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  1. [Mucositis in head and neck cancer patients undergoing radiochemotherapy].

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    Santos, Renata Cristina Schmidt; Dias, Rodrigo Souza; Giordani, Adelmo José; Segreto, Roberto Araújo; Segreto, Helena Regina Comodo

    2011-12-01

    The objective of present study was to classify oral mucositis according to the Common Toxicity Criterion (CTC) international parameters in head and neck tumor patients simultaneously treated with radio and chemotherapy, and characterize a patient profile in our area, observing the individuals' habits, tumor characteristics, treatment protocol and acute reaction intensity. Fifty patients undergoing simultaneous 66 to 70 Gy megavoltage radiotherapy and cisplatin/carboplatin chemotherapy were evaluated in this study. Weekly evaluations of the degree of mucositis were perfoemed according to CTC, a four-degree ordinal scale; 36% of all patients and 100% of those with diabetes discontinued treatment due to mucositis, showing that this pathology contributes to the severity of mucositis.

  2. Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Quist, Morten; Rørth, Mikael; Langer, Seppo

    2012-01-01

    To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy.......To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy....

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

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    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.

  4. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    OpenAIRE

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite...

  5. Effects of Darbepoetin Alfa with exercise in cancer patients undergoing chemotherapy: an explorative study

    DEFF Research Database (Denmark)

    Rørth, Mikael; Rich Madsen, Katrine; Burmølle, Stine Hvid;

    2011-01-01

    Fatigue is frequent in cancer patients undergoing chemotherapy. Erythropoietins (EPO) have shown well-documented effects on these patients, and administered in pharmacological doses, may reduce the need for transfusion of blood cells and improve quality of life (QoL). An explorative, descriptive,...

  6. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy.

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    Allen, Valerie A; Manahan, Kelly J; Geisler, John P

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient's diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  7. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    Directory of Open Access Journals (Sweden)

    Valerie A. Allen

    2016-01-01

    Full Text Available Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI. Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient’s diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  8. The use of ovarian cancer cells from patients undergoing surgery to generate primary cultures capable of undergoing functional analysis.

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    O Donnell, Rachel L; McCormick, Aiste; Mukhopadhyay, Asima; Woodhouse, Laura C; Moat, Madeleine; Grundy, Anna; Dixon, Michelle; Kaufman, Angelika; Soohoo, San; Elattar, Ahmed; Curtin, Nicola J; Edmondson, Richard J

    2014-01-01

    The use of cell lines or animal models has significant disadvantages when dealing with a set of heterogeneous diseases such as epithelial ovarian cancer. This has clinical relevance in that biomarkers developed using cell line or animal models are often not transferable to the clinical setting. In this study, we describe the development of a robust protocol for developing primary cultures of ovarian cancer which will overcome some of these difficulties. Women undergoing surgery for ovarian cancer were recruited and samples of ascites and solid tumour deposits were used to develop primary cultures. Cells were characterised using a panel of immunofluorescent antibodies prior to use in a variety of assays including functional assessment of DNA repair pathways. During the four year study period, viable cultures, confirmed to be epithelial in origin were generated from 156 of 172 (91%) cases recruited. Characterisation was carried out using a panel of antibodies including pancytokeratin, CA125, EpCAM, MOC-31, D2-40 and vimentin. Senescence occurred between the 2nd and 8th passages in all cultures except one in which spontaneous immortalization occurred. Cells could be successfully cultured even after a period of storage at 4°C and cultured cells were capable of being used for a variety of applications including functional assays. Upon functional assessment there was minimal intra-tumour heterogeneity. It is therefore possible to derive viable ovarian cancer cell cultures in the majority of patients undergoing surgery. Cells cultured directly from patient cancers provide an accurate and highly diverse model.

  9. The use of ovarian cancer cells from patients undergoing surgery to generate primary cultures capable of undergoing functional analysis.

    Directory of Open Access Journals (Sweden)

    Rachel L O Donnell

    Full Text Available The use of cell lines or animal models has significant disadvantages when dealing with a set of heterogeneous diseases such as epithelial ovarian cancer. This has clinical relevance in that biomarkers developed using cell line or animal models are often not transferable to the clinical setting. In this study, we describe the development of a robust protocol for developing primary cultures of ovarian cancer which will overcome some of these difficulties. Women undergoing surgery for ovarian cancer were recruited and samples of ascites and solid tumour deposits were used to develop primary cultures. Cells were characterised using a panel of immunofluorescent antibodies prior to use in a variety of assays including functional assessment of DNA repair pathways. During the four year study period, viable cultures, confirmed to be epithelial in origin were generated from 156 of 172 (91% cases recruited. Characterisation was carried out using a panel of antibodies including pancytokeratin, CA125, EpCAM, MOC-31, D2-40 and vimentin. Senescence occurred between the 2nd and 8th passages in all cultures except one in which spontaneous immortalization occurred. Cells could be successfully cultured even after a period of storage at 4°C and cultured cells were capable of being used for a variety of applications including functional assays. Upon functional assessment there was minimal intra-tumour heterogeneity. It is therefore possible to derive viable ovarian cancer cell cultures in the majority of patients undergoing surgery. Cells cultured directly from patient cancers provide an accurate and highly diverse model.

  10. Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

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    Siegel, Pamela; da Motta, Pedro Mourão Roxo; da Silva, Luis G; Stephan, Celso; Lima, Carmen Silvia Passos; de Barros, Nelson Filice

    2016-01-01

    The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

  11. Sleep disturbances and changes in urinary 6-sulphatoxymelatonin levels in patients with breast cancer undergoing lumpectomy

    DEFF Research Database (Denmark)

    Voigt Hansen, Melissa; Madsen, M T; Wildschiødtz, Gordon

    2013-01-01

    Sleep disturbances and changes in self-reported discomfort and melatonin secretion are common in the post-operative period. We aimed to study the distribution of sleep stages in the perioperative period and evaluate changes in secretion of the melatonin metabolite aMT6s and subjective parameters ...... of sleepiness, pain, general well-being and fatigue in patients undergoing surgery for breast cancer....

  12. Successful afatinib treatment of advanced non-small-cell lung cancer patients undergoing hemodialysis.

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    Imai, Hisao; Kaira, Kyoichi; Naruse, Ichiro; Hayashi, Hideki; Iihara, Hirotoshi; Kita, Yutaro; Mizusaki, Naoki; Asao, Takayuki; Itoh, Yoshinori; Sugiyama, Tadashi; Minato, Koichi; Yamada, Masanobu

    2017-01-01

    The treatment for patients with lung cancer undergoing hemodialysis, who are frequently elderly and have poor performance status, becomes a more important subject. However, the feasibility of afatinib in patients with chronic renal failure undergoing hemodialysis has not, so far, been reported. Here, afatinib was administered to three patients with NSCLC harboring EGFR mutation and chronic renal failure undergoing hemodialysis. Pharmacokinetic (PK) data of afatinib supported the safety of afatinib treatment. After receiving their written informed consent from all patients, they were administered 30 mg afatinib daily with HD three times a week. We performed PK analyses of afatinib on days 1, 2, 10, and 11 after initial administration of afatinib. All three patients exhibited a partial response without any serious adverse events during the administration of afatinib. These PK data were similar to those of patients with normal organ function, which were previously reported. Our findings may be particularly useful given the current opportunity to use afatinib as a first-line treatment for EGFR-mutated NSCLC patients, providing an additional option for patients with impaired renal function.

  13. Metabolic syndrome in patients with prostate cancer undergoing intermittent androgen-deprivation therapy

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    Rezaei, Mohammadali Mohammadzadeh; Rezaei, Mohammadhadi Mohammadzadeh; Ghoreifi, Alireza; Kerigh, Behzad Feyzzadeh

    2016-01-01

    Introduction: The presence of metabolic syndrome in men with prostate cancer (PCa) undergoing androgen-deprivation therapy (ADT), especially intermittent type, has not been completely evaluated. The aim of this study is to evaluate metabolic syndrome in men with PCa undergoing intermittent ADT. Methods: In this longitudinal study, we studied the prevalence of metabolic syndrome and its components in 190 patients who were undergoing intermittent ADT. The metabolic syndrome was defined according to the Adult Treatment Panel III criteria. All metabolic parameters, including lipid profile, blood glucose, blood pressures, and waist circumferences of the patients were measured six and 12 months after treatment. Results: Mean age of the patients was 67.5 ± 6.74 years. The incidence of metabolic syndrome after six and 12 months was 6.8% and 14.7%, respectively. Analysis of various components of the metabolic syndrome revealed that patients had significantly higher overall prevalence of hyperglycemia, abdominal obesity, and hypertriglyceridemia in their six- and 12-month followups, but blood pressure has not been changed in the same period except for diastolic blood pressure after six months. Conclusions: Although there was an increased risk of metabolic syndrome in patients receiving intermittent ADT, it was lower than other studies that treated the same patients with continuous ADT. Also it seems that intermittent ADT has less metabolic complications than continuous ADT and could be used as a safe alternative in patients with advanced and metastatic PCa. PMID:27695584

  14. Effect of melatonin on depressive symptoms and anxiety in patients undergoing breast cancer surgery

    DEFF Research Database (Denmark)

    Hansen, Melissa V; Andersen, Lærke T; Madsen, Michael T

    2014-01-01

    Depression, anxiety and sleep disturbances are known problems in patients with breast cancer. The effect of melatonin as an antidepressant in humans with cancer has not been investigated. We investigated whether melatonin could lower the risk of depressive symptoms in women with breast cancer...... in a three-month period after surgery and assessed the effect of melatonin on subjective parameters: anxiety, sleep, general well-being, fatigue, pain and sleepiness. Randomized, double-blind, placebo-controlled trial undertaken from July 2011 to December 2012 at a department of breast surgery in Copenhagen......, Denmark. Women, 30-75 years, undergoing surgery for breast cancer and without signs of depression on Major Depression Inventory (MDI) were included 1 week before surgery and received 6 mg oral melatonin or placebo for 3 months. The primary outcome was the incidence of depressive symptoms measured by MDI...

  15. New perspectives in the nursing role in cancer patients undergoing radiotherapy

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    Lavdaniti M.

    2012-01-01

    Full Text Available Introduction: Cancer is the second leading cause of death worldwide and the radiotherapy is one of the types of cancer treatment. It is calculated that more than half of all people with cancer will undergoing radiotherapy as at least part of their cancer treatment. Purpose: The purpose of the present study was the description of role of nurse in radiation oncology. Method: Literature review of the relevant articles in the databases pubmed and scopus was conducted, but also were used articles of international professional nursing organizations Results: The radiation oncology nursing role is multidimensional and is focused in patient assessment, patient and family education, support and counselling, physical care of patient and in the research. The patient’s care is mainly focused in the conducting of suitable nursing interventions that will alleviate the patient from the side effects of radiotherapy. Conclusions: The nurses should be known the technologies that are used in the radiotherapy so that they are enable to educate their patients and provide qualitative nursing care. Changes in the health care environment and changes in treatment and technology continue to drive cancer care. So nurses should collaborate and communicate with other members of interdisciplinary team and incorporate evidence into practice

  16. Emotional aspects and pranayama in breast cancer patients undergoing radiation therapy: A randomized controlled trial

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    Jyothi Chakrabarty

    2016-01-01

    Full Text Available Objective: Emotional disturbances are commonly experienced by cancer patients. The aim of this study was to determine the effectiveness of certain Pranayama techniques on the emotional aspects such as impatience, worry, anxiety, and frustration among breast cancer patients undergoing radiation therapy in India. Methods: The study was conducted as a randomized controlled trial. Patients were recruited when they were seeking radiation therapy for breast cancer. They were allocated into two groups using block randomization technique. The experimental group performed Pranayama along with radiation therapy, whereas the control group received only routine care. Results: Emotional aspects of the two groups were compared at the end of the treatment. Mann-Whitney U-test was used for comparison as the data were not following normality. It showed a significant difference between the two groups with the group who performed Pranayama showing a lesser mean score for these negative emotions. Conclusions: Pranayama might help in controlling the negative emotions likely to be faced by breast cancer patients, and it can be used as a supportive therapy for breast cancer patients receiving radiation therapy.

  17. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

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    Maurizio Bossola

    2015-01-01

    Full Text Available The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC and oral nutritional supplements (ONS should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started, prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy.

  18. Prognostic factors of T4 gastric cancer patients undergoing potentially curative resection

    Institute of Scientific and Technical Information of China (English)

    Naoto Fukuda; Yasuyuki Sugiyama; Joji Wada

    2011-01-01

    AIM: To investigate the prognostic factors of T4 gas-tric cancer patients without distant metastasis who could undergo potentially curative resection. METHODS: We retrospectively analyzed the clinical data of 71 consecutive patients diagnosed with T4 gas-tric cancer and who underwent curative gastrectomy at our institutions. The clinicopathological factors that could be associated with overall survival were evalu-ated. The cumulative survival was determined by the Kaplan-Meier method, and univariate comparisons be-tween the groups were performed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model and a step-wise procedure.RESULTS: The study patients comprised 53 men (74.6%) and 18 women (25.4%) aged 39-89 years (mean, 68.9 years). Nineteen patients (26.8%) had postoperative morbidity: pancreatic fistula developed in 6 patients (8.5%) and was the most frequent compli-cation, followed by anastomosis stricture in 5 patients (7.0%). During the follow-up period, 28 patients (39.4%) died because of gastric cancer recurrence, and 3 (4.2%) died because of another disease or accident. For all patients, the estimated overall survival was 34.1% at 5 years. Univariate analyses identified the following statis-tically significant prognostic factors in T4 gastric cancer patients who underwent potentially curative resection: peritoneal washing cytology (P < 0.01), number of met-astatic lymph nodes (P < 0.05), and venous invasion (P < 0.05). In multivariate analyses, only peritoneal wash-ing cytology was identified as an independent prognos-tic factor (HR = 3.62, 95% CI = 1.37-9.57) for long-term survival. CONCLUSION: Positive peritoneal washing cytology was the only independent poor prognostic factor for T4 gastric cancer patients who could be treated with potentially curative resection.

  19. Sustaining hope and life courage in patients undergoing ovarian cancer surgery - the impact of care

    DEFF Research Database (Denmark)

    Seibaek, L; Delmar, C; Hounsgaard, L

    2017-01-01

    Ovarian cancer is the leading cause of death from a gynaecological malignancy in the Western World. To explore if experiences of physical comfort influenced hope and life courage during final diagnosis and early treatment, qualitative research interviews were performed with women undergoing surgery......, and it was a main finding that sufficient symptom management combined with sensitive attention of the patient sustained her hope, life courage and action competences. Surgery constitutes an essential part of sufficient cancer treatment. However, the diagnostic and pre-operative phase represents an insufficiently...... for ovarian cancer. By applying a phenomenological-hermeneutic methodology, the findings were systematically identified, put into meaning-structures, interpreted and critically discussed. The empirical material constituted a main theme concerning "Hope and life courage are created in the interplay between...

  20. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Adamsen, Lis; Quist, Morten; Andersen, Christina

    2009-01-01

    .05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P....0001). No significant effect was seen on global health status/quality of life. CONCLUSION: A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced......OBJECTIVE: To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced...

  1. Effect of a Multimodal High Intensity Exercise Intervention in Cancer Patients Undergoing Chemotherapy

    DEFF Research Database (Denmark)

    Adamsen, Lis; Quist, Morten; Andersen, Christina

    2009-01-01

    .64), role emotional (0.32, 0.05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P....4 to 34.9, Phealth status/quality of life. Conclusion: A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant......Abstract: Objective To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment...

  2. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial

    DEFF Research Database (Denmark)

    Adamsen, Lis; Quist, Morten; Andersen, Christina

    2009-01-01

    .05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P....0001). No significant effect was seen on global health status/quality of life. CONCLUSION: A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced......OBJECTIVE: To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced...

  3. Factors affecting the quality of life of cancer patients undergoing chemotherapy: A questionnaire study

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    Sema Üstündag

    2015-01-01

    Full Text Available Objective: This descriptive and cross-sectional study was undertaken to determine the factors affecting cancer patients′ quality of life. Methods: We collected data from 352 chemotherapy patients of an Outpatient Chemotherapy Unit in a state hospital. We included volunteered chemotherapy patients with a signed informed consent and at least 50 Karnofsky Performance Scale points. We gathered data by Personal Information Form and Nightingale Symptom Assessment Scale (N-SAS and analyzed via basic descriptive statistics and linear regression analysis. Results: Patients were women (54.8%, married (83.5%, elementary school graduates (57.1%, housewives (44.6% and undergoing fluorouracil-based therapy (47.2%, and almost all patients had religious and cultural rituals for the disease. Women experienced worse physical and social well-being than men (P = 0.001, P = 0.0001. Singles had worse psychological and general well-being (P = 0.0001, P = 0.0001. Housewives had the worst physical and social well-being (P 0.05. Breast cancer and sarcoma patients had the worst social well-being than other cancer patients. The N-SAS points of patients were not affected by blessings/prays, vow/sacrifice, consulting local herbalists and visiting "ocaks (folk physicians" (P > 0.05. Patients with bad quality of life practiced lead pouring and amulets (P < 0.05. Gender was the first factor affecting the quality of life. Conclusion: Advanced studies on individual quality of life factors affecting cancer would empower nurses for better personal care techniques and patients for easily overcoming the disease.

  4. Pharmacokinetics and pharmacodynamics of propofol in cancer patients undergoing major lung surgery.

    Science.gov (United States)

    Przybyłowski, Krzysztof; Tyczka, Joanna; Szczesny, Damian; Bienert, Agnieszka; Wiczling, Paweł; Kut, Katarzyna; Plenzler, Emilia; Kaliszan, Roman; Grześkowiak, Edmund

    2015-04-01

    Despite the growing number of cancer cases and cancer surgeries around the world, the pharmacokinetics (PK) and pharmacodynamics (PD) of anesthetics used in this population are poorly understood. Patients operated due to cancer are usually in severe state and often require chemotherapy. It might affect the PK/PD of drugs used in this population. Therefore, in this study we explored the PK/PD of propofol in cancer patients having a major lung surgery. 23 patients that underwent a propofol-fentanyl total intravenous anesthesia were included in the analysis. A large set of demographic, biochemical and hemodynamic parameters was collected for the purpose of covariate analysis. Nonlinear mixed effect modeling in NONMEM was used to analyze the collected data. A three-compartment model was sufficient to describe PK of propofol. The anesthetic effect (AAI index) was linked to the propofol effect site concentrations through a sigmoidal E max model. A slightly higher value of clearance, a lower value of distribution clearance, and a decreased volume of peripheral compartment were observed in our patients, as compared with the literature values reported for healthy volunteers by Schnider et al. and by Eleveld et al. Despite these differences, both models led to a clinically insignificant bias of -8 and -1 % in concentration predictions, as reflected by the median performance error. The C e50 and propofol biophase concentration at the time of postoperative orientation were low and equaled 1.40 and 1.13 mg/L. The population PK/PD model was proposed for cancer patients undergoing a major lung surgery. The large body of studied covariates did not affect PK/PD of propofol significantly. The modification of propofol dosage in the group of patients under study is not necessary when TCI-guided administration of propofol by means of the Schnider model is used.

  5. Effect of exercise on the caloric intake of breast cancer patients undergoing treatment

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    C.L. Battaglini

    2008-08-01

    Full Text Available The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake (TCI of breast cancer patients undergoing treatment. A secondary purpose was to determine whether or not a relationship existed between changes in TCI, body fat composition (%BF, and fatigue during the study, which lasted 6 months. Twenty females recently diagnosed with breast cancer, scheduled to undergo chemotherapy or radiation, were assigned randomly to an experimental (N = 10 or control group (N = 10. Outcome measures included TCI (3-day food diary, %BF (skinfolds, and fatigue (revised Piper Fatigue Scale. Each exercise session was conducted as follows: initial cardiovascular activity (6-12 min, followed by stretching (5-10 min, resistance training (15-30 min, and a cool-down (approximately 8 min. Significant changes in TCI were observed among groups (F1,18 = 8.582; P = 0.009, at treatments 2 and 3, and at the end of the study [experimental (1973 ± 419, control (1488 ± 418; experimental (1946 ± 437, control (1436 ± 429; experimental (2315 ± 455, control (1474 ± 294, respectively]. A significant negative correlation was found (Spearman rho(18 = -0.759; P < 0.001 between TCI and %BF and between TCI and fatigue levels (Spearman rho(18 = -0.541; P = 0.014 at the end of the study. In conclusion, the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects, including decreased TCI, increased fatigue, and negative changes in body composition.

  6. Effects of neoadjuvant chemotherapy on pathological parameters and survival in patients undergoing radical cystectomy for muscle-invasive bladder cancer

    OpenAIRE

    ÇAĞLAYAN, Alper; Akbulut, Ziya; Atmaca, Ali Fuat; Altinova,Serkan; KILIÇ, Metin; Balbay, Mevlana Derya

    2012-01-01

    Aim: To evaluate the effect of neoadjuvant chemotherapy on tumor pathology and patient survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy. Neoadjuvant chemotherapy is believed to prevent micrometastasis and provide pathological downstaging. Materials and methods: Between June 2004 and March 2009, 74 patients with muscle-invasive bladder cancer were treated with radical cystectomy. Patients fit to receive chemotherapy were administered systemic chemotherapy...

  7. Risk factors for developing hyponatremia in thyroid cancer patients undergoing radioactive iodine therapy.

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    Jung Eun Lee

    Full Text Available Due to the alarming increase in the incidence of thyroid cancer worldwide, more patients are receiving postoperative radioactive iodine (RAI therapy and these patients are given a low-iodine diet along with levothyroxine withdrawal to induce a hypothyroid state to maximize the uptake of RAI by thyroid tissues. Recently, the reported cases of patients suffering from life-threatening severe hyponatremia following postoperative RAI therapy have increased. This study aimed to systematically assess risk factors for developing hyponatremia following RAI therapy in post-thyroidectomy patients.We reviewed the medical records of all thyroid cancer patients who underwent thyroidectomy and postoperative RAI therapy from July 2009 to February 2012. Demographic and biochemical parameters including serum sodium and thyroid function tests were assessed along with medication history.A total of 2229 patients (47.0±11.0 years, female 76.3% were enrolled in the analysis. Three hundred seven patients (13.8% of all patients developed hyponatremia; 44 patients (2.0% developed moderate to severe hyponatremia (serum Na+≤130 mEq/L and another 263 (11.8% patients showed mild hyponatremia (130 mEq/Lpatients undergoing RAI therapy after total thyroidectomy. Multivariate analysis showed that old age, female sex, use of thiazide diuretics, and hyponatremia at the initiation of RAI therapy were independent risk factors for the development of hyponatremia.Our data suggest that age greater than 60 years, female sex, use of thiazide, and hyponatremia at the initiation of RAI therapy are important

  8. Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer

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    Welch Neil T

    2008-01-01

    Full Text Available Abstract Background Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer. This study aimed to audit the pattern of blood crossmatch and to evaluate factors predictive of transfusion requirements in oesophagectomy patients. Methods Data was collected from the database of all patients who underwent oesophagectomy for cancer over a 2-year period. Clinico-pathological data collected included patients demographics, clinical factors, tumour histopathological data, preoperative and discharge haemoglobin levels, total blood loss, number of units of blood crossmatched pre-, intra- and postoperatively, number of blood units transfused, crossmatched units reused for another patient and number of blood units wasted. Clinico-pathological variables were evaluated and logistic regression analysis was performed to determine which factors were predictive of blood transfusion. Results A total of 145 patients with a male to female ratio of 2.5:1 and median age of 68 (40–85 years were audited. The mean preoperative haemoglobin (Hb was 13.0 g/dl. 37% of males (Hb 70 years, Hb level Conclusion The cohort of patients audited was over-crossmatched. The identified independent predictors of blood transfusion should be considered in preoperative blood ordering for oesophagectomy patients. This study has directly led to a reduction in the maximum surgical blood-ordering schedule for oesophagectomy to 2 units and a reaudit is underway.

  9. Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial

    OpenAIRE

    2016-01-01

    Head and neck malignant tumors have numerous locations of the disease. After patients receive radiotherapy, their nutritional status is very poor, thus the curative effect is unsatisfactory. The aims of the present study were to investigate and analyze the nutritional status of patients with head and neck cancer undergoing radiotherapy (RT) in order to provide positive nutrition intervention for assisting the radiotherapy effect. A total of 40 patients with head and neck cancer were selected ...

  10. Effects of different general anaesthetic techniques on immune responses in patients undergoing surgery for tongue cancer.

    Science.gov (United States)

    Zhang, T; Fan, Y; Liu, K; Wang, Y

    2014-03-01

    The aim of this study was to investigate the effects of different general anaesthesia techniques on immune responses in patients undergoing surgery for tongue cancer. Sixty American Society of Anesthesiologists physical status 1 or 2 patients undergoing elective reconstructive surgery for tongue cancer were randomised to three groups. Group 1 received propofol induction and maintenance (TIVA), group 2 received propofol induction and sevoflurane maintenance (MIXED) and group 3 received sevoflurane induction and maintenance (SEVO). All patients received an infusion of remifentanil. Blood samples were obtained at eight time-points: 30 minutes before induction (T0); one hour (T1), three hours (T2) and five hours (T3) after induction; at the end of the operation (T4); and 24 hours (T5), 48 hours (T6) and 72 hours (T7) after operation. The T lymphocyte subsets (including CD3(+) cells, CD3(+)CD4(+) cells and CD3(+)CD8(+)cells) and CD4(+)/CD8(+) ratio, natural killer cells and B lymphocytes were analysed by flow cytometry. All immunological indicators except CD3(+)CD8(+) cells were significantly decreased in all groups at T1~T5 compared to T0 (P <0.05). The percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios were significantly lower in the MIXED groups and SEVO groups but not the TIVA group at T6 as compared with T0 (P <0.05). There were minor but statistically significant differences in the percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios between the SEVO group and the TIVA group at T2approxT6 (P <0.05). These findings suggest that propofol has slightly less effect on cellular immune responses than sevoflurane.

  11. Spiritual concerns in Hindu cancer patients undergoing palliative care: A qualitative study

    Directory of Open Access Journals (Sweden)

    Srinagesh Simha

    2013-01-01

    Full Text Available Aims: Spiritual concerns are being identified as important components of palliative care. The aim of this study was to explore the nature of spiritual concerns in cancer patients undergoing palliative care in a hospice in India. Materials and Methods: The methodology used was a qualitative method: Interpretive phenomenological analysis. A semi-structured interview guide was used to collect data, based on Indian and western literature reports. Certain aspects like karma and pooja, relevant to Hindus, were included. Theme saturation was achieved on interviewing 10 participants. Results: The seven most common spiritual concerns reported were benefit of pooja, faith in God, concern about the future, concept of rebirth, acceptance of one′s situation, belief in karma, and the question "Why me?" No participant expressed four of the concerns studied: Loneliness, need of seeking forgiveness from others, not being remembered later, and religious struggle. Conclusions: This study confirms that there are spiritual concerns reported by patients receiving palliative care. The qualitative descriptions give a good idea about these experiences, and how patients deal with them. The study indicates the need for adequate attention to spiritual aspects during palliative care.

  12. Cryopreservation of in vitro matured oocytes after ex vivo oocyte retrieval from gynecologic cancer patients undergoing radical surgery

    Science.gov (United States)

    Park, Chan Woo; Lee, Sun Hee; Yang, Kwang Moon; Lee, In Ho; Lim, Kyung Teak; Lee, Ki Heon

    2016-01-01

    Objective The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). Methods Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. Results A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. Conclusion Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays. PMID:27358831

  13. Audiotaped social comparison information for cancer patients undergoing radiotherapy : Differential effects of procedural, emotional and coping information

    NARCIS (Netherlands)

    Bennenbroek, FTC; Buunk, BP; Stiegelis, HE; Hagedoorn, M; Sanderman, R; Van den Bergh, ACM; Botke, G; Buunk, Abraham (Bram)

    2003-01-01

    The present study focused on the effects of social comparison information on subjective understanding of radiation therapy, validation of emotions, and self-efficacy of cancer patients undergoing radiation therapy. The effects of three different audiotapes, containing different kinds of social compa

  14. Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: protocol proposal

    Science.gov (United States)

    RAPONE, B.; NARDI, G.M.; DI VENERE, D.; PETTINI, F.; GRASSI, F.R.; CORSALINI, M.

    2016-01-01

    SUMMARY Purpose This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications. Materials and methods This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department. Results Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome. Conclusions The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy. PMID:28280537

  15. Low Recent Protein Intake Predicts Cancer-Related Fatigue and Increased Mortality in Patients with Advanced Tumor Disease Undergoing Chemotherapy.

    Science.gov (United States)

    Stobäus, Nicole; Müller, Manfred J; Küpferling, Susanne; Schulzke, Jörg-Dieter; Norman, Kristina

    2015-01-01

    Cancer patients, in general, suffer from anorexia hence diminished nutritional intake. In a prospective observational study, we investigated the impact of recent energy and protein intake on cancer-related fatigue and 6-month mortality in patients undergoing chemotherapy. Recent protein and energy intake was assessed by 24-h recall in 285 patients. Cancer-related fatigue was determined by Brief Fatigue Inventory, and fat free mass index (FFMI) was assessed with bioelectrical impedance analysis. Symptoms with the validated German version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (30 questions) and 6-month mortality was documented. Risk factors of cancer-related fatigue and predictors of mortality were investigated with logistic regression analysis and stepwise Cox regression analysis, respectively. Low protein intake (protein intake emerged as the strongest contributor to cancer-related fatigue followed by nausea/vomiting, insomnia, and age. Reduced protein intake, male sex, number of comorbidities, and FFMI were identified as significant predictors for increased 6-month mortality. In conclusion, a low recent protein intake assessed by 24-h recall is associated with a more than twofold higher risk of cancer-related fatigue and 6-month mortality. Every effort should be taken to assess and guarantee proper nutritional intake in patients undergoing chemotherapy.

  16. Safety and effectiveness of scalp cooling in cancer patients undergoing cytotoxic treatment

    NARCIS (Netherlands)

    Hurk, Corina Johanna Geertruida van den

    2013-01-01

    Various cytotoxics cause severe alopecia, it is estimated to affect more than 15.000 Dutch cancer patients per year. Hair loss has high impact on the majority of these patients, they describe it as stigmatizing and a constant reminder of cancer disease. Scalp cooling decreases hair loss and is well

  17. Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence?

    Directory of Open Access Journals (Sweden)

    Carlotta Mainini

    2016-10-01

    Full Text Available Surgical resection appears to be the most effective treatment for early-stage non-small cell lung cancer. Recent studies suggest that perioperative pulmonary rehabilitation improves functional capacity, reduces mortality and postoperative complications and enhances recovery and quality of life in operated patients. Our aim is to analyse and identify the most recent evidence-based physical exercise interventions, performed before or after surgery. We searched in MEDLINE, EMBASE, CINAHL, Cochrane Library and PsycINFO. We included randomised controlled trials aimed at assessing efficacy of exercise-training programmes; physical therapy interventions had to be described in detail in order to be reproducible. Characteristics of studies and programmes, results and outcome data were extracted. Six studies were included, one describing preoperative rehabilitation and three assessing postoperative intervention. It seems that the best preoperative physical therapy training should include aerobic and strength training with a duration of 2–4 weeks. Although results showed improvement in exercise performance after preoperative pulmonary rehabilitation, it was not possible to identify the best preoperative intervention due to paucity of clinical trials in this area. Physical training programmes differed in every postoperative study with conflicting results, so comparison is difficult. Current literature shows inconsistent results regarding preoperative or postoperative physical exercise in patients undergoing lung resection. Even though few randomised trials were retrieved, treatment protocols were difficult to compare due to variability in design and implementation. Further studies with larger samples and better methodological quality are urgently needed to assess efficacy of both preoperative and postoperative exercise programmes.

  18. Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence?

    Science.gov (United States)

    Mainini, Carlotta; Rebelo, Patrícia Fs; Bardelli, Roberta; Kopliku, Besa; Tenconi, Sara; Costi, Stefania; Tedeschi, Claudio; Fugazzaro, Stefania

    2016-01-01

    Surgical resection appears to be the most effective treatment for early-stage non-small cell lung cancer. Recent studies suggest that perioperative pulmonary rehabilitation improves functional capacity, reduces mortality and postoperative complications and enhances recovery and quality of life in operated patients. Our aim is to analyse and identify the most recent evidence-based physical exercise interventions, performed before or after surgery. We searched in MEDLINE, EMBASE, CINAHL, Cochrane Library and PsycINFO. We included randomised controlled trials aimed at assessing efficacy of exercise-training programmes; physical therapy interventions had to be described in detail in order to be reproducible. Characteristics of studies and programmes, results and outcome data were extracted. Six studies were included, one describing preoperative rehabilitation and three assessing postoperative intervention. It seems that the best preoperative physical therapy training should include aerobic and strength training with a duration of 2-4 weeks. Although results showed improvement in exercise performance after preoperative pulmonary rehabilitation, it was not possible to identify the best preoperative intervention due to paucity of clinical trials in this area. Physical training programmes differed in every postoperative study with conflicting results, so comparison is difficult. Current literature shows inconsistent results regarding preoperative or postoperative physical exercise in patients undergoing lung resection. Even though few randomised trials were retrieved, treatment protocols were difficult to compare due to variability in design and implementation. Further studies with larger samples and better methodological quality are urgently needed to assess efficacy of both preoperative and postoperative exercise programmes.

  19. Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Midtgaard, J.; Baadsgaard, M.T.; Moller, T.;

    2009-01-01

    BACKGROUND: Physical activity is considered an important and determining factor for the cancer patient's physical well-being and quality of life. However, cancer treatment may disrupt the practice of physical activity, and the prevention of sedentary lifestyles in cancer survivors is imperative....... PURPOSE: The current study aimed at investigating self-reported physical activity behaviour, exercise motivation and information in cancer patients undergoing chemotherapy. METHODS AND SAMPLE: Using a cross-sectional design, 451 patients (18-65 years) completed a questionnaire assessing pre...... not exercising as much as desired. Exercise barriers included fatigue (74%) and physical discomfort (45%). Present physical activity behaviour was associated with pre-illness physical activity behaviour (p40 years...

  20. Exercise may reduce depression but not anxiety in self-referred cancer patients undergoing chemotherapy. Post-hoc analysis of data from the 'Body & Cancer' trial

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Stage, Maria; Møller, Tom

    2011-01-01

    Abstract Background. The diagnosis and treatment of cancer may cause clinically significant and persistent psychological morbidity. The objective of this study was to determine the short-term effect of a six week exercise intervention on anxiety and depression in cancer patients undergoing.......021). Conclusion. Anti-depressant effects could be caused by exercise in self-referred cancer patients undergoing chemotherapy. Dedicated trials and follow-up studies are needed to clarify the optimal duration and content of exercise interventions to meet the needs of clinically depressive or anxious patients....... chemotherapy (The 'Body & Cancer' trial). Methods. Two hundred and nine self-referred patients (52 males, 157 females, mean age 47 years) were randomised into an intervention group and a waiting-list control group. Anxiety and depression was measured by the Hospital Anxiety and Depression Scale. Results...

  1. Nurses′ knowledge and education about oral care of cancer patients undergoing chemotherapy and radiation therapy

    Directory of Open Access Journals (Sweden)

    Radhika R Pai

    2015-01-01

    Setting and design: A cross sectional descriptive survey was conducted among 158 staff nurses working in oncology related areas from 4 different hospitals of Dakshina Kannada district and Udupi district of Karnataka state, India. Statistical Analysis: descriptive and inferential statistics was used by using SPSS 16 version. Results: Majority 81 (51.3% of the staff nurses had poor knowledge of oral care in cancer patients whereas 87 (55.1% reported that knowledge acquired through basic education in oral care is not sufficient. Most of the staff nurses 115 (72.8% did not receive basic education in oral care of cancer patients. There was significant association between knowledge and variables such as designation (.005, years of work experience (.040 and years of experience in cancer wards (.000 at 0.05 levels. Conclusion: Lack of knowledge suggest the need to develop and implement continuing nursing education programs on oral care specifically for patients receiving cancer treatments, for improving knowledge of staff nurses′ in order to render comprehensive care to the patients. This study also recommends the importance of inclusion of cancer patient specific oral care in the curriculum which can enhance competency of the qualified nurses in cancer wards.

  2. Advanced thymic cancer treated with carboplatin and paclitaxel in a patient undergoing hemodialysis.

    Science.gov (United States)

    Miura, Satoru; Kagamu, Hiroshi; Sakai, Takehito; Nozaki, Koichiro; Asakawa, Katsuaki; Moro, Hiroshi; Okajima, Masaaki; Watanabe, Satoshi; Yamamoto, Suguru; Iino, Noriaki; Goto, Shin; Kazama, Junichiro James; Yoshizawa, Hirohisa; Narita, Ichiei

    2015-01-01

    A 53-year-old man with an asymptomatic anterior mediastinal tumor undergoing hemodialysis was referred to our institution. He was diagnosed with thymic basaloid carcinoma based on the findings of a chest tomography-guided biopsy and successfully treated with carboplatin (300 mg/m(2)/day) and paclitaxel (200 mg/m(2)/day) on day 1 for six three-week cycles. To our knowledge, this is the first report regarding the efficiency of a carboplatin dose-definition method based on the body surface area with paclitaxel in a hemodialysis patient. This report may therefore be useful for treating hemodialysis patients who are candidates for carboplatin and paclitaxel therapy.

  3. Metformin Increases Overall Survival in Patients with Diabetes Undergoing Surgery for Colorectal Cancer

    DEFF Research Database (Denmark)

    Fransgaard, Tina; Thygesen, Lau Caspar; Gögenur, Ismail

    2015-01-01

    between diabetes and overall survival after resection for CRC. Furthermore, the association between antidiabetic medication and overall survival was examined. METHODS: Patients diagnosed with CRC between January 1, 2003 and December 31, 2012 were identified through the Danish Colorectal Cancer Group......BACKGROUND: Emerging evidence suggests that metformin decreases the risk of developing colorectal cancer in patients with diabetes, but only few studies have examined potential survival benefits after surgery for colorectal cancer (CRC). The purpose of the study was to examine the association......'s National Clinical Database (DCCG). The Danish National Patient Register (NPR) records all hospital contacts in Denmark, and the diagnosis of diabetes was identified by combining NPR data with use of antidiabetic drugs identified through the Danish National Prescription Registry and DCCG. The Kaplan...

  4. The clinical analysis of acute pancreatitis in colorectal cancer patients undergoing chemotherapy after operation

    Directory of Open Access Journals (Sweden)

    Ji YL

    2015-09-01

    Full Text Available Yanlei Ji,1 Zhen Han,2 Limei Shao,1 Yunling Li,1 Long Zhao,1 Yuehuan Zhao1 1Department of Special Diagnosis, Shandong Cancer Hospital and Institute, Jinan, People’s Republic of China; 2Department of Internal Medicine, Jinan Second People’s Hospital, Jinan, People’s Republic of China Abstract: Acute pancreatitis is a rare complication in postoperative colorectal cancer patients after FOLFOX6 (oxaliplatin + calcium folinate +5-FU [5-fluorouracil] chemotherapy. In this paper, a total of 62 patients with gastrointestinal cancer were observed after the burst of acute pancreatitis. Surgery of the 62 cases of colorectal cancer patients was completed successfully. But when they underwent FOLFOX6 chemotherapy, five patients got acute pancreatitis (8.06%, four (6.45% had mild acute pancreatitis, and one (1.61% had severe acute pancreatitis, of which two were males (3.23% and three females (4.84%. No patients (0.00% had acute pancreatitis on the 1st day after chemotherapy; one patient (1.61% got it in the first 2 and 3 days after chemotherapy; and three others (4.83% got it in the first 4 days after chemotherapy. In the 62 patients with malignant tumors, the body mass index (BMI was less than 18 (underweight in six of them, with two cases of acute pancreatitis (33.33%; the BMI was 18–25 (normal weight in 34 cases, with one case (2.94% of acute pancreatitis; the BMI was 25–30 (overweight in 13 cases, with 0 cases (0.00% of acute pancreatitis; and the BMI was ≥30 (obese in nine patients, with two cases of acute pancreatitis (22.22%. After symptomatic treatment, four patients were cured and one died; the mortality rate was 1.61%. Most of them appeared in the first 4 days after chemotherapy; the probability of this complication is significantly higher in slim and obese patients than in normal weight patients. Postoperative colorectal cancer patients after FOLFOX6 chemotherapy have a sudden onset of acute pancreatitis occult, especially in

  5. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection

    Science.gov (United States)

    Cueto Ladrón de Guevara, Antonio; Puche, Jose L.; Ruiz Zafra, Javier; de Miguel-Pérez, Diego; Ramos, Abel Sánchez-Palencia; Giraldo-Ospina, Carlos Fernando; Navajas Gómez, Juan A.; Delgado-Rodriguez, Miguel; Lorente, Jose A.; Serrano, María Jose

    2016-01-01

    Background Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC) stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs) is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC. Patients and Methods 56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR) expression. Results 51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1%) (p = 0.035). The mean number of CTCs was 3.16 per 10 ml (range 0–84) preoperatively and 0.66 (range 0–3) in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018) and a shorter disease free survival (DFS) (p = .008). In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50–21.946, p = 0.010) and N status (HR = 0.296, 95% CI: 0.091–0.961, p = 0.043) were independent prognostic factors for DFS. Conclusion CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence. PMID:26913536

  6. Molecular biomarkers in extrahepatic bile duct cancer patients undergoing chemoradiotherapy for gross residual disease after surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Hyeon Kang; Kim, Kyu Bo; Chie, Eui Kyu; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Hae Jin [Dept. of Radiation Oncology, Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2012-12-15

    To analyze the outcomes of chemoradiotherapy for extrahepatic bile duct (EHBD) cancer patients who underwent R2 resection or bypass surgery and to identify prognostic factors affecting clinical outcomes, especially in terms of molecular biomarkers. Medical records of 21 patients with EHBD cancer who underwent R2 resection or bypass surgery followed by chemoradiotherapy from May 2001 to June 2010 were retrospectively reviewed. All surgical specimens were re-evaluated by immunohistochemical staining using phosphorylated protein kinase B (pAKT), CD24, matrix metalloproteinase 9 (MMP9), survivin, and {beta}-catenin antibodies. The relationship between clinical outcomes and immunohistochemical results was investigated. At a median follow-up of 20 months, the actuarial 2-year locoregional progression-free, distant metastasis-free and overall survival were 37%, 56%, and 54%, respectively. On univariate analysis using clinicopathologic factors, there was no significant prognostic factor. In the immunohistochemical staining, cytoplasmic staining, and nuclear staining of pAKT was positive in 10 and 6 patients, respectively. There were positive CD24 in 7 patients, MMP9 in 16 patients, survivin in 8 patients, and {beta}-catenin in 3 patients. On univariate analysis, there was no significant value of immunohistochemical results for clinical outcomes. There was no significant association between clinical outcomes of patients with EHBD cancer who received chemoradiotherapy after R2 resection or bypass surgery and pAKT, CD24, MMP9, survivin, and {beta}-catenin. Future research is needed on a larger data set or with other molecular biomarkers.

  7. PS1-42: Beyond Risk Reduction: Decision-Making Factors Among Breast Cancer Patients Undergoing Contralateral Prophylactic Mastectomy

    Science.gov (United States)

    Rendle, Katharine; Halley, Meghan; Ventre, Nicole; Frosch, Dominick; May, Suepattra

    2013-01-01

    Background/Aims Women diagnosed with unilateral breast cancer are electing to undergo contralateral prophylactic mastectomy (CPM)—or removal of the healthy breast—at rapidly increasing rates worldwide. CPM significantly reduces the risk of recurrence of contralateral breast cancer; however, it is also believed to be unnecessary for most patients due to the relatively low risk of contralateral breast cancer, and the effectiveness of less invasive treatment options. Additionally, since the risk of systemic metastases often exceeds the risk of contralateral breast cancer, most patients will not receive any survival benefit. As such, there is a growing need to understand why patients are electing to have CPM. Drawing from prospective, in-depth interviews with breast cancer patients, we explore how women are making this decision and investigate what factors beyond risk reduction may be impacting their decision. Methods Participants were recruited from a multispecialty clinic in Northern California. Participants were interviewed at four time points during their treatment journey. Medical records for each participant were reviewed to confirm therapies received. Analysis of interview transcripts used grounded theory to identify emergent decision-making factors across participants. Results Of the 41 patients enrolled in the study, 11 (27%) women elected to have CPM. The majority of these women underwent BCRA testing (9 or 82%), but only two women received a positive result. Influential factors identified across participants were: 1) desire to reduce or avoid breast cancer treatment; 2) having a close relationship with someone who died from breast cancer; 3) wanting to maintain (or improve) breast appearance; and 4) receiving imaging results that showed “suspicious” but ultimately benign changes in their healthy breast. Conclusions The decision to undergo CPM is impacted by a variety of factors including, but not limited to, risk reduction. Moreover, perceptions of

  8. The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Andersen, Christina; Adamsen, Lis; Møller, Tom

    2006-01-01

    these scores in questionnaires. Twelve possible symptoms/side-effects were registered daily: lack of appetite, nausea, vomiting, diarrhea, paraesthesia, constipation, physical fatigue, mental fatigue, treatment-related fatigue, muscle pain, arthralgia and other pain. During the intervention a decrease....../side-effects than patients with no evidence of disease (n=28) (P=0.027). The results indicate that a six weeks multidimensional exercise intervention undertaken by cancer patients with or without residual disease while undergoing chemotherapy can lead to a reduction in treatment-related symptoms....

  9. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection.

    Directory of Open Access Journals (Sweden)

    Clara Bayarri-Lara

    Full Text Available Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC.56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR expression.51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1% (p = 0.035. The mean number of CTCs was 3.16 per 10 ml (range 0-84 preoperatively and 0.66 (range 0-3 in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018 and a shorter disease free survival (DFS (p = .008. In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50-21.946, p = 0.010 and N status (HR = 0.296, 95% CI: 0.091-0.961, p = 0.043 were independent prognostic factors for DFS.CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence.

  10. Predictors of Pathologic Complete Response in Rectal Cancer Patients Undergoing Total Mesorectal Excision After Preoperative Chemoradiation.

    Science.gov (United States)

    Han, Yoon Dae; Kim, Woo Ram; Park, Seung Wan; Cho, Min Soo; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu

    2015-11-01

    Preoperative chemoradiotherapy (CRT) is the standard of care for patients with stage II and III rectal cancer. This strategy leads to pathologic complete response (pCR) in a significant number of patients. Factors predictive of pCR are currently being extensively investigated. The aim of this study was to analyze clinical factors that might be predictive of pCR.This study was a retrospective analysis of rectal cancer patients from January 2004 through December 2012. A total of 332 stage II and III patients with middle and low rectal cancer (≤10 cm) who received CRT and underwent curative total mesorectal excision were eligible. The median radiation dose was 50.4 Gy, and 72.6% of patients received infusional 5-fluorouracil with leucovorin, whereas 19.6% of patients received TS-1 with irinotecan, and 7.8% of patients received xeloda only. Pathologic complete response was confirmed by using pathologic specimens and analyzed based on predictive clinical factors.Among the 332 patients, 27.4% (n = 91) achieved pCR. Age, sex, body mass index, clinical T and N stages, tumor differentiation, the chemotherapy agent for CRT, and the time interval between CRT and surgery did not differ between the pCR and non-pCR groups. Carcinoembryogenic antigen (CEA) levels before CRT were 4.61 ± 7.38 ng/mL in the pCR group and 10.49 ± 23.83 ng/mL in the non-pCR group (P = 0.035). Post-CRT CEA levels were 1.4 ± 1.07 ng/mL in the pCR group and 2.16 ± 2.8 ng/mL in the non-pCR group (P = 0.014), and the proportion of middle rectal cancer patients was higher in pCR group (54.9%, P = 0.028). The results from multivariate logistic regression analysis indicated that higher tumor location (odds ratio 2.151; P = 0.003) and low post-CRT CEA level (odds ratio 0.789; P = 0.04) were independent predictive factors for pCR.Tumor location and post-CRT CEA level were predictive factors in pCR for rectal cancer patients. Therefore, these factors may

  11. Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

    DEFF Research Database (Denmark)

    Fredslund Hajdu, Sara Vinther; Wessel, Irene; Johansen, Christoffer

    2017-01-01

    BACKGROUND: Head and neck cancer (HNC) patients are often challenged by treatment induced dysphagia and trismus. Traditionally, rehabilitation is initiated when loss of function has already occurred. There is increasing evidence that it is of benefit to patients to initiate an early rehabilitation...... process before and during treatment. HNC patients have a unique set of functional challenges such as pre- and post-treatment dysphagia, pain and weight loss. The aim of the trial is to investigate the effects of swallowing and mouth-opening exercises combined with progressive resistance training (PRT...... that exercise according to protocol is tolerable and feasible....

