by a boost of 5.4 Gy to the presacral space in conventional fractionation with 1.8 Gy per fraction. 5-FU chemotherapy was administered as 120-hours continuous infusion in the first and fifth radiation week via a central venous catheter in a daily dosage of 1000 mg/m{sup 2}. All patients were offered to participate in a phase-II study using additional amifostine. Fifteen patients participated and received 500 mg amifostine daily on chemotherapy days (days 1 to 5 and 29 to 33) immediately prior to the daily radiation fraction. Fifteen patients did not participate and served as non-randomized control. The study was approved by the ethical committee of the Martin-Luter-University and informed consent was obtained from all patients. Results: The distribution of patients' characteristics and prognostic parameters was comparable in both groups. Side effects of amifostine were mild and included hypotension (53% grade I, 7% grade II) and nausea (47% grade I, 13% grade II). Antiemetics were not routinely used. All patients completed radiochemotherapy plus amifostine without unplanned breaks or dose reductions. One patients developed a cerebral infraction which was considered to be not related to the use of amifostine. As compared to the non-randomized control group, patients with additional amifostine had less acute skin and bowel toxicity (maximum erythema score 1.47{+-}0.64 without vs 0.87{+-}0.52 with amifostine, p=0.009 and maximum diarrhea score 1.07{+-}1.03 vs 0.40{+-}0.63, p=0.044). Oral 5-FU-related mucositis and hematological toxicity were not significantly different. (orig.) [German] Zwischen September 1997 und Oktober 1998 wurden 15 Patienten mit postoperativer

  18. The relationship among acute-phase response proteins, cytokines and hormones in cachectic patients with colon cancer

    Directory of Open Access Journals (Sweden)

    Dulger Ahmet

    2010-09-01

    Full Text Available Abstract Backgraund Acute-phase response proteins (APRP, cytokines and hormones have been claimed to be an independent prognostic factor of malignancies, however the basis for their association with prognosis remains unexplained. We suggest that in colon malignancies, as similar to pancreatic and lung cancers, changes in APRP are associated with angiogenesis. Methods C-reactive protein (CRP, albumin, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, midkine, VEGF-A, VEGF-C, leptin, adiponectin, and ghrelin serum levels are studied in 126 colon cancer patients and 36 healthy subjects. Results We found statistically significant difference and correlations between two groups. We found significantly higher serum CRP, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C and leptin concentrations in patients relative to controls (p Conclusions Cachexia in patients with colon cancers is associated with changes in APRP, cytokines and hormone concentrations. These biomarkers and cachexia together have a direct relationship with accelerated angiogenesis. This may lead to a connection between the outcomes in malignancies and the biomarkers.

  19. 上颌埋伏尖牙非手术助萌的正畸治疗%Orthodontic treatment of non-surgical eruption of impacted maxillary canines

    Institute of Scientific and Technical Information of China (English)

    席兰兰; 靳淑梅; 颜淑云; 周亚丽; 张君

    2011-01-01

    Objective To invesigate the indications of orthodontic treatment of non-surgical eruption of impacted maxillary canines and observe the clinical effect. Methods 20 patients ( 10 ~ 15 year-old)with impacted maxillary canines diagnosed by three-dimensional spiral computed tomography (CT) reconstructions were selected and the location, orientation in the maxilla and root development of the impacted tooth were identified. 12 appropriate cases were treated by non-surgical orthodontic methods to expand space for the impacted teeth. Wait for its own eruption. 8 cases were treated by flap surgery traction. Results Maxillary canines in the non-surgery eruption group erupted to the normal position with normal periodontal attachment in 3-10 months after enough space was expanded. Maxillary canines in proper positions of the 8 surgery eruption cases showed various degree of periodontal attachment loss, affecting gingival appearance. Conclusions Three-dimensional spiral CT technology can provide intuitive information of impacted tooth for clinicians to develop a clear diagnosis and treatment options, reducing surgical indications. Non-surgical methods can help the impacted maxillary canines erupt themselves, avoiding surgical trauma.%目的 探讨上颌埋伏尖牙非手术助萌正畸治疗的适应证及其临床效果.方法 选取10~15岁上颌埋伏尖牙患者20例,应用螺旋CT三维重建技术对其进行诊断,明确埋伏尖牙颌骨内位置、方向及牙根发育情况,选取适合病例12例通过正畸手段为埋伏尖牙开辟间隙,等待其自行萌出;8例采用外科翻瓣导萌术牵引导萌.结果 12例非手术助萌患者,正畸拓展足够间隙后经3~10个月上颌埋伏尖牙均自行萌出至正常位置,牙周附着健康;8例外科手术导萌患者,上颌埋伏尖牙正畸牵引到位后均有不同程度的牙周附着丧失,影响龈缘美观.结论 采用螺旋CT三维重建技术可以立体直观的提供埋伏尖牙的信息,为

  20. 新生儿单纯颅骨凹陷骨折的非手术治疗%Non-surgical therapy on skull simple depressed fractures in neonate

    Institute of Scientific and Technical Information of China (English)

    余雷; 余腾; 胡家高

    2012-01-01

    目的 探讨非手术方式治疗新生儿单纯颅骨凹陷性骨折的可行性.同时结合文献复习,期望为新生儿颅骨凹陷骨折提供一个合理的治疗方案.方法 回顾分析1997年8月至2012年2月非手术治疗的11例新生儿单纯颅骨凹陷性骨折的临床转归.全部病例均是出生后即发现颅骨凹陷.入院年龄为出生后9h~17d,凹陷深度0.3~1.0 cm,其中6例凹陷深度>0.5 cm.合并颅内出血4例,有神经系统症状1例.10例采取观察,待其自然恢复;1例采取产科负压吸引器抽吸颅骨凹陷.结果 10例观察患儿颅骨凹陷在1~7个月后恢复,没有后遗神经系统并发症;1例颅骨凹陷使用产科负压吸引器抽吸后,颅骨凹陷立即恢复.复查脑CT,原有颅内出血灶无增大,颅内颅外也未见新出血灶及病变.结论 非手术疗法可成为新生儿单纯颅骨凹陷性骨折之选择;在不增加危险的情况下,负压抽吸术是一种快速解决更大而深骨折凹陷的选择,还可以减轻患儿家属的焦虑情绪.%Objective The purpose of this study is to offer a rational principle for neonate suffering from skull simple depressed fractures through the investigation of non-surgical therapy and relevant references review.Methods Between August 1997 and February 2012,total 11 neonates underwent non-surgical treatment in our department and better efficacy was found in them.Their clinical data was reviewed and analyzed.All of them were diagnosed as skull depressed fractures in post-born and admitted once definite diagnosis.The depressed depth ranged from 0.3 cm to 1.0 cm in depth and 6 of them were more than 0.5 cm.4 cases were found to be complicated with intracranial hemorrhage,only 1 case presented nervous symptoms.10 cases underwent the conservative therapy and vacuum extraction was performed in 1 case.Results Spontaneous restoration was observed in 10 patients within a period ranging from 1 to 7 months and no neurological deficits was

  1. Concomitant radiochemotherapy with 5-FU and cisplatin for invasive bladder cancer. Acute toxicity and first results

    Energy Technology Data Exchange (ETDEWEB)

    Birkenhake, S.; Leykamm, S.; Sauer, R. [Friedrich-Alexander Univ., Erlangen-Nuernberg (Germany). Dept. of Radiooncology; Martus, P. [Friedrich-Alexander Univ., Erlangen-Nuernberg (Germany). Dept. of Medical Statistics

    1999-03-01

    Purpose: To evaluate acute toxicity and efficacy of simultaneous radiochemotherapy for invasive urothelial cancer of the bladder. Patients and Methods: From September 1993 to July 1997, 61 patients with invasive bladder cancer were treated with a transurethral resection (TURB) followed by radiochemotherapy (RCT). Twenty-five received a combination of 5-FU and cisplatin. The prescribed doses were 600 mg/m{sup 2} 5-FU daily as continuous infusion over 5 days each in the 1st and 5th treatment week and 20 mg/m{sup 2} cisplatin daily at the same days as a short infusion. The pelvis was irradiated with 54 Gy, the bladder with 59.4 Gy and the paraortic nodes in 7 cases with 45 Gy, respectively. Six to 8 weeks after RCT a second TURB was performed for reasons of restaging. Results: Twenty out of 25 patients received at least 80% of the prescribed chemotherapy, in 13 cases the full dose could be given. Gastrointestinal toxicity of Grade I and II occurred in 10 cases, 1 patient developed severe diarrhea (Grade VI). After the 1st course of chemotherapy 7 patients had leuco- or thrombopenia of Grade III. One patient had a leucopenia of Grade IV. After the 2nd course 4 patients developed Grade III leuko- and thrombopenia, 1 of Grade IV. Two Grade II anemia were found. All more severe toxicities and necessary dose reductions were related to radiation of the paraaortic nodes. No life threatening infections, bleedings or cardiotoxicity was found. Restaging TURBs resulted in 22 complete remissions, 1 patient had a de-novo-carcinoma (Tis) at this time, 2 were non-responders (8%). After a median follow-up of 38 months 20 patients are alive (80%). Conclusions: 1. If irradiation of paraaortic nodes is necessary, 5-FU should not be applied, because the gastrointestinal toxicity is too extensive. In all other cases side effects are tolerable and can be managed by supportive care. 2. The first results are promising and should be evaluated in a prospective study. (orig.) [Deutsch

  2. Acute toxicity profile and compliance to accelerated radiotherapy plus carbogen and nicotinamide for clinical stage T2-4 laryngeal cancer: results of a phase III randomized trial.

    NARCIS (Netherlands)

    Janssens, G.O.R.J.; Terhaard, C.H.J.; Doornaert, P.A.; Bijl, H.P.; Ende, P. van den; Chin, A.; Pop, L.A.M.; Kaanders, J.H.A.M.

    2012-01-01

    PURPOSE: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. METHODS AND MATERIALS: From April 2001 to February 2008, 345 patients with

  3. ACUTE TOXICITY PROFILE AND COMPLIANCE TO ACCELERATED RADIOTHERAPY PLUS CARBOGEN AND NICOTINAMIDE FOR CLINICAL STAGE T2-4 LARYNGEAL CANCER : RESULTS OF A PHASE III RANDOMIZED TRIAL

    NARCIS (Netherlands)

    Janssens, Geert O.; Terhaard, Chris H.; Doornaert, Patricia A.; Bijl, Hendrik P.; van den Ende, Piet; Chin, Alim; Pop, Lucas A.; Kaanders, Johannes H.

    2012-01-01

    Purpose: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. Methods and Materials: From April 2001 to February 2008, 345 patients with

  4. Timed Get Up and Go Test and Geriatric 8 Scores and the Association With (Chemo-) Radiation Therapy Noncompliance and Acute Toxicity in Elderly Cancer Patients

    NARCIS (Netherlands)

    Middelburg, Judith G.; Mast, Mirjam E.; de Kroon, Maaike; Jobsen, Jan J.; Rozema, Tom; Maas, Huub A. A. M.; Baartman, Elizabet A.; Geijsen, Debby; van der Leest, Annija H.; van den Bongard, Desiree J.; van Loon, Judith; Budiharto, Tom; Coebergh, Jan-Willem; Aarts, Mieke J; Struikmans, Henk

    2017-01-01

    Purpose: To investigate whether the Geriatric 8 (G8) and the Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with acute toxicity of radiation therapy and noncompliance in elderly cancer patients being irradiated with curative intent. Methods and

  5. Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence

    Directory of Open Access Journals (Sweden)

    Uden H

    2012-01-01

    Full Text Available Hayley Uden1, Saravana Kumar21Podiatry Department, University of South Australia, Adelaide, South Australia, Australia; 2Post Doctoral Senior Research Fellow, International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaBackground: An intoed gait pattern is one of the most common referrals for children to an orthopedic consultation. Parental concern as to the aesthetics of the child’s gait pattern and/or its symptomatic nature will primarily drive these referrals during a child’s early developmental years. Whilst some of these referrals prove to be the result of a normal growth variant, some children will present with a symptomatic intoed gait pattern. Various treatments, both conservative and surgical, have been proposed including: braces, wedges, stretches and exercises, shoe modifications, and surgical procedures. However, which treatments are effective and justified in the management of this condition is not clear within the literature. The aim of this systematic review was to therefore identify and critique the best available evidence for the non-surgical management of an intoed gait pattern in a pediatric population.Method: A systematic review was conducted of which only experimental studies investigating a management option for an intoeing gait pattern were included. Studies needed to be written in English, pertaining to a human pediatric population, and published within a peer reviewed journal. Electronic databases were searched: Ovid (Medline, EMBASE, AMED, PubMed, SportDiscus, CINAHL, and Cochrane Library. The National Health and Medical Research Council’s designation of levels of hierarchy and the Critical Appraisal Skills Programme cohort studies critical appraisal tool were used.Results: Five level IV studies were found. The studies were of varied quality and with mixed results. Gait plates, physiologic/standardized shoes, and orthotic devices (with gate plate extension

  6. The Effect of Non-surgical Periodontal Therapy on Hemoglobin A1c Levels in Persons with Type 2 Diabetes and Chronic Periodontitis: A Randomized Clinical Trial

    Science.gov (United States)

    Engebretson, Steven P.; Hyman, Leslie G.; Michalowicz, Bryan S.; Schoenfeld, Elinor R.; Gelato, Marie C.; Hou, Wei; Seaquist, Elizabeth R.; Reddy, Michael S.; Lewis, Cora E.; Oates, Thomas W.; Tripathy, Devjit; Katancik, James A.; Orlander, Philip R.; Paquette, David W.; Hanson, Naomi Q.; Tsai, Michael Y.

    2014-01-01

    Importance Chronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control. Objective To determine if non-surgical periodontal treatment reduces hemoglobin A1c (HbA1c) in persons with type 2 diabetes (DM) and moderate to advanced chronic periodontitis. Design, Setting and Participants The Diabetes and Periodontal Therapy Trial (DPTT) is a 6-month, single-masked, randomized, multi-center clinical trial. Participants had DM, were taking stable doses of medications, had HbA1c ≥7% and <9%, and untreated periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with five academic medical centers. Intervention The treatment group (n=257) received scaling and root planing plus chlorhexidine oral rinse at baseline, and supportive periodontal therapy at three and six months. The control group (n=257) received no treatment for six months. Main Outcome Measure Difference in HbA1c change from baseline between groups at six months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose, and the Homeostasis Model Assessment (HOMA2). Results Enrollment was stopped early due to futility. At 6 months, the periodontal therapy group increased HbA1c 0.17% (1.0) (mean (SD)) compared to 0.11% (1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference = -0.05%; 95% Confidence Interval (CI): -0.23%, 0.12%; p=0.55). Probing depth, clinical attachment loss, bleeding on probing and gingival index measures improved in the treatment group compared to the control group at six months with adjusted between-group differences of 0.33mm (95% CI: 0.26, 0.39), 0

  7. Tratamento não-cirúrgico de abscessos intra-cavitários pós-apendicectomia Non surgical management of post appendectomy intraperitoneal abscesses

    Directory of Open Access Journals (Sweden)

    Giliatt Hanois Falbo Neto

    2001-12-01

    Full Text Available OBJETIVOS: avaliar a eficácia do tratamento não cirúrgico em crianças que desenvolveram abscessos intra-cavitários pós-apendicectomia, no Instituto Materno Infantil de Pernambuco, Recife, Brasil, e comparar os resultados obtidos com dois esquemas antimicrobianos (Cefoxitina versus Amicacina com Metronidazol utilizados. MÉTODOS: o estudo corresponde ao período de janeiro de 1997 a janeiro de 2000 no qual 427 crianças foram apendicectomizadas; 41 delas desenvolveram abscessos intra-cavitários sendo 39 incluídas no estudo. O diagnóstico dos abscessos intra-cavitários baseou-se em sinais clínicos e exames complementares. RESULTADOS: A incidência de abscessos intra-cavitários pós-apendicectomias foi de 9,6%. 89,7% dos pacientes obtiveram sucesso com o tratamento. Não houve diferença entre os percentuais de cura obtidos com os dois esquemas antimicrobianos. CONCLUSÕES: o tratamento não cirúrgico de abscessos intra-cavitários pós-apendicectomias, baseado na antibioticoterapia endovenosa é uma opção segura e eficaz. Os esquemas antimicrobianos com Cefo-xitina e associação de Amicacina com Metronidazol têm eficácia semelhantes. A associação Amicacina com Metronidazol é recomenda pelo seu menor custo.OBJECTIVES: to evaluate the effectiveness of non-surgical treatment of post appendectomy, abdominal abscesses in children at the Instituto Materno Infantil de Pernambuco, Recife, Brazil and to compare the results of two anti-microbial schemes (Cefoxitin versus Amikacin plus Metronidazole. METHODS: the study corresponds to the period from January 1997 to January 2000. There were 427 appendectomies performed in children during this period and 41 of them developed intra-abdominal abscesses. Thirty-nine were studied. The diagnosis of the abscesses was based on clinical signs, laboratorial tests and ultrasound examination. RESULTS: abscesses developed in 9,6% of the cases. Healing of the abscess occurred in 89,7% of the patients

  8. Management of acute skin toxicity with Hypericum perforatum and neem oil during platinum-based concurrent chemo-radiation in head and neck cancer patients.

    Science.gov (United States)

    Franco, Pierfrancesco; Rampino, Monica; Ostellino, Oliviero; Schena, Marina; Pecorari, Giancarlo; Garzino Demo, Paolo; Fasolis, Massimo; Arcadipane, Francesca; Martini, Stefania; Cavallin, Chiara; Airoldi, Mario; Ricardi, Umberto

    2017-02-01

    Acute skin toxicity is a frequent finding during combined radiotherapy and chemotherapy in head and neck cancer patients. Its timely and appropriate management is crucial for both oncological results and patient's global quality of life. We herein report clinical data on the use of Hypericum perforatum and neem oil in the treatment of acute skin toxicity during concurrent chemo-radiation for head and neck cancer. A consecutive series of 50 head and neck cancer patients undergoing concomitant radio-chemotherapy with weekly cisplatin was analyzed. Treatment with Hypericum perforatum and neem oil was started in case of G2 acute skin toxicity according to the RTOG/EORTC scoring scale and continued during the whole treatment course and thereafter until complete recovery. The maximum detected acute skin toxicity included Grade 2 events in 62% of cases and G3 in 32% during treatment and G2 and G3 scores in 52 and 8%, respectively, at the end of chemo-radiation. Grade 2 toxicity was mainly observed during weeks 4-5, while G3 during weeks 5-6. Median times spent with G2 or G3 toxicity were 23.5 and 14 days. Patients with G3 toxicity were reconverted to a G2 profile in 80% of cases, while those with a G2 score had a decrease to G1 in 58% of cases. Time between maximum acute skin toxicity and complete skin recovery was 30 days. Mean worst pain score evaluated with the Numerical Rating Scale-11 was 6.9 during treatment and 4.5 at the end of chemo-radiotherapy. Hypericum perforatum and neem oil proved to be a safe and effective option in the management of acute skin toxicity in head and neck cancer patients submitted to chemo-radiation with weekly cisplatin. Further studies with a control group and patient-reported outcomes are needed to confirm this hypothesis.

  9. Genetic polymorphisms of PAI-1 and PAR-1 are associated with acute normal tissue toxicity in Chinese rectal cancer patients treated with pelvic radiotherapy.

    Science.gov (United States)

    Zhang, Hui; Wang, Mengyun; Shi, Tingyan; Shen, Lijun; Zhu, Ji; Sun, Menghong; Deng, Yun; Liang, Liping; Li, Guichao; Wu, Yongxin; Fan, Ming; Wei, Qingyi; Zhang, Zhen

    2015-01-01

    Plasminogen activator inhibitor type 1 (PAI-1) and protease-activated receptor-1 (PAR-1) are crucial mediators of the intestinal microenvironment and are involved in radiation-induced acute and chronic injury. To evaluate whether genetic polymorphisms of PAI-1 and PAR-1 were predictors of radiation-induced injury in patients with rectal cancer, we retrospectively evaluated 356 rectal cancer patients who had received pelvic radiotherapy and analyzed the association of genetic polymorphisms of PAI-1 and PAR-1 with acute toxicities after radiotherapy. Acute adverse events were scored, including dermatitis, fecal incontinence (anal toxicity), hematological toxicity, diarrhea, and vomiting. The patients were grouped into grade ≥2 and grade 0-1 toxicity groups to analyze the acute toxicities. Genotyping of six single nucleotide polymorphisms (SNPs) of PAI-1 and PAR-1 was performed using TaqMan assays. A logistic regression model was used to estimate the odds ratios and 95% confidence intervals. Of the 356 individuals, 264 (72.5%) had grade ≥2 total toxicities; within this group, there were 65 (18.3%) individuals who reached grade ≥3 toxicities. There were 19.5% (69/354) and 36.9% (130/352) patients that developed grade ≥2 toxicities for diarrhea and fecal incontinence, respectively. The variant genotype GG of rs1050955 in PAI-1 was found to be negatively associated with the risk of diarrhea and incontinence (PPAI-1 were associated with an increased risk of incontinence. The CT genotype of PAR-1 rs32934 was associated with an increased risk of total toxicity compared with the CC allele. Our results demonstrated that SNPs in the PAI-1 and PAR-1 genes were associated with acute injury in rectal cancer patients treated with pelvic irradiation. These SNPs may be useful biomarkers for predicting acute radiotoxicity in patients with rectal cancer if validated in future studies.

  10. The role of MRI in the diagnosis of acute radiation reaction in breast cancer patient

    Science.gov (United States)

    Startseva, Zh A.; Musabaeva, L. I.; Usova, AV; Frolova, I. G.; Simonov, K. A.; Velikaya, V. V.

    2016-02-01

    A clinical case with acute radiation reaction of the left breast after organ-preserving surgery with 10 Gy IORT (24.8 Gy) conventional radiation therapy has been presented. Comprehensive MRI examination showed signs of radiation- induced damage to skin, soft tissues and vessels of the residual breast.

  11. Acute Toxicity Profile and Compliance to Accelerated Radiotherapy Plus Carbogen and Nicotinamide for Clinical Stage T2-4 Laryngeal Cancer: Results of a Phase III Randomized Trial

    Energy Technology Data Exchange (ETDEWEB)

    Janssens, Geert O., E-mail: g.janssens@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Terhaard, Chris H. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Doornaert, Patricia A. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Bijl, Hendrik P. [Department of Radiation Oncology, University Medical Center Groningen, Groningen (Netherlands); Ende, Piet van den [Department of Radiation Oncology, Maastricht University Medical Centre, Maastricht (Netherlands); Chin, Alim [Department of Clinical Oncology, Leiden University Medical Centre, Leiden (Netherlands); Pop, Lucas A.; Kaanders, Johannes H. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-02-01

    Purpose: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. Methods and Materials: From April 2001 to February 2008, 345 patients with cT2-4 squamous cell laryngeal cancer were randomized to AR (n = 174) and ARCON (n = 171). Acute toxicity was scored weekly until Week 8 and every 2-4 weeks thereafter. Compliance to carbogen and nicotinamide was reported. Results: Between both treatment arms (AR vs. ARCON) no statistically significant difference was observed for incidence of acute skin reactions (moist desquamation: 56% vs. 58%, p = 0.80), acute mucosal reactions (confluent mucositis: 79% vs. 85%, p = 0.14), and symptoms related to acute mucositis (severe pain on swallowing: 53% vs. 58%, p = 0.37; nasogastric tube feeding: 28% vs. 28%, p = 0.98; narcotic medicines required: 58% vs. 58%, p = 0.97). There was a statistically significant difference in median duration of confluent mucositis in favor of AR (2.0 vs 3.0 weeks, p = 0.01). There was full compliance with carbogen breathing and nicotinamide in 86% and 80% of the patients, with discontinuation in 6% and 12%, respectively. Adjustment of antiemesis prophylaxis was needed in 42% of patients. Conclusion: With the exception of a slight increase in median duration of acute confluent mucositis, the present data reveal a similar acute toxicity profile between both regimens and a good compliance with ARCON for clinical stage T2-4 laryngeal cancers. Treatment outcome and late morbidity will determine the real therapeutic benefit.

  12. Acute toxicity profile and compliance to accelerated radiotherapy plus carbogen and nicotinamide for clinical stage T2-4 laryngeal cancer: results of a phase III randomized trial.

    Science.gov (United States)

    Janssens, Geert O; Terhaard, Chris H; Doornaert, Patricia A; Bijl, Hendrik P; van den Ende, Piet; Chin, Alim; Pop, Lucas A; Kaanders, Johannes H

    2012-02-01

    To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. From April 2001 to February 2008, 345 patients with cT2-4 squamous cell laryngeal cancer were randomized to AR (n = 174) and ARCON (n = 171). Acute toxicity was scored weekly until Week 8 and every 2-4 weeks thereafter. Compliance to carbogen and nicotinamide was reported. Between both treatment arms (AR vs. ARCON) no statistically significant difference was observed for incidence of acute skin reactions (moist desquamation: 56% vs. 58%, p = 0.80), acute mucosal reactions (confluent mucositis: 79% vs. 85%, p = 0.14), and symptoms related to acute mucositis (severe pain on swallowing: 53% vs. 58%, p = 0.37; nasogastric tube feeding: 28% vs. 28%, p = 0.98; narcotic medicines required: 58% vs. 58%, p = 0.97). There was a statistically significant difference in median duration of confluent mucositis in favor of AR (2.0 vs 3.0 weeks, p = 0.01). There was full compliance with carbogen breathing and nicotinamide in 86% and 80% of the patients, with discontinuation in 6% and 12%, respectively. Adjustment of antiemesis prophylaxis was needed in 42% of patients. With the exception of a slight increase in median duration of acute confluent mucositis, the present data reveal a similar acute toxicity profile between both regimens and a good compliance with ARCON for clinical stage T2-4 laryngeal cancers. Treatment outcome and late morbidity will determine the real therapeutic benefit. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Analysis of the clinical symptoms of patients complicated with acute intestinal obstr uction after the surger y of colon cancer

    Directory of Open Access Journals (Sweden)

    Pei-Jun Ye

    2016-09-01

    Full Text Available Objective: To study the content of serum inflammatory medium of the patients complicated with acute intestinal obstruction after the surgery of colon cancer. Methods: A total of 150 patients with colon cancer received limited surgery treatment during the period of May 2012 to October 2015 were selected as the study objects. They were divided into postoperative ileus (POI group and non-postoperative ileus (non-POI group according to the presence or absence of intestinal obstruction. Then, the contents of serum procalcitonin (PCT, C-reactive protein (CRP, tumor necrosis factor-alpha (TNFa and interleukin-6 (IL-6 were detected at the 1st, 3rd, 5th and 7th days after the surgery. Results: The levels of serum PCT, CRP, TNF-a and IL-6 of two groups at the 1st day had no differences after the surgery. The level of serum PCT of POI group tended to increase and its levels of serum CRP, TNF-a and IL-6 tended to decrease at the 3rd, 5th and 7th days after the surgery, while the levels of serum PCT, CRP, TNF-a and IL-6 of non-POI group were decreased. The content of serum PCT of POI group and non-POI group at the 3rd day after the surgery had no differences (P > 0.05, and the level of serum PCT of POI group was higher than that of non-POI group at the 5th and 7th days after the surgery (P 0.05. Conclusions: The raising of the content of serum PCT after the surgery can be used as the laboratory index to predict the incidence of acute intestinal obstruction after the surgery of colon cancer. 1. Introduction Postoperative ileus (POI mainly happens after major abdominal surgeries causing the clinical symptoms such as abdominal pain, abdominal distension, no flatus and defecation, etc. Colorectal cancer is a common malignant tumor in the digestive system, and the incidence and death rates of the disease were all tending to in

  14. [Renal infarction and acute arterial obstruction of the lower extremity encountered after surgery for primary lung cancer].

    Science.gov (United States)

    Tamaki, Masafumi; Miura, Kazumasa; Norimura, Shoko; Kenzaki, Koichirou; Yosizawa, Kiyoshi

    2013-02-01

    The patient was 68-year-old who underwent left upper lobectomy and lymph node dissection. On the 4th postoperative day, he developed vomiting and lumbar pain. On 5th postoperative day, he complained of pain, sensory paralysis and cold sensation of the right lower extremity. Computed tomography(CT)examination revealed left renal infarction and acute arterial obstruction of the right common iliac artery. Emergency thrombectomy of the right lower extremity was performed. Postoperatively, he received anticoagulant therapy and was able to leave the hospital on the 20th postoperative day. Attention should be paid to the infarction of abdominal organs when developing abdominal symptoms after lung cancer surgery in elderly patients.

  15. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

    Directory of Open Access Journals (Sweden)

    Roxana Jurubita

    2016-01-01

    Full Text Available Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis, but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient’s complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases.

  16. Treatment-related myelodysplastic syndrome (t-MDS)/acute myeloid leukemia (AML) in children with cancer: A single-center experience.

    Science.gov (United States)

    Tragiannidis, Athanasios; Gombakis, Nikolaos; Papageorgiou, Maria; Hatzipantelis, Emmanuel; Papageorgiou, Theodotis; Hatzistilianou, Maria

    2016-12-01

    Treatment-related myelodysplastic syndrome (t-MDS)/acute myeloid leukemia (AML) is a devastating early or late complication of treatment for childhood cancer related with a significant morbidity and mortality. We retrospectively studied survivors of childhood cancer. Overall, 287 patients were recorded in the databases and we identified three (1.04%) with t-MDS. The primary cancer diagnoses were Langerhans cell histiocytosis (one patient) and acute lymphoblastic leukemia (ALL; two patients). The mean age of patients was 12.1 years. All patients had received systemic antifungal treatment for invasive pulmonary aspergillosis successfully treated with voriconazole and liposomal amphotericin B before diagnosis of t-MDS. Two patients (66%) remain alive after a median follow-up period of 3.5 years.