  12. Comparison of Quality of Life and Nutritional Status in Gastric Cancer Patients Undergoing Gastrectomies.

    Science.gov (United States)

    Lim, Hee-Sook; Cho, Gyu-Seok; Park, Yoon-Hyung; Kim, Soon-Kyung

    2015-07-01

    The aim of this study was to compare the quality of life (QoL) depending on the postoperative survival period or nutritional status in gastric cancer patients. Surviving gastric cancer patients (n = 222) after the gastrectomy were included in the study at Soonchunhyang University Bucheon Hospital from April 2010 to August 2012. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and a gastric cancer-specific module, the EORTC QLQ-STO22, were used to assess the QoL. The postoperative survival period of the patients fell into two groups; the less-than-1-year group or the more-than-1-year group, and the nutritional status of the patients fell into three groups by a score of patient generated-subjective global assessment (SGA)-A, B, and C. As a result, the rate of malnutrition was 34.5% in the less-than-1-year group and 19.8% in the more-than-1-year group, respectively. Score for the fatigue (p = 0.006), loss of appetite (p = 0.002), reflux (p = 0.027) and body image (p = 0.004) in which the QoL was significantly lower in the less-than-1-year group than in the more-than-1-year group. The score of QoL according to the nutritional status of all subjects, overall health status (p = 0.043), physical functioning (p = 0.016), fatigue (p = 0.006), pain (p = 0.028), loss of appetite (p = 0.017), reflux (p = 0.003), eating restriction (p = 0.002), anxiety (p = 0.010), and body image (p = 0.001) was significantly lower in the SGA-C group than in other SGA groups. These results suggest that the nutritional status of the gastrectomy patients with stomach cancer may impact on their QoL. It is necessary to to develop nutritional intervention to improve QoL in gastric cancer patients with postoperative malnutrition.

  13. Music does not alter anxiety in patients with suspected lung cancer undergoing bronchoscopy

    DEFF Research Database (Denmark)

    Jeppesen, Elisabeth; Pedersen, Carsten M; Larsen, Klaus R;

    2016-01-01

    in the operating theatre, scores varied significantly between patients with and without music, with lower scores in the music group [median (interquartile range, IQR) 35 (18) vs. 43 (25); p=0.03]. Post hoc multiple regression revealed treatment group as insignificant when adjusting for sex and baseline anxiety......BACKGROUND: The use of music to relieve anxiety has been examined in various studies, but the results are inconclusive. METHODS: From April to October 2015, 160 patients undergoing examination of pulmonary nodules were randomly assigned to MusiCure or no music. MusiCure was administered through...... earplugs to ensure blinding of the staff and was played from admission to the operating theatre to the end of the bronchoscopy. Spielberger's State-Trait Anxiety Inventory (STAI) was administered on admission, immediately before bronchoscopy, and on discharge. Secondary outcomes were p...

  14. Circulating tumour cells in patients with lung cancer undergoing endobronchial cryotherapy.

    Science.gov (United States)

    Chudasama, Dimple; Rice, Alexandra; Soppa, Gopal; Anikin, Vladimir

    2015-08-01

    Early diagnosis of lung cancer still poses a major issue, with a large proportion of patients diagnosed at late stages. Therapeutic options and treatment remain limited in these patients. In most cases only palliative therapies are available to alleviate any severe symptoms. Endobronchial cryotherapy (EC) is one form of palliative treatment offered to patients with obstructive airway tumours. Although successful, the impact on circulating tumour cell (CTCs) spread has not been investigated in detail. This study recruited 20 patients awaiting EC treatment. Baseline and post EC blood samples were analysed for presence of CTCs. Results showed an increase in CTCs following EC in 75% of patients. Significant increases were noticeable in some cases. Although EC is a well-accepted modality of treatment to alleviate symptoms, it may lead to an increase in CTCs, which in turn may have implications for tumour dissemination and metastatic spread.

  15. Preventing prolonged post-operative ileus in gastric cancer patients undergoing gastrectomy and intra-peritoneal chemotherapy

    Institute of Scientific and Technical Information of China (English)

    De-Chuan Chan; Kuo-Liang Shen; Yao-Chi Liu; Cheng-Jueng Chen; Jyh-Cherng Yu; Heng-Cheng Chu; Fa-Chang Chen; Teng-Wei Chen; Huan-Fa Hsieh; Tzu-Ming Chang

    2005-01-01

    AIM: To assess the efficacy of metoclopramide (Met) for prevention of prolonged post-operative ileus in advanced gastric cancer patients undergoing D2 gastrectomy and intra-peritoneal chemotherapy (IPC).METHODS: Thirty-two advanced gastric cancer patients undergoing D2 gastrectomy and IPC were allocated to two groups. Sixteen patients received Met immediately after operation (group A), and 16 did not (group B). Another 16 patients who underwent D2 gastrectomy without IPC were enrolled as the control group (group C). All patients had received epidural pain control. The primary endpoints were time to first post-operative flatus and time until oral feeding with a soft diet without discomfort. Secondary endpoints were early complications during hospitalization.RESULTS: Gender, the type of resection, operating time,blood loss, tumor status and amount of narcotics were connparable in the three groups. However, the group C patients were older than those in groups A and B (67.5±17.7 vs 56.8±13.2, 57.5±11.7 years, P= 0.048). First bowel flatus occurred after 4.35±0.93 d in group A, 4.94±1.37 d in group B, and 4.71±1.22 d in group C (P>0.05). Oral feeding of a soft diet was tolerated 7.21±1.92 d after operation in group A, 10.15±2.17 d in group B, and 7.53±1.35 d in group C(groups A and C vsgroup B, P<0.05). There was no significant difference in respect to the first flatus among the three groups. However, the time of tolerating oral intake with soft food in groups A and C patients was significantly shorter than that in group B patients. Levels of C-reactive protein (CRP) were significantly lower in group C and there was a more prominent and prolonged response in CRP level in patients undergoing IPC. The incidence of post-operative complications was similar in the three groups except for prolonged post-operative ileus. There was no increased risk of anastomotic leakage in patients receiving Met.CONCLUSION: The results suggest that a combination of intravenous

  16. Treatment-associated severe thrombocytopenia affects survival rate in esophageal cancer patients undergoing concurrent chemoradiotherapy

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    Y M Huang

    2015-01-01

    Full Text Available Background: Esophageal cancer is commonly treated with surgery, concurrent chemoradiotherapy (CCRT, or a combination of both. The correlation between the hematological parameters during CCRT and early survival of esophageal cancer has not been fully evaluated. Materials And Methods: We analyzed the records of 65 esophageal cancer patients treated by CCRT between 2007 and 2010 retrospectively. The association between CCRT-associated myelosuppression, demographic variables, and survival rates were analyzed by univariate and multivariate analysis. Results: The univariate analysis showed that tumor extent of T3-4, a higher stage of tumor, a lower albumin level, grade 3 or higher anemia and thrombocytopenia, and interruptions in treatment affected survival rates. Further, the multivariate analysis revealed that stage IV (P = 0.030 is an independently negative prognostic factor for a one-year survival rate. Stage IV (P = 0.035, tumor extent of T3-4 (P = 0.002, and grade 3-4 thrombocytopenia (P = 0.015 are independently negative prognostic factors for a two-year survival rate. Conclusions: Severe decrease in platelet count during CCRT independently affects survival of esophageal cancer patients in addition to stage of the tumor.

  17. Pain management in head and neck cancer patients undergoing chemo-radiotherapy: Clinical practical recommendations.

    Science.gov (United States)

    Mirabile, A; Airoldi, M; Ripamonti, C; Bolner, A; Murphy, B; Russi, E; Numico, G; Licitra, L; Bossi, P

    2016-03-01

    Pain in head and neck cancer represents a major issue, before, during and after the oncological treatments. The most frequent cause of pain is chemo/radiation related oral mucositis, which involves 80% of the patients and worsens their quality of life inhibiting speaking, eating, drinking or swallowing and sometimes reducing the treatment compliance, the maximum dose intensity and thus the potential efficacy of treatment. Nevertheless pain is still often under estimated and undertreated. An Italian multidisciplinary group of head and neck cancer specialists met with the aim of reaching a consensus on pain management in this setting. The Delphi Appropriateness method was used for the consensus. External expert reviewers evaluated the final statements. The paper contains 30 consensus-reached statements about pain management in HNC patients and offers a review of recent literature in these topics.

  18. Preoperative pulmonary rehabilitation in lung cancer patients undergoing lung resection surgery

    OpenAIRE

    Sebio García, Raquel

    2016-01-01

    [Abstract] INTRODUCTION: Lung resection surgery (LRS) remains the treatment of choice for early stages of lung cancer but significant morbidity is associated, especially among patients with poor preoperative status. Preoperative exercise training (PET) has been proposed as an effective way of optimizing patients’ condition before surgery and enhancing postoperative recovery. However, it remains unknown whether or not similar results can be achieved after video-assisted thora...

  19. Effect of dietary supplementation with Agaricus sylvaticus fungus on the hematology and immunology systems of breast cancer patients undergoing chemotherapy

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    Fabiana VALADARES

    2011-06-01

    Full Text Available Objective: Patients with cancer tend to develop hematological and immunological alterations during the disease process. Medicinal fungi can stimulate the immune and hematopoietic systems, promoting improvements in the prognosis and physiological response. In this trial it is aimed to evaluate changes in hematological and immunological parameters in patients with breast cancer undergoing chemotherapy after dietary supplementation with Agaricus sylvaticus. Method: A randomized, double-blind, placebo-controlled study was carried out. 46 patients (stadiums II and III, were randomly assigned to receive either: nutritional supplement with A. sylvaticus (2.1 g/day or placebo. Patients received three cycles (n=26 and six cycles (n=20 of chemotherapy. Clinical and laboratory evaluations were performed. The results were analyzed using Microsoft Excel 2003 and R-version 2.11.1, significant results at p≤ 0.05. Results: The A. sylvaticus group showed an increase of hematocrits (p=0.04, red blood count (p=0.03, mean corpuscular hemoglobin concentration (p=0.001, leukocytes (p=0.03, monocytes (p=0.001, and total lymphocyte count (p=0.009 after three months. Those changes were not observed in the placebo group. After six months, patients receiving A. sylvaticus showed increased levels of red blood count (p=0.02, hemoglobin (p=0.02, hematocrits (p=0.02, corpuscular hemoglobin concentration (p=0.02, leukocytes (p=0.02; lymphocytes (p=0.02, neutrophils (p=0.02 and TLC (p=0.02. The placebo group showed a reduction in leukocytes (p=0.004, basophiles (p=0.005 and TLC (p=0.01. Conclusion: The results suggest the usefulness of dietary supplementation with A. sylvaticus in patients with breast cancer undergoing chemotherapy.

  20. {sup 18}F-FDG PET/CT predicts survival in patients with inflammatory breast cancer undergoing neoadjuvant chemotherapy

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    Carkaci, Selin [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); The Ohio State University, Department of Radiology, Columbus, OH (United States); Sherman, Christopher T.; Ozkan, Efe; Adrada, Beatriz E.; Yang, Wei T. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Wei, Wei [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Rohren, Eric M. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Mawlawi, Osama R. [The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, TX (United States); Ueno, Naoto T. [The University of Texas MD Anderson Cancer Center, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Department of Breast Medical Oncology, Houston, TX (United States); Buchholz, Thomas A. [The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX (United States)

    2013-12-15

    The objective of this study was to evaluate the role of {sup 18}F-FDG PET/CT in predicting overall survival in inflammatory breast cancer patients undergoing neoadjuvant chemotherapy. Included in this retrospective study were 53 patients with inflammatory breast cancer who had at least two PET/CT studies including a baseline study before the start of neoadjuvant chemotherapy. Univariate and multivariate analyses were performed to assess the effects on survival of the following factors: tumor maximum standardized uptake value (SUVmax) at baseline, preoperatively and at follow-up, decrease in tumor SUVmax, histological tumor type, grade, estrogen, progesterone, HER2/neu receptor status, and extent of disease at presentation including axillary nodal and distant metastases. By univariate analysis, survival was significantly associated with decrease in tumor SUVmax and tumor receptor status. Patients with decrease in tumor SUVmax had better survival (P = 0.02). Patients with a triple-negative tumor (P = 0.0006), a Her2/neu-negative tumor (P = 0.038) or an ER-negative tumor (P = 0.039) had worse survival. Multivariate analysis confirmed decrease in tumor SUVmax and triple-negative receptor status as significant predictors of survival. Every 10 % decrease in tumor SUVmax from baseline translated to a 15 % lower probability of death, and complete resolution of tumor FDG uptake translated to 80 % lower probability of death (P = 0.014). Patients with a triple-negative tumor had 4.11 times higher probability of death (P = 0.004). Decrease in tumor SUVmax is an independent predictor of survival in patients with inflammatory breast cancer undergoing neoadjuvant chemotherapy. Further investigation with prospective studies is warranted to clarify its role in assessing response and altering therapy. (orig.)

  1. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    Institute of Scientific and Technical Information of China (English)

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  2. 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

  3. Aromatase Inhibitor-Induced Erythrocytosis in a Patient Undergoing Hormonal Treatment for Breast Cancer

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    Sri Lakshmi Hyndavi Yeruva

    2015-01-01

    Full Text Available Aromatase inhibitors (AIs are most commonly used for breast cancer patients with hormone receptor positive disease. Although the side effect profile of aromatase inhibitors is well known, including common side effects like arthralgia, bone pain, arthritis, hot flashes, and more serious problems like osteoporosis, we present a case of an uncommon side effect of these medications. We report the case of a postmenopausal woman on adjuvant hormonal therapy with anastrozole after completing definitive therapy for stage IIIB estrogen receptor-positive breast cancer, who was referred to hematology service for evaluation of persistent erythrocytosis. Primary and known secondary causes of polycythemia were ruled out. On further evaluation, we found that her erythrocytosis began after initiation of anastrozole and resolved after it was discontinued. We discuss the pathophysiology of aromatase inhibitor-induced erythrocytosis and reference of similar cases reported in the literature.

  4. Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy.

    Science.gov (United States)

    Astrup, Guro Lindviksmoen; Rustøen, Tone; Miaskowski, Christine; Paul, Steven M; Bjordal, Kristin

    2015-05-01

    Pain is a common symptom in patients with head and neck cancer (HNC) that is associated with significant decrements in physical and psychological functioning. Only 4 studies have evaluated for changes in and predictors of different pain characteristics in these patients. In this longitudinal study of patients with HNC, changes in pain intensity (i.e., average pain, worst pain), pain interference with function, and pain relief were evaluated from the initiation of radiotherapy and through the following 6 months. Hierarchical linear modeling was used to evaluate for changes over time in these 4 pain characteristics, as well as to identify predictors of interindividual variability in each characteristic. Overall, pain intensity and interference with function scores were in the mild-to-moderate range, while pain relief scores were in the moderate range. The occurrence of pain, as well as scores for each pain characteristic, increased from the initiation to the completion of radiotherapy, followed by a gradual decrease to near pretreatment levels at 6 months. However, interindividual variability existed in patients' ratings of each pain characteristic. Predictors of more severe pain characteristic scores were more comorbidities, worse physical functioning, not having surgery before radiotherapy, difficulty swallowing, mouth sores, sleep disturbance, fatigue, more energy, and less social support. Patients with more depressive symptoms had better pain relief. Although some of the predictors cannot be modified (e.g., rrence of surgery), other predictors (e.g., symptoms) can be treated. Therefore, information about these predictors may result in decreased pain in patients with HNC.

  5. Quality of life of Brazilian and Spanish cancer patients undergoing chemotherapy: an integrative literature review

    Directory of Open Access Journals (Sweden)

    Namie Okino Sawada

    2016-01-01

    Full Text Available Objective: characterize the scientific production of Brazil and Spain in regard to methodological aspects and aspects of health-related quality of life experienced by cancer patients receiving chemotherapy in both countries. Method: integrative literature review was conducted using the following databases: CINAHL, MEDLINE, SCOPUS and CUIDEN and the electronic libraries PubMed and SciELO, conducted in September 2013. Results: a total of 28 papers met the inclusion criteria. The synthesis of knowledge was presented in three categories of analysis: assessment of quality of life in different types of cancer; sociodemographic factors that influenced quality of life; and type of cancer and interventions that improve quality of life. Chemotherapy affects health-related quality of life and the most important factors were: age, sex, chemotherapy protocol, type of surgery, stage of the disease, educational level, and emotional intelligence. Complementary therapies such as acupuncture, guided visualization, prayers and exercise were positive and reduced side effects. Conclusion: the results showed a poor level of evidence, since 86% of the studies were cross-sectional descriptive studies; the instrument most frequently used to measure health-related quality of life was EORTC QLQ C-30 and more studies were conducted in Brazil than in Spain.

  6. Safety and efficacy of resistance training in germ cell cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Tolver, Anders

    2014-01-01

    Abstract Background: Bleomycin–etoposid–cisplatin (BEP) chemotherapy is curative in most patients with disseminated germ cell cancer (GCC) but also associated with toxic actions and dysfunction in non-targeted tissues. We investigated changes in muscle function during BEP and the safety...... and efficacy of resistance training to modulate these changes. Methods: Thirty GCC patients were randomly assigned to resistance training (resistance training group (INT), n=15) or usual care (CON, n=15) during 9 weeks of BEP therapy. Resistance training consisted of thrice weekly sessions of four exercises, 3...... changes compared with the INT-group (PBEP was associated with significant reduction in lean mass and strength and trends toward unfavourable changes in muscle fibre size and phenotype composition. Resistance training was safe and attenuated dysfunction in selected endpoints, but BEP...

  7. Improvements in breast cancer pathology practices among medicare patients undergoing unilateral extended simple mastectomy.

    Science.gov (United States)

    Imperato, Pascal James; Waisman, Jerry; Wallen, Marcia D; Llewellyn, Christine C; Pryor, Veronica

    2003-01-01

    The information contained in pathology reports of breast cancer specimens is of critical importance to treating physicians for selection of local regional treatment, adjuvant therapy, evaluation of therapy, estimation of prognosis, and analysis of outcomes. This information is also of great importance to patients and their families. In 2000, a Breast Cancer Pathology Advisory Group was formed to advise on the design of a project to assess the quality of pathology reports on unilateral extended simple mastectomy (ICD-9-CM procedure code 85.43) specimens from Medicare patients in New York State. This group comprised clinical pathologists, breast surgeons, medical oncologists, clinical breast cancer specialists, and a radiation oncologist. The group suggested that the reports be examined for several elements (quality indicators) that are relevant to patient care and prognosis. Baseline random sample data assessing these elements were established from a random sample of all cases for the calendar year 1999. A random sample of 748 cases (43.5%) of unilateral extended simple mastectomy was chosen from among 1718 cases for the calendar year 1999. Of these, 555 (74.2%) were suitable for review. The remaining 193 (25.8%) cases did not satisfy the inclusion criteria. Aggregate performance on 7 quality indicators (presence of carcinoma, laterality of specimen, number of lymph nodes present, number of positive nodes, documentation of lymph nodes, histologic type, and largest dimension of the tumor) was 83.7% or better, whereas performance was 69.4% or less on 10 others (resection margin status, verification of tumor size, gross observation of the lesion, histologic grade, angiolymphatic invasion, nuclear grade, location of the tumor, mitotic rate, extent of tubule formation, and perineural invasion). The last, perineural invasion, was used as a control element and was not considered an evaluative quality indicator. Performance levels for New York State were significantly lower

  8. Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Rao Raghavendra

    2008-01-01

    Full Text Available Context : Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. Objective : The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Methods : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL-2 receptor (IL-2R, tumor necrosis factor (TNF-alpha and interferon (IFN-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. Results : Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36. The results suggest a significant decrease in the duration of hospital stay ( P = 0.003, days of drain retention ( P = 0.001 and days for suture removal ( P = 0.03 in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group ( P < 0.001, as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. Conclusion : The results suggest

  9. Can Mathematical Models Predict the Outcomes of Prostate Cancer Patients Undergoing Intermittent Androgen Deprivation Therapy?

    Science.gov (United States)

    Everett, R. A.; Packer, A. M.; Kuang, Y.

    Androgen deprivation therapy is a common treatment for advanced or metastatic prostate cancer. Like the normal prostate, most tumors depend on androgens for proliferation and survival but often develop treatment resistance. Hormonal treatment causes many undesirable side effects which significantly decrease the quality of life for patients. Intermittently applying androgen deprivation in cycles reduces the total duration with these negative effects and may reduce selective pressure for resistance. We extend an existing model which used measurements of patient testosterone levels to accurately fit measured serum prostate specific antigen (PSA) levels. We test the model's predictive accuracy, using only a subset of the data to find parameter values. The results are compared with those of an existing piecewise linear model which does not use testosterone as an input. Since actual treatment protocol is to re-apply therapy when PSA levels recover beyond some threshold value, we develop a second method for predicting the PSA levels. Based on a small set of data from seven patients, our results showed that the piecewise linear model produced slightly more accurate results while the two predictive methods are comparable. This suggests that a simpler model may be more beneficial for a predictive use compared to a more biologically insightful model, although further research is needed in this field prior to implementing mathematical models as a predictive method in a clinical setting. Nevertheless, both models are an important step in this direction.

  10. Improvement of QOL and Immunological Function With Lentinula Edodes Mycelia in Patients Undergoing Cancer Immunotherapy: An Open Pilot Study.

    Science.gov (United States)

    Tanigawa, Keishi; Itoh, Yusuke; Kobayashi, Yasunobu

    2016-07-01

    Context • Combined treatment with an extract of Lentinula edodes mycelia (LEM) and chemotherapy has been reported to improve quality of life (QOL) and immunological function in cancer patients. However, those effects have not been elucidated for patients receiving cancer immunotherapy. Objective • The present study intended to investigate the effects of oral LEM on QOL and immunological function in cancer patients receiving immunotherapy. Design • The research team designed an open-label, single-armed pilot study. Setting • The study took place at Bio-Thera Clinic, a facility associated with Tokyo Women's Medical University in Tokyo, Japan. Participants • The participants were 10 cancer patients undergoing cancer immunotherapy at Bio-Thera Clinic. Intervention • The participants received either dendritic cell (DC)-based cancer vaccine therapy or CD3-activated T-lymphocyte (CAT) therapy as immunotherapy. They received the immunotherapy only for the first 4 wk of the study, and then oral LEM (1800 mg/d) was added for the next 4 wk. Outcome Measures • Preintervention and at 4 and 8 wk after the start of the study, participants completed a QOL survey, and immunological parameters were measured. Results • Participants' QOL symptom scores increased (ie, worsened) by 5.1 ± 1.7 during the first 4 wk of treatment when they were receiving immunotherapy only, but it decreased (ie, improved) by -2.5 ± 1.6 during the next 4 wk when the immunotherapy was combined with the LEM, P immunotherapy combined with LEM showed that the amount of interferon-γ (IFN-γ) produced in the peripheral blood tended to increase as compared with that during the first 4 wk of immunotherapy only. The rise in IFN-γ was correlated with changes in several regulatory T cells (Tregs) (ie, forkhead box P3 [FOXP3]+/cluster of differentiation 4 [CD4]+ and transforming growth factor beta [TGF-β]). Conclusions • The findings suggest that a combined treatment of LEM and immunotherapy might

  11. Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial.

    Science.gov (United States)

    Kang, Wen-Xing; Li, Wentao; Huang, Shi-Gao; Dang, Yazhang; Gao, Hongxiang

    2016-09-01

    Head and neck malignant tumors have numerous locations of the disease. After patients receive radiotherapy, their nutritional status is very poor, thus the curative effect is unsatisfactory. The aims of the present study were to investigate and analyze the nutritional status of patients with head and neck cancer undergoing radiotherapy (RT) in order to provide positive nutrition intervention for assisting the radiotherapy effect. A total of 40 patients with head and neck cancer were selected using a method of subjective global assessment (SGA) to assess nutritional status, including calorie intake and energy expenditure. In a randomized, controlled study, 20 patients received intensive dietary counseling and nutritional therapy (G1) and 20 received regular dietary as controls (G0) preradiotherapy and postradiotherapy. The primary endpoint was calorie intake and energy expenditure. The secondary endpoint was SGA rating with nutritional therapy. At the end of RT, energy intake showed a net increase in G1 (1,691±301 kcal) compared with that in G0 (1,066±312 kcal) (Pnutritional intervention can effectively prevent weight loss and muscle wasting. Additionally, it may improve quality of life by decreasing the frequency of severe malnutrition.

  12. Factors associated with cancer-related fatigue in breast cancer patients undergoing endocrine therapy in an urban setting: a cross-sectional study

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    Huang Xu

    2010-08-01

    Full Text Available Abstract Background Fatigue is prevalent in breast cancer survivors and has profound effects on daily life. The interference of fatigue with endocrine therapy may be difficult to separate. This study investigates the prevalence and severity of fatigue and identifies the demographic, clinical, and lifestyle factors associated with cancer-related fatigue (CRF in breast cancer patients undergoing endocrine therapy in an urban area. Methods Women with stage I-IIIA breast cancer were recruited and asked to participate (n = 371 in the study. The 315 women who responded to the questionnaire (84.9%, 54 (17.1% had completed endocrine therapy and 261 (82.9% were still undergoing endocrine therapy. The patients had been diagnosed at an average of 31 months prior to recruitment (range, 7 to 60 months; the average age was 48 (range, 33 to 72 years. The 11-point scale and Visual Analog Scale (VAS were employed to quantify the level of fatigue experienced by the patients. Logistic regression analyses and a trend test method were performed to evaluate factors associated with CRF. Results Among the 315 patients, 189 (60% had experienced or were experiencing CRF during endocrine therapy. Logistic regression analysis was performed to identify factors associated with CRF, including BMI (body mass index, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet. Factors unrelated to CRF were age, marital status, treatment, endocrine therapy drugs, alcohol intake, and smoking. The trend test method revealed an association between physical activity and dietary level and the intensity of CRF. Conclusions The present findings suggest that fatigue is an important problem in the majority of breast cancer patients during endocrine therapy. We found that BMI, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet are associated with fatigue. Future research should focus on the impact factors of CRF

  13. Reducing psychological distress in patients undergoing chemotherapy.

    Science.gov (United States)

    Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

    Psychological distress is a common problem among patients with cancer, yet it mostly goes unreported and untreated. This study examined the association of a psycho-educational intervention with the psychological distress levels of breast cancer and cervical cancer patients undergoing chemotherapy. The design of the study was quasi-experimental, pretest-posttest design with a comparison group. One hundred patients at a cancer hospital in Jakarta, Indonesia, completed Distress Thermometer screening before and after chemotherapy. Fifty patients in the intervention group were given a psycho-educational video with positive reappraisal, education and relaxation contents, while receiving chemotherapy. Patients who received the psycho-educational intervention had significantly lower distress levels compared with those in the control group. Routine distress screening, followed by distress management and outcome assessment, is needed to improve the wellbeing of cancer patients.

  14. Effect of volume replacement with hydroxyethyl starch solution on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    郭向阳; 徐仲煌; 任洪智; 罗爱伦; 黄宇光; 叶铁虎

    2003-01-01

    Objective To investigate the effectiveness of using a medium molecular weight hydroxyethyl starch solution (HES) administered as a replacement for estimated blood loss (EBL) during cytoreductive surgery for ovarian cancer on splanchnic oxygenation. Methods Forty-two patients undergoing cytoreductive surgery for ovarian cancer were enrolled in this prospective randomized study. As soon as the EBL exceeded 10% but was less than 20% of the estimated blood volume, the patients were randomly assigned to receive either a volume of lactated Ringer's solution (LRS) equal to three times the EBL (LRS group, n=22) or a volume of 6% HES equal to the EBL (HES group, n=20). Tissue oxygenation was assessed indirectly by measuring tonometric parameters, including the difference between gastric intramucosal PsCO2 and arterial PaCO2 (Ps-a CO2 gap), gastric intramucosal pH (pHi) and arterial lactate acid concentration at 30 min after induction of anesthesia (baseline value), 1 hour and 2 hours after skin incision, and at the end of surgery. Results At the end of surgery,the Ps-a CO2 gap in the HES group (8.7±1.6 mmHg) was significantly lower than that of the LRS group (18.74±4.4 mmHg, P<0.01), while the pHi (7.30±0.05 mmHg) in the HES group was significantly higher than that of the LRS group (7.21±0.07 mmHg, P<0.01). There was no significant difference between the two groups in terms of arterial lactate acid concentration. Conclusion In patients undergoing major surgery with relatively large blood losses, volume resuscitation with medium molecular weight hydroxyethyl starch solution may improve splanchnic blood flow and tissue oxygenation.

  15. Effect on changes of blood coagulation function, cytokines and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jia-Qi Liu; Shao-Jun Yang; Jie-Qing Chen; Ru-Kui Su; Zhong Huang; Yin-Zhuo Qi

    2017-01-01

    Objective:To explore the changes of coagulation function, cytokines and T lymphocyte in patients undergoing laparoscopic radical gastrectomy for gastric cancer and its clinical significance.Methods: 40 cases of laparoscopic radical gastrectomy for gastric cancer patients and 40 cases of open radical gastrectomy for gastric cancer patients in our hospital were selected to detect and investigate the perioperative coagulation function [APTT (activated partial thromboplastin time), FIB (fibrinogen), and PLT (platelet)], cytokines [CRP (C reactive protein), IL-6 (IL-6) and TNF-alpha (Tumor necrosis factor-alpha)] and T lymphocytes (CD4+, CD8+ and CD4+/CD8+) changes and clinical meaning of patients in the two groups.Results: The coagulation function related indicators, cytokines and T lymphocytes of the two groups before treatment did not change significantly (P>0.05). 1 d after operation, blood coagulation, TNF-alpha, CD4+ and CD4+/CD8+ levels were significantly lower than that before operation in two groups of patients (P<0.05), while IL-6, CRP and CD8+ were significantly higher than that before the operation (P<0.05), and the index change in open group was more obvious. 3 d after surgery, the APTT, IL-6, CRP, CD4+, CD8+ and PLT levels in two group patients were significantly lower than that 1 d after surgery, while FIB, TNF-alpha and CD4+/CD8+ were significantly higher than that 1 d after surgery; blood coagulation index, TNF-alpha and CD4+ and CD4+/CD8+ were significantly lower in the laparotomy group patients than in laparoscopic group, while IL-6, CRP and CD8+ were significantly higher than the laparoscopic group (P<0.05). 5 d after operation, the APTT, TNF-alpha, FIB, CD4+, CD4+/CD8+ and PLT in two groups were significantly higher than that 3 d after surgery (P<0.05), while IL-6, CRP and CD8+ levels were significantly lower than that of 3 d after surgery (P<0.05); blood coagulation index, TNF-alpha and CD4+ and CD4+/CD8+ in the laparotomy group patients were

  16. Prognostic implication of human papillomavirus types and species in cervical cancer patients undergoing primary treatment.

    Science.gov (United States)

    Lau, Yat Ming; Cheung, Tak Hong; Yeo, Winnie; Mo, Frankie; Yu, Mei Yung; Lee, Kun Min; Ho, Wendy C S; Yeung, Apple C M; Law, Priscilla T Y; Chan, Paul K S

    2015-01-01

    High-risk human papillomavirus (HPV) types are associated with cervical cancer. It is well established that individual HPV types vary in oncogenicity, but current data on their prognostic implication remain controversial. We examined the association between HPV types/species and the survival of 236 Chinese women aged 26-87 (mean 54.4) years after receiving primary treatment for cervical cancer. Overall, 45.8% were of FIGO stage I, 41.9% stage II, and 12.3% stage III. The four most prevalent types found were HPV-16 (60.2%), HPV-18 (21.6%), HPV-52 (11.9%), and HPV-58 (9.3%). Overall, 19.5% of patients had multiple-type infections, 78.4% harboured one or more alpha-9 species, and 28.8% harboured one or more alpha-7 species. After a median follow-up of 8.0 years, 156 (66.1%) patients survived. The 3-year overall survival rate was 75.5%. Factors independently associated with a poorer 3-year overall survival were age >60 years, tumour size >4 cm, lymph node involvement and treatment with radiotherapy+/-chemotherapy. Univariate analysis showed HPV-16 single-type infection was associated with a marginally poorer disease-specific survival (71.6% vs. 87.0%, HR: 1.71, 95% CI = 1.01-2.90), whereas non-HPV-16 alpha-9 species was associated with a better disease-specific survival (90.0% vs. 76.2%, HR: 0.36, 95% CI = 0.16-0.79). However, on multivariate analysis, HPV infection status irrespective of different grouping methods, including individual types, species, single-type or co-infection, did not carry any significant prognostic significance. In conclusion, we did not observe any association between infection with a particular HPV type/species and survival. An HPV type-based stratification in treatment and follow-up plan could not be recommended.

  17. Prognostic implication of human papillomavirus types and species in cervical cancer patients undergoing primary treatment.

    Directory of Open Access Journals (Sweden)

    Yat Ming Lau

    Full Text Available High-risk human papillomavirus (HPV types are associated with cervical cancer. It is well established that individual HPV types vary in oncogenicity, but current data on their prognostic implication remain controversial. We examined the association between HPV types/species and the survival of 236 Chinese women aged 26-87 (mean 54.4 years after receiving primary treatment for cervical cancer. Overall, 45.8% were of FIGO stage I, 41.9% stage II, and 12.3% stage III. The four most prevalent types found were HPV-16 (60.2%, HPV-18 (21.6%, HPV-52 (11.9%, and HPV-58 (9.3%. Overall, 19.5% of patients had multiple-type infections, 78.4% harboured one or more alpha-9 species, and 28.8% harboured one or more alpha-7 species. After a median follow-up of 8.0 years, 156 (66.1% patients survived. The 3-year overall survival rate was 75.5%. Factors independently associated with a poorer 3-year overall survival were age >60 years, tumour size >4 cm, lymph node involvement and treatment with radiotherapy+/-chemotherapy. Univariate analysis showed HPV-16 single-type infection was associated with a marginally poorer disease-specific survival (71.6% vs. 87.0%, HR: 1.71, 95% CI = 1.01-2.90, whereas non-HPV-16 alpha-9 species was associated with a better disease-specific survival (90.0% vs. 76.2%, HR: 0.36, 95% CI = 0.16-0.79. However, on multivariate analysis, HPV infection status irrespective of different grouping methods, including individual types, species, single-type or co-infection, did not carry any significant prognostic significance. In conclusion, we did not observe any association between infection with a particular HPV type/species and survival. An HPV type-based stratification in treatment and follow-up plan could not be recommended.

  18. Effect of deep anesthesia on blood gas and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Zhen Wang; Xiao-Fan Li; Hui Wang; Zhi-Jun Mao; Tong Xue; Rui Yang

    2016-01-01

    Objective:To investigate the effects of deep anesthesia on blood gas and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer. Methods:A total of 84 gastric cancer patients in our hospital were randomly divided into observation group (42 cases) and control group (42 cases). Patients in observation group were treated by deep anesthesia, while the control group was treated with shallow anesthesia. The blood gas was observed and compared before and after CO2 pneumoperitoneum, and the immune function was observed and compared before anesthesia, after operation and 72 h post-operation. Results:The PaCO2 and pH level of patients in the two groups had no significant difference before pneumoperitoneum;Compared with before pneumoperitoneum, no obvious blood gas change was observed in the observation group, the difference had no statistically significant;Blood gas level of control group was significantly higher than that of before pneumoperitoneum , the difference was statistically significant, pH (7.26±0.07) was statistically decreased;After pneumoperitoneum, the level of PaCO2 and pH was significantly different in both groups , the difference was statistically significant. Indexes of the patients in the observation and control group of CD3+, CD4+, CD4+/CD8+, NK level had no significant difference before anesthesia, the difference was not statistically significant;The immunology index of CD3+, CD4+, CD4+/CD8+and NK cell levels of the postoperative patients in both groups were significantly lower than before anesthesia, and the differences were statistically significant, but each index in the observation group decreased significantly less than that of the control group, the difference was statistically significant;The immunological indexes can be restored to before anesthesia postoperative 72 h with two groups, and had no significant difference. Conclusion:The blood gas analysis index was stable and the immune function was suppressed in

  19. A systematic review of dental disease in patients undergoing cancer therapy

    NARCIS (Netherlands)

    Hong, Catherine H. L.; Napnas, Joel J.; Hodgson, Brian D.; Stokman, Monique A.; Mathers-Stauffer, Vickie; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    2010-01-01

    This purpose of this systematic review was to evaluate the literature and update our current understanding of the impact of present cancer therapies on the dental apparatus (teeth and periodontium) since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies. A s

  20. The Effect of Guided Imagery on Stress and Fatigue in Patients with Thyroid Cancer Undergoing Radioactive Iodine Therapy

    Directory of Open Access Journals (Sweden)

    Mi Hye Lee

    2013-01-01

    Full Text Available This study was conducted to evaluate the effects of guided imagery on stress and fatigue in patients undergoing radioactive iodine therapy after thyroidectomy in Korea. Participants were 84 individuals (44 for experimental group and 40 for control group with thyroid cancer. The experimental group listened to a guided imagery CD once a day for 4 weeks. Global Assessment of Recent Stress and Revised Piper Fatigue Scale were self-administered, and heart rate variability was measured at three time points; prior to intervention (T1, just before intervention (T2 and 1 week later after intervention (T3. Heart rate variability was consisted of Standard Deviation of all NN interval (SDNN, Total Power (TP, Low Frequency (LF, and High Frequency (HF. There were significant decreases in stress (F = 28.45, and fatigue (F = 26.17, over time in the experimental group compared to the control group. Heart rate variability changed over time in the experimental group relative to the control group; SDNN (F = 6.68, P = 0.002, TP (F = 5.29, , LF (F = 4.58, P = 0.012, and HF (F = 3.71, . From the results of this study guided imagery can be recommended as an effective intervention to thyroid cancer patients with stress and fatigue.

  1. Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation.

    Science.gov (United States)

    Chang, Pei-Hung; Yeh, Kun-Yun; Huang, Jen-Seng; Lai, Chien-Hong; Wu, Tsung-Han; Lan, Yii-Jenq; Tsai, Jason Chien-Sheng; Chen, Eric Yen-Chao; Yang, Shih-Wei; Wang, Cheng-Hsu

    2013-05-01

    Unexpected fatal events in patients with head and neck cancers undergoing concurrent chemoradiation therapy are a clinical concern. Malnutrition, which is reported frequently in head and neck cancer patients, are associated with immunity derangement. The purpose of this study was to identify risk factors for early death of patients undergoing chemoradiation. We retrospectively analyzed the records of 194 stage III, IVA, and IVB head and neck cancer patients who were treated with chemoradiation between 2007 and 2009. We defined early death as death while receiving chemoradiation or within 60 days of treatment completion. Risk factors for early death were tested using univariate and multivariate analyses. Fourteen patients (7.2 %) experienced early death, 78.6 % of whom died of infection. Univariate analysis revealed significant correlations between early death and several pretreatment variables, including Eastern Cooperative Oncology Group performance status (PS) >1, hemoglobin total lymphocyte count 1, BMI total lymphocyte count malnutrition before chemoradiation independently predict early death in locally advanced head and neck cancer patients undergoing chemoradiation. Cautious management of head and neck cancer patients with these risk factors is required throughout chemoradiation period.

  2. Type I Collagen Synthesis Marker Procollagen I N-Terminal Peptide (PINP) in Prostate Cancer Patients Undergoing Intermittent Androgen Suppression

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, Gerhard, E-mail: gerhard.hamilton@toc.lbg.ac.at; Olszewski-Hamilton, Ulrike [Ludwig Boltzmann Cluster of Translational of Oncology, Nussdorfer Strasse 64, Vienna A-1090 (Austria); Theyer, Gerhard [Hospital Kittsee, Kittsee A-2421, Burgenland (Austria)

    2011-09-15

    Intermittent androgen suppression (IAS) therapy for prostate cancer patients attempts to maintain the hormone dependence of the tumor cells by cycles alternating between androgen suppression (AS) and treatment cessation till a certain prostate-specific antigen (PSA) threshold is reached. Side effects are expected to be reduced, compared to standard continuous androgen suppression (CAS) therapy. The present study examined the effect of IAS on bone metabolism by determinations of serum procollagen I N-terminal peptide (PINP), a biochemical marker of collagen synthesis. A total of 105 treatment cycles of 58 patients with prostate cancer stages ≥pT2 was studied assessing testosterone, PSA and PINP levels at monthly intervals. During phases of AS lasting for up to nine months PSA levels were reversibly reduced, indicating apoptotic regression of the prostatic tumors. Within the first cycle PINP increased at the end of the AS period and peaked in the treatment cessation phase. During the following two cycles a similar pattern was observed for PINP, except a break in collagen synthesis as indicated by low PINP levels in the first months off treatment. Therefore, measurements of the serum PINP concentration indicated increased bone matrix synthesis in response to >6 months of AS, which uninterruptedly continued into the first treatment cessation phase, with a break into each of the following two pauses. In summary, synthesis of bone matrix collagen increases while degradation decreases during off-treatment phases in patients undergoing IAS. Although a direct relationship between bone matrix turnover and risk of fractures is difficult to establish, IAS for treatment of biochemical progression of prostate tumors is expected to reduce osteoporosis in elderly men often at high risk for bone fractures representing a highly suitable patient population for this kind of therapy.

  3. Commentary on “Music Does Not Alter Anxiety in Patients with Suspected Lung Cancer Undergoing Bronchoscopy: A Randomised Controlled Trial” – European Clinical Respiratory Journal

    DEFF Research Database (Denmark)

    Jeppesen, Elisabeth; Pedersen, Carsten Michel

    2016-01-01

    Introduction Not only may the prognosis of lung cancer provoke fear in patients with suspected lung cancer undergoing bronchoscopy, but also the thought of undergoing bronchoscopy may provoke fear [1]. This can be fear of pain, of shortness of breath and also fear of death in connection...... with the bronchoscopy (Figure 1). depression-anxiety-Department-Respiratory-Medicine Figure 1: Patient from Department of Respiratory Medicine, Bispebjerg Hosptial, who had supporting colleagues who printed this t-shirt for her. This patient expressed major worries about the bronchoscopy she had to undergo. The aim...... of the study was to measure the effect of “MusiCure -music as medicine”, on bronchoscopy-related anxiety. We hypothesised that MusiCure reduces bronchoscopy-related anxiety. MusiCure is music composed by the danish composer Niels Eje. There are contradictory findings both on the effect of MusiCure on anxiety...

  4. Trajectories of fatigue in family caregivers of patients undergoing radiation therapy for prostate cancer.

    Science.gov (United States)

    Fletcher, Barbara A Swore; Schumacher, Karen L; Dodd, Marylin; Paul, Steven M; Cooper, Bruce A; Lee, Kathryn; West, Claudia; Aouizerat, Bradley E; Swift, Patrick S; Wara, William; Miaskowski, Christine

    2009-04-01

    Predictors of and trajectories for evening and morning fatigue were evaluated in family caregivers of oncology patients using hierarchical linear modeling. Evening fatigue trajectory fit a quadratic model. Predictors included baseline sleep disturbances in family caregivers and baseline evening fatigue in patients. Morning fatigue trajectory fit a linear model. Predictors were baseline trait anxiety, levels of perceived family support, and baseline morning fatigue in patients. Findings suggest considerable inter-individual variability in the trajectories of evening and morning fatigue. Evaluating family caregivers for sleep disturbance, anxiety, and poor family support, as well as high levels of patient fatigue, could identify those family caregivers at highest risk for sustained fatigue trajectories.

  5. Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy

    NARCIS (Netherlands)

    Berg, van den M.G.A.; Rasmussen-Conrad, E.L.; Wei, K.H.; Lintz-Luidens, H.; Kaanders, J.H.A.M.; Merkx, M.A.W.

    2010-01-01

    Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (S

  6. Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy.

    NARCIS (Netherlands)

    Berg, M.G. van den; Rasmussen-Conrad, E.L.; Wei, K.H.; Lintz-Luidens, H.; Kaanders, J.H.A.M.; Merkx, M.A.W.

    2010-01-01

    Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (S

  7. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy : A Dutch randomized controlled multicentre trial (BOOG 2013-07)

    NARCIS (Netherlands)

    Roozendaal, L.M.; de Wilt, J.H.; van Dalen, T.; van der Hage, J.A.; Strobbe, L.J.; Boersma, L.J.; Linn, S.C.; Lobbes, M.B.; Poortmans, P.M.P.; Tjan-Heijnen, V. C. G.; van de Vijver, K.K.; Westenberg, A.G.; Kessels, A.G.; Smidt, M.L.; de Vries, J.

    2015-01-01

    BACKGROUND: Trials failed to demonstrate additional value of completion axillary lymph node dissection in case of limited sentinel lymph node metastases in breast cancer patients undergoing breast conserving therapy. It has been suggested that the low regional recurrence rates in these trials might

  8. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

    DEFF Research Database (Denmark)

    Larsen, Ellen Frøsig Moseholm; Rydahl Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio......-demographic and medical factors associated with HRQoL at the time of diagnosis. Methods This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after...... completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. Results A total of 838 patients participated...

  9. Stepwise Application of Urine Markers to Detect Tumor Recurrence in Patients Undergoing Surveillance for Non-Muscle-Invasive Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Tilman Todenhöfer

    2014-01-01

    Full Text Available Background. The optimal use of urine markers in the surveillance of non-muscle-invasive bladder cancer (NMIBC remains unclear. Aim of the present study was to investigate the combined and stepwise use of the four most broadly available urine markers to detect tumor recurrence in patients undergoing surveillance of NMIBC. Patients and Methods. 483 patients with history of NMIBC were included. Cytology, UroVysion, fluorescence in situ hybridization (FISH, immunocytology (uCyt+, and NMP22 ELISA were performed before surveillance cystoscopy. Characteristics of single tests and combinations were assessed by contingency analysis. Results. 128 (26.5% patients had evidence of tumor recurrence. Sensitivities and negative predictive values (NPVs of the single tests ranged between 66.4–74.3 and 82.3–88.2%. Two-marker combinations showed sensitivities and NPVs of 80.5–89.8 and 89.5–91.2%. A stepwise application of the two-test combinations with highest accuracy (cytology and FISH; cytology and uCyt+; uCyt+ and FISH showed NPVs for high-risk recurrences (G3/Cis/pT1 of 98.8, 98.8, and 99.1%, respectively. Conclusions. Combinations of cytology, FISH, immunocytology, and NMP22 show remarkable detection rates for recurrent NMIBC. Stepwise two-test combinations of cytology, FISH, and immunocytology have a low probability of missing a high-risk tumor. The high sensitivities may justify the use of these combinations in prospective studies assessing the use of urine markers to individualize intervals between cystoscopies during follow-up.

  10. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

    DEFF Research Database (Denmark)

    Moseholm, Ellen; Rydahl-Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    AIM: Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact...... of socio-demographic and medical factors associated with HRQoL at the time of diagnosis. METHODS: This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality...... of life scale before and after completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. RESULTS...

  11. Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer.

    NARCIS (Netherlands)

    Gerritsen, A.; Bollen, T.L.; Nio, C.Y.; Molenaar, I.Q.; Dijkgraaf, M.G.; Santvoort, H.C. van; Offerhaus, G.J.; Brosens, L.A.; Biermann, K.; Sieders, E.; Jong, K.P. de; Dam, R.M. van; Harst, E. van der; Goor, H. van; Ramshorst, B. van; Bonsing, B.A.; Hingh, I.H. de; Gerhards, M.F.; Eijck, C.H. van; Gouma, D.J.; Borel Rinkes, I.H.M.; Busch, O.R.; Besselink, M.G.

    2015-01-01

    INTRODUCTION: Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing i

  12. Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer

    NARCIS (Netherlands)

    Gerritsen, Arja; Bollen, Thomas L.; Nio, C. Yung; Molenaar, I. Quintus; Dijkgraaf, Marcel G W; van Santvoort, Hjalmar C.; Offerhaus, G. Johan; Brosens, Lodewijk A.; Biermann, Katharina; Sieders, Egbert; de Jong, Koert P.; van Dam, Ronald M.; van der Harst, Erwin; van Goor, Harry; van Ramshorst, Bert; Bonsing, Bert A.; de Hingh, Ignace H.; Gerhards, Michael F.; van Eijck, Casper H.; Gouma, Dirk J.; Borel Rinkes, IHM; Busch, Olivier R C; Besselink, Marc G H

    2015-01-01

    INTRODUCTION: Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing i

  13. Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer

    NARCIS (Netherlands)

    Gerritsen, Atja; Bollen, Thomas L.; Nio, C. Yung; Molenaar, I. Quintus; Dijkgraaf, Marcel G. W.; van Santvoort, Hjalmar C.; Offerhaus, G. Johan; Brosens, Lodewijk A.; Biermann, Katharina; Sieders, Egbert; de Jong, Koert P.; van Dam, Ronald M.; van der Harst, Erwin; van Goor, Harry; van Ramshorst, Bert; Bonsing, Bert A.; de Hingh, Ignace H.; Gerhards, Michael F.; van Eijck, Casper H.; Gouma, Dirk J.; Rinkes, Inne H. M. Borel; Busch, Olivier R. C.; Besselink, Marc G. H.