  17. Acute myelocytic leukemia and plasmacytoma secondary to chemotherapy and radiotherapy in a long-term survivor of small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fukunishi, Keiichi; Kurokawa, Teruo; Takeshita, Atsushi [Osaka Medical Coll., Takatsuki (Japan)] [and others

    1999-05-01

    A 68 year-old man was given a diagnosis of lung cancer of the right upper lobe (small cell carcinoma, T 4 N 2 M 0, stage IIIB) in February 1991. The tumor diminished after chemotherapy and radiotherapy. In February 1992, a partial resection of the lower lobe of the right lung was performed because of the appearance of a metastatic tumor. In September 1994, squamous cell carcinoma developed in the lower part of the esophagus, but disappeared after radiotherapy. In February 1998, a diagnosis of myelodysplastic syndrome was made. Two months later, the patient had an attack of acute myelocytic leukemia and died of cardiac tamponade. An autopsy determined that both the lung cancer and esophageal cancer had disappeared. Acute myelocytic leukemia and plasmacytoma of lymph nodes in the irradiated area were confirmed. These were regarded as secondary malignancies induced by chemotherapy and radiotherapy. (author)

  18. Oral hygiene care of patients with oral cancer during postoperative irradiation. An alleviating effect on acute radiation mucositis

    Energy Technology Data Exchange (ETDEWEB)

    Katsura, Kouji; Masuko, Noriko; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry; Sugita, Tadashi; Sakai, Kunio; Tsuchida, Emiko; Matsumoto, Yasuo; Sasamoto, Ryuta

    2000-09-01

    To evaluate the effect of oral hygiene care of patients with oral cancer on alleviating acute radiation mucositis. Eighteen patients receiving postoperative radiotherapy for tongue and oral floor cancer were evaluated. Radiotherapy was given in 2 Gy per fraction, 5 times a week for a total dose of 50 Gy in most patients. Radiation field included the tongue and oral floor. During radiotherapy, 8 patients were treated by dento-maxillofacial radiologists with special concern on oral hygiene (oral hygiene group) and the remaining 10 patients were treated with routine dental care (standard medication group). Mucositis were evaluated using JCOG grade and EORTC/RTOG score by radiotherapists or dento-maxillofacial radiologists at 10 Gy intervals. Oral hygiene plans comprised motivation to maintain oral hygiene and establishing the habits of oral self care 4 times per day. Once a week, oral hygiene and oral cleaning of patients were checked by dento-maxillofacial radiologists. Oral self care included mechanical tooth brushing and a chemical mouthwash. No patients with grade 3 and score 4 mucositis were noted in the oral hygiene group. Severe mucositis occurred less frequently in the oral hygiene group than in the standard medication group. Interruption of radiotherapy due to severe mucositis did not occur in the oral hygiene group. On the other hand, interruption of radiotherapy occurred in four patients in the standard medication group, and in three it was due to severe oral pain. Our results suggested that our method of oral hygiene was more effective for alleviating acute radiation mucositis than other methods so far reported. In addition, our method is considered to be useful in preventing rampant dental caries and severe periodontitis due to the xerostomia induced by radiotherapy. (author)

  19. Anti-dsDNA Positivity in a Patient with Prostate Cancer and Acute Kidney Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    Kenan TURGUTALP

    2013-05-01

    Full Text Available OBJECTIVE: Patients with malignancies may develop autoimmune and rheumatic manifestations as a result of generation of autoantibodies, paraneoplastic syndromes, direct invasion of joints and muscles by the tumour cells, or combination chemotherapy. We present a case with prostate cancer and acute kidney injury (AKI mimicking rapidly progressive glomerulonephritis with a positive test result for anti-double-stranded deoxyribonucleic acid antibodies (Anti-dsDNA ab. CASE PRESENTATION: The 78-year-old male patient applied to our center with the complaint of generalized bone pain since approximately two months, and rapid onset of weakness, oliguria and dysuria for three days. He had been diagnosed metastatic prostate cancer (PC for two years and at the time of application had received high dose of naproxen sodium because of severe bone pain for 5 days. Serum creatinine level was elevated on admission (2.4 mg/dl. Urinalysis revealed microscopic hematuria, granular casts and proteinuria of 1.2 gr/day. Immunologic tests including Anti-dsDNA antibody were done regarding acute nephritic syndrome. The subject was positive for Anti-dsDNA ab with a value of 96 IU/ml (normal, <10 IU/ml. Renal biopsy was planned but the patient refused the procedure. After 6 days of oliguric period, his clinical condition and renal functions returned almost to normal with supportive care within 12 days. CONCLUSION: Malignant diseases may be a trigger for either the generation of some autoantibodies. Attention must be paid when interpreting the Anti-dsDNA positivity in malignant patients with AKI mimicking RPGN.

  20. Acute Inflammatory Response to Low-, Moderate-, and High-Load Resistance Exercise in Women With Breast Cancer-Related Lymphedema.

    Science.gov (United States)

    Cormie, Prue; Singh, Benjamin; Hayes, Sandi; Peake, Jonathan M; Galvão, Daniel A; Taaffe, Dennis R; Spry, Nigel; Nosaka, Kazunori; Cornish, Bruce; Schmitz, Kathryn H; Newton, Robert U

    2016-09-01

    Background Resistance exercise is emerging as a potential adjunct therapy to aid in the management of breast cancer-related lymphedema (BCRL). However, the mechanisms underlying the relationships between the acute and long-term benefits of resistance exercise on BCRL are not well understood. Purpose To examine the acute inflammatory response to upper-body resistance exercise in women with BCRL and to compare these effects between resistance exercises involving low, moderate, and high loads. The impact on lymphedema status and associated symptoms was also compared. Methods A total of 21 women, 62 ± 10 years old, with BCRL participated in the study. Participants completed low-load (15-20 repetition maximum [RM]), moderate-load (10-12 RM), and high-load (6-8 RM) exercise sessions consisting of 3 sets of 6 upper-body resistance exercises. Sessions were completed in a randomized order separated by a 7- to 10-day wash-out period. Venous blood samples were obtained to assess markers of exercise-induced muscle damage and inflammation. Lymphedema status was assessed using bioimpedance spectroscopy and arm circumferences, and associated symptoms were assessed using Visual Analogue Scales for pain, heaviness, and tightness. Measurements were conducted before and 24 hours after the exercise sessions. Results No significant changes in creatine kinase, C-reactive protein, interleukin-6, and tumor necrosis factor-α were observed following the 3 resistance exercise sessions. There were no significant changes in arm swelling or symptom severity scores across the 3 resistance exercise conditions. Conclusions The magnitude of acute exercise-induced inflammation following upper-body resistance exercise in women with BCRL does not vary between resistance exercise loads. © The Author(s) 2015.

  1. Transcriptional targeting of acute hypoxia in the tumour stroma is a novel and viable strategy for cancer gene therapy.

    Science.gov (United States)

    Ingram, N; Porter, C D

    2005-07-01

    Deregulated tumour growth and neovascularization result in an inadequate tumour blood supply, leading to areas of chronic hypoxia and necrosis. Irregular vascular structure and abnormal tumour physiology also cause erratic blood flow in tumour vessels. We reasoned that tumour stroma, including vascular endothelial cells, would consequently experience transient hypoxia that may allow transcriptional targeting as part of an antivascular gene therapy approach to cancer. To exploit hypoxia for transcriptional regulation, retroviral vectors were generated with modified LTRs: a 6-mer of hypoxia response elements in place of the viral enhancer produced near wild-type levels of expression in hypoxia but was functionally inert in normoxia. In a tumour xenograft model, expression was mainly around areas of necrosis, which were shown to be hypoxic; no expression was detected in tumour stroma. Time-course experiments in vitro demonstrated that expression was transient in response to a hypoxic episode, such that a reporter gene would be insensitive to acute hypoxia in vivo. In contrast, a significant therapeutic effect was seen upon ganciclovir administration with a vector expressing thymidine kinase (TK) in the tumour stroma. Expression of TK was more effective when targeted to acute hypoxia in the stroma compared to chronic hypoxia in the poorly vascularized regions of the tumour cell compartment. The data presented here are evidence that hypoxia in the stromal compartment does occur and that transient hypoxia constitutes a valid therapeutic target.

  2. Primary prevention and treatment of venous thromboembolic events in patients with gastrointestinal cancers- Review

    Institute of Scientific and Technical Information of China (English)

    Hanno Riess; Piet Habbel; Anja Jühling; Marianne Sinn; Uwe Pelzer

    2016-01-01

    Venous thromboembolism event(VTE) is a common and morbid complication in cancer patients. Patients with gastrointestinal cancers often suffer from symptomatic or incidental splanchnic vein thrombosis, impaired liver function and/or thrombocytopenia. These characteristics require a thorough risk/benefit evaluation for individual patients. Considering the risk factors for the development of VTE and bleeding events in addition to recent study results may be helpful for correct initiation of primary pharmacological prevention and treatment of cancer-associated thrombosis(CAT), preferably with low molecular weight heparins(LMWH). Whereas thromboprophylaxis is most often recommended in hospitalized surgical and non-surgical patients with malignancy, there is less agreement as to its duration. With regard to ambulatory cancer patients, the lack of robust data results in low grade recommendations against routine use of anticoagulant drugs. Anticoagulation with LMWH for the first months is the evidence-based treatment for acute CAT, but duration of secondary prevention and the drug of choice are unclear. Based on published guidelines and literature, this review will focus on prevention and treatment strategies of VTE in patients with gastrointestinal cancers.

  3. Alternative analyses for handling incomplete follow-up in the intention-to-treat analysis: the randomized controlled trial of balloon kyphoplasty versus non-surgical care for vertebral compression fracture (FREE

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2012-03-01

    Full Text Available Abstract Background Clinical trial participants may be temporarily absent or withdraw from trials, leading to missing data. In intention-to-treat (ITT analyses, several approaches are used for handling the missing information - complete case (CC analysis, mixed-effects model (MM analysis, last observation carried forward (LOCF and multiple imputation (MI. This report discusses the consequences of applying the CC, LOCF and MI for the ITT analysis of published data (analysed using the MM method from the Fracture Reduction Evaluation (FREE trial. Methods The FREE trial was a randomised, non-blinded study comparing balloon kyphoplasty with non-surgical care for the treatment of patients with acute painful vertebral fractures. Patients were randomised to treatment (1:1 ratio, and stratified for gender, fracture aetiology, use of bisphosphonates and use of systemic steroids at the time of enrolment. Six outcome measures - Short-form 36 physical component summary (SF-36 PCS scale, EuroQol 5-Dimension Questionnaire (EQ-5D, Roland-Morris Disability (RMD score, back pain, number of days with restricted activity in last 2 weeks, and number of days in bed in last 2 weeks - were analysed using four methods for dealing with missing data: CC, LOCF, MM and MI analyses. Results There were no missing data in baseline covariates values, and only a few missing baseline values in outcome variables. The overall missing-response level increased during follow-up (1 month: 14.5%; 24 months: 28%, corresponding to a mean of 19% missing data during the entire period. Overall patterns of missing response across time were similar for each treatment group. Almost half of all randomised patients were not available for a CC analysis, a maximum of 4% were not included in the LOCF analysis, and all randomised patients were included in the MM and MI analyses. Improved estimates of treatment effect were observed with LOCF, MM and MI compared with CC; only MM provided improved

  4. Internalization: acute apoptosis of breast cancer cells using herceptin-immobilized gold nanoparticles

    Directory of Open Access Journals (Sweden)

    Rathinaraj P

    2015-02-01

    Full Text Available Pierson Rathinaraj,1 Ahmed M Al-Jumaily,1 Do Sung Huh21Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand; 2Department of Nano science and Engineering, Inje University, Gimhea, South KoreaAbstract: Herceptin, the monoclonal antibody, was successfully immobilized on gold nanoparticles (GNPs to improve their precise interactions with breast cancer cells (SK-BR3. The mean size of the GNPs (29 nm, as determined by dynamic light scattering, enlarged to 82 nm after herceptin immobilization. The in vitro cell culture experiment indicated that human skin cells (FB proliferated well in the presence of herceptin-conjugated GNP (GNP–Her, while most of the breast cancer cells (SK-BR3 had died. To elucidate the mechanism of cell death, the interaction of breast cancer cells with GNP–Her was tracked by confocal laser scanning microscopy. Consequently, GNP–Her was found to be bound precisely to the membrane of the breast cancer cell, which became almost saturated after 6 hours incubation. This shows that the progression signal of SK-BR3 cells is retarded completely by the precise binding of antibody to the human epidermal growth factor receptor 2 receptor of the breast cancer cell membrane, causing cell death.Keywords: herceptin, gold nanoparticles, SK-BR3 cells, intracellular uptake

  5. CD22: A Promising Target for Acute Lymphoblastic Leukemia Treatment | Center for Cancer Research

    Science.gov (United States)

    There are about 4,000 new cases of acute lymphoblastic leukemia (ALL) in the United States each year. Great improvements have been made in the treatment of ALL, but many patients suffer from side effects of standard therapy and continue to die of this disease. One of the most promising therapeutic strategies includes engineering T cells with a chimeric antigen receptor (CAR) that alters T cell specificity and function to recognize tumor antigens.

  6. The molecular genetic makeup of acute lymphoblastic leukemia | Office of Cancer Genomics

    Science.gov (United States)

    Abstract: Genomic profiling has transformed our understanding of the genetic basis of acute lymphoblastic leukemia (ALL). Recent years have seen a shift from microarray analysis and candidate gene sequencing to next-generation sequencing. Together, these approaches have shown that many ALL subtypes are characterized by constellations of structural rearrangements, submicroscopic DNA copy number alterations, and sequence mutations, several of which have clear implications for risk stratification and targeted therapeutic intervention.

  7. Acute Toxicity of Radiochemotherapy in Rectal Cancer Patients: A Risk Particularly for Carriers of the TGFB1 Pro25 variant

    Energy Technology Data Exchange (ETDEWEB)

    Schirmer, Markus Anton; Mergler, Caroline Patricia Nadine [Department of Clinical Pharmacology, University Medical Center, Goettingen (Germany); Rave-Fraenk, Margret; Herrmann, Markus Karl; Hennies, Steffen [Department of Radiotherapy and Radiooncology, University Medical Center, Goettingen (Germany); Gaedcke, Jochen; Conradi, Lena-Christin; Jo, Peter [Department of General and Visceral Surgery, University Medical Center, Goettingen (Germany); Beissbarth, Tim [Department of Medical Statistics, University Medical Center, Goettingen (Germany); Hess, Clemens Friedrich [Department of Radiotherapy and Radiooncology, University Medical Center, Goettingen (Germany); Becker, Heinz; Ghadimi, Michael [Department of General and Visceral Surgery, University Medical Center, Goettingen (Germany); Brockmoeller, Juergen [Department of Clinical Pharmacology, University Medical Center, Goettingen (Germany); Christiansen, Hans [Department of Radiotherapy and Radiooncology, University Medical Center, Goettingen (Germany); Wolff, Hendrik Andreas, E-mail: hendrik.wolff@med.uni-goettingen.de [Department of Radiotherapy and Radiooncology, University Medical Center, Goettingen (Germany)

    2012-05-01

    Purpose: Transforming growth factor-beta1 is related to adverse events in radiochemotherapy. We investigated TGFB1 genetic variability in relation to quality of life-impairing acute organ toxicity (QAOT) of neoadjuvant radiochemotherapy under clinical trial conditions. Methods and Materials: Two independent patient cohorts (n = 88 and n = 75) diagnosed with International Union Against Cancer stage II/III rectal cancer received neoadjuvant radiation doses of 50.4 Gy combined with 5-fluorouracil-based chemotherapy. Toxicity was monitored according to Common Terminology Criteria for Adverse Events. QAOT was defined as a CTCAE grade {>=}2 for at least one case of enteritis, proctitis, cystitis, or dermatitis. Nine germline polymorphisms covering the common genetic diversity in the TGFB1 gene were genotyped. Results: In both cohorts, all patients carrying the TGFB1 Pro25 variant experienced QAOT (positive predictive value of 100%, adjusted p = 0.0006). In a multivariate logistic regression model, gender, age, body mass index, type of chemotherapy, or disease state had no significant impact on QAOT. Conclusion: The TGFB1 Pro25 variant could be a relevant marker for individual treatment stratification and carriers may benefit from adaptive clinical care or specific radiation techniques.

  8. Comparison of Acute and Late Toxicities for Three Modern High-Dose Radiation Treatment Techniques for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, Nasiruddin [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Kestin, Larry, E-mail: lkestin@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai; Krauss, Daniel; Vicini, Frank; Brabbins, Donald; Gustafson, Gary; Ye Hong; Martinez, Alavaro [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-01-01

    Purpose: We compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicities in prostate cancer patients treated with three different high-dose radiation techniques. Methods and Materials: A total of 1,903 patients with localized prostate cancer were treated with definitive RT at William Beaumont Hospital from 1992 to 2006: 22% with brachytherapy alone (BT), 55% with image-guided external beam (EB-IGRT), and 23% external beam with high-dose-rate brachytherapy boost (EBRT+HDR). Median dose with BT was 120 Gy for LDR and 38 Gy for HDR (9.5 Gy Multiplication-Sign 4). Median dose with EB-IGRT was 75.6 Gy (PTV) to prostate with or without seminal vesicles. For EBRT+HDR, the pelvis was treated to 46 Gy with an additional 19 Gy (9.5 Gy Multiplication-Sign 2) delivered via HDR. GI and GU toxicity was evaluated utilizing the NCI-CTC criteria (v.3.0). Median follow-up was 4.8 years. Results: The incidences of any acute {>=} Grade 2 GI or GU toxicities were 35%, 49%, and 55% for BT, EB-IGRT, and EBRT+HDR (p < 0.001). Any late GU toxicities {>=} Grade 2 were present in 22%, 21%, and 28% for BT, EB-IGRT, and EBRT+HDR (p = 0.01), respectively. Patients receiving EBRT+HDR had a higher incidence of urethral stricture and retention, whereas dysuria was most common in patients receiving BT. Any Grade {>=}2 late GI toxicities were 2%, 20%, and 9% for BT, EB-IGRT, and EBRT+HDR (p < 0.001). Differences were most pronounced for rectal bleeding, with 3-year rates of 0.9%, 20%, and 6% (p < 0.001) for BT, EB-IGRT, and EBRT+HDR respectively. Conclusions: Each of the three modern high-dose radiation techniques for localized prostate cancer offers a different toxicity profile. These data can help patients and physicians to make informed decisions regarding radiotherapy for prostate andenocarcinoma.

  9. Acute Radiation-Induced Nocturia in Prostate Cancer Patients Is Associated With Pretreatment Symptoms, Radical Prostatectomy, and Genetic Markers in the TGF{beta}1 Gene

    Energy Technology Data Exchange (ETDEWEB)

    De Langhe, Sofie, E-mail: Sofie.DeLanghe@UGent.be [Department of Basic Medical Sciences, Ghent University, Gent (Belgium); De Ruyck, Kim [Department of Basic Medical Sciences, Ghent University, Gent (Belgium); Ost, Piet; Fonteyne, Valerie [Department of Radiation Oncology, Ghent University Hospital, Gent (Belgium); Werbrouck, Joke [Department of Basic Medical Sciences, Ghent University, Gent (Belgium); De Meerleer, Gert; De Neve, Wilfried [Department of Radiation Oncology, Ghent University Hospital, Gent (Belgium); Thierens, Hubert [Department of Basic Medical Sciences, Ghent University, Gent (Belgium)

    2013-02-01

    Purpose: After radiation therapy for prostate cancer, approximately 50% of the patients experience acute genitourinary symptoms, mostly nocturia. This may be highly bothersome with a major impact on the patient's quality of life. In the past, nocturia is seldom reported as a single, physiologically distinct endpoint, and little is known about its etiology. It is assumed that in addition to dose-volume parameters and patient- and therapy-related factors, a genetic component contributes to the development of radiation-induced damage. In this study, we investigated the association among dosimetric, clinical, and TGF{beta}1 polymorphisms and the development of acute radiation-induced nocturia in prostate cancer patients. Methods and Materials: Data were available for 322 prostate cancer patients treated with primary or postoperative intensity modulated radiation therapy (IMRT). Five genetic markers in the TGF{beta}1 gene (-800 G>A, -509 C>T, codon 10 T>C, codon 25 G>C, g.10780 T>G), and a high number of clinical and dosimetric parameters were considered. Toxicity was scored using an symptom scale developed in-house. Results: Radical prostatectomy (P<.001) and the presence of pretreatment nocturia (P<.001) are significantly associated with the occurrence of radiation-induced acute toxicity. The -509 CT/TT (P=.010) and codon 10 TC/CC (P=.005) genotypes are significantly associated with an increased risk for radiation-induced acute nocturia. Conclusions: Radical prostatectomy, the presence of pretreatment nocturia symptoms, and the variant alleles of TGF{beta}1 -509 C>T and codon 10 T>C are identified as factors involved in the development of acute radiation-induced nocturia. These findings may contribute to the research on prediction of late nocturia after IMRT for prostate cancer.

  10. The role of breast cancer resistance protein in acute lymphoblastic leukemia

    NARCIS (Netherlands)

    Plasschaert, SLA; van der Kolk, D.M.; de Bout, ESJM; Kamps, WA; Morisaki, K; Bates, SE; Scheffer, GL; Scheper, RJ; Vellenga, E; de Vries, EGE

    2003-01-01

    Purpose: Overexpression of the transporter ABCG2, also known as breast cancer resistance protein and mitoxantrone resistance protein, can confer resistance to a variety of cytostatic drugs, such as mitoxantrone, topotecan, doxorubicin, and daunorubicin. This study analyzes the ABCG2 expression and a

  11. Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence.

    Science.gov (United States)

    Imamura, M; Abrams, P; Bain, C; Buckley, B; Cardozo, L; Cody, J; Cook, J; Eustice, S; Glazener, C; Grant, A; Hay-Smith, J; Hislop, J; Jenkinson, D; Kilonzo, M; Nabi, G; N'Dow, J; Pickard, R; Ternent, L; Wallace, S; Wardle, J; Zhu, S; Vale, L

    2010-08-01

    To assess the clinical effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence (SUI) through systematic review and economic modelling. The Cochrane Incontinence Group Specialised Register, electronic databases and the websites of relevant professional organisations and manufacturers, and the following databases: CINAHL, EMBASE, BIOSIS, Science Citation Index and Social Science Citation Index, Current Controlled Trials, ClinicalTrials.gov and the UKCRN Portfolio Database. The study comprised three distinct elements. (1) A survey of 188 women with SUI to identify outcomes of importance to them (activities of daily living; sex, hygiene and lifestyle issues; emotional health; and the availability of services). (2) A systematic review and meta-analysis of non-surgical treatments for SUI to find out which are most effective by comparing results of trials (direct pairwise comparisons) and by modelling results (mixed-treatment comparisons - MTCs). A total of 88 randomised controlled trials (RCTs) and quasi-RCTs reporting data from 9721 women were identified, considering five generic interventions [pelvic floor muscle training (PFMT), electrical stimulation (ES), vaginal cones (VCs), bladder training (BT) and serotonin-noradrenaline reuptake inhibitor (SNRI) medications], in many variations and combinations. Data were available for 37 interventions and 68 treatment comparisons by direct pairwise assessment. Mixed-treatment comparison models compared 14 interventions, using data from 55 trials (6608 women). (3) Economic modelling, using a Markov model, to find out which combinations of treatments (treatment pathways) are most cost-effective for SUI. Titles and abstracts identified were assessed by one reviewer and full-text copies of all potentially relevant reports independently assessed by two reviewers. Any disagreements were resolved by consensus or arbitration by a third person. Direct pairwise comparison and MTC

  12. Dosimetric Predictors of Radiation-induced Acute Nausea and Vomiting in IMRT for Nasopharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Victor H.F., E-mail: vhflee@hku.hk [Department of Clinical Oncology, University of Hong Kong, Queen Mary Hospital (Hong Kong); Ng, Sherry C.Y.; Leung, T.W.; Au, Gordon K.H.; Kwong, Dora L.W. [Department of Clinical Oncology, University of Hong Kong, Queen Mary Hospital (Hong Kong)

    2012-09-01

    Purpose: We wanted to investigate dosimetric parameters that would predict radiation-induced acute nausea and vomiting in intensity-modulated radiation therapy (IMRT) for undifferentiated carcinoma of the nasopharynx (NPC). Methods and Materials: Forty-nine consecutive patients with newly diagnosed NPC were treated with IMRT alone in this prospective study. Patients receiving any form of chemotherapy were excluded. The dorsal vagal complex (DVC) as well as the left and right vestibules (VB-L and VB-R, respectively) were contoured on planning computed tomography images. A structure combining both the VB-L and the VB-R, named VB-T, was also generated. All structures were labeled organs at risk (OAR). A 3-mm three-dimensional margin was added to these structures and labeled DVC+3 mm, VB-L+3 mm, VB-R+3 mm, and VB-T+3 mm to account for physiological body motion and setup error. No weightings were given to these structures during optimization in treatment planning. Dosimetric parameters were recorded from dose-volume histograms. Statistical analysis of parameters' association with nausea and vomiting was performed using univariate and multivariate logistic regression. Results: Six patients (12.2%) reported Grade 1 nausea, and 8 patients (16.3%) reported Grade 2 nausea. Also, 4 patients (8.2%) complained of Grade 1 vomiting, and 4 patients (8.2%) experienced Grade 2 vomiting. No patients developed protracted nausea and vomiting after completion of IMRT. For radiation-induced acute nausea, V40 (percentage volume receiving at least 40Gy) to the VB-T and V40>=80% to the VB-T were predictors, using univariate analysis. On multivariate analysis, V40>=80% to the VB-T was the only predictor. There were no predictors of radiation-induced acute vomiting, as the number of events was too small for analysis. Conclusions: This is the first study demonstrating that a V40 to the VB-T is predictive of radiation-induced acute nausea. The vestibules should be labeled as sensitive OARs

  13. Targetable kinase-activating lesions in Ph-like acute lymphoblastic leukemia | Office of Cancer Genomics

    Science.gov (United States)

    Publication Abstract:  Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is characterized by a gene-expression profile similar to that of BCR-ABL1-positive ALL, alterations of lymphoid transcription factor genes, and a poor outcome. The frequency and spectrum of genetic alterations in Ph-like ALL and its responsiveness to tyrosine kinase inhibition are undefined, especially in adolescents and adults. We performed genomic profiling of 1725 patients with precursor B-cell ALL and detailed genomic analysis of 154 patients with Ph-like ALL.

  14. Adverse events profile of PrePex a non-surgical device for adult male circumcision in a Ugandan urban setting.

    Directory of Open Access Journals (Sweden)

    Moses Galukande

    Full Text Available BACKGROUND: Safe Male Circumcision is a proven approach for partial HIV prevention. Several sub Saharan African countries have plans to reach a prevalence of 80% of their adult males circumcised by 2015. These targets require out of ordinary organization, demand creation, timely execution and perhaps the use of SMC devices. OBJECTIVE: To profile Adverse Events rate and acceptance of PrePex, a non surgical device for adult male circumcision. METHODS: A prospective study, conducted at International Hospital Kampala, Uganda, between August and October 2012. Ethical approval was obtained from Uganda National Council of Science and Technology. RESULTS: Of 1,040 men received to undergo SMC, 678 opted for PrePex, 36 were excluded at an initial physical examination screening. 642 were enrolled and consented, and another 17 were excluded before device placement. 625 underwent the procedure. Average age was 24 years (± 7. Twelve moderate AEs occurred among 10 participants 12/625, (1.9%. These were all reversible. Five had device displacement, one had an everted foreskin; five had bleeding after the device was removed and one had voiding difficulties. The majority (279 out of 300 of men interviewed complained of some pain within the week of placement. Mean pain score at device placement (using visual analogue scale was 0.5, at device removal 4.5 and within 2 min of removal the pain score was 1.4. Over 70% of the devices were placed and removed by non-physician clinicians. Presented with a choice, 60% of men chose PrePex over surgical SMC. Close to 90% would recommend the device to their friends. Odour from the necrotic skin was a concern. Removals done 1-2 days earlier than day 7 were beneficial and conferred no extra risk. CONCLUSION: AEs of a moderate or severe nature associated with PrePex were low and reversible. PrePex is feasible for mass safe male circumcision scaling up.

  15. [Impact of the level of metabolic control on the non-surgical periodontal therapy outcomes in diabetes mellitus type 2 patients--clinical effects].

    Science.gov (United States)

    Mirnić, Jelena; Djurić, Milanko; Predin, Tanja; Gusić, Ivana; Petrović, Djordje; Andjelković, Aleksandra; Bajkin, Branislav

    2013-01-01

    Diabetes mellitus as a complex metabolic disease influences functioning of numerous organs. Chronic periodontitis is one of frequent diabetic complications. The aim of this study was to compare the clinical effects of non-surgical periodontal therapy between diabetes mellitus type 2 patients (DM type 2) and non-diabetic individuals (control group). Our study included 41 DM type 2 subjects and 21 non-diabetic individuals, all of them with chronic periodontitis. The diabetic group was divided into two subgroups based on the level of glycosylated hemoglobin (HbA1c) as follows: D1 - 18 subjects with good metabolic control (HbA1c or = 7%). State of oral hygiene and periodontal clinical parameters of subjects, such as: plaque index (PI), gingival index (GI), papilla bleeding index (PBI), probing pocket depth (PPD) and clinical attachment level (CAL), were evaluated at the baseline and 3 months after scaling and root-planning. ANOVA test showed that there was no statistically significant difference of treatment success between studied groups in relation to GI (p = 0.52), PBI (p = 0.36) and CAL (p = 0.11). Reduction of PI and PPD in the control group (deltaPI = 0.84; deltaPPD = 0.35 mm) was significantly higher (p diabetes (group D1 deltaPI = 0.60, deltaPPD = 0.11 mm; group D2 deltaPI = 0.53, deltaPPD = 0.11 mm). Although there were differences in treatment success between DM subjects and non-diabetic individuals, they were not significant for the most measured parameters. The results of this study did not absolutely support the assumption that the level of glycemic control significantly affected the periodontal therapy outcome in diabetics.