    2015-01-01

    Introduction. Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing i

  14. Hypotension due to Chemotherapy in a Patient with Small Cell Lung Cancer and Lambert-Eaton Myasthenic Syndrome Undergoing Hemodialysis: A First Case Report

    Directory of Open Access Journals (Sweden)

    Taiji Kuwata

    2012-01-01

    Full Text Available We present the first case of small cell lung cancer with Lambert-Eaton myasthenic syndrome during hemodialysis (HD. A 72-year-old male patient receiving HD experienced progressive muscle weakness. He was diagnosed with small cell lung cancer with Lambert-Eaton myasthenic syndrome due to an increased serum level of anti-voltage-gated calcium channel antibody and aspiration cytology on endobronchial ultrasonography for the swelling of a subcarinal lymph node. He received chemotherapy consisting of carboplatin (300 mg/m2 and etoposide (50 mg/m2, to which he had a partial response. However, the second therapy course could not be administered because of the unexpected development of severe hematological adverse events, which also prevented him from undergoing further HD. This case indicates that caution should be taken when using chemotherapy for such patients because of hypotension due to chemotherapy, with which it is impossible to undergo HD.

  15. Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy

    OpenAIRE

    2010-01-01

    Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (SC). A prospective study, conducted between 2005 and 2007, compared individual dietary counselling (IDC, optimal energy and protein requirement) to SC by an oncology nurse (standard nutritional coun...

  16. Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy.

    OpenAIRE

    2010-01-01

    Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (SC). A prospective study, conducted between 2005 and 2007, compared individual dietary counselling (IDC, optimal energy and protein requirement) to SC by an oncology nurse (standard nutritional coun...

  17. Short-term Androgen-Deprivation Therapy Improves Prostate Cancer-Specific Mortality in Intermediate-Risk Prostate Cancer Patients Undergoing Dose-Escalated External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zumsteg, Zachary S.; Spratt, Daniel E.; Pei, Xin; Yamada, Yoshiya; Kalikstein, Abraham [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Kuk, Deborah; Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Zelefsky, Michael J., E-mail: zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-03-15

    Purpose: We investigated the benefit of short-term androgen-deprivation therapy (ADT) in patients with intermediate-risk prostate cancer (PC) receiving dose-escalated external beam radiation therapy. Methods and Materials: The present retrospective study comprised 710 intermediate-risk PC patients receiving external beam radiation therapy with doses of ≥81 Gy at a single institution from 1992 to 2005, including 357 patients receiving neoadjuvant and concurrent ADT. Prostate-specific antigen recurrence-free survival (PSA-RFS) and distant metastasis (DM) were compared using the Kaplan-Meier method and Cox proportional hazards models. PC-specific mortality (PCSM) was assessed using competing-risks analysis. Results: The median follow-up was 7.9 years. Despite being more likely to have higher PSA levels, Gleason score 4 + 3 = 7, multiple National Comprehensive Cancer Network intermediate-risk factors, and older age (P≤.001 for all comparisons), patients receiving ADT had improved PSA-RFS (hazard ratio [HR], 0.598; 95% confidence interval [CI], 0.435-0.841; P=.003), DM (HR, 0.424; 95% CI, 0.219-0.819; P=.011), and PCSM (HR, 0.380; 95% CI, 0.157-0.921; P=.032) on univariate analysis. Using multivariate analysis, ADT was an even stronger predictor of improved PSA-RFS (adjusted HR [AHR], 0.516; 95% CI, 0.360-0.739; P<.001), DM (AHR, 0.347; 95% CI, 0.176-0.685; P=.002), and PCSM (AHR, 0.297; 95% CI, 0.128-0.685; P=.004). Gleason score 4 + 3 = 7 and ≥50% positive biopsy cores were other independent predictors of PCSM. Conclusions: Short-term ADT improves PSA-RFS, DM, and PCSM in patients with intermediate-risk PC undergoing dose-escalated external beam radiation therapy.

  18. The effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review.

    Science.gov (United States)

    Kiss, Nicole K; Krishnasamy, Meinir; Isenring, Elisabeth A

    2014-01-01

    The prevalence of malnutrition in lung cancer patients across a variety of treatment modalities and disease stages ranges from 45% to 69%. Malnutrition is associated with poorer clinical outcomes in cancer patients. This systematic review examined whether dietary counseling or oral supplements during chemotherapy and/or radiotherapy in patients with lung cancer affect patient or clinical outcomes. Relevant nutrition intervention studies from 1980 to March 2012 were identified. Articles meeting predetermined inclusion/exclusion criteria were critically appraised and included in the review. The outcomes of interest included dietary intake, weight, nutritional status, quality of life, functional status, treatment response, and survival. Five eligible studies were identified including 3 randomized controlled trials, 1 historical cohort, and 1 case series. These studies suggest dietary counseling improves energy and protein intake during chemotherapy in patients with lung cancer but has no benefit to other outcomes during chemotherapy. There is insufficient evidence regarding the effect on patient or clinical outcomes during radiotherapy. Randomized trials examining dietary counseling in patients with lung cancer during radiotherapy are required.

  19. Effect of perioperative immuno-enhanced enteral nutrition on inflammatory response, nutritional status, and outcomes in head and neck cancer patients undergoing major surgery.

    Science.gov (United States)

    Felekis, Dimitrios; Eleftheriadou, Anna; Papadakos, Georgios; Bosinakou, Irini; Ferekidou, Eliza; Kandiloros, Dimitrios; Katsaragakis, Stylianos; Charalabopoulos, Konstantinos; Manolopoulos, Leonidas

    2010-01-01

    Administration of immuno-enhanced nutritional support may decrease postoperative morbidity, mortality, and infectious complications in cancer patients. The aim of this study was to verify that perioperative enteral diet, enriched with the nutrients arginine, ribonucleic acid (RNA), and ω-3 fatty acids improves outcomes of head and neck cancer patients undergoing major surgery. Forty patients with squamous cell carcinoma of the head and neck were studied. Group 1 received no preoperative nutritional support, whereas Group 2 received an oral formula with nutrients arginine, RNA, and ω-3 fatty acids. After surgery, Group 1 received a standard enteral formula, whereas Group 2 received an enriched enteral formula. Albumin (g/dl), prealbumin, fibrinogen, CRP, Il-6, and TNFa were measured 5 days before and 8 days after surgery. No statistically significant difference was observed for all the evaluated markers between postoperative and preoperative levels for both groups. The rate of complications was significantly reduced in the total number of patients receiving immunonutrition and in the particular subgroup of well-nourished patients receiving an immuno-enhanced diet. Perioperative enteral immuno-enhanced feeding in head and neck cancer patients undergoing major surgery may influence the postoperative outcomes by reducing the frequency rate of infections and wound complications.

  20. Concerns about Breast Cancer, Pain, and Fatigue in Non-Metastatic Breast Cancer Patients Undergoing Primary Treatment

    Directory of Open Access Journals (Sweden)

    Chelsea R. Amiel

    2016-08-01

    Full Text Available Women diagnosed with breast cancer often endorse psychosocial concerns prior to treatment, which may influence symptom experiences. Among these, low perceived social support relates to elevated fatigue. Those with low social support perceptions may also experience a greater sense of rejection. We sought to determine if social rejection concerns post-surgery predict fatigue interference 12 months later in women with non-metastatic breast cancer. Depressive symptoms and pain severity after completion of adjuvant therapy (six months post-surgery were examined as potential mediators. Women (N = 240 with non-metastatic breast cancer were recruited 2–10 weeks post-surgery. Multiple regression analyses examined relationships among variables adjusting for relevant covariates. Greater rejection concerns at study entry predicted greater fatigue interference 12 months later (p < 0.01. Pain severity after adjuvant therapy partially mediated the relationship between social rejection concerns and fatigue interference, with significant indirect (β = 0.06, 95% CI (0.009, 0.176 and direct effects (β = 0.18, SE = 0.07, t(146 = 2.78, p < 0.01, 95% CI (0.053, 0.311. Therefore, pain levels post-treatment may affect how concerns of social rejection relate to subsequent fatigue interference. Interventions targeting fears of social rejection and interpersonal skills early in treatment may reduce physical symptom burden during treatment and into survivorship.

  1. Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy

    DEFF Research Database (Denmark)

    Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren

    2017-01-01

    -, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM®) and thrombin generation. RESULTS: Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority...

  2. Effects of Honey on Oral Mucositis among Pediatric Cancer Patients Undergoing Chemo/Radiotherapy Treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia

    Science.gov (United States)

    Al Jaouni, Soad K.; Al Muhayawi, Mohammad S.; Hussein, Abear; Elfiki, Iman; Al-Raddadi, Rajaa; Al Muhayawi, Saad M.; Almasaudi, Saad

    2017-01-01

    One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis. A significant reduction of oral mucositis, associated Candida, and aerobic pathogenic bacterial infections was noted in patients in the honey treatment group. Also, there is a significant decrease in the duration of hospitalization for all those in the treatment group combined with a significant increase of body weight, delayed onset, and decreased severity of pain related to oral mucositis. Complications of oral mucositis can be tremendously reduced by the topical application of local Saudi honey and honey should be used as an integrative approach in prophylaxis and treatment of chemo/radiotherapy-induced oral mucositis in pediatric cancer patients. Further research is needed to elucidate and better understand the underlying mechanism.

  3. Comparison of dosimetric parameters and toxicity in esophageal cancer patients undergoing 3D conformal radiotherapy or VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Muench, Stefan; Aichmeier, Sylvia; Duma, Marciana-Nona; Oechsner, Markus; Habermehl, Daniel [TU Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Hapfelmeier, Alexander [TU Muenchen, Institute of Medical Statistics and Epidemiology (IMSE), Klinikum rechts der Isar, Muenchen (Germany); Feith, Marcus [TU Muenchen, Department of Visceral Surgery, Klinikum rechts der Isar, Muenchen (Germany); Combs, Stephanie E. [TU Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Oberschleissheim (Germany)

    2016-10-15

    Volumetric-modulated arc therapy (VMAT) achieves high conformity to the planned target volume (PTV) and good sparing of organs at risk (OAR). This study compares dosimetric parameters and toxicity in esophageal cancer (EC) patients treated with VMAT and 3D conformal radiotherapy (3D-CRT). Between 2007 and 2014, 17 SC patients received neoadjuvant chemoradiation (CRT) with VMAT. Dose-volume histograms and toxicity were compared between these patients and 20 treated with 3D-CRT. All patients were irradiated with a total dose of 45 Gy. All VMAT patients received simultaneous chemotherapy with cisplatin and 5-fluorouracil (5-FU) in treatment weeks 1 and 5. Of 20 patients treated with 3D-CRT, 13 (65 %) also received CRT with cisplatin and 5-FU, whereas 6 patients (30 %) received CRT with weekly oxaliplatin and cetuximab, and a continuous infusion of 5-FU (OE-7). There were no differences in baseline characteristics between the treatment groups. For the lungs, VMAT was associated with a higher V{sub 5} (median 90.1 % vs. 79.7 %; p = 0.013) and V{sub 10} (68.2 % vs. 56.6 %; p = 0.014), but with a lower V{sub 30} (median 6.6 % vs. 11.0 %; p = 0.030). Regarding heart parameters, VMAT was associated with a higher V{sub 5} (median 100.0 % vs. 91.0 %; p = 0.043), V{sub 10} (92.0 % vs. 79.2 %; p = 0.047), and D{sub max} (47.5 Gy vs. 46.3 Gy; p = 0.003), but with a lower median dose (18.7 Gy vs. 30.0 Gy; p = 0.026) and V{sub 30} (17.7 % vs. 50.4 %; p = 0.015). Complete resection was achieved in 16 VMAT and 19 3D-CRT patients. Due to systemic progression, 2 patients did not undergo surgery. The most frequent postoperative complication was anastomosis insufficiency, occurring in 1 VMAT (6.7 %) and 5 3D-CRT patients (27.8 %; p = 0.180). Postoperative pneumonia was seen in 2 patients of each group (p = 1.000). There was no significant difference in 3-year overall (65 % VMAT vs. 45 % 3D-CRT; p = 0.493) or 3-year progression-free survival (53 % VMAT vs. 35 % 3D-CRT; p = 0

  4. Skeletal Muscle Depletion Predicts the Prognosis of Patients with Advanced Pancreatic Cancer Undergoing Palliative Chemotherapy, Independent of Body Mass Index.

    Directory of Open Access Journals (Sweden)

    Younak Choi

    Full Text Available Body composition has emerged as a prognostic factor in cancer patients. We investigated whether sarcopenia at diagnosis and loss of skeletal muscle during palliative chemotherapy were associated with survival in patients with pancreatic cancer.We retrospectively reviewed the clinical outcomes of pancreatic cancer patients receiving palliative chemotherapy between 2003 and 2010. The cross-sectional area of skeletal muscle at L3 by computed tomography was analyzed with Rapidia 3D software. We defined sarcopenia as a skeletal muscle index (SMI< 42.2 cm2/m2 (male and < 33.9 cm2/m2 (female using ROC curve.Among 484 patients, 103 (21.3% patients were sarcopenic at diagnosis. Decrease in SMI during chemotherapy was observed in 156 (60.9% male and 65 (40.6% female patients. Decrease in body mass index (BMI was observed in 149 patients (37.3%, with no gender difference. By multivariate analysis, sarcopenia (P< 0.001, decreasedBMI and SMI during chemotherapy (P = 0.002, P = 0.004, respectively were poor prognostic factors for overall survival (OS. While the OS of male patients was affected with sarcopenia (P< 0.001 and decreased SMI (P = 0.001, the OS of female patients was influenced with overweight at diagnosis (P = 0.006, decreased BMI (P = 0.032 and decreased SMI (P = 0.014. Particularly, while the change of BMI during chemotherapy did not have impact on OS within the patients with maintained SMI (P = 0.750, decrease in SMI was associated with poor OS within the patients with maintained BMI (HR 1.502; P = 0.002.Sarcopenia at diagnosis and depletion of skeletal muscle, independent of BMI change, during chemotherapy were poor prognostic factors in advanced pancreatic cancer.

  5. Examination of a CRP first approach for the detection of postoperative complications in patients undergoing surgery for colorectal cancer

    Science.gov (United States)

    McSorley, Stephen T.; Khor, Bo Y.; MacKay, Graham J.; Horgan, Paul G.; McMillan, Donald C.

    2017-01-01

    Abstract The aim of the present study was to examine whether a C-reactive protein (CRP) first approach would improve the detection rate of postoperative complications by CT. CRP is a useful biomarker to identify major complications following surgery for colorectal cancer. Patients with histologically confirmed colorectal cancer, who underwent elective surgery between 2008 and 2015 at a single centre were included. Exceeding the established CRP threshold of 150 mg/L on postoperative day (POD) 4 was recorded. Results of CT performed between postoperative days 4 and 14 were recorded. Four hundred ninety-five patients were included. The majority were male (58%), over 65 (68%), with node-negative disease (66%) and underwent open surgery (70%). Those patients who underwent a CT scan (n = 93), versus those who did not (n = 402), were more likely to have a postoperative complication (84% vs 35%, P cancer. PMID:28207541

  6. Preoperative serum carcinoembryonic antigen, albumin and age are supplementary to UICC staging systems in predicting survival for colorectal cancer patients undergoing surgical treatment

    Directory of Open Access Journals (Sweden)

    Kuo Chao-Hung

    2009-08-01

    Full Text Available Abstract Background The aim of this study was to determine influence of prognostic factors in addition to UICC staging systems, on cancer-specific and overall survival rates for patients with colorectal cancer (CRC undergoing surgical treatment. Methods Between January 1996 and December 2006, a total of 1367 CRC patients who underwent surgical treatment in Kaohsiung Medical University Hospital were analyzed. We retrospectively investigated clinicopathologic features of these patients. All patients were followed up intensively, and their outcomes were investigated completely. Results Of 1367 CRC patients, there were seven hundred and fifty-seven males (55.4% and 610 (44.6% females. The median follow-up period was 60 months (range, 3–132 months. A multivariate analysis identified that low serum albumin level (P = 0.011, advanced UICC stage (P P P P P Conclusion Preoperative serum albumin level, CEA level and age could prominently affect postoperative outcome of CRC patients undergoing surgical treatment. In addition to conventional UICC staging system, it might be imperative to take these additional characteristics of factors into account in CRC patients prior to surgical treatment.

  7. Heavy Metal Exposure in Predicting Peripheral Neuropathy in Patients With Stage I-III Breast Cancer Undergoing Chemotherapy

    Science.gov (United States)

    2015-05-01

    Male Breast Cancer; Neurotoxicity; Peripheral Neuropathy; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  8. Radiobiological modeling analysis of the optimal fraction scheme in patients with peripheral non-small cell lung cancer undergoing stereotactic body radiotherapy

    OpenAIRE

    Bao-Tian Huang; Jia-Yang Lu; Pei-Xian Lin; Jian-Zhou Chen; De-Rui Li; Chuang-Zhen Chen

    2015-01-01

    This study aimed to determine the optimal fraction scheme (FS) in patients with small peripheral non-small cell lung cancer (NSCLC) undergoing stereotactic body radiotherapy (SBRT) with the 4 × 12 Gy scheme as the reference. CT simulation data for sixteen patients diagnosed with primary NSCLC or metastatic tumor with a single peripheral lesion ≤3 cm were used in this study. Volumetric modulated arc therapy (VMAT) plans were designed based on ten different FS of 1 × 25 Gy, 1 × 30 Gy, 1 × 34 Gy...

  9. The impact of chronic obstructive pulmonary disease on intensive care unit admission and 30-day mortality in patients undergoing colorectal cancer surgery

    DEFF Research Database (Denmark)

    Platon, Anna Maria; Erichsen, Rune; Christiansen, Christian Fynbo;

    2014-01-01

    all patients undergoing CRC surgery in the period 2005-2011, identified through medical databases. We categorised the patients according to the history of COPD. We assessed the rate of complications within 30 days. We computed 30-day mortality among patients with/without COPD using the Kaplan......-Meier method. We used Cox regression to compute HRs for death, controlling for age, gender, type of admission, cancer stage, hospital volume, alcohol-related diseases, obesity and Charlson comorbidity score. RESULTS: We identified 18 302 CRC surgery patients. Of these, 7.9% had a prior diagnosis of COPD. Among...... patients with COPD, 16.1% were admitted postoperatively to the intensive care unit, 1.9% were treated with mechanical ventilation, and 3.6% were treated with non-invasive ventilation. In patients without COPD, the corresponding proportions were 9.7%, 1.1% and 1.1%. The reoperation rate was 10.6% among...

  10. The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

    DEFF Research Database (Denmark)

    Quist, Morten; Adamsen, Lis; Rørth, Mikael

    2015-01-01

    of the present study was to investigate the benefits of a 6-week supervised group exercise intervention and to outline the effect on aerobic capacity, strength, health-related quality of life (HRQoL), anxiety, and depression. Methods: VO2peak was assessed using an incremental exercise test. Muscle strength......Introduction: Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic physical and psychosocial symptoms. Despite several years of research in exercise oncology, few exercise studies have targeted advanced lung cancer patients undergoing chemotherapy. The aim....... Forty-three patients dropped out. No serious adverse events were reported. Exercise adherence in the group training was 68%. Improvements in VO2peak (P

  11. SU-E-I-54: Effective Dose and Radiation Cancer Risks for Scoliosis Patients Undergoing Full Spine Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Y [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road., Kwei-Shan, Taoyuan 333, Taiwan (China); Hwang, Y [Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan (China); Tsai, H [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road., Kwei-Shan, Taoyuan 333, Taiwan (China); Medical Physics Research Center, Institute for Radiological Research, Chang Gung University / Chang Gung Memorial Hospital, Linkou, Taoyuan 33302, Taiwan (China); Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (China)

    2015-06-15

    Purpose: Scoliotic patients underwent a lot of radiologic examinations during the control and treatment periods. This study used the PCXMC program to calculate the effective dose of the patients and assess the radiation cancer risks. Methods: Seventy five scoliotic patients were examined using CR or DR systems during the control and treatment periods in Chang Gung Memorial Hospital. The technical factors were recorded for each patient during his/her control and treatment period. The entrance surface dose was measured using thermoluminence dosimeters and derived from technical factors and irradiated geometry. The effective dose of patients and relative radiation cancer risks were calculated by the PCXMC program. All required information regarding patient age and sex, the x-ray spectra, and the tube voltage and current were registered. The radiation risk were estimated using the model developed by the BEIR VII committee (2006). Results: The effective doses of full spine radiography with anteroposterior and lateral projections were 0.626 mSv for patients using DR systems, and 0.483mSv for patients using CR systems, respectively. The dose using DR system was 29.6% higher than those using CR system. The maximum organ dose was observed in the breast for both projections in all the systems. The risk of exposure—induced cancer death (REID) of patients for DR and CR systems were 0.009% and 0.007%, respectively. Conclusion: The risk estimates were regarded with healthy skepticism, placed more emphasis on the magnitude of the risk. The effective doses estimated in this study could be served as a reference for radiologists and technologists and demonstrate the necessity to optimize patient protection for full spine radiography though the effective doses are not at the level to induce deterministic effects and not significant in the stochastic effect. This study was supported by the grants from the Chang Gung Memorial Hospital (CMRPD1D0421)

  12. In vivo synergistic cytogenetic effects of aminophylline on lymphocyte cultures from patients with lung cancer undergoing chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mylonaki, Effie; Manika, Katerina [Pulmonary Department, “G.Papanikolaou” General Hospital, Aristotle University of Thessaloniki (Greece); Zarogoulidis, Paul, E-mail: pzarog@hotmail.com [Pulmonary Department, “G.Papanikolaou” General Hospital, Aristotle University of Thessaloniki (Greece); Domvri, Kalliopi; Voutsas, Vasilis; Zarogoulidis, Kostas [Pulmonary Department, “G.Papanikolaou” General Hospital, Aristotle University of Thessaloniki (Greece); Mourelatos, Dionysios [Biology and Genetics, Medical School, Aristotle University of Thessaloniki (Greece)

    2012-12-15

    Highlights: ► SCEs in vivo, a possible predictor of tumor chemoresponse. ► In vivo exposure to combined treatment, applying the SCE assay. ► Aminophylline enhances DNA instability induced by chemotherapy in vivo. ► In vivo synergistic effect of Aminophylline with the chemotherapeutic agents. - Abstract: Background: The anti-cancer and cytogenetic effects of aminophylline (AM) have been demonstrated in several clinical trials. The aim of the present study was to investigate the in vivo cytogenetic effects of AM in newly diagnosed patients with small cell (SCLC) and non-small cell lung cancer (NSCLC), receiving chemotherapy for the first time. Methods: Sister chromatid exchanges (SCEs) and proliferation rate index (PRI) were evaluated in peripheral blood lymphocyte cultures from six patients with SCLC and six patients with NSCLC after the in vitro addition of AM and after the in vivo administration of AM in patients receiving chemotherapy. Results: The in vitro addition of AM significantly increased SCEs only in SCLC patients (p < 0.001). The in vivo administration of AM after chemotherapy increased SCEs in both cancer types (SCLC: p < 0.001, NSCLC: p = 0.003) and this increase was synergistic, the rates of SCEs in the presence of AM were higher than the expected SCE values if the increases above background for chemotherapy and AM were independent and additive (SCLC: p < 0.001, NSCLC: p = 0.008). Although in both groups of patients cell division delays were observed after the combined chemotherapy plus in vivo AM treatment, the correlation between the magnitude of the SCE response and the PRI depression was not statistically significant (p > 0.05). Conclusions: These observations suggest that AM enhances the results of concurrently administered chemotherapy by synergistically increasing its cytogenetic effects in patients with lung cancer.

  13. Interactive Gentle Yoga in Improving Quality of Life in Patients With Stage I-III Breast Cancer Undergoing Radiation Therapy

    Science.gov (United States)

    2017-01-17

    Anxiety Disorder; Depression; Ductal Breast Carcinoma in Situ; Fatigue; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  14. A Randomized Controlled Trial for the Effectiveness of Progressive Muscle Relaxation and Guided Imagery as Anxiety Reducing Interventions in Breast and Prostate Cancer Patients Undergoing Chemotherapy

    Directory of Open Access Journals (Sweden)

    Andreas Charalambous

    2015-01-01

    Full Text Available Objective. To test the effectiveness of guided imagery (GI and progressive muscle relaxation (PMR as stress reducing interventions in patients with prostate and breast cancer who undergo chemotherapy. Methods. Patients were randomly assigned to either the control group or the intervention group (PMR and GI. Patients were observed for a total duration of 3 weeks and assessed with the SAS and BECK-II questionnaires for anxiety and depression, respectively, in addiotion to two biological markers (saliva cortisol and saliva amylase (trial registration number: NCT01275872. Results. 256 patients were registered and 236 were randomly assigned. In total 104 were randomised to the control group and 104 to the intervention group. Intervention’s mean anxiety score and depression score changes were significantly different compared to the control’s (b=-29.4, p<0.001; b=-29.4, p<0.001, resp.. Intervention group’s cortisol levels before the intervention (0.30±0.25 gradually decreased up to week 3 (0.16±0.18, whilst the control group’s cortisol levels before the intervention (0.21±0.22 gradually increased up to week 3 (0.44±0.35. The same interaction appears for the Amylase levels (p<0.001. Conclusions. The findings showed that patients with prostate and breast cancer undergoing chemotherapy treatment can benefit from PMR and GI sessions to reduce their anxiety and depression.

  15. Proteome data of whole saliva which are associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy

    Directory of Open Access Journals (Sweden)

    Nico Jehmlich

    2016-09-01

    Full Text Available Saliva as major human body fluid may act as an indicator of oral disease status. Oral mucositis is a common and often treatment-limiting side effect of radiotherapy for head and neck cancer patients. In this dataset, we provide the complete proteome dataset (raw and search files of the patients at baseline of radiotherapy treatment in patients undergoing radiotherapy analyzed by nano liquid chromatography coupled to mass spectrometry (LC–MS/MS. In the data set, 5323 tryptic peptides were identified which can be assigned to 487 distinct proteins (≥2 peptides. The MS data have been deposited to the ProteomeXchange (“ProteomeXchange provides globally coordinated proteomics data submission and dissemination” [1] via the PRIDE partner repository with the dataset identifier PRIDE: PXD003230. The data are associated with the previously published work, “Differences in the whole saliva baseline proteome profile associated with development of oral mucositis in head and neck cancer patients undergoing radiotherapy” [2].

  16. Telomere Length in Predicting Toxicity in Older Patients With Stage III-IV Colorectal Cancer Undergoing Chemotherapy

    Science.gov (United States)

    2017-01-25

    Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IV Colon Cancer; Stage IV Rectal Cancer

  17. Importance of Extracranial Disease Status and Tumor Subtype for Patients Undergoing Radiosurgery for Breast Cancer Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Dyer, Michael A.; Kelly, Paul J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Pinnell, Nancy E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Claus, Elizabeth B. [Harvard Medical School, Boston, MA (United States); Department of Neurosurgery, Brigham and Women' s Hospital, Boston, MA (United States); Yale University School of Medicine, New Haven, CT (United States); Lee, Eudocia Q. [Harvard Medical School, Boston, MA (United States); Center for Neuro-Oncology, Dana-Farber/Brigham and Women' s Center, Boston, MA (United States); Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Arvold, Nils D. [Harvard Radiation Oncology Program, Boston, MA (United States); Lin, Nancy U. [Harvard Medical School, Boston, MA (United States); Department of Medical Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Alexander, Brian M., E-mail: bmalexander@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States)

    2012-07-15

    Purpose: In this retrospective study, we report on outcomes and prognostic factors for patients treated with stereotactic radiosurgery (SRS) for breast cancer brain metastases. Methods and Materials: We identified 132 consecutive patients with breast cancer who were treated with SRS for brain metastases from January 2000 through June 2010. We retrospectively reviewed records of the 51 patients with adequate follow-up data who received SRS as part of the initial management of their brain metastases. Overall survival (OS) and time to central nervous system (CNS) progression from the date of SRS were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Results: Triple negative subtype was associated with CNS progression on univariate analysis (hazard ratio [HR] = 5.0, p = 0.008). On multivariate analysis, triple negative subtype (HR = 8.6, p = 0.001), Luminal B subtype (HR = 4.3, p = 0.03), and omission of whole-brain radiation therapy (HR = 3.7, p = 0.02) were associated with CNS progression. With respect to OS, Karnofsky Performance Status (KPS) {<=} 80% (HR = 2.0, p = 0.04) and progressive extracranial disease (HR = 3.1, p = 0.002) were significant on univariate analysis; KPS {<=} 80% (HR = 4.1, p = 0.0004), progressive extracranial disease (HR = 6.4, p < 0.0001), and triple negative subtype (HR = 2.9, p = 0.04) were significant on multivariate analysis. Although median survival times were consistent with those predicted by the breast cancer-specific Graded Prognostic Assessment (Breast-GPA) score, the addition of extracranial disease status further separated patient outcomes. Conclusions: Tumor subtype is associated with risk of CNS progression after SRS for breast cancer brain metastases. In addition to tumor subtype and KPS, which are incorporated into the Breast-GPA, progressive extracranial disease may be an important prognostic factor for OS.

  18. Socioeconomic status is an independent predictor of biochemical recurrence among patients with prostate cancer who undergo radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Victor Srougi

    2011-08-01

    Full Text Available PURPOSE: Socioeconomic status (SES may influence cancer characteristics and behavior in several aspects. We analyzed PCa characteristics and behavior among low income uninsured men, and compare them to high income patients with health insurance in a developing country. MATERIALS AND METHODS: A retrospective case-control study was performed on 934 patients with clinically localized PCa who underwent radical prostatectomy between March, 1999 and July, 2009. Patients were divided in two groups, according to their SES. In group 1 (n=380, all had low income, low educational levels and couldn't afford medical insurance. In group 2 (n=554, all had higher income, higher education and had medical insurance. RESULTS: Patients from group 1 were older, had higher Gleason scores, higher rates of seminal vesicle and bladder neck involvement. The Kaplan Meier disease-free survival curve demonstrated that after a follow-up of four years, about 50% of uninsured patients had biochemical recurrence, versus 21% of insured patients (Log rank test: p < 0.001. A multivariate Cox regression analysis for the risk of disease recurrence demonstrated that only PSA levels, Gleason score, seminal vesicle involvement and SES were statistically significant variables. Patients with a low SES presented 1.8 times the risk of recurrence as compared to patients with a high SES. CONCLUSIONS: Patients with low SES were older, presented more aggressive PCa characteristics and a high rate of disease recurrence. A low SES constituted an independent predictor for disease recurrence.

  19. Massage therapy alone and in combination with meditation for breast cancer patients undergoing autologous tissue reconstruction: A randomized pilot study.

    Science.gov (United States)

    Dion, Liza J; Engen, Deborah J; Lemaine, Valerie; Lawson, Donna K; Brock, Charise G; Thomley, Barbara S; Cha, Stephen S; Sood, Amit; Bauer, Brent A; Wahner-Roedler, Dietlind L

    2016-05-01

    This study explored whether massage combined with meditation is more helpful than massage alone for women recovering from autologous tissue reconstruction after mastectomy for breast cancer. Forty patients were randomly assigned to either massage therapy or massage plus meditation on postoperative days 1 through 3. Outcome measures were 1) visual analog scale (VAS) scores for stress, anxiety, relaxation, insomnia, alertness, fatigue, tension, pain, mood, and energy, and 2) Perceived Stress Scale-14 scores. Nineteen patients in each group finished the study. Preintervention and postintervention mean total VAS scores improved significantly in both groups (P < .001), but no significant difference occurred between groups.

  20. Prevalence of incidental prostate cancer in patients undergoing radical cystoprostatectomy:data from China and other Asian countries

    Institute of Scientific and Technical Information of China (English)

    Yi-Ping Zhu; Ding-Wei Ye; Xu-Dong Yao; Shi-Lin Zhang; Bo Dai; Hai-Liang Zhang; Yi-Jun Shen; Yao Zhu; Guo-Hai Shi

    2009-01-01

    The purpose of this study is to investigate the frequency of prostate cancer (Pea) discovered incidentally in radical eystoprostatectomy specimens in Asia and to determine the feasibility of prostate-sparing cystectomy (PSC) for Asian patients.Ninety-two male bladder cancer patients who underwent radical eystoprostatectomy at our center between January 2003 and January 2008 were included in this study.The mean age of patients was 67.1 years (range:32-75 years).Prostate-specific antigen (PSA) levels and digital rectal examination (DRE) results before surgery were obtained retrospectively.Prostates of all patients were embedded and sectioned at 5-mm intervals.The same pathologist examined the prostatic tissues from radical cystoprostatectomy specimens.Finally,a structured literature review was performed using MEDLINE and PUBMED to estimate the occurrence of incidental Pea in Asia.Of the 92 patients,3 (3.3%) were found to have Pea;in one out of three (33.3%) patients the disease was clinically significant due to a Gleason grade 4 carcinoma.Eight articles were included in our review.The overall incidence of Pea discovered incidentally in radical cystoprostatectomy specimens in Asia was 9.9% (64/642).When age was restricted to<60 years,only 7 out of 222 (3.2%)patients were found to have synchronous Pea,and none of the cases was clinically significant.The occurrence of Pea in radical eystoprostatectomy specimens in Asia is much lower than that in Western countries.PSC might be feasible for Asian patients under a strict preoperative selection.

  1. Spiritual well-being and its influence on fatigue in patients undergoing active cancer directed treatment: A correlational study

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    Shirley Lewis

    2014-01-01

    Full Text Available Introduction: Spiritual well-being and fatigue are key parameters in assessing health related quality of life that determine treatment tolerance, treatment outcomes and reflect patient′s coping ability in the illness-wellness disease trajectory. Materials and Methods: A total of 200 patients on active cancer treatment were enrolled to the study. Functional assessment of chronic illness therapy-spirituality (FACIT-Sp and FACIT-Fatigue scales were used to assess spiritual well-being and fatigue scores during their cancer treatment. Data were analyzed using one-way analysis of variance and bivariate relationships determined using the Spearman Correlation analysis. Linear regression analysis was performed to determine predictors of fatigue score during treatment. Results: Mean spiritual well-being score was 20.96 out of 48 and scores were significantly higher in females compared with males (P = 0.03, lower with higher stage (P = 0.008 and lower in head and neck and gastrointestinal malignancies (P = 0.03 when compared with gynecological and breast malignancies. Fatigue was present in all the 200 patients studied and the mean fatigue score was 13.09. Higher fatigue scores were observed in patients with advanced stages of cancer (Stage IV (F [3,199] = 5.67, P = 0.001. There was a significant inverse relationship between fatigue scores with spiritual well-being (P < 0.001. Spiritual well-being score emerged as a significant primary negative predictor (β = -0.23, P = 0.001 for fatigue scores followed by stage of disease (β =0.23, P = 0.001 and gender (β = -0.18, P = 0.01 as significant secondary predictors. Conclusion: Fatigue during cancer directed treatment is influenced by spiritual wellbeing, disease stage and gender. Further studies should examine the mediating variables that influence fatigue.

  2. Endoscopic biliary drainage for patients with unresectable pancreatic cancer with obstructive jaundice who are to undergo gemcitabine chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Osamu Takasawa; Naotaka Fujita; Go Kobayashi; Yutaka Noda; Kei Ito; Jun Horaguchi

    2006-01-01

    AIM: To assess optimum endoscopic biliary drainage (EBD) in cases with unresectable pancreatic cancer in the era of gemcitabine (GEM).METHODS: Thirty patients with unresectable pancreatic cancer, who presented with jaundice and underwent chemotherapy using GEM after EBD were included in this study (GEM group). Fifteen cases with the same clinical manifestation and stage of pancreatic cancer treated with EBD alone were also included as controls. A covered metallic stent (CMS) or a plastic stent (PS) was used for EBD. The mean survival time (MST) in each group,risk factors of survival time, type of stent used and associated survival time, occlusion rate of stent, patency period of stent, and risk factors of stent occlusion were evaluated.RESULTS: MST in the GEM group was longer than that in the control (9.9 mo vs 6.2 mo). In the GEM group,the survival time was not different between those who underwent metallic stenting and those who underwent plastic stenting. Stent occlusion occurred in 60% of the PS group and 7% of the CMS group. The median stent patency in the PS-GEM group and the CMS-GEM group was 5 mo and 7.5 mo, respectively. Use of a PS was the only risk factor of stent occlusion.CONCLUSION: A CMS is recommended in cases presenting with jaundice due to unresectable pancreatic cancer, since the use of a CMS makes it possible to continue chemotherapy using GEM without repetition of stent replacement.

  3. Adjuvant hormone therapy in patients undergoing high-intensity focused ultrasound therapy for locally advanced prostate cancer

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    A. I. Neimark

    2014-01-01

    Full Text Available Objective: to evaluate the efficiency and safety of using the luteinizing hormone releasing hormone leuprorelin with the Atrigel delivery system in doses of 7.5, 22.5, and 45 mg as an adjuvant regimen in high- and moderate-risk cancer patients who have received high-intensity focused ultrasound (HIFU therapy.Subjects and methods. Moderate- and high-risk locally advanced prostate cancer (PC patients treated with HIFU (n = 28 and HIFU in combination with hormone therapy during 6 months (n = 31 were examined.Results. The investigation has shown that leuprorelin acetate monotherapy used within 6 months after HIFU therapy can achieve the highest reduction in prostate-specific antigen levels and positively affect the symptoms of the disease. HIFU in combination with androgen deprivation substantially diminishes the clinical manifestations of the disease and improves quality of life in HIFU-treated patients with PC, by reducing the degree of infravesical obstruction (according to uroflowmetric findings and IPSS scores, and causes a decrease in prostate volume as compared to those who have undergone HIFU only. Treatment with leuprorelin having the Atrigel delivery system has demonstrated the low incidence of adverse reactions and good tolerability.

  4. 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.

  5. Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

    Directory of Open Access Journals (Sweden)

    Saikat Majumdar

    2014-01-01

    Full Text Available Background: Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. Materials and Methods: From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F and (P Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS and amount of fentanyl were measured for postoperative pain assessment (24 h. Results and Statistical analysis: The mean VAS score in 1 st , 2 nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU and hospital stay which was also statistically significant. Conclusion: The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

  6. Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Magliocca, Kelly R. [Department of Pathology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hanasoge, Sheela [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Aiken, Ashley H.; Hudgins, Patricia A. [Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Chen, Susie A. [Department of Radiation Oncology, University of Texas Southwestern, Dallas, Texas (United States); Eaton, Bree R.; Higgins, Kristin A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Saba, Nabil F. [Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Beitler, Jonathan J. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-01-01

    Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initial surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.

  7. Predictive and prognostic value of circulating nucleosomes and serum biomarkers in patients with metastasized colorectal cancer undergoing Selective Internal Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Fahmueller Yvonne

    2012-01-01

    Full Text Available Abstract Background Selective Internal Radiation Therapy (SIRT is a new and effective locoregional anticancer therapy for colorectal cancer patients with liver metastases. Markers for prediction of therapy response and prognosis are needed for the individual management of those patients undergoing SIRT. Methods Blood samples were prospectively and consecutively taken from 49 colorectal cancer patients with extensive hepatic metastases before, three, six, 24 and 48 h after SIRT to analyze the concentrations of nucleosomes and further laboratory parameters, and to compare them with the response to therapy regularly determined 3 months after therapy and with overall survival. Results Circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1, carcinoembryonic antigen (CEA, C-reactive protein (CRP and various liver markers increased already 24 h after SIRT. Pretherapeutical levels of CYFRA 21-1, CEA, cancer antigen 19-9 (CA 19-9, asparate-aminotransferase (AST and lactate dehydrogenase (LDH as well as 24 h values of nucleosomes were significantly higher in patients suffering from disease progression (N = 35 than in non-progressive patients (N = 14. Concerning overall survival, CEA, CA 19-9, CYFRA 21-1, CRP, LDH, AST, choline esterase (CHE, gamma-glutamyl-transferase, alkaline phosphatase, and amylase (all 0 h, 24 h and nucleosomes (24 h were found to be prognostic relevant markers in univariate analyses. In multivariate Cox-Regression analysis, the best prognostic model was obtained for the combination of CRP and AST. When 24 h values were additionally included, nucleosomes (24 h further improved the existing model. Conclusion Panels of biochemical markers are helpful to stratify pretherapeutically colorectal cancer patients for SIR-therapy and to early estimate the response to SIR-therapy.

  8. Impact of operative and peri-operative factors on the long-term prognosis of primary liver cancer patients undergoing hepatectomy.

    Science.gov (United States)

    Xu, Li-Ning; Xu, Ying-Ying; Gao, De-Wei

    2016-08-01

    This study examined the impact of the operative and peri-operative factors on the long-term prognosis of patients with primary liver cancer undergoing hepatectomy. A total of 222 patients with primary liver cancer who underwent hepatectomy were followed up from January 1986 to December 2010 at Chinese PLA General Hospital. The post-operative complication rate was 14.0% for all cases, 13.7% for hepatocellular carcinoma (HCC), 10.0% for cholangiocarcinoma. The 1-, 3-, 5- and 10-year overall survival rates in patients with primary liver cancer after resection were 76.6%, 57.6%, 41.4%, and 21.0%. The survival rates were significantly higher in the HCC group than in the cholangiocarcinoma group (P=0.000), in the non-anatomical resection group than in the anatomical resection group (P=0.005), in the female group than in the male group (P=0.002), in patients receiving no blood transfusion than in those who were given intra-operative blood transfusion (P=0.000), in patients whose intra-operative blood loss was less than 400 mL than in those who intra-operatively lost more than 400 mL (P=0.000). No significant difference was found in the survival rate between the HBsAg-positive group and the HBsAg-negative group (P=0.532). Our study showed that anatomical resection, blood loss and blood transfusion were predictors of poor survival after hepatectomy for primary liver cancer patients, and concomitant hepatitis B virus infection bore no relation with the post-resection survival.

  9. Analysis of risk factors of involvement of seminal vesicles in patients with prostate cancer undergoing radical prostatectomy

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    Marcos F. Dall'Oglio

    2004-12-01

    Full Text Available OBJECTIVE: To determine through preoperative serum PSA level, Gleason score on biopsy and percentage of fragments affected by tumor on biopsy, the probability of involvement of the seminal vesicles. MATERIALS AND METHODS: During the period between March 1991 to December 2002, we selected 899 patients undergoing radical prostatectomy for treatment of localized prostate adenocarcinoma. The analyzed preoperative variables were PSA, percentage of positive fragments and Gleason score on the biopsy. Pre-operative PSA was divided in scales from 0 to 4.0 ng/mL, 4.1 to 10 ng/mL, 10.1 to 20 ng/mL and > 20 ng/mL, Gleason score was categorized in scales from 2 to 6. 7 and 8 to 10, and the percentage of affected fragments was divided in 0 to 25%, 25.1% to 50%, 50.1% to 75%, and 75.1% to 100%. All these variables were correlated with the involvement of seminal vesicles in the surgical specimen. RESULTS: Of the 899 patients under study, approximately 11% (95% CI, [9% - 13%] had involvement of seminal vesicles. On the multivariate analysis, when PSA was < 4, the Gleason score was 2 to 6, and less than 25% of fragments were involved on the biopsy, only 3.6%, 7.6% and 6.2% of patients respectively, had involvement of seminal vesicles. On the multivariate analysis, we observed that PSA, Gleason score and the percentage of involved fragments were independent prognostic factors for invasion of seminal vesicles. CONCLUSION: The preoperative variables used in the present study allow the identification of men with minimal risk (lower than 5% if involvement of seminal vesicles.

  10. Perioperative Immunonutrition in Well-Nourished Patients Undergoing Surgery for Head and Neck Cancer: Evaluation of Inflammatory and Immunologic Outcomes

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    Lindsay D. Plank

    2013-04-01

    Full Text Available Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer, particularly if well-nourished. We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome. Patients scheduled for radical resection of the oral cavity were randomised to 5 day preoperative and 5 day postoperative Impact® (IMN, n = 4, or no preoperative supplementary nutrition and Isosource® postoperatively (STD, n = 4. Plasma fatty acids, C-reactive protein (CRP, tumour necrosis factor (TNF-α, interleukin (IL-6 and IL-10 were measured at baseline, day of surgery and on postoperative days (POD 2, 4 and 10. Postoperative complications were recorded. The (eicosapentaenoic acid plus docosahexaenoic acid to arachidonic acid ratio was significantly higher in IMN patients on POD 2, 4 and 10 (P < 0.01. While not statistically significant, CRP, TNF-α, and IL-6 concentrations were higher in the STD group on POD2 while IL-10 was lower. Median length of stay was 10 (range 10–43 days in the IMN group and 21.5 (7–24 days in the STD group. Five complications were seen in the STD group and two in the IMN group. The results support the need for a larger trial focusing on clinical outcome.

  11. Lactobacillus in Preventing Infection in Patients Undergoing a Donor Stem Cell Transplant for Hematologic Cancer or Myelodysplastic Syndrome

    Science.gov (United States)

    2017-02-02

    Breast Cancer; Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Neuroblastoma; Ovarian Cancer; Testicular Germ Cell Tumor

  12. Risk Factors of anemia in head and neck cancer patients undergoing chemotherapy with high-dose cisplatin

    Directory of Open Access Journals (Sweden)

    Johan Kurnianda

    2008-12-01

    Full Text Available Cisplatin is well-known for its effectiveness against cancer, as well as its toxicity to human tissues. Of several documented side effects, anemia was reported to have significant association with decreased quality of life. This study was conducted to investigate development of cisplatin-induced anemia, and to identify independent factors contributing to anemia. Clinical data from head and neck cancer patients treated with high-dose cisplatin between December 2002 and December 2005 were obtained in this study. Incidence and risk factors of anemia were assessed in a model including age, sex, baseline hemoglobin level, baseline creatinine clearance, and occurrence of distant metastases. Multivariate logistic regression was used to define independent predictors of anemia. Among 86 eligible patients, 26 (30.2% developed anemia, defined as Hb level lower than 11 g/dL. Age > 55 years old (RR = 2.2, 95% CI, 1.2-4.0, female sex (RR = 2.0, 95% CI, 1.2-3.8, baseline Hb ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4 and baseline CrCl < 50 mL/min (RR = 2.9, 95% CI, 1.7-5.1 were significantly correlated with incidence of anemia (P < 0.05. In multivariate analysis, baseline Hb and baseline CrCl were identified as independent risk factors for anemia. However, considerable confounding was observed in baseline CrCl after stratified by age (aRR = 2.2, 95% CI, 1.1-4.7. Thus, baseline Hb level was the strongest predictor of anemia. The findings suggested that baseline Hb and CrCl were useful to recognize cisplatin-treated patients at risk for anemia who might benefits from preventive measures. (Med J Indones 2008; 17: 248-54Keywords: anemia, cisplatin, chemotherapy, hemoglobin, creatinine clearance

  13. Postoperative complications and clinical outcomes among patients undergoing thoracic and gastrointestinal cancer surgery: A prospective cohort study

    Science.gov (United States)

    Martos-Benítez, Frank Daniel; Gutiérrez-Noyola, Anarelys; Echevarría-Víctores, Adisbel

    2016-01-01

    Objective This study sought to determine the influence of postoperative complications on the clinical outcomes of patients who underwent thoracic and gastrointestinal cancer surgery. Methods A prospective cohort study was conducted regarding 179 consecutive patients who received thorax or digestive tract surgery due to cancer and were admitted to an oncological intensive care unit. The Postoperative Morbidity Survey was used to evaluate the incidence of postoperative complications. The influence of postoperative complications on both mortality and length of hospital stay were also assessed. Results Postoperative complications were found for 54 patients (30.2%); the most common complications were respiratory problems (14.5%), pain (12.9%), cardiovascular problems (11.7%), infectious disease (11.2%), and surgical wounds (10.1%). A multivariate logistic regression found that respiratory complications (OR = 18.68; 95%CI = 5.59 - 62.39; p < 0.0001), cardiovascular problems (OR = 5.06, 95%CI = 1.49 - 17.13; p = 0.009), gastrointestinal problems (OR = 26.09; 95%CI = 6.80 - 100.16; p < 0.0001), infectious diseases (OR = 20.55; 95%CI = 5.99 - 70.56; p < 0.0001) and renal complications (OR = 18.27; 95%CI = 3.88 - 83.35; p < 0.0001) were independently associated with hospital mortality. The occurrence of at least one complication increased the likelihood of remaining hospitalized (log-rank test, p = 0.002). Conclusions Postoperative complications are frequent disorders that are associated with poor clinical outcomes; thus, structural and procedural changes should be implemented to reduce postoperative morbidity and mortality. PMID:27096675

  14. Music does not alter anxiety in patients with suspected lung cancer undergoing bronchoscopy: a randomised controlled trial

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    Elisabeth Jeppesen

    2016-11-01

    Full Text Available Background: The use of music to relieve anxiety has been examined in various studies, but the results are inconclusive. Methods: From April to October 2015, 160 patients undergoing examination of pulmonary nodules were randomly assigned to MusiCure or no music. MusiCure was administered through earplugs to ensure blinding of the staff and was played from admission to the operating theatre to the end of the bronchoscopy. Spielberger's State-Trait Anxiety Inventory (STAI was administered on admission, immediately before bronchoscopy, and on discharge. Secondary outcomes were p-cortisol, physiological variables, dosage of sedatives, movements measured by Actigraph, bronchoscopy duration, number of re-examinations, and overall perception of the sounds in the operating theatre measured by Visual analogue scale. Results: The STAI scores were similar on admission, but after a 10-min wait in the operating theatre, scores varied significantly between patients with and without music, with lower scores in the music group [median (interquartile range, IQR 35 (18 vs. 43 (25; p=0.03]. Post hoc multiple regression revealed treatment group as insignificant when adjusting for sex and baseline anxiety. However, there was a significantly more positive perception of the sounds in the operating theatre in the music group (median (IQR 8.2 (1.8 vs. 5.4 (6.8; p<0.0001 and fewer re-examinations in the music group (19.2% vs. 7.7%, p<0.032. Conclusions: Ten minutes with MusiCure does not alter anxiety when adjusting for baseline anxiety and sex. The current study indicates that this field of research has many confounders.