  16. 子宫腺肌病的非手术治疗研究进展%Non-surgical treatment of adenomyosis

    Institute of Scientific and Technical Information of China (English)

    陈燕; 周洪贵

    2013-01-01

    The adenomyosis is a common kind of benign lesions of department of gynecology, surgery is traditional treatment, drug supplemented. But injure of hysterectomy was great, that brought psychological distress to patients. As medical technology advances, non-surgical treatment gradually has become the preferred treatment, including medication, uterine artery embolization, high intensity focused ultrasound and so on, each have advantages and disadvantages. The high intensity focused ultrasound, which is a kind of scientific, noninvasive, safe and effective treatment method, and no severe complications, is expected to become the first choice treatment of uterine adenomyosis.%子宫腺肌病是妇科常见的一种良性病变,传统的治疗方法为手术为主、药物为辅。手术切除子宫创伤大、不能保留子宫,给患者带来身体及心理的极大创伤。随着医疗技术进步,非手术治疗方式逐渐成为首选治疗方式,包括药物治疗、子宫动脉栓塞、高强度聚焦超声等。每种治疗方式各有优缺点,而高强度聚焦超声是一种科学、无创、安全有效的治疗方法,近期疗效显著,有望成为子宫腺肌病的首选治疗方法。

  17. Comparison of acute and subacute genitourinary and gastrointestinal adverse events of radiotherapy for prostate cancer using intensity-modulated radiation therapy, three-dimensional conformal radiation therapy, permanent implant brachytherapy and high-dose-rate brachytherapy

    NARCIS (Netherlands)

    Morimoto, Masahiro; Yoshioka, Yasuo; Konishi, Koji; Isohashi, Fumiaki; Takahashi, Yutaka; Ogata, Toshiyuki; Koizumi, Masahiko; Teshima, Teruki; Bijl, Henk P; van der Schaaf, Arjen; Langendijk, Johannes A; Ogawa, Kazuhiko

    2014-01-01

    AIMS AND BACKGROUND: To examine acute and subacute urinary and rectal toxicity in patients with localized prostate cancer monotherapeutically treated with the following four radiotherapeutic techniques: intensity-modulated radiation therapy, three-dimensional conformal radiation therapy,

  18. Image-guided intensity-modulated radiotherapy of prostate cancer. Analysis of interfractional errors and acute toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Rudat, Volker; Nour, A.; Hammoud, M.; Alaradi, A.; Mohammed, A. [Saad Specialist Hospital, Department of Radiation Oncology, Al Khobar (Saudi Arabia)

    2016-02-15

    The aim of the study was to estimate interfractional deviations in patient and prostate position, the impact of the frequency of online verification on the treatment margins, and to assess acute radiation reactions of high-dose external beam image-guided intensity-modulated radiotherapy (IG-IMRT) of localized prostate cancer. IG-IMRT was performed by daily online verification of implanted fiducial prostate markers using a megavoltage electronic portal imaging device (EPID). A total of 1011 image-guided treatment fractions from 23 consecutive unselected prostate cancer patients were analyzed. The median total dose was 79.2 Gy (range 77.4-81.0 Gy). Acute radiation reactions were assessed weekly during radiotherapy using the Common Terminology Criteria for Adverse Events (CTCAE) v.4.03. A relevant combined patient set-up and prostate motion population random error of 4-5 mm was observed. Compared to daily IGRT, image guidance every other day required an expansion of the CTV-PTV (clinical target volume-planning target volume) margin of 8.1, 6.6, and 4.1 mm in the longitudinal, vertical, and lateral directions, thereby, increasing the PTV by approximately 30-40 %. No grade 3 or 4 acute radiation reactions were observed with daily IG-IMRT. A high dose with surprisingly low acute toxicity can be applied with daily IG-IMRT using implanted fiducial prostate markers. Daily image guidance is clearly superior to image guidance every other fraction concerning adequate target coverage with minimal margins. (orig.) [German] Ziel der Studie war es, die interfraktionelle Variabilitaet der Patientenlagerung und Prostataposition, den Einfluss der Bildgebungsfrequenz und die akuten Strahlenreaktionen bei einer hochdosierten bildgesteuerten intensitaetsmodulierten Strahlentherapie (IG-IMRT) des Prostatakarzinoms zu untersuchen. IG-IMRT wurde durch taegliche Verifikation von implantierten roentgendichten Prostatamarkern mittels Megavolt-Bildgebung (''electronic portal imaging

  19. Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosis.

    Science.gov (United States)

    Giannousi, Zoe; Gioulbasanis, Ioannis; Pallis, Athanasios G; Xyrafas, Alexandros; Dalliani, Danai; Kalbakis, Kostas; Papadopoulos, Vassilis; Mavroudis, Dimitris; Georgoulias, Vassilis; Papandreou, Christos N

    2012-08-01

    Cancer cachexia is a metabolic syndrome related with poor outcome. Cytokines play a key role in the pathophysiology of that syndrome. The aim of this study was to investigate the potential correlations between nutritional status, systemic inflammation, and psychological distress in cancer patients. The prognostic significance of the recorded parameters was also assessed. Patients with metastatic lung cancer were eligible. Mini Nutritional Assessment (MNA) was used for the evaluation of nutritional status, Glasgow Prognostic Score (GPS) for the estimation of systemic inflammation, and Hospital Anxiety and Depression Scale (HADS) for psychological assessment. Totally, 122 patients were enrolled (71.3% with NSCLC and 28.7% with SCLC). The following correlations were observed: MNA and GPS (r = 0.289, p = 0.001), MNA and HADS (depression scale) (r = 0.275, p = 0.002), GPS and HADS (depression scale) (r = 0.256, p = 0.004), and GPS and HADS (anxiety scale) (r =0.194, p =0.033). In univariate analysis, GPS (p = 0.002) and MNA (p = 0.010) emerged as significant predictors of survival. In multivariate analysis, both MNA (p = 0.032) and GPS (p = 0.020) retained their importance. This study highlights the associations between nutritional status, systemic inflammation, and psychological distress, supporting their common underlying pathophysiological mechanisms and further suggesting the necessity of a holistic anti-cachectic approach.

  20. Profiles and Time Course of Acute Radiation Toxicity Symptoms during Conformal Radiotherapy for Cancer of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Hovdenak, Nils; Karlsdottir, Aasa; Soerbye, Halfdan; Dahl, Olav [Univ. of Bergen (Norway). Div. of Gastroenterology

    2003-11-01

    Symptoms of gastrointestinal toxicity are dose-limiting for pelvic radiotherapy (RT). Existing toxicity registrations (RTOG/EORTC) are helpful in defining maximal tolerated doses, but tend to underestimate the total toxicity burden by excluding several minor complaints. We have applied a more detailed and quantitative recording of symptoms and related these scores to RT-induced endoscopic and histopathologic changes. Prevalence and severity of specific toxicity symptoms were recorded before, during (weeks 2 and 6) and 2 and 8 weeks after RT in 96 patients undergoing external beam RT for localized prostate cancer. RTOG/EORTC acute toxicity and ad hoc total toxicity scores (TTS) were recorded. TTS scores were calculated by adding scores based on visual analog scale (VAS) grading of individual symptoms. Fifty of the patients also underwent sequential proctoscopy with mucosal biopsy. Individual symptoms increased, but differed in prevalence and intensity during and after RT. TTS increased during the entire treatment course in spite of normalizing histopathologic and endoscopic changes from week 2 onwards. Twenty-seven patients had no RTOG/EORTC toxicity, four had grade 3 and none had grade 4 toxicity. All patients with grade 0 had increased TTS. Thus, TTS appeared more sensitive than RTOG/EORTC scoring. The study demonstrates that multiple toxicity symptoms contribute to total toxicity in response to pelvic RT. TTS is a feasible and sensitive method for detecting and quantifying acute toxicity and unveils morbidity which remains hidden with the RTOG/EORTC score system. The development and timing of symptoms may give clues to pathogenesis, treatment, and prophylaxis.

  1. Acute Generalized Exanthematous Pustulosis Induced by Erlotinib (Tarceva with Superimposed Staphylococcus aureus Skin Infection in a Pancreatic Cancer Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Egbert Liquete

    2012-05-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare acute reaction that is drug induced in 90% of the cases and characterized by a widespread, sterile pustular rash. Erlotinib, a small-molecule EGFR tyrosine kinase inhibitor, has been approved by the FDA for patients with pancreatic cancer and non-small cell lung cancer. Skin rash is a well-known side effect related with all EGFR blocking agents. It has been suggested that rash could be used as a surrogate marker for response and possibly be associated with prolonged survival. We report a case of rare presentation of AGEP involving an adverse effect of erlotinib. The commonly reported adverse effects of erlotinib are mild skin eruptions. However, our case describes the rare presentation of AGEP induced by erlotinib. The estimated incidence rate of AGEP is approximately 1–5 cases per million/year.

  2. Acute renal failure secondary to drug-related crystalluria and/or drug reaction with eosinophilia and systemic symptom syndrome in a patient with metastatic lung cancer

    Directory of Open Access Journals (Sweden)

    Saime Paydas

    2017-01-01

    Full Text Available Drug reaction with eosinophilia and systemic symptoms (DRESS or drug-induced hypersensitivity is a severe adverse drug-induced reaction. Aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, and some drugs, can induce DRESS. Atypical crystalluria can be seen in patients treated with amoxycillin or some drugs and can cause acute renal failure. We describe a 66-year-old man who presented fever and rash and acute renal failure three days after starting amoxycillin. He was also using phenytoin because of cerebral metastatic lung cancer. Investigation revealed eosinophilia and atypical crystalluria. The diagnosis of DRESS syndrome was made, amoxicillin was stopped, and dose of phenytoin was reduced. No systemic corticosteroid therapy was prescribed. Symptoms began to resolve within three to four days. The aim of this paper is to highlight the importance of microscopic examination of urine in a case with acute renal failure and skin lesions to suspect DRESS syndrome.

  3. Acute myeloid leukemia (AML) - children

    Science.gov (United States)

    Acute myeloid leukemia is a cancer of the blood and bone marrow. Bone marrow is the soft tissue inside ... develops quickly. Both adults and children can get acute myeloid leukemia ( AML ). This article is about AML in children.

  4. Proton pump inhibitor-induced Sweet’s syndrome: report of acute febrile neutrophilic dermatosis in a woman with recurrent breast cancer

    OpenAIRE

    Cohen, Philip R.

    2015-01-01

    Background: Sweet’s syndrome, also referred to as acute febrile neutrophilic dermatosis, can either occur as an idiopathic disorder or associated with another condition, including cancer, or induced by exposure to a drug. Proton pump inhibitors selectively inhibit gastric parietal cell H+-K+-adenosine triphosphatase and are most commonly used for the treatment of gastroesophageal reflux disease. Purpose: Proton pump inhibitor-associated Sweet’s syndrome is described in a woman with recurrent ...

  5. Researchers Identify Genomic Alterations Associated with Drug-Targetable Kinase Activation in Ph-like Acute Lymphoblastic Leukemia | Office of Cancer Genomics

    Science.gov (United States)

    Acute lymphoblastic leukemia (ALL) is the most prevalent cancer among children and young adults, and standard treatments within this population generally result in favorable outcomes. By contrast, one particular subtype of this disease, Philadelphia chromosome-like ALL (Ph-like ALL), is associated with inferior outcomes. Ph-like ALL exhibits a gene expression profile similar to chromosome 9:22 translocation positive ALL, yet it lacks the characteristic BCR-ABL fusion protein.

  6. Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dong Gyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Jung, So Lyung [Seoul St. Marys Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-06-15

    Radiofrequency ablation is a new non-surgical treatment modality for patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the treatment of benign thyroid nodules and recurrent thyroid cancers using radiofrequency ablation. These recommendations are based on evidence from the current literature and expert consensus

  7. Recent achievements and acute toxicity after TP concurrent chemoradiotherapy for the advanced cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Qinghua Ke; Shiqiong Zhou; Wei Du; Yong Lei; Min Huang; Fei Luo; Jiyuan Yang

    2012-01-01

    Objective: The aim of our study was to investigate the early outcome of the taxotere and cisplatin chemora-diotherapy to the advanced cervical cancer. Methods: Fifty-six cases with cervical cancer (FIGO IIb to IVa) were divided randomly into two groups in the oncology hospital of Jingzhou from September 2009 to October 2010, radiotherapy alone (28 cases) and radiation plus chemotherapy (TP) group. There was no difference of radiotherapy between the two groups, the RT + C cases who accepted TP regimen during the radiation, and DDP once weekly injection of vain, according to 20 mg/m2 and taxotere once weekly i.v. according to 35 mg/m2. These regimen were given for 4–5 weeks, and some medicine for vomit-ing was given to the RT + C cases. Two groups were received an oral medicine MA 160 mg every day during the treatment. Results: The early outcome: the complete remission rate was 64.3% and partial remission rate was 35.7% in RT + C. The complete remission rate was 32.1% and partial remission rate was 39.3% in RT. The total response rate and complete remis-sion of RT + C group was higher than that of the RT group. There was significant difference between the two groups. In RT + C group, 1-year survive rate was 100.00% (28/28); in RT group, 1-year survive rate was 85.71% (24/28). There was significant difference between the two groups (χ2 = 4.31 > 3.84, P < 0.05). Conclusion: The taxotere and cisplatin chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and the adverse effect are raised, but that can be endured.

  8. High-grade acute organ toxicity during preoperative radiochemotherapy as positive predictor for complete histopathologic tumor regression in multimodal treatment of locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, Hendrik Andreas; Herrmann, Markus Karl Alfred; Hennies, Steffen; Rave-Fraenk, Margret; Hess, Clemens Friedrich; Christiansen, Hans [Dept. of Radiotherapy and Radiooncology, Univ. Medicine Goettingen (Germany); Gaedcke, Jochen; Liersch, Torsten [Dept. of Surgery, Univ. Medicine Goettingen (Germany); Jung, Klaus [Dept. of Medical Statistics, Univ. Medicine Goettingen (Germany); Hermann, Robert Michael [Dept. of Radiotherapy and Radiooncology, Univ. Medicine Goettingen (Germany); Dept. of Radiotherapy and Radiooncology, Aerztehaus am Diako, Bremen (Germany); Rothe, Hilka [Dept. of Pathology, Univ. Medicine Goettingen (Germany); Schirmer, Markus [Dept. of Clinical Pharmacology, Univ. Medicine Goettingen (Germany)

    2010-01-15

    Purpose: To test for a possible correlation between high-grade acute organ toxicity during preoperative radiochemotherapy and complete tumor regression after total mesorectal excision in multimodal treatment of locally advanced rectal cancer. Patients and Methods: From 2001 to 2008, 120 patients were treated. Preoperative treatment consisted of normofractionated radiotherapy at a total dose of 50.4 Gy, and either two cycles of 5-fluorouracil (5-FU) or two cycles of 5-FU and oxaliplatin. Toxicity during treatment was monitored weekly, and any toxicity CTC (Common Toxicity Criteria) {>=} grade 2 of enteritis, proctitis or cystitis was assessed as high-grade organ toxicity for later analysis. Complete histopathologic tumor regression (TRG4) was defined as the absence of any viable tumor cells. Results: A significant coherency between high-grade acute organ toxicity and complete histopathologic tumor regression was found, which was independent of other factors like the preoperative chemotherapy schedule. The probability of patients with acute organ toxicity {>=} grade 2 to achieve TRG4 after neoadjuvant treatment was more than three times higher than for patients without toxicity (odds ratio: 3.29, 95% confidence interval: [1.01, 10.96]). Conclusion: Acute organ toxicity during preoperative radiochemotherapy in rectal cancer could be an early predictor of treatment response in terms of complete tumor regression. Its possible impact on local control and survival is under further prospective evaluation by the authors' working group. (orig.)

  9. A single group follow-up study of non-surgical patients seen by physiotherapists working in expanded roles in orthopaedic departments: recall of recommendations, change in exercise and self-efficacy

    Directory of Open Access Journals (Sweden)

    MacKay Crystal

    2012-12-01

    Full Text Available Abstract Background Specially trained physiotherapists (advanced practice physiotherapists (APP are working in orthopaedic clinics to improve access to orthopaedic services and support chronic disease management. Little attention has been paid to the impact APPs may have on non-surgical patients. In non-surgical patients with hip or knee arthritis consulting an APP in an orthopaedic clinic, the objectives were to: 1 describe patients’ recall of APP recommendations, use of self-management strategies, and barriers to management six weeks following consultation; and, 2 compare exercise behaviour and self-efficacy at baseline and six weeks. Findings This was a single group pre-and post-intervention study of patients who saw an APP when consulting the orthopaedic departments of two hospitals. At baseline and six weeks participants completed the adapted Stanford Exercise Behaviour Scale (response options: none,  3 hours/week, and the Chronic Disease Self-efficacy Scale (range 1–10; higher scores indicate higher self-efficacy. At follow-up participants completed questions on recall of APP recommendations, use of self-management strategies and barriers to management. Seventy three non-surgical patients with hip or knee arthritis participated, a response rate of 89% at follow-up. Seventy one percent of patients reported that the APP recommended exercise, of whom 83% reported exercising to manage their arthritis since the visit. Almost 50% reported an increase in time spent stretching; over 40% reported an increase in time spent walking or doing strengthening exercises at follow-up. Common barriers to arthritis management were time, cost and other health problems. Mean chronic disease self-efficacy scores significantly improved from 6.3 to 7.2 (p  Conclusions This pilot study of an APP intervention for non-surgical patients referred for orthopaedic consultation showed promising results, particularly for enhancing use of conservative management

  10. DNA repair capacity and acute radiotherapy adverse effects in Italian breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Sterpone, Silvia; Cornetta, Tommaso [Department of Biology, University of ' Roma TRE' , V.le G. Marconi 446, Rome 00146 (Italy); Padua, Luca [' Don Carlo Gnocchi' Foundation, Rome (Italy); Mastellone, Valeria [Department of Biology, University of ' Roma TRE' , V.le G. Marconi 446, Rome 00146 (Italy); Giammarino, Daniela [' S. Camillo-Forlanini' Hospital, Radiation Oncology Unit, Rome (Italy); Testa, Antonella; Tirindelli, Donatella [Toxicology and Biomedical Sciences Section, ENEA, Casaccia, Rome (Italy); Cozzi, Renata, E-mail: cozzi@uniroma3.it [Department of Biology, University of ' Roma TRE' , V.le G. Marconi 446, Rome 00146 (Italy); Donato, Vittorio [' S. Camillo-Forlanini' Hospital, Radiation Oncology Unit, Rome (Italy)

    2010-02-03

    Therapeutic exposure to ionising radiation can induce normal tissue side effects which consistently differ among individuals suggesting a possible genetic control. One approach to elucidate the underlying mechanisms is to analyse the relation between genetic traits, biomarkers of in vitro DNA damage and side toxicity in vivo. 43 breast cancer (BC) patients receiving radiotherapy after a breast-conserving surgery were recruited together with 34 age- and sex-matched healthy controls. Adverse tissue reactions were recorded as indicators of radiotherapy susceptibility. All blood samples from both patients (35) and controls (34) were irradiated in vitro and DNA primary damage and repair kinetic were measured through Comet assay. All study subjects were genotyped for XRCC1, OGG1 and XRCC3 gene polymorphisms. In our small groups we found a positive association between XRCC1 variant allele (399Gln) and the occurrence of breast cancer [p = 0.01; OR = 2.41, 95%CI (1.24-4.66)]. BC patients showed a higher degree of basal (p < 0.001) and X-ray induced DNA damage (p < 0.01) when compared to healthy controls. A reduced repair ability was found in BC patients showing high degrees of tissue side effects as classified by Radiation Morbidity Scoring Scheme. BC patients showed an impairment of their DNA repair capacity associated with the development of radiation sensitivity but not with polymorphisms in any of the considered genes.

  11. Acute Cavernous Sinus Syndrome from Metastasis of Lung Cancer to Sphenoid Bone

    Directory of Open Access Journals (Sweden)

    Marianna Zelenak

    2012-01-01

    Full Text Available Cavernous sinus syndrome is a rare entity in oncology reported only in occasional case reports. Optimal therapy is thus poorly defined with rapidly progressive disease dominating the picture. Management includes prompt diagnosis, attempts at stabilization of cranial nerve function, and aggressive control of central pain syndrome. Here, we report cavernous sinus syndrome secondary to the original squamous cell carcinoma of the lung. With common presenting causes of this syndrome being infection, thrombosis or tumor, it might seem that metastatic tumor would be expected in a patient with a cancer diagnosis. What was not so expected was the extremely rapid progression from mild headache and mild trigeminal neuralgia with negative-contrast head CT to a massive, destructive lesion involving several skull bones and skull base, only 3 weeks later. In addition, the patient was severely immunosuppressed at the completion of induction chemotherapy. Infectious processes, although unlikely, were considered, as aggressive cancer therapy (including high-dose steroids and radiation therapy had no impact on this disease. Despite accurate localization, the aggressive nature of this disease with massive bone destruction and dural thickening limited any chance of a durable control. We discuss the process of evaluation, diagnosis and treatment of symptoms and the importance of a team approach to best palliate these unfortunate patients.

  12. Acute Kidney Injury and Bisphosphonate Use in Cancer: A Report From the Research on Adverse Drug Events and Reports (RADAR) Project

    Science.gov (United States)

    Edwards, Beatrice J.; Usmani, Sarah; Raisch, Dennis W.; McKoy, June M.; Samaras, Athena T.; Belknap, Steven M.; Trifilio, Steven M.; Hahr, Allison; Bunta, Andrew D.; Abu-Alfa, Ali; Langman, Craig B.; Rosen, Steve T.; West, Dennis P.

    2013-01-01

    Purpose: To determine whether acute kidney injury (AKI) is identified within the US Food and Drug Administration's Adverse Events and Reporting System (FDA AERS) as an adverse event resulting from bisphosphonate (BP) use in cancer therapy. Methods: A search of the FDA AERS records from January 1998 through June 2009 was performed; search terms were “renal problems” and all drug names for BPs. The search resulted in 2,091 reports. We analyzed for signals of disproportional association by calculating the proportional reporting ratio for zoledronic acid (ZOL) and pamidronate. Literature review of BP-associated renal injury within the cancer setting was conducted. Results: Four hundred eighty cases of BP-associated acute kidney injury (AKI) were identified in patients with cancer. Two hundred ninety-eight patients (56%) were female; mean age was 66 ± 10 years. Multiple myeloma (n = 220, 46%), breast cancer (n = 98, 20%), and prostate cancer (n = 24, 5%) were identified. Agents included ZOL (n = 411, 87.5%), pamidronate (n = 8, 17%), and alendronate (n = 36, 2%). Outcomes included hospitalization (n = 304, 63.3%) and death (n = 68, 14%). The proportional reporting ratio for ZOL was 1.22 (95% CI, 1.13 to 1.32) and for pamidronate was 1.55 (95% CI, 1.25 to 1.65), reflecting a nonsignificant safety signal for both drugs. Conclusion: AKI was identified in BP cancer clinical trials, although a safety signal for BPs and AKI within the FDA AERS was not detected. Our findings may be attributed, in part, to clinicians who believe that AKI occurs infrequently; ascribe the AKI to underlying premorbid disease, therapy, or cancer progression; or consider that AKI is a known adverse drug reaction of BPs and thus under-report AKI to the AERS. PMID:23814519

  13. Minimally Important Differences and Change Across Time in Patients Treated Surgically and Non-Surgically for Full-Thickness Rotator Cuff Tears

    Science.gov (United States)

    Miller, Bruce S.; Robbins, Christopher; Gagnier, Joel Joseph

    2016-01-01

    Objectives: The minimally important difference (MID) is the smallest change in an outcome measure that is perceived by patients as beneficial. The MIDs for the ASES and WORC scores have not been established in a homogenous population of patients with rotator cuff tears. The objective of the present study was to establish the MIDs for patients with known cuff tears who were treated both surgically and non-surgically, and to compare the MIDs over time. Methods: We included 209 subjects with known full-thickness rotator cuff tears who were followed prospectively for two years. The WORC and ASES scores were collected at baseline, 4, 8, 16, 32, and 48 weeks, 1 year and 2 years. At the final follow-up point patients filled out an end-of-study form which included questions regarding change in their condition after treatment. Results: For those that indicated being minimally better, the change from baseline for the ASES score was -20.57 (-2.94 to -38.20) and for the WORC was 418.60 (70.39 to 766.81); both indicated improvement in outcomes. When converted to the percentage change score the WORC change represented 19.93%. The plots of these new MID values for the ASES and WORC indicate that not only does the operative group improve more than the non-operative group but it does so to an extent that is greater than the MID. The non-operative group also improved across time, but the magnitude did not exceed the MID for either the WORC or the ASES. Conclusion: We found that the ASES and the WORC MIDs in patients with rotator cuff tears is different from that previously reported, and that the operative group change was greater than the non-operative group change. This information will directly improve our ability to: (1) Determine when patients with RCTs are changing in a meaningful manner; (2) Accurately power clinical studies using these outcome measures; (3) Make more informed choices of treatments in these patients. This is the first study to report MIDs for the ASES and WORC

  14. CD90 and CD110 correlate with cancer stem cell potentials in human T-acute lymphoblastic leukemia cells

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Hiroto; Nishida, Hiroko; Iwata, Satoshi [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan); Dang, Nam H. [Department of Hematologic Malignancies, Nevada Cancer Institute, Las Vegas, NV (United States); Morimoto, Chikao, E-mail: morimoto@ims.u-tokyo.ac.jp [Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo 108-8639 (Japan)

    2009-05-29

    Although cancer stem cells (CSCs) have been recently identified in myeloid leukemia, published data on lymphoid malignancy have been sparse. T-acute lymphoblastic leukemia (T-ALL) is characterized by the abnormal proliferation of T-cell precursors and is generally aggressive. As CD34 is the only positive-selection marker for CSCs in T-ALL, we performed extensive analysis of CD markers in T-ALL cell lines. We found that some of the tested lines consisted of heterogeneous populations of cells with various levels of surface marker expression. In particular, a small subpopulation of CD90 (Thy-1) and CD110 (c-Mpl) were shown to correlate with stem cell properties both in vitro and in transplantation experiments. As these markers are expressed on hematopoietic stem cells, our results suggest that stem cell-like population are enriched in CD90+/CD110+ fraction and they are useful positive-selection markers for the isolation of CSCs in some cases of T-ALL.

  15. Heparin based prophylaxis to prevent venous thromboembolic events and death in patients with cancer - a subgroup analysis of CERTIFY

    Directory of Open Access Journals (Sweden)

    Abletshauser Claudia

    2011-07-01

    Full Text Available Abstract Background Patients with cancer have an increased risk of VTE. We compared VTE rates and bleeding complications in 1 cancer patients receiving LMWH or UFH and 2 patients with or without cancer. Methods Acutely-ill, non-surgical patients ≥70 years with (n = 274 or without cancer (n = 2,965 received certoparin 3,000 UaXa o.d. or UFH 5,000 IU t.i.d. for 8-20 days. Results 1 Thromboembolic events in cancer patients (proximal DVT, symptomatic non-fatal PE and VTE-related death occurred at 4.50% with certoparin and 6.03% with UFH (OR 0.73; 95% CI 0.23-2.39. Major bleeding was comparable and minor bleedings (0.75 vs. 5.67% were nominally less frequent. 7.5% of certoparin and 12.8% of UFH treated patients experienced serious adverse events. 2 Thromboembolic event rates were comparable in patients with or without cancer (5.29 vs. 4.13% as were bleeding complications. All cause death was increased in cancer (OR 2.68; 95%CI 1.22-5.86. 10.2% of patients with and 5.81% of those without cancer experienced serious adverse events (OR 1.85; 95% CI 1.21-2.81. Conclusions Certoparin 3,000 UaXa o.d. and 5,000 IU UFH t.i.d. were equally effective and safe with respect to bleeding complications in patients with cancer. There were no statistically significant differences in the risk of thromboembolic events in patients with or without cancer receiving adequate anticoagulation. Trial Registration clinicaltrials.gov, NCT00451412

  16. Clinical and dosimetric predictors of acute hematologic toxicity in rectal cancer patients undergoing chemoradiotherapy

    Science.gov (United States)

    Yang, T. Jonathan; Oh, Jung Hun; Apte, Aditya; Son, Christina H.; Deasy, Joseph O.; Goodman, Karyn A.

    2016-01-01

    Background and purpose To identify clinical and dosimetric factors associated with hematologic toxicity (HT) during chemoradiotherapy for rectal cancer. Materials and methods We analyzed 120 rectal cancer patients treated with neoadjuvant pelvic radiotherapy (PRT) with concurrent 5-fluorouracil-based chemotherapy. The coxal (ilium, ischium, and pubis) bone marrow (BM), sacral BM, and femoral BM were contoured and dose-volume parameters were extracted. Associations between cell count trend and clinical predictors were tested using repeated-measures analysis of variance (ANOVA) test. Associations between clinical variables, Vx (percentage volume receiving x Gy), and cell count ratio at nadir were tested using linear regression models. Results Nadirs for white blood cell count (WBC), absolute neutrophil count (ANC), and platelets (PLT) occurred in the second week of PRT and the fifth week for hemoglobin and absolute lymphocyte count (ALC). Using cell count ratio, patients treated with 3DCRT had a lower WBC ratio trend during PRT compared to patients treated with IMRT (p = 0.04), and patients ≥59 years of age had a lower hemoglobin ratio trend during PRT (p = 0.02). Using absolute cell count, patients treated with 3DCRT had lower ANC cell count trend (p = 0.03), and women had lower hemoglobin cell count trend compared to men (p = 0.03). On univariate analysis, use of 3DCRT was associated with a lower WBC ratio at nadir (p = 0.02). On multiple regression analysis using dosimetric variables, coxal BM V45 (p = 0.03) and sacral BM V45 (p = 0.03) were associated with a lower WBC and ANC ratio at nadir, respectively. Conclusions HT trends during PRT revealed distinct patterns: WBC, ANC, and PLT cell counts reach nadirs early and recover, while hemoglobin and ALC decline steadily. Patients who were treated with 3DCRT and older patients experienced lower cell count ratio trend during PRT. Dosimetric constraints using coxal BM V45 and sacral BM V45 can be considered. PMID

  17. KEGG PATHWAY / Acute myeloid leukemia [KEGG

    Lifescience Database Archive (English)

    Full Text Available PATHWAY: map05221 Entry map05221Pathway Name Acute myeloid leukemia Description Acute...Class Human Diseases; Cancers Pathwaymap map05221Acute myeloid leukemia Disease H00003Acute myeloid leukemia...inkDB DBGET integrated database retrieval system KEGG PATHWAY / Acute myeloid leukemia ...

  18. Absolute volume of the rectum and AUC from rectal DVH between 25Gy and 50Gy predict acute gastrointestinal toxicity with IG-IMRT in prostate cancer.

    Science.gov (United States)

    Mirjolet, Céline; Walker, Paul M; Gauthier, Mélanie; Dalban, Cécile; Naudy, Suzanne; Mazoyer, Frédéric; Martin, Etienne; Maingon, Philippe; Créhange, Gilles

    2016-11-04

    To determine whether dose/volume specific endpoints (DVSE) or Area under the rectal DVH curve (rAUC) better predict acute gastrointestinal (GI) toxicity in prostate cancer patients treated with IMRT in the era of daily image guidance (IG-IMRT). A set of DVSE was recorded from V25 to V75 (increments of 5Gy) (both in % and in cc) for 180 men. The rAUC was calculated for doses ranging between 25Gy and 50Gy (rAUC25-50). Univariate and multivariate logistic regressions were performed to determine the relationship between DVSE or rAUC25-50 and the appearance of any acute GI toxicity. The rates of acute grade 1 (G1), G2 and G3 GI toxicities were 53.3 %, 10.6 % and 1.1 %, respectively. No G4+ toxicity was observed. Rectal V25 to V75 expressed in % were not predictive of G ≥ 1 GI toxicity (p ≥ 0.12) whereas rectal V25 to V50 expressed in cc did correlate with GI toxicity G ≥ 1 (p ≤ 0.04). rAUC25-50 expressed in cc. Gy correlated significantly with the occurrence of any acute GI toxicity G ≥ 1 (p = 0.027). The absolute volume of the rectum between 25Gy and 50Gy and rAUC25-50 could significantly predict any acute rectal toxicity in prostate cancer patients treated with daily IG-IMRT.

  19. Common variants of eNOS and XRCC1 genes may predict acute skin toxicity in breast cancer patients receiving radiotherapy after breast conserving surgery.

    Science.gov (United States)

    Terrazzino, Salvatore; La Mattina, Pierdaniele; Masini, Laura; Caltavuturo, Tina; Gambaro, Giuseppina; Canonico, Pier Luigi; Genazzani, Armando A; Krengli, Marco

    2012-05-01

    To evaluate the impact of functional polymorphisms in genes related to DNA repair mechanisms (XRCC1, TP53, MSH2, MSH3, XPD), oxidative stress response (GSTP1, GSTA1, eNOS, SOD2) and fibroblast proliferation (TGFβ1) on the risk of acute skin toxicity in breast cancer patients receiving radiotherapy. Skin toxicity was scored according to the Radiation Therapy Oncology Group criteria in 286 breast cancer patients who received radiotherapy after breast conserving surgery. Genotyping was conducted by PCR-RFLP analysis and real-time PCR allelic discrimination assay on genomic DNA extracted from peripheral blood. In the multivariate analysis, nominally significant associations, before multiple testing corrections, were found between XRCC1 T-77C (T carriers vs. CC, OR: 2.240, 95% CI: 1.015-4.941, P=0.046), eNOS G894T polymorphisms (TT vs. G carriers, OR: 2.473, 95% CI: 1.220-5.012, P=0.012), breast diameter (OR: 1.138, 95% CI: 1.001-1.293, P=0.048), boost dose-fractionation (3 Gy vs. no boost, OR: 4.902, 95% CI: 1.458-16.483, P=0.010) and ≥ grade 2 acute radiation skin toxicity in breast cancer patients. As our exploratory study suggests that XRCC1 T-77C and eNOS G874T may confer an increased risk of acute skin reactions to radiotherapy in breast cancer patients, further confirmatory studies are warranted to determine the clinical significance. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... for information in your local library and on the Internet. Good sources include the National Cancer Institute, the ... mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/basics/definition/CON-20042915 . Mayo Clinic Footer Legal Conditions and ...

  1. Acute Myelogenous Leukemia (AML)

    Science.gov (United States)

    ... for information in your local library and on the Internet. Good sources include the National Cancer Institute, the ... mayoclinic.org/diseases-conditions/acute-myelogenous-leukemia/basics/definition/CON-20043431 . Mayo Clinic Footer Legal Conditions and ...

  2. CLINICAL FEATURES AND CLINICAL OUTCOME OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS TREATED AT CAIRO NATIONAL CANCER INSTITUTE IN EGYPT

    Directory of Open Access Journals (Sweden)

    Tamer M Fouad

    2011-01-01

    Full Text Available

    The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL presented to National Cancer Institute (NCI-Cairo, in Egypt from January 2007 to January 2011. The median follow-up time was 36 months. All patients were treated with the simultaneous administration of all-trans retinoic acid (ATRA and anthracyclin. The treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with doxorubicin in most of the cases and the inclusion of cytarbine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission (CRm after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. The median age at presentation was 29 years. There was a slight male predominance (53%.  Bleeding was the most common presenting symptom (79%. Most patients had an intermediate risk Sanz score (49% and 34% had a high risk score.  All patients achieved molecular CR at end of consolidation therapy with a median duration of 100 days. The main therapeutic complications during the induction phase were febrile neutropenia (42%, bleeding (18% and differentiation syndrome (11%. Five patients died at diagnosis due to bleeding, three died during induction chemotherapy due to febrile neutropenia (n=2 and bleeding (n=1 and one patient died during consolidation therapy due to febrile neutropenia.  The 3-year OS was 89% and relapse rate was 3%. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during treatment consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin may be a valid treatment option in developing countries. In spite of the increased incidence of high and intermediate risk score APL in our sample, we reported an acceptable CR rate

  3. CLINICAL FEATURES AND CLINICAL OUTCOME OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS TREATED AT CAIRO NATIONAL CANCER INSTITUTE IN EGYPT

    Directory of Open Access Journals (Sweden)

    Ola Khorshid

    2011-12-01

    Full Text Available The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL presented to National Cancer Institute (NCI-Cairo, in Egypt from January 2007 to January 2011. The median follow-up time was 36 months. All patients were treated with the simultaneous administration of all-trans retinoic acid (ATRA and anthracyclin. The treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with doxorubicin in most of the cases and the inclusion of cytarbine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission (CRm after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. The median age at presentation was 29 years. There was a slight male predominance (53%.  Bleeding was the most common presenting symptom (79%. Most patients had an intermediate risk Sanz score (49% and 34% had a high risk score.  All patients achieved molecular CR at end of consolidation therapy with a median duration of 100 days. The main therapeutic complications during the induction phase were febrile neutropenia (42%, bleeding (18% and differentiation syndrome (11%. Five patients died at diagnosis due to bleeding, three died during induction chemotherapy due to febrile neutropenia (n=2 and bleeding (n=1 and one patient died during consolidation therapy due to febrile neutropenia.  The 3-year OS was 89% and relapse rate was 3%. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during treatment consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin may be a valid treatment option in developing countries. In spite of the increased incidence of high and intermediate risk score APL in our sample, we reported an acceptable CR rate, toxicity and OS.

  4. Influence of Double-Strand Break Repair on Radiation Therapy-Induced Acute Skin Reactions in Breast Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Mumbrekar, Kamalesh Dattaram [Division of Radiobiology and Toxicology, School of Life Sciences, Manipal University, Manipal, Karnataka (India); Fernandes, Donald Jerard [Department of Radiotherapy and Oncology, Shirdi Sai Baba Cancer Hospital and Research Centre, Kasturba Hospital, Manipal, Karnataka (India); Goutham, Hassan Venkatesh [Division of Radiobiology and Toxicology, School of Life Sciences, Manipal University, Manipal, Karnataka (India); Sharan, Krishna [Department of Radiotherapy and Oncology, Shirdi Sai Baba Cancer Hospital and Research Centre, Kasturba Hospital, Manipal, Karnataka (India); Vadhiraja, Bejadi Manjunath [Manipal Hospital, Bangalore, Karnataka (India); Satyamoorthy, Kapaettu [Division of Biotechnology, School of Life Sciences, Manipal University, Manipal, Karnataka (India); Bola Sadashiva, Satish Rao, E-mail: satishraomlsc@gmail.com [Division of Radiobiology and Toxicology, School of Life Sciences, Manipal University, Manipal, Karnataka (India)

    2014-03-01

    Purpose: Curative radiation therapy (RT)-induced toxicity poses strong limitations for efficient RT and worsens the quality of life. The parameter that explains when and to what extent normal tissue toxicity in RT evolves would be of clinical relevance because of its predictive value and may provide an opportunity for personalized treatment approach. Methods and Materials: DNA double-strand breaks and repair were analyzed by microscopic γ-H2AX foci analysis in peripheral lymphocytes from 38 healthy donors and 80 breast cancer patients before RT, a 2 Gy challenge dose of x-ray exposed in vitro. Results: The actual damage (AD) at 0.25, 3, and 6 hours and percentage residual damage (PRD) at 3 and 6 hours were used as parameters to measure cellular radiosensitivity and correlated with RT-induced acute skin reactions in patients stratified as non-overresponders (NOR) (Radiation Therapy Oncology Group [RTOG] grade <2) and overresponders (OR) (RTOG grade ≥2). The results indicated that the basal and induced (at 0.25 and 3 hours) γ-H2AX foci numbers were nonsignificant (P>.05) between healthy control donors and the NOR and OR groups, whereas it was significant between ORs and healthy donors at 6 hours (P<.001). There was a significantly higher PRD in OR versus NOR (P<.05), OR versus healthy donors (P<.001) and NOR versus healthy donors (P<.01), supported further by the trend analysis (r=.2392; P=.0326 at 6 hours). Conclusions: Our findings strongly suggest that the measurement of PRD by performing γ-H2AX foci analysis has the potential to be developed into a clinically useful predictive assay.

  5. Preoperative prediction and prevention of intraoperative acute liver failure after major liver resection for metastatic colorectal cancer

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Objective: improve the results of treatment of patients with metastatic cancer of liver by reducing the risk of post-resection liver failure based on the assessment of liver functional reserve.Materials and methods. The study included 2 independent samples of patients underwent surgery for liver metastases in the department of abdominal oncology at the P. A. Herzen Moscow Oncological Research Institute. Group 1 included 47 patients: in addition to the standard treatment algorithm they underwent 13C methacetin breath test and dynamic scintigraphy of liver in the preoperative stage. Patients from the group 2 (n = 30 underwent standard clinical and laboratory examination, without preoperative evaluation of liver functional reserves; the level of total bilirubin, albumin and prothrombin time showed no decrease in liver function. Post-resection liver failure was established based on 50/50 criterion when evaluated on the 5th postoperative day.Results. The analysis of operational characteristics of functional tests showed absolute sensitivity of 13C methacetin breath test (SE ≥ 100 % and negative predictive value (–VP ≥ 100 % in case of integrated application of 2 diagnostic methods. An incidence of post-resection acute liver failure in the study group was significantly 2.2-fold lower than in the control group – 10.6 % and 23.3 %, respectively (p < 0.001.Conclusion. Combination of preoperative dynamic scintigraphy of liver with 13C methacetin breath test allows to perform comprehensive assessment of liver functional reserves, and it can greatly improve preoperative assessment and postoperative results of anatomic resections in patients with liver metastases.

  6. Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis. A prospective evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Hille, Andrea; Herrmann, Markus K.A.; Kertesz, Tereza; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F. [University Hospital, Goettingen (Germany). Department of Radiotherapy and Radiooncology; Pradier, Olivier [University Hospital, Brest (France). Department of Radiotherapy and Radiooncology; Schmidberger, Heinz [University Hospital, Mainz (Germany). Department of Radiotherapy and Radiooncology

    2008-12-15

    To evaluate prospectively the effect of sodium butyrate enemas on the treatment of acute and the potential influence on late radiation-induced proctitis. 31 patients had been treated with sodium butyrate enemas for radiation-induced acute grade II proctitis which had developed after 40 Gy in median. During irradiation the toxicity was evaluated weekly by the Common Toxicity Criteria (CTC) and subsequently yearly by the RTOG (Radiation Therapy Oncology Group) and LENT-SOMA scale. 23 of 31 patients (74%) experienced a decrease of CTC grade within 8 days on median. A statistical significant difference between the incidence and the severity of proctitis before start of treatment with sodium butyrate enemas compared to 14 days later and compared to the end of irradiation treatment course, respectively, was found. The median follow-up was 50 months. Twenty patients were recorded as suffering from no late proctitis symptom. Eleven patients suffered from grade I and 2 of these patients from grade II toxicity, too. No correlation was seen between the efficacy of butyrate enemas on acute proctitis and prevention or development of late toxicity, respectively. Sodium butyrate enemas are effective in the treatment of acute radiation-induced proctitis in patients with prostate cancer but have no impact on the incidence and severity of late proctitis. (orig.)

  7. Comparison of acute skin reaction following morning versus late afternoon radiotherapy in patients with breast cancer who have undergone curative surgical resection.

    Science.gov (United States)

    Noh, Jae Myoung; Choi, Doo Ho; Park, Hyojung; Huh, Seung Jae; Park, Won; Seol, Seung Won; Jeong, Bae Kwon; Nam, Seok Jin; Lee, Jeong Eon; Kil, Won-Ho

    2014-05-01

    We investigated the relationship between the time of radiotherapy (RT) and treatment outcomes in breast cancer. Patients with pathologic T1-2N0-1 breast cancer who received adjuvant RT in the morning (before 10:00 AM) or late afternoon (after 3:00 PM) were eligible for inclusion in this study. We retrospectively compared the clinicopathologic characteristics, acute skin reaction, and survival outcomes according to the time of RT. The median follow-up duration was 83 months (range, 10-131 months). From the 395 eligible patients, 190 (48.1%) and 205 (51.9%) patients were classified into the morning RT group and the afternoon RT group, respectively. The clinicopathologic characteristics were relatively well balanced between the treatment groups, except for pathologic N-stage (P = 0.0409). Grade 2 or higher acute skin reaction according to the Radiation Therapy Oncology Group criteria was observed in 39 (9.9%) patients, with a higher frequency in the afternoon RT group than the morning RT group (13.7% vs 5.8%, respectively; P = 0.0088). There was no difference in the failure patterns or survival outcomes between the treatment groups. RT in late afternoon was associated with increased Grade 2 or more skin reaction after RT for breast cancer patients, but treatment outcomes did not differ according to the time of RT. Individualized considerations for treatment should be taken into account to reduce the risk of skin reactions.

  8. Effect of Nd:YAG laser-assisted non-surgical mechanical debridement on clinical and radiographic peri-implant inflammatory parameters in patients with peri-implant disease.

    Science.gov (United States)

    Abduljabbar, Tariq; Javed, Fawad; Kellesarian, Sergio Varela; Vohra, Fahim; Romanos, Georgios E

    2017-03-01

    The efficacy of neodymium-doped yttrium aluminium garnet (Nd:YAG) laser-assisted non-surgical mechanical debridement (MD) in the treatment of periimplant diseases remains uninvestigated. The aim was to assess the efficacy of Nd:YAG laser-assisted non-surgical MD on clinical and radiographic periimplant inflammatory parameters in patients with periimplant disease. Treatment wise, 63 male patients with periimplant diseases were divided into 2 groups: Group-1 (32 patients): treatment of periimplant disease using MD alone (control group); and Group-2 (n=31 patients): treatment of periimplant disease using MD with a single application of Nd:YAG laser. Peri-implant inflammatory parameters (plaque index [PI], bleeding on probing [BOP] and probing depth [PD]) were measured at baseline and at 3 and 6months' follow-up. Periimplant crestal bone loss (CBL) was measured at baseline and at 6months' follow-up. Statistical analysis was performed using the Kruskall-Wallis and Bonferroni Post hoc tests. P-valuesnd baseline scores of periimplant PI, BOP and PD were comparable. At 3-month follow-up, scores of periimplant PI, BOP and PD were higher among patients in Group-1 compared with Group-2. At 6-month follow-up, scores of periimplant PI, BOP and PD were comparable among patients in groups 1 and 2. There was no statistically significant difference in periimplant CBL in both groups at all time intervals. Nd:YAG laser-assisted non-surgical MD is more effective in reducing periimplant soft tissue inflammatory parameters than MD alone in short-term but not in long-term. Copyright © 2017. Published by Elsevier B.V.

  9. Effects of treatment intensification on acute local toxicity during radiotherapy for head and neck cancer: prospective observational study validating CTCAE, version 3.0, scoring system.

    Science.gov (United States)

    Palazzi, Mauro; Tomatis, Stefano; Orlandi, Ester; Guzzo, Marco; Sangalli, Claudia; Potepan, Paolo; Fantini, Simona; Bergamini, Cristiana; Gavazzi, Cecilia; Licitra, Lisa; Scaramellini, Gabriele; Cantu', Giulio; Olmi, Patrizia

    2008-02-01

    To quantify the incidence and severity of acute local toxicity in head and neck cancer patients treated with radiotherapy (RT), with or without chemotherapy (CHT), using the Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE v3.0), scoring system. Between 2004 and 2006, 149 patients with head and neck cancer treated with RT at our center were prospectively evaluated for local toxicity during treatment. On a weekly basis, patients were monitored and eight toxicity items were recorded according to the CTCAE v3.0 scoring system. Of the 149 patients, 48 (32%) were treated with RT alone (conventional fractionation), 82 (55%) with concomitant CHT and conventional fractionation RT, and 20 (13%) with accelerated-fractionation RT and CHT. Severe (Grade 3-4) adverse events were recorded in 28% (mucositis), 33% (dysphagia), 40% (pain), and 12% (skin) of patients. Multivariate analysis showed CHT to be the most relevant factor independently predicting for worse toxicity (mucositis, dysphagia, weight loss, salivary changes). In contrast, previous surgery, RT acceleration and older age, female gender, and younger age, respectively, predicted for a worse outcome of mucositis, weight loss, pain, and dermatitis. The T-score method confirmed that conventional RT alone is in the "low-burden" class (T-score = 0.6) and suggests that concurrent CHT and conventional fractionation RT is in the "high-burden" class (T-score = 1.15). Combined CHT and accelerated-fractionation RT had the highest T-score at 1.9. The CTCAE v3.0 proved to be a reliable tool to quantify acute toxicity in head and neck cancer patients treated with various treatment intensities. The effect of CHT and RT acceleration on the acute toxicity burden was clinically relevant.

  10. Analysis of the effects of exposure to acute hypoxia on oxidative lesions and tumour progression in a transgenic mouse breast cancer model

    Directory of Open Access Journals (Sweden)

    Lunt Sarah

    2008-05-01

    Full Text Available Abstract Background Tumour hypoxia is known to be a poor prognostic indicator, predictive of increased risk of metastatic disease and reduced survival. Genomic instability has been proposed as one of the potential mechanisms for hypoxic tumour progression. Both of these features are commonly found in many cancer types, but their relationship and association with tumour progression has not been examined in the same model. Methods To address this issue, we determined the effects of 6 week in vivo acute hypoxic exposure on the levels of mutagenic lipid peroxidation product, malondialdehyde, and 8-oxo-7,8-dihydro-2'-deoxyguanosine DNA (8-oxo-dG lesions in the transgenic polyomavirus middle T (PyMT breast cancer mouse model. Results We observed significantly increased plasma lipid peroxidation and 8-oxo-dG lesion levels in the hypoxia-exposed mice. Consumption of malondialdehyde also induced a significant increase in the PyMT tumour DNA lesion levels, however, these increases did not translate into enhanced tumour progression. We further showed that the in vivo exposure to acute hypoxia induced accumulation of F4/80 positive tumour-associated macrophages (TAMs, demonstrating a relationship between hypoxia and macrophages in an experimental model. Conclusion These data suggest that although exposure to acute hypoxia causes an increase in 8-oxo-dG lesions and TAMs in the PyMT tumours, these increases do not translate into significant changes in tumour progression at the primary or metastatic levels in this strong viral oncogene-driven breast cancer model.

  11. Survival of Mexican Children with Acute Lymphoblastic Leukaemia under Treatment with the Protocol from the Dana-Farber Cancer Institute 00-01

    Science.gov (United States)

    Jiménez-Hernández, Elva; Jaimes-Reyes, Ethel Zulie; Arellano-Galindo, José; García-Jiménez, Xochiketzalli; Tiznado-García, Héctor Manuel; Sánchez-Jara, Berenice; Bekker-Méndez, Vilma Carolina; Ortíz-Torres, María Guadalupe; Ortíz-Fernández, Antonio; Marín-Palomares, Teresa; Mejía-Aranguré, Juan Manuel

    2015-01-01

    Our aim in this paper is to describe the results of treatment of acute lymphoblastic leukaemia (ALL) in Mexican children treated from 2006 to 2010 under the protocol from the Dana-Farber Cancer Institute (DFCI) 00-01. The children were younger than 16 years of age and had a diagnosis of ALL de novo. The patients were classified as standard risk if they were 1–9.9 years old and had a leucocyte count 100 × 109/L. The poor outcomes were associated with toxic death during induction, complete remission, and relapse. These factors remain the main obstacles to the success of this treatment in our population. PMID:25922837

  12. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve treatment outcomes. |

  13. Diagnostic approach and management of acute abdominal pain.

    Science.gov (United States)

    Abdullah, Murdani; Firmansyah, M Adi

    2012-10-01

    The incidence of acute abdominal pain ranges between 5-10% of all visits at emergency department. Abdominal emergencies of hospital visits may include surgical and non-surgical emergencies. The most common causes of acute abdomen are appendicitis, biliary colic, cholecystitis, diverticulitis, bowel obstruction, visceral perforation, pancreatitis, peritonitis, salpingitis, mesenteric adenitis and renal colic. Good skills in early diagnosis require a sound knowledge of basic anatomy and physiology of gastrointestinal tract, which are reflected during history taking and particularly, physical examination of the abdomen. Advanced diagnostic approaches such as radiography and endoscopy enhance the treatment for acute abdomen including pharmacological and surgical treatment. Therapeutic endoscopy, interventional radiology treatment and therapy using adult laparoscopy are the common modalities for treating patients with acute abdomen.

  14. Days spent in acute care hospitals at the end of life of cancer patients in four Swiss cantons: a retrospective database study (SAKK 89/09).

    Science.gov (United States)

    Matter-Walstra, K W; Achermann, R; Rapold, R; Klingbiel, D; Bordoni, A; Dehler, S; Konzelmann, I; Mousavi, M; Clough-Gorr, K M; Szucs, T; Schwenkglenks, M; Pestalozzi, B C

    2016-02-09

    Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.

  15. Effect of osteosynthesis, primary hemiarthroplasty, and non-surgical management for displaced four-part fractures of the proximal humerus in elderly: a multi-centre, randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Johannsen Hans

    2009-07-01

    Full Text Available Abstract Background Fractures of the proximal humerus are common injuries and account for 4–5 percent of all fractures, second only to hip and wrist fractures. The incidence is positively correlated with age and osteoporosis, and is likely to increase. Displaced four-part fractures are among the most severe injuries, accounting for 2–10 percent of proximal humeral fractures. The optimal intervention is disputed. Two previous randomised trials were very small and involved a noticeable risk of bias, and systematic reviews consequently conclude that there is inadequate basis for evidence-based treatment decisions. We aim to compare the effect of osteosynthesis with angle-stable plate with non-surgical management, and the effect of primary hemiarthroplasty with both osteosynthesis and non-surgical management. Methods/Design We will conduct a randomised, multi-centre, clinical trial including patients from ten national shoulder units within a two-year period. We plan to include 162 patients. A central randomisation unit will allocate patients. All patients will receive a standardised three-month rehabilitation program of supervised physiotherapy regardless of treatment allocation. Patients will be followed at least one year. The primary outcomes will be the overall score on the Constant Disability Scale, and its pain subscale, measured at 12 months. A blinded physiotherapist will carry out the assessments. Other secondary outcomes are Oxford Shoulder Score, and general health status (Short Form-36.

  16. The Study on Acute and Subacute Toxicity and Sarcoma-180 Anti-cancer Effects of Carthami Tinctor-Fructus Herbal-acupuncture(CF

    Directory of Open Access Journals (Sweden)

    Chang-Suk An

    2002-02-01

    Full Text Available Objective: The purpose of this study was to investigate acute and subacute toxicity and sarcoma-180 anti-cancer effects of herbal acupuncture with Carthami- Tinctorii fructus (CF in mice and rats. Method: Balb/c mice were injected intraperitoneally with Carthami - Tinctorii fructus (CF for LD50 and acute toxicity test. Sprague Dawley rats were injected intraperitoneally with Carthami- Tinctorii fructus (CF for subacute toxicity test. The Carthami- Tinctorii fructus herbal-acupuncture was injected on Chung-wan (CV12 of mice with Sarcoma-180 cancer cell line. Results: 1. LD50 was uncountable as none of the subjects expired during the test. 2. In acute toxicity test, toxic symptoms were not detected, but the body weight of mice was increased in treatment Ⅰ, treatment Ⅱ groups, compared to the normal group.(p<0.05 3. In acute toxicity test of serum biochemical values of mice, glucose was increased in treatment Ⅰ and treatment Ⅱ groups, total cholesterol was increased in treatment I group, GOT was decreased in treatment Ⅱ group, and GPT was decreased in treatment Ⅰ group, compared to the normal group.(p<0.05 4. The clinical signs and the body weight of mice treated with 0.1 cc, 0.2cc Carthami- Tinctorii fructus (CF were not affected during the subacute toxicity test. 5. In subacute toxicity test, treatment groups didn't show significant changes in complete blood count test (CBC of rats, compared to the nonnal group.(p<0.05 6. In subacute toxicity test of serum biochemical values of rats, uric acid was decreased in treatment Ⅰ and treatment Ⅱ groups, compared to the nonnal group, triglyceride was decreased in treatment I group, compared to the normal group, GOT and GPT were decreased in treatment I and treatment Ⅱ groups, and alkaline phosphatase was decreased in treatment Ⅰ and treatment Ⅱ groups, compared to the normal group.(p<0.05 7. Median survival time was increased in all the treatment groups for Sarcoma-180 cancer cell

  17. Clinical Analysis of Acute Renal Failure after Surgery for Esophageal Cancer%食管癌术后急性肾衰竭的临床分析

    Institute of Scientific and Technical Information of China (English)

    徐澄澄; 孙威; 付向宁

    2011-01-01

    为了探讨食管癌术后急性肾衰竭发生的原因及防治经验,回顾性分析13例术后发生急性肾衰竭食管癌患者的临床资料,并总结防治体会.结果显示患者平均年龄67.5岁,体重50.4千克,皆有严重的吞咽梗阻症状,其中8例术前发现低蛋白血症,3例术前有不同程度的肾功能不全;术后3天内出现急性肾衰竭,治疗纠正肾前性病因、利尿和改善肾血流灌注等,其中4例结合血液净化;10例治愈,3例好转自动出院.就此得出结论食管癌患者术前低容量且营养不良状态是术后急性肾衰竭的重要原因;治疗注意纠正肾前性因素和改善肾灌注,必要时结合血液净化治疗,有助于防治食管癌术后急性肾功能衰竭.%To investigate the causes and experience of treatment for acute renal failure following the surgery for esophageal cancer, the clinical data of 13 patients with acute renal failure after surgery for esophageal cancer were retrospectively reviewed. The average age of patients was 67.5, and the mean weight was 50.4 kg. All patients had severe obstructive symptom, 8 of 13 patients with hypoproteinemia and 3 of 13 patients with renal dysfunction were detected preoperatively.Acute renal failure was followed in three days after operation. Treatment included correction of possible prerenal causes,diuretic drugs and improvement of renal perfusion and so on. Four of 13 patients underwent blood purification. Ten cases were cured and 3 cases improved markedly and were discharged. The conclusions include that hypovolemia and malnutrition are the important causes of acute renal failure following the surgery for esophageal cancer, and correction of possible prerenal causes, improvement of renal perfusion and adequate blood purification can contribute to its treatment.

  18. Radiation-induced stress response in peripheral blood of breast cancer patients differs between patients with severe acute skin reactions and patients with no side effects to radiotherapy.

    Science.gov (United States)

    Skiöld, Sara; Naslund, Ingemar; Brehwens, Karl; Andersson, Arja; Wersall, Peter; Lidbrink, Elisabet; Harms-Ringdahl, Mats; Wojcik, Andrzej; Haghdoost, Siamak

    2013-08-30

    The aim of the study was to compare the radiation-induced oxidative stress response in blood samples from breast cancer patients that developed severe acute skin reactions during the radiotherapy, with the response in blood samples from patients with no side effects. Peripheral blood was collected from 12 breast cancer patients showing no early skin reactions after radiotherapy (RTOG grade 0) and from 14 breast cancer patients who developed acute severe skin reactions (RTOG grade 3-4). Whole blood was irradiated with 0, 5 and 2000mGy γ-radiation and serum was isolated. The biomarker for oxidative stress, 8-oxo-dG, was analyzed in the serum by a modified ELISA. While a significant radiation-induced increase of serum 8-oxo-dG levels was observed in serum of the RTOG 0 patients, no increase was seen in serum of the RTOG 3-4 patients. The radiation induced increase in serum 8-oxo-dG levels after 5mGy did not differ significantly from the increase observed for 2000mGy in the RTOG 3-4 cohort, thus no dose response relation was observed. A receiver operating characteristic (ROC) value of 0.97 was obtained from the radiation-induced increase in 8-oxo-dG indicating that the assay could be used to identify patients with severe acute adverse reactions to radiotherapy. The results show that samples of whole blood from patients, classified as highly radiosensitive (RTOG 3-4) based on their skin reactions to radiotherapy, differ significantly in their oxidative stress response to ionizing radiation compared to samples of whole blood from patients with no skin reactions (RTOG 0). Extracellular 8-oxo-dG is primarily a biomarker of nucleotide damage and the results indicate that the patients with severe acute skin reactions differ in their cellular response to ionizing radiation at the level of induction of oxidative stress or at the level of repair or both. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Analysis of Dosimetric Parameters Associated With Acute Gastrointestinal Toxicity and Upper Gastrointestinal Bleeding in Locally Advanced Pancreatic Cancer Patients Treated With Gemcitabine-Based Concurrent Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Akira [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Matsuo, Yukinori; Nakamura, Mitsuhiro; Shiinoki, Takehiro; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan)

    2012-10-01

    Purpose: To identify the dosimetric parameters associated with gastrointestinal (GI) toxicity in patients with locally advanced pancreatic cancer (LAPC) treated with gemcitabine-based chemoradiotherapy. Methods and Materials: The data from 40 patients were analyzed retrospectively. Chemoradiotherapy consisted of conventional fractionated three-dimensional radiotherapy and weekly gemcitabine. Treatment-related acute GI toxicity and upper GI bleeding (UGB) were graded according to the Common Toxicity Criteria Adverse Events, version 4.0. The dosimetric parameters (mean dose, maximal absolute dose which covers 2 cm{sup 3} of the organ, and absolute volume receiving 10-50 Gy [V{sub 10-50}]) of the stomach, duodenum, small intestine, and a composite structure of the stomach and duodenum (StoDuo) were obtained. The planning target volume was also obtained. Univariate analyses were performed to identify the predictive factors for the risk of grade 2 or greater acute GI toxicity and grade 3 or greater UGB, respectively. Results: The median follow-up period was 15.7 months (range, 4-37). The actual incidence of acute GI toxicity was 33%. The estimated incidence of UGB at 1 year was 20%. Regarding acute GI toxicity, a V{sub 50} of {>=}16 cm{sup 3} of the stomach was the best predictor, and the actual incidence in patients with V{sub 50} <16 cm{sup 3} of the stomach vs. those with V{sub 50} of {>=}16 cm{sup 3} was 9% vs. 61%, respectively (p = 0.001). Regarding UGB, V{sub 50} of {>=}33 cm{sup 3} of the StoDuo was the best predictor, and the estimated incidence at 1 year in patients with V{sub 50} <33 cm{sup 3} of the StoDuo vs. those with V{sub 50} {>=}33 cm{sup 3} was 0% vs. 44%, respectively (p = 0.002). The dosimetric parameters correlated highly with one another. Conclusion: The irradiated absolute volume of the stomach and duodenum are important for the risk of acute GI toxicity and UGB. These results could be helpful in escalating the radiation doses using novel

  20. Elevated ARG1 expression in primary monocytes-derived macrophages as a predictor of radiation-induced acute skin toxicities in early breast cancer patients.