  15. Biofeedback Therapy Before Ileostomy Closure in Patients Undergoing Sphincter-Saving Surgery for Rectal Cancer: A Pilot Study

    Science.gov (United States)

    Kim, Jeong-Ki; Jeon, Byeong Geon; Song, Yoon Suk; Seo, Mi Sun; Kwon, Yoon-Hye; Park, JI Won; Ryoo, Seung-Bum; Jeong, Seung-Yong

    2015-01-01

    Purpose This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and subjective bowel function in patients after sphincter-saving surgery for rectal cancer. Methods Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study. Conservative management included lifestyle modifications, Kegel exercises, and medication. Patients were evaluated at baseline and at 1, 3, 6, and 12 months after ileostomy closure by using anal manometry, modified Wexner Incontinence Scores (WISs), and fecal incontinence quality of life (FI-QoL) scores. Results Before the ileostomy closure, the groups did not differ in baseline clinical characteristics or resting manometric parameters. After 12 months of follow-up, the biofeedback group demonstrated a statistically significant improvement in the mean maximum squeezing pressure (from 146.3 to 178.9, P = 0.002). However, no beneficial effect on the WIS was noted for biofeedback compared to conservative management alone. Overall, the FI-QoL scores were increased significantly in both groups after ileostomy closure (P = 0.006), but did not differ significantly between the two groups. Conclusion Although the biofeedback therapy group demonstrated a statistically significant improvement in the maximum squeezing pressure, significant improvements in the WISs and the FI-QoL scores over time were noted in both groups. The study was terminated early because no therapeutic benefit of biofeedback had been demonstrated. PMID:26361615

  16. Radiation dose and cancer risk in patients undergoing multiple radiographs in intravenous urography X-ray examinations

    Science.gov (United States)

    Suliman, I. I.; Al-Jabri, Amna J.; Badawi, A. A.; Halato, M. A.; Alzimami, K.; Sulieman, A.

    2014-11-01

    The purpose of the this study was to measure the entrance surface air kerma (ESAK) and body organs, and the effective doses in intravenous urography (IVU) X-ray examinations in Sudanese hospitals. Seventy-two patients who underwent IVU multiple radiographs from five hospitals (six rooms) were examined. ESAK was calculated from incident air kerma (Ki) using patient exposure parameters and tube output Y(d). Dose calculations were performed using CALDOSE X 5.1 Monte Carlo-based software. Risk of cancer induction (4-8) and mortality per million (2-4) varied. The gallbladder, colon, stomach, gonads and uterus received organ doses of 5.3, 3.6, 3.2, 0.61, and 0.8 mGy, respectively. ESAK values ranged from 6.6 to 15.3 mGy (effective doses: 0.70-1.6 mSv). Mean ESAK fall slightly above the diagnostic reference level. Several optimization strategies to improve dose performance were discussed. Reducing the number of radiographs and the use of technique charts according to patient sizes and anatomic areas are among the most important dose optimization tools in IVU.

  17. Distress screening using distress thermometer in head and neck cancer patients undergoing radiotherapy and evaluation of causal factors predicting occurrence of distress

    Directory of Open Access Journals (Sweden)

    Shirley Lewis

    2013-01-01

    Full Text Available Introduction: Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors. Materials and Methods: Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress. Results: Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and on completion of radiotherapy treatment (all P′s < 0.001 compared to pretreatment. Those who had chemotherapy (CT along with radiation had significantly greater pain score (t = 5.54, P = 0.03 and distress score (t = 3.9, P = 0.05 at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers′ d = 0.36, P = 0.02 and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02 at 4 weeks into radiotherapy. Conclusion: Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.

  18. Risk of biochemical recurrence and positive surgical margins in patients with pT2 prostate cancer undergoing radical prostatectomy

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Thomsen, Frederik Birkebæk; Berg, Kasper Drimer

    2014-01-01

    BACKGROUND AND OBJECTIVE: To investigate risk factors associated with positive surgical margins (PSM) and biochemical recurrence (BR) in organ confined tumors (pT2) after radical prostatectomy (RP) for localized prostate cancer (PCa). METHODS: Between 1995 and 2011, 1,649 patients underwent RP...... at our institution. The study includes the 1,133 consecutive patients with pT2 tumors at final histopathology. Logistic regression analysis was used for risk of PSM. Risk of BR, defined as the first PSA ≥ 0.2 ng/ml, was analyzed with Kaplan-Meier and Cox regression analysis. RESULTS: Median follow......-up was 3.6 years (range: 0.5-15.5 years). In logistic regression, NS surgery was independently associated with an increased risk of pT2 PSM (OR = 1.68, 95% CI: 1.3-2.0, P = 0.01) relative to non-NS surgery. NS surgery was not independently associated with BR but the interaction of PSM and NS surgery...

  19. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

    Energy Technology Data Exchange (ETDEWEB)

    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  20. Effect of melatonin on depressive symptoms and anxiety in patients undergoing breast cancer surgery: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Hansen, Melissa V; Andersen, Lærke T; Madsen, Michael T; Hageman, Ida; Rasmussen, Lars S; Bokmand, Susanne; Rosenberg, Jacob; Gögenur, Ismail

    2014-06-01

    Depression, anxiety and sleep disturbances are known problems in patients with breast cancer. The effect of melatonin as an antidepressant in humans with cancer has not been investigated. We investigated whether melatonin could lower the risk of depressive symptoms in women with breast cancer in a three-month period after surgery and assessed the effect of melatonin on subjective parameters: anxiety, sleep, general well-being, fatigue, pain and sleepiness. Randomized, double-blind, placebo-controlled trial undertaken from July 2011 to December 2012 at a department of breast surgery in Copenhagen, Denmark. Women, 30-75 years, undergoing surgery for breast cancer and without signs of depression on Major Depression Inventory (MDI) were included 1 week before surgery and received 6 mg oral melatonin or placebo for 3 months. The primary outcome was the incidence of depressive symptoms measured by MDI. The secondary outcomes were area under the curve (AUC) for the subjective parameters. 54 patients were randomized to melatonin (n = 28) or placebo (n = 26) and 11 withdrew from the study (10 placebo group and 1 melatonin group, P = 0.002). The risk of developing depressive symptoms was significantly lower with melatonin than with placebo (3 [11 %] of 27 vs. 9 [45 %] of 20; relative risk 0.25 [95 % CI 0.077-0.80]), giving a NNT of 3.0 [95 % CI 1.7-11.0]. No significant differences were found between AUC for the subjective parameters. No differences in side effects were found (P = 0.78). Melatonin significantly reduced the risk of depressive symptoms in women with breast cancer during a three-month period after surgery.

  1. The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project

    DEFF Research Database (Denmark)

    Klausen, Julie Midtgaard; Tveterås, Anders; Rørth, Mikael Rahbek

    2006-01-01

    BACKGROUND: Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over...... the course of cancer survivorship. OBJECTIVE: This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years......, and postprogram changes in depression. SIGNIFICANCE OF RESEARCH: Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence...

  2. Struggling with cancer and treatment: young athletes recapture body control and identity through exercise: qualitative findings from a supervised group exercise program in cancer patients of mixed gender undergoing chemotherapy

    DEFF Research Database (Denmark)

    Adamsen, L.; Andersen, C.; Midtgaard, J.

    2009-01-01

    Cancer and treatment can negatively affect the body's performance and appearance. Exercise has been tested in a few studies for altered body image among middle-aged women with breast cancer. The aim of the study was to explore how young pre-cancer athletes of both genders experience disease......- and treatment-related physical fitness and appearance changes while undergoing chemotherapy and participating in a 6-week group exercise intervention. A prospective, explorative study using semi-structured interviews was conducted before and at termination of the intervention. The study included 22 cancer...... patients (median age 28 years). The young athletes experienced a change from a high level of physical activity, body satisfaction and a positive self-identity to a low level of physical activity, body denial and a negative self-identity. In the program, the patients experienced increased physical strength...

  3. The Therapeutic Effects of Rehmannia Oral Liquid for the Syndrome of Heat Accumulation with Yin Consumption in Esophagus Cancer Patients Undergoing Radiotherapy - A Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the clinical therapeutic effects of Rehmannia Oral Liquid on the syndrome of heat accumulation with Yin consumption in intermediate or late esophagus cancer patients undergoing radiotherapy. Methods: The IFN-α, TNF-α, IL-1β and TGF-β1 levels in sera were determined by the method of ABC-WLISA before and after the treatment with Rehmannia Oral Liquid. At the same time, the observation was carried out on the patient's general condition, symptoms and signs, barium meal or CT examinations, and biopsy. Another 30 cases of esophagus cancer were treated singly with radiotherapy as the control group. Results: Rehmannia Oral Liquid could obviously improve the patient's general condition, and the symptoms and signs after radiotherapy. Based on the X-ray examination and biopsy, the short-term local control rate of the treatment group and the control group was 70.0% and 40.0% respectively, showing a significant difference (P0.05) after treatment. The difference between groups was significant (P<0.05). Conclusion: Rehmannia Oral Liquid can obviously reduce the radiotherapy reaction, improve the quality of life, and raise the therapeutic effects. The action mechanism of the Liquid may lie in balancing the cytokine network and regulating the disordered signal transmission.

  4. Prognostic value of DCE-MRI in breast cancer patients undergoing neoadjuvant chemotherapy: a comparison with traditional survival indicators

    Energy Technology Data Exchange (ETDEWEB)

    Pickles, Martin D.; Lowry, Martin; Turnbull, Lindsay W. [Hull York Medical School at University of Hull, Hull Royal Infirmary, Centre for Magnetic Resonance Investigations, Hull (United Kingdom); Manton, David J. [Hull and East Yorkshire Hospitals NHS Trust, Radiation Physics Department, Hull (United Kingdom)

    2015-04-01

    To determine associations between dynamic contrast-enhanced MR imaging (DCE-MRI) parameters and survival intervals in patients with locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC), surgery, and adjuvant therapies. Further, to compare the prognostic value of DCE-MRI parameters against traditional survival indicators. DCE-MRI and MR tumour volume measures were obtained prior to treatment and post 2nd NAC cycle. To demonstrate which parameters were associated with survival, Cox's proportional hazards models (CPHM) were employed. To avoid over-parameterisation, only those MR parameters with at least a borderline significant result were entered into the final CPHM. When considering disease-free survival positive axillary nodal status (hazard ratio [HR] 6.79), younger age (HR 3.37), negative oestrogen receptor status (HR 3.24), pre-treatment Maximum Enhancement Index (MaxEI) (HR 6.51), and percentage change in MaxEI (HR 1.02) represented the retained CPHM covariates. Similarly, positive axillary nodal status (HR 11.47), negative progesterone receptor status (HR 4.37) and percentage change in AUC{sub 90} (HR 1.01) represented the retained predictive variables for overall survival. Multivariate survival analysis has demonstrated that DCE-MRI parameters obtained prior to NAC and/or post 2nd cycle can provide independent prognostic information that can complement traditional prognostic indicators available prior to treatment. (orig.)

  5. Development and feasibility of a set of quality indicators relative to the timeliness and organisation of care for new breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Ferrua Marie

    2012-06-01

    Full Text Available Abstract Background Because breast cancer is a major public health issue, it is particularly important to measure the quality of the care provided to patients. Survival rates are affected by the timeliness of care, and waiting times constitute key quality criteria. The aim of this study was to develop and validate a set of quality indicators (QIs relative to the timeliness and organisation of care in new patients with infiltrating, non-inflammatory and metastasis-free breast cancer undergoing surgery. The ultimate aim was to use these QIs to compare hospitals. Methods The method of QI construction and testing was developed by COMPAQ-HPST. We first derived a set of 8 QIs from consensus guidelines with the aid of experts and professional associations and then tested their metrological properties in a panel of 60 volunteer hospitals. We assessed feasibility using a grid exploring 5 dimensions, discriminatory power using the Gini coefficient as a measure of dispersion, and inter-observer reliability using the Kappa coefficient. Results Overall, 3728 records were included in the analyses. All 8 QIs showed acceptable feasibility (but one QI was subject to misinterpretation, fairly strong agreement between observers (Kappa = 0.66, and wide variations in implementation among hospitals (Gini coefficient  Conclusions Of the 8 QIs, 3 are ready for nationwide implementation (time to surgery, time to postoperative multidisciplinary team meeting (MDTM, conformity of MDTM. Four are suitable for use only in hospitals offering surgery with on-site postoperative treatment (waiting time to first appointment after surgery, patient information, time to first postoperative treatment, and traceability of information relating to prognosis. Currently, in the French healthcare system, a patient receives cancer care from different institutions whose databases cannot as yet be easily merged. Nationwide implementation of QIs covering the entire care pathway will thus

  6. Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Rao Raghavendra

    2008-01-01

    Full Text Available Context: Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes. Aims : The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery. Settings and Design : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery. Methods and Material : Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK cell % counts and serum immunoglobulins (IgG, IgA and IgM. Statistical analysis used : We used analysis of covariance to compare interventions postoperatively. Results: Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36. The results suggest a significant decrease in the state ( P = 0.04 and trait ( P = 0.004 of anxiety, depression ( P = 0.01, symptom severity ( P = 0.01, distress ( P < 0.01 and improvement in quality of life ( P = 0.01 in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% ( P = 0.02 and lower levels of serum IgA ( P = 0.001 in the yoga group as compared to controls following surgery. Conclusions : The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

  7. Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Rao Raghavendra

    2008-01-01

    Full Text Available Context : Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes. Aims : The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery. Settings and Design : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery. Materials and Methods : Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK cell % counts and serum immunoglobulins (IgG, IgA and IgM. Statistical Analysis Used : We used analysis of covariance to compare interventions postoperatively. Results : Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36. The results suggest a significant decrease in the state ( P = 0.04 and trait ( P = 0.004 of anxiety, depression ( P = 0.01, symptom severity ( P = 0.01, distress ( P < 0.01 and improvement in quality of life ( P = 0.01 in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% ( P = 0.02 and lower levels of serum IgA ( P = 0.001 in the yoga group as compared to controls following surgery. Conclusions : The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

  8. Clinical Usefulness of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography in Patients With Locally Advanced Pancreatic Cancer Planned to Undergo Concurrent Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jee Suk; Choi, Seo Hee; Lee, Youngin; Kim, Kyung Hwan [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Jeong Youp; Song, Si Young [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cho, Arthur; Yun, Mijin; Lee, Jong Doo [Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil, E-mail: jsseong@yuhs.ac [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-01

    Purpose: To assess the role of coregistered {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting radiographically occult distant metastasis (DM) at staging in patients with locally advanced pancreatic cancer (LAPC) and to study whether FDG-PET parameters can predict relatively long-term survival in patients who are more likely to benefit from chemoradiation therapy (CRT). Methods and Materials: From our institutional database, we identified 388 LAPC patients with M0 on conventional computed tomography (CT) who were planned to undergo CRT. Coregistered FDG-PET staging was offered to all patients, and follow-up FDG-PET was used at the clinical discretion of the physician. Results: FDG-PET detected unsuspected CT-occult DM in 33% of all 388 patients and allowed them to receive systemic therapy immediately. The remaining 260 patients (PET-M0) underwent CRT selectively as an initial treatment. Early DM arose in 13.1% of 260 patients, and the 1-year estimated locoregional recurrence rate was 5.4%. Median overall survival (OS) and progression-free survival (PFS) were 14.6 and 9.3 months, respectively, at a median follow-up time of 32.3 months (range, 10-99.1 months). Patients with a baseline standardized uptake value (SUV) <3.5 and/or SUV decline ≥60% had significantly better OS and PFS than those having none, even after adjustment for all potential confounding variables (all P<.001). Conclusions: FDG-PET can detect radiographically occult DM at staging in one-third of patients and spare them from the potentially toxic therapy. Additionally, FDG-PET parameters including baseline SUV and SUV changes may serve as useful clinical markers for predicting the prognosis in LAPC patients.

  9. Changes in plasma chemokine C-C motif ligand 2 levels during treatment with eicosapentaenoic acid predict outcome in patients undergoing surgery for colorectal cancer liver metastasis

    Science.gov (United States)

    Volpato, Milene; Perry, Sarah L; Marston, Gemma; Ingram, Nicola; Cockbain, Andrew J.; Burghel, Heather; Jake, Mann; Lowes, David; Wilson, Erica; Droop, Alastair; Randerson-Moor, Juliette; Coletta, P Louise; Hull, Mark A

    2016-01-01

    The mechanism of the anti-colorectal cancer (CRC) activity of the omega-3 fatty acid eicosapentaenoic acid (EPA) is not understood. We tested the hypothesis that EPA reduces expression of chemokine C-C motif ligand 2 (CCL2), a pro-inflammatory chemokine with known roles in metastasis. We measured CCL2 in clinical samples from a randomized trial of EPA in patients undergoing liver surgery for CRC liver metastasis (LM) and preclinical models. Genome-wide transcriptional profiling of tumors from EPA-treated patients was performed. EPA decreased CCL2 synthesis by CRC cells in a dose-dependent manner. CCL2 was localized to malignant epithelial cells in human CRCLM. EPA did not reduce CCL2 content in human or mouse tumors compare to control. However, EPA treatment was associated with decreased plasma CCL2 levels compared with controls (P=0.04). Reduction in plasma CCL2 following EPA treatment predicted improved disease-free survival (HR 0.32; P=0.003). Lack of ‘CCL2 response’ was associated with a specific CRCLM gene expression signature. In conclusion, reduction in plasma CCL2 in patients with CRCLM treated with EPA predicts better clinical outcome and a specific tumor gene expression profile. Further work is needed to validate CCL2 as a therapeutic response biomarker for omega-3 fatty acid treatment of CRC patients. PMID:27058904

  10. Music in Reducing Anxiety and Pain in Adult Patients Undergoing Bone Marrow Biopsy for Hematologic Cancers or Other Diseases

    Science.gov (United States)

    2017-01-18

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Lymphoproliferative Disorder; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Pain; Precancerous Condition; Psychosocial Effects of Cancer and Its Treatment

  11. Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study

    Directory of Open Access Journals (Sweden)

    Aramita Saha

    2013-12-01

    showed a similar declining pattern.-------------------------Cite this article as:Saha A, Chattopadhyay S. Assessment of pulmonary toxicities in breast cancer patients undergoing treatment with anthracycline and taxane based chemotherapy and radiotherapy- a prospective study. Int J Cancer Ther Oncol 2013; 1(2:01021.DOI: http://dx.doi.org/10.14319/ijcto.0102.1

  12. Photodynamic Therapy Using HPPH in Treating Patients Undergoing Surgery for Primary or Recurrent Head and Neck Cancer

    Science.gov (United States)

    2017-03-28

    Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Thyroid Cancer; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Basal Cell Carcinoma of the Lip; Stage I Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage I Follicular Thyroid Cancer; Stage I Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Papillary Thyroid Cancer; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the

  13. Quality of life in cancer patients undergoing chemotherapy in a tertiary care center in Malwa region of Punjab

    Directory of Open Access Journals (Sweden)

    Harminder Singh

    2014-01-01

    Conclusion: Although QOL scoring system did not show significant improvement in all areas (except insomnia, pain, appetite loss, constipation, and financial difficulties with reference to their respective chemotherapy cycles, but a judicious diagnosis with an appropriate treatment including chemotherapy may lessen the negative perception of cancer as a deadly and fatal disease in our rural population.

  14. Aspirin in patients undergoing noncardiac surgery

    DEFF Research Database (Denmark)

    Devereaux, P J; Mrkobrada, Marko; Sessler, Daniel I;

    2014-01-01

    BACKGROUND: There is substantial variability in the perioperative administration of aspirin in patients undergoing noncardiac surgery, both among patients who are already on an aspirin regimen and among those who are not. METHODS: Using a 2-by-2 factorial trial design, we randomly assigned 10......,010 patients who were preparing to undergo noncardiac surgery and were at risk for vascular complications to receive aspirin or placebo and clonidine or placebo. The results of the aspirin trial are reported here. The patients were stratified according to whether they had not been taking aspirin before...... the study (initiation stratum, with 5628 patients) or they were already on an aspirin regimen (continuation stratum, with 4382 patients). Patients started taking aspirin (at a dose of 200 mg) or placebo just before surgery and continued it daily (at a dose of 100 mg) for 30 days in the initiation stratum...

  15. Acetylcysteine Rinse in Reducing Saliva Thickness and Mucositis in Patients With Head and Neck Cancer Undergoing Radiation Therapy

    Science.gov (United States)

    2016-02-04

    Mucositis; Oral Complications; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Basal Cell Carcinoma of the Lip; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Nasopharynx; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the Oral Cavity; Stage II Basal Cell Carcinoma of the Lip; Stage II Lymphoepithelioma of the Nasopharynx; Stage II Lymphoepithelioma of the Oropharynx; Stage II Mucoepidermoid Carcinoma of the Oral Cavity; Stage II Salivary Gland Cancer; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Basal Cell Carcinoma of the Lip; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Mucoepidermoid

  16. 根治性治疗后非小细胞肺癌的预防性脑照射%Prophylactic Cranial Irradiation for Preventing Brain Metastases in Patients Undergoing Radical Treatment for Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    李伟雄; 黄玉娟

    2008-01-01

    @@ 1 文献来源 Lester JF,Coles B,Macbeth FR.Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer[DB/CD].The Cochrane Library 2007,Issue 3.

  17. Estimation of the risk of secondary cancer in the thyroid gland and the breast outside the treated volume in patients undergoing brain, mediastinum and breast radiotherapy.

    Science.gov (United States)

    Vlachopoulou, Vassiliki; Malatara, Georgia; Delis, Harry; Kardamakis, Dimitrios; Panayiotakis, George

    2013-04-01

    The purpose of this study was to measure the peripheral dose which is the absorbed dose in organs located outside the treatment volume such as the thyroid gland and the breast in patients undergoing radiotherapy, utilising the MOSFET dosemeters, as well as to estimate the probability of secondary cancer. The thyroid gland doses, expressed as a percentage of the prescribed dose (%TD), were measured to be 2.0±0.3 %, in whole brain irradiation, 10.0±8.0 % in mediastinum treatment and 8.0±2.0 and 2.0±0.8 % in breast treatment, with and without the supraclavicular irradiation, respectively, with a corresponding risk of 0.2, 2.0, 1.0 and 0.3 %. The dose to the breast was 7.0±2.0 %, in the mediastinum treatment, and 4.0±1.0 and 2.0±0.8 %, in the breast treatment, with and without supraclavicular irradiation, respectively, with a corresponding risk of 4.0, 2.0 and 1.0 %. Although the results indicate that the risk is not negligible, its significance should be considered in conjunction with the existing pathology and age of the patients.

  18. The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study

    DEFF Research Database (Denmark)

    Klausen, Julie Midtgaard; Rørth, Mikael Rahbek; Stelter, Reinhard

    2005-01-01

    Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91.......91 for anxiety and [minus sign]0.44 ± 2.77 for depression. Improvements in fitness were correlated with improvements in depression, [chi]2(1) = 3.966, p = 0.046, but not with improvements in anxiety, [chi]2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact...... patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p depression (p = 0.042) was significantly reduced. The mean ± SD of the change was [minus sign]1.14 ± 2...

  19. Clinical utility of Ancer 20 injection in oral cancer patients undergoing chemoradiotherapy. Preventive effect on the occurrence of stomatitis and peripheral leukopenia

    Energy Technology Data Exchange (ETDEWEB)

    Kirita, Tadaaki; Sugimura, Masahito [Nara Medical Univ., Kashihara (Japan)

    2000-07-01

    We conducted a comparative study to investigate the effects of polysaccharides extracted from M. tuberculosis strain Aoyama B (Ancer 20 injection) on blood cell counts and objective symptoms in oral cancer patients undergoing chemoradiotherapy. During the period of chemoradiotherapy, the number of peripheral RBC, leukocytes, platelets, and hemoglobin values in both a group treated with chemoradiotherapy and Ancer 20 injection (Group Z) and a group treated only with chemoradiotherapy (Group R) changed within the normal ranges of physiological variation. However, the peripheral lymphocyte count in Group Z fell to 67.2% and 65.7% of the pretreatment count, against 51.3% and 41.5% in Group R after two and three weeks after the initiation of the treatment, respectively. The reductions in counts were significantly mitigated in Group Z (2 weeks: p=0.040; 3 weeks: p=0.008). On the contrary, the delayed onset and lower severeness of stomatitis and fever were observed in the patients of Group Z. These results suggest that Ancer 20 injection during chemoradiotherapy reduces host immune function. (author)

  20. Sleep Disorders in ESRD Patients Undergoing Hemodialysis

    OpenAIRE

    Mohammad Reza Abassi; Amin Safavi; Masoumeh Haghverdi; Babak Saedi

    2016-01-01

    Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questi...

  1. Effects of Psychological Interventions in Cancer Patients Undergoing Radiotherapy%癌症放疗患者不同心理干预方式效果研究

    Institute of Scientific and Technical Information of China (English)

    汪达山; 李桂兰; 陈建华; 刘新民

    2011-01-01

    group were significantly lower than those in the control group(P<0.01); Compared with anxiety and depression at week 4 and week 8, anxiety and depression were significantly lower than those at week 0 (P<0.01); but both were rebound significantly at week 8 than those at week 4(P<0.01). Conclusion: Both the clinical training in relaxation with music and antidepressant medications are necessary for that they can help the cancer patients undergoing radiotherapy to relieve soon and can increase the patients' compliance with the cancer treatment.

  2. The prognostic value of functional tumor volume and total lesion glycolysis in patients with colorectal cancer liver metastases undergoing {sup 90}Y selective internal radiation therapy plus chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gulec, Seza A.; Suthar, Rekha R.; Barot, Tushar C. [Jackson North Medical Center, Florida International University College of Medicine, North Miami Beach, FL (United States); Pennington, Kenneth [Center for Cancer Care, Goshen, IN (United States)

    2011-07-15

    Functional tumor volume (FTV) and total lesion glycolysis (TLG) are measures of metabolic activity of tumors determined by fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images. These parameters could potentially have clinical value in response to treatment evaluation and disease prognostication. The objectives of this study were to investigate the relationship between functional tumor parameters (FTV and TLG) and clinical outcomes in patients with colorectal cancer liver metastases (CRCLM) undergoing {sup 90}Y-resin microsphere selective internal radiation therapy (SIRT) (SIR-Spheres {sup registered}, Sirtex Medical Limited, Lane Cove, NSW, Australia). FDG PET/CT studies of 20 patients with unresectable CRCLM who underwent {sup 90}Y SIRT under a phase II clinical trial were analyzed. FTV and TLG were calculated using PET VCAR (GE Healthcare, Milwaukee, WI, USA) on pretreatment and 4-week posttreatment scans. The effects of pretreatment and posttreatment functional tumor activity on patient survival were evaluated using Kaplan-Meier survival curves. The median survival in the study group was 14.8 months (range 2.0-27.7 months). The median survival for patients with pretreatment FTV values of above and below 200 cc were 11.2 and 26.9 months, respectively (p < 0.05). The median survival for patients with 4-week posttreatment FTV values of above and below 30 cc were 10.9 and 26.9 months, respectively (p < 0.05). The median survival for patients with pretreatment TLG values of above and below 600 g were 11.2 and 26.9 months, respectively (p < 0.05). The median survival for patients with 4-week posttreatment TLG values of above and below 100 g were 10.9 and 26.9 months, respectively (p < 0.05). Pretreatment and posttreatment FTV and TLG showed very strong association with survival. These values can be useful quantitative criteria for patient selection and disease prognostication when {sup 90}Y SIRT is contemplated in patients with CRCLM. (orig.)

  3. Survey of patient dosimetry for head and neck cancer patients undergoing external radiotherapy treatment: A study from northeastern hospitals of India

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    Sharma Arunkumar

    2009-01-01

    Full Text Available Aim : To study dosimetry of patients during the external radiotherapy of head and neck cancers from different hospitals of the northeastern region (NER of India. Materials and Methods : 35 confirmed cases of head and neck cancers reporting to three different hospitals in the NER of India who underwent radiation treatment were the materials for the study. Dosimetry was carried out at 8(eight anatomical points to these patients, namely, target (entrance and exit points, forehead, chest, abdomen, gonad, arm, and leg respectively by thermoluminescence (TL as well as optically stimulated luminescence (OSL dosimeters. Unlike conventional appliances, we used common iodized salt as TL/OSL phosphor. Results : Patient dosimetry was found to vary with an average of 1.17 ± 0.39 Sv at forehead, 1.24 ± 0.39 Sv at chest, 0.52 ± 0.13 Sv at gonad to a minimum of 0.26 ± 0.07 Sv at leg areas when exposed to a cumulative dose of 65 Sv at the target. Conclusion : Maximum dose received from a stray radiation is about 1.5 Sv at forehead/chest and dosimetry of patient among the three centers is not significantly different at the 5% level of probability.

  4. Predictors of Grade 3 or Higher Late Bowel Toxicity in Patients Undergoing Pelvic Radiation for Cervical Cancer: Results From a Prospective Study

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    Chopra, Supriya, E-mail: schopra@actrec.gov.in [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Dora, Tapas [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Chinnachamy, Anand N. [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Thomas, Biji [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Kannan, Sadhna [Epidemiology and Clinical Trials Unit, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Engineer, Reena; Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Phurailatpam, Reena; Paul, Siji N. [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Shrivastava, Shyam Kishore [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India)

    2014-03-01

    Purpose: The present study investigates relationship between dose–volume parameters and severe bowel toxicity after postoperative radiation treatment (PORT) for cervical cancer. Methods and Materials: From June 2010 to December 2012, a total of 71 patients undergoing PORT were included. Small bowel (SB) and large bowel (LB) loops were contoured 2 cm above the target volume. The volume of SB and LB that received 15 Gy, 30 Gy, and 40 Gy was calculated (V15 SB, V15 LB, V30 SB, V30 LB, V40 SB, V 40 LB). On follow-up, bowel toxicity was scored using Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. A reciever operating characteristic (ROC) curve identified volume thresholds that predicted for grade 3 or higher toxicity with highest specificity. All data was dichotomized across these identified cut-off values. Univariate and multivariate analysis was performed using SPSS, version 15. Results: The median patient age was 47 years (range, 35-65 years). Of the 71 patients, 46 received image-guided intensity modulated radiation therapy, and 25 received conformal radiation (50 Gy in 25 fractions for 5 weeks). Overall, 63 of 71 patients received concurrent chemotherapy. On a median follow-up of 18 months (range, 8-29 months), grade 2 or higher bowel toxicity was seen in 22 of 71 patients (30.9%) and grade 3 or higher bowel toxicity was seen in 9 patients (12.6%). On univariate analysis, V15 SB <275 cc (P=.01), V30 SB <190 cc (P=.02), V40 SB <150 cc (P=.01), and V15 LB <250 cc (P=.03), and V40 LB <90 cc (P=.04) predicted for absence of grade 3 or higher toxicity. No other patient- or treatment-related factors were statistically significant. On multivariate analysis, only V15 SB (P=.002) and V15 LB (P=.03) were statistically significant. Conclusions: V 15 Gy SB and LB are independent predictors of late grade 3 or higher toxicity. Restricting V15 SB and V15 LB to <275 cc and <250 cc can reduce grade 3 or higher toxicity to less than 5%.

  5. Effects of a Short-Term Dance Movement Therapy Program on Symptoms and Stress in Patients With Breast Cancer Undergoing Radiotherapy: A Randomized, Controlled, Single-Blind Trial

    OpenAIRE

    Luk, MY; Yip, PSF; Cheung, IKM; Fong, TCt; Ho, RTH

    2016-01-01

    Context: Integrated interventions with combined elements of body movement and psychotherapy on treatment-related symptoms in cancer patients are relatively scarce. Objectives: The aim of the present study is to investigate the effectiveness of dance movement therapy (DMT) on improving treatment-related symptoms in a randomized controlled trial. Methods: A total of 139 Chinese patients with breast cancer awaiting adjuvant radiotherapy were randomized to DMT or control group. The intervention i...

  6. Liquid discharges from patients undergoing {sup 131}I treatments

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    Barquero, R. [Servicio de Radiofisica y Proteccion Radiologica, Hospital Universitario Rio Hortega, E-47010 Valladolid (Spain)], E-mail: rbarquero@hurh.sacyl.es; Basurto, F. [Departamento de Fisica Teorica, Atomica y Optica, Universidad de Valladolid, E-47010 Valladolid (Spain); Nunez, C. [Servicio de Radiofisica y Proteccion Radiologica, Fundacion Jimenez Diaz, FJD, E-82001 Madrid (Spain); Esteban, R. [Servicio de Radiologia, Hospital Clinico Universitario, E-47005 Valladolid (Spain)

    2008-10-15

    This work discusses the production and management of liquid radioactive wastes as excretas from patients undergoing therapy procedures with {sup 131}I radiopharmaceuticals in Spain. The activity in the sewage has been estimated with and without waste radioactive decay tanks. Two common therapy procedures have been considered, the thyroid cancer (4.14 GBq administered per treatment), and the hyperthyroidism (414 MBq administered per treatment). The calculations were based on measurements of external exposure around the 244 hyperthyroidism patients and 23 thyroid cancer patients. The estimated direct activity discharged to the sewage for two thyroid carcinomas and three hyperthyroidisms was 14.57 GBq and 1.27 GBq, respectively, per week; the annual doses received by the most exposed individual (sewage worker) were 164 {mu}Sv and 13 {mu}Sv, respectively. General equations to calculate the activity as a function of the number of patient treated each week were also obtained.

  7. Progressive Resistance Training and Cancer Testis (PROTRACT - Efficacy of resistance training on muscle function, morphology and inflammatory profile in testicular cancer patients undergoing chemotherapy: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mackey Abigail L

    2011-08-01

    Full Text Available Abstract Background Standard treatment for patients with disseminated germ cell tumors is combination chemotherapy with bleomycin, etoposide and cisplatin (BEP. This treatment is highly effective, but the majority of patients experience severe adverse effects during treatment and are at risk of developing considerable long-term morbidity, including second malignant neoplasms, cardiovascular disease, and pulmonary toxicity. One neglected side effect is the significant muscular fatigue mentioned by many patients with testicular cancer both during and after treatment. Very limited information exists concerning the patho-physiological effects of antineoplastic agents on skeletal muscle. The primary aim of this study is to investigate the effects of BEP-treatment on the skeletal musculature in testicular cancer patients, and to examine whether the expected treatment-induced muscular deterioration can be attenuated or even reversed by high intensity progressive resistance training (HIPRT. Design/Methods The PROTRACT study is a randomized controlled trial in 30 testicular cancer patients undergoing three cycles of BEP chemotherapy. Participants will be randomized to either a 9-week HIPRT program (STR initiated at the onset of treatment, or to standard care (UNT. 15 healthy matched control subjects (CON will complete the same HIPRT program. All participants will take part in 3 assessment rounds (baseline, 9 wks, 21 wks including muscle biopsies, maximum muscle strength tests, whole body DXA scan and blood samples. Primary outcome: mean fiber area and fiber type composition measured by histochemical analyses, satellite cells and levels of protein and mRNA expression of intracellular mediators of protein turnover. Secondary outcomes: maximum muscle strength and muscle power measured by maximum voluntary contraction and leg-extensor-power tests, body composition assessed by DXA scan, and systemic inflammation analyzed by circulating inflammatory markers

  8. Oral surgery in patients undergoing chemoradiation therapy.

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    Demian, Nagi M; Shum, Jonathan W; Kessel, Ivan L; Eid, Ahmed

    2014-05-01

    Oral health care in patients undergoing chemotherapy and/or radiation therapy can be complex. Care delivered by a multidisciplinary approach is timely and streamlines the allocation of resources to provide prompt care and to attain favorable outcomes. A hospital dentist, oral and maxillofacial surgeon, and a maxillofacial prosthodontist must be involved early to prevent avoidable oral complications. Prevention and thorough preparation are vital before the start of chemotherapy and radiation therapy. Oral complications must be addressed immediately and, even with the best management, can cause delays and interruption in treatment, with serious consequences for the outcome and prognosis.

  9. Dermatillomania: In patient undergoing orthodontic treatment

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    Adit

    2014-01-01

    Full Text Available Dermatillomania is a disorder in which a person habitually picks their skin, and this is a form of self-injury. It can involve any part of the body, but usually involves the face, neck, arms and shoulders. Symptoms often follow an event that has caused severe emotional distress. A dermatillomania or compulsive skin picking episode may be a conscious response to anxiety or depression but is frequently done as an unconscious habit. In this case report, a patient undergoing orthodontic treatment was found to be suffering from dermatillomania and was treated using psychological counseling.

  10. The Practicability of a Novel Prognostic Index (PI Model and Comparison with Nottingham Prognostic Index (NPI in Stage I-III Breast Cancer Patients Undergoing Surgical Treatment.

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    Jiahuai Wen

    Full Text Available Previous studies have indicated the prognostic value of various laboratory parameters in cancer patients. This study was to establish a prognostic index (PI model for breast cancer patients based on the potential prognostic factors.A retrospective study of 1661 breast cancer patients who underwent surgical treatment between January 2002 and December 2008 at Sun Yat-sen University Cancer Center was conducted. Multivariate analysis (Cox regression model was performed to determine the independent prognostic factors and a prognostic index (PI model was devised based on these factors. Survival analyses were used to estimate the prognostic value of PI, and the discriminatory ability of PI was compared with Nottingham Prognostic Index (NPI by evaluating the area under the receiver operating characteristics curves (AUC.The mean survival time of all participants was 123.6 months. The preoperative globulin >30.0g/L, triglyceride >1.10mmol/L and fibrinogen >2.83g/L were identified as risk factors for shorter cancer-specific survival. The novel prognostic index model was established and enrolled patients were classified as low- (1168 patients, 70.3%, moderate- (410 patients, 24.7% and high-risk groups (83 patients, 5.0%, respectively. Compared with the low-risk group, higher risks of poor clinical outcome were indicated in the moderate-risk group [Hazard ratio (HR: 1.513, 95% confidence interval (CI: 1.169-1.959, p = 0.002] and high-risk group (HR: 2.481, 95%CI: 1.653-3.724, p< 0.001.The prognostic index based on three laboratory parameters was a novel and practicable prognostic tool. It may serve as complement to help predict postoperative survival in breast cancer patients.

  11. Effect of a Perioperative Nutritional Supplementation with Oral Impact® in Patients undergoing Hepatic Surgery for Liver Cancer: A Prospective, Placebo-Controlled, Randomized, Double-Blind Study.

    Science.gov (United States)

    Seguin, Philippe; Locher, Clara; Boudjema, Karim; Hamon, Catherine; Mouchel, Catherine; Malledant, Yannick; Bellissant, Eric

    2016-01-01

    Perioperative nutrition with supplements containing L-arginine, ω3-polyunsaturated fatty acids, and nucleotides could boost liver function recovery, immune response, and resistance to infection after hepatic resection. We conducted a placebo-controlled, randomized, double-blind study to assess the effect of a perioperative nutritional supplementation with Oral Impact® in patients undergoing hepatic surgery for liver cancer. Treatment was given three times daily for 7 days before and 3 days after surgery. Primary outcome was factor V, 3 days after surgery. Thirty-five patients (placebo: 17; Oral Impact: 18) were included. Five patients (placebo: three; Oral Impact: two) were not operated and five (placebo: two; Oral Impact: three) did not undergo hepatic resection. Factor V (mean ± SD) was 70 ± 27% and 79 ± 25% (P = 0.409) 3 days after surgery and 90 ± 30% and 106 ± 16% (P = 0.066) 5 days after surgery, in placebo and Oral Impact groups, respectively. There were no significant differences between groups on other outcomes assessing liver function recovery (bile production, γ-glutamyl transferase, α-fetoprotein), immune response (CD3, CD4, CD8 cells, CD4/CD8 ratio, natural killer cells, B lymphocytes), number of infections, and tolerance. A 10-day perioperative nutritional supplementation with Oral Impact does not improve hepatic function, immune response, and resistance to infection in patients undergoing hepatic surgery for liver cancer.

  12. Characteristics of users and implications for the use of complementary and alternative medicine in Ghanaian cancer patients undergoing radiotherapy and chemotherapy: a cross- sectional study

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    Yarney Joel

    2013-01-01

    Full Text Available Abstract Background There is widespread use of Complementary and Alternative Medicine (CAM in Ghana, driven by cultural consideration and paradigm to disease causation. Whether there is concurrent use of conventional medicine and CAM in cancer patients is unknown. This study investigates the prevalence, pattern and predictors of CAM use in cancer patients. Overlapping toxicity, sources of information, and whether users inform their doctor about CAM use is examined. Method Cross-sectional study using a questionnaire administered to cancer patients, who were receiving radiotherapy and or chemotherapy or had recently completed treatment at a single institution was used. Results Ninety eight patients participated in the study with a mean age of 55.5 (18–89, made up of 51% females. Married individuals formed 56% of the respondents, whilst 49% had either secondary or tertiary education. Head and neck cancer patients were 15.3%, breast (21.4%, abdomen/pelvic cancers constituted (52%.Seventy seven (78.6% patients received radiotherapy only, 16.3% received radiation and chemotherapy and 5.3% had chemotherapy only. Ninety five patients were diagnosed of cancer within the past 24 months,73.5% were CAM users as follows; massage(66.3%, herbal(59.2%, mega vitamins(55.1%, Chinese medicine(53.1%,and prayer(42.9%. Sixty eight percent were treated with curative intent. Overlapping toxicity was reported. Majority (83.3% of users had not informed their doctor about CAM use. On univariate analysis, female (p=0.004 and palliative patients, p=0.032 were more likely to be CAM users. Multivariate analysis identified female (p Friends and Media are the main sources of information on CAM. There was increase in CAM use after the diagnosis of cancer mainly for Chinese Medicine and vitamins. Conclusion There is high CAM usage among Cancer patients, comparable to use in the general population, there is concurrent use of CAM and conventional medicine with reported

  13. Bioimpedance Spectroscopy in Detecting Lower-Extremity Lymphedema in Patients With Stage I, Stage II, Stage III, or Stage IV Vulvar Cancer Undergoing Surgery and Lymphadenectomy

    Science.gov (United States)

    2016-02-09

    Lymphedema; Perioperative/Postoperative Complications; Stage IA Vulvar Cancer; Stage IB Vulvar Cancer; Stage II Vulvar Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Vulvar Cancer; Stage IVB Vulvar Cancer

  14. Perioperative Education of Patient Undergoing Cardiac Surgery

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    Alexandros Zacharis

    2011-04-01

    Full Text Available In recent years, the number of patients undergoing cardiac surgeries is steadily increasing. In Greece, approximately 10,500 patients per year are admitted to some kind of cardiac operation. Constant evolution of heart surgery techniques calls for adaptation of the perioperative nursing care given. Patient education, as an important part of the perioperative care, is directly related to the reduction of postoperative complications and stress management, thus promoting the patient's overall postoperative well-being. Aim: The aim of this review was to present the most important aspects of the patient's perioperative education and the role that the nurse has to play in it. Methods: Data from selected articles were extracted from Pubmed, Chinahl and Cohrane, as well as from non-electronically published scientific studies ranging from 1998-2010 and 2003-2008 respectively. Results: According to the literature, perioperative patient education can be implemented in various ways, such as through verbal updates, the use of audiovisual means and the provision of informative leaflets. The teaching topics can be divided into those of the preoperative and postoperative phase. Stress management prepares the patients psychologically and also enhances the therapeutic nurse-patient relationship. The teaching of breathing techniques and isometric exercises of the lower limbs, the cessation of smoking, the diet to be followed, as well as the management of medication, aim in the patients' physical preparation, in order to optimize their postoperative course. Conclusion: Perioperative patient education, regardless of how it is implemented, constitutes both an integral part of the nursing care and an independent nursing intervention per se, which strengthens the nurses' autonomy and improves the patient's postoperative course.

  15. Pectoral stretching program for women undergoing radiotherapy for breast cancer.

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    Lee, T S; Kilbreath, S L; Refshauge, K M; Pendlebury, S C; Beith, J M; Lee, M J

    2007-05-01

    Surgery and radiotherapy commonly cause adverse musculoskeletal problems, particularly loss of strength and range of motion, in the upper quadrant of breast cancer patients. Few well-designed studies have investigated whether these impairments can be prevented. Stretching is an effective technique for increasing range of motion, hence the aim of this study was to investigate whether a stretching program reduced acute musculoskeletal impairments in patients undergoing radiotherapy for breast cancer. Sixty-four women were recruited prior to commencement of radiotherapy following breast cancer surgery. Participants were randomised to either a control or stretch group. Participants in both groups were reviewed by the physical therapist on a weekly basis for approximately 6 weeks, and were given general information about skin care and lymphedema. The control group received no advice about exercise. The stretch group received instruction on low-load, prolonged pectoral stretches, which were to be performed daily and were checked at weekly visits. Shoulder range of motion, strength, arm circumference, and quality of life measurements were taken prior to, and at completion of radiotherapy, and at 7 months after radiotherapy. There was no difference in any outcome between groups. Breast symptoms increased for both groups during radiotherapy, without loss of strength or range of movement. The incidence of lymphedema during the study was low for both groups and did not differ between groups. The pectoral stretching program did not influence the outcomes measured because the symptoms reported by patients were not a consequence of contracture.

  16. Sleep Disorders in ESRD Patients Undergoing Hemodialysis

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    Mohammad Reza Abassi

    2016-04-01

    Full Text Available Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011, 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected. The patients selected their specific sleep disorders using a nine-item scale while the Epworth Sleepiness Scale (ESS determined both the presence and severity of sleep disorders. The data was finally analyzed with their baseline characteristics, dialysis characteristics, medication/stimulants use, and clinical and biochemical parameters. Over 95% of the patients had, at least, one specific sleep disorder while the ESS revealed 36.36% of patients as normal, 59.09% as having mild sleep disorders, and 4.54% as having moderate to severe sleep disorders. Sleep disorders were significantly correlated with older ages (P=0.035, dialysis dose (P=0.001, blood creatinine levels (P=0.037, upper airways obstruction (P=0.035, hepatomegaly (P=0.006, hepatic failure (P=0.001, higher blood TSH levels (P=0.039, history of hypothyroidism (P=0.005, and the use of levodopa (P=0.004, anti-hypertensive medications (P=0.006, benzodiazepines (P=0.006, Eprex (Erythropoietin (P=0.001, Venofer (Iron Sucrose Injection (P=0.013, and phosphate-binders agents (P=0.018. Sleep disorders are common findings among ESRD patients and seem to be a more complicated issue than a simple accumulation of the wastes products in the body. Whatever the causes of sleep disorders are, disorder-specific treatments should be considered.

  17. Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease

    Science.gov (United States)

    Kristo, Ivan; Riss, Stefan; Argeny, Stanislaus; Maschke, Svenja; Chitsabesan, Praminthra; Stift, Anton

    2017-01-01

    AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD). METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control (UICC). RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6 (1.2%) patients (4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43 (27-66) years and a median history of CD of 16 (7-36) years. Malignant lesions were found in the rectum (n = 4, 66.7%), descending colon (n = 1, 16.7%) and ileocolon (n = 1, 16.7%). According to the UICC classification two patients were stages as I (33.3%), whereas the other patients were classified as stage IIA (16.7%), stage IIIB (16.7%), stage IIIC (16.7%) and stage IV (16.7%), respectively. After a median follow-up of 2 (0.03-8) years only 1 patient is still alive. CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum. PMID:28210083

  18. Analysis of perception control and influencing factors in patients with lung cancer undergoing chemotherapy%肺癌化疗患者感知控制水平现状调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    谭杏; 黄丽芳; 孙彩霞; 蒋睿; 曾谷清

    2016-01-01

    Objective To analyze the perceived control of lung cancer patients undergoing chemotherapy and to explore its influencing factors. Methods A total of 185 patients with lung cancer were recruited and assessed by homemade general information questionnaire and the Cancer Experience and Efficacy Scale. Results The total score of cancer experience during chemotherapy in patients with lung cancer was (62.50±6.99) points. The total score of efficacy during chemotherapy in patients with lung cancer was (42.52±8.08) points. Single factor analysis showed the influencing factors of perceived control were personal income, sex, education, metastasis, surgical treatment and stage of disease. Conclusions The cancer-related experience and efficacy of patients with lung cancer is at middle level. Health-care worker should pay attention to the impact of lung cancer patients and take effective measures to mitigate the negative cancer-related experience, thereby improving the perceived control of the lung cancer patients.%目的:探讨肺癌住院患者化疗期间感知控制能力现状及影响因素。方法采用自制的一般资料调查表和癌症经验与效能量表对185例肺癌化疗患者进行调查。结果肺癌患者化疗期间癌症经验总分为(62.50±6.99)分,癌症效能总分为(42.52±8.08)分。个人收入、性别、文化程度、是否转移、是否手术、疾病分期是肺癌患者感知控制能力的主要影响因素。结论肺癌住院患者化疗期间的患癌经验和控制效能呈中等水平。护理人员应重视感知控制能力对肺癌患者的影响,采取有效措施降低患者的患癌负面体验,提高其应对肺癌的控制效能。

  19. Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the 'obesity paradox' really exist?