    Science.gov (United States)

    Jung, Karen; Sabri, Siham; Hanson, John; Xu, Yaoxian; Wang, Ying Wayne; Lai, Raymond; Abdulkarim, Bassam S

    2015-01-01

    Radiation therapy (RT) the front-line treatment after surgery for early breast cancer patients is associated with acute skin toxicities in at least 40% of treated patients. Monocyte-derived macrophages are polarized into functionally distinct (M1 or M2) activated phenotypes at injury sites by specific systemic cytokines known to play a key role in the transition between damage and repair in irradiated tissues. The role of M1 and M2 macrophages in RT-induced acute skin toxicities remains to be defined. We investigated the potential value of M1 and M2 macrophages as predictive factors of RT-induced skin toxicities in early breast cancer patients treated with adjuvant RT after lumpectomy. Blood samples collected from patients enrolled in a prospective clinical study (n = 49) were analyzed at baseline and after the first delivered 2Gy RT dose. We designed an ex vivo culture system to differentiate patient blood monocytes into macrophages and treated them with M1 or M2-inducing cytokines before quantitative analysis of their "M1/M2" activation markers, iNOS, Arg1, and TGFß1. Statistical analysis was performed to correlate experimental data to clinical assessment of acute skin toxicity using Common Toxicity Criteria (CTC) grade for objective evaluation of skin reactions. Increased ARG1 mRNA significantly correlated with higher grades of erythema, moist desquamation, and CTC grade. Multivariate analysis revealed that increased ARG1 expression in macrophages after a single RT dose was an independent prognostic factor of erythema (p = 0 .032), moist desquamation (p = 0 .027), and CTC grade (p = 0 .056). Interestingly, multivariate analysis of ARG1 mRNA expression in macrophages stimulated with IL-4 also revealed independent prognostic value for predicting acute RT-induced toxicity factors, erythema (p = 0 .069), moist desquamation (p = 0 .037), and CTC grade (p = 0 .046). To conclude, our findings underline for the first time the biological significance of increased ARG1 m

  1. Dose-Painted Intensity-Modulated Radiation Therapy for Anal Cancer: A Multi-Institutional Report of Acute Toxicity and Response to Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kachnic, Lisa A., E-mail: lisa.kachnic@bmc.org [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Tsai, Henry K. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, MA (United States); Coen, John J. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Blaszkowsky, Lawrence S. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hartshorn, Kevan [Department of Medicine, Boston Medical Center, Boston, MA (United States); Kwak, Eunice L. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Willins, John D. [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ryan, David P. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hong, Theodore S. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2012-01-01

    Purpose: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). Patients and Methods: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 Gy/fx to elective nodal PTV, and 54 Gy, 1.8 Gy/fx to the anal tumor and metastatic nodal PTV >3 cm with 50.4 Gy, 1.68 Gy/fx to nodal PTVs {<=}3 cm in size. Acute and late toxicity was reported by the treating physician. Actuarial analysis was performed using the Kaplan-Meier method. Results: Median age was 58 years; 67% female; 16% Stage I, 37% II; 42% III; 5% IV. Fourteen patients were immunocompromised: 21% HIV-positive and 12% on chronic immunosuppression. Median follow-up was 24 months (range, 0.6-43.5 months). Sixty percent completed chemoradiation without treatment interruption; median duration of treatment interruption was 2 days (range, 2-24 days). Acute Grade 3+ toxicity included: hematologic 51%, dermatologic 10%, gastrointestinal 7%, and genitourinary 7%. Two-year local control, overall survival, colostomy-free survival, and metastasis-free survival were 95%, 94%, 90%, and 92%, respectively. Conclusions: Dose-painted IMRT appears effective and well-tolerated as part of a chemoradiation therapy regimen for the treatment of anal canal cancer.

  2. Timed Get Up and Go Test and Geriatric 8 Scores and the Association With (Chemo-)Radiation Therapy Noncompliance and Acute Toxicity in Elderly Cancer Patients.

    Science.gov (United States)

    Middelburg, Judith G; Mast, Mirjam E; de Kroon, Maaike; Jobsen, Jan J; Rozema, Tom; Maas, Huub; Baartman, Elizabet A; Geijsen, Debby; van der Leest, Annija H; van den Bongard, Desirée J; van Loon, Judith; Budiharto, Tom; Coebergh, Jan Willem; Aarts, Mieke J; Struikmans, Henk

    2017-07-15

    To investigate whether the Geriatric 8 (G8) and the Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with acute toxicity of radiation therapy and noncompliance in elderly cancer patients being irradiated with curative intent. Patients were eligible if aged ≥65 years and diagnosed with breast, non-small cell lung, prostate, head and neck, rectal, or esophageal cancer, and were referred for curative radiation therapy. We recorded acute toxicity and noncompliance and identified potential predictors, including the G8 and TGUGT. We investigated 402 patients with a median age of 72 years (range, 65-96 years). According to the G8, 44.4% of the patients were frail. Toxicity grade ≥3 was observed in 22% of patients who were frail according to the G8 and 9.1% of patients who were not frail. The difference was 13% (confidence interval 5.2%-20%; P=.0006). According to the TGUGT 18.8% of the patients were frail; 21% of the frail according to the TGUGT developed toxicity grade ≥3, compared with 13% who were not frail. The difference was 7.3% (confidence interval -2.7% to 17%; P=.11). Overall compliance was 95%. Toxicity was most strongly associated with type of primary tumor, chemotherapy, age, and World Health Organization performance status. Compliance was associated with type of primary tumor and age. The usefulness of the TGUGT and G8 score in daily practice seems to be limited. Type of primary tumor, chemoradiotherapy, age, and World Health Organization performance status were more strongly associated with acute toxicity. Only chemoradiotherapy and age were associated with noncompliance. Overall the compliance was very high. To allow better-informed treatment decisions, a more accurate prediction of toxicity is desirable. Copyright © 2017. Published by Elsevier Inc.

  3. Non-surgical approach to the benign nodular goiter: new opportunities by recombinant human TSH-stimulated (131)I-therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Fast, Søren; Hegedüs, Laszlo

    2011-01-01

    nodule. If thyroid hyperfunction due to nodular autonomy is the dominant problem, life-long anti-thyroid drug treatment may be relevant in elderly individuals. With the advent of recombinant human TSH (rhTSH) stimulation the goiter reduction following (131)I-therapy is significantly enhanced...... and this treatment is of particular benefit, as compared with conventional (131)I-therapy, in patients with a low baseline thyroid (131)I uptake and a large goiter. If the rhTSH dose does not exceed 0.1 mg the risk of temporary hyperthyroidism and acute thyroid swelling is low. Since patient satisfaction seemingly...... is not improved by the greater goiter reduction obtained by rhTSH-stimulated (131)I-therapy, and permanent hypothyroidism is more frequent, it may be more relevant to reduce the administered radioactivity equivalent to the rhTSH-induced increase in the thyroid (131)I uptake. Future large-scale well...

  4. Acute Urinary Morbidity Following Stereotactic Body Radiation Therapy for Prostate Cancer with Prophylactic Alpha-Adrenergic Antagonist and Urethral Dose Reduction

    Directory of Open Access Journals (Sweden)

    Michael Charles Repka

    2016-05-01

    Full Text Available Background: Stereotactic body radiation therapy (SBRT delivers high doses of radiation to the prostate while minimizing radiation to adjacent critical organs. Large fraction sizes may increase urinary morbidity due to unavoidable treatment of the prostatic urethra. This study reports rates of acute urinary morbidity following SBRT for localized prostate cancer with prophylactic alpha-adrenergic antagonist utilization and urethral dose reduction (UDR.Methods: From April 2013 to September 2014, 102 patients with clinically localized prostate cancer were treated with robotic SBRT to a total dose of 35-36.25 Gy in 5 fractions. UDR was employed to limit the maximum point dose of the prostatic urethra to 40 Gy. Prophylactic alpha-adrenergic antagonists were initiated five days prior to SBRT and continued until resolution of urinary symptoms. Quality of life (QoL was assessed before and after treatment using the American Urological Association Symptom Score (AUA and the Expanded Prostate Cancer Index Composite-26 (EPIC-26. Clinical significance was assessed using a minimally important difference (MID of one half standard deviation change from baseline.Results: 102 patients underwent definitive prostate SBRT with UDR and were followed for 3 months. No patient experienced acute urinary retention requiring catheterization. A mean baseline AUA symptom score of 9.06 significantly increased to 11.83 one-week post-SBRT (p = 0.0024 and 11.84 one-month post-SBRT (p = 0.0023 but returned to baseline by 3 months. A mean baseline EPIC-26 irritative/obstructive score of 87.7 decreased to 74.1 one-week post-SBRT (p < 0.0001 and 77.8 one-month post-SBRT (p < 0.0001 but returned to baseline at 3 months. EPIC-26 irritative/obstructive score changes were clinically significant, exceeding the MID of 6.0. At baseline, 8.9% of men described their urinary function as a moderate to big problem, and that proportion increased to 37.6% one week following completion of SBRT

  5. Evolution of modern treatment of childhood acute leukemia and cancer: adventures and battles in the 1970s and 1980s.

    Science.gov (United States)

    Ravindranath, Yaddanapudi

    2015-02-01

    This article summarizes the adventures and explorations in the 1970s and 1980s in the treatment of children with leukemia and cancer that paved the way for the current success in childhood cancers. Indeed, these were adventures and bold steps into unchartered waters. Because childhood leukemia the most common of the childhood cancers, success in childhood leukemia was pivotal in the push toward cure of all childhood cancers. The success in childhood leukemia illustrates how treatment programs were designed using clinical- and biology-based risk factors seen in the patients. Copyright © 2015. Published by Elsevier Inc.

  6. Role of serum sodium in assessing hospital mortality in cancer patients with spontaneous tumour lysis syndrome inducing acute uric acid nephropathy.

    Science.gov (United States)

    Hsu, H-H; Chen, Y-C; Tian, Y-C; Chan, Y-L; Kuo, M-C; Tang, C-C; Fang, J-T; Lee, S-Y; Yang, C-W

    2009-05-01

    Spontaneous tumour lysis syndrome (STLS) inducing acute uric acid nephropathy, a rare and neglected disease, presents more insidiously than conventional post-treatment tumour lysis syndrome. Although STLS is a serious and potentially fatal complication in patients with neoplastic disorders, few investigations have addressed the relevance of clinical and laboratory features in assessing prognosis. A retrospective study was conducted, reviewing the records of all patients who developed acute renal failure (ARF) at Chang Gung memorial hospital between 1 July 1999 and 30 June 2003. STLS-induced acute uric acid nephropathy was identified in 12 of 1072 ARF patients (1.1%) during the study period. All patients had advanced stage tumours with large tumour burden, and 66.7% of cases had abdominal organ involvement. All 12 hyperuricemic patients became oliguric despite conservative therapy, and remained hyperuricemic (21.6 +/- 5.2 mg/dl) before dialysis therapy. Diuresis developed in eight patients (66.7%), with associated resolution of hyperuricemia, azotemia and metabolic derangements following dialysis initiation. Overall hospital mortality was 58.3%. Death in most patients was related to hyponatremia and hypoalbuminemia on admission. The serum sodium was found to have the best Youden index (0.86) and highest overall prediction accuracy (93%). Moreover, serum sodium and serum albumin for individual patients were significantly and positively correlated (r = 0.617, p = 0.032). This investigation confirms a grave prognosis for cancer patients with STLS inducing acute uric acid nephropathy. Hyponatremia and hypoalbuminemia on the first day of admission indicate poor prognosis in such patients.

  7. CATCH: A randomized trial comparing tinzaparin versus warfarin for treatment of acute venous thromboembolism (VTE) in cancer patients

    NARCIS (Netherlands)

    Lee, Agnes Y.; Bauersachs, Rupert; Janas, Mette S.; Jarner, Mikala F.; Kamphuisen, Pieter W.; Meyer, Guy; Paz-Ares, Luis; Khorana, Alok A.

    2012-01-01

    Background: VTE is a major cause of morbidity and mortality in cancer patients. LMWHs have been shown to be superior to warfarin in one randomized study, but adequately powered confirmatory studies have not been conducted and warfarin continues to be widely used for treatment of cancer-associated VT

  8. Therapy-related myelodysplastic syndrome and acute myeloid leukemia following chemotherapy (paclitaxel and carboplatin) and radiation therapy in ovarian cancer: a case report.

    Science.gov (United States)

    Ishikawa, M; Nakayama, K; Rahman, M T; Rahman, M; Katagiri, H; Katagiri, A; Ishibashi, T; Iida, K; Nakayama, N; Miyazaki, K

    2014-01-01

    In recent years, the incidence of therapy-related myelodysplastic syndrome (t-MDS) and therapy-related acute myeloid leukemia (t-AML) that occur during chemotherapy for ovarian cancer has increased. While alkylating agents and topoisomerase II inhibitors are particularly mutagenic and have strong leukemogenic potential, paclitaxel and combination chemotherapy/radiation therapy also appear to induce t-MDS. The present authors report a case of t-MDS that developed during chemotherapy and radiation therapy for ovarian cancer. The patient was a 75-year-old woman who received six courses of cyclophosphamide/doxorubicin/cisplatin (CAP) therapy after initial surgery for Stage IIIc grade ovarian cancer in 1995. Beginning in February 2005, the patient experienced multiple recurrences due to sternal metastasis. Chemotherapy, including paclitaxel and carboplatin (TC), was administered intermittently and was combined with radiation therapy to a sternal metastatic lesion. Pancytopenia was observed in December 2008, and she was diagnosed with t-MDS (WHO subtype, refractory cytopenias with multilineage dysplasia [RCMD]): the time from first chemotherapy to t-MDS onset was 106 months. Without evidence of blast crisis, the recurrent lesions continued to grow and caused multiple cerebral infarctions, from which she eventually died. The cumulative doses of paclitaxel and carboplatin administered to this patient were 1,968 mg and 6,480 mg, respectively.

  9. The Effect of Resveratrol Supplementation in Adjunct with Non-surgical Periodontal Treatment on Blood Glucose, Triglyceride, Periodontal Status and Some Inflammatory Markers in Type 2 Diabetic Patients with Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Ahmad Zare Javid

    2016-02-01

    Full Text Available Background and Objectives: Diabetes mellitus and periodontal disease are two chronic and common diseases with close relationship together affecting public health and quality of life. The aim of this study was to investigate the effect of resveratrol supplementation in adjunct with non-surgical periodontal treatment (NST on blood glucose, triglyceride, periodontal status and inflammatory markers in type 2 diabetic patients with periodontal disease. Materials and Methods: This double-blind clinical trial study was conducted on 43 diabetic patients with periodontitis referred to the Endocrinology Clinic at Golestan Hospital in Ahvaz, Iran. All subjects were randomly assigned into two groups of intervention and control. The intervention and control groups received either 480 mg/d resveratrol or placebo capsules (2 PCs for four weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric parameters, 24-hour dietary recall, fasting blood sugar, insulin, insulin resistance (HOMA-IR, triglycerides, pocket depth (PD, IL6 and TNF&alpha were evaluated in all subjects pre- and post-intervention. Results: The mean serum levels of fasting insulin and insulin resistance (HOMA-IR were significantly (P=0.02, P=0.045, respectively lower in the intervention group compared with the control group (10.42 ± 0.28 and 10.92 ± 0.9 3.66 ± 0.97 and 4.49 ± 1.56, respectively . Moreover, significant difference (P < 0.001 was obtained in the mean pocket depth (PD between the intervention and control groups (2.35 ± 0.6 and 3.38 ± 0.5, respectively post-intervention. In the intervention group, the mean serum level of IL6 was reduced significantly (P= 0.039 post-intervention (1.58 ± 1.06 and 2.19± 1.09. No significant differences were seen in the mean levels of fasting blood sugar, triglycerides, IL6 and TNF&alpha between the two groups post-intervention. Conclusions: It is suggested that resveratrol may be recommended as

  10. Normal Tissue Complication Probability Analysis of Acute Gastrointestinal Toxicity in Cervical Cancer Patients Undergoing Intensity Modulated Radiation Therapy and Concurrent Cisplatin

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Daniel R.; Song, William Y. [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Moiseenko, Vitali [Department of Medical Physics, Vancouver Cancer Centre, BC (Canada); Rose, Brent S.; Yashar, Catheryn M.; Mundt, Arno J. [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States)

    2012-05-01

    Purpose: To test the hypothesis that increased bowel radiation dose is associated with acute gastrointestinal (GI) toxicity in cervical cancer patients undergoing concurrent chemotherapy and intensity-modulated radiation therapy (IMRT), using a previously derived normal tissue complication probability (NTCP) model. Methods: Fifty patients with Stage I-III cervical cancer undergoing IMRT and concurrent weekly cisplatin were analyzed. Acute GI toxicity was graded using the Radiation Therapy Oncology Group scale, excluding upper GI events. A logistic model was used to test correlations between acute GI toxicity and bowel dosimetric parameters. The primary objective was to test the association between Grade {>=}2 GI toxicity and the volume of bowel receiving {>=}45 Gy (V{sub 45}) using the logistic model. Results: Twenty-three patients (46%) had Grade {>=}2 GI toxicity. The mean (SD) V{sub 45} was 143 mL (99). The mean V{sub 45} values for patients with and without Grade {>=}2 GI toxicity were 176 vs. 115 mL, respectively. Twenty patients (40%) had V{sub 45} >150 mL. The proportion of patients with Grade {>=}2 GI toxicity with and without V{sub 45} >150 mL was 65% vs. 33% (p = 0.03). Logistic model parameter estimates V50 and {gamma} were 161 mL (95% confidence interval [CI] 60-399) and 0.31 (95% CI 0.04-0.63), respectively. On multivariable logistic regression, increased V{sub 45} was associated with an increased odds of Grade {>=}2 GI toxicity (odds ratio 2.19 per 100 mL, 95% CI 1.04-4.63, p = 0.04). Conclusions: Our results support the hypothesis that increasing bowel V{sub 45} is correlated with increased GI toxicity in cervical cancer patients undergoing IMRT and concurrent cisplatin. Reducing bowel V{sub 45} could reduce the risk of Grade {>=}2 GI toxicity by approximately 50% per 100 mL of bowel spared.

  11. Validation and Modification of a Prediction Model for Acute Cardiac Events in Patients With Breast Cancer Treated With Radiotherapy Based on Three-Dimensional Dose Distributions to Cardiac Substructures

    NARCIS (Netherlands)

    van den Bogaard, Veerle A B; Ta, Bastiaan D P; van der Schaaf, Arjen; Bouma, Angelique B; Middag, Astrid M H; Bantema-Joppe, Enja J; van Dijk, Lisanne V; van Dijk-Peters, Femke B J; Marteijn, Laurens A W; de Bock, Gertruida H; Burgerhof, Johannes G M; Gietema, Jourik A; Langendijk, Johannes A; Maduro, John H; Crijns, Anne P G

    2017-01-01

    Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors f

  12. Percutaneous mechanical assist for severe cardiogenic shock due to acute right ventricular failure.

    Science.gov (United States)

    Kipp, Ryan; Raval, Amish N

    2015-05-01

    Acute right ventricular failure can lead to severe cardiogenic shock and death. Recovery may be achieved with early supportive measures. In many patients, intravenous fluid and inotropic resuscitation is inadequate to improve cardiac output. In these cases, percutaneous mechanical assist may provide a non-surgical bridge to recovery. Herein, we describe a case series of patients with severe, refractory cardiogenic shock due to acute right ventricular failure who received a continuous flow percutaneous ventricular device primarily utilizing the right internal jugular vein for out flow cannula placement.

  13. Acute Aortic Syndromes: Update in Current Medical Management.

    Science.gov (United States)

    Morris, Jacqueline H; Mix, Doran; Cameron, Scott J

    2017-04-01

    Advances in medical therapy and non-surgical percutaneous options to manage the specter of acute aortic syndromes have improved both patient morbidity and mortality. There are key features in the patient history and initial exam which physicians should be attuned to in order to diagnose acute aortic syndromes such as aortic dissection, penetrating aortic ulcer, and intramural hematoma. Once recognized, early initiation of the appropriate pharmacologic therapy is important, and further appreciating the limitations of such therapy before considering a surgical approach is critical to improve patient outcomes. For the undifferentiated patient with acute aortic dissection presenting to facilities who do not routinely manage this condition, adding pharmacologic agents in the correct sequence assures the best chance for a satisfactory outcome.

  14. 牙周基础治疗在侵袭性牙周炎中的应用效果观察%Application effect observation of periodontal non-surgical treatment for aggressive periodontitis

    Institute of Scientific and Technical Information of China (English)

    王迪; 曾莉; 王丽泉

    2015-01-01

    目的:探讨牙周基础治疗在侵袭性牙周炎中的应用效果。方法选取本院2012年12月~2014年5月收治的68例(患牙142颗)侵袭性牙周炎患者作为研究对象,所有患者均给予牙周基础治疗。观察并记录牙周基础治疗前和治疗后6个月的患牙探诊深度(PD)、临床附着丧失(CAL)、出血指数(BI)、菌斑指数(PLI)和牙齿松动度(TM)情况。结果牙周基础治疗6个月后,PD、CAL、BI、PLI显著低于治疗前,差异有统计学意义(P<0.05)。与治疗前比较,治疗6个月后的牙齿松动程度显著好转,差异有统计学意义(P<0.01)。结论牙周基础治疗在侵袭性牙周炎中的应用效果显著,能明显减少PD、CAL、PLI,有效控制牙龈出血,明显改善牙齿松动情况,值得临床推广应用。%Objective To exolore the application effect of periodental non-surgical treatment for aggressive periodonti-tis. Methods 68 cases(142 cases with sick teeth) with aggressive periodontitis from December 2012 to May 2014 in our hospital were selected as research object.All the patients were given the periodental non-surgical treatment.The condi-tions of probing depth(PD) of sick teeth,clinic attachment level(CAL),bleeding index(BI),tooth mobility(TM) before peri-odental non-surgical treatment and six months after treatment was observed and recorded respectively. Results six months after treatment,PD,CAL,BI,PLI was lower than that before treatment,with significant difference (P<0.05).Com-pared with before treatment,the degree of TM six months after treatment was statistically improved,with significant dif-ference(P<0.01). Conclusion Application effect of periodontal non-surgical treatment for aggressive periodontitis is ob-vious,can reduce PD,CAL,PLI obviously,control gingival bleeding effectively,improve the conditions of TM significantly, it is worthy of clinical promotion and application.

  15. Influence of non-surgical periodontal therapy and metabolic control on periodontal condition in diabetic patients with periodontitis%牙周炎患者治疗前后牙周状况调查

    Institute of Scientific and Technical Information of China (English)

    闫大钧

    2012-01-01

    目的:调查老年糖尿病牙周炎患者治疗前后牙周状况,牙周基础治疗及代谢控制对其影响.方法:选取2009年10月~201 0年1 0月在我科就诊的糖尿病合并牙周炎患者42例(糖尿病牙周炎组),同期非糖尿病牙周炎患者39例作为对照(对照组).测量并比较两组患者的菌斑指数(PLI)、探诊深度(PD)、附着丧失(CAL)等牙周炎临床指标.糖尿病合并牙周炎患者给予牙周基础治疗(包括口腔卫生指导、龈上洁治、龈下刮治和根面平整)及强化代谢控制3月,并在代谢控制前后测定了糖化血红蛋白(HbA1c)水平.结果:糖尿病牙周炎组PLI、PD及CAL值均显著高于对照组(P<0.01),牙周基础治疗及代谢控制后上述指标明显好转(P<0.05).结论:老年糖尿病患者牙周炎发病率高,代谢控制及牙周基础治疗能有效改善糖尿病牙周炎患者的牙周状况.%Objective To investigate the influence of non -surgical periodontal therapy and metabolic control on periodontal condition in diabetic patients with periodontitis. Methods The periodontal condition were investigated in 42 diabetic patients with periodontitis(experimental group) and 39 chronic periodontitis patients(control group) in Oct. 2009 to Oct. 2010.The periodontal indexes such as plaque index (PLI), teeth probing depth (PD) and clinical attaching loss (CAL) were observed in two groups. Non -surgical periodontal therapy and metabolic control were dealt with in experimental group for three months, and the above data and glycosylated hemoglobin (HbA1c) were measured before and after treatment. Results At the baseline, the PLI, PD and CAL values in experimental group were 2.87, 5.85 mm and 4.98 mm, respectively, significantly higher than that of control group (2.01,4.61 mm and 4.05 mm), P<0.01. After non-surgical periodontal therapy and metabolic control, the PLI, PD and CAL and HbA1c values in experimental group significantly improved compared with the baseline

  16. 食管癌非手术治疗临床分期新标准的对比研究%A comparative study of new clinical staging systems for esophageal carcinoma treated with non-surgical therapy

    Institute of Scientific and Technical Information of China (English)

    祝淑钗; 么伟楠; 李娟; 李红云; 刘志坤; 沈文斌; 闫可

    2016-01-01

    Objective To evaluate the predictive values of different systems for clinical staging of esophageal carcinoma in one group of patients and improve the criteria for T staging,and to provide a basis for accurate clinical staging. Methods A retrospective study was performed in 701 patients with esophageal carcinoma who received radical radiotherapy in our hospital. The prognosis was performed according to American Joint Committee on Cancer ( AJCC) tumor-node-metastasis staging system,Chinese 2004 staging system,the draft of Chinese 2009 staging system,and gross tumor volume of the primary tumor (GTV-T). Results In terms of T stage,patients evaluated according to the AJCC staging system were in relatively early stages;23. 1% of them were in stage T1,and the survival curves of T3 and T4 patients were close to each other;the survival curves plotted according to the Chinese 2004 staging system were well separated, but relatively few patients were in stages T1 and T4 , yielding an uneven distribution;according to the draft of Chinese 2009 staging system, the survival curve of T3 patients intersected that of T4 patients, and up to 43. 2% of patients were in stage T4.The new T staging was performed based on GTV and the extent of tumor invasion into the adjacent tissue and organ, and the results showed that there was no intersection between survival curves and a relatively balanced T stage distribution. In terms of N staging,patients were divided into stages N0 ,N1 ,and N2 . The TNM staging was performed by a combination of N staging and new T staging, resulting in significant separation between survival curves ( P=0. 000) . Conclusions The combination of T staging,which is based on GTV and the extent of tumor invasion,and N staging,which is based on metastasis of lymph nodes, can accurately predict the survival of non-surgically treated patients with esophageal carcinoma.%目的 比较不同食管癌临床分期对同一组病例的预测价值,并完善T分期标准,为更

  17. Non-surgical treatment in 39 tumor patients with malignant bowel obstruction(MBO)%肿瘤患者并肠梗阻39例非手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    夏月琴; 焦爱民; 朱红梅

    2012-01-01

    Objective: To study the efficacy of non - surgical comprehensive measures including drugs, parenteral nutrition support, gastrointestinal decompression, and local physical therapy for MBO. Methods: Thirty - nine tumor patients complicated with MBO were enrolled in the retrospective study. All the patients received treatment such as gastrointestinal decompression, drugs combined with octreotide, antiemetic,painkillers and glucocorticoid hormone, and parenteral nutrition support, medicinal plaster applied to navel region, abdomen massage, abdominal thermother-apy, therapeutic efficacy of bowel obstruction and KPS score before and after treatment were observed. Results: Of the 39 cases with MBO, 30 patients had complete response after the treatment with the clinical symptoms vanishing completely, intestines pneumatosis and product fluid vanishing when X - ray inspection was performed;5 patients had good response with partial remission of clinical symptoms and X - ray examination of bowel obstruction; 4 patients were ineffective, with the clinical symptoms and X - ray signs of bowel obstruction without improvement even exacerbation. The KPS score in all cases after treatment was significantly higher, P < 0. 001. The median survival of all cases was 6 months. 1 , 2, and 3 -year survival rates were 23.08% , 7.69% and 5. 13% respectively. Conclusion: Ihe regimen consisting oi drugs combined with octreotide, antiemetic,painkillers and glucocorticoid hormone, parenteral nutrition support, gastrointestinal decompression, and local physical therapy including abdomen massage, abdominal thermotherapy and medicinal plaster applied to navel region in tumor patients complicated with MBO especially cancer treatment - related obstruction has a good efficacy and mild side effects, can improve quality of life of patients.%目的 探讨药物、肠外营养支持联合胃肠减压、局部物理疗法等非手术措施治疗恶性肠梗阻的疗效.方法 收集39例恶性肿瘤合并

  18. Survival of Mexican Children with Acute Lymphoblastic Leukaemia under Treatment with the Protocol from the Dana-Farber Cancer Institute 00-01

    Directory of Open Access Journals (Sweden)

    Elva Jiménez-Hernández

    2015-01-01

    Full Text Available Our aim in this paper is to describe the results of treatment of acute lymphoblastic leukaemia (ALL in Mexican children treated from 2006 to 2010 under the protocol from the Dana-Farber Cancer Institute (DFCI 00-01. The children were younger than 16 years of age and had a diagnosis of ALL de novo. The patients were classified as standard risk if they were 1–9.9 years old and had a leucocyte count 100 × 109/L. The poor outcomes were associated with toxic death during induction, complete remission, and relapse. These factors remain the main obstacles to the success of this treatment in our population.

  19. Is standard breast-conserving therapy (BCT in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

    Directory of Open Access Journals (Sweden)

    Eilf Kirsten

    2010-11-01

    Full Text Available Abstract Background Breast conserving therapy (BCT is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed. Methods Toxicity was measured in 109 patients at initiation (t1, during radiotherapy (t2-t7, and 6 weeks after treatment completion (t8 using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5 based on CTC (Common Toxicity Criteria -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: 60 years. Results Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7, and dropped to 0.23 (t8. Univariate analyses revealed slightly higher toxicity in older (> 60 years versus young patients ( 60 years patients (p = 0.039. Toxicity differences in all other scales were not significant. Between older (> 60 years and midaged patients (50-60 years no significant differences in toxicity were found. This was also true for the comparison between young ( Conclusion The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women.

  20. Proteomic profiling of a mouse model of acute intestinal Apc deletion leads to identification of potential novel biomarkers of human colorectal cancer (CRC).

    Science.gov (United States)

    Hammoudi, Abeer; Song, Fei; Reed, Karen R; Jenkins, Rosalind E; Meniel, Valerie S; Watson, Alastair J M; Pritchard, D Mark; Clarke, Alan R; Jenkins, John R

    2013-10-25

    Colorectal cancer (CRC) is the fourth most common cause of cancer-related death worldwide. Accurate non-invasive screening for CRC would greatly enhance a population's health. Adenomatous polyposis coli (Apc) gene mutations commonly occur in human colorectal adenomas and carcinomas, leading to Wnt signalling pathway activation. Acute conditional transgenic deletion of Apc in murine intestinal epithelium (AhCre(+)Apc(fl)(/)(fl)) causes phenotypic changes similar to those found during colorectal tumourigenesis. This study comprised a proteomic analysis of murine small intestinal epithelial cells following acute Apc deletion to identify proteins that show altered expression during human colorectal carcinogenesis, thus identifying proteins that may prove clinically useful as blood/serum biomarkers of colorectal neoplasia. Eighty-one proteins showed significantly increased expression following iTRAQ analysis, and validation of nine of these by Ingenuity Pathaway Analysis showed they could be detected in blood or serum. Expression was assessed in AhCre(+)Apc(fl)(/)(fl) small intestinal epithelium by immunohistochemistry, western blot and quantitative real-time PCR; increased nucelolin concentrations were also detected in the serum of AhCre(+)Apc(fl)(/)(fl) and Apc(Min)(/)(+) mice by ELISA. Six proteins; heat shock 60kDa protein 1, Nucleolin, Prohibitin, Cytokeratin 18, Ribosomal protein L6 and DEAD (Asp-Glu-Ala-Asp) box polypeptide 5,were selected for further investigation. Increased expression of 4 of these was confirmed in human CRC by qPCR. In conclusion, several novel candidate biomarkers have been identified from analysis of transgenic mice in which the Apc gene was deleted in the intestinal epithelium that also showed increased expression in human CRC. Some of these warrant further investigation as potential serum-based biomarkers of human CRC.

  1. Acute skin toxicity-related, out-of-pocket expenses in patients with breast cancer treated with external beam radiotherapy: a descriptive, exploratory study.

    Science.gov (United States)

    Schnur, Julie B; Graff Zivin, Joshua; Mattson, David M K; Green, Sheryl; Jandorf, Lina H; Wernicke, A Gabriella; Montgomery, Guy H

    2012-12-01

    Acute skin toxicity is one of the most common side effects of breast cancer radiotherapy. To date, no one has estimated the nonmedical out-of-pocket expenses associated with this side effect. The primary aim of the present descriptive, exploratory study was to assess the feasibility of a newly developed skin toxicity costs questionnaire. The secondary aims were to: (1) estimate nonmedical out-of-pocket costs, (2) examine the nature of the costs, (3) explore potential background predictors of costs, and (4) explore the relationship between patient-reported dermatologic quality of life and expenditures. A total of 50 patients (mean age = 54.88, Stage 0-III) undergoing external beam radiotherapy completed a demographics/medical history questionnaire as well as a seven-item Skin Toxicity Costs (STC) questionnaire and the Skindex-16 in week 5 of treatment. Mean skin toxicity costs were $131.64 (standard error [SE] = $23.68). Most frequently incurred expenditures were new undergarments and products to manage toxicity. Education was a significant unique predictor of spending, with more educated women spending more money. Greater functioning impairment was associated with greater costs. The STC proved to be a practical, brief measure which successfully indicated specific areas of patient expenditures and need. Results reveal the nonmedical, out-of-pocket costs associated with acute skin toxicity in the context of breast cancer radiotherapy. To our knowledge, this study is the first to quantify individual costs associated with this treatment side effect, as well as the first to present a scale specifically designed to assess such costs. In future research, the STC could be used as an outcome variable in skin toxicity prevention and control research, as a behavioral indicator of symptom burden, or as part of a needs assessment.

  2. Genetic Variants in CD44 and MAT1A Confer Susceptibility to Acute Skin Reaction in Breast Cancer Patients Undergoing Radiation Therapy.

    Science.gov (United States)

    Mumbrekar, Kamalesh Dattaram; Bola Sadashiva, Satish Rao; Kabekkodu, Shama Prasada; Fernandes, Donald Jerard; Vadhiraja, Bejadi Manjunath; Suga, Tomo; Shoji, Yoshimi; Nakayama, Fumiaki; Imai, Takashi; Satyamoorthy, Kapaettu

    2017-01-01

    Heterogeneity in radiation therapy (RT)-induced normal tissue toxicity is observed in 10% of cancer patients, limiting the therapeutic outcomes. In addition to treatment-related factors, normal tissue adverse reactions also manifest from genetic alterations in distinct pathways majorly involving DNA damage-repair genes, inflammatory cytokine genes, cell cycle regulation, and antioxidant response. Therefore, the common sequence variants in these radioresponsive genes might modify the severity of normal tissue toxicity, and the identification of the same could have clinical relevance as a predictive biomarker. The present study was conducted in a cohort of patients with breast cancer to evaluate the possible associations between genetic variants in radioresponsive genes described previously and the risk of developing RT-induced acute skin adverse reactions. We tested 22 genetic variants reported in 18 genes (ie, NFE2L2, OGG1, NEIL3, RAD17, PTTG1, REV3L, ALAD, CD44, RAD9A, TGFβR3, MAD2L2, MAP3K7, MAT1A, RPS6KB2, ZNF830, SH3GL1, BAX, and XRCC1) using TaqMan assay-based real-time polymerase chain reaction. At the end of RT, the severity of skin damage was scored, and the subjects were dichotomized as nonoverresponders (Radiation Therapy Oncology Group grade skin reactions. Generalized multifactor dimensionality reduction analysis showed significant (P=.0107) gene-gene interactions between MAT1A and CD44. Furthermore, an increase in the total number of risk alleles was associated with increasing occurrence of overresponses (P=.0302). The genetic polymorphisms in radioresponsive genes act as genetic modifiers of acute normal tissue toxicity outcomes after RT by acting individually (rs8193), by gene-gene interactions (MAT1A and CD44), and/or by the additive effects of risk alleles. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Acute side effects after dose-escalation treatment of prostate cancer using the new urethral catheter BeamCath{sup R} technique

    Energy Technology Data Exchange (ETDEWEB)

    Fransson, Per; Loefroth, P.O.; Franzen, L.; Henriksson, Roger; Bergstroem, P.; Widmark, A. [Umeaa Univ. (Sweden). Dept. of Oncology

    2001-11-01

    Acute side effects after dose-escalated radiotherapy for prostate cancer with different treatment techniques were evaluated, using a daily diary recorded by the patients. Dose escalation was performed using the urethral catheter BeamCath{sup R} (registered trade mark name) technique. Side effects were evaluated in 267 patients by means of a daily diary during the treatment and at 3-months' follow-up. The patients' evaluations were compared with those of patients treated with conventional or conformal techniques. Looser stools were reported in the conventional (placebo) and 76 Gy groups at 3-months' follow-up compared with at week 1. No other obvious increase in rectal or bladder morbidity was seen in the 76 Gy group. The catheter did not increase the urinary frequency in comparison to the other groups. The reported urgency and starting problems at the beginning of treatment seemed to improve in all groups at 3-months' follow-up. External beam radiotherapy dose escalation using the BeamCath{sup R} technique did not result in a dose-dependent increase in acute side effects.

  4. Evaluating the consistency of location of the most severe acute skin reaction and highest skin dose measured by thermoluminescent dosimeter during radiotherapy for breast cancer.

    Science.gov (United States)

    Sun, Li-Min; Huang, Chih-Jen; Chen, Hsiao-Yun; Chang, Gia-Hsin; Tsao, Min-Jen

    2016-01-01

    We conducted this prospective study to evaluate whether the location of the most severe acute skin reaction matches the highest skin dose measured by thermoluminescent dosimeter (TLD) during adjuvant radiotherapy (RT) for patients with breast cancer after breast conservative surgery. To determine whether TLD measurement can reflect the location of the most severe acute skin reaction, 80 consecutive patients were enrolled in this prospective study. We divided the irradiated field into breast, axillary, inframammary fold, and areola/nipple areas. In 1 treatment session when obvious skin reaction occurred, we placed the TLD chips onto the 4 areas and measured the skin dose. We determined whether the highest measured skin dose area is consistent with the location of the most severe skin reaction. The McNemar test revealed that the clinical skin reaction and TLD measurement are more consistent when the most severe skin reaction occurred at the axillary area, and the p = 0.0108. On the contrary, TLD measurement of skin dose is less likely consistent with clinical observation when the most severe skin reaction occurred at the inframammary fold, breast, and areola/nipple areas (all the p > 0.05). Considering the common site of severe skin reaction over the axillary area, TLD measurement may be an appropriate way to predict skin reaction during RT. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  5. KEGG DISEASE / Acute myeloid leukemia (AML) [KEGG DISEASE

    Lifescience Database Archive (English)

    Full Text Available DISEASE: H00003 Entry H00003Disease Name Acute myeloid leukemia (AML) Description Acute.... Category Cancer Brite Human diseases [BR:br08402] Cancers Cancers of haematopoietic and lymphoid tissues H00003Acute...atopoietic and related tissue C92Myeloid leukaemia H00003Acute myeloid leukemia (AML) Cancer-accociated carb...ohydrates [br08441.html] H00003 Pathway hsa05221Acute myeloid leukemiahsa05202Transcriptional misregulation ... or t(16; 16)(p13, q22), (CBF-beta/MYH11) ICD-O: 9866/3, Tumor type: Acute promyelocytic leukaemia (AML with

  6. Treatment of acute obstructive cased by colorectal cancer%急性结直肠癌性梗阻的治疗策略

    Institute of Scientific and Technical Information of China (English)

    吴文周; 郭亚飞; 许榕生; 梁山

    2014-01-01

    目的 探讨结直肠癌引起急性肠梗阻的治疗方法.方法 回顾性分析结直肠癌性肠梗阻26例临床资料,复习手术术式及相关文献.结果 右侧结肠梗阻行根治性右半结肠切除术9例.左侧结直肠癌性梗阻17例:12例行一期根治性切除,其中4例行一期吻合,8例行Hartmann术;3例行梗阻近侧结肠造口术;1例直肠癌并升结肠绞窄行右半结肠切除+乙状结肠造口术;1例拒绝手术.术后2例死于MODS,1例并发炎症性肠梗阻经保守治疗痊愈;病程中合并脓毒性休克、MODS 3例,肺部感染5例,心脏疾病2例;低蛋白血症16例.结论 右侧结肠癌性梗阻可一期切除吻合,左侧结直肠癌性梗阻应遵循损伤控制理论,先行肠减压或清除腹腔炎性渗液,减少毒素吸收以控制病情进一步加重,再根据病情选择有效、安全的术式.术后加强抗感染和营养支持治疗.%Objective To investigate the treatment of acute obstructive colorectal cancer.Methods The clinical data of 26 cases with acute obstructive colorectal cancer were analysed retrospectively and relevant literatures were reviewed.Results Radical right hemicolectomy was performed in 9 patients with obstructive right colonic cancer.Among 17 patients with obstructive left colorectal cancer,one-stage radical resection was perfomed in 12 cases,including one-stage anastomosis in 4 cases and Hartmann's operation in 8 cases.Palliative colostomy was performed in 3 cases.Right hemicolectomy and sigmoid colon loop colostomy was performed in 1 case of rectum cancer with ascending colon strangulation.One case refused surgery.Two cases died of MODS and 1 case with inflammatory ileus recovering from conservative treatment after operation.In the course of disease,septic shock and MODS happened in 3 cases,lung infection in 5 cases,heart disease in 2 cases and Hypoalbuminemia in 16 cases.Conclusions One-stage radical colectomy and anastomosis should be performed in patients with

  7. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  8. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  9. Peptide Vaccination Against Cancer Testis Antigens in Combination With Azacitidine for Patients With Myelodysplastic Syndrome and Acute Myeloid Leukemia

    DEFF Research Database (Denmark)

    Holmberg, S.; Ortved Gang, A.; Svane, I.M.;

    2016-01-01

    . The demand for more effective therapies in this patient group is huge. Though the mechanism of AZA is not fully elucidated re-expression of tumor suppressor genes can serve as a mechanism for growth arrest. In addition, there is accumulating evidence for an up-regulation of cancer testis antigens (CTA......), which could lead to increased immune recognition of tumor cells and immune-mediated tumor cell killing. CTA’s are known to be immunogenic and are only expressed at immunoprivileged sites and on malignant cells, making them attractive as targets for therapeutic cancer vaccination....

  10. Genetic variations in DNA repair genes, radiosensitivity to cancer and susceptibility to acute tissue reactions in radiotherapy-treated cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Chistiakov, Dimitry A. (Dept. of Pathology, Univ. of Pittsburgh, Pittsburgh (US)); Voronova, Natalia V. (Dept. of Molecular Diagnostics, National Research Center GosNIIgenetika, Moscow (RU)); Chistiakov, Pavel A. (Dept. of Radiology, Cancer Research Center, Moscow (RU))

    2008-06-15

    Ionizing radiation is a well established carcinogen for human cells. At low doses, radiation exposure mainly results in generation of double strand breaks (DSBs). Radiation-related DSBs could be directly linked to the formation of chromosomal rearrangements as has been proven for radiation-induced thyroid tumors. Repair of DSBs presumably involves two main pathways, non-homologous end joining (NHEJ) and homologous recombination (HR). A number of known inherited syndromes, such as ataxia telangiectasia, ataxia-telangiectasia like-disorder, radiosensitive severe combined immunodeficiency, Nijmegen breakage syndrome, and LIG4 deficiency are associated with increased radiosensitivity and/or cancer risk. Many of them are caused by mutations in DNA repair genes. Recent studies also suggest that variations in the DNA repair capacity in the general population may influence cancer susceptibility. In this paper, we summarize the current status of DNA repair proteins as potential targets for radiation-induced cancer risk. We will focus on genetic alterations in genes involved in HR- and NHEJ-mediated repair of DSBs, which could influence predisposition to radiation-related cancer and thereby explain interindividual differences in radiosensitivity or radioresistance in a general population

  11. Risk of severe acute liver injury among patients with brain cancer treated with temozolomide: a nested case-control study using the healthcore integrated research database.

    Science.gov (United States)

    Desai, Vibha C A; Quinlan, Scott C; Deitz, Anne C; He, Jinghua; Holick, Crystal N; Lanes, Stephan

    2017-08-01

    Temozolomide (TMZ) is used to treat adult patients with glioblastoma multiforme (GBM). Cases of hepatotoxicity have been reported among patients using TMZ. The objective of the study was to assess the relation, if any, between exposure to TMZ and serious acute liver injury (SALI). We used the HealthCore Integrated Research Database to perform a case-control study nested within a retrospective cohort of adult patients aged 18-100 years with at least two diagnoses of brain cancer anytime between 2006 and 2014. Patients without continuous eligibility or with a SALI diagnosis within 6 months prior to the date of incident brain cancer diagnosis were excluded. Medical records were sought for potential SALI cases and reviewed by two hepatologists. Five controls were selected for each case using incidence density sampling, matched on age and calendar year of index date. The analysis included 61 confirmed SALI cases and 305 selected controls. Exposure to TMZ was classified according to dispensing date and days supply of medication dispensed. We estimated odds ratios using conditional logistic regression models. The odds ratio for any exposure to TMZ was 0.91 (95% CI 0.44-1.91), for recent exposure to TMZ was 0.62 (95% CI 0.21-1.85). There was no increased risk of SALI with increasing duration of exposure to TMZ. When patients with unconfirmed SALI were included in the analysis, results were similar (OR 1.04; 95% CI 0.70-1.54). In conclusion, this study did not find an association between TMZ and SALI risk among patients with brain cancer.

  12. DEXA measures of body fat percentage and acute phase proteins among breast cancer survivors: a Cross-Sectional Analysis

    Directory of Open Access Journals (Sweden)

    Dee Anne

    2012-08-01

    Full Text Available Abstract Background C-reactive protein (CRP and Serum amyloid A protein (SAA increases with systemic inflammation and are related to worse survival for breast cancer survivors. This study examines the association between percent body fat and SAA and CRP and the potential interaction with NSAID use and weight change. Methods Participants included 134 non-Hispanic white and Hispanic breast cancer survivors from the Health, Eating, Activity, and Lifestyle Study. Body fat percentage, measured with Dual Energy X-ray Absorptiometer (DEXA, and circulating levels of CRP and SAA were obtained 30 months after breast cancer diagnosis. Results Circulating concentrations of CRP and SAA were associated with increased adiposity as measured by DEXA after adjustment for age at 24-months, race/ethnicity, dietary energy intake, weight change, and NSAID use. Survivors with higher body fat ≥35% had significantly higher concentrations of CRP (2.01 mg/l vs. 0.85 mg/l and SAA (6.21 mg/l vs. 4.21 mg/l compared to non-obese (body fat  Conclusions Breast cancer survivors with higher body fat had higher mean concentrations of CRP and SAA than women with lower body fat. Further assessment of NSAID use and weight control in reducing circulating inflammatory markers among survivors may be worthwhile to investigate in randomized intervention trials as higher inflammatory markers are associated with worse survival.

  13. Effect of mild acute stress on immune cell distribution and natural killer cell activity in breast cancer patients

    NARCIS (Netherlands)

    van der Pompe, G; Antoni, MH; Visser, A; Heijnen, CJ

    1998-01-01

    The present study explored cardiovascular and immune responses to a standardized laboratory challenge (speech task) in 23 breast cancer patients. All patients were diagnosed with positive axilliary lymph nodes and received tamoxifen as an adjuvant treatment throughout the course of the study. As a c

  14. Acute toxicity and surgical complications after preoperative (chemo)radiation therapy for rectal cancer in patients with inflammatory bowel disease

    NARCIS (Netherlands)

    Bosch, S.L.; Rooijen, S.J. van; Bökkerink, G.M.J.; Braam, H.J.; Derikx, L.A.A.P.; Poortmans, P.M.P.; Marijnen, C.A.; Nagtegaal, I.D.; Wilt, J.H.W. de

    2017-01-01

    PURPOSE: Preoperative therapy reduces local recurrences and may facilitate surgery in rectal cancer patients. However, in patients with inflammatory bowel disease (IBD) this treatment is often withheld due to the perceived risk of excessive side-effects, even though evidence is limited. The purpose

  15. The possible role of matrix metalloproteinase (MMP)-2 and MMP-9 in cancer, e.g. acute leukemia

    NARCIS (Netherlands)

    Klein, G.; Vellenga, E.; Fraaije, M.W.; Kamps, W.A.; Bont, E.S.J.M. de

    2004-01-01

    In the past decades, a lot of effort has been put in identifying the role of matrix metalloproteinases (MMPs) in cancer. The main role of MMPs in angiogenesis, tumor growth and metastasis is degradation of extracellular matrix (ECM) and release and/or activation of growth factors through their

  16. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer

    Science.gov (United States)

    Davidson, Susan E; Gillespie, Catherine; Allum, William H; Swarbrick, Edwin

    2011-01-01

    Backgound The number of patients with chronic gastrointestinal (GI) symptoms after cancer therapies which have a moderate or severe impact on quality of life is similar to the number diagnosed with inflammatory bowel disease annually. However, in contrast to patients with inflammatory bowel disease, most of these patients are not referred for gastroenterological assessment. Clinicians who do see these patients are often unaware of the benefits of targeted investigation (which differ from those required to exclude recurrent cancer), the range of available treatments and how the pathological processes underlying side effects of cancer treatment differ from those in benign GI disorders. This paper aims to help clinicians become aware of the problem and suggests ways in which the panoply of syndromes can be managed. Methods A multidisciplinary literature review was performed to develop guidance to facilitate clinical management of GI side effects of cancer treatments. Results Different pathological processes within the GI tract may produce identical symptoms. Optimal management requires appropriate investigations and coordinated multidisciplinary working. Lactose intolerance, small bowel bacterial overgrowth and bile acid malabsorption frequently develop during or after chemotherapy. Toxin-negative Clostridium difficile and cytomegalovirus infection may be fulminant in immunosuppressed patients and require rapid diagnosis and treatment. Hepatic side effects include reactivation of viral hepatitis, sinusoidal obstruction syndrome, steatosis and steatohepatitis. Anticancer biological agents have multiple interactions with conventional drugs. Colonoscopy is contraindicated in neutropenic enterocolitis but endoscopy may be life-saving in other patients with GI bleeding. After cancer treatment, simple questions can identify patients who need referral for specialist management of GI symptoms. Other troublesome pelvic problems (eg, urinary, sexual, nutritional) are frequent

  17. Tratamento cirúrgico e conservador da agenesia vaginal: análise de uma série de casos Surgical and non-surgical treatment of vaginal agenesis: analysis of a series of cases

    Directory of Open Access Journals (Sweden)

    Juliana Straehl Marin

    2012-06-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento da agenesia vaginal pela técnica cirúrgica de McIndoe-Bannister modificada e pela técnica de Frank. MÉTODOS: Este estudo retrospectivo foi conduzido com uma amostra de conveniência de 25 mulheres portadoras de agenesia vaginal em seguimento no Ambulatório de Ginecologia Infanto Puberal. Quinze mulheres foram submetidas à cirúrgica modificada de McIndoe-Bannister Grupo Cirúrgico e 10 fora tratadas com a técnica de Frank Grupo Frank. Para a análise comparativa entre essas duas amostras, foram considerados os seguintes parâmentros: vaginometria final, efeitos adversos e satisfação sexual após o tratamento. Esses dados foram obtidos por meio dos registros nos prontuários médicos. A satisfação sexual foi aferida por questão simples: como está sua vida sexual? RESULTADOS: Houve diferença em relação ao comprimento da vagina tanto naquelas submetidas à técnica de Frank (comprimento inicial 2,4±2,0 cm, após o tratamento 6,9±1,1 cm, pPURPOSE: This study aimed to evaluate the results of neovaginoplasty by a modified McIndoe-Bannister technique and by the non-surgical Frank technique. METHODS: This retrospective study was conducted on a convenience sample of 25 women with vaginal agenesis undergoing surgical or conservative treatment at an Infant-Pubertal Gynecology Outpatient Clinic. Data were obtained from the medical records. Fifteen women underwent the surgical McIndoe-Bannister modified technique Surgical Group, and 10 women underwent the non-surgical Frank technique Frank Group. The following parameters were considered for comparative analysis between the two samples: vaginometry, surgical and non-surgical complications, and sexual satisfaction after treatment. Sexual satisfaction was assessed by a simple question: How is your sex life? RESULTS: There were differences related to vaginal length before and after performing exercises in both Frank Group (initial vaginal length 2

  18. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  19. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  20. The genomic landscape of pediatric and young adult T-lineage acute lymphoblastic leukemia | Office of Cancer Genomics

    Science.gov (United States)

    Genetic alterations that activate NOTCH1 signaling and T cell transcription factors, coupled with inactivation of the INK4/ARF tumor suppressors, are hallmarks of T-lineage acute lymphoblastic leukemia (T-ALL), but detailed genome-wide sequencing of large T-ALL cohorts has not been carried out. Using integrated genomic analysis of 264 T-ALL cases, we identified 106 putative driver genes, half of which had not previously been described in childhood T-ALL (for example, CCND3, CTCF, MYB, SMARCA4, ZFP36L2 and MYCN).

  1. The importance of non-surgical optical correction and treatment of keratoconus%重视圆锥角膜的非手术光学矫正与治疗

    Institute of Scientific and Technical Information of China (English)

    谢培英

    2015-01-01

    Keratoconus is a complicated refractive disease,and is more common in adolescents and young adults around the age of 15-25 years.The prevalence of domestic and international surveys shows an average of about 1/2 000.This age range is a critical period of ones life,when rapid growth and development occur,laying down a foundation and broadening horizons.Therefore,recognizing the harmful impact of this kind of disease for young people's visual development and the benefits of non-surgical treatment for optical correction and treatment are particularly important.This article combines research progress both locally and internationally,from the improvement of visual quality and function,the stability of the treatment,the influence on physical and mental development and the impact on studying and living.This article also analyzes the advantages of using non-surgical optical correction treatments by a specially designed contact lens and existing problems involving convenience,operability and safety aspects.%圆锥角膜属于青少年时期较常见的屈光性疑难疾病,好发于15~25岁,国内外调查显示其患病率为1/2 000左右.这一年龄段正处于人生的快速生长、发育、奠定基础和开拓视野的关键时期,因此认识到本病对青少年视觉发育的危害性以及采用非手术光学矫正和治疗方法的益处尤为重要.笔者结合国内外研究的进展,从视觉质量和功能的提高,控制效果的稳定性,对身心发育及对学习、生活的影响,以及简捷性、可操作性及安全性等方面,分析利用特殊设计接触镜这一非手术矫正方法的优势以及存在的问题.

  2. TU-F-12A-09: GLCM Texture Analysis for Normal-Tissue Toxicity: A Prospective Ultrasound Study of Acute Toxicity in Breast-Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, T; Yang, X; Curran, W; Torres, M [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA (United States)

    2014-06-15

    Purpose: To evaluate the morphologic and structural integrity of the breast glands using sonographic textural analysis, and identify potential early imaging signatures for radiation toxicity following breast-cancer radiotherapy (RT). Methods: Thirty-eight patients receiving breast RT participated in a prospective ultrasound imaging study. Each participant received 3 ultrasound scans: 1 week before RT (baseline), and at 6-week and 3-month follow-ups. Patients were imaged with a 10-MHz ultrasound on the four quadrant of the breast. A second order statistical method of texture analysis, called gray level co-occurrence matrix (GLCM), was employed to assess RT-induced breast-tissue toxicity. The region of interest (ROI) was 28 mm × 10 mm in size at a 10 mm depth under the skin. Twenty GLCM sonographic features, ratios of the irradiated breast and the contralateral breast, were used to quantify breast-tissue toxicity. Clinical assessment of acute toxicity was conducted using the RTOG toxicity scheme. Results: Ninety-seven ultrasound studies (776 images) were analyzed; and 5 out of 20 sonographic features showed significant differences (p < 0.05) among the baseline scans, the acute toxicity grade 1 and 2 groups. These sonographic features quantified the degree of tissue damage through homogeneity, heterogeneity, randomness, and symmetry. Energy ratio value decreased from 108±0.05 (normal) to 0.99±0.05 (Grade 1) and 0.84±0.04 (Grade 2); Entropy ratio value increased from 1.01±0.01 to 1.02±0.01 and 1.04±0.01; Contrast ratio value increased from 1.03±0.03 to 1.07±0.06 and 1.21±0.09; Variance ratio value increased from 1.06±0.03 to 1.20±0.04 and 1.42±0.10; Cluster Prominence ratio value increased from 0.98±0.02 to 1.01±0.04 and 1.25±0.07. Conclusion: This work has demonstrated that the sonographic features may serve as imaging signatures to assess radiation-induced normal tissue damage. While these findings need to be validated in a larger cohort, they suggest

  3. Effects of Methylphenidate on Attention Deficits in Childhood Cancer Survivors

    Science.gov (United States)

    2015-03-16

    ALL, Childhood; Leukemia, Lymphoblastic; Leukemia, Lymphoblastic, Acute; Leukemia, Lymphoblastic, Acute, L1; Leukemia, Lymphoblastic, Acute, L2; Leukemia, Lymphoblastic, Acute, Philadelphia-Positive; Leukemia, Lymphocytic, Acute; Leukemia, Lymphocytic, Acute, L1; Leukemia, Lymphocytic, Acute, L2; Lymphoblastic Leukemia; Lymphoblastic Leukemia, Acute; Lymphoblastic Leukemia, Acute, Childhood; Lymphoblastic Leukemia, Acute, L1; Lymphoblastic Leukemia, Acute, L2; Lymphoblastic Lymphoma; Lymphocytic Leukemia, Acute; Lymphocytic Leukemia, L1; Lymphocytic Leukemia, L2; Brain Tumors; Cancer of the Brain; Cancer of Brain; Malignant Primary Brain Tumors; Brain Neoplasms, Malignant

  4. Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index.

    Science.gov (United States)

    Mammen, Jerry; Vadakkekuttical, Rosamma Joseph; George, Joseraj Manaloor; Kaziyarakath, Jaishid Ahadal; Radhakrishnan, Chandni

    2017-08-01

    A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis. © 2016 John Wiley & Sons Australia, Ltd.

  5. Effect of Age of Self-Reported, Non-Surgical Menopause on Time to First Fracture and Bone Mineral Density in the Women’s Health Initiative Observational Study

    Science.gov (United States)

    Lehman, Amy; Thomas, Fridtjof; Johnson, Karen C.; Jackson, Rebecca; Wactawski-Wende, Jean; Ko, Marcia; Chen, Zhao; Curb, J David; Howard, Barbara V.