    Science.gov (United States)

    Li, Shuangjiang; Wang, Zhiqiang; Huang, Jian; Fan, Jun; Du, Heng; Liu, Lunxu; Che, Guowei

    2016-12-30

    The paradoxical benefit of obesity, the 'obesity paradox', has been recently identified in surgical populations. Our goal was to evaluate by a systematic review with meta-analysis the prognostic role of body mass index (BMI) and to identify whether the 'obesity paradox' exists in lung cancer surgery. Comprehensive literature retrieval was conducted in PubMed to identify the eligible articles. The odds ratios (OR) and hazard ratios (HR) with the corresponding 95% confidence intervals (CI) were used to synthesize in-hospital and long-term survival outcomes, respectively. The heterogeneity level and publication bias between studies were also estimated. Finally, 25 observational studies with 78 143 patients were included in this review. The pooled analyses showed a significantly better long-term survival rate in patients with higher BMI, but no significant benefit of increased BMI was found for in-hospital morbidity. The pooled analyses also showed that overall morbidity (OR: 0.84; 95% CI: 0.73-0.98; P = 0.025) and in-hospital mortality (OR: 0.78; 95% CI: 0.63-0.98; P = 0.031) were significantly decreased in obese patients. Obesity could be a strong predictor of the favourable long-term prognosis of lung cancer patients (HR: 0.69; 95% CI: 0.56-0.86; P = 0.001). The robustness of these pooled estimates was strong. No publication bias was detected. In summary, obesity has favourable effects on in-hospital outcomes and long-term survival of surgical patients with lung cancer. The 'obesity paradox' does have the potential to exist in lung cancer surgery.

  20. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    Science.gov (United States)

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  1. Impact of combined pulmonary fibrosis and emphysema on surgical complications and long-term survival in patients undergoing surgery for non-small-cell lung cancer

    Directory of Open Access Journals (Sweden)

    Hata A

    2016-06-01

    Full Text Available Atsushi Hata,1,2 Yasuo Sekine,1 Ohashi Kota,1 Eitetsu Koh,1 Ichiro Yoshino2 1Department of Thoracic Surgery, Tokyo Women’s Medical University Yachiyo Medical Centre, Yachiyo, 2Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan Purpose: The outcome of radical surgery for lung cancer was investigated in patients with combined pulmonary fibrosis and emphysema (CPFE. Methods: A retrospective chart review involved 250 patients with lung cancer who underwent pulmonary resection at Tokyo Women’s Medical University Yachiyo Medical Center between 2008 and 2012. Based on the status of nontumor-bearing lung evaluated by preoperative computed tomography (CT, the patients were divided into normal, emphysema, interstitial pneumonia (IP, and CPFE groups, and their clinical characteristics and surgical outcome were analyzed. Results: The normal, emphysema, IP, and CPFE groups comprised 124 (49.6%, 108 (43.2%, seven (2.8%, and eleven (4.4% patients, respectively. The 5-year survival rate of the CPFE group (18.7% was significantly lower than that of the normal (77.5% and emphysema groups (67.1% (P<0.0001 and P=0.0027, respectively but equivalent to that of the IP group (44.4% (P=0.2928. In a subset analysis of cancer stage, the 5-year overall survival rate of the CPFE group in stage I (n=8, 21.4% was also lower than that of the normal group and emphysema group in stage I (n=91, 84.9% and n=70, 81.1%; P<0.0001 and P<0.0001, respectively. During entire observation period, the CPFE group was more likely to die of respiratory failure (27.2% compared with the normal and emphysema groups (P<0.0001. Multivariate analysis of prognostic factors using Cox proportional hazard model identified CPFE as an independent risk factor (P=0.009. Conclusion: CPFE patients have a poorer prognosis than those with emphysema alone or with normal lung on CT finding. The intensive evaluation of preoperative CT images is

  2. Splenic vein thrombosis is associated with an increase in pancreas-specific complications and reduced survival in patients undergoing distal pancreatectomy for pancreatic exocrine cancer.

    Science.gov (United States)

    Dedania, Nishi; Agrawal, Nidhi; Winter, Jordan M; Koniaris, Leonidas G; Rosato, Ernest L; Sauter, Patricia K; Leiby, Ben; Pequignot, Edward; Yeo, Charles J; Lavu, Harish

    2013-08-01

    Distal pancreatectomy and splenectomy (DPS) is the procedure of choice for the surgical treatment of pancreatic exocrine cancer localized to the body and tail of the pancreas. Splenic vein thrombosis (SVT) can occur in patients with malignant pancreatic exocrine tumors secondary to direct tumor invasion or compression of the splenic vein by mass effect. This study examines the effect of preoperative SVT on postoperative outcomes. In this retrospective cohort study, we queried our pancreatic surgery database to identify patients who underwent DPS from October 2005 to June 2011. These cases were evaluated for evidence of preoperative SVT on clinical records and cross-sectional imaging (CT,MRI, endoscopic US). Outcomes for patients with and without SVT were compared. From an overall cohort of 285 consecutive patients who underwent DPS during the study period, data were evaluated for 70 subjects who underwent surgery for pancreatic exocrine cancer (27 with SVT, 43 without SVT). The preoperative demographics and co-morbidities were similar between the groups, except the average age was higher for those without SVT (ppancreatic fistula (33 versus 7 %,ppancreatic ductal adenocarcinoma can be performed safely in patients with SVT, but with higher intraoperative blood loss, increased pancreas-specific complications, and a trend towards lower long-term survival rates. This paper was presented as a poster at the 53rd annual meeting of the Society for Surgery of the Alimentary Tract and at the 46th annual meeting of the Pancreas Club, San Diego, CA, May 2012.

  3. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta;

    2015-01-01

    in all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (p Gleason score....... MATERIAL AND METHODS: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI...... upgrade of at least one grade based on the mp-MRI-bx. Secondary PCa lesions not visible on mp-MRI were detected by TRUS-bx in six out of 39 PCa patients. The secondary foci were all Gleason 6 (3 + 3) in 5-10% of the biopsy core. According to the Epstein criteria, 37 out of 39 cancer patients were...

  4. Overexpression of activated phospholipase Cγ1 is a risk factor for distant metastases in T1-T2, N0 breast cancer patients undergoing adjuvant chemotherapy.

    Science.gov (United States)

    Lattanzio, Rossano; Marchisio, Marco; La Sorda, Rossana; Tinari, Nicola; Falasca, Marco; Alberti, Saverio; Miscia, Sebastiano; Ercolani, Cristiana; Di Benedetto, Anna; Perracchio, Letizia; Melucci, Elisa; Iacobelli, Stefano; Mottolese, Marcella; Natali, Pier Giorgio; Piantelli, Mauro

    2013-03-01

    Phospholipase Cγ1 (PLCγ1) is highly expressed in several tumors. We have previously reported that both stable and inducible PLCγ1 down-regulation resulted in an almost complete inhibition of breast cancer-derived experimental lung metastasis formation. The aim of our study is to evaluate the association between the expression of PLCγ1 and of PLCγ1 phosphorylated at Tyr1253 (PLCγ1-pY1253) and at Tyr783 (PLCγ1-pY783) with the clinical outcome of patients with node negative, T1/T2 breast cancers. The study groups consisted of 292 (training set) and 122 (validation set) patients presenting with primary unilateral breast carcinoma (T1-T2), with no evidence of nodal involvement and distant metastases. PLCγ1, PLCγ1-pY1253 and PLCγ1-pY783 protein expression were assessed by immunohistochemistry on tissue microarrays and the results correlated with the clinical data using Kaplan-Meier curves and multivariate Cox regression analysis. Tumor cells while expressing variable proportions of cytoplasmic PLCγ1, express PLCγ1-pY1253 and PLCγ1-pY783 predominantly in the nucleus. High expression of PLCγ1, and of its activated forms, is associated with a worse clinical outcome in terms of incidence of distant metastases, and not of local relapse in T1-T2, N0 breast cancer patients undergone adjuvant chemotherapy. PLCγ1 over-expression appears to be a reliable predictive surrogate marker of development of metastases. Thus, targeting PLCγ1 pathways might represent a potential therapeutic approach for the prevention of metastatic disease in breast cancer.

  5. Acupuncture and PC6 stimulation for the prevention of postoperative nausea and vomiting in patients undergoing elective laparoscopic resection of colorectal cancer: a study protocol for a three-arm randomised pilot trial

    Science.gov (United States)

    Kim, Kun Hyung; Kim, Dae Hun; Bae, Ji Min; Son, Gyung Mo; Kim, Kyung Hee; Hong, Seung Pyo; Yang, Gi Young; Kim, Hee Young

    2017-01-01

    Introduction This study aims to assess the feasibility of acupuncture and a Pericardium 6 (PC6) wristband as an add-on intervention of antiemetic medication for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing elective laparoscopic colorectal cancer resection. Methods and analysis A total of 60 participants who are scheduled to undergo elective laparoscopic resection of colorectal cancer will be recruited. An enhanced recovery after surgery protocol using standardised antiemetic medication will be provided for all participants. Participants will be equally randomised into acupuncture plus PC6 wristband (Acupuncture), PC6 wristband alone (Wristband), or no acupuncture or wristband (Control) groups using computer-generated random numbers concealed in opaque, sealed, sequentially numbered envelopes. For the acupuncture combined with PC6 wristband group, the embedded auricular acupuncture technique for preoperative anxiolysis and up to three sessions of acupuncture treatments with manual and electrical stimulation within 48 hours after surgery will be provided by qualified Korean medicine doctors. The PC6 wristband will be applied in the Acupuncture and Wristband groups, beginning 1 hour before surgery and lasting 48 hours postoperatively. The primary outcome will be the number of participants who experience moderate or severe nausea, defined as nausea at least 4 out of 10 on a severity numeric rating scale or vomiting at 24 hours after surgery. Secondary outcomes, including symptom severity, participant global assessments and satisfaction, quality of life, physiological recovery, use of medication and length of hospital stay, will be assessed. Adverse events and postoperative complications will be measured for 1 month after surgery. Ethics and dissemination All participants will provide written informed consent. The study has been approved by the institutional review board (IRB). This pilot trial will inform a full

  6. Effect of Zinc Supplementation on Antioxidant Defenses and Oxidative Stress Markers in Patients Undergoing Chemotherapy for Colorectal Cancer: a Placebo-Controlled, Prospective Randomized Trial.

    Science.gov (United States)

    Ribeiro, Sofia Miranda de Figueiredo; Braga, Camila Bitu Moreno; Peria, Fernanda Maris; Domenici, Fernanda Aparecida; Martinez, Edson Zangiacomi; Feres, Omar; da Rocha, José Joaquim Ribeiro; da Cunha, Selma Freire de Carvalho

    2016-01-01

    The study aimed to investigate the effect of oral zinc supplementation on antioxidant defenses and oxidative stress markers during chemotherapy for colorectal cancer. Twenty-four patients who had undergone surgical resection of colorectal cancer participated in this placebo-controlled, prospective randomized study. The supplementation was started in the perioperative period, in which 10 patients received 70 mg of zinc (zinc group, n = 10) and 14 patients received placebo (placebo group, n = 14) for 16 weeks. Approximately 45 days after surgical resection of tumor, all patients received a chemotherapeutic regimen (capecitabine, capecitabine combined with oxaliplatin or 5-fluorouracil). Vitamin C, vitamin E, antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), and lipid peroxidation markers malondialdehyde (MDA) and 8-isoprostane were determined before the first, second, third, and fourth chemotherapy cycles. Compared with the placebo group, the zinc group presented higher SOD values before the first, second, and fourth chemotherapy cycles and lower GPx values before the third cycle. There were no statistical differences between the study groups in vitamin C, vitamin E, MDA, or 8-isoprostane plasma values. Longitudinal analysis revealed decreased vitamin E concentration in the placebo group before the second and fourth cycles as compared with the initial values. Zinc supplementation during chemotherapy cycles increased SOD activity and maintained vitamin E concentrations. Although no effect of zinc supplementation on oxidative stress markers was observed, the increase in SOD activity indicates a production of stable free radicals, which may have a positive effect in cancer treatment.

  7. Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

    Energy Technology Data Exchange (ETDEWEB)

    Gouvea de Lima, Aline [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Villar, Rosangela Correa [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Castro, Gilberto de, E-mail: gilberto.castro@usp.br [Department of Clinical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, SP (Brazil); Antequera, Reynaldo [Divisao de Odontologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Gil, Erlon; Rosalmeida, Mauro Cabral [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moises Longo [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil)

    2012-01-01

    Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm{sup 2} or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60-70 Gy (range, 1.8-2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might

  8. Increasing Radiation Therapy Dose Is Associated With Improved Survival in Patients Undergoing Stereotactic Body Radiation Therapy for Stage I Non–Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koshy, Matthew, E-mail: mkoshy@radonc.uchicago.edu [Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois (United States); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Malik, Renuka [Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Weichselbaum, Ralph R. [Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois (United States); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Sher, David J. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)

    2015-02-01

    Purpose: To determine the comparative effectiveness of different stereotactic body radiation therapy (SBRT) dosing regimens for early-stage non–small-cell lung cancer, using a large national database, focusing on the relative impact of dose as a function of tumor stage. Methods and Materials: The study included patients in the National Cancer Database from 2003 to 2006 with T1-T2N0M0 inoperable lung cancer (n=498). The biologically effective dose (BED) was calculated according to the linear quadratic formula using an α/β ratio of 10. High versus lower-dose (HD vs LD) SBRT was defined as a calculated BED above or below 150 Gy. Overall survival was estimated using Kaplan-Meier methods and Cox proportional hazard regression. Results: The 5 most common dose fractionation schemes (percentage of cohort) used were 20 Gy × 3 (34%), 12 Gy × 4 (16%), 18 Gy × 3 (10%), 15 Gy × 3 (10%), and 16 Gy × 3 (4%). The median calculated BED was 150 Gy (interquartile range 106-166 Gy). The 3-year overall survival (OS) for patients who received HD versus LD was 55% versus 46% (log–rank P=.03). On subset analysis of the T1 cohort there was no association between calculated BED and 3-year OS (61% vs 60% with HD vs LD, P=.9). Among the T2 cohort, patients receiving HD experienced superior 3-year OS (37% vs 24%, P=.01). On multivariable analysis, factors independently prognostic for mortality were female gender (hazard ratio [HR] 0.76, P=.01), T2 tumor (HR 1.99, P=.0001), and HD (HR 0.68, P=.001). Conclusions: This comparative effectiveness analysis of SBRT dose for patients with stage I non–small-cell lung cancer suggests that higher doses (>150 Gy BED) are associated with a significant survival benefit in patients with T2 tumors.

  9. Therapeutic efficacy of traditional Chinese medicine, Shen-Mai San, in cancer patients undergoing chemotherapy or radiotherapy: study protocol for a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Lo Lun-Chien

    2012-12-01

    Full Text Available Abstract Background Cancer is one of the major health issues worldwide. An increasing number of cancer patients are offered treatment with surgery, chemotherapy and radiotherapy. Traditional Chinese medicine (TCM is one of the most common complementary therapies offered to cancer patients in Taiwan. We designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of TCM in patients with cancer. Methods/design In this study, inclusion criteria are postoperative patients with histologically confirmed cancer within 3 years who are undergoing chemotherapy or radiotherapy, more than 18 years old, have given signed informed consent, have the ability to read Chinese, and the ability for oral intake. Exclusion criteria include being pregnant, breast feeding, having completed chemotherapy or radiotherapy, brain metastasis with Eastern Cooperative Oncology Group (ECOG performance status of two to four, delusion or hallucinations, acute infection, and have received medications under other clinical trials. The patients were separated into an intervention group (Shen-Mai-San, SMS and a placebo group for four weeks using a randomized, double-blind procedure. The European Organization for Research and Treatment of Cancer (EORTC Quality of Life questionnaire (QOL-C30 was used to evaluate the quality of life. General data, hemoglobin (Hb, hematocrit (Hct, glutamic-oxalacetic transaminase (GOT, glutamic-pyruvic transaminase (GPT, blood urea nitrogen (BUN, creatinine, carcinoembryonic antigen (CEA, TCM diagnosis data and heart rate variability (HRV were also recorded. These data were collected at baseline, two weeks and four weeks after receiving medication. The patients were prescribed granules which contained therapeutic medicines or placebo. Paired-T test was used for statistical analysis. Discussion Shen-Mai-San is composed of processed Ginseng radis, Liriope spicata, and Schizandrae fructus. It was found to be effective for

  10. Volume-based quantitative FDG PET/CT metrics and their association with optimal debulking and progression-free survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, H.A.; Burger, I.A.; Micco, M.; Sosa, R.E.; Weber, W.; Hricak, H.; Sala, E. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Goldman, D.A. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Chi, D.S. [Memorial Sloan Kettering Cancer Center, Department of Surgery, New York, NY (United States)

    2015-11-15

    Our aim was to evaluate the associations between quantitative {sup 18}F-fluorodeoxyglucose positron-emission tomography (FDG-PET) uptake metrics, optimal debulking (OD) and progression-free survival (PFS) in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery. Fifty-five patients with recurrent ovarian cancer underwent FDG-PET/CT within 90 days prior to surgery. Standardized uptake values (SUV{sub max}), metabolically active tumour volumes (MTV), and total lesion glycolysis (TLG) were measured on PET. Exact logistic regression, Kaplan-Meier curves and the log-rank test were used to assess associations between imaging metrics, OD and PFS. MTV (p = 0.0025) and TLG (p = 0.0043) were associated with OD; however, there was no significant association between SUV{sub max} and debulking status (p = 0.83). Patients with an MTV above 7.52 mL and/or a TLG above 35.94 g had significantly shorter PFS (p = 0.0191 for MTV and p = 0.0069 for TLG). SUV{sub max} was not significantly related to PFS (p = 0.10). PFS estimates at 3.5 years after surgery were 0.42 for patients with an MTV ≤ 7.52 mL and 0.19 for patients with an MTV > 7.52 mL; 0.46 for patients with a TLG ≤ 35.94 g and 0.15 for patients with a TLG > 35.94 g. FDG-PET metrics that reflect metabolic tumour burden are associated with optimal secondary cytoreductive surgery and progression-free survival in patients with recurrent ovarian cancer. (orig.)

  11. Perioperative nursing of patients undergoing radical prostatectomy of endometrial cancer with DaVinci Robot%经达芬奇机器人行子宫内膜癌根治术的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    裴丽娟; 叶梅; 闫迎虎; 孙燕蕾

    2014-01-01

    目的:总结30例采用达芬奇机器人行子宫内膜癌根治术围手术期护理经验。方法回顾分析本院2010年5月~2014年4月采用达芬奇机器人行子宫内膜癌根治术的30例患者的临床资料并总结护理经验。结果30例患者均恢复良好,顺利出院。术后发生尿潴留2例,下肢静脉血栓1例,轻度皮下气肿10例,经对症治疗后好转。结论良好的围手术期护理是采用达芬奇机器人行子宫内膜癌根治术成功的重要保障。%Objective To summarize the nursing points of 30 patients undergoing radical prostatectomy of endometrial cancer with DaVinci Robot.Method The clinical histories of patients undergoing radical prostatectomy of endometrial cancer with DaVinci Robot from May 2010 to April 2014 in the Second Artillery General Hospital of Chinese People’s Liberation Army were analyzed retrospectively.Result All 30 patients were discharged successfully with 2 postoperative uroschesis,1 lower extremity varicose veins,10 subcutaneous emphysema.Conclusion Perfect preoperative nursing is the guarantee for the success of radical prostatectomy of endometrial cancer with DaVinci Robot.

  12. Could semiquantitative FDG analysis add information to the prognosis in patients with stage II/III breast cancer undergoing neoadjuvant treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Evangelista, Laura; Cervino, Anna Rita [Veneto Institute of Oncology IOV - IRCCS, Radiotherapy and Nuclear Medicine Unit, Padua (Italy); Ghiotto, Cristina; Guarneri, Valentina; Conte, Pierfranco [Veneto Institute of Oncology IOV - IRCCS, Medical Oncology 2 Unit, Padua (Italy); Saibene, Tania; Michieletto, Silvia; Fernando, Bozza [Veneto Institute of Oncology IOV - IRCCS, Breast Unit, Padua (Italy); Orvieto, Enrico [University Hospital of Padua, Department of Pathology, Padua (Italy)

    2015-10-15

    We investigated whether maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), total lesion glycolysis (TLG) and whole-body (WB) SUVmax, WB MTV and WB TLG measured by {sup 18}F-FDG PET/CT could improve prognostic stratification in patients with stage II/III breast cancer (BC). We prospectively enrolled 99 consecutive women (median age 50 years, range 27 - 77 years) with pathologically proven stage II/III BC who underwent pretreatment FDG PET/CT. WB SUVmax, WB MTV and WB TLG were measured in all malignant lesions. Survival was analysed using the Kaplan-Meier method. Cox proportional hazards models were constructed to test for relationships among WB SUVmax, WB MTV, WB TLG, and overall survival (OS) and disease-free survival (DFS), after adjustment for age, and histopathological and immunohistochemical features (oestrogen/progesterone and HER2 expression, proliferation index and grade). The median values of WB SUVmax, WB MTV and WB TLG were 16.2 (range 1.5 - 33.1), 14 cm{sup 3} (range 0.03 - 708.6 cm{sup 3}) and 62.5 (0.06 - 3869.4), respectively. All WB semiquantitative values were higher in patients with higher TNM stage, although not significantly (all p > 0.05). The median follow-up for surviving patients was 30 months, with a range of 13 - 45 months. Both PFS and OS of patients with low WB SUVmax, WB MTV and WB TLG were longer than that of patients with high WB values for progression, although not statistically significant. However, stratifying the patients in accordance with the stage of disease, both PFS and OS were significantly lower in patients with high WB TLG and stage III than in patients with stage II (p < 0.05). In multivariate analyses, WB MTV and WB TLG were independent prognostic factors for PFS (hazard ratio 1.004, 95 % confidence interval 1.002 - 1.006, p < 0.001, and hazard ratio 1.001, 95 % confidence interval 1.000 - 1.001, p = 0.011, respectively). The addition of WB TLG to clinical data may provide a more detailed

  13. 化疗期癌症患者主要照顾者心理弹性状况及其影响因素分析%Factors of resilience of primary caregivers of cancer patients undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    何苗; 张静

    2016-01-01

    Objective To investigate the resilience of primary caregivers of cancer patients undergoing chemotherapy and explore the influencing factors. Methods General information questionnaire and Cornor-Davidson resilience scale (CD-RISC) were used in the survey among 173 cancer patients undergoing chemotherapy as well as their primary caregivers. Results The score of resilience of primary caregivers was (70.76 ±13.34), at middle or above level. Multiple linear regression analysis showed that caregivers'resilience was affected by gender, age, family income and religious belief (all P<0.05). Conclusion The resilience among primary caregivers of cancer patients undergoing chemotherapy is at a relatively high level. Clinically, we should pay more attention to female and young patients with lower family income and no religious beliefs.%目的:调查化疗期癌症患者主要照顾者的心理弹性现状,探讨其心理弹性的影响因素。方法采用一般资料调查表、Cornor-Davidson弹性量表对173例化疗期癌症患者及其主要照顾者进行调查。结果化疗期癌症患者主要照顾者心理弹性得分是(70.76±13.34)分,处于中等偏上水平。多元线性回归分析结果显示,照顾者性别、年龄、家庭月收入和有无宗教信仰是其心理弹性的影响因素(均P<0.05)。结论化疗期癌症患者主要照顾者的心理弹性水平较高,在临床工作中应关注女性、年轻、家庭收入较低和无宗教信仰的照顾者。

  14. 手部按摩对改善乳腺癌患者化疗期间生活质量的作用%Effect of hand massage therapy on the quality of life in breast cancer patients undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    张一敏; 孙秋华

    2012-01-01

    Objective To evaluate the effect of hand massage therapy guided by the Chinese Medicine meridian theory,neural reflexology and biological holographic theory on the quality of life in breast cancer patients undergoing chemotherapy. Methods Sixty breast cancer patients undergoing chemotherapy were randomly assigned to hand massage therapy group (experimental group) and routine care group(control group). Quality of Life Scale of Breast Cancer(QLSBC) was used to measure the quality of life before and after the invention. Results After the invention, the total score of the quality of life, physical function dimension score and psychological function dimension score were significantly higher in the experimental group than in the control group(P<0.05). Conclusion Hand massage therapy can improve the quality of life,relieve anxiety and depression in breast cancer undergoing chemotherapy.%目的 探讨以中医经络学说、神经反射学说、生物全息理论为指导的手部按摩疗法对乳腺癌患者化疗期间生活质量的影响.方法 将60例乳腺癌化疗患者按随机数字表分成试验组和对照组各30例.两组患者均给予乳腺癌化疗护理常规,试验组在此基础上给予手部按摩疗法.分别于干预前后采用乳腺癌患者生活质量量表评估两组患者的生活质量.结果 干预后试验组生活质量总分、躯体功能维度得分、心理功能维度得分均高于对照组,差异有统计学意义(P<0.05).结论 手部按摩疗法能改善乳腺癌患者化疗期间的生活质量,减轻焦虑、抑郁等负性情绪的程度.

  15. Venous thromboembolism in cancer patients

    Directory of Open Access Journals (Sweden)

    Mehmet Fuat Eren

    2013-09-01

    Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

  16. Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Schmidt, Jakob Friis; Christensen, Jesper Frank;

    2013-01-01

    Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club...... (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer....

  17. Effects of systemic lidocaine versus magnesium administration on postoperative functional recovery and chronic pain in patients undergoing breast cancer surgery: A prospective, randomized, double-blind, comparative clinical trial

    Science.gov (United States)

    Kim, Myoung Hwa; Lee, Ki Young; Park, Seho; Kim, Seung Il; Park, Hyung Seok

    2017-01-01

    Introduction We aimed to compare the effects of intraoperative lidocaine and magnesium on postoperative functional recovery and chronic pain after mastectomy due to breast cancer. Systemic lidocaine and magnesium reduce pain hypersensitivity to surgical stimuli; however, their effects after mastectomy have not been evaluated clearly. Methods In this prospective, double-blind, clinical trial, 126 female patients undergoing mastectomy were randomly assigned to lidocaine (L), magnesium (M), and control (C) groups. Lidocaine and magnesium were administered at 2 mg/kg and 20 mg/kg for 15 minutes immediately after induction, followed by infusions of 2 mg/kg/h and 20 mg/kg/h, respectively. The control group received the same volume of saline. Patient characteristics, perioperative parameters, and postoperative recovery profiles, including the Quality of Recovery 40 (QoR-40) survey, pain scales, length of hospital stay, and the short-form McGill pain questionnaire (SF-MPQ) at postoperative 1 month and 3 months were evaluated. Results The global QoR-40 scores on postoperative day 1 were significantly higher in group L than in group C (P = 0.003). Moreover, in sub-scores of the QoR-40 dimensions, emotional state and pain scores were significantly higher in group L than those in groups M and C (P = 0.027 and 0.023, respectively). At postoperative 3 months, SF-MPQ and SF-MPQ-sensitive scores were significantly lower in group L than in group C (P = 0.046 and 0.036, respectively). Conclusions Intraoperative infusion of lidocaine improved the quality of recovery and attenuated the intensity of chronic pain in patients undergoing breast cancer surgery. PMID:28253307

  18. 综合干预对乳腺癌术后化疗患者心理状态的影响%Effect of general nursing intervention on the mental state of patients with breast cancer undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    曾慧美; 陈春贤; 林克如; 汪红霞; 范晓兰

    2014-01-01

    Objective To investigate the effect of general nursing intervention on the mental state of the patients with breast cancer undergoing chemotherapy.Methods Forty-eight breast cancer patients undergoing postoperative chemotherapy received nursing general interventions including healthy education,psychological nursing care,pantosomatous,relaxation therapy and rehabilitative exercise. All patients were evaluated by self-rating depression scale (SDS) and depression status inventory (DSI) before and after the general intervention.Result The scores of SDS and DSI after intervention were significantly lower than those before intervention (bothP<0.05).Conclusion The general nursing intervention could significantly improve patients’ psychological state and life quality,promote rehabilitation and improve their quality of life.%目的:探讨综合干预对乳腺癌术后化疗患者心理状态的影响。方法对48例乳腺癌术后化疗患者实施综合干预,包括疾病知识教育、心理护理、放松疗法、康复锻炼等。干预前后采用抑郁自评量表(self-rating depression scale,SDS)及抑郁状态问卷(depression status inventory,DSI)对患者进行测评。结果干预后患者SDS和DSI得分均较干预前低,干预前后比较,差异具有统计学意义(均P<0.05)。结论综合干预可改善乳腺癌术后化疗患者心理状态,促进患者康复,提高患者生命质量。

  19. Eating As Treatment (EAT) study protocol: a stepped-wedge, randomised controlled trial of a health behaviour change intervention provided by dietitians to improve nutrition in patients with head and neck cancer undergoing radiotherapy

    Science.gov (United States)

    Britton, Ben; McCarter, Kristen; Baker, Amanda; Wolfenden, Luke; Wratten, Chris; Bauer, Judith; Beck, Alison; McElduff, Patrick; Halpin, Sean; Carter, Gregory

    2015-01-01

    Introduction Maintaining adequate nutrition for Head and Neck Cancer (HNC) patients is challenging due to both the malignancy and the rigours of radiation treatment. As yet, health behaviour interventions designed to maintain or improve nutrition in patients with HNC have not been evaluated. The proposed trial builds on promising pilot data, and evaluates the effectiveness of a dietitian-delivered health behaviour intervention to reduce malnutrition in patients with HNC undergoing radiotherapy: Eating As Treatment (EAT). Methods and analysis A stepped-wedge cluster randomised design will be used. All recruitment hospitals begin in the control condition providing treatment as usual. In a randomly generated order, oncology staff at each hospital will receive 2 days of training in EAT before switching to the intervention condition. Training will be supplemented by ongoing supervision, coaching and a 2-month booster training provided by the research team. EAT is based on established behaviour change counselling methods, including motivational interviewing, cognitive–behavioural therapy, and incorporates clinical practice change theory. It is designed to improve motivation to eat despite a range of barriers (pain, mucositis, nausea, reduced or no saliva, taste changes and appetite loss), and to provide patients with practical behaviour change strategies. EAT will be delivered by dietitians during their usual consultations. 400 patients with HNC (nasopharynx, hypopharynx, oropharynx, oral cavity or larynx), aged 18+, undergoing radiotherapy (>60 Gy) with curative intent, will be recruited from radiotherapy departments at 5 Australian sites. Assessments will be conducted at 4 time points (first and final week of radiotherapy, 4 and 12 weeks postradiotherapy). The primary outcome will be a nutritional status assessment. Ethics and dissemination Ethics approval from all relevant bodies has been granted. Study findings will be disseminated widely through peer

  20. 3D dosimetry in patients with early breast cancer undergoing Intraoperative Avidination for Radionuclide Therapy (IART {sup registered}) combined with external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, Mahila E.; Cremonesi, Marta; Di Dia, Amalia; Botta, Francesca; Pedroli, Guido [European Institute of Oncology, Division of Medical Physics, Milan (Italy); De Cicco, Concetta; Calabrese, Michele; Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Sarnelli, Anna [IRCCS Istituto Romagnolo per lo Studio e la Cura dei Tumori, Medical Physics Unit, Meldola, FC (Italy); Pedicini, Piernicola [Centro Regionale Oncologico Basilicata (IRCCS-CROB), Department of Radiation Oncology, Rionero in Vulture, PZ (Italy); Orecchia, Roberto [European Institute of Oncology, Division of Radiotherapy, Milan (Italy)

    2012-11-15

    Intraoperative Avidination for Radionuclide Therapy (IART {sup registered}) is a novel targeted radionuclide therapy recently used in patients with early breast cancer. It is a radionuclide approach with {sup 90}Y-biotin combined with external beam radiotherapy (EBRT) to release a boost of radiation in the tumour bed. Two previous clinical trials using dosimetry based on the calculation of mean absorbed dose values with the hypothesis of uniform activity distribution (MIRD 16 method) assessed the feasibility and safety of IART {sup registered}. In the present retrospective study, a voxel dosimetry analysis was performed to investigate heterogeneity in distribution of the absorbed dose. The aim of this work was to compare dosimetric and radiobiological evaluations derived from average absorbed dose vs. voxel absorbed dose approaches. We evaluated 14 patients who were injected with avidin into the tumour bed after conservative surgery and 1 day later received an intravenous injection of 3.7 GBq of {sup 90}Y-biotin (together with 185 MBq {sup 111}In-biotin for imaging). Sequential images were used to estimate the absorbed dose in the target region according to the standard dosimetry method (SDM) and the voxel dosimetry method (VDM). The biologically effective dose (BED) distribution was also evaluated. Dose/volume and BED volume histograms were generated to derive equivalent uniform BED (EUBED) and equivalent uniform dose (EUD) values. No ''cold spots'' were highlighted by voxel dosimetry. The median absorbed-dose in the target region was 20 Gy (range 15-27 Gy) by SDM, and the median EUD was 20.4 Gy (range 16.5-29.4 Gy) by the VDM; SDM and VDM estimates differed by about 6 %. The EUD/mean voxel absorbed dose ratio was >0.9 in all patients, indicative of acceptable uniformity in the target. The median BED and EUBED values were 21.8 Gy (range 15.9-29.3 Gy) and 22.8 Gy (range 17.3-31.8 Gy), respectively. VDM highlighted the absence of significant

  1. Experiense with remineraling means in patients undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Stepanova Ye.A.

    2011-03-01

    Full Text Available In patients undergoing orthodontic treatment using bracket-technology a high risk of caries development. The algorithm of preventive interventions for the prevention of hair demineralization of enamel of the teeth

  2. 乳腺癌术前化疗对罗库溴铵肌松效应的影响%Effect of chemotherapy on neuromuscular blocking of rocuronium in patients undergoing brest cancer

    Institute of Scientific and Technical Information of China (English)

    李振江; 蒋晖; 马新军

    2009-01-01

    Objective To investigate the effect of chemotherapy on neuromuscular blocking of rocuronium in patients undergoing brest cancer. Methods Forty-three femail patients undergoing selective brest cancer operation under general anesthesia were divided into 25 patients who had received chemotherapy before surgery(group A)and 18 cases who had not(group B).The neuromuscular function was monitored by TOF stimulation using accelerograph.The onset time,clinical duration of action and recovery index were recorded after rocuronium 0.6 mg/kg was administered iv.Results The onset times of group A and group B were (93±18) s in and (96±19) s, respectively. The clinical duration of action in group A was (49±16) min. which was longer than(37±19)min in group B(P<0.05).So did the recovery inde)[[(14.2±3.0)min vs.(10.9±2.5)min(P<0.05).Conclusion Chemotherapy before surgery could make the clinical duration of action and recovery of rocuromum in patients with brest cancer.%目的 研究乳腺癌术前化疗对罗库溴铵肌松效应的影响.方法 全麻下肌松监测乳腺癌手术患者43例,分为术前化疗组(A组,25例)和未进行化疗组(B组,18例).两组术前均未用对肌松有影响的药物.用加速度仪监测拇内收肌收缩反应,观察罗库溴铵0.6 mg/kg静注后肌松时效的差异.结果 A、B两组起效时间分别为(93±18)S和(96±19)s,差异无统计学意义;A组临床时效长于B组[(49±16)min vs.(37±13)min],A组恢复指数也长于B组[(14.2±3.0)min vs.(10.9±2.5)min](P<0.05).结论 乳腺癌术前化疗对罗库溴铵的临床作用时效和恢复延长.

  3. Perioperative Optimization of Patients Undergoing Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    C. E. Owers

    2012-01-01

    Full Text Available Bariatric surgery is fast becoming an efficient and safe method of weight reduction, especially for patients in whom conservative measures have failed. As the obese population of the world increases, so will the number of patients requesting or requiring surgical weight loss methods. Bariatric patients however have numerous co-morbidities that make their operative course more difficult, and therefore is important to have a good understanding of the important issues surrounding their pre, peri and post operative management. This article aims to educate the reader about optimal management of the bariatric surgical patient.

  4. The ratio of weight loss to planning target volume significantly impacts setup errors in nasopharyngeal cancer patients undergoing helical tomotherapy with daily megavoltage computed tomography

    Directory of Open Access Journals (Sweden)

    Hou Wei-Hsien

    2016-12-01

    Full Text Available Changes in head and neck anatomy during radiation therapy (RT produce setup uncertainties of nasopharyngeal cancer (NPC irradiation. We retrospectively analyzed image guidance data to identify clinical predictors of setup errors.

  5. Quality of life of women undergoing treatment for cervical cancer

    Directory of Open Access Journals (Sweden)

    Francieli Ana Dallabrida

    2014-04-01

    Full Text Available This study aimed to evaluate the quality of life of women with cervical cancer. This is a cross-sectional, descriptive study developed with 43 women undergoing oncological treatment assisted at an Oncology High Complexity Center, in the Southern region of Brazil. The instrument used was the European Organization for Research and Treatment of Cancer – Quality of Life Questionnaire Core-30, and the data were analyzed through descriptive statistics. The average age was 54.6 years old. Married women prevailed (53.4%, with incomplete elementary education (72.1% and income from one to two minimum wages (62.8%. Quality of Life was considered very satisfactory. According to the development scales and emotional functioning, the result was from regular to satisfactory. The most frequent symptoms were fatigue, lack of appetite and pain. There is a need of structure of public health policies, for preventing cervical cancer in the most vulnerable population.

  6. 护理干预与宫颈癌术后尿潴留发生率的Meta分析%Meta analysis on nursing intervention and rate of postoperative urinary retention for patients undergoing cervical cancer operation

    Institute of Scientific and Technical Information of China (English)

    张意玲; 杨邵英

    2011-01-01

    Objective To study the relation between nursing intervention and rate of postoperative urinary retention for patients undergoing cervical cancer operation by Meta analysis. Method Take Meta analysis with fixed effect model on randomized controlled study results of 28 domestic literature on nursing intervention and postoperative urinary retention of cervical cancer operation by RevMan 4.2. Result There is a significant relation between nursing intervention and reducing the rate of postoperative urinary retention of cervical cancer operation (Z= 14. 99, P<0. 00001). Relative risk (RR) is 0. 25. 95% confidence interval (CI) is 0. 2l~0. 30. Conclusion Nursing intervention is an important method to reduce postoperative urinary retention of cervical cancer operation.%目的 通过Meta分析探讨护理干预与宫颈癌术后尿潴留之间的相互关系.方法 采用RevMan 4.2分析专用软件,对国内28篇关于护理干预与宫颈癌术后尿潴留关系文献的随机对照研究结果,进行固定效应模型的Meta分析.结果 综合护理干预与降低宫颈癌术后尿潴留之间关联明显(Z=14.99,P<0.00001),合并计算的相对危险度(RR值)为0.25,95%置信区间(CI)为0.21~0.30.结论 综合护理干预是减少宫颈癌术后尿潴留发生的一个重要手段.

  7. Individualized Comprehensive Lifestyle Intervention in Patients Undergoing Chemotherapy with Curative or Palliative Intent: Who Participates?

    Directory of Open Access Journals (Sweden)

    Karianne Vassbakk-Brovold

    Full Text Available Knowledge about determinants of participation in lifestyle interventions in cancer patients undergoing chemotherapy, particularly with palliative intent, remains poor. The objective of the present study was to identify determinants of participating in a 12 month individualized, comprehensive lifestyle intervention, focusing on diet, physical activity, mental stress and smoking cessation, in cancer patients receiving chemotherapy with curative or palliative intent. The secondary objective was to identify participation determinants 4 months into the study.Newly diagnosed cancer patients starting chemotherapy at the cancer center in Kristiansand/Norway (during a 16 month inclusion period were screened. Demographic and medical data (age, sex, body mass index, education level, marital status, smoking status, Eastern Cooperative Oncology Group performance status (ECOG, diagnosis, tumor stage and treatment intention was analyzed for screened patients.100 of 161 invited patients participated. There were more females (69 vs. 48%; P = 0.004, breast cancer patients (46 vs. 25%; P = 0.007, non-smokers (87 vs. 74%; P = 0.041, younger (mean age 60 vs. 67 yrs; P 70 years were less likely to participate at baseline and 4 months.Individualized lifestyle interventions in cancer patients undergoing chemotherapy appear to facilitate a high participation rate that declines with increasing age; both during the enrollment process and completing the intervention. Neither oncologic nor socioeconomic variables deterred participation.

  8. The effect of malnutrition on patients undergoing elective joint arthroplasty.

    Science.gov (United States)

    Huang, Ronald; Greenky, Max; Kerr, Glenn J; Austin, Matthew S; Parvizi, Javad

    2013-09-01

    Malnutrition has been linked to serious complications in patients undergoing elective total joint arthroplasty (TJA). This study prospectively evaluated 2,161 patients undergoing elective TJA for malnutrition as defined by either an abnormal serum albumin or transferrin. The overall incidence of malnutrition was 8.5% (184 of 2,161) and the rate of overall complications in the malnourished group was 12% as compared to 2.9% in patients with normal parameters (PMalnutrition predicted serious complications involving hematoma formation, infection, renal and cardiac complications. Obesity, defined by a body mass index (BMI) of 30kg/m(2) was present in 42.9% of malnourished patients with a significantly higher complication rate in this cohort. Malnutrition remains prevalent in patients >55years-old undergoing TJA and is associated with a significant increase in post-operative complications.

  9. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    Fellström, Bengt C; Jardine, Alan G; Schmieder, Roland E;

    2009-01-01

    BACKGROUND: Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved. METHODS: We conducted an international, multicenter, randomized, double-blind, prospective...... trial involving 2776 patients, 50 to 80 years of age, who were undergoing maintenance hemodialysis. We randomly assigned patients to receive rosuvastatin, 10 mg daily, or placebo. The combined primary end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke......: In patients undergoing hemodialysis, the initiation of treatment with rosuvastatin lowered the LDL cholesterol level but had no significant effect on the composite primary end point of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (ClinicalTrials.gov number, NCT00240331.)...

  10. Patients direct costs to undergo TB diagnosis

    Institute of Scientific and Technical Information of China (English)

    Rachel M.Anderson de Cuevas; Lovett Lawson; Najla Al-Sonboli; Nasher Al-Aghbari; Isabel Arbide; Jeevan B.Sherchand; Emenyonu E.Nnamdi

    2016-01-01

    Background:A major impediment to the treatment of TB is a diagnostic process that requires multiple visits.Descriptions of patient costs associated with diagnosis use differentprotocols and are not comparable.Methods:We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis.Surveys of 2225 adults attending smear-microscopy centres in Nigeria,Nepal,Ethiopia and Yemen.Adults >18 years with cough >2 weeks were enrolled prospectively.Direct costs were quantified using structured questionnaires.Patients with costs >75th quartile were considered to have high expenditure (cases) and compared with patients with costs <75th quartile to identify factors associated with high expenditure.Results:The most significant expenses were due to clinic fees and transport.Most participants attended the centres with companions.High expenditure was associated with attending with company,residing in rural areas/other towns and illiteracy.Conclusions:The costs incurred by patients are substantial and share common patterns across countries.Removing user fees,transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs.In locations with limited resources,support could be prioritised for those most at risk of high expenditure;those who are illiterate,attend the service with company and rural residents.

  11. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pastromas, Georgios, E-mail: geopastromas@gmail.com; Spiliopoulos, Stavros, E-mail: stavspiliop@upatras.gr; Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com; Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr; Siablis, Dimitrios, E-mail: siablis@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece)

    2013-12-15

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) {>=} 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 {+-} 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 {+-} 22.9 months (range 3-95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher's exact test; p < 0.05). According to Kaplan-Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31-0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  12. Patients undergoing radical prostatectomy have a better survival than the background population

    DEFF Research Database (Denmark)

    Andreas Røder, Martin; Brasso, Klaus; Drimer Berg, Kasper;

    2013-01-01

    INTRODUCTION: The objective of this study was to investigate standardised relative survival and mortality ratio for patients undergoing radical prostatectomy for localized prostate cancer at our institution. MATERIAL AND METHODS: Between 1995 and 2010, a total of 1,350 consecutive patients underw...... better than expected in the age-matched background population. This finding is likely explained by selection bias. Although the results indicate an excellent outcome in terms of cancer control, the efficacy of prostatectomy for localized prostate cancer remains at debate....

  13. The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer

    DEFF Research Database (Denmark)

    Moseholm Larsen, Ellen Frøsig; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

    2016-01-01

    of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories...... for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment...

  14. The Influence of Splenectomy Performed Simultaneously with Gastrectomy on Postoperative Complications in Patients with Gastric Cancer Undergoing Surgery with the Intention to Treat

    Directory of Open Access Journals (Sweden)

    Głuszek Stanisław

    2014-07-01

    Full Text Available Despite the growing understanding of the pathophysiological processes in the perioperative period and significant advancements in surgical techniques, operative treatment for gastric cancer remains a challenge for surgeons, especially because the primary procedure of total or nearly total gastrectomy must at times be extended by the resection of other organs.

  15. Effects of mild perioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer%轻度低温对直肠癌根治术患者细胞免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    赵敏; 赵光瑜; 戴春宇; 张毅

    2012-01-01

    Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P < 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P < 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.%目的 评价轻度低温对直肠癌根治术患者细胞免疫功能的影响.方法 择期拟行直肠癌根治术患者50例,ASA分级Ⅰ或Ⅱ级,年龄30~64岁,采用随机数字表法,将其随机分为轻度低温组和常温组,每组25例.分别于麻醉前1 h(T1)、手术结束时(T2)、术后24 h(T3)及术后第7天(T4)采用流式细胞仪测定血清Th1型、Th2

  16. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.

    Science.gov (United States)

    Watters, William; Rethman, Michael P; Hanson, Nicholas Buck; Abt, Elliot; Anderson, Paul A; Carroll, Karen C; Futrell, Harry C; Garvin, Kevin; Glenn, Stephen O; Hellstein, John; Hewlett, Angela; Kolessar, David; Moucha, Calin; O'Donnell, Richard J; O'Toole, John E; Osmon, Douglas R; Evans, Richard Parker; Rinella, Anthony; Steinberg, Mark J; Goldberg, Michael; Ristic, Helen; Boyer, Kevin; Sluka, Patrick; Martin, William Robert; Cummins, Deborah S; Song, Sharon; Woznica, Anne; Gross, Leeaht

    2013-03-01

    The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

  17. TSH alone is not sufficient to exclude all patients with a functioning thyroid nodule from undergoing testing to exclude thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hurtado-Lopez, Luis-Mauricio; Monroy-Lozano, Blanca-Estela [General Hospital of Mexico, Mexico City (Mexico); Martinez-Duncker, Carlos [Hospital Infantil de Mexico Federico Gomez, Medicina Nuclear Molecular, Mexico City, DF (Mexico)

    2008-06-15

    The purpose of the study was to analyze whether the thyroid-stimulating hormone (TSH) alone avoids tests to exclude malignancy in all patients with functional thyroid nodules (FTN). Sixty-nine patients with FTN on {sup 99m}Tc scintigraphy, radioiodine uptake test (RIU), {sup 99m}Tc thyroid uptake, TSH assay, T3, and T4 obtained within 48 h were retrospectively identified out of 2,356 thyroid scans performed from January 2000 to April 2007. FTNs were classified as causing total, partial, or no inhibition of the thyroid as group 1, 2, or 3, respectively. TSH was subnormal in 21 of 69 (30.43%) patients. In group 1 (N = 23, 33.3%), TSH was subnormal, normal, and high in eight, nine, and six patients; in group 2 (N = 17, 24.6%), TSH was subnormal, normal, and high in four, six, and seven patients, and in group 3 (N = 29, 42%), TSH was subnormal, normal, and high in 9, 13, and 7 patients, respectively. TSH was significantly lower in group 1. In T3, T4, {sup 99m}Tc thyroid uptake, and RIU, there were no differences between the three groups. Only 30.43% of patients had subnormal TSH. TSH alone cannot avoid tests to exclude malignancy in all patients with FTN. FTN existence can only be accurately assessed by thyroid scintigraphy. The current incidence of FTN may be unknown because scintigraphy is not routinely performed in all patients with thyroid nodules. Thyroid scintigraphy of patients with high TSH can detect diseases such as Hashimoto's thyroiditis and identify patients with FTN in whom no further diagnostic procedures would be needed in patients with normal TSH levels with nondiagnostic fine-needle aspiration results. (orig.)