    2015-01-01

    Objective Menopause is a risk factor for fracture, thus menopause age may affect bone mass and fracture rates. We compared Bone Mineral Density (BMD) and fracture rates among healthy postmenopausal women with varying ages of self-reported non-surgical menopause. Methods Hazard ratios for fracture and differences in BMD among 21,711 postmenopausal women from the Women’s Health Initiative Observational cohort without prior hysterectomy, oophorectomy, or hormone therapy, who reported age of menopause of menopausal age groups. After multivariable adjustments for known risk factors for fracture, women undergoing menopause menopause ≥50 years (HR=1.21, 95% CI: 1.02, 1.44; p=0.03). In a subset with BMD measurements (n=1,351), whole body BMD was lower in women who reported menopause menopause menopause menopause age may be a risk factor contributing to decreased BMD and increased fracture risk in healthy postmenopausal women. Our data suggest that menopause age should be taken into consideration, along with other osteoporotic risk factors, when estimating fracture risk in postmenopausal women. PMID:25803670

  6. Modeling the Risk of Radiation-Induced Acute Esophagitis for Combined Washington University and RTOG Trial 93-11 Lung Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ellen X.; Bradley, Jeffrey D.; El Naqa, Issam [Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO (United States); Hope, Andrew J.; Lindsay, Patricia E. [Princess Margaret Hospital, Toronto, ON (Canada); Bosch, Walter R.; Matthews, John W. [Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO (United States); Sause, William T. [Department of Radiation Oncology, LDS Hospital, Salt Lake City, UT (United States); Graham, Mary V. [Department of Radiation Oncology, Phelps County Regional Hospital, Rolla, MO (United States); Deasy, Joseph O., E-mail: deasyj@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-04-01

    Purpose: To construct a maximally predictive model of the risk of severe acute esophagitis (AE) for patients who receive definitive radiation therapy (RT) for non-small-cell lung cancer. Methods and Materials: The dataset includes Washington University and RTOG 93-11 clinical trial data (events/patients: 120/374, WUSTL = 101/237, RTOG9311 = 19/137). Statistical model building was performed based on dosimetric and clinical parameters (patient age, sex, weight loss, pretreatment chemotherapy, concurrent chemotherapy, fraction size). A wide range of dose-volume parameters were extracted from dearchived treatment plans, including Dx, Vx, MOHx (mean of hottest x% volume), MOCx (mean of coldest x% volume), and gEUD (generalized equivalent uniform dose) values. Results: The most significant single parameters for predicting acute esophagitis (RTOG Grade 2 or greater) were MOH85, mean esophagus dose (MED), and V30. A superior-inferior weighted dose-center position was derived but not found to be significant. Fraction size was found to be significant on univariate logistic analysis (Spearman R = 0.421, p < 0.00001) but not multivariate logistic modeling. Cross-validation model building was used to determine that an optimal model size needed only two parameters (MOH85 and concurrent chemotherapy, robustly selected on bootstrap model-rebuilding). Mean esophagus dose (MED) is preferred instead of MOH85, as it gives nearly the same statistical performance and is easier to compute. AE risk is given as a logistic function of (0.0688 Asterisk-Operator MED+1.50 Asterisk-Operator ConChemo-3.13), where MED is in Gy and ConChemo is either 1 (yes) if concurrent chemotherapy was given, or 0 (no). This model correlates to the observed risk of AE with a Spearman coefficient of 0.629 (p < 0.000001). Conclusions: Multivariate statistical model building with cross-validation suggests that a two-variable logistic model based on mean dose and the use of concurrent chemotherapy robustly predicts

  7. Human papillomaviruses and cancer.

    Science.gov (United States)

    Haedicke, Juliane; Iftner, Thomas

    2013-09-01

    Human papillomaviruses (HPV) are small oncogenic DNA viruses of which more than 200 types have been identified to date. A small subset of these is etiologically linked to the development of anogenital malignancies such as cervical cancer. In addition, recent studies established a causative relationship between these high-risk HPV types and tonsillar and oropharyngeal cancer. Clinical management of cervical cancer and head and neck squamous cell carcinomas (HNSCCs) is largely standardized and involves surgical removal of the tumor tissue as well as adjuvant chemoradiation therapy. Notably, the response to therapeutic intervention of HPV-positive HNSCCs has been found to be better as compared to HPV-negative tumors. Although the existing HPV vaccine is solely licensed for the prevention of cervical cancer, it might also have prophylactic potential for the development of high-risk HPV-associated HNSCCs. Another group of viruses, which belongs to the beta-HPV subgroup, has been implicated in nonmelanoma skin cancer, however, the etiology remains to be established. Treatment of HPV-induced nonmelanoma skin cancer is based on local excision. However, topically applied immune-modulating substances represent non-surgical alternatives for the management of smaller cutaneous tumors. In this review we present the current knowledge of the role of HPV in cancer development and discuss clinical management options as well as targets for the development of future intervention therapies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. [Non-surgical treatment of hemorrhoids].

    Science.gov (United States)

    Libeskind, M

    1987-01-01

    The treatment of hemorrhoids includes a vast array of medical and instrumental means. If there is no true medical treatment, there are numerous products in order to act on the symptoms or one of the factors of the hemorrhoidal complex. Thus, phlebotonics, local topical agents, anti-infectious and anti-inflammatory agents, myorelaxants, transit regulators. Instrumental means are essentially represented by sclerosing injections, infra-red photocoagulation, cryotherapy, and mainly elastic rubber bands. All these treatments, some of which were offered as a substitute to surgery, often give interesting results, but are not devoid of danger. The attitude of the medico-surgical proctologist is then to find a happy medium between a procedure which is insufficient and one which may become unnecessarily aggressive.

  9. Non-surgical management of tooth hypersensitivity.

    Science.gov (United States)

    Clark, Danielle; Levin, Liran

    2016-10-01

    Tooth sensitivity is a common complaint of patients in dental practices. Studies have demonstrated dentinal hypersensitivity to affect 10-30% of the population. There are various potential causes of tooth sensitivity and a variety of available treatment options. This narrative review will discuss the possible aetiology of this condition, as well as the treatment modalities available. A tailor-made treatment plan that starts with the most non-invasive treatment options and escalates only when those options have proven insufficient in alleviating symptoms should be provided for each patient. Only after all non- and less-invasive methods have failed to reduce the symptoms should more invasive treatment options, such as root-coverage, be considered.

  10. Non surgical treatment of vestibular schwannoma.

    Science.gov (United States)

    Arribas, Leoncio; Chust, María L; Menéndez, Antonio; Arana, Estanislao; Vendrell, Juan B; Crispín, Vicente; Pesudo, Carmen; Mengual, José L; Mut, Alejandro; Arribas, Mar; Guinot, José L

    2015-01-01

    To evaluate the results of local control and complications in the treatment of vestibular schwannoma treated with radiation. A retrospective study of 194 patients diagnosed with vestibular schwannoma, treated consecutively with radiation (either stereotactic radiosurgery or fractionated radiotherapy) from 1997 to 2012. We analyze the local control of tumors, as well as secondary complications to treatment with radiation. A total of 132 (68%) tumors 68% are grade I-II tumors of the Koos classification, 40 (19%) are grade III, and 22 (13%) are grade IV. The tumors associated with neurofibromatosis (NF2), are 3.6% (6 tumors in 4 patients). The tumor control for the overall serie is 97% at 5 years, with a median follow-up of 80.4 months. For large tumors the local control is 91% at 5 years. Free survival of chronic complications is 89% at 5 years. Additionally, 50 tumors were subjected to regular follow-up with MRI without treatment, and 28 (58%) did not experienced tumor growth. Radiation and follow up with MRI, are an alternative to surgery in the treatment of vestibular schwannoma, with a low level of complications inside of multidisciplinary approach. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  11. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  12. Acute esophagitis for patients with local-regional advanced non small cell lung cancer treated with concurrent chemoradiotherapy

    DEFF Research Database (Denmark)

    Pan, Yi; Brink, Carsten; Knap, Marianne

    2016-01-01

    PURPOSE: Esophagitis is common in patients treated with definitive radiotherapy for local-regional advanced non small cell lung cancer (NSCLC). The purpose of this study was to estimate the dose-effect relationship using clinical and dosimetric parameters in patients receiving intensity modulated...... radiotherapy (IMRT) and concomitant chemotherapy (CCT). METHODS: Between 2009 and 2013, 117 patients with stages IIB-IIIB NSCLC were treated in a multicenter randomized phase II trial with 2 cycles of induction chemotherapy followed by IMRT and CCT. The esophagitis was prospectively scored using the Common...

  13. Acute mucosal radiation reactions in patients with head and neck cancer. Patterns of mucosal healing on the basis of daily examinations

    Energy Technology Data Exchange (ETDEWEB)

    Wygoda, A.; Skladowski, K.; Rutkowski, T.; Hutnik, M.; Golen, M.; Pilecki, B.; Przeorek, W.; Lukaszczyk-Widel, B. [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice (Poland). 1st Dept. of Radiation Oncology

    2012-08-15

    Purpose: The goal of this research was to evaluate the healing processes of acute mucosal radiation reactions (AMRR) in patients with head and neck cancer. Materials and methods: In 46 patients with oral and oropharyngeal cancer patients irradiated with conventional (n = 25) and accelerated (n = 21) dose fractionation AMRR was evaluated daily during and after radiotherapy. Complex of morphological and functional symptoms according to the Dische score were collected daily until complete healing. Results: Duration of healing after the end of radiotherapy ranged widely (12-70 days). It was on the average 8 days longer for accelerated than for conventional radiotherapy (p = 0.016). Duration of dysphagia was also longer for accelerated irradiation (11 days, p = 0.027). Three types of morphological symptoms were observed as the last symptom at the end of AMRR healing: spotted and confluent mucositis, erythema, and edema. Only a slight correlation between healing duration and area of irradiation fields (r = 0.23) was noted. In patients with confluent mucositis, two morphological forms of mucosal healing were observed, i.e., marginal and spotted. The spotted form was noted in 71% of patients undergoing conventional radiotherapy and in 38% of patients undergoing accelerated radiotherapy. The symptoms of mucosal healing were observed in 40% patients during radiotherapy. Conclusion: The wide range of AMRR healing reflects individual potential of mucosa recovery with longer duration for accelerated radiotherapy. Two morphological forms of confluent mucositis healing were present: marginal and spotted. Healing of AMRR during radiotherapy can be observed in a significant proportion of patients. (orig.)

  14. DNA Double-Strand Break Analysis by {gamma}-H2AX Foci: A Useful Method for Determining the Overreactors to Radiation-Induced Acute Reactions Among Head-and-Neck Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Goutham, Hassan Venkatesh; Mumbrekar, Kamalesh Dattaram [Division of Radiobiology and Toxicology, Manipal Life Sciences Centre, Manipal University, Manipal, Karnataka (India); Vadhiraja, Bejadi Manjunath [Manipal Hospital, Bangalore, Karnataka (India); Fernandes, Donald Jerard; Sharan, Krishna [Department of Radiotherapy and Oncology, Shiridi Sai Baba Cancer Hospital and Research Centre, Kasturba Hospital, Manipal, Karnataka (India); Kanive Parashiva, Guruprasad; Kapaettu, Satyamoorthy [Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal, Karnataka (India); Bola Sadashiva, Satish Rao, E-mail: satishraomlsc@gmail.com [Division of Radiobiology and Toxicology, Manipal Life Sciences Centre, Manipal University, Manipal, Karnataka (India)

    2012-12-01

    Purpose: Interindividual variability in normal tissue toxicity during radiation therapy is a limiting factor for successful treatment. Predicting the risk of developing acute reactions before initiation of radiation therapy may have the benefit of opting for altered radiation therapy regimens to achieve minimal adverse effects with improved tumor cure. Methods and Materials: DNA double-strand break (DSB) induction and its repair kinetics in lymphocytes of head-and-neck cancer patients undergoing chemoradiation therapy was analyzed by counting {gamma}-H2AX foci, neutral comet assay, and a modified version of neutral filter elution assay. Acute normal tissue reactions were assessed by Radiation Therapy Oncology Group criteria. Results: The correlation between residual DSBs and the severity of acute reactions demonstrated that residual {gamma}-H2AX foci in head-and-neck cancer patients increased with the severity of oral mucositis and skin reaction. Conclusions: Our results suggest that {gamma}-H2AX analysis may have predictive implications for identifying the overreactors to mucositis and skin reactions among head-and-neck cancer patients prior to initiation of radiation therapy.

  15. Severe acute interstitial lung disease in a patient with anaplastic lymphoma kinase rearrangement-positive non-small cell lung cancer treated with alectinib.

    Science.gov (United States)

    Yamamoto, Yuzo; Okamoto, Isamu; Otsubo, Kohei; Iwama, Eiji; Hamada, Naoki; Harada, Taishi; Takayama, Koichi; Nakanishi, Yoichi

    2015-10-01

    Alectinib, the second generation anaplastic lymphoma kinase (ALK) inhibitor, has significant potency in patients with ALK rearrangement positive non-small cell lung cancer (NSCLC), and its toxicity is generally well tolerable. We report a patient who developed severe acute interstitial lung disease after alectinib treatment. An 86-year-old woman with stage IV lung adenocarcinoma positive for rearrangement of ALK gene was treated with alectinib. On the 215th day after initiation of alectinib administration, she was admitted to our hospital with the symptom of progressive dyspnea. Computed tomography (CT) revealed diffuse ground glass opacities and consolidations in both lungs, and analysis of bronchoalveolar lavage fluid revealed pronounced lymphocytosis. There was no evidence of infection or other specific causes of her condition, and she was therefore diagnosed with interstitial lung disease induced by alectinib. Her CT findings and respiratory condition improved after steroid pulse therapy. As far as we are aware, this is the first reported case of alectinib-induced severe interstitial lung disease (ILD). We should be aware of the possibility of such a severe adverse event and should therefore carefully monitor patients treated with this drug.

  16. Assessment of corticosteroid-induced osteonecrosis in children undergoing chemotherapy for acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group.

    Science.gov (United States)

    Hyakuna, Nobuyuki; Shimomura, Yasuto; Watanabe, Arata; Taga, Takashi; Kikuta, Atsushi; Matsushita, Takeji; Kogawa, Kazuhiro; Kawakami, Chihiro; Horikoshi, Yasuo; Iwai, Tsuyako; Okamoto, Yasuhiro; Tsurusawa, Masahito; Asami, Keiko

    2014-01-01

    Steroid-induced osteonecrosis (ON) is a challenging complication encountered during modern chemotherapy for childhood acute lymphoblastic leukemia (ALL). We retrospectively assessed the incidence of ON and its risk factors in a total of 1095 patients enrolled in 3 consecutive Japanese Children's Cancer and Leukemia Study Group ALL studies (ALL941 [1994 to 2000], n=464; ALL2000 [2000 to 2004], n=305; and ALL2004 [2004 to 2010], n=326). ON was diagnosed in 16 patients, of whom 15 were symptomatic. The cumulative incidence of ON was 0.76% in ALL941, 0.35% in ALL2000, and 3.6% in ALL2004. The incidence of ON in ALL941/2000, in which only prednisolone was administered as a steroid, was significantly lower than that in ALL2004, in which dexamethasone was used as a partial substitute for prednisolone (P<0.01). In ALL2004, sex and age were significantly correlated with the incidence of ON (1.3% in boys vs. 6.7% in girls, P=0.0132; 0.42% for age <10 y vs. 15.6% for age ≥10 y, P<0.0001), suggesting that girls aged 10 years and above are at a greater risk of ON onset. These results indicate that the risk of ON should be considered when administering dexamethasone as part of ALL protocol treatment in girls aged 10 years and above.

  17. Chromosomal differences between acute nonlymphocytic leukemia in patients with prior solid tumors and prior hematologic malignancies. A study of 14 cases with prior breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mamuris, Z.; Dumont, J.; Dutrillaux, B.; Aurias, A. (Institut Curie, Paris (France))

    1989-10-01

    A cytogenetic study of 14 patients with secondary acute nonlymphocytic leukemia (S-ANLL) with prior treatment for breast cancer is reported. The chromosomes recurrently involved in numerical or structural anomalies are chromosomes 7, 5, 17, and 11, in decreasing order of frequency. The distribution of the anomalies detected in this sample of patients is similar to that observed in published cases with prior breast or other solid tumors, though anomalies of chromosome 11 were not pointed out, but it significantly differs from that of the S-ANLL with prior hematologic malignancies. This difference is principally due to a higher involvement of chromosome 7 in patients with prior hematologic malignancies and of chromosomes 11 and 17 in patients with prior solid tumors. A genetic determinism involving abnormal recessive alleles located on chromosomes 5, 7, 11, and 17 uncovered by deletions of the normal homologs may be a cause of S-ANLL. The difference between patients with prior hematologic malignancies or solid tumors may be explained by different constitutional mutations of recessive genes in the two groups of patients.

  18. Acute onset of brain atrophy and dementia in a patient with small cell lung cancer: a case report.

    Science.gov (United States)

    Asano, Michiko; Fujimoto, Nobukazu; Gemba, Kenichi; Wada, Sae; Ono, Katsuichiro; Ozaki, Shinji; Adachi, Yoshiaki; Yamamoto, Hiromichi; Kishimoto, Takumi

    2011-03-01

    A 59-year-old man who was diagnosed with small cell lung cancer (SCLC), achieved a complete response to the induction chemoradiotherapy and received prophylactic cranial irradiation (PCI) (25 Gy at 250 cGy per fraction) in October 2008. Three months later, he complained of anorexia, weight loss, fatigue, and short-term memory loss and developed dementia and systemic muscle weakness. Magnetic resonance imaging in April and July 2009 revealed the progression of the diffuse brain atrophy without evidence of the metastasis of SCLC. Paraneoplastic neurological syndrome was suspected because anti-Hu antibody was detected in his serum and cerebrospinal fluid, but the adverse effects of chemotherapy and/or radiotherapy were also suspected as the cause of his neurological disorder.

  19. The co-presence of deletion 7q, 20q and inversion 16 in therapy-related acute myeloid leukemia developed secondary to treatment of breast cancer with cyclophosphamide, doxorubicin, and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Yonal Ipek

    2012-02-01

    Full Text Available Abstract Introduction Therapy-related acute myeloid leukemia occurs as a complication of treatment with chemotherapy, radiotherapy, immunosuppressive agents or exposure to environmental carcinogens. Case presentation We report a case of therapy-related acute myeloid leukemia in a 37-year-old Turkish woman in complete remission from breast cancer. Our patient presented to our facility with fatigue, fever, sore throat, peripheral lymphadenopathy, and moderate hepatosplenomegaly. On peripheral blood and bone marrow aspirate smears, monoblasts were present. Immunophenotypic analysis of the bone marrow showed expression of CD11b, CD13, CD14, CD15, CD33, CD34, CD45 and human leukocyte antigen-DR, findings compatible with the diagnosis of acute monoblastic leukemia (French-American-British classification M5a. Therapy-related acute myeloid leukemia developed three years after adjuvant chemotherapy consisting of an alkylating agent, cyclophosphamide and DNA topoisomerase II inhibitor, doxorubicin and adjuvant radiotherapy. Cytogenetic analysis revealed a 46, XX, deletion 7 (q22q34, deletion 20 (q11.2q13.1 karyotype in five out of 20 metaphases and inversion 16 was detected by fluorescence in situhybridization. There was no response to chemotherapy (cytarabine and idarubicin, FLAG-IDA protocol, azacitidine and our patient died in the 11th month after diagnosis. Conclusions The median survival in therapy-related acute myeloid leukemia is shorter compared to de novoacute myeloid leukemia. Also, the response to therapy is poor. In therapy-related acute myeloid leukemia, complex karyotypes have been associated with abnormalities of chromosome 5, rather than 7. To the best of our knowledge, this is the first case of therapy-related acute myeloid leukemia showing the co-presence of deletion 7q, 20q and the inversion 16 signal.

  20. Cancer

    Science.gov (United States)

    ... uses a surgical tool to remove the tumor.Mohs' surgery. Layers of cancer cells are removed one ... usually have not been approved by the U.S. Food and Drug Administration (FDA). The medicine may have ...

  1. The indications and contraindications of non-surgical treatment for patients with perforated peptic ;ulcer%消化性溃疡穿孔非手术治疗的适应证与禁忌证

    Institute of Scientific and Technical Information of China (English)

    邵永胜; 金太欣; 肖新波; 莫涛; 周姣军; 高红章; 钟鸣

    2014-01-01

    目的:探讨消化性溃疡穿孔非手术治疗的适应证和禁忌证。方法回顾性分析2010年1月至2013年6月连续237例消化性溃疡穿孔患者治疗的临床结果,计算非手术治疗成功率,分析非手术治疗失败的相关因素。结果本组237例非手术治疗成功率为88.4%(167/189),除外其中17例高龄和合并内科疾病或免疫抑制状态的患者,非手术治疗成功率可达97.1%(167/172);非手术治疗失败的相关因素包括年龄≥70岁、入院时休克、既往其他部位恶性肿瘤史以及合并糖尿病和肝硬化(χ2=7.631~42.38,P<0.01)。结论只要严格掌握适应证和禁忌证,消化性溃疡穿孔的非手术治疗是安全、可行的;患者年龄≥70岁、入院时休克、合并糖尿病、肝硬化或其他部位恶性肿瘤史等免疫抑制状态,是非手术治疗的禁忌证。%Objective To investigate the indications and contraindications of non-surgical treatment for patients with perforated peptic ulcer. Methods Between January 2010 and June 2013, the clinical outcomes of 237 consecutive patients with perforated peptic ulcer were analyzed retrospectively. The success rate of conservative treatment was calculated, and the risk facts of unsuccessful non-operative management were analyzed. Results The success rate of conservative treatment was 88.4%(167/189), but a success rate as high as 97.1%(167/172) after 17 cases with an older age or medical comorbidities or immunity suppression were excluded. An age≥70 years, shock on admission, previous other malignancy, diabetes mellitus and cirrhosis were high risk factors for unsuccessful non-operative treatment (χ2=7.631-42.38, P<0.01). Conclusions As long as the indications and contraindications are controlled strictly, non-operative management for perforated peptic ulcer is safe and feasible. The presence of an age≥70 years, shock on admission, associated medical diseases such as diabetes mellitus

  2. Detection of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans after Systemic Administration of Amoxicillin Plus Metronidazole as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Dakic, Aleksandar; Boillot, Adrien; Colliot, Cyrille; Carra, Maria-Clotilde; Czernichow, Sébastien; Bouchard, Philippe

    2016-01-01

    Objective: To evaluate the variations in the detection of Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after systemic administration of amoxicillin plus metronidazole in association with non-surgical periodontal therapy (NSPT). Background: The adjunctive use of antibiotics has been advocated to improve the clinical outcomes of NSPT. However, no systematic review has investigated the microbiological benefit of this combination. Materials and Methods: An electronic search was conducted up to December 2015. Randomized clinical trials comparing the number of patients testing positive for P. gingivalis and/or A. actinomycetemcomitans before and after NSPT with (test group) or without (control group) amoxicillin plus metronidazole were included. The difference between groups in the variation of positive patients was calculated using the inverse variance method with a random effects model. Results: The frequency of patients positive for A. actinomycetemcomitans was decreased by 30% (p = 0.002) and by 25% (p = 0.01) in the test group compared to the control group at 3- and 6-month follow-up, respectively. Similar findings were observed when considering the frequency of patients positive for Porphyromonas gingivalis, with a reduction by 28% (p < 0.0001), 32% (p < 0.0001), and 34% (p = 0.03) in the test group compared to the control group at 3-, 6-, and 12-month follow-up, respectively. Conclusion: The systemic administration of amoxicillin plus metronidazole as an adjunct to NSPT significantly decreased the number of patients positive for P. gingivalis and A. actinomycetemcomitans compared with periodontal therapy alone or with a placebo. PMID:27594851

  3. Effect analysis of non-surgical spinal decompression in the treatment of lumbar intervertebral disc herniation%非手术脊柱减压治疗腰椎间盘突出症的效果分析

    Institute of Scientific and Technical Information of China (English)

    黄江湖; 尹晓明; 林飞跃; 徐杨; 许春财; 林蕴硕

    2014-01-01

    目的:探讨非手术脊柱减压治疗腰椎间盘突出症的效果。方法选取2008年7月~2012年10月本院收治的100例腰椎间盘突出症患者为研究对象,将其随机分为观察组和对照组,每组50例。对照组患者采用普通腰椎牵引治疗,观察组患者采用非手术脊柱减压系统进行牵引治疗,治疗结束后,对比两组患者的治疗效果。结果观察组治疗有效率为96.00%,高于对照组的82.00%,差异有统计学意义(P0.05)。治疗后,两组VAS、CODI均降低,观察组降低程度更明显,差异有统计学意义(P0.05).After therapy,VAS score and CODI was decreased respectively,the decreasing level in observation group was more remarkable than that in control group respectively,with statistical difference (P<0.05). Conclusion In comparison with common traction,non-surgical spinal decompression in the treatment of lumbar intervertebral disc herniation can better improve patients’symptoms and signs,help them to get recovery of daily life activity.

  4. Triple-tandem high-dose-rate brachytherapy for early-stage medically inoperable endometrial cancer: Initial report on acute toxicity and dosimetric comparison to stereotactic body radiation therapy.

    Science.gov (United States)

    Kauffmann, Greg; Wu, Tianming; Al-Hallaq, Hania; Hasan, Yasmin

    Stereotactic body radiotherapy (SBRT) may be appealing in medically inoperable endometrial cancer to avoid procedural risks. We performed a dosimetric comparison to triple-tandem, high-dose-rate (HDR) brachytherapy. Six consecutive clinical stage I, grade 1-2, medically inoperable endometrial cancer patients were treated with triple-tandem HDR brachytherapy. We report patient factors and acute toxicity. Also, we performed dosimetric comparison to SBRT using both 3D conformal arc (3DArc) and volumetric-modulated arc therapy. D2cc values for normal tissues were calculated and compared to the HDR plans. Median age was 57 years. Patient comorbidities included morbid obesity, congestive heart failure, diabetes, and pulmonary emboli. In three patients who received prior external beam radiation (EBRT), median EBRT and HDR doses were 46 Gy and 20 Gy, respectively. The median dose with HDR brachytherapy monotherapy was 35 Gy. Acute toxicities during EBRT included gastrointestinal (3/3 with grade 1-2) and genitourinary (3/3 with grade 1-2). Acute toxicities during HDR brachytherapy were gastrointestinal (2/6 total with grade 1-2) and genitourinary (2/6 total with grade 1). The mean D2cc/Gy of prescription dose for rectum, sigmoid, and bladder were 0.58, 0.40, and 0.47 respectively. Overall, doses to normal tissues were higher for SBRT plans as compared to HDR. Also, the R50 (ratio of the 50% prescription isodose volume to the PTV) was lowest with HDR brachytherapy. In medically inoperable, clinical stage I endometrial cancer patients with multiple comorbidities, definitive triple-tandem, HDR brachytherapy results in mild acute toxicity. In addition, HDR brachytherapy achieves relatively lower doses to surrounding normal tissues as compared to SBRT. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Potentiation of acute morphine-induced analgesia measured by a thermal test in bone cancer-bearing mice.

    Science.gov (United States)

    González-Rodríguez, Sara; Llames, Sara; Hidalgo, Agustín; Baamonde, Ana; Menéndez, Luis

    2012-06-01

    Agonists of μ-opioid receptors are currently used in the management of cancer pain. However, several data suggest that the analgesic effect of morphine can diminish during the development of experimental tumors. By using a thermal test, we have studied whether the analgesic effect evoked by morphine is altered in mice bearing two painful bone tumors. The analgesic effect evoked by systemic morphine remained unaltered after the intratibial inoculation of B16-F10 melanoma cells and was potentiated after the inoculation of NCTC 2472 osteosarcoma cells. Although the number of spinal μ-opioid receptors measured by western blot studies was not augmented in osteosarcoma-bearing mice, the analgesia evoked by intrathecal (i.t.) morphine was also enhanced. The analgesic response produced by the spinal administration of the Gi/o protein activator mastoparan was amplified, whereas the analgesic response evoked by the i.t. administration of the N-type calcium channel blocker ω-conotoxin remained unaltered. The efficacy of the GIRK channel blocker tertiapin-Q to antagonize the analgesic effect produced by a maximal dose of morphine was also increased in osteosarcoma-bearing mice. Our results seem to indicate that the analgesic effect of morphine on thermal nociception can be enhanced in response to the development of particular bone tumors in mice, being this potentiation probably related to a greater efficacy of the transduction system driven by Gi/o proteins and GIRK channels.

  6. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; Heide, Uulke A. van der; Herk, Marcel van [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-03-15

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade ≥1, ≥2, and ≥3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P<.001) with IG-IMRT for anorectum, anal canal, and bladder. The mean dose to the anorectum was 34.4 Gy versus 47.3 Gy (P<.001), 23.6 Gy versus 44.6 Gy for the anal canal (P<.001), and 33.1 Gy versus 43.2 Gy for the bladder (P<.001). Significantly lower grade ≥2 toxicity was observed for proctitis, stool frequency ≥6/day, and urinary frequency ≥12/day. IG-IMRT resulted in significantly lower overall RTOG grade ≥2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade ≥2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions.

  7. Acute Bronchitis

    Science.gov (United States)

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  8. Bronchitis - acute

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001087.htm Bronchitis - acute To use the sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflamed tissue in the main ...

  9. Impact of post operative intensity modulated radiotherapy on acute gastro-intestinal toxicity for patients with endometrial cancer: results of the phase II RTCMIENDOMETRE French multicentre trial.