  18. Application of psychological crisis intervention in the management of rectal cancer patients undergoing enterostomy%心理危机干预技术在直肠癌肠造口患者中的应用

    Institute of Scientific and Technical Information of China (English)

    叶新梅; 厉群; 姚秋琼

    2012-01-01

    目的 探讨心理危机干预技术在直肠癌肠造口患者中的应用.方法 将124例直肠癌肠造口患者随机分为两组,每组各62例,对照组患者给予一般的心理护理,实验组患者应用心理危机干预技术进行心理干预,时间为1个月.比较两组患者心理干预前后负性情绪、免疫细胞及两组患者心理干预后生活质量情况.结果 干预后实验组患者焦虑、抑郁、恐惧、生活质量及T细胞亚群的CD3、CD4、CD8和自然杀伤细胞(NK Cell)明显优于对照组,两组比较,差异具有统计学意义(均P<0.01);两组患者干预后自身前后比较,对照组患者恐惧及焦虑程度明显减轻,T细胞亚群的CD3、CD4、CD8和NK Cell数量明显减少(均P<0.01),而实验组患者焦虑、抑郁及恐惧程度明显减轻(均P<0.01),CD3、CD4、CD8和自然杀伤细胞(NK Cell)无明显减少(均P> 0.05).结论 心理危机干预技术在直肠癌肠造口患者中应用,有利于改善直肠癌肠造口患者不良心理状况及提高患者生活质量.%Objective To investigate the application of psychological crisis intervention in the management of rectal cancer patients undergoing enterostomy. Methods 124 rectal cancer patients undergoing enterostomy were randomly divided into the control group and the experiment group; the formal group received general psychological nursing and the latter received psychological crisis intervention for one month. The two groups were compared in respect of negative motions, immunologieal function and life quality after intervention. Results In comparison, the experiment group could relive their anxiety, depression and terror more effectively than the controls did (P 0.05) in spite of significant reliefs in the anxiety and depress and terror in the experiment group (P < 0.01). Conclusions The application of psychological crisis intervention in rectal cancer patients undergoing enterostomy could preferably release their negative

  19. Estimating cancer risks to adults undergoing body CT examinations.

    Science.gov (United States)

    Huda, Walter; He, Wenjun

    2012-06-01

    The purpose of the study is to estimate cancer risks from the amount of radiation used to perform body computed tomography (CT) examination. The ImPACT CT Patient Dosimetry Calculator was used to compute values of organ doses for adult body CT examinations. The radiation used to perform each examination was quantified by the dose-length product (DLP). Patient organ doses were converted into corresponding age and sex dependent cancer risks using data from BEIR VII. Results are presented for cancer risks per unit DLP and unit effective dose for 11 sensitive organs, as well as estimates of the contribution from 'other organs'. For patients who differ from a standard sized adult, correction factors based on the patient weight and antero-posterior dimension are provided to adjust organ doses and the corresponding risks. At constant incident radiation intensity, for CT examinations that include the chest, risks for females are markedly higher than those for males, whereas for examinations that include the pelvis, risks in males were slightly higher than those in females. In abdominal CT scans, risks for males and female patients are very similar. For abdominal CT scans, increasing the patient age from 20 to 80 resulted in a reduction in patient risks of nearly a factor of 5. The average cancer risk for chest/abdomen/pelvis CT examinations was ∼26 % higher than the cancer risk caused by 'sensitive organs'. Doses and radiation risks in 80 kg adults were ∼10 % lower than those in 70 kg patients. Cancer risks in body CT can be estimated from the examination DLP by accounting for sex, age, as well as patient physical characteristics.

  20. 肠内营养制剂联合乳清蛋白对肿瘤化疗患者的营养效果观察%Entera nutrition with whey protein support in cancer patients undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    沈颖; 韩婷; 张玉兰; 张月华; 蔡颂文; 陆婷

    2012-01-01

    目的 观察恶性肿瘤患者化疗期间应用肠内营养制剂联合乳清蛋白对肿瘤化疗患者营养状况的影响.方法 将70例需进行化疗的肿瘤患者随机分为治疗组和对照组,治疗组35例,在常规饮食的基础上,采用肠内营养支持联合乳清蛋白制剂;对照组35例,进行常规饮食,不进行肠内营养支持.分别观察两组患者化疗前1d、化疗第20天营养指标和免疫指标的变化情况.结果 化疗第20天时对照组血清白蛋白、前白蛋白、血红蛋白明显低于化疗前,有统计学差异(P<0.05);治疗组化疗后血清氨基酸谱有所变化,亮氨酸、异亮氨酸和缬氨酸含量明显增高,苏氨酸、酪氨酸、组氨酸也有所升高,其余氨基酸血清含量无明显改变;对照组免疫指标均低于化疗前,其中治疗组免疫指标高于对照组,血清IgG、IgM及IgA等水平差异有统计学意义(P<0.05).结论 肿瘤患者化疗期间肠内营养联合乳清蛋白应用有利于机体营养状况和免疫功能的维持和改善.%Objective To evaluate the nutritional status and immune function in cancer patients receiving enteral nurtrition support during chemotherapy. Methods Seventy patients with malignant tumors undergoing chemotherapy were randomly assigned into two groups: 35 patients received enteral nutrition support and whey protein on the basis of conventional diet( intervention group) , while another 35 patients received conventional diet only (control group). The changes of nutritional status and immune functions of the patients before and at 20 d of chemotherapy were evaluated. Results On the 20 day of chemotherapy, the AIB, PA and HB of patients in intervention group were higher than those of patients in control group(P <0.05). Comparing to the levels before chemotherapy the AIB, PA and HB of patients in control group were decreased significantly (P <0.05). Comparing to the levels before study serum leucine, iosleucine and valine

  1. 集束护理干预策略对乳腺癌保乳术后放化疗患者的影响%Influence of Cluster Nursing Intervention on Breast Cancer Patients Undergoing Radiochemotherapy after Conservative Surgery

    Institute of Scientific and Technical Information of China (English)

    王泽芬

    2015-01-01

    目的:探讨集束护理干预策略对乳腺癌保乳术后放化疗患者的影响。方法:将进行保乳术且术后同期接受放化疗的乳腺癌患者随机分为观察组和对照组,每组60例。对照组给予常规护理(放疗护理常规、化疗护理常规、专科护理常规),观察组在此基础上给予集束护理干预。观察2组患者心理状态、营养状态及生活质量。结果:自评抑郁量表(SDS)、焦虑自评量表(SAS)评分干预后观察组低于对照组(P<0.05)。MNA评分观察组护理干预后在不同时段MNA评分均优于对照组(P<0.05)。各项生活评分护理干预后在不同时段观察组均优于对照组(P<0.05)。结论:集束护理干预策略对乳腺癌患者保乳治疗术后同期放化疗所出现的不良情绪具有缓解作用,并可提高患者的生活质量,改善近、远期营养状况。%To explore the influence of cluster nursing intervention on breast cancer patients with conservative surgery undergoing radiochemotherapy. Methods: The breast cancer patients accepting current ra-diochemotherapy after conservative surgery were randomly divided into the observation group and the control groups with 60 cases in each. Patients in the control group were given routine nursing care (routine radiotherapy care, routine chemotherapy care, routine nursing care), while the observation group was given cluster nursing inter-vention on the basis of routine nursing. Psychological state, nutritional status and life quality of patients in two groups were analyzed. Results: The SDS and SAS scores in the observation group were lower than that in the control group (P<0.05).The MNA scores in the observation group were better than that in the control group in different pe-riod (P<0.05). All life scores of the observation group in different period were better than that in the control group (P<0.05). Conclusion: Cluster nursing intervention can effectively relieve the negative emotions

  2. Effect of darbepoetin alfa on physical function in patients undergoing surgery for colorectal cancer. A randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Norager, C B; Jensen, Martin Bach; Rørbæk Madsen, Mogens;

    2007-01-01

    on the hemoglobin (Hb) concentration. Patients were assessed 10 days before, as well as 7 and 30 days after surgery for work capacity, postural sway, muscle strength, fatigue and quality of life (QoL). The primary outcome measure were the changes in patients' physical performance from preoperative to postoperative...... day 7. RESULTS: Of 221 included patients, 151 were evaluable. Baseline characteristics were similar in the 2 groups. Patients receiving DA had a significantly better working capacity on day 7 (p = 0.03) and day 30 (p = 0.03) compared with the placebo group. There were no statistically significant......: Perioperative DA treatment improved postoperative work capacity and Hb concentrations, but had no effect on postoperative fatigue, postural sway, QoL and muscle strength. Udgivelsesdato: 2006-null...

  3. Evaluation of the in vivo genotoxic effects of gamma radiation on the peripheral blood leukocytes of head and neck cancer patients undergoing radiotherapy.

    Science.gov (United States)

    Kadam, Samit B; Shyama, Soorambail K; Almeida, Valentine G

    2013-04-15

    The present study aimed to evaluate the genotoxic effects of ionizing radiation on non-target cells of Head and Neck Squamous Cell Carcinoma (HNSCC) patients exposed to various cumulative doses of gamma rays during radiotherapy. The ten patients (P1-P10) were treated with cobalt 60 gamma radiation (External Beam Radiotherapy) for a period of five to six weeks with a daily fraction of 2Gy for 5 days each week. The genotoxic effects of radiation (single strand breaks - SSBs) in these patients were analyzed using the alkaline single cell gel electrophoresis (SCGE) technique, with the Olive Tail Moment (OTM) as the critical parameter. A sample of each patient's peripheral blood before starting with radiotherapy (pre-therapy) served as the control, and blood collected at weekly time intervals during the course of the radiotherapy served as treated (10, 20, 30, 40, 50 and 60Gy) samples. In vivo radiosensitivity of these patients, as indicated by SSB's after the cumulative radiation doses at the various times, was assessed using Student's t-test. Significant DNA damage relative to the individual patient's pre-therapy baseline data was observed in all patients. Inter-individual variation of the genotoxic effects was analyzed using two-way ANOVA. The correlation between doses for the means of smoker and non-smoker patients was calculated using the Pearson test. The results of this study may indicate the need to reduce the daily radiotherapy dose further to prevent genotoxic effects on non-target cells, thus improving safety. Furthermore, these results may indicate that the estimation of DNA damage following exposure to a gamma radiation, as measured by the comet assay in whole blood leukocytes, can be used to screen human populations for radiation-induced genetic damage at the molecular level.

  4. Progressive Resistance Training and Cancer Testis (PROTRACT) - Efficacy of resistance training on muscle function, morphology and inflammatory profile in testicular cancer patients undergoing chemotherapy: design of a randomized controlled trial

    DEFF Research Database (Denmark)

    Christensen, Jesper F; Andersen, Jesper L; Adamsen, Lis

    2011-01-01

    of developing considerable long-term morbidity, including second malignant neoplasms, cardiovascular disease, and pulmonary toxicity. One neglected side effect is the significant muscular fatigue mentioned by many patients with testicular cancer both during and after treatment. Very limited information exists...... concerning the patho-physiological effects of antineoplastic agents on skeletal muscle. The primary aim of this study is to investigate the effects of BEP-treatment on the skeletal musculature in testicular cancer patients, and to examine whether the expected treatment-induced muscular deterioration can....... Primary outcome: mean fiber area and fiber type composition measured by histochemical analyses, satellite cells and levels of protein and mRNA expression of intracellular mediators of protein turnover. Secondary outcomes: maximum muscle strength and muscle power measured by maximum voluntary contraction...

  5. Understanding women's hesitancy to undergo less frequent cervical cancer screening.

    Science.gov (United States)

    Gerend, Mary A; Shepherd, Melissa A; Kaltz, Emily A; Davis, Whitney J; Shepherd, Janet E

    2017-02-01

    Inappropriate cervical cancer screening (e.g., screening too often) can result in unnecessary medical procedures, treatment, and psychological distress. To balance the benefits and harms, cervical cancer screening guidelines were recently modified in favor of less frequent screening (i.e., every 3 to 5 years). This study investigated women's acceptance of less frequent cervical cancer screening and their primary concerns about extending the screening interval beyond one year. A national sample of 376 U.S. women ages 21-65 completed an online survey in 2014. Predictors of willingness to get a Pap test every 3 to 5 years were identified using logistic regression. We also examined perceived consequences of less frequent screening. Over two thirds were willing to undergo less frequent screening if it was recommended by their healthcare provider. Nevertheless, nearly 20% expressed discomfort with less frequent screening and 45% were either in opposition or unsure whether they would be comfortable replacing Pap testing with primary HPV testing. Women whose most recent Pap test was (vs. was not) within the past year and women who ever (vs. never) had an abnormal Pap test were less willing to extend the screening interval. Additionally, women who typically saw an obstetrician/gynecologist or nurse practitioner for their Pap test (vs. a family physician) were less accepting of the guidelines. Hesitancy about the longer screening interval appears to stem from concern about developing cancer between screenings. Findings contribute to the growing body of research on cancer overscreening and may inform interventions for improving adherence to cancer screening guidelines.

  6. Assessment of the radioprotective effect of propolis in breast cancer patients undergoing radiotherapy. New perspective for an old honey bee product

    Directory of Open Access Journals (Sweden)

    Samia A. Ebeid

    2016-10-01

    Conclusions: Supplementation of propolis with radiotherapy treatment offers a quite measurable protection against DNA damage caused by ionizing radiation in BC patients leukocytes and inhibits RRM2 overexpression. Moreover, propolis has beneficial effects on the serum antioxidant capacity and improves the digestive utilization of iron and the regeneration efficiency of hemoglobin. Larger prospective studies are required to confirm our findings.

  7. Seroepidemiology of infection with Toxoplasma gondii in patients with vision and hearing impairments, cancer, HIV, or undergoing hemodialysis in Durango, Mexico

    Science.gov (United States)

    Toxoplasma gondii infection may cause a variety of symptoms involving virtually all organs. Little is known of the epidemiology of T. gondii infection in different patient groups in Mexico. We sought to determine the prevalence of T. gondii infection and associated epidemiological characteristics in...

  8. Application of OPLAC laryngeal mask in patients with breast cancer undergoing radical mastectomy%欧普乐喉罩在乳腺癌根治术病人全身麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    王其敏; 宋琼

    2011-01-01

    目的 比较气管插管或放置欧普乐喉罩全身麻醉下行乳腺癌根治术对血流动力学的影响,探讨欧普乐喉罩(Oro-Pharyngeal Airway CapOPLAC)在乳腺手术全麻中的应用.方法 选择ASA Ⅰ-Ⅱ级择期乳腺手术患者60例,随机分为欧普乐喉罩组(H组)和气管导管组(Q组),每组30例,记录每组麻醉诱导前(T0),麻醉诱导后(T1),气管导管/喉罩置入即刻(T2),气管导管/喉罩置入后5min(T3),气管导管/喉罩拔出即刻时(T4)的心率(HR)、血压(收缩压/舒张压).结果 气管导管组在T2、T4时的心率、血压均明显高于欧普乐喉罩组.结论 欧普乐喉罩置入简便,放置、拔出时应激反应轻,,血流动力稳定,在乳腺癌根治术病人全身麻醉值得推广.%Objective To compare the influence on hemodynamics of tracheal intubation or place OPLAC laryngeal mask to radical mastectomy patient under general anesthesia, to approach the application of OPLAC on radical mastectomy patient under general anesthesia. Methods Sixty ASA I or Ⅱ patient suffered from breast cancer were randomly divided into OPLAC group ( H group) and the endotracheal tube group (Q group), each group is thirty. SBP、DBP、HR were recorded before anesthesia induction ( T0) , After induction of anesthesia ( T1 ), endotracheal tube / laryngeal mask immediately (T2 ), endotracheal tube/laryngeal mask insertion after 5min (T3 ), endotracheal tube / laryngeal mask pulled out immediately (T4). Results SBP、DBP、HR of Q group in T2 and T4 were significantly higher than the H group. Conclusions OPLAC laryngeal mask is simple to be placed,stress responseis light when place or pull out, hemodynamic of patient is stable, it should be generalized in patients suffered from breast cancer undergoing general anesthesia.

  9. Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Schmidt, Jakob Friis; Christensen, Jesper Frank;

    2013-01-01

    (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer.......Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club...

  10. Sedation versus general anaesthesia in paediatric patients undergoing chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Lam, W.W.M.; So, N.M.C.; Metreweli, C. [Chinese Univ. of Hong Kong, Dept. of Diagnostic Radiology and Organ Imaging (China); Chen, P.P. [Chinese Univ. of Hong Kong, Anaesthesiology and Intensive Care (China)

    1998-05-01

    Objective: CT of the chest in paediatric patients often requires sedation or general anaesthesia to minimize motion artefacts. Both sedation and general anaesthesia are associated with atelectasis which obscures the underlying pulmonary pathology. We conducted a prospective study to compare these two methods with respect to degree of motion artefacts and extent of atelectasis. Material and Methods: Nineteen patients undergoing 22 chest CT examinations were randomly selected for either sedation or general anaesthesia. The total area of atelectasis and the degree of motion artefacts were measured. Results: The mean percentage of atelectasis was 6.67% for general anaesthesia and 0.01% for sedation (p=0.01). There was no significant difference in the quality of the images between the sedation patients and the general anaesthesia patients. Conclusion: Whenever the clinical condition permits it, sedation rather than general anaesthesia should be given to paediatric patients undergoing chest CT. (orig.).

  11. Health-related quality of life in patients with serious non-specific symptoms undergoing evaluation for possible cancer and their experience during the process

    DEFF Research Database (Denmark)

    Moseholm Larsen, Ellen Frøsig; Rydahl-Hansen, S; Lindhardt, B Ø;

    2016-01-01

    understanding of their HRQoL experience during this stressful life event. METHODS: A convergent mixed methods (MM) design was used and involved quantitative data about HRQoL measured by the EORTC-QLQ-C30 instrument and qualitative interview data about patients' HRQoL experiences. Participants completed...... the EORTC-QLQ-C30 questionnaire prior to and after evaluation. The baseline questionnaire informed the purposive sampling for the qualitative interview study, and open-end questions matched to the EORTC-QLQ-C30 constructs were used in the semi-structured interviews. RESULTS: A total of 838 patients were......, cognitive function, social function, symptoms and quality of life. CONCLUSION: The survey results illustrate that HRQoL improved over time and the qualitative findings confirmed and further expanded the survey results. The MM analysis underlines that the HRQoL experience cannot be observed independently...

  12. Desempenho profissional ou doméstico das pacientes em quimioterapia para câncer de mama Professional or household performance of patients with breast cancer undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Lourdes Conceição Martins

    2009-01-01

    Full Text Available OBJETIVOS: Analisar os aspectos epidemiológicos, clínicos, desempenho profissional e doméstico nas pacientes com câncer de mama em tratamento quimioterápico. MÉTODOS: O estudo foi transversal, com 52 mulheres entrevistadas, divididas em dois grupos: afastadas e não afastadas das atividades profissionais e domésticas, durante o tratamento com quimioterapia para câncer de mama. As pacientes foram provenientes de dois hospitais, um situado no município de Santo André e o outro no município de São Bernardo do Campo. Ambos são hospitais públicos de referência, que atendem a população de Santo André, São Bernardo do Campo, São Caetano do Sul, Diadema e Mauá, que são municípios vizinhos, pertencentes ao Estado de São Paulo, próximos da capital. Utilizou-se o questionário WPAI-GH (Work Productitity and Actitity Impairment para avaliar a atividade profissional e/ou doméstica das pacientes. RESULTADOS: As pacientes tinham idade média de 55,7 anos (dp=13,8, a maior parte de etnia branca (88,5%, casada (55,8%, assalariada (65,3% e a maioria se afastou das atividades (51,0%, com estadiamento da doença mais avançado (pOBJECTIVES: Evaluate patients with breast cancer undergoing chemotherapy with respect to their epidemiologic and clinical variables as well as performance at work or at home. METHODS: this was a cross-sectional study including 52 women interviewed during breast cancer chemotherapy, stratified in two groups: those who continued to work and do household tasks, and did not continue to work or do household tasks. Patients were from two public hospitals in the State of São Paulo, one in Santo Andre and the other in São Bernardo do Campo. The WPAI - GH (Work Productivity and Activity Impairment questionnaire was used to evaluate work and household performance of professionals or housewives, respectively. RESULTS: Mean age of the patients was 55.7 (SD=13.8, most were Caucasian (88.5%, married (55.8%, employed (65.3% and

  13. Identification of Candida species in patients with oral lesion undergoing chemotherapy along with minimum inhibitory concentration to fluconazole

    Directory of Open Access Journals (Sweden)

    Mehrnoush Maheronnaghsh

    2016-01-01

    Conclusion: Data were shown that C. albicans is the most commonly identified species in oral candidiasis and majority of fluconazole resistant C. albicans were found in patients with gastrointestinal cancer and lymphoma. Therefore, we recommend an alternative drug instead of fluconazole as a first line of treatment for these type of cancers and administration of fluconazole in patients undergoing chemotherapy should be prescribed in accordance with the type of cancer.

  14. Hoping for the Best, Preparing for the Worst: The lived experiences of women undergoing ovarian cancer surgery

    DEFF Research Database (Denmark)

    Seibæk, L.; Petersen, L.; Blaakaer, J.;

    2012-01-01

    In this study, the lived experiences of women undergoing ovarian cancer surgery were explored, aiming to provide a patient perspective on being newly diagnosed and starting treatment for ovarian cancer. The study period ran from the first visit in the outpatient clinic, till 8 weeks later, when t....... By offering targeted family counselling and taking good care of the women's general health and well-being, hope could be sustained and early cancer rehabilitation initiated....

  15. Preoperative Thyroid Ultrasound Is Indicated in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Cletus A. Arciero, Zita S. Shiue, Jeremy D. Gates, George E. Peoples, Alan P. B. Dackiw, Ralph P. Tufano, Steven K. Libutti, Martha A. Zeiger, Alexander Stojadinovic

    2012-01-01

    Full Text Available Background: Primary hyperaparathyroidism (pHPT is often accompanied by underlying thyroid pathology that can confound preoperative parathyroid localization studies and complicate intra-operative decision making. The aim of this study was to examine the utility of preoperative thyroid ultrasonography (US in patients prior to undergoing parathyroidectomy for pHPT.Methods: An Institutional Review Board approved prospective study was undertaken from January 2005 through July 2008. All patients with pHPT meeting inclusion criteria (n=94 underwent preoperative thyroid ultrasound in addition to standard 99mTc-sestamibi scintigraphy for parathyroid localization. Demographics, operative management and final pathology were examined in all cases.Results: Fifty-four of the 94 patients (57% were noted to have a thyroid nodule on preoperative US, of which 30 (56% underwent further examination with fine needle aspiration biopsy. Alteration of the operative plan attributable to underlying thyroid pathology occurred in 16 patients (17%, with patients undergoing either total thyroidectomy (n=9 or thyroid lobectomy (n=7. Thyroid cancer was noted in 33% of patients undergoing thyroid resection, and 6% of all patients with HPT.Conclusions: The routine utilization of preoperative thyroid ultrasound in patients prior to undergoing parathyroid surgery for pHPT is indicated. The added information from this non-invasive modality facilitates timely management of co-incidental, and sometimes malignant, thyroid pathology.

  16. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J;

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...

  17. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    DEFF Research Database (Denmark)

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    : To investigate whether uterine artery embolization generates a reduced inflammatory response as compared with conventional hysterectomy. MATERIAL AND METHODS: 40 women, 20 in each group, entered this prospective, non-randomized study. The two groups were comparable concerning age, comorbidity, and body......-mass index (BMI). RESULTS: We found a significant difference between the inflammatory responses in women undergoing embolization compared with the inflammatory response in women having an abdominal hysterectomy. Women undergoing embolization were subjected to a much smaller inflammatory burden, their total...... morphine consumption was lower, and their return to work was faster than women subjected to conventional hysterectomy. CONCLUSION: Uterine artery embolization generates a reduced inflammatory response compared with conventional hysterectomy....

  18. Postoperative Enteral Immunonutrition for Patients Undergoing Surgery for Gastric Cancer: A Meta Analysis%胃癌术后肠内免疫营养对胃癌患者近期疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    吴佳; 张宇龙; 张璐; 韩伟; 王琦; 张亚武; 张有成

    2012-01-01

    目的 系统评价肠内免疫营养用于胃癌患者术后营养支持的近期疗效.方法 计算机检索Cochrane图书馆(2011年)、PubMed、EMBASE、CBM、CNKI、VIP、万方(截至2011年10月).收集肠内免疫营养用于胃癌术后营养支持的随机对照试验,采用Cochrane系统评价的方法,由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析.结果 共纳入17项随机对照试验,包括812例患者.Meta分析结果显示:在免疫功能方面CD3[加权均数差=5.81,95%可信区间(2.64,8.99)]、CD4[加权均数差=6.10,95%可信区间(4.39,7.81)]、IgG[加权均数差=1.33,95%可信区间(0.70,1.96)]、IgM[加权均数差=0.16,95%可信区间(0.06,0.26)]及胃癌患者术后体内白介素-2、白介素-6水平方面,肠内免疫营养与对照组差异均有统计学意义.结论 肠内免疫营养对胃癌患者术后免疫功能的改善有一定疗效且可控制胃癌患者术后的应激与炎性反应程度,提高患者术后近期疗效.但限于纳入研究在方法学方面的局限性,尚需要开展高质量的随机对照试验进一步验证其疗效.%Objective To evaluate the clinical efficacy and safty of postoperative enteral immunonutrition in patients undergoing surgery for gastric cancer. Methods We searched the electronic bibliographic databases, including the Cochrane Library, PubMed, EMBASE, CBM, CNKI, VIP database and Wanfang database to assemble the randomized controlled trials (RCTs) of postoperative enteral immunonutrition in patients undergoing surgery for gastric cancer. The deadline of the retrieval time was October 2011. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The RevMan 5.0 software was used for meta-analysis on homogeneous studies. Results Seventeen RCTs involving 812 patients were included. The results of meta-analysis showed that there were significant differences in CD3 [WMD

  19. 肿瘤患者化疗性口腔炎的预防及护理%Cancer Patients Undergoing Chemotherapy Stomatitis Prevention and Care

    Institute of Scientific and Technical Information of China (English)

    许飞翼

    2014-01-01

    口腔炎的发生不仅影响患者的生存质量和对治疗的依从性,严重者还可导致治疗计划中断。本文介绍了化疗性口腔炎的发病机制及临床表现,并从增强营养、保持口腔清洁、应用黏膜保护剂等方面预防护理口腔炎。%Stomatitis occurs not only af ects the quality of life of patients and adherence to treatment,severe cases can lead to treatment plans inter upted.Positive before chemotherapy,chemotherapy, prevention and treatment of chemotherapy after chemotherapy stomatitis has a vital significance.This article describes the pathogenesis and clinical manifestations of chemotherapy stomatitis,and from the enhanced nutrition,keep your mouth clean,apply preventive care mucosal protective agent stomatitis.

  20. Predictive value of PSA velocity over early clinical and pathological parameters in patients with localized prostate cancer who undergo radical retropubic prostatectomy

    Directory of Open Access Journals (Sweden)

    Martinez Carlos A.L.

    2004-01-01

    Full Text Available OBJECTIVES: To analyze the behavior of the prostate specific antigen velocity (PSAV in localized prostate adenocarcinoma. MATERIALS AND METHODS: We conducted a retrospective study of 500 men who had localized prostate adenocarcinoma, who underwent radical retropubic prostatectomy between January 1986 and December 1999. The PSAV was calculated for each patient and subsequently, the values were correlated with 5 groups: age, initial PSA value, clinical stage, tumor volume and Gleason score. RESULTS: The behavior of PSAV presented statistic significance with an increment between 1.3 ng/mL and 9.6 ng/mL, ranging from 38.6% and 59.8% when compared with the initial PSA value (p < 0.0001, clinical stage (p = 0.0002, tumor volume (p < 0.0001 and Gleason score (p = 0.0009. CONCLUSION: PSAV up to 2.5 ng/mL/year is associated with factors of good prognosis, such as initial PSA below 10 mg/mL, clinical stage T1, tumor volume below 20% and Gleason score lower than 7.

  1. Changes in preoperative characteristics in patients undergoing radical prostatectomy - a 16-year nationwide analysis

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Brasso, Klaus; Christensen, Ib Jarle;

    2013-01-01

    . Our hypothesis was that an increasing amount of men undergo RP for lower risk PCa. MATERIAL AND METHODS: All patients operated from 1995 to 2011 were identified via patient files and registries. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS....... This effect is most likely attributed to an increasing use of PSA as marker for early prostate cancer diagnosis in Denmark and new international guidelines for Gleason grading and scoring.......-risk patients increased significantly. The proportion of patients age 70 or above increased from 2% to 13% in the period studies. CONCLUSION: Significant preoperative stage- and Gleason grade migration was found in this complete Danish nationwide cohort of patients undergoing RP during the past 16 years...

  2. Nursing care for patients undergoing transoral robotic surgery.

    Science.gov (United States)

    Murray, Shannon

    2009-01-01

    Otorhinolaryngologists began developing new operative techniques to minimize open surgical resections of the head and neck. While striving to reduce the morbidity and mortality associated with head and neck surgery and decrease the many psychosocial issues facing these patients, a new procedure defined as Transoral Robotic Surgery (TORS) was developed. With the development of new surgical techniques, nursing care must also change to meet the needs of the patient. As the TORS procedure becomes fully defined, so is nursing's role in the care of the patient. This paper aims to define TORS and discuss the nursing care of the patient undergoing this new surgical procedure.

  3. Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Karmel L. Tambunan

    2009-12-01

    Full Text Available Aim: To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis.Methods: This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confi rm the symptomatic VTE. These patients were followed up to one month after surgery.Results: A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1% underwent hip fracture surgery (HFS. The median time from injury to surgery was 23 days (range 2 to 197 days, the median duration of surgery was 90 minutes (range 60 to 255 minutes, and the median duration of immobilization was 3 days (range 1 to 44 days. Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2% at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%, all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study.Conclusion: The incidence of asymptomatic (69.2% and symptomatic (23.1% VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA, and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted. (Med J Indones 2009; 18: 249-56Keywords: venous thromboembolism (VTE, orthopedic surgery, Indonesia

  4. Influence of use of antibiotics on postoperative infections in gastric cancer patients undergoing surgery%胃癌手术患者抗菌药物应用对术后感染的影响分析

    Institute of Scientific and Technical Information of China (English)

    张占东; 杨巍; 马飞; 张永磊; 马二民; 孔烨; 刘洪兴; 花亚伟

    2016-01-01

    目的:研究不同抗菌药物应用对胃癌术后感染的影响。方法回顾性分析2013年1月-2015年1月郑州大学附属肿瘤医院600例进行治疗的胃癌患者临床资料,调查患者使用抗菌药物的种类及术后感染率。结果所有患者均预防性应用抗菌药物,其中使用药物排在第一的为头孢类,排在第二位的为硝基咪唑类抗厌氧菌药物;使用单药的200例,二联用药的360例,三联用药的40例,其中联合用药应用最多的为硝基咪唑类抗厌氧菌药物;预防性药物多于手术开始后1h内进行,患者中未出现术中追加使用抗菌药物的情况;术后发生感染的患者90例感染率15.00%,感染部位,分别为切口感染16例占17.78%,腹腔感染为30例占33.33%以及肺部感染44例占48.89%;感染患者均采用穿刺引流培养的方式进行病原菌培养,共分离出病原菌178株,包括革兰阳性菌80株占44.94%,革兰阴性菌78株占43.82%,真菌20株占11.24%。结论对于胃癌手术患者应该重视抗菌药物的预防性应用,避免不合理用药的发生。%OBJECTIVE To observe the influence of use of antibiotics on postoperative infections in gastric cancer patients undergoing surgery .METHODS The clinical data of 600 gastric cancer patients who were treated in The Affiliated Cancer Hospital of Zhengzhou University from 2013 to 2015 were retrospectively analyzed ,and the types of antibiotics and incidence of postoperative infections were investigated .RESULTS All the patients were treated with antibiotics prophylaxis ,the cephalosporins ranked the first place among the antibiotics ,followed by nitroimidazoles for treatment of anaerobic bacteria infections .Totally 200 patients were given one-drug therapy , 360 cases were given two-drug therapy ,and 40 cases were given three-drug therapy ;the nitroimidazoles were the most frequently used among the combined drug therapy .The

  5. Quality of Life determinants in women with breast cancer undergoing treatment with curative intent

    Directory of Open Access Journals (Sweden)

    Ratheesan Kuttan

    2005-09-01

    Full Text Available Abstract Background The diagnosis of breast cancer and its subsequent treatment has significant impact on the woman's physical functioning, mental health and her well-being, and thereby causes substantial disruption to quality of life (QOL. Factors like patient education, spousal support and employment status, financial stability etc., have been found to influence QOL in the breast cancer patient. The present study attempts to identify the determinants of QOL in a cohort of Indian breast cancer patients. Patients and methods Functional Assessment of Cancer Therapy-Breast (FACT-B Version 4 Malayalam was used to assess quality of life in 502 breast cancer patients undergoing treatment with curative intent. The data on social, demographic, disease, treatment, and follow-up were collected from case records. Data was analysed using Analysis of Variance (ANOVA and multinomial logistic regression. Results The mean age of the patients was 47.7 years with 44.6% of the women being pre-menopausal. The FACT-B mean score was 90.6 (Standard Deviation [SD] = 18.4. The mean scores of the subscales were – Physical well-being 19.6 (SD = 4.7, Social well-being 19.9 (SD = 5.3, Emotional well-being 14 (SD = 4.9, Functional well-being 13.0 (SD = 5.7, and the Breast subscale 23.8 (SD = 4.4. Younger women ( Conclusion QOL derangements are common in breast cancer patients necessitating the provisions for patient access to psychosocial services. However, because of the huge patient load, a screening process to identify those meriting intervention over the general population would be a viable solution.

  6. Evidence-based nursing radical psychological impact on patients undergoing colon cancer with laparotomy%循证护理对开腹结肠癌根治术患者术前心理的影响

    Institute of Scientific and Technical Information of China (English)

    米卫华

    2014-01-01

    Objective To investigate the psychological impact of evidence-based care in patients undergoing colon cancer with laparotomy. Methods 80 cases were divided into two groups, each 40 cases, the observation group were implemented evidence-based nursing interventions in this study, the control group were implemented routine care, such as general care, general psychological care, health education, fears, depression, self-assessment, then patients with nursing intervention tables and Self-Rating Anxiety scale score and intraoperative vital signs during the night before 20:00were compared in the two groups. Results The observation group without fear of proportion was higher than control group (P<0.05), the proportion of moderate fear was more than control group (P<0.05), Self-Rating Depression Scale and the Self-Rating Anxiety Scale scores were lower than control group (P<0.05), systolic blood pressure, diastolic blood pressure were lower than control group (P<0.05), heart rate was slower than control group (P < 0.05). Conclusion The evidence-based psychological interventions for reducing pre-nursing patients undergoing abdominal cancer treatment anxiety and fear has a positive meaning, it can stable the preoperative vital signs.%目的:探讨循证护理对开腹结肠癌根治术患者术前的心理影响。方法选择患者80例,分为两组,各40例,观察组实施本研究循证护理干预方法,对照组则实施常规护理,如一般护理、普通心理护理,健康教育等,比较两组患者护理干预后恐惧情绪、抑郁自评量表和焦虑自评量表得分以及,术前晚20点时的生命体征。结果观察组术前无恐惧比例高于对照组(P<0.05),中度以上恐惧比例低于对照组(P<0.05),抑郁自评量表和焦虑自评量表得分低于对照组(P<0.05),收缩压、舒张压低于对照组(P<0.05),心率慢于对照组(P<0.05)。结论循证护理心理

  7. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy.

    Science.gov (United States)

    Levitzky, Benjamin E; Vargo, John J

    2008-08-01

    Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP), a prodrug of propofol with a slower pharmacokinetic profile, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.

  8. Perioperative nutrition in cancer patients.

    Science.gov (United States)

    Daly, J M; Redmond, H P; Gallagher, H

    1992-01-01

    Cancer patients have the highest incidence of protein-calorie malnutrition seen in hospitalized patients, with significant malnutrition occurring in more than 30% of cancer patients undergoing major upper gastrointestinal procedures. Clinically significant malnutrition occurs as a result of diminished nutrient intake, increased nutrient losses, and tumor-induced derangements in host metabolism. In the absence of adequate exogenous nutrients, the body utilizes endogenous substrates to satisfy the ongoing requirements of both host and tumor for energy and protein. In those patients with malignant obstruction of the gastrointestinal tract, the tumor itself may induce diminished nutrient intake. Present day treatment modalities including gastrointestinal resection, chemotherapy, and radiotherapy compound these metabolic derangements, further increasing the risk of postoperative morbidity and death. The presence of malnutrition in cancer patients has prognostic importance. In a review of more than 3000 cancer patients, DeWys and colleagues identified significantly improved survival in those patients without weight loss compared with those had lost 6% of their body weight (Am J Med 69:491-497, 1980). Other investigators have noted increased postoperative morbidity and mortality associated with malnutrition. Early hypotheses suggested that reversal of weight loss would improve survival. The development and refinements of enteral and parenteral nutrition have provided the opportunity for studying the relationship between nutritional supplementation and postoperative prognosis. Nutrition support is therefore often instituted to improve nutritional status and thereby reduce the risks of postoperative complications. This article addresses the beneficial role of preoperative nutrition therapy in cancer patients.

  9. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Yoshimi Iwasaki; Tokihiko Sawada; Shozo Mori; Yukihiro Iso; Masato Katoh; Kyu Rokkaku; Junji Kita; Mitsugi Shimoda; Keiichi Kubota

    2009-01-01

    AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy. METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared. RESULTS: There were 37 patients (18.8%) withabnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients ( P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality ( P = 0.0936 and P = 0.0875, respectively). CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

  10. [Pharmacokinetics of defibrotide in uremic patients undergoing hemodialysis].

    Science.gov (United States)

    Rossi, R; Farma, A; Maggi, G C; Marelli, A

    1991-12-01

    Defibrotide pharmacokinetics were studied in 6 voluntary healthy subjects and in 10 uremic patients undergoing dialysis during which (instead of heparin) defibrotide was administered to prevent fibrino-formation in the circuit. Blood concentrations of the drug were assessed (expressed with reference to the residual glycidic deoxyribose) during a standard dialysis using defibrotide, 3.5, 15, 30, 45, 60 and 90 minutes after the defibrotide bolus (200 mg) had been injected into the arterial channel. The half-lives of the alpha and beta plasmatic phases were found to be equal at 3.79 and 41.4 min in dialysed subjects and at 1.13 and 16.54 in healthy volunteers. These results indicate that in uremic patients undergoing dialysis at intervals using defibrotide, a longer time is required to eliminate the drug from the circulation. This variation does not however appear to be significant in terms of the therapeutic use of the drug during dialysis.

  11. Knowledge of electromyography (EMG) in patients undergoing EMG examinations.

    Science.gov (United States)

    Mondelli, Mauro; Aretini, Alessandro; Greco, Giuseppe

    2014-01-01

    The aim of this study was to evaluate knowledge of electromyography (EMG) in patients undergoing the procedure. In one year, 1,586 consecutive patients (mean age 56 years; 58.8% women) were admitted to two EMG labs to undergo EMG for the first time. The patients found to be "informed" about the how an EMG examination is performed and about the purpose of EMG numbered 448 (28.2%), while those found to be "informed" only about the manner of its execution or only about its purpose numbered 161 (10.2%) and 151 (9.5%), respectively. The remaining 826 (52.1%) patients had either no information, or the information they had was very poor or incorrect (this was particularly true if they had been consulting websites). Being "informed" was associated with level of education (high), type of referring physician (specialist) and with an appropriate referral diagnosis specified in the EMG request. The quality of patient information on EMG was found to be very poor and could be improved. Physicians referring patients for EMG examinations, especially general practitioners, should assume primary responsibility for patient education and counseling in this field.

  12. Prevalence of renal artery stenosis in patients undergoing cardiac catheterization.

    Science.gov (United States)

    Marcantoni, Carmelita; Carmelita, Marcantoni; Rastelli, Stefania; Stefania, Rastelli; Zanoli, Luca; Luca, Zanoli; Tripepi, Giovanni; Giovanni, Tripepi; Di Salvo, Marilena; Marilena, Di Salvo; Monaco, Sergio; Sergio, Monaco; Sgroi, Carmelo; Carmelo, Sgroi; Capodanno, Davide; Davide, Capodanno; Tamburino, Corrado; Corrado, Tamburino; Castellino, Pietro; Pietro, Castellino

    2013-08-01

    To investigate the prevalence of significant renal artery stenosis (RAS ≥50%), and to identify clinical predictors for significant RAS in patients with an elevated cardiovascular risk, such as those affected by ischemic heart disease. In patients with an elevated cardio-vascular risk, both atherosclerotic renovascular disease and coronary artery disease (CAD) are likely to occur. Prospectively from April 2007 to March 2008, all consecutive patients with ischemic heart disease undergoing non-emergent cardiac catheterization were also evaluated for atherosclerotic RAS by renal arteriography. A RAS ≥50% was considered as significant. A total of 1,298 patients underwent cardiac and renal angiography. Significant RAS was found in 70 out of 1,298 patients (5.4%). The presence of peripheral vascular disease, eGFR 66 years, dyslipidemia, CAD severity and pulse pressure >52 mmHg were independent clinical predictors of significant RAS, and jointly produced a ROC AUC of 0.79 (95% CI 0.73-0.85, P < 0.001). Based on these data, a prediction rule for significant RAS was developed, and it showed an adequate predictive performance with 64% sensitivity and 82% specificity. In a large cohort of patients undergoing coronary angiography, significant RAS is a relatively rare comorbidity (5.4%). A model based on simple clinical variables may be useful for the clinical identification of high CV risk patients who may be suitable for renal arteriography at the time of cardiac catheterization.

  13. Influencing Factors of Quality of Life of Primary Caregivers of Lung Cancer Patients Undergoing Chemotherapy%肺癌化疗患者主要照顾者生活质量的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    陈丽; 任小红; 黄伶智; 焦杰

    2013-01-01

      目的探讨肺癌化疗患者主要照顾者生活质量的影响因素.方法采用自编的一般情况问卷、Zarit护理负担量表及癌症患者照料者生活质量调查表(Caregiver Quality of Life,CQOL)对294例肺癌化疗患者主要照顾者进行问卷调查.结果肺癌化疗患者主要照顾者生活质量总得分为(171.18±34.96)分,得分由低到高分别为心理健康、精神健康、社会健康和生理健康.影响肺癌化疗患者主要照顾者生活质量的主要因素有照顾负担、有无慢性病、文化程度以及患者年龄和疾病分期(P<0.05).复相关系数R=0.685,决定系数R2=0.469.结论肺癌化疗患者主要照顾者生活质量以心理健康维度得分最低,总体生活质量与照顾负担、照顾者文化程度、是否有慢性病、患者年龄、患者疾病分期有关,其中照顾负担对生活质量的影响尤为显著.%Objective To explore the factors influencing the quality of life (QOL) in primary caregivers of lung cancer patients undergoing chemotherapy. Methods The QOL of 294 primary caregivers of lung cancer patients undergoing chemotherapy was surveyed by a self-designed general information questionnaire, Zarit Burden Interview, Caregiver Quality of Life (CQOL) scare. Results The total score of QQL in 294 primary caregivers was 171.18±34.96 and factors scoring from low to high respectively were mental health, psychological health and social health. Factors influencing the QQL of caregivers included care burdens, whether to have chronic illness, education background of caregivers, patients’ age and disease stage (P<0.05). The multiple correlation coefficient (R) was 0.685 and total coefficient of determination (R2) was 0.469. Conclusion Mental health scores lowest in the QOL of primary caregivers. Care burdens, whether to have chronic illness, education background of caregiver, patients’ age, and disease stage are the major influencing factors and care burden exerts the most

  14. The impact of patients controlled analgesia undergoing orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Aluane Silva Dias

    2016-06-01

    Full Text Available ABSTRACT INTRODUCTION: The currently common musculoskeletal disorders have been increasingly treated surgically, and the pain can be a limiting factor in postoperative rehabilitation. RATIONALE: Patient controlled analgesia (PCA controls pain, but its adverse effects can interfere with rehabilitation and in the patient discharge process. This study becomes important, since there are few studies evaluating this correlation. OBJECTIVES: To compare the outcomes of patients who used and did not use patient controlled analgesia in postoperative orthopedic surgery with respect to pain, unscheduled need for O2 (oxygen, and time of immobility and in-hospital length of stay. METHODS: This is an observational, prospective study conducted at Hospital Abreu Sodré from May to August 2012. The data was daily obtained through assessments and interviews of patients undergoing total hip arthroplasty (THA and total knee arthroplasty (TKA, thoracolumbar spine arthrodesis (long PVA, cervical spine arthrodesis (cervical AVA and lumbar spine arthrodesis (lumbar PVA. RESULTS: The study showed some differences between groups, namely: the painful level was higher in the group undergoing lumbar PVA without PCA compared with the group with PCA (p = 0.03 and in the group of long PVA without PCA in the early postoperative period. This latter group used O2 for a longer time (p = 0.09. CONCLUSION: In this study, PCA was useful for analgesia in patients undergoing lumbar PVA and probably would have influenced the usage time of O2 in the group of long PVA in face of a larger sample. The use of PCA did not influence the time of leaving the bed and the in-hospital length of stay for the patients studied.

  15. [Has ketamine preemptive analgesic effect in patients undergoing abdominal hysterectomy?].

    Science.gov (United States)

    Karaman, Semra; Kocabaş, Seden; Zincircioğlu, Ciler; Firat, Vicdan

    2006-07-01

    The aim of this study was to determine if preemptive use of the NMDA receptor antogonist ketamine decreases postoperative pain in patients undergoing abdominal hystrectomy. A total of 60 patients admitted for total abdominal hysterectomy were included in this study after the approval of the ethic committee, and the patients were randomly classified into three groups. After standart general anaesthesia, before or after incision patients received bolus saline or ketamine. Group S received only saline while Group Kpre received ketamine 0.4 mg/kg before incision and saline after incision, and Group Kpost received saline before incision and 0.4 mg/kg ketamine after incision. Postoperatif analgesia was maintained with i.v. PCA morphine. Pain scores were assessed with Vizüal Analog Scale (VAS), Verbal Rating Scale (VRS) at 1., 2, 3., 4., 8., 12. ve 24. hours postoperatively. First analgesic requirement time, morphine consumption and side effects were recorded. There were no significant differences between groups with respect to VAS / VRS scores, the time for first analgesic dose, and morphine consumption ( p>0.05). Patients in Group S had significantly lower sedation scores than either of the ketamine treated groups ( pketamin had no preemptive analgesic effect in patients undergoing abdominal hysterectomy, but further investigation is needed for different operation types and dose regimens.

  16. Nutrition application through percutaneous endoscopic gastrostomy in head and neck cancer patients undergoing radiotherapy%经皮内镜胃造瘘营养支持在头颈部肿瘤放疗中的应用

    Institute of Scientific and Technical Information of China (English)

    葛奎; 徐兵; 张霖; 曹大春; 朱健; 周龙女

    2013-01-01

    PURPOSE:To investigate the clinical cffect of nutritional supplementation through percutaneous endoscopic gastrostomy on head and neck cancer patients undergoing radiotherapy.METHODS:One hundred and three head and neck cancer patients who received radiotherapy with food intake limitation and need of nutrition supplementation were randomly divided into two groups:PEG group of 47 cases and nasal feeding group of 56 cases.The patients were supplemented with same intensity food through percutaneous endoscopic gastrostomy and nasal intubation.Patients' mood,appetite,life quality,tolerance and compliance were observed during treatment.Infection situation was recorded,infection rate and average Defined Daily Dose (DDD) number during whole course were calculated.Nutrition index,including body weight,serum album,transferrin,were also tested before and after radiotherapy respectively.The data was analyzed with SPSS 11.0 software package.RESULTS:In clinical observation,patients' mood,appetite and life quality decreased unobviously after radiotherapy,but tolerance and compliance increased obviously,and social activities were not affected in PEG group.But in nasal intubation group,the status was not optimistic,patients' mood,appetite and life quality were depressed,their tolerance and compliance were bad,social activities were reduced.The infection rate in PEG group was 19.1%,which was significantly less than 33.9% of nasal intubation group (P=0.0292).Accordingly,DDDs in PEG group was 1.5,smaller than 4.3 of nasal intubation group.In nutrition index,body weight and serum album decreased sharply from (63.6±4.2) kg and (34.0±4.5) g/L before treatment to (60.7±2.5) kg and (31.4±3.8) g/L after treatment in PEG group,but transferrin increased from (27.6±3.9) μmol/L to (28.4±1.3) μmol/L,although no significant difference was noted.In the same way,body weight,serum album and transferrin decreased from (65.3±5.6) kg,(33.7±3.1) g/L and (28.2±2.1) μmol/L before treatment

  17. Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

    Science.gov (United States)

    Lubis, L. E.; Badawy, M. K.

    2016-03-01

    The increasing prevalence and complexity of fluoroscopically guided interventions (FGI) raises concern regarding radiation dose to patients subjected to the procedure. Despite current evidence showing the risk to patients from the deterministic effects of radiation (e.g. skin burns), radiation induced injuries remain commonplace. This review aims to increase the awareness surrounding radiation dose measurement for patients undergoing FGI. A review of the literature was conducted alongside previous researches from the authors’ department. Studies pertaining to patient dose measurement, its formalism along with current advances and present challenges were reviewed. Current patient monitoring techniques (using available radiation dosimeters), as well as the inadequacy of accepting displayed dose as patient radiation dose is discussed. Furthermore, advances in real-time patient radiation dose estimation during FGI are considered. Patient dosimetry in FGI, particularly in real time, remains an ongoing challenge. The increasing occurrence and sophistication of these procedures calls for further advances in the field of patient radiation dose monitoring. Improved measuring techniques will aid clinicians in better predicting and managing radiation induced injury following FGI, thus improving patient care.

  18. Body mass index, conversion rate and complications among patients undergoing robotic surgery for endometrial carcinoma.

    Science.gov (United States)

    Cunningham, Mary J; Dorzin, Esther; Nguyen, Loan; Anderson, Elizabeth; Bunn, W Douglas

    2015-12-01

    A retrospective cohort study was performed to evaluate the relationship of BMI to conversion rate in patients undergoing robotic surgery for endometrial cancer. Secondary outcomes were operative times, number of lymph nodes retrieved, and complications. Women with endometrial cancer scheduled for robotic surgery from September 2008 to September 2012 were included. Women were divided into three groups based on BMI, and conversion rates to laparotomy were compared. Descriptive and comparative analyses were performed among non-obese, obese, and morbidly obese women who completed robotic surgery. 298 women were scheduled for robotic surgery for endometrial carcinoma: 87 non-obese (BMI 19-29, μ 25.23), 110 obese (BMI 30-39, μ 34.21), and 101 morbidly obese (BMI 40-71, μ 47.38). Conversion to laparotomy occurred in 18 patients (6%), with no difference in conversion rate between BMI categories. Direct comparison between converted and completed robotic patients showed no significant differences in preoperative characteristics, except that patients who required conversion had a higher number of previous abdominal surgeries. Patients completing robotic surgery underwent node dissections at similar rates in all three BMI categories. Operating room time, but not surgical time, was increased in morbidly obese patients. There were no significant differences in complications, performance of lymphadenectomy, or lymph node yields between BMI categories. Increase in BMI was not associated with an increase in rate of conversion to laparotomy or complication rate in patients undergoing robotic surgery for endometrial carcinoma. Node dissections were pathologically equivalent between BMI categories.

  19. Protective effects of lung protective ventilation on lungs in patients undergoing radical resection for esophageal cancer%肺保护性通气对食管癌根治术病人的肺保护效应

    Institute of Scientific and Technical Information of China (English)

    方向志; 张扬; 高巨

    2015-01-01

    目的 评价肺保护性通气对食管癌根治术病人的肺保护效应.方法 择期全麻下行食管癌根治术病人68例,性别不限,年龄40 ~ 64岁,ASA分级Ⅰ或Ⅱ级,体重指数17~40 kg/m2,采用随机数字表法分为2组(n=34):常规通气组(CV组)和保护性通气组(PV组).麻醉诱导后置入左侧双腔支气管导管,接麻醉机行机械通气.CV组双肺通气时VT10 ml/kg,单肺通气时VT7 ml/kg,吸呼比1∶2;PV组双肺通气时VT7 ml/kg,单肺通气时VT5 ml/kg,吸呼比1∶2,并给予PEEP 10 cmH2O,每45 min双肺行肺复张1次.分别于麻醉诱导前、术后第1天、第3天和第5天时行动脉血气分析,并记录临床改良肺部感染评分;分别于麻醉诱导前和术后第5天时行床旁肺功能检查,记录每分钟最大通气量占预计值的百分比(MVV%)、用力肺活量占预计值的百分比(FVC%)、第1秒用力呼气量占预计值的百分比(FEV1%),计算FEV1/FVC;记录术后5d内呼吸衰竭、肺不张、切口感染等的发生情况.结果 与CV组比较,PV组MVV%、FVC%、FEV1%和FEV1/FVC升高,术后各时点临床改良肺部感染评分降低,SaO2和PaO2升高(P<0.05),肺不张和切口感染的发生率差异无统计学意义(P>0.05).结论 肺保护性通气对食管癌根治术病人具有肺保护效应.%Objective To evaluate the protective effects of lung protective ventilation on the lungs in patients undergoing radical resection for esophageal cancer.Methods Sixty-eight patients of both sexes,aged 40-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 17-40 kg/m2,scheduled for elective radical resection for esophageal cancer,were randomly divided into conventional ventilation group (CV group,n =34) and protective ventilation group (PV group,n =34) using a random number table.Double lumen tube was inserted after induction of anesthesia,an anesthesia machine was connected,and the patients were mechanically ventilated.In group CV,VT was set at 10 ml

  20. Anxiety, depression and illness uncertainty in cervical cancer patients undergoing radiotherapy%放疗期间宫颈癌患者疾病不确定感与焦虑抑郁的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张苏梅; 李小妹; 顾炜; 石晓婷; 韩冬芳

    2014-01-01

    Objective To explore the relationship between illness uncertainty and anxiety as well as depression in cervical cancer patients undergoing radiotherapy .Methods Hospital Anxiety and Depression Scale ( HADS) and Mishel Uncertainty in Illness Scale ( MUIS) were used to investigate 68 cervical cancer patients .Results The total score of MUIS was 93.06 ±7.91.The average score of HADS-A was 6.90 ±3.50 and HADS-D was 6.26 ±4.06.The prevalence of depressive disorders , anxiety disorders, and comorbidity of both disorders was 39.7% (27), 35.3% (24) and 26.47% (18), respectively.HADS-A was positively correlated with total score of illness uncertainty and ambiguity (r=0.374,P=0.002;r=0.526,P=0.000).HADS-D was positively correlated with total score of illness uncertainty, ambiguity and inconsistency (r=0.381,P=0.001;r=0.397,P=0.001;r =0.318,P=0.009).Unpredictability was negatively correlated with HADS-A and HADS-D (r=-0.355,P=0.003;r=-0.272,P=0.026).Conclusion Illness uncertainty is closely related with the feeling of anxiety and depression in cervical cancer patients undergoing radiotherapy .Doctors and nurses should attach concerns to the uncertainty of the patients , and reduce illness uncertainty , anxiety and depression by providing more relevant information .%目的:描述放疗期间宫颈癌患者疾病不确定感水平及焦虑抑郁状况;探讨疾病不确定感与焦虑、抑郁之间的关系。方法应用医院焦虑抑郁量表( HADS)、疾病不确定感量表( MUIS)对68例放疗期宫颈癌患者进行调查。结果放疗期间宫颈癌患者疾病不确定感总得分为(93.06±7.91);焦虑得分为(6.90±3.50)分,抑郁得分为(6.26±4.06)分;焦虑(HADS-A≥8)27人(39.7%),抑郁(HADS-A≥8)24人(35.3%),焦虑合并抑郁18人(26.47%);疾病不确定感总分、不明确性与焦虑呈正相关(r=0.374,P=0.002;r=0.526,P=0.000);疾

  1. Hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    Mahdi; Najafi; David; Faraoni

    2015-01-01

    Although red blood cells(RBCs) transfusion is sometimes associated with adverse reactions,anemia could also lead to increased morbidity and mortality in highrisk patients. For these reasons,the definition of perioperative strategies that aims to detect and treat preoperative anemia,prevent excessive blood loss,and define "optimal" transfusion algorithms is crucial. Although the treatment with preoperative iron and erythropoietin has been recommended in some specific conditions,several controversies exist regarding the benefit-to-risk balance associated with these treatments. Further studies are needed to better define the indications,dosage,and route of administration for preoperative iron with or without erythropoietin supplementation. Although restrictive transfusion strategies in patients undergoing cardiac surgery have been shown to effectively reduce the incidence and the amount of RBCs transfusion without increase in side effects,some high-risk patients(e.g.,symptomatic acute coronary syndrome) could benefit from higher hemoglobin concentrations. Despite all efforts made last decade,a significant amount of work remains to be done to improve hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery.

  2. Association between self-efficacy and quality of life in women with breast cancer undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    MZ. Kiaei

    2016-06-01

    Full Text Available Background: Self-efficacy is known as a factor which influences health behaviors, chronic diseases management and quality of life in patients with cancer. Objective: The aim of this study was to investigate the association of self-efficacy and quality of life in women with breast cancer undergoing chemotherapy. Methods: This cross sectional study was conducted in 100 women with breast cancer referred to Seyed Al-Shohada Hospital, Isfahan in 2015. The study subjects were selected by simple random sampling method. The measurement tools were the Sherer self-efficacy scale and the World Health Organization WHOQOL-BREF quality of life assessment. Data were analyzed using one-way ANOVA and Pearson’s correlation coefficient. Findings: Mean age was 48.25±11.93 years. The mean self-efficacy score and quality of life score were 55.78± 11 and 75.91±15.28, respectively and both of them were average. There was positive significant correlation between self-efficacy and quality of life. There was also significant association between self-efficacy and quality of life domains including physical health, mental health, social relationships and environment. Conclusion: With regards to the results, it seems that activities such as workshops for patients, presence of a psychologist in department of chemotherapy, and providing health facilities can be effective for increasing self-efficacy and quality of life in patients with cancer.

  3. Fatigue and Quality of Life of Women Undergoing Chemotherapy or Radiotherapy for Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Winnie K.W.So; Gene Marsh; W.M.Ling; F.E Leung; Joe C.K.Lo; Maggie Yeung; George K.H.Li

    2009-01-01

    OBJECTIVE To examine fatigue and quality of life (QOL) in breast cancer patients undergoing chemotherapy or radiotherapy.METHODS A self-report survey derived from the Chinese version of Brief Fatigue Inventory, the Functional Assessment of Chronic Illness Therapy for Breast Cancer, and the Medical Outcomes Study Social Support Survey. Descriptive statistics was used to examine the intensity of fatigue and the prevalence of severe fatigue. Multivariate analysis of variance was used to determine factors that affect the five domains of QOL among the participants.RESULTS The majority of the participants (n = 261) perceived a mild level of fatigue, but 35.6% of them suffered severe fatigue. Fatigue had a significantly negative association with all domains of QOL except social/family wellbeing. The participants who were receiving chemotherapy, undergoing curative treatment and having inadequate social support were more likely to have poorer QOL in all five domains (after adjustment for age).CONCLUSION Although the majority of the participants experienced a mild level of fatigue, there was a substantial group of breast cancer patients who perceived their fatigue as severe. The findings of this study showed that fatigue had a detrimental effect on the various aspects of the participants'QOL. Demographic and clinical characteristics of breast cancer patients who were at risk of getting poorer QOL were identified. The results of the study demonstrate that we should enhance healthcare professionals' awareness of the importance of symptom assessment, and provide them with information for planning effective symptom-management strategies among this study population.

  4. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    Directory of Open Access Journals (Sweden)

    Benjamin E Levitzky

    2008-09-01

    Full Text Available Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP, a prodrug of propofol with a slower pharmacokinetic profi le, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.Keywords: fospropofol, Aquavan, propofol, sedation, colonoscopy

  5. Maintaining periodontal health in patients undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Shobhana Misra

    2012-01-01

    Full Text Available Presence of fixed orthodontic appliances in the mouth leads to accumulation of food debris and an elevation in the amount of plaque. It also hinders plaque removal by tooth brushing alone. Chemical agents may be used during the active phase of orthodontic treatment to reduce the bacterial plaque accumulation and decrease the occurrence of periodontal disease in these patients. The present study was therefore done to compare the efficacy of chemical plaque control by chlorhexidiene in patients undergoing orthodontic treatment. Forty five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis, and at the end of one month in all the three groups. The data obtained was subjected to stastical analysis. Anova test showed significant difference among all the three groups for bleeding index, modified gingival index and plaque index. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for chlorhexidine group. Modified gingival index showed significant difference in the chlorhexidine group. For plaque index significant difference was found for chlorhexidine, and control groups. Chlorhexidine mouthrinse 0.12% was found to be the most effective in reducing the bleeding scores, modified gingival index scores and the plaque index scores. It can therefore be said that chlorhexidine mouthrinse 0.12% provides greater benefits to the patients undergoing fixed orthodontic treatment.

  6. Immediate hemodynamic response to furosemide in patients undergoing chronic hemodialysis.

    Science.gov (United States)

    Schmieder, R E; Messerli, F H; deCarvalho, J G; Husserl, F E

    1987-01-01

    To evaluate the effect of furosemide on cardiovascular hemodynamics in patients with end-stage renal failure, we studied ten patients undergoing hemodialysis three times a week. Arterial pressure, heart rate, and cardiac output (indocyanine green dye) were measured in triplicate; total peripheral resistance and central blood volume were calculated by standard formulas. Hemodynamics were determined at baseline and 5, 10, 15, and 30 minutes after intravenous (IV) bolus injection of furosemide 60 mg. Furosemide produced a decrease in central blood volume of -13% +/- 2.2% from pretreatment values (P less than .01) that was most pronounced five minutes after injection, together with a fall in cardiac output (from 6.76 +/- 0.59 to 6.17 +/- 0.52 L/min, P less than .10). Stroke volume decreased with a maximum fall occurring after 15 minutes (from 84 +/- 7 to 79 +/- 7 mL/min, P less than .05), and total peripheral resistance increased (from 15.8 +/- 2.1 to 17.8 +/- 2.3 units, P less than .05) after furosemide. Arterial pressure and heart rate did not change. The decrease in central blood volume reflects a shift of the total blood volume from the cardiopulmonary circulation to the periphery, suggesting dilation of the peripheral venous bed. Thus, even in patients undergoing hemodialysis, furosemide acutely decreases left ventricular preload by venous dilation and should therefore prove to be beneficial in acute volume overload.

  7. Stress perception among patients in pre-colonoscopy period and those undergoing chemotherapy treatment

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    Graziela de Souza Alves da Silva

    2015-05-01

    Full Text Available Objective: comparing the perception of stress among patients with colorectal cancer undergoing chemotherapy with those in pre-colonoscopy period. Methods: a comparative descriptive study developed with 144 people receiving chemotherapy and 100 patients in the pre-colonoscopy period, using biosocial and clinical data, Stress Assessment Tool and Perceived Stress Scale. Results: a predominance of females (73%, aged over 65 (50% were predominant for the pre-colonoscopy period patients. In patients receiving chemotherapy, gender parity with ages ranging from 40-64 years (68.1% was observed. Pre-colonoscopy patients showed higher perceived stress compared to those receiving chemotherapy (p <0.001. Conclusion: the phase of diagnostic definition represents greater stress to patients in comparison to period of treatment, even despite the characteristic manifestations of chemotherapy.

  8. Heart rhythm complexity impairment in patients undergoing peritoneal dialysis

    Science.gov (United States)

    Lin, Yen-Hung; Lin, Chen; Ho, Yi-Heng; Wu, Vin-Cent; Lo, Men-Tzung; Hung, Kuan-Yu; Liu, Li-Yu Daisy; Lin, Lian-Yu; Huang, Jenq-Wen; Peng, Chung-Kang

    2016-06-01

    Cardiovascular disease is one of the leading causes of death in patients with advanced renal disease. The objective of this study was to investigate impairments in heart rhythm complexity in patients with end-stage renal disease. We prospectively analyzed 65 patients undergoing peritoneal dialysis (PD) without prior cardiovascular disease and 72 individuals with normal renal function as the control group. Heart rhythm analysis including complexity analysis by including detrended fractal analysis (DFA) and multiscale entropy (MSE) were performed. In linear analysis, the PD patients had a significantly lower standard deviation of normal RR intervals (SDRR) and percentage of absolute differences in normal RR intervals greater than 20 ms (pNN20). Of the nonlinear analysis indicators, scale 5, area under the MSE curve for scale 1 to 5 (area 1-5) and 6 to 20 (area 6-20) were significantly lower than those in the control group. In DFA anaylsis, both DFA α1 and DFA α2 were comparable in both groups. In receiver operating characteristic curve analysis, scale 5 had the greatest discriminatory power for two groups. In both net reclassification improvement model and integrated discrimination improvement models, MSE parameters significantly improved the discriminatory power of SDRR, pNN20, and pNN50. In conclusion, PD patients had worse cardiac complexity parameters. MSE parameters are useful to discriminate PD patients from patients with normal renal function.

  9. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Hyoung Soo Kim

    2017-02-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

  10. Preoperative autologous plateletpheresis in patients undergoing open heart surgery.

    Directory of Open Access Journals (Sweden)

    Tomar Akhlesh

    2003-01-01

    Full Text Available Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB. It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I in which one unit of whole blood was withdrawn, and PRP group (Group II where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p<0.001 and required 38.5% less homologous blood and blood products (p<0.05, in the postoperative period. Haemoglobin levels on day zero (day of operation and day three were statistically not different between the two groups. We

  11. Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers. We hypothesized that nasogastric intubation in patients undergoing laparotomy reduces lower esophageal sphincter pressure and promotes gastroesophageal reflux in the perioperative period. METHODS: A prospective randomized case-control study was undertaken in which 15 consenting patients, admitted electively for bowel surgery, were randomized into 2 groups. Group 1 underwent nasogastric intubation after induction of anesthesia, and Group 2 did not. All patients had manometry and pH probes placed with the aid of endoscopic vision at the lower esophageal sphincter and distal esophagus, respectively. Nasogastric tubes, where present, were left on free drainage, and sphincter pressures and pH were recorded continuously during a 24-hour period. Data were analyzed with 1-way analysis of variance. RESULTS: The mean number of reflux episodes (defined as pH < 4) in the nasogastric tube group was 137 compared with a median of 8 episodes in the group managed without nasogastric tubes (P =.006). The median duration of the longest episode of reflux was 132 minutes in Group 1 and 1 minute in Group 2 (P =.001). A mean of 13.3 episodes of reflux lasted longer than 5 minutes in Group 1, with pH less than 4 for 37.4% of the 24 hours. This was in contrast to Group 2 where a mean of 0.13 episodes lasted longer than 5 minutes (P =.001) and pH less than 4 for 0.2% of total time (P =.001). The mean lower esophageal sphincter pressures were lower in Group 1. CONCLUSIONS. These findings demonstrate that patients undergoing elective laparotomy with routine nasogastric tube placement have significant gastroesophageal

  12. [Anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation].

    Science.gov (United States)

    Oda, Toshiyuki; Takahama, Yutaka

    2012-11-01

    This chapter describes anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation (AF) based on electrophysiologic or pharmacological aspects. In the 2011 guidelines of the Japanese Circulation Society for non-pharmacotherapy of cardiac arrhythmias, catheter ablation is recommended as Class I therapeutic modality for the patients with drug-refractory paroxysmal AF. Catheter ablation of AF is an invasive and long-lasting procedure necessitating sedation during treatment. However, in the most of the patients, sedation or anesthesia is possibly performed by cardiologists using propofol, midazolam or dexmedetomidine. Deep sedation accompanies a high risk of ventilatory or circulatory derangement. Furthermore, life-threatening complications, such as cerebral infarction or cardiac tamponade, can occur during ablation. Patients with AF are increasing in number as a trend in the aging society, resulting in an increase in catheter ablation in high risk patients. To accomplish safe anesthetic management of the patients for catheter ablations, anesthesiologists are required to have fundamental knowledge and skill in the performance of the catheter ablation.

  13. Medanta insulin protocols in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2014-01-01

    Full Text Available Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient′s estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.

  14. Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvia Maria Rodrigues Querido

    2011-12-01

    Full Text Available Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37ºC. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.

  15. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

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    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  16. Dysphagia outcomes in patients with brain tumors undergoing inpatient rehabilitation.

    Science.gov (United States)

    Wesling, Michele; Brady, Susan; Jensen, Mary; Nickell, Melissa; Statkus, Donna; Escobar, Nelson

    2003-01-01

    The purpose of this retrospective study was to compare functional dysphagia outcomes following inpatient rehabilitation for patients with brain tumors with that of patients following a stroke. Group 1 (n = 24) consisted of consecutive admissions to the brain injury program with the diagnosis of brain tumor and dysphagia. Group 2 (n = 24) consisted of matched, consecutive admissions, with the diagnosis of acute stroke and dysphagia. Group 2 was matched for age, site of lesion, and initial composite cognitive FIM score. The main outcome measures for this study included the American Speech-Language-Hearing Association (ASHA) National Outcome Measurement System (NOMS) swallowing scale, length of stay, hospital charges, and medical complications. Results showed that swallowing gains made by both groups as evaluated by the admission and discharge ASHA NOMS levels were considered to be statistically significant. The differences for length of stay, total hospital charges, and speech charges between the two groups were not considered to be statistically significant. Three patients in the brain tumor group (12.5%) demonstrated dysphagia complications of either dehydration or pneumonia during their treatment course as compared to 0% in the stroke group. This study confirms that functional dysphagia gains can be achieved for patients with brain tumors undergoing inpatient rehabilitation and that they should be afforded the same type and intensity of rehabilitation for their swallowing that is provided to patients following a stroke.

  17. 人文关怀在癌症化疗期患者护理中的应用%Application of humanistic care in patients with cancer who undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    金娜; 赵翠云; 王焕; 李云仙; 杨艳; 吴婷婷

    2014-01-01

    Medical humanities concern is the concrete embodiment of humanistic spirit in medical activities.Giving humane care for patients with cancer,can strengthen the confidence and courage of them to conquer the disease.Therefore,giving psychological and spiritual care and comfort is very important for patients with cancer.Through analysis of negative psychological reaction often appeared in chemotherapy period of cancer patients,such as fear,anxiety,depression,anorexia,nausea,vomiting,we should strengthen the humanistic care of cancer patients during chemotherapy.Incorporate includes:strengthen the scientific knowledge education in cancer patients,listen to the voice of patients,to strengthen social support,and strengthen social support,personalized treatment.%医学人文关怀是人文精神在医疗活动中的具体体现。给予癌症患者以人文关怀,能增强其战胜疾病的信心和勇气。因此,心理和精神上的关怀和抚慰对癌症患者至关重要。本文通过分析癌症患者在化疗期常出现恐惧、焦虑、抑郁、厌食、恶心、呕吐等负性心理反应,提出应加强癌症患者化疗期间的人文关怀。具体措施:加强癌症患者科普知识教育、倾听患者心声、指导患者行为训练、强化社会支持、制定个性化方案。

  18. Application of fast track surgery in patients undergoing surgery for rectal cancer%快速康复外科在直肠癌手术患者的应用

    Institute of Scientific and Technical Information of China (English)

    钱飞; 朱建伟; 于嘉伟; 孙乃志; 肖建佳; 陈澍周

    2015-01-01

    Objective To investigate the value of fast track surgery in the patients undergoing rectal cancer surgery .Methods Sixty patients with rectal cancer were randomized into two groups of A(treated with fast track surgery ,30 cases) and B(treated with conventional surgery ,30 cases) .The measures of fast track surgery included having liquid food and oral laxative ,but without enema one day before operation ,drinking a liquid with energy such as sugar water 250 ml ,not inserting indwelling gastric tube and urine catheter before surgery ,and having liquid food and restrictively infusing fluid of 2000‐2500 ml on the first postoperative day .The white blood cell counting one day after operation ,the first time of flatus passage ,postoperative hospital stay and complications were compared between two groups .Results Compared to group B ,the patients in group A had less white blood cell counting [(10.50 ± 1.56) × 109/L vs .(13.04 ± 2.53 ) × 109/L ]( P<0 .05 ) ,earlier passage of flatus [(2.5 ± 0.6) d vs .(3.8 ± 0.7 ) d ] ( P<0 .05 ) ,shorter hospital stay [(9.1 ± 2.9 ) d vs .(11.6 ± 3.5 ) d ] (P<0 .05) and lower incidence of complication (10.0% vs .30.0% )(P<0 .05) .Conclusion Fast track surgery in rectal cancer surgery can promote the recovery of bowel function ,reduce complications and hospital stay .%目的探讨快速康复外科在直肠癌手术中的应用价值。方法符合入组条件的60例直肠癌患者随机均分为快速康复组(A组)和传统治疗组(B组)。A组快速康复外科措施包括:(1)术前进流质1d,口服泻剂,不灌肠;(2)术前4h一次性口服能量液体,例如糖水250ml;(3)术前不留置胃管和导尿管;(4)术后第1天进流质后,限制性补液,补液量2000‐2500ml。比较术后第1天白细胞计数、术后首次排气时间、术后住院天数和并发症发生率等指标。结果与B组比较,A组术后第1天白细胞计数低[(10.50±1.56)×109/Lvs.(13

  19. Radiation dose estimation of patients undergoing lumbar spine radiography

    Directory of Open Access Journals (Sweden)

    Prince Kwabena Gyekye

    2013-01-01

    Full Text Available Radiation dose to organs of 100 adult patients undergoing lumbar spine (LS radiography at a University Hospital have been assessed. Free in air kerma measurement using an ionization chamber was used for the patient dosimetry. Organ and effective dose to the patients were estimated using PCXMC (version 1.5 software. The organs that recorded significant dose due to LS radiography were lungs, stomach, liver, adrenals, kidney, pancreas, spleen, galbladder, and the heart. It was observed that the stomach recorded the highest dose (48.2 ± 1.2 μGy for LS anteroposterior (AP. The spleen also recorded the highest dose (41.2 ± 0.5 μGy for LS lateral (LAT. The mean entrance surface air kerma (ESAK of LS LAT (122.2 μGy was approximately twice that of LS AP (76.3 μGy, but the effective dose for both examinations were approximately the same (LS LAT = 8.6 μSv and LS AP = 10.4 μSv. The overall stochastic health effect of radiation to patients due to LS radiography in the University Hospital is independent of the projection of the examination (AP or LAT.

  20. Effect of music on patients undergoing outpatient colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Matthew L Bechtold; Rodney A Perez; Srinivas R Puli; John B Marshall

    2006-01-01

    AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist.SETHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played.RESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time,endoscopist assessment of scope insertion difficulty,endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure.The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales.CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

  1. Nitric oxide synthetase and Helicobacter pylori in patients undergoing appendicectomy.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: This study was designed to determine whether Helicobacter pylori forms part of the normal microenvironment of the appendix, whether it plays a role in the pathogenesis of acute appendicitis, and whether it is associated with increased expression of inducible nitric oxide synthetase (iNOS) in appendicular macrophages. METHODS: Serology for H. pylori was performed on 51 consecutive patients undergoing emergency appendicectomy. Appendix samples were tested for urease activity, cultured and stained for H. pylori, graded according to the degree of inflammatory infiltrate, and probed immunohistochemically for iNOS expression. RESULTS: The mean age of the patients was 21 (range 7-51) years. Seventeen patients (33 per cent) were seropositive for H. pylori but no evidence of H. pylori was found in any appendix specimen. However, an enhanced inflammatory cell infiltration was observed in seropositive patients (P < 0.04) and the expression of macrophage iNOS in the mucosa of normal and inflamed appendix specimens was increased (P < 0.01). CONCLUSION: H. pylori does not colonize the appendix and is unlikely to be a pathogenic stimulus for appendicitis. Priming effects on mucosal immunology downstream from the foregut may occur after infection with H. pylori.

  2. Heart-Kidney Biomarkers in Patients Undergoing Cardiac Stress Testing

    Directory of Open Access Journals (Sweden)

    Mikko Haapio

    2011-01-01

    Full Text Available We examined association of inducible myocardial perfusion defects with cardiorenal biomarkers, and of diminished left ventricular ejection fraction (LVEF with kidney injury marker plasma neutrophil gelatinase-associated lipocalin (NGAL. Patients undergoing nuclear myocardial perfusion stress imaging were divided into 2 groups. Biomarkers were analyzed pre- and poststress testing. Compared to the patients in the low ischemia group (n=16, the patients in the high ischemia group (n=18 demonstrated a significantly greater rise in cardiac biomarkers plasma BNP, NT-proBNP and cTnI. Subjects were also categorized based on pre- or poststress test detectable plasma NGAL. With stress, the group with no detectable NGAL had a segmental defect score 4.2 compared to 8.2 (P=.06 in the detectable NGAL group, and 0.9 vs. 3.8 (P=.03 at rest. BNP rose with stress to a greater degree in patients with detectable NGAL (10.2 vs. 3.5 pg/mL, P=.03. LVEF at rest and with stress was significantly lower in the detectable NGAL group; 55.8 versus 65.0 (P=.03 and 55.1 vs. 63.8 (P=.04, respectively. Myocardial perfusion defects associate with biomarkers of cardiac stress, and detectable plasma NGAL with significantly lower LVEF, suggesting a specific heart-kidney link.

  3. Care of the patient undergoing robotic-assisted laparoscopic pyeloplasty.

    Science.gov (United States)

    Francis, Paula; Winfield, Howard N

    2006-04-01

    Laparoscopic pyeloplasty as a treatment for ureteropelvic junction obstruction has shown comparable success rates with open pyeloplasty techniques. The use of robotic technology to assist during laparoscopic pyeloplasty procedures has been encouraged by the steep learning curve for laparoscopic surgical skills, and the complexity of laparoscopic suturing. Robotic technology provides the surgeon with the ability to filter out any physiologic hand tremor, more degrees of freedom of movement than traditional laparoscopic instruments, the ability to scale movement to provide better control for microsurgery, better ergonomics during surgery, and three-dimensional vision. Details of the procedure and specific nursing care of the patient undergoing robotic-assisted laparoscopic pyeloplasty at the University of Iowa Hospital and Clinics are described.

  4. Study of the effect of psychological intervention on the negative emotion and coping mode of patients with breast cancer undergoing radical mastectomy%心理干预对乳腺癌术后病人负性情绪和应对方式影响的研究

    Institute of Scientific and Technical Information of China (English)

    郑珊红; 和晓美

    2010-01-01

    Objective To explore the importance of the effect of psychological intervention on the negative emotion and coping mode of patients with breast cancer undergoing radical mastectomy. Methods One hundred and twenty patients with breast cancer undergoing radical mastectomy were randomly divided into observation (n=65) and control groups (n=55).The comprehensive psychological intervention was adopted in the observation group and routine nursing was given in the control group. The relevant factors of the negative emotion and coping mode of patients with breast cancer undergoing radical mastectomy were investigated by SDS, SAS and MCMQ questionnaire. Results All indicators of the observation group and control group had obvious difference and the difference was of significance in statistics science. Conclusions Psychological intervention has significant effect on mitigating the negative emotion of patients and establishing positive coping mode.%目的 探讨心理干预对乳腺癌根治术后病人负性情绪和应对方式的影响.方法 采用随机分组法将120例乳腺癌根治术患者分为干预组65例,对照组55例.干预组进行综合性心理干预,对照组给予常规护理,采用抑郁自评量表(SDS)和焦虑自评量表(SAS)医学应对问卷(McMQ)对其负性情绪及应对方式的相关因素进行问卷调查.结果 对照组和干预组各项指标差异具有统计学意义.结论 心理干预对改善乳腺癌根治术病人负性情绪,建立积极的应对方式有显著效果.

  5. Thyroid doses and risk to paediatric patients undergoing neck CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, Maria Vittoria; Tipnis, Sameer; Huda, Walter [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Tavernier, Joshua [Medical University of South Carolina, College of Medicine, Charleston, SC (United States)

    2015-07-15

    To estimate thyroid doses and cancer risk for paediatric patients undergoing neck computed tomography (CT). We used average CTDI{sub vol} (mGy) values from 75 paediatric neck CT examinations to estimate thyroid dose in a mathematical anthropomorphic phantom (ImPACT Patient CT Dosimetry Calculator). Patient dose was estimated by modelling the neck as mass equivalent water cylinder. A patient size correction factor was obtained using published relative dose data as a function of water cylinder size. Additional correction factors included scan length and radiation intensity variation secondary to tube-current modulation. The mean water cylinder diameter that modelled the neck was 14 ± 3.5 cm. The mathematical anthropomorphic phantom has a 16.5-cm neck, and for a constant CT exposure, would have thyroid doses that are 13-17 % lower than the average paediatric patient. CTDI{sub vol} was independent of age and sex. The average thyroid doses were 31 ± 18 mGy (males) and 34 ± 15 mGy (females). Thyroid cancer incidence risk was highest for infant females (0.2 %), lowest for teenage males (0.01 %). Estimated absorbed thyroid doses in paediatric neck CT did not significantly vary with age and gender. However, the corresponding thyroid cancer risk is determined by gender and age. (orig.)

  6. Myoinositol Improves Embryo Development in PCOS Patients Undergoing ICSI

    Science.gov (United States)

    2016-01-01

    The aim of this study was to investigate the activity of myoinositol, in a court of 217 PCOS women undergoing intracytoplasmic sperm injection (ICSI), on pregnancy rate, embryo development, estradiol, and progesterone concentration in blood serum, superoxide dismutase (SOD), and catalase (CAT) in follicular fluid. Concerning the court of patient, 112 (groups I and II) out of 217 were PCOS women, whereas group III consisted of healthy subjects (not PCOS). Group I patients were treated with 400 μg of folic acid per day for 3 months before ICSI, whereas group II patients received 4000 mg of myoinositol and 400 μg of folic acid per day for 3 months before ICSI. Group II revealed a shorter embryo/blastocyst development period between microinjection and 5-cell stage compared to group I. The difference in SOD concentration between groups I and II and between groups II and III was statistically significant. In group II, 34.62% of pregnancies were obtained, whereas in group I this number reached 20% (NS). Myoinositol increased embryo development dynamics and accelerated blastocyst stage reaching time; however, no effect was shown on clinical pregnancy. Furthermore, it restored SOD concentration, lowered in PCOS women, but did not exert any effect on CAT concentration. PMID:27777587

  7. Can patients with schizophrenia undergo renal transplantation with success?

    Directory of Open Access Journals (Sweden)

    Saoussen Bouhlel

    2014-01-01

    Full Text Available We report a case of a 41-year-old man suffering from paranoid schizophrenia. The patient has been consulting in our psychiatric hospital since he was 29 years old. Eight years later, he developed kidney failure and required peritoneal dialysis. After more than two years, the nephrology team indicated a renal transplantation and his brother suggested giving his kidney. There were no obstacles for transplantation in the immune and histological compatibilities; the psychiatric staff decided to check the patient′s compliance with medication. The patient was compliant to all his medications and to the salt-free diet after the transplant operation. Few weeks later, he developed steroid-induced diabetes. Through the last two years, he had psychotic exacerbations with major anxiety and fear of losing the transplant. These relapses were managed by increasing doses of antipsychotics without need for hospitalization. At the present time, three years after transplantation, the nephrologists are decreasing the immunosuppressive agents and the steroids. The renal function is optimum and the diabetes is stabilized. This case exemplifies the potential for schizophrenic patients to undergo renal transplantation and to comply with follow-up medical care through a close cooperation between the patient′s family, the psychiatric staff and the nephrology team.

  8. Is Antibiotic Prophylaxis Necessary in Patients Undergoing Ureterolithotripsy?

    Directory of Open Access Journals (Sweden)

    Ali Pasha Meysamie

    2011-08-01

    Full Text Available Transurethral Ureterolithotripsy (TUL is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. Thisstudy was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications (fever, positive blood culture, significant bactriuria, the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure.

  9. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    Science.gov (United States)

    Wang, Chu

    Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence

  10. Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC.

    Science.gov (United States)

    Salvi, Rosario; Meoli, Ilernando; Cennamo, Antonio; Perrotta, Fabio; Saverio Cerqua, Francesco; Montesano, Raffaele; Curcio, Carlo; Lassandro, Francesco; Stefanelli, Francesco; Grella, Edoardo; Tafuri, Domenico; Mazzarella, Gennaro; Bianco, Andrea

    2016-01-01

    Thoracic surgery remains the better therapeutic option for non-small cell lung cancer patients that are diagnosed in early stage disease. Preoperative lung function assessment includes respiratory function tests (RFT) and cardio-pulmonary exercise testing (CPET). Vo2 peak, FEV1 and DLCO as well as recognition of performance status, presence of co-morbidities, frailty indexes, and age predict the potential impact of surgical resection on patient health status and survival risk. In this study we have retrospectively assessed the benefit of a high-intensity preoperative pulmonary rehabilitation program (PRP) in 14 patients with underlying lung function impairment prior to surgery. Amongst these, three patients candidate to surgical resection exhibited severe functional impairment associated with high score of frailty according CHS and SOF index, resulting in a substantial mortality risk. Our observations indicate that PRP appear to reduce the mortality and morbidity risk in frail patients with concurrent lung function impairment undergoing thoracic surgery. PRP produced improvement of VO2 peak degree and pulmonary function resulting in reduced postoperative complications in high-risk patients from our cases. Our results indicate that a preoperative training program may improve postoperative clinical outcomes in fraillung cancer patients with impaired lung function prior to surgical resection.

  11. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198

  12. Alteration of the oral environment in patients undergoing esophagectomy during the perioperative period

    Directory of Open Access Journals (Sweden)

    Masami Yoshioka

    2013-04-01

    Full Text Available Objective: During the perioperative period, oral ingestion is changed considerably in esophagectomy patients. The aim of this study was to investigate oral environment modifications in patients undergoing esophageal cancer treatments due to changes in dietary intake and swallowing functions. Material and Methods: Thirty patients who underwent operation for removal of esophageal cancer in Tokushima University Hospital were enrolled in this study. Results: It was found that 1 the flow rate of resting saliva decreased significantly at postoperative period by deprived feeding for one week, although it did not recover several days after oral ingestion began, 2 the accumulation of dental plaque and the number of mutans streptococci in saliva decreased significantly after operation, while both increased relatively quick when oral ingestion began, and 3 the swallowing function decreased significantly in the postoperative period. Conclusions: These results suggest that dental professionals should emphasize the importance of oral health care and provide instructions on plaque control to patients during the perioperative period of esophageal cancer treatment.

  13. Care of the patient undergoing robotic-assisted prostatectomy.

    Science.gov (United States)

    Starnes, Danielle N; Sims, Terran Warren

    2006-04-01

    Prostate cancer has many treatment options. In addition to open retropubic and perineal approaches to radical prostatectomy, laparoscopic robotic prostatectomy is available as a newer surgical option. Potential advantages of robotic surgery include reduced pain and trauma, less blood loss, reduced infection risk, shorter hospital stay, faster recovery, and less scarring (Intuitive Surgical, 2005). A variety of nursing care considerations involving pre-operative education and preparation, intra-operative and immediate postoperative care issues, and long-term followup must be understood to meet the needs of a robotic surgical patient. Patient selection is very important to optimize a positive surgical outcome. Just as certain criteria make a good surgical candidate, there are factors that could complicate the surgery or adversely affect recovery.

  14. Is there a role for homeopathy in breast cancer surgery? A first randomized clinical trial on treatment with Arnica montana to reduce post-operative seroma and bleeding in patients undergoing total mastectomy

    Science.gov (United States)

    Sorrentino, Luca; Piraneo, Salvatore; Riggio, Eliana; Basilicò, Silvia; Sartani, Alessandra; Bossi, Daniela; Corsi, Fabio

    2017-01-01

    Aim: This study aimed to evaluate the benefits of Arnica montana on post-operative blood loss and seroma production in women undergoing unilateral total mastectomy by administering Arnica Montana 1000 Korsakovian dilution (1000 K). Materials and Methods: From 2012 to 2014, 53 women were randomly assigned to A. montana or placebo and were followed up for 5 days. The main end point was the reduction in blood and serum volumes collected in drainages. Secondary end points were duration of drainage, a self-evaluation of pain, and the presence of bruising or hematomas. Results: The per-protocol analysis revealed a lower mean volume of blood and serum collected in drainages with A. montana (−94.40 ml; 95% confidence interval [CI]: 22.48-211.28; P = 0.11). A regression model including treatment, volume collected in the drainage on the day of surgery, and patient weight showed a statistically significant difference in favor of A. montana (−106.28 ml; 95% CI: 9.45-203.11; P = 0.03). Volumes collected on the day of surgery and the following days were significantly lower with A. montana at days 2 (P = 0.033) and 3 (P = 0.0223). Secondary end points have not revealed significant differences. Conclusions: A. montana 1000 K could reduce post-operative blood and seroma collection in women undergoing unilateral total mastectomy. Larger studies are needed with different dilutions of A. montana to further validate these data. PMID:28163953

  15. Standards and options: recommendations for the use of erythropoiesis-stimulating agents (ESA) in anemic cancer patients undergoing radiotherapy (2007 update); Standards, options: recommandations 2007. Indication des agents stimulants l'erythropoiese (ASE) dans la prise en charge de l'anemie induite par la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Marchal, Ch. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Misset, J.L. [Hopital Saint-Louis, 75 - Paris (France); Casadevall, N. [Hopital Saint Antoine, 75 - Paris (France); Marec-Berard, P.; Ray-Coquard, I. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Chastagner, P. [Hopital d' Enfants Nancy, 54 (France); Kassab-Chahmi, D. [Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC), 75 - Paris (France)

    2008-03-15

    Introduction. - Beginning 1998, a working group of specialists convened by the guidelines department (Standards, Options and Recommendations: S.O.R.) of the National French Federation of Comprehensive Cancer Centres (F.N.C.L.C.C.) published then regularly updated Recommendations relative to the use of ESA (epoetin alfa, epoetin beta, darbepoetin) in anemic patients with cancer. This article presents the updated Recommendations set up in 2007. Methods. - This updating process is based on the methodology developed and used in the 'Standards, Options: Recommendations' programme. The methodological approach combines systematic review with the judgement of a multidisciplinary group of experts. On the basis of analysis of literature, the conclusions and their level of evidence are established. Then, the conclusions accompanied by experts judgement lead to the Recommendations. A Recommendation is a proposal of one or several clinical attitudes intended to improve cancer patient care. Before publication, the R.P.C.-S.O.R. are re-examined by independent reviewers selected according to the same principles as the group of expert writers. Results. - New data, relative to the 'use of ESA in anemic cancer patients undergoing radiotherapy', did not lead to update the latest Recommendations validated in 2003. However, new data relative to the 'use of ESA in anaemia prophylaxis among adult patients with cancer' and to the 'use of iron with ESA in cancer patients' were sufficient to generate either major or minor modifications to the initial Recommendations. Conclusions. - Thus, it appears relevant to re-examine these Recommendations according to a systematic monitoring process which should be renewed in two years. (authors)

  16. Identification of Candida species in patients with oral lesion undergoing chemotherapy along with minimum inhibitory concentration to fluconazole

    Science.gov (United States)

    Maheronnaghsh, Mehrnoush; Tolouei, Sepideh; Dehghan, Parvin; Chadeganipour, Mostafa; Yazdi, Maryam

    2016-01-01

    Background: Various species of Candida, especially Candida albicans was known as the most important etiological agent of fungal infections. Oral candidiasis is the most common fungal infection in patients undergoing chemotherapy. The purpose of this study was to identify Candida species from oral lesions of these patients and antifungal susceptibility of the clinical isolates. Materials and Methods: Among 385 patients with cancer, 55 (14.3%) showed oral lesions. Oral swabs were performed to identify the yeasts using direct smear and CHROMagar medium. Micro dilution method was prepared in different concentrations of fluconazole and minimum inhibitory concentration and minimum fungicidal concentration of each species were compared. Results: Oral candidiasis confirmed in 36 cases by direct examination and culture. C. albicans and non-albicans represented in 26 (72.2%) and 10 (27.8%) of the isolates, respectively. 76.5% of C. albicans and 23.5% non-albicans isolates were resistant to fluconazole. Data were shown that 62% and 30.7% of resistant strains of C. albicans were found in patient with gastrointestinal cancer and lymphoma respectively. Conclusion: Data were shown that C. albicans is the most commonly identified species in oral candidiasis and majority of fluconazole resistant C. albicans were found in patients with gastrointestinal cancer and lymphoma. Therefore, we recommend an alternative drug instead of fluconazole as a first line of treatment for these type of cancers and administration of fluconazole in patients undergoing chemotherapy should be prescribed in accordance with the type of cancer. PMID:27656601

  17. Vancomycin Utilization Review in Patients Undergoing Bone MarrowTransplantation

    Directory of Open Access Journals (Sweden)

    Saghar Taheri

    2015-10-01

    Full Text Available Background:  Infections  in  neutropenic  patients  are  considered  as  major  causes  of  mortality and the emergence of drug resistance. Gram positive bacterial infections are crucially important to be covered if indicated. Vancomycin is active against most Gram positive bacteria including Methicillin Resistant Staphylococcus Aureus (MRSA. In this study, we evaluated the appropriate utilization of this agent in bone marrow transplantation (BMT patients.Methods: In a cross sectional study, all patients who received vancomycin in a seven months period at bone marrow transplantation research center in Shariati teaching hospital in Tehran, Iran, were entered to the study. Clinical and preclinical parameters such as serum creatinine, microbial culture, antibacterial sensitivity, WBC count and fever were collected and recorded for analysis. We also measured vancomycin trough level after administration of three doses.Results: Fifty one patients were entered in the study and reviewed in two adult BMT wards. The age range was 18 to 65 years. Most patients received allogenic versus autologous transplantation (56.9%, 43.1%. About 80% of the vancomycin used for the patients with febrile neutropenia was compatible with National Comprehensive Cancer Network (NCCN guideline. 21.6% of patients received appropriate doses. Vancomycin trough serum concentration range was 15.0±11.9 μg/mL.Conclusion: Vancomycin is an antibiotic used to treat resistant gram-positive infections and must be prescribed by a specialist. Vancomycin wrong dosing or initiation prescribing with dose 1 gr/q12h increases the resistance and toxicity to drug, and cause an inappropriate response to the drug.

  18. Rectosigmoid findings are not associated with proximal colon cancer: Analysis of 6 196 consecutive cases undergoing total colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Makoto Okamoto; Takao Kawabe; Yutaka Yamaji; Jun Kato; Tsuneo Ikenoue; Goichi Togo; Haruhiko Yoshida; Yasushi Shiratori; Masao Omata

    2005-01-01

    AIM: To review the risk of proximal colon cancer in patients undergoing colonoscopy.METHODS: We estimated the risk of advanced proximal adenomas and cancers in 6 196 consecutive patients that underwent colonoscopy (mean age 60 years, 65% males,without prior history of colorectal examination). Neoplasms were classified as diminutive adenoma (5 mm or less),small adenoma (6-9 mm), advanced adenoma (10 mm or more, with villous component or high-grade dysplasia)and cancer (invasive adenocarcinoma). The sites of neoplasms were defined as rectosigmoid (rectum and sigmoid colon) and proximal colon (from cecum to descending colon).RESULTS: The trend of the prevalence of advanced proximal adenoma was to increase with severe rectosigmoid findings, while the prevalence of proximal colon cancer did not increase with severe rectosigmoid findings. Among the 157 patients with proximal colon cancer, 74% had no neoplasm in the rectosigmoid colon. Multivariate logisticregression analysis revealed that age was the main predictor of proximal colon cancer and existence of rectosigmoid adenoma was not a predictor of proximal colon cancer.CONCLUSION: Sigmoidoscopy is inadequate for colorectal cancer screening, especially in older populations.

  19. Pulmonary physiotherapy effect on patients undergoing open cardiac surgery

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    Seyed Kazem Shakuri

    2014-09-01

    Full Text Available Backgrounds and Objectives — Respiratory complications after open heart surgeries are common problems which can lead to death if not properly managed. The aim of this study was to evaluate the role of pulmonary rehabilitation before and after surgery for reducing the risk of pulmonary complications after surgery also correlations of the six-minute walk test and respiratory following open heart surgery. Material and Methods — In a randomized clinical trial, 60 patients undergoing heart surgery were divided into two groups randomly (groups A and B. In group A it was performed physiotherapy before and after chest physiotherapy surgery, but on patients in group B were done only chest physiotherapy after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and six-minute walk test. Results — Thirty nine of males (65% and 21 females (35% with a mean age of 8.10±9.56 was been analyzed. The mean difference in predicted forced vital capacity (CI95%: 1.3 to 8.7 and predicted peak flow indices (CI95%: 1.9 to 9.4 of spirometery indicator was significant, also evaluation of six-minute walk test showed, mean difference in walking distant (CI95%: 8.8 to 21.0 and mean oxyhemoglobin saturation (CI95%: 0.59 to 1.67 in group A was more than group B. Inverse correlation of heart rate with forced vital capacity showed that patients with more restriction had more heart rate during the walking test. Conclusion — Pulmonary rehabilitation program before surgery is recommended to reduce complications of heart surgery. Further evaluations are necessary in relation to the sensitivity and specificity of six-minute walk test parameters alone in the evaluation of respiratory performance.