    Science.gov (United States)

    Barillot, Isabelle; Tavernier, Elsa; Peignaux, Karine; Williaume, Danièle; Nickers, Philippe; Leblanc-Onfroy, Magali; Lerouge, Delphine

    2014-04-01

    Whole "conventional" pelvic irradiation (up to 45-50Gy) following hysterectomy is associated with a high rate of adverse gastro-intestinal (GI) adverse events, of which around 60% correspond to acute grade 2 toxicity. The phase II RTCMIENDOMETRE trial was designed to test the hypothesis that IMRT could reduce the incidence of grade 2 or more acute GI toxicity to less than 30% in patients irradiated post-operatively for an endometrial cancer. Patients with post-operative stage Ib G3, Ic or II endometrial carcinomas with no history of chronic inflammatory bowel disease were eligible. Guidelines for volume delineation and dose prescription were detailed in the protocol. The investigators were advised to use a web-based atlas developed for the RTOG 0418 study. The dose of the vaginal and nodal PTV was 45Gy in 25 fractions. To assess the ability of the participating centres to comply with the protocol guidelines, they were requested to complete a dummy run procedure before inclusion of their 1st patient. GI and genito-urinary (GU) toxicity were graded according to the CTCAE V 3.0 classification and were prospectively recorded every week during irradiation, as well as at time of brachytherapy insertions and during the follow-up visit at week 15 (W15). Special attention was given to note any changes to the grade of adverse events between W5 and W15. From May 2008 to April 2010, 49 patients from 6 centres were recruited for the trial. One patient could not be treated, one patient died of vascular stroke at W3 without toxicity, and 1 patient refused to be followed-up after treatment. Thus, 46 cases were available for analysis at W15. The distribution by stage was as follows: Ib 16.3%, Ic 64.2%, II 20.4%. Thirty six patients (75%) received an additional vaginal vault boost of 6-10Gy delivered by HDR brachytherapy in 1 or 2 fractions. Among the 47 patients who completed IMRT, 27% (95% CI 14.5-39.7%) developed at least 1 GI grade 2 adverse event (diarrhoea in 92% of cases

  10. Immediate treatment effects of high-dose methotrexate and cranial irradiation on neuropsychological functions of children treated for acute lymphoblastic leukemia at a regional cancer center

    Directory of Open Access Journals (Sweden)

    Sundaramoorthy Chidambaram

    2014-01-01

    Full Text Available Context: Overall cure rates for pediatric acute lymphoblastic leukemia (ALL have improved; however, the neuropsychological sequelae of ALL treatment have not been adequately documented in India. Aims: The present study assesses the immediate effects of ALL treatment on neuropsychological functioning, at the Regional Cancer Center in Chennai, South India. Materials and Methods: Newly diagnosed with ALL patients (n = 24 (aged 6-15 years; 13M:11F registered between March 2008 and February 2009 were included. Patients who had received high-dose methotrexate (HD-MTX and cranial radiotherapy (CRT as part of their treatment were enrolled for the study. Neurocognitive assessments were done to assess various functions such as performance intelligence, visuo-perception, visuo-spatial, perceptual organization, processing speed, planning, working memory, and immediate verbal memory (IVM (Malin′s intelligence scale; verbal fluency (ideation fluency test and verbal attention (vigilance test. Three assessments were done during induction (baseline, after re-induction phase (second and during the maintenance phase (third. Results: The patients performed significantly worse in the third assessment (mean duration from diagnosis 17.48 months on performance intelligence quotient (PIQ, visuo-perception, visuo-spatial, processing speed, planning, IVM, verbal attention, and verbal fluency (P 0.05. Significant difference was observed between age groups 6 and 10 (41.7% and 11-15 years (58.3% in perceptual organization, verbal fluency, and verbal attention (P 0.05. Conclusions: Combining HD MTX and CRT had an immediate effect on neuropsychological sequelae among the children with ALL, however, long-term evaluation is recommended to study the long-term effects.

  11. Treatment of acute radiodermatitis with an oil-in-water emulsion following radiation therapy for breast cancer. A controlled, randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Jens-Michael; Gau, Tanja; Foelster-Holst, Regina; Proksch, Ehrhardt [Kiel Univ. (Germany). Dept. of Dermatology; Schultze, Juergen [Kiel Univ. (Germany). Dept. of Therapeutic Radiology; Lemmnitz, Gunter; Abels, Christoph [Dr. August Wolff GmbH und Co. KG Arzneimittel, Bielefeld (Germany); May, Theodor [Gesellschaft fuer Biometrie und Psychometrie GbR, Bielefeld (Germany)

    2011-06-15

    A side effect of radiotherapy for breast cancer is acute radiodermatitis. It is a common practice to keep irradiated skin dry on account of data from the 1950s that suggested this regimen limits dermatitis. However, severe dryness of the skin induced by irradiation results in itching and discomfort. Dry skin is characterized by scaliness, epidermal barrier dysfunction, and reduced stratum corneum hydration, and these signs and symptoms are reduced by treatment with an emulsion. We performed a randomized, controlled, open-label study with 66 patients (ITT population), treating the irradiated skin in one group (n = 34) with an oil-in-water emulsion (WO1932), while leaving the other group untreated (n = 32). Clinical scoring (ONS radiation skin reaction scoring, pruritus) and biophysical measurements (stratum corneum hydration and transepidermal water loss (TEWL), as a marker of skin barrier function) were determined at day 1 (directly after termination of the radiation therapy), day 8, and day 47 ({+-} 7). Irradiation increased the ONS score and pruritus, whereas skin hydration and TEWL were reduced. The primary hypothesis that the increase in skin hydration was significantly greater in the emulsion-treated compared to the untreated group as early as after 8 days of treatment could not be confirmed. At the end of the study (day 47 {+-} 7), however, normalization of stratum corneum hydration was more advanced in the treatment group compared to the untreated group and nearly reached the values of the contralateral healthy breast skin. ONS score and pruritus also revealed an advantage for the emulsion-treated group. TEWL did not show significant changes during emulsion treatment. No adverse events were caused by the treatment regimens. Treatment of radiodermatitis with an oil-in-water emulsion was well tolerated, enhanced stratum corneum hydration, improved clinical indicators, and provided relief from itching. (orig.)

  12. Cancer procoagulant and tissue factor are differently modulated by all-trans-retinoic acid in acute promyelocytic leukemia cells.

    Science.gov (United States)

    Falanga, A; Consonni, R; Marchetti, M; Locatelli, G; Garattini, E; Passerini, C G; Gordon, S G; Barbui, T

    1998-07-01

    All-trans-retinoic acid (ATRA) downregulates the expression of two cellular procoagulants, tissue factor (TF) and cancer procoagulant (CP), in human promyelocytic leukemia cells. To evaluate whether or not changes of the procoagulant activities (PCAs) may share mechanisms with the ATRA-induced cyto-differentiation process, we have characterized the effect of ATRA on the TF and CP expression by NB4 cells, an ATRA maturation-inducible cell line, and two NB4-derived cell lines resistant to ATRA-induced maturation, the NB4. 306 and NB4.007/6 cells. Next, we evaluated the effect on the PCAs of the NB4 parental cells of three synthetic retinoid analogues, ie: AM580 (selective for the retinoic acid receptor [RAR] alpha), capable to induce the granulocytic differentiation of NB4 cells; and CD2019 (selective for RARbeta) and CD437 (selective for RARgamma), both lacking this capability. Cells were treated with either ATRA or the analogues (10(-6) to 10(-8) mol/L) for 96 hours. The effect on cell differentiation was evaluated by morphologic changes, cell proliferation, nitro blue tetrazolium reduction assay, and flow cytometry analysis of the CD33 and CD11b surface-antigen expression. PCA was first measured in 20 mmol/L Veronal Buffer cell extracts by the one-stage clotting assay of normal and FVII-deficient plasmas. Further TF and CP have been characterized and quantified in cell-sample preparations by chromogenic and immunological assays. In the first series of experiments, ATRA downregulates both TF and CP in NB4 parental cells, as expected. However, in the differentiation-resistant cell lines, it induced a significant loss of TF but had little or no effect on CP. In a second series of experiments, in the NB4 parental cells, the RARalpha agonist (AM580) induced cell maturation and reduced 91% CP expression, whereas CD437 and CD2019 had no cyto-differentiating effects and did not affect CP levels. On the other hand, in the same cells the TF expression was reduced by ATRA

  13. Alterations in 18F-FDG accumulation into neck-related muscles after neck dissection for patients with oral cancers

    Science.gov (United States)

    Kito, Shinji; Koga, Hirofumi; Kodama, Masaaki; Habu, Manabu; Kokuryo, Shinya; Oda, Masafumi; Matsuo, Kou; Nishino, Takanobu; Matsumoto-Takeda, Shinobu; Uehara, Masataka; Yoshiga, Daigo; Tanaka, Tatsurou; Nishimura, Shun; Miyamoto, Ikuya; Sasaguri, Masaaki; Tominaga, Kazuhiro; Yoshioka, Izumi; Morimoto, Yasuhiro

    2016-01-01

    Background 18F-fluoro-2-deoxy-D-glucose (18F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. Material and Methods 18F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. Results According to the extent of ND of cervical lymph nodes, the rate of patients with 18F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. Conclusions In evaluating 18F-FDG accumulations after ND for oral cancers, we should pay attention to the 18F-FDG distributions in neck-related muscles including the non-surgical side as false-positive findings. Key words:18F-FDG, PET-CT, oral cancers, muscles. PMID:27031062

  14. A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams.

    Science.gov (United States)

    Ulff, Eva; Maroti, Marianne; Serup, Jörgen; Falkmer, Ursula

    2013-08-01

    The aim was to investigate whether treatment with potent local steroids can reduce signs and symptoms of acute radiation dermatitis in breast cancer patients undergoing adjuvant radiotherapy (RT) compared to emollient creams. The study was randomised and double-blinded. Patients with breast cancer who had undergone mastectomy or breast-conserving surgery were included when they started adjuvant 3-D planned RT. In all, 104 patients were randomised 2:1:1 to three treatment groups, i.e. betamethasone+Essex® cream, Essex® cream or Canoderm® cream. The patients themselves treated the irradiated area during the radiation period (5 weeks) and two weeks after cessation of RT. Signs of RT dermatitis were measured qualitatively with RTOG clinical scoring and quantitatively by colorimeter. In addition, the patients' symptoms were recorded as well as the Fitzpatrick skin type. There was a statistically significant difference (p=0.05) in skin reactions when assessed with RTOG in favour of the group treated with the potent steroid. Patient-related symptoms did not differ between the treatment groups. The effect of the steroid was prominent in three subgroups, i.e. (i) patients treated with ablation of the breast, (ii) patients receiving RT to the armpit and the supraclavicular fossa, and (iii) patients with Fitzpatrick skin type 1. Treatment with betamethasone cream is more efficient than moisturizers for the control of acute RT dermatitis in patients treated with adjuvant RT for breast cancer. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  16. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  17. Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anne Sophie Weingertner

    2009-01-01

    Full Text Available The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi 131I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of 131I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind.

  18. Target volume delineation in individualized radiotherapy of non-surgical esophageal carcinoma%非手术食管癌个体化放疗的靶区勾画进展

    Institute of Scientific and Technical Information of China (English)

    营巧玲; 李前文; 杜云翔

    2014-01-01

    Individualized radiotherapy is the ideal model of radiation therapy, based on tailoring the treatment in a large num-ber of individual clinical, pathological and molecular genetic level. Two key problems exist in the implementation of individualized ra-diotherapy, one is how to identify and individually delineate the target volume of esophageal carcinoma, and the other is how to individ-ually implement the precise exposure. Due to technological advances and the renovation of equipment in radiotherapy for esophageal car-cinoma, the individualized implementation of the precise exposure has become possible. In recent years, with the advent of functional imaging, molecular imaging and other new technologies, it points out the future research direction of individualized tumor target volume delineation. This article reviewed the definition of the target volume in the individual radiotherapy of non-surgical esophageal carcinoma, which involves the application of new technologies such as anatomical imaging, functional imaging, hypoxia, molecular im-aging to individually identify and delineat the tumor target volume, including gross tumor volume, clinical tumor volume, planning tar-get volume, biological target volume and etc.%个体化放疗的实施取决于两个关键环节,首先是靶区的个体化识别和勾画,另一个是射线的个体化施照。由于放疗设备的更新和精确放疗技术的快速发展,实现射线个体化的精确施照成为可能。近年来,随着功能影像和分子显像等新技术的出现,指明了肿瘤个体化放疗靶区勾画的研究方向。本文对非手术食管癌患者个体化放疗的靶区勾画进行综述,内容涉及应用解剖影像、功能影像、乏氧和分子显像等新技术个体化识别和勾画非手术食管癌的放疗靶区,包括大体肿瘤靶区、临床靶区、计划靶区、生物靶区等。

  19. The effect of multidisciplinary team care on cancer management.

    Science.gov (United States)

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical oncologist. The report further suggested that a lead clinician with a well established interest in cancer care should be appointed to organise and coordinate the whole range of cancer services provided within the Cancer Unit. Many people have argued that the multidisciplinary team management of patients has resulted in better care and improved survival. However, there are barriers to the optimal effectiveness of the multidisciplinary team. This paper aims to review various studies on the effectiveness of the multidisciplinary team in the management of cancer patients and also discuss some of the barriers to the multidisciplinary team.

  20. Acute and late vaginal toxicity after adjuvant high-dose-rate vaginal brachytherapy in patients with intermediate risk endometrial cancer: is local therapy with hyaluronic acid of clinical benefit?

    Science.gov (United States)

    Delishaj, Durim; Fabrini, Maria Grazia; Gonnelli, Alessandra; Morganti, Riccardo; Perrone, Franco; Tana, Roberta; Paiar, Fabiola; Gadducci, Angiolo

    2016-01-01

    Purpose The aim of the present study was to evaluate the effectiveness of hyaluronic acid (HA) in the prevention of acute and late vaginal toxicities after high-dose-rate (HDR) vaginal brachytherapy (BT). Material and methods Between January 2011 and January 2015, we retrospectively analyzed 126 patients with endometrial cancer who underwent extrafascial hysterectomy with or without lymphadenectomy and adjuvant HDR-vaginal BT +/– adjuvant chemotherapy. The total dose prescription was 21 Gy in 3 fractions (one fraction for week). Vaginal ovules containing 5 mg of HA were given for whole duration of vaginal BT and for the two following weeks. Acute and late toxicities were evaluated according to CTCAE vs 4.02. Results According to the revised FIGO 2009 classification, most tumors were in stage IA (30.9%) and in stage IB (57.9%). Thirty-three patients (26.2%) received adjuvant chemotherapy before vaginal BT. Five-year disease-free survival (DFS) and five-year overall survival (OS) were 88% and 93%, respectively. The most common grade 1-2 acute toxicities were vaginal inflammation (18 patients, 14.3%) and dyspareunia (7 patients, 5.5%). Two patients (1.6%) had more than one toxicity. Late toxicity occurred in 20 patients (15.9%). Grade 1-2 late toxicities were fibrosis (14 patients, 11.1%) and telangiectasias (7 patients, 5.5%). Six patients (4.8%) had more than one late toxicity. No grade 3 or higher acute or late toxicities were observed. Conclusions These results appear to suggest that the local therapy with HA is of clinical benefit for intermediate risk endometrial cancer patients who receive adjuvant HDR-vaginal BT after surgery. A randomized trial comparing HA treatment vs. no local treatment in this clinical setting is warranted to further evaluate the efficacy of HA in preventing vaginal BT-related vaginal toxicity. PMID:28115957

  1. A Discussion on Clinical Diagnosis and Treatment of Colon Cancer with the Symptom of Acute Abdomen%以急腹症为表现的结肠癌临床诊断及治疗探讨

    Institute of Scientific and Technical Information of China (English)

    胡建华

    2012-01-01

    目的:探讨以急腹症为表现的结肠癌临床诊治经验.方法:对2009年2月~2011年7月我院收治的56例结肠癌致使急腹症的患者资料进行回顾性分析.结果:56例中治愈出院共29例;好转出院共16例;4例伤口感染,5例肺部感染;2例分别在术后1d、4d因中毒性休克经抢救无效死亡.结论:对于结肠癌并发急腹症,做好术前准备工作,选择合理的手术方式及加强术后综合治疗是减少术后并发症及提高患者生存质量的重要保障.%Objective:To discuss the experiences in the clinical diagnosis and treatment of colon cancer with the symptom of acute abdomen.Methods:Took a review analysis on 56 patients with colon cancer caused acute abdomen from February 2009 to July 2011. Results:29 of 56 cases left hospital with recovery; 16 cases left hospital with better symptoms; 4 cases had wound infection and 5 cases had pulmonary infection; 2 cases died 1 day and 4 days after the operation because of the toxic shock.Conclusion:For the colon cancer companiedwith the acute abdomen, it should do preparation before the operation, choose the reasonable operation method and strengthen the post-operative comprehensive treatment, which are the important guarantee to reduce the post-operative complications and enhance the survival quality of patients.

  2. A unique hypofractionated radiotherapy schedule with 51.3 Gy in 18 fractions three times per week for early breast cancer: outcomes including local control, acute and late skin toxicity.

    Science.gov (United States)

    Vassilis, Kouloulias; Ioannis, Gogalis; Anna, Zygogianni; Christina, Armpilia; Christos, Antypas; John, Kokakis; Porfyrios, Koromperlis; Vassiliki, Gennimata; John, Kouvaris

    2017-03-01

    Evaluation of local control and acute and late toxicity regarding a hypofractionated RT schedule for breast cancer patients. Between October 2007 and October 2009, 80 women with early breast cancer were treated by 42.75 Gy in 15 fractions over 5 weeks. This treatment involved three fractions per week (Monday-Wednesday-Friday). All patients received an additional boost dose to the tumor bed of 8.55 Gy in 3 fractions using 6 MV photons. The primary endpoint included any local recurrence in the treated breast. Secondary endpoint included acute and late radiation skin toxicity. The median follow-up time was 63 months (range 60-72). Radiation toxicity was graded according the RTOG/EORTC criteria. Neither local nor distant recurrence was noted in any patient during this 3-year follow-up. Grade 0, 1, 2 acute skin toxicity was observed in 56/80 (70.0 %), in 19/80 (23.8 %) and in 5/80 (6.3 %), respectively. Three months post-RT, toxicity grades 0, 1, 2 skin toxicity were 64/80 (80 %), 14/80 (17.5 %) and 2/80 (2.5 %), respectively. Late toxicity as grade 0, 1 was observed in 72/80 (90.0 %) and in 8/80 (10.0 %), respectively, 6 months post-RT, whereas after 1 year they were 78/80 (97.5 %) and 2/80 (2.5 %), respectively. Preliminary results regarding skin reactions, cosmetic appearance and local control are consistent with published data that support the use of shorter fractionation schedules in early breast cancer patients after breast conservative surgery. Longer follow-up and a randomized prospective study stand in need for the extraction of safe conclusions.

  3. Therapeutic efficacy of surgical vs non-surgical treatment of scapular fractures in 58 patients%手术治疗及非手术治疗肩胛骨骨折58例的疗效分析

    Institute of Scientific and Technical Information of China (English)

    罗晓东; 黄必留; 何志明

    2016-01-01

    目的::分析肩胛骨骨折的类型和手术治疗方法、效果,为类似病例提供参考。方法:回顾性分析本院2009年4月-2014年3月58例肩胛骨骨折患者的治疗情况,其中41例患者根据骨折类型采用个性化的手术治疗,设为手术组,17例保守治疗的患者设为非手术组,采用Hardegger功能评定评价疗效。所有患者均随访9~36个月,记录有无骨折移位、断钉、钢板断裂等手术并发症和非手术治疗相关并发症。结果:根据骨折与肩盂位置、肩关节整体的稳定性采用AO分类法,手术组关节内骨折、关节外骨折稳定骨折和不稳定骨折的构成比例分别为26.83%、34.15%、39.02%;根据骨折部位的Hardegger分型,手术组肩胛骨体部骨折、盂缘骨折、外科颈骨折、盂窝骨折、肩胛冈骨折、肩峰骨折、喙突骨折、粉碎性骨的构成比例分别为39.02%、19.51%、9.76%、7.32%、9.76%、7.32%、2.44%、4.88%;Milleretal分型手术组共骨折73处,Ⅰ、Ⅱ、Ⅲ、Ⅳ型构成比例分别为28.77%、28.77%、16.44%和26.03%;3种骨折分类方法手术组均与非手术组比较差异无统计学意义( P>0.05)。手术组41例患者治疗后,根据末次随访评价疗效,手术组平均肌力高于非手术组,关节活动度评分和疼痛评分均低于非手术组非手术组( P0. 05 ) . After treatment,the 41 patients in the surgical group showed higher muscle strength,lower joint motion scores and pain scores than the non-surgical group,as evaluated in the last follow-up ( P<0.05) . The efficacy was excellent in 48. 78%,or good in 85.37%,of patients in the surgical group,which was significantly better compared with the non-surgical group (P<0.05). Of the 41 patients in the surgical group,13 experienced joint abduction,arthritis or other complications,corresponding to a complication rate of 31.71% which was significantly lower compared with the control group (P<0

  4. 腰椎间盘突出症非手术治疗效果系统评价综述%Effectiveness of Non-Surgical Treatment of Lumbar Disc Herniation:A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    陈新用; 王振飞; 梁裕

    2012-01-01

    腰椎间盘突出症是临床上引起腰腿痛的最常见原因之一.腰椎间盘突出症的非手术治疗方法众多.在临床实践中广泛使用.为获得最佳治疗方案,笔者全面检索了近年发表的非手术治疗腰椎间盘突出症的系统评价,最终共获得13篇相关系统评价,其中1篇关于保守治疗,8篇涉及中医治疗,4篇关于化学酶髓核溶解和封闭疗法.其结果显示:保守治疗涉及注射、牵引、理疗、卧床、手法、药物和针灸,但未发现哪种保守治疗方法明确优于包括不治疗的其他保守方法.有系统评价结果显示:中医治疗安全性较高.中医综合治疗效果较单一治疗效果相对较好;电针与常规治疗(卧床休息、腰围保护、骨盆牵引、手法或理疗)和口服药物相比,是一种安全有效的治疗方法,能更有效地改善患者的疼痛和整体功能;中药熏蒸联合牵引治疗较单纯牵引有效.胶原酶髓核溶解经皮治疗的Meta分析结果显示其短期疗效不错.硬膜外类固醇经皮注射治疗也有一定疗效.综上所述.中医治疗、化学酶髓核溶解和封闭疗法治疗腰椎间盘突出症可能有一定疗效.但因为当前证据质量不高,甚至出现结论冲突,尚需开展更多高质量的临床研究加以验证.%Lumbar disc herniation is one of the most common causes of low back and leg pain in clinic. There are a lot of non-surgical therapeutic methods widely used in clinic for treating lumbar disc herniation. The author assessed the available systematic reviews of non-surgical methods in treating lumbar disc herniation which had been published in these years, and finally a total of 13 systematic reviews were retrieved including 1 about conservative treatments, 8 Chinese medicine treatments, and 4 percutaneous treatments, such as chemonucleolysis and epidural steroid injection. The results showed that the conservative treatments included injections, traction, physical therapy, bed

  5. CANCER

    Directory of Open Access Journals (Sweden)

    N. Kavoussi

    1973-09-01

    Full Text Available There are many carcinogenetic elements in industry and it is for this reason that study and research concerning the effect of these materials is carried out on a national and international level. The establishment and growth of cancer are affected by different factors in two main areas:-1 The nature of the human or animal including sex, age, point and method of entry, fat metabolism, place of agglomeration of carcinogenetic material, amount of material absorbed by the body and the immunity of the body.2 The different nature of the carcinogenetic material e.g. physical, chemical quality, degree of solvency in fat and purity of impurity of the element. As the development of cancer is dependent upon so many factors, it is extremely difficult to determine whether a causative element is principle or contributory. Some materials are not carcinogenetic when they are pure but become so when they combine with other elements. All of this creates an industrial health problem in that it is almost impossible to plan an adequate prevention and safety program. The body through its system of immunity protects itself against small amounts of carcinogens but when this amount increases and reaches a certain level the body is not longer able to defend itself. ILO advises an effective protection campaign against cancer based on the Well –equipped laboratories, Well-educated personnel, the establishment of industrial hygiene within factories, the regular control of safety systems, and the implementation of industrial health principles and research programs.

  6. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  7. P-glycoprotein and breast cancer resistance protein in acute myeloid leukaemia cells treated with the Aurora-B Kinase Inhibitor barasertib-hQPA

    Directory of Open Access Journals (Sweden)

    Russell Nigel H

    2011-06-01

    Full Text Available Abstract Background Aurora kinases play an essential role in orchestrating chromosome alignment, segregation and cytokinesis during mitotic progression, with both aurora-A and B frequently over-expressed in a variety of human malignancies. Over-expression of the ABC drug transporter proteins P-glycoprotein (Pgp and Breast cancer resistance protein (BCRP is a major obstacle for chemotherapy in many tumour types with Pgp conferring particularly poor prognosis in acute myeloid leukaemia (AML. Barasertib-hQPA is a highly selective inhibitor of aurora-B kinase that has shown tumouricidal activity against a range tumour cell lines including those of leukaemic AML origin. Methods Effect of barasertib-hQPA on the pHH3 biomarker and cell viability was measured in a panel of leukaemic cell lines and 37 primary AML samples by flow cytometry. Pgp status was determined by flow cytometry and BCRP status by flow cytometry and real-time PCR. Results In this study we report the creation of the cell line OCI-AML3DNR, which over-expresses Pgp but not BCRP or multidrug resistance-associated protein (MRP, through prolonged treatment of OCI-AML3 cells with daunorubicin. We demonstrate that Pgp (OCI-AML3DNR and KG-1a and BCRP (OCI-AML6.2 expressing AML cell lines are less sensitive to barasertib-hQPA induced pHH3 inhibition and subsequent loss of viability compared to transporter negative cell lines. We also show that barasertib-hQPA resistance in these cell lines can be reversed using known Pgp and BCRP inhibitors. We report that barasertib-hQPA is not an inhibitor of Pgp or BCRP, but by using 14[C]-barasertib-hQPA that it is effluxed by these transporters. Using phosphoHistone H3 (pHH3 as a biomarker of barasertib-hQPA responsiveness in primary AML blasts we determined that Pgp and BCRP positive primary samples were less sensitive to barasertib-hQPA induced pHH3 inhibition (p = 50 inhibition of pHH3 by barasertib-hQPA was achieved in 94.6% of these samples after 1

  8. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: An Economic Analysis

    Science.gov (United States)

    2016-01-01

    Background Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer. Methods We performed a systematic review of health economic studies to identify relevant studies that compare the cost-effectiveness of kyphoplasty or vertebroplasty with non-surgical management for the treatment of vertebral compression fractures in adults with cancer. We also performed a primary cost-effectiveness analysis to assess the clinical benefits and costs of kyphoplasty or vertebroplasty compared with non-surgical management in the same population. We developed a Markov model to forecast benefits and harms of treatments, and corresponding quality-adjusted life years and costs. Clinical data and utility data were derived from published sources, while costing data were derived using Ontario administrative sources. We performed sensitivity analyses to examine the robustness of the results. In addition, a 1-year budget impact analysis was performed using data from Ontario administrative sources. Two scenarios were explored: (a) an increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario, maintaining the current proportion of kyphoplasty versus vertebroplasty; and (b) no increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario but an increase in the proportion of kyphoplasties versus vertebroplasties. Results The base case considered each of

  9. Acute nierschade

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; van Heurn, L.W.E.; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  10. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  11. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  12. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  13. Compare the results of non-surgical periodontal therapy on moderate to severe periodontitis according to the location of the molar periodontal lesion%比较非手术治疗对重度慢性牙周炎磨牙不同部位牙周病变的疗效

    Institute of Scientific and Technical Information of China (English)

    笪海芹

    2012-01-01

    目的:根据磨牙中重度慢性牙周炎发生不同部位病变比较非手术治疗的疗效.方法:根据单个磨牙深牙周袋发生的部位(颊侧或舌/腭侧)将收集的上、下颌磨牙各分为两组(上颌Ⅰ组、上颌Ⅱ组、下颌Ⅰ组、下颌Ⅱ组),观察各组治疗前后牙周指标的变化,比较疗效差异.结果:4组病例治疗后6周各项牙周指标均较基线有明显改善,差异有显著性(P<0.01).上颌两组间及下颌两组间比较,可见6周时上颌Ⅱ组的PD、BI、CAL均高于上颌Ⅰ组,差异有显著性(P<0.01);下颌Ⅱ组的PD、BI、CAL高于下颌Ⅰ组,差异有显著性(P<0.01).结论:发生在磨牙的牙周炎症无论是上颌还是下颌,颊侧病变的预后均好于舌/腭侧,差异有显著性.%Objective:To compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of the molar periodontal lesion in moderate to severe periodontitis. Method: 46 molars (maxillary / mandibular) with moderate to severe periodontitis each were divided in two subgroups according to the distribution of deep pocket depth on a single molar (buccal or lingual / palatal). Observe the change of clinical periodontal indies before and after non-surgical periodontal therapy. Result: All indices of four groups improved significant improvement (P <0.01) after therapy. After 6 weeks . PD-BI-CAL in Group II patients showed significant improvement (P<0.01) compared with Croup I patients no matter maxillary or mandibular molars. Conclusion: Inflammation occurs at buccal surfaces responded better to the non-surgical periodontal therapy than those at lingual / palatal surfaces.Objective:To compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of the molar periodontal lesion in moderate to severe periodontitis. Method: 46 molars (maxillary / mandibular) with moderate to severe periodontitis each were divided in two subgroups according to the

  14. Diagnostic value of maximal-outer-diameter and maximalmural- thickness in use of ultrasound for acute appendicitis in children

    Institute of Scientific and Technical Information of China (English)

    Bo-Kyung Je; Sung-Bum Kim; Seung Hwa Lee; Ki Yeol Lee; Sang Hoon Cha

    2009-01-01

    AIM: To evaluate the maximal-outer-diameter (MOD) and the maximal-mural-thickness (MMT) of the appendix in children with acute appendicitis and to determine their optimal cut-off values to diagnose acute appendicitis. METHODS: In total, 164 appendixes from 160 children between 1 and 17 years old (84 males, 76 females; mean age, 7.38 years) were examined by high-resolution abdominal ultrasound for acute abdominal pain and the suspicion of acute appendicitis. We measured the MOD and the MMT at the thickest point of the appendix. Patients were categorized into two groups according to their medical records: patients who had surgery (surgical appendix group) and patients who did not have surgery (non-surgical appendix group). Data were analyzed by MedCalc v.9.3. The rank sum test (Mann-Whitney test) was used to evaluate the difference in the MOD and the MMT between the two groups. ROC curve analysis was used to determine the optimal cut-off value of the MOD and the MMT on diagnosis of acute appendicitis.RESULTS: There were 121 appendixes (73.8%) in the non-surgical appendix group and 43 appendixes (26.2%) in the surgical appendix group. The median 26.2%) in the surgical appendix group. The median MOD differed significantly between the two groups (0.37 cm vs 0.76 cm, P 0.57 cm (sensitivity 95.4%, specificity 93.4%) and > 0.22 cm (sensitivity 90.7%, specificity 79.3%), respectively. CONCLUSION: The MOD and the MMT are reliable criteria to diagnose acute appendicitis in children. An MOD > 0.57 cm and an MMT > 0.22 cm are the optimal criteria.

  15. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients

    Institute of Scientific and Technical Information of China (English)

    LI Feng-yan; HE Zhen-yu; XUE Ming; CHEN Li-xin; WU San-gang; GUAN Xun-xing

    2011-01-01

    Background A growing number of studies worldwide have advocated the replacement of whole-breast irradiation with accelerated partial breast irradiation using three-dimension