  20. Is Sentinel Lymph Node Dissection Necessary in All Patients with Ductal Carcinoma In Situ Undergoing Total Mastectomy?

    Science.gov (United States)

    Bonev, Valentina; De Paz Villanueva, Carlos Chavez; Solomon, Naveenraj; Senthil, Maheswari; Reeves, Mark E; Garberoglio, Carlos; Lum, Sharon S

    2016-10-01

    When ductal carcinoma in situ (DCIS) is found on core needle biopsy, rates of upgrade to invasive cancer of 25 per cent and nodal positivity of 10 per cent have been reported. Sentinel lymph node dissection (SLND) is recommended when mastectomy is performed for DCIS. We investigated the role of SLND in DCIS patients undergoing partial and total mastectomy (TM). During the study period 2004 to 2013, 170 patients with DCIS were identified with a median age of 60 years (range 26-84 years). Of these, 58.2 per cent had partial mastectomy (PM) alone, 10.6 per cent had PM with SLND, and 31.1 per cent had TM with or without contralateral prophylactic mastectomy with SLND. Overall, SLND identified positive nodes in 4.2 per cent of patients. Upgrade to invasive carcinoma on final breast pathology was found in 8.2 per cent of patients overall, including 4.0 per cent of patients undergoing PM alone, 22.2 per cent undergoing PM with SLND, and 11.3 per cent for TM with SLND (P = 0.8). In this study, patients diagnosed with DCIS on core needle biopsy had lower than expected rates of positive sentinel nodes and upgrade to invasive carcinoma. Surgeons and patients should revisit the necessity of SLND in DCIS patients undergoing mastectomy, which could lead to decreased health expenditure, resources, time, morbidity, and emotional impact on patients.

  1. [Nutrition and cancer patients].

    Science.gov (United States)

    Katsuramaki, T; Hirata, K; Isobe, M

    1998-03-01

    Nutritional therapy for cancer patients includes various objectives such as improvement of cachexia, elucidation of the mechanism of malnutrition, development of therapy for anorexia, nutrition support during chemotherapy or radiotherapy, and inhibition of tumor growth under controlled caloric intake. This review describes recent remarkable developments in nutritional therapy for cancer patients. Cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor which induce proteolysis and lipolysis are involved in the cause of malnutrition and cachexia in cancer patients. IL-1 also plays a significant role in the development of cancer anorexia via direct action in the brain. For anorexia therapy, progestogens have been shown to improve appetite and food intake in cancer patients. Moreover, glutamine supplementation improves the host protein metabolism without enhancement of tumor growth during chemotherapy. Among the effects of caloric intake on anticancer therapy, AO-90, a methionine-free intravenous amino acid solution, has been shown to increase the antitumor effect of 5-fluorouracil in clinical studies. From these observations, recent progress in nutritional therapy for cancer patients has been remarkable. Further study of nutritional therapy is required in order to maintain or improve the quality of life of cancer patients in the future.

  2. Effects of Glutamine Supplementation on Patients Undergoing Abdominal Surgery

    Institute of Scientific and Technical Information of China (English)

    Yue-ping Fan; Jian-chun Yu; Wei-ming Kang; Qun Zhang

    2009-01-01

    Objective To evaluate the effects of supplementation of glutamine (GLN) on maintaining glutathione (GSH) level, immune system function, liver function, and clinical outcome of patients receiving abdominal operation. Methods Forty patients undergoing elective abdominal surgical treatment were randomly divided into 2 groups: study group (n = 20) and control group (n = 20). All patients received total parenteral nutrition (TPN) for up to 7 days during perioperative period. The study group received TPN supplemented with GLN dipeptide while the control group received TPN without GLN dipeptide. Patients in both groups received equivalent nitrogen and caloric intake. Blood sample was taken on preoperative day, and the 1st, 3rd, 6th postoperative day to measure GSH level, immune indexes, and liver function indexes. Results The decrease of GSH level in plasma and red blood cell (RBC) in study group was less than that in control group during postoperative period. Ratio of GSH/glutathione disulfide (GSSG) in plasma in study group was higher than that in control group on the 3rd postoperative day (52.53 ± 11.46 vs. 31.43 ± 7.27, P = 0.001). Albumin level in study group was higher than that in control group on the 3rd postoperative day (37.7 ± 3.8 g/L vs. 33.8 ± 4.2 g/L, P = 0.02). There was no significant difference in the levels of immunoglobin (IgG, IgM, IgA) or T lymphocyte subgroup (CD4, CD8, CD4/CD8) in both groups during postoperative period. There was one case with infectious complication in control group, while none in study group. A trend of shortened hospital stay was observed in study group compared with control group (22.3 ± 2.1 d vs. 24.9 ± 1.7 d, P = 0.32). Conclusions Supplementation of GLN-enriched TPN has beneficial effects on maintaining GSH levels in plasma and RBC, sustaining GSH/GSSG ratio and albumin level, and keeping antioxidant abilities during postoperative period in patients with abdominal operation, with the trends of decreasing incidence of

  3. The Impact of Free/Total PSA Ratio on Prostate Cancer Diagnosis in Patients with PSA Level Between 2,5-10 mg/dl Undergoing Transrectal Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Nevzat Sener

    2014-02-01

    Full Text Available Aim:  In this study, we aimed to compare the outcomes of pathologic results of patients underwent transrectal prostate biopsy (TRIB with free/total PSA ratio. Material and Method: Patients having a PSA level between 2.5-10 ng/ml and underwent TRIB were retrospectively analyzed. Patients were divided into two groups as having a free/total PSA ratio below and over 20%. The ratio below 20% was in Group 1 and over 20% were in Group 2. Results: There were 60 patients in Group 1 and 82 patients in Group 2. PSA levels were 7,45 ± 2,14 and 6,31 ± 1,89 for groups 1 and 2, respectively (p=0.067. Fourteen patients in Group 1 (23% and 15 patients in Group 2 (18% were diagnosed with prostate cancer. Sensitivity was 100% and specificity was 23% when PSA level was between 2.5 and 10. Discussion: Free/Total PSA ratio can be applied to PSA levels between 2.5 and 10. Even though it has a low specificity, with high sensitivity, it can be used in urologic practice.

  4. Punica granatum Linn. prevention of oral candidiasis in patients undergoing anticancer treatment

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    Manuela Gouvêa Campêlo dos SANTOS

    Full Text Available Abstract Introduction Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck. Studies show that herbal medicine has proven to be a promising alternative for the treatment of candidiasis. Objective To evaluate the effectiveness of the gel Punica granatum Linn. in the prevention of oral candidiasis in patients undergoing radiotherapy with or without chemotherapy for squamous cell carcinoma of the head and neck, and adverse effects associated with its use. Material and method It was performed a clinical trial, double blind, in the period 2012-2013, with patients seen at a referral hospital for cancer treatment. The sample consisted of 17 patients who did not have signs nor symptoms of oral candidiasis. These patients were divided into two groups: experimental (n=11: composed of patients who used the gel Punica granatum Linn. 6.25% since the beginning of the anticancer treatment and completed a week after the end of the treatment regimen; control (n=6: for patients who used the gel Miconazol 2%, following the same guidelines of the previous group. Data were tabulated and analyzed using descriptive statistics, the chi-square test and calculation of continuing Yates correction (p<0.05. Result There was no oral candidiasis in 63.6% of patients in the experimental group and in none of the control group patients. Conclusion Most patients who used the experimental gel showed no clinical signs of fungal infection, and there was no association of adverse effects.

  5. Prognostic analysis of patients with pancreatic head adenocarcinoma less than 2 cm undergoing resection

    Institute of Scientific and Technical Information of China (English)

    Kun-Chun Chiang; Chun-Nan Yeh; Wei-Chen Lee; Yi-Yin Jan; Tsann-Long Hwang

    2009-01-01

    AIM: To investigate the differences in clinicopathological features between patients with pancreatic cancer greater or less than 2 cm situated over the pancreatic head and the prognostic factors for survival of patients with pancreatic cancer < 2 cm over the pancreatic head. METHODS: From 1983 to 2006, 159 patients with histologically proven pancreatic adenocarcinoma (PAC) at the pancreatic head undergoing curative resection at the Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan were reviewed, comprising 123 cases of large (L)-PAC (tumor > 2 cm) and 36 cases of small (S)-PAC (tumor ≤ 2 cm). We compared the clinicopathological characteristics and prognosis of L-PAC and S-PAC patients. The clinicopathological characteristics of S-PAC were investigated to clarify the prognosis predictive factors of S-PAC. RESULTS: One hundred and fifty-nine PAC patients, aged 16-93 years (median, 59.0 years) with a tumor at the pancreatic head undergoing intentional curative resection were investigated. The S-PAC and L-PAC patients had similar demographic data, clinical features, and tumor markers (a similar positive rate of carcinoembryonic antigen and carbohydrate antigen 19-9). There were also similar rates of lymph node metastasis, portal vein invasion, stage distribution, tumor differentiation, positive resection margin, surgical morbidity and mortality observed between the two groups. During a follow-up period ranging from 1.0 to 122.7 mo (median, 10.9 mo), S-PAC and L-PAC patients had a similar prognosis after resection (P = 0.4805). Among the S-PAC patients group, patients with higher albumin level (> 3.5 g/dL) had more favorable survival than those with lower albumin levels, which was the only favorable predictive prognostic factor. Meanwhile, early-staged (stage Ⅰ, Ⅱ) S-PAC patients tended to have a more favorable outcome than late-stage (stage Ⅲ, Ⅳ) S-PAC patients, but this was not statistically significant. CONCLUSION: S-PAC patients

  6. Neoadjuvant hormonal deprivation for patients undergoing radical prostatectomy

    Institute of Scientific and Technical Information of China (English)

    Xu Gao; Tie Zhou; Yuan-Jie Tang; Xin Lu; Ying-Hao Sun

    2009-01-01

    The purpose of this study is to evaluate the therapeutic effect of radical prostatectomy combined with preoperative neoadjuvant hormonal ablation therapy for prostate cancer (PCa).In this study,a total of 31 patients with local PCa underwent radical prostatectomy;of these,12 patients underwent preoperative hormonal deprivation with a combination of goserelin and flutamide for a period of 5.6 months.Data regarding clinical characteristics were compared between the neoadjuvant therapy and radical prostatectomy groups.A total of 31 patients received pelvic lymph node clearance,and the rate of positive lymph nodes was 12.9% (4/31).Serum prostate-specific antigen (PSA) was 8.9±1.2μg L-1 after the neoadjuvant therapy and 0.4±0.3μg L-1 one month after the radical prostatectomy.There were significant differences in the positive surgical margins,seminal vesicle invasion and lymph node metastasis between the neoadjuvant therapy group (n=12) and the radical prostatectomy group (n=19,P<0.01).The resulsts indicates that preoperative hormonal deprivation induced by goserelin and flutamide can decrease clinical and pathological staging,but assessment of its influence on long-term prognosis requires further study.

  7. Enhanced Recovery After Surgery Program in Patients Undergoing Pancreaticoduodenectomy

    Science.gov (United States)

    Xiong, Junjie; Szatmary, Peter; Huang, Wei; de la Iglesia-Garcia, Daniel; Nunes, Quentin M.; Xia, Qing; Hu, Weiming; Sutton, Robert; Liu, Xubao; Raraty, Michael G.

    2016-01-01

    -regression analysis. Our study suggested that ERAS was as safe as CPC and improved recovery of patients undergoing PD, thus reducing in-hospital costs. General adoption of ERAS protocols during PD should be recommended. PMID:27149448

  8. Clinical and biochemical outcomes of men undergoing radical prostatectomy or radiation therapy for localized prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schreiber, David; Weiss, Jeffrey P.; Safdieh, Joseph; Weiner, Joseph; Rotman, Marvin; Schwartz, David [Veterans Affairs, New York Harbor Healthcare System, Brooklyn (United States); Rineer, Justin [University of Florida Health Cancer Center at Orlando Health, Orlando (United States)

    2015-03-15

    We analyzed outcomes of patients with prostate cancer undergoing either radical retropubic prostatectomy (RRP) +/- salvage radiation or definitive radiation therapy (RT) +/- androgen deprivation. From 2003-2010 there were 251 patients who underwent RRP and 469 patients who received RT (> or =7,560 cGy) for prostate cancer. Kaplan-Meier analysis was performed with the log-rank test to compare biochemical control (bCR), distant metastatic-free survival (DMPFS), and prostate cancer-specific survival (PCSS) between the two groups. The median follow-up was 70 months and 61.3% of the men were African American. For low risk disease the 6-year bCR were 90.3% for RT and 85.6% for RRP (p = 0.23) and the 6-year post-salvage bCR were 90.3% vs. 90.9%, respectively (p = 0.84). For intermediate risk disease the 6-year bCR were 82.6% for RT and 59.7% for RRP (p < 0.001) and 82.6% vs. 74.0%, respectively, after including those salvaged with RT (p = 0.06). For high risk disease, the 6-year bCR were 67.4% for RT and 41.3% for RRP (p < 0.001) and after including those salvaged with RT was 67.4% vs. 43.1%, respectively (p < 0.001). However, there were no significant differences between the two groups in regards to DMPFS or PCSS. Treatment approaches utilizing RRP +/- salvage radiation or RT +/- androgen deprivation yielded equivalent DMPFS and PCSS outcomes. Biochemical control rates, using their respective definitions, appeared equivalent or better in those who received treatment with RT.

  9. INTERVENTION IN THE QUALITY OF LIFE OF PATIENTS WITH RECTAL CANCER UNDERGOING STOMA%参与型护理模式对提高直肠癌造口患者生存质量的干预

    Institute of Scientific and Technical Information of China (English)

    杨善兰

    2015-01-01

    Objective To discuss the significance that participatory nursing mode improve the quality of life of the colorectal cancer patients w hose stoma receiving radiotherapy .Methods 40 Cases of rectal cancer patients whose stoma receiving radiotherapy were randomly divided into two groups :20 cases for interven‐tion group and 20 cases for control group .The control group was given only conventional nursing ,while the intervention group was received not only the conventional nursing but also the participatory nursing , then evaluate the quality of life of these two groups .Results The patients’ quality of life of the interven‐tion group is higher than the control group through the questionnaire( P<0 .05) .Conclusion Participatory nursing can improve the quality of life of the colorectal cancer patients w hose stoma receiving radiotherapy .%目的:探讨参与型护理模式对提高直肠癌造瘘口放疗患者生存质量的影响。方法将40例直肠癌造口病人随机分为干预组与对照组各20例,两组分别给予常规护理,干预组在此基础上给予参与型护理模式干预,对两组护理效果进行生存质量。结果干预组病人肠癌造口生存质量调查问卷优于对照组( P <0.05)。结论参与型护理提高直肠癌造瘘口患者生存质量有效。

  10. Sarcopenia in Cancer Patients.

    Science.gov (United States)

    Chindapasirt, Jarin

    2015-01-01

    Sarcopenia, characterized by a decline of skeletal muscle plus low muscle strength and/or physical performance, has emerged to be an important prognostic factor for advanced cancer patients. It is associated with poor performance status, toxicity from chemotherapy, and shorter time of tumor control. There is limited data about sarcopenia in cancer patients and associated factors. Moreover, the knowledge about the changes of muscle mass during chemotherapy and its impact to response and toxicity to chemotherapy is still lacking. This review aimed to provide understanding about sarcopenia and to emphasize its importance to cancer treatment.

  11. Identification and characterization of locus specific methylation patterns within novel loci undergoing hypermethylation during breast cancer pathogenesis

    DEFF Research Database (Denmark)

    Wojdacz, Tomasz K; Windeløv, Johanne Agerlin; Thestrup, Britta Boserup;

    2014-01-01

    biomarkers for early cancer detection and stratification of patients. METHODS: We used ultrahigh-resolution microarrays to compare genomewide methylation patterns of breast carcinomas (n = 20) and nonmalignant breast tissue (n = 5). Biomarker properties of a subset of discovered differentially methylated....... Analysis of the screening results showed that all DMRs tested displayed significant gains of methylation in the cancer tissue compared to the levels in control tissue. Interestingly, we observed two types of locus-specific methylation, with loci undergoing either predominantly full or heterogeneous...... methylation during carcinogenesis. Almost all tested DMRs (17 of 19) displayed low-level methylation in nonmalignant breast tissue, independently of locus-specific methylation patterns in cases. CONCLUSIONS: Specific loci can undergo either heterogeneous or full methylation during carcinogenesis, and loci...

  12. The preoperative serum ratio of total prostate specific antigen (PSA to free testosterone (FT, PSA/FT index ratio, and prostate cancer. Results in 220 patients undergoing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Antonio B. Porcaro

    2016-03-01

    Full Text Available Objectives: To evaluate associations of preoperative total prostate specific antigen (PSA to free testosterone (FT, the PSA/FT index ratio, with features of pathology prostate cancer (PCA and to investigate its prognostic potential in clustering the PCA population. Patients and methods: After excluding criteria, the records of 220 patients who underwent radical prostatectomy (RP were retrospectively reviewed. Serum samples of PSA, total testosterone (TT and FT were collected at 8.00 A.M., one month after biopsies and before RP. The PSA/FT ratio was computed in the population of patients who were clustered in groups according to ranking intervals of the PSA/FT ratio which identified at least 4 clusters which were coded as A, B, C, and D. The independent associations of the PSA/FT index ratio were assessed by statistical methods and a two-sided P < 0.05 was considered to indicate statistical significance. Results: TT correlated to FT which was a significant predictor of PSA in the population of patients who were subsequently clustered, according to increasing interval values of the PSA/FT index ratio, in groups that showed a stronger linear association of FT with PSA. The PSA/FT index ratio significantly associated with pathology features of prostate cancer such as pathology Gleason score (pGS, invasion of the seminal vesicles (pT3b, proportion of positive cores (P+ and proportion of cancer involving the volume of the prostate. In the population of patients, TT, PSA/FT index ratio and P+ independently associated with pGS ≥ 7 and pT3b; moreover, the odds ratio (OR of the PSA/FT index ratio resulted 9.11 which was stronger than TT (OR = 1.11 and P+ (OR = 8.84. In the PCA population, TT, PSA/FT index ratio and P+ also independently associated with pT3b PCA; interestingly, the OR of PSA/FT index resulted 54.91 which was stronger than TT (OR = 1.31 and P+ (26.43. Conclusions: Preoperative PSA/FT index ratio is an independent strong factor which

  13. Determination of the Effects of Digoxin on the Right Ventricular Function in Patients Undergoing Pneumonectomy

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    Alireza Sharifian Attar

    2014-02-01

    Full Text Available Introduction: Pneumonectomy is the standard treatment of lung cancer, even though patients should undergo several evaluations before surgery; deterioration of cardiopulmonary function after pulmonary resection is inevitable. We have evaluated the effects of digoxin on the improvement of right ventricular function and prevention of probable complications after lung resection surgery. Materials and Methods: All patients who were candidate for pneumonectomy or extensive lobectomy in Ghaem hospital from 2010 to 2012 were enrolled into this study and were divided into two groups randomly. The first group (group D received digoxin during surgery and in the second group (group C normal saline was administered as placebo. Echocardiographic evaluation of the patients was accomplished the day before and the day after surgery. Results: Among 20 patients in each group, male to female ratio was almost 2:1 and mean age was 63.8 (ranged 46-83 years. The most common cause of pneumonectomy was lung cancer. Comparison of the preoperative demographic variables, blood biochemistry, pulmonary function tests, echocardiographic and blood gas indexes showed no statistically significant differences between two groups. ,But postoperative evaluations showed a significant improvement in left ventricular ejection fraction in group D. Right ventricular systolic and diastolic diameters and pulmonary artery pressure were decreased significantly  as well. Conclusion: According to our results, we suggest a single dose of digoxin during lung resection surgery to improve cardiac performance after pneumonectomy.

  14. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Jon Cacicedo; Francisco Casquero; Lorea Martinez-Indart; Olga del Hoyo; Alfonso Gomez de Iturriaga; Arturo Navarro; Pedro Bilbao

    2014-01-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P=0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  15. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy.

    Science.gov (United States)

    Cacicedo, Jon; Casquero, Francisco; Martinez-Indart, Lorea; del Hoyo, Olga; Gomez de Iturriaga, Alfonso; Navarro, Arturo; Bilbao, Pedro

    2014-04-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P = 0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  16. Prediction of Survival by [18F]Fluorodeoxyglucose Positron Emission Tomography in Patients With Locally Advanced Non–Small-Cell Lung Cancer Undergoing Definitive Chemoradiation Therapy: Results of the ACRIN 6668/RTOG 0235 Trial

    Science.gov (United States)

    Machtay, Mitchell; Duan, Fenghai; Siegel, Barry A.; Snyder, Bradley S.; Gorelick, Jeremy J.; Reddin, Janet S.; Munden, Reginald; Johnson, Douglas W.; Wilf, Larry H.; DeNittis, Albert; Sherwin, Nancy; Cho, Kwan Ho; Kim, Seok-ki; Videtic, Gregory; Neumann, Donald R.; Komaki, Ritsuko; Macapinlac, Homer; Bradley, Jeffrey D.; Alavi, Abass

    2013-01-01

    Purpose In this prospective National Cancer Institute–funded American College of Radiology Imaging Network/Radiation Therapy Oncology Group cooperative group trial, we hypothesized that standardized uptake value (SUV) on post-treatment [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) correlates with survival in stage III non–small-cell lung cancer (NSCLC). Patients and Methods Patients received conventional concurrent platinum-based chemoradiotherapy without surgery; postradiotherapy consolidation chemotherapy was allowed. Post-treatment FDG-PET was performed at approximately 14 weeks after radiotherapy. SUVs were analyzed both as peak SUV (SUVpeak) and maximum SUV (SUVmax; both institutional and central review readings), with institutional SUVpeak as the primary end point. Relationships between the continuous and categorical (cutoff) SUVs and survival were analyzed using Cox proportional hazards multivariate models. Results Of 250 enrolled patients (226 were evaluable for pretreatment SUV), 173 patients were evaluable for post-treatment SUV analyses. The 2-year survival rate for the entire population was 42.5%. Pretreatment SUVpeak and SUVmax (mean, 10.3 and 13.1, respectively) were not associated with survival. Mean post-treatment SUVpeak and SUVmax were 3.2 and 4.0, respectively. Post-treatment SUVpeak was associated with survival in a continuous variable model (hazard ratio, 1.087; 95% CI, 1.014 to 1.166; P = .020). When analyzed as a prespecified binary value (≤ v > 3.5), there was no association with survival. However, in exploratory analyses, significant results for survival were found using an SUVpeak cutoff of 5.0 (P = .041) or 7.0 (P < .001). All results were similar when SUVmax was used in univariate and multivariate models in place of SUVpeak. Conclusion Higher post-treatment tumor SUV (SUVpeak or SUVmax) is associated with worse survival in stage III NSCLC, although a clear cutoff value for routine clinical use as a prognostic

  17. Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Rofail, S

    1999-01-01

    The prevalence of obesity and previous knee injury was assessed in a retrospective study of 115 patients under-going total knee replacement due to osteoarthritis. Obesity was considered a contributing factor in the development of osteoarthritis in 37% of the patients, and 33% of the patients had...... had an injury to the knee in question. Unilateral osteoarthritis was significantly more frequent than bilateral osteoarthritis among patients with a history of previous knee injury. The association of previous injury to the knee and unilateral osteoarthritis was stronger in men than women. Aggressive...... treatment of patients with knee injuries seems warranted....

  18. Oral cancer knowledge among Turkish dental patients

    Directory of Open Access Journals (Sweden)

    Melda Misirlioglu

    2013-01-01

    Full Text Available Aims: To determine the level of oral cancer awareness and knowledge among patients referred to the Department of Oral and Maxillofacial Radiology in Central Anatolia. Settings and Design: The study was conducted with 1,125 patients who applied to the school of dentistry for routine dental examinations. The authors collect information with a 20-item written questionnaire from the participants about oral cancer risk factors, epidemiology, etiology, and signs and symptoms. Statistical Analysis: Descriptive statistics of demographic variables and other data were reported as means and percentages. Statistical analysis was performed by means of SPSS +11.0 statistical package. Results: Overall, only 48.9% of all patients showed awareness of oral cancer, with awareness especially poor among lower socioeconomic groups. Awareness of oral cancer risk factors and signs and symptoms did not vary significantly between men and women (P > 0.5; however, older participants (aged 40-64 years were more familiar with oral cancer signs than younger participants. More than half of all participants (56.8% were unaware of the common clinical presentations of oral cancer. Conclusions: The results of this survey showed knowledge regarding oral cancer to be quite low. Thus, educational programs are needed to increase public awareness about oral cancer, and dentists should request patients undergo examinations for oral cancer to ensure early detection.

  19. Comments on M. Henke's article: 'erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomized, double blind, placebo controlled trial' or how a cytokine stay a cytokine; Commentaires sur l'article de M. Henke: ''erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double blind, placebo controlled trial'' ou comment une cytokine reste une cytokine

    Energy Technology Data Exchange (ETDEWEB)

    Lartigau, E. [Centre Oscar-Lambret, Dept. de Radiotherapie, 59 - Lille (France); Denis, F. [Centre Hospitalier Universitaire, Clinique d' oncologie et de radiotherapie, Inserm U316, 37 - Tours (France)

    2004-06-01

    For fifty years, the radio therapists have been working on the concept of oxygen effect, that corresponds to the reduction of the biological effect observed with the low linear energy transfer radiation (Let) used in routine when irradiated cells are exposed to a low concentration in oxygen. The appearance of erythropoietin at the beginning of 1990 has reopened the debate: clean molecules without any risk in transfusion, allowing to increase the hemoglobin concentration for the cancerous patients. The benefit of anemia correction could be important and the article of Henke and al. constitutes a first step in the research of new therapies. (N.C.)

  20. Ductal carcinoma In-Situ in turner syndrome patient undergoing hormone replacement therapy: A case report

    Directory of Open Access Journals (Sweden)

    Rashmi Bawa

    2016-03-01

    Full Text Available Turner’s syndrome is a rare congenital disease which affects about 1 in every 2500-3000 live-born females. This happens due to chromosomal abnormalities in a phenotypic female, causing increased gonadotropin concentrations and low concentrations of estrogens from infancy. As a result, hormone replacement therapy is started in most adolescent Turner syndrome patients to initiate and sustain sexual maturation. Accordingly, most Turner’s syndrome patients undergo several decades of estrogen replacement therapy, from puberty to post-menopausal age. The highly publicized findings of the Women’s Health Initiative have called into question the appropriateness of hormone replacement therapy in adolescents with Turner’s syndrome. Those concerns were mostly theoretical extrapolations, as few prospective studies of cancer occurrence in women with Turner syndrome have been reported. Consequently, several recent publications have challenged those extrapolations, based on the assertion that the levels of hormone replacement in Turner syndrome patients are well below the physiologic levels observed in normal menstruating women, as well as the fact that these women are significantly younger than those studied by the Women’s Health Initiative. In discord to those reports, we present a case of ductal carcinoma in-situ in a 40-year-old Turner patient, who had undergone over two decades of combined hormone replacement therapy. The patient underwent an elective excisional biopsy for a palpable mass, with histopathology revealing a complex fibroadenoma with a nidus of ductal carcinoma in-situ. The lesion was noted to be estrogen receptor positive and progesterone receptor negative, with heavy staining for HER-2/Neu receptor. The patient was treated with tamoxifen. While a rare case, it is imperative for the astute clinician to keep in mind the consequences of long-term hormone replacement therapy in Turner’s syndrome patients in order to avoid missed

  1. Stomatitis-related pain in women with breast cancer undergoing autologous hematopoietic stem cell transplant.

    Science.gov (United States)

    Fall-Dickson, Jane M; Mock, Victoria; Berk, Ronald A; Grimm, Patricia M; Davidson, Nancy; Gaston-Johansson, Fannie

    2008-01-01

    The purpose of this cross-sectional, correlational study was to describe stomatitis-related pain in women with breast cancer undergoing autologous hematopoietic stem cell transplant. The hypotheses that significant, positive relationships would exist between oral pain and stomatitis, state anxiety, depression, and alteration in swallowing were tested. Stomatitis, sensory dimension of oral pain, and state anxiety were hypothesized to most accurately predict oral pain overall intensity. Thirty-two women were recruited at 2 East Coast comprehensive cancer centers. Data were collected on bone marrow transplantation day +7 +/- 24 hours using Painometer, Oral Mucositis Index-20, Oral Assessment Guide, State-Trait Anxiety Inventory, and Beck Depression Inventory. Data analysis included descriptive statistics, correlations, and stepwise multiple regression. All participants had stomatitis; 47% had oral pain, with a subset reporting continuous moderate to severe oral pain despite pain management algorithms. Significant, positive associations were seen between oral pain, stomatitis, and alteration in swallowing and between oral pain with swallowing and alteration in swallowing. Oral pain was not significantly correlated with state anxiety and depression. Oral sensory and affective pain intensity most accurately predicted oral pain overall intensity. Future research needs to explore factors that affect perception and response to stomatitis-related oropharyngeal pain and individual patient response to opioid treatment.

  2. "Wet diapers--dry patients": an effective dressing for patients undergoing arthroscopic shoulder surgery.

    Science.gov (United States)

    Kapila, Atul; Bhargava, Amit; Funk, Len; Copeland, Stephen; Levy, Ofer

    2005-02-01

    Shoulder arthroscopy is very commonly associated with postoperative leakage of irrigation fluid. This causes apprehension to patients and their relatives and leads to frequent change of dressings. We describe a simple and effective diaper dressing for patients undergoing arthroscopic shoulder surgery. It is highly absorbent, cost-effective, and easy to apply. We have used this dressing successfully in more than 1,500 shoulder arthroscopies over the last 3 years with no adverse reaction.

  3. Health related quality of life in 2002 and 2015 in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    Knudsen, Signe de Place; Eidemak, Inge; Molsted, Stig

    2016-01-01

    Health related quality of life (HRQOL) has become a recognized outcome in studies of the treatment of patients undergoing hemodialysis (HD). The aim of this study was to assess changes in HRQOL reported by two different samples of patients undergoing HD in the same dialysis center in 2002 and 2015...

  4. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    LENUS (Irish Health Repository)

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  5. Best practices in the management of newly diagnosed multiple myeloma patients who will not undergo transplant.

    Science.gov (United States)

    Niesvizky, Ruben; Coleman, Morton; Mark, Tomer

    2010-03-01

    No survival advantage of autologous stem cell transplantation (ASCT) has been documented for patients older than 65 years, and in the era of thalidomide (Thalomid), bortezomib (Velcade), and lenalidomide (Revlimid), ASCT has a diminished role in the front-line treatment of older patients with myeloma. For these individuals and for those who cannot or choose not to undergo ASCT, the initial treatment regimens now recommended by both the National Comprehensive Cancer Network and the International Myeloma Working Group are melphalan (Alkeran)/prednisone/thalidomide (MPT), bortezomib/melphalan/prednisone (VMP), and lenalidomide/low-dose dexamethasone. Melphalan/prednisone should no longer be considered the reference treatment, although it may be appropriate for a small number of patients with serious comorbidity and/or poor performance status. Advantages of VMP over MPT include rapid response, high rates of complete response, patient compliance, and more extensive evidence of efficacy in patients with certain cytogenetic abnormalities. Lenalidomide/low-dose dexamethasone is particularly appropriate for patients with preexisting neurotoxicity and those who wish to postpone ASCT. Toxicity profiles differ among the newly established and emerging regimens, and oncology teams must take care to apply the appropriate risk management measures, including dose reduction where necessary.

  6. 化疗期卵巢癌患者自我效能感水平及其影响因素调查分析%Investigation and Analysis of the Level and Influencing Factors of General Self-efficacy in Ovarian Cancer Patients Undergoing Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    边彦慧; 王清馨

    2015-01-01

    Objective:To learn the level of general self-efficacy and its influencing factors in ovarian cancer patients undergoing chemotherapy and explore the possible countermeasures to improve self-efficacy.Method:82 cases of ovarian cancer patients undergoing chemotherapy from a certain hospital of Shanxi selected as research objects by using convenience sampling method were investigated by a general patient questionnaire and the general self-efficacy scale,then their general self-efficacy levels and influencing factors were analyzed.Result:Mean score of general self-efficacy of 82 cases of ovarian cancer patients undergoing chemotherapy was (23.40±6.46),of which only 17 cases(20.73%) showed a high level of self-efficacy.The level of self-efficacy of patients with different age,permanent residence,education level,family income,clinical stage of disease,course of the disease,chemotherapy times was statistically significant.Conclusion:Ovarian cancer patients undergoing chemotherapy had a low level of General Self-efficacy,so when develop nursing interventions and do patient follow-up,nurses should assess the level of general self-efficacy in patients,also should looking for possible influencing factors and supply appropriate interventions to improve self-efficacy.%目的:了解化疗期卵巢癌患者的一般自我效能感水平及其影响因素,探讨可能提高患者一般自我效能感水平的对策。方法:应用便利抽样法,采用患者一般情况调查表和一般自我效能感量表,对山西省某三级甲等医院82例化疗期卵巢癌患者进行调查,分析其一般自我效能感水平及影响因素。结果:82例化疗期卵巢癌患者一般自我效能感平均得分为(23.40±6.46)分,其中仅17例(20.73%)表现出高水平自我效能。不同年龄、长住地、文化程度、家庭人均月收入、疾病临床分期、疾病病程、化疗次数患者的自我效能感水平差异有统计学意义(P<0.05)

  7. Quality of Life of Patients with Rectal Cancer Undergoing Colostomy and Its Influencing Factors%直肠癌结肠造口患者生活质量及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    杨秀秀; 付菊芳; 李秦; 王波; 刘莹; 段娇博

    2012-01-01

    Objective To understand the quality of life (QOL)of colostomy patients with rectal cancer and to explore its influencing factors,to provide evidences for improving the QOL of permanent colostomy patients.Methods 145 colostomy patients with rectal cancer were surveyed with EORTC-QLQ-C30,and the data were collected for statistical analysis.Results The score of QOL of colostomy patients was 60.31±23.19 and the scores of role function and social function were significantly lower than those of the norm (P<0.01).Besides,the scores of diarrhea and economic difficulties were significantly higher than those of the norm (P<0.01).Correlation analysis showed mat the psychological condition and stoma complications were the main factors thai affected the QOL of colostomy patients and multiple siepwise regression analysis indicated the psychological condition,postoperative time,complication entered into the regression equation of QOL.The psychological condition and postoperative time were positively correlated with the QOL- while the stoma complication was negatively correlated with the QOL.Conclusion The role function and social function of colostomy patients arc significantly affected,and the diarrhea symptom and economic difficulties are severe.To improve the QOL of colostomy patients,specialized nurses for stoma should provide psychological support for patients and help to train patients withregular bowel movement so to ptrvent and treat stoma complications through varous ways.%目的 了解西安市直肠癌结肠造口患者的生活质量现状及其影响因素,为提高永久性结肠造口患者的生活质量提供依据.方法 使用欧洲癌症研究与治疗组织生活质量核心问卷对145例在西安市4所三级甲等医院行直肠癌结肠造口患者的生活质量进行问卷调查,将所得资料进行统计学分析.结果 结肠造口患者总体生活质量得分为(60.31±23.19)分,角色功能和社会功能得分显著低于常模(P<0.01),腹泻

  8. Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy

    DEFF Research Database (Denmark)

    Kolmos, H J; Lerche, A; Kristoffersen, Kirsten Lydia;

    1994-01-01

    Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination...

  9. Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed E. Abdalla

    2013-01-01

    Conclusion: There is impairment of lung function in patients with CRF undergoing hemodialysis. The main changes are small airway obstruction, reduction in carbon monoxide transfer and diminished 6MWT that were not completely improved in the kidney transplant patients.

  10. [Physiotherapy of cancer patients].

    Science.gov (United States)

    Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

    2016-07-01

    Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

  11. Impact of neoadjuvant therapy on postoperative complications in patients undergoing resection for rectal adenocarcinoma.

    Science.gov (United States)

    Turner, Immanuel I; Russell, Gregory B; Blackstock, A William; Levine, Edward A

    2004-12-01

    Surgical resection continues to be the mainstay of treatment for rectal cancer. Neoadjuvant therapy (chemotherapy and radiation) has also been shown to be efficacious. The impact of preoperative chemotherapy and radiation on postoperative complications is unclear. The purpose of this study is to evaluate the relationship of neoadjuvant therapy on postoperative complications in patients undergoing a resection of rectal cancer. A total of 325 patients who underwent curative resection for rectal cancer from 1984 to 2001 were retrospectively reviewed. Only cases with complete data sets who had undergone surgery at this institution were evaluable (257). The patients were divided into groups based on the operative procedure performed; abdominoperineal resection (APR) versus sphincter-sparing (SS) procedures (LAR/Transanal) and whether or not preoperative chemotherapy or radiation was administered. There was no significant difference between complication rates for APR and SS with 19 per cent and 14 per cent, respectively. The preoperative therapy had no effect on complications after APR. However, the SS group showed 21 per cent of the patients who received radiation had complications compared to 11 per cent in those who did not (P = 0.087). Complications in the SS group included leaks, wound infections, abscess, embolism, cardiac dysrhythmias, and myocardial infarctions. The 30-day mortality was 1.9 per cent for the entire cohort with no clear difference between groups. There was no significant difference in complication rate between APR and SS. In the APR group, neoadjuvant therapy had no impact on the incidence of complications. However, the SS group did show a trend between preoperative chemotherapy and radiation and complication rate. However, this may not outweigh the advantages of preoperative therapy in this setting.

  12. Sleep Quality of Breast Cancer Patients Undergoing Chemotherapy after Radical Mastectomy and Its Influencing Factors%乳腺癌根治术后化疗患者睡眠质量及相关因素研究

    Institute of Scientific and Technical Information of China (English)

    邢宏利; 邱阚; 张琳; 尹长恒

    2016-01-01

    Objective: To study the radical mastectomy or modified radical mastectomy and chemotherapy in patients with sleep quality and related factors affecting the quality of sleep.Methods:110 cases of radical mastectomy or modified radical mastectomy and chemotherapy patients,using the Pittsburgh Sleep Quality Index (PSQI) evaluated sleep quality scale,Medical Coping questionnaire (MCMQ),Support Rating Scale (SSRS) evaluate mental status,coping strategies and social support on sleep quality.Results:SAS,SDS postoperative chemotherapy for breast cancer patients with risk factors of sleep quality(P<0.05). Conclusion:SAS,SDS,to support the use of chemotherapy and mastectomy patients sleep quality are closely related.%目的:研究乳腺癌根治术或改良根治术后化疗患者的睡眠质量状况及影响睡眠质量的相关因素。方法:选择110例乳腺癌根治术或改良根治术后化疗患者,采用匹兹堡睡眠质量指数(PSQI)量表评价睡眠质量,医学应对问卷(MCMQ)、社会支持评定量表(SSRS)评价心理状态、应对策略和社会支持对睡眠质量的影响。结果:SAS、SDS为乳腺癌术后化疗患者睡眠质量危险因素(P<0.05)。结论:SAS、SDS、对支持的利用度与乳腺癌根治术后化疗患者睡眠质量关系密切。

  13. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review

    NARCIS (Netherlands)

    Eijzenga, W.; Hahn, D.E.E.; Aaronson, N.K.; Kluijt, I.; Bleiker, E.M.A.

    2014-01-01

    Approximately 25 % of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial probl

  14. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review

    NARCIS (Netherlands)

    W. Eijzenga; D.E.E. Hahn; N.K. Aaronson; I. Kluijt; E.M.A. Bleiker

    2013-01-01

    Approximately 25 % of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial probl

  15. 磁共振成像在乳腺癌保乳术前评价中的应用%Application of preoperative MRI on breast cancer patients undergoing breast-conserving surgery

    Institute of Scientific and Technical Information of China (English)

    王文静; 洪庆山; 张嫣; 郭庆禄

    2014-01-01

    Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.%目的:评价术前磁共振成像(MRI)对乳腺癌保乳术切缘阳性率的影响。方法收集乳腺癌患者64例为研究组,历史对照组73例乳腺癌患者,所有患者经常规检查及评估后均适合行保乳术。研究组患者术前行乳腺 MRI 检查,经评估后确定最终的手术计划。历史对照组未行 MRI 检查。比较2组患者的切缘阳性率差异,记录研究组的手术变更率。结果与对照组相比,研究组保乳术中的切缘阳性率降低(9.6% vs 24.7%;P =0.04)。术前 MRI 使18.8%的患者改变手术计划而行乳房全切术。结论术前乳腺 MRI 检查能更准确评估乳腺癌病灶的范围,从而有助于降低保乳术患者的术中切缘阳性率。

  16. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia

    2012-08-01

    Full Text Available Abstract Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment. Methods Acute ( 3 months (n = 255 neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQ at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement. Results Baseline mean neck pain and total disability scores were significantly (p  Conclusions The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

  17. Prealbumin is predictive for postoperative liver insufficiency in patients undergoing liver resection

    Institute of Scientific and Technical Information of China (English)

    Liang Huang; Jing Li; Jian-Jun Yan; Cai-Feng Liu; Meng-Chao Wu; Yi-Qun Yan

    2012-01-01

    AIM:To investigate the risk factors for postoperative liver insufficiency in patients with Child-Pugh class A liver function undergoing liver resection.METHODS:A total of 427 consecutive patients undergoing partial hepatectomy from October 2007 to April 2011 at a single center (Department of Hepatic Surgery Ⅰ,Eastern Hepatobiliary Surgery Hospital,Shanghai,China) were included in the study.All the patients had preoperative liver function of Child-Pugh class A and were diagnosed as having primary liver cancer by postoperative histopathology.Surgery was performed by the same team and hepatic resection was carried out by a clamp crushing method.A clamp/unclamp time of 15 min/5 min was adopted for hepatic inflow occlusion.Patients' records of demographic variables,intraoperative parameters,pathological findings and laboratory test results were reviewed.Postoperative liver insufficiency and failure were defined as prolonged hyperbilirubinemia unrelated to biliary obstruction or leak,clinically apparent ascites,prolonged coagulopathy requiring frozen fresh plasma,and/or hepatic encephalopathy.The incidence of postoperative liver insufficiency or liver failure was observed and the attributing risk factors were analyzed.A multivariate analysis was conducted to determine the independent predictive factors.RESULTS:Among the 427 patients,there were 362 males and 65 females,with a mean age of 51.1 ±10.4 years.Most patients (86.4%) had a background of viral hepatitis and 234 (54.8%) patients had liver cirrhosis.Indications for partial hepatectomy included hepatocellular carcinoma (391 patients),intrahepatic cholangiocarcinoma (31 patients) and a combination of both (5 patients).Hepatic resections of ≤ 3 and ≥4 liver segments were performed in 358 (83.8%) and 69 (16.2%) patients,respectively.Seventeen (4.0%)patients developed liver insufficiency after hepatectomy,of whom 10 patients manifested as prolonged hyperbilirubinemia unrelated to biliary obstruction or

  18. Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

    Directory of Open Access Journals (Sweden)

    Brunna Berton

    Full Text Available Abstract Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges.

  19. Educational Needs of Patients Undergoing Total Joint Arthroplasty

    Science.gov (United States)

    MacKay, Crystal; Saryeddine, Tina; Davis, Aileen M.; Flannery, John F.; Jaglal, Susan B.; Levy, Charissa; Mahomed, Nizar

    2010-01-01

    ABSTRACT Purpose: To identify the educational needs of adults who undergo total hip and total knee replacement surgery. Methods: A qualitative research design using a semi-standardized interviewing method was employed. A purposive sampling technique was used to recruit participants, who were eligible if they were scheduled to undergo total hip or total knee replacement or had undergone total hip or total knee replacement in the previous 3 to 6 months. A comparative contrast method of analysis was used. Results: Of 22 potential participants who were approached, 15 participated. Five were booked for upcoming total hip or total knee replacement and 10 had undergone at least one total hip or total knee replacement in the previous 3 to 6 months. Several themes related to specific educational needs and factors affecting educational needs, including access, preoperative phase, surgery and medical recovery, rehabilitation process and functional recovery, fears, and expectations counterbalanced with responsibility, emerged from the interviews. Conclusions: Educational needs of adults who undergo total hip and knee replacement surgery encompass a broad range of topics, confirming the importance of offering an all-inclusive information package regarding total hip and total knee replacement. PMID:21629598

  20. Effects of intraoperative thermostasis on respiratory burst of polymorphonuclear neutrophil in patients undergoing radical operation for lung cancer%术中保温对肺癌根治术患者中性粒细胞呼吸爆发的影响

    Institute of Scientific and Technical Information of China (English)

    姚允泰; 刘定华; 赵晶

    2010-01-01

    Objective To investigate the influence of intraoperative thermostasis over respiratory burst of polymorphonuclear neutrophils (PMNs) in patients undergoing radical operation for lung cancer.Methods Thirty-two ASA Ⅱ or Ⅲ patients scheduled for radical operation for lung cancer under general anesthesia were randomized into two groups ( n = 16 each): control group (Group C) and warming group (Group W). The patients in Group C were kept warm by routine measures such as using woollen blankets, while the patients in Group W were kept warm by force-air warming system and fluid warming device as soon as the patients were admitted to the operation room. Rectal and axillary temperatures were continuously monitored as the core and surface temperature, respectively. The core temperature was maintained at the preoperative level (baseline). Anesthesia was induced with midazolam, fentanyl and propofol. Tracheal intubation was facilitated with rocuronium. Anesthesia was maintained with isoflurane and nitrous oxide and intermittent i.v. boluses of fentanyl, midazolam and vecuronium. Venous blood samples were obtained before, during and at the end of surgery for normal blood analysis and respiratory burst of PMNs which included activated PMNs count and reactive oxygen species (ROS) production.Results (1) WBC and PMN counts were significantly increased during and after operation as compared with the baseline values before operation in both groups and there was no significant difference in WBC and PMN counts between the two groups. (2)Phorbol-12-myristate-13-acetate (PMA) stimulation resulted in higher intraoperative and postoperative activated PMN counts in both groups and higher postoperative ROS production in Group W. Postoperative ROS production was significantly higher in Group W than in Group C. (3) The PMN counts without stimulation activation during operation and intra- and post-operative ROS production were significantly decreased as compared with the baseline values

  1. The impact of fair colonoscopy preparation on colonoscopy use and adenoma miss rates in patients undergoing outpatient colonoscopy

    Science.gov (United States)

    Menees, Stacy B.; Kim, H. Myra; Elliott, Eric E.; Mickevicius, Jennifer L.; Graustein, Brittany B.; Schoenfeld, Philip S.

    2013-01-01

    Background The impact of fair bowel preparation on endoscopists’ recommendations and adenoma miss rates in average-risk patients undergoing colonoscopy is unknown. Objective To assess the impact of fair bowel preparation on endoscopists’ interval colonoscopy recommendations and miss rates in colonoscopies performed within 3 years of the index colonoscopy in average-risk patients undergoing colorectal cancer screening. Design Retrospective chart review. Setting Tertiary-care center. Patients Average-risk patients undergoing index colonoscopy for colorectal cancer screening between 2004 and 2006. Intervention Colonoscopy. Main Outcome Measurements Endoscopists’ interval recommendations, adenoma miss rates. Results A total of 16,251 colonoscopy records were reviewed over a 2-year period. Of these cases, 1943 colonoscopies were performed for the sole indication of average risk or screening. Of these, fair bowel preparation was reported in 619 patients (31.9%). A repeat colonoscopy within 5 years was recommended in 70.4% of patients. The follow-up colonoscopy compliance rate within 3 years was 55.9%. Adenoma detection rates at index and follow-up colonoscopy were 20.5% and 28.2%, respectively. Of the 39 patients with follow-up colonoscopy within 3 years, the overall adenoma miss rate was 28%. Of the patients with an adenoma identified on follow-up colonoscopy, 13.6% had normal colonoscopy results on index examination. Limitations Retrospective design. Conclusion Fair bowel preparation led to a deviation from national guidelines with early repeat colonoscopy follow-up recommendations in nearly 60% of average-risk patients with normal colonoscopy results. In patients who returned for repeat colonoscopy within 3 years, the overall adenoma miss rate was 28%. Further guidelines on timing for repeat colonoscopy for fair bowel preparation are needed. PMID:23642491

  2. 乳腺癌术后放疗期患者创伤后成长与人格特征的相关性分析%Relationship between post traumatic growth and personality characteristics among patients with breast cancer undergoing postoperative radiotherapy

    Institute of Scientific and Technical Information of China (English)

    童晓丹; 张平; 宋旭红

    2014-01-01

    目的:了解乳腺癌术后放疗期患者心理症状与人格的关系。方法采用问卷调查法,采用艾森克人格问卷( EPQ)和创伤后成长评定量表( PTGI)对169例乳腺癌术后放疗期患者进行调查,了解乳腺癌术后放疗患者的人格状况及成长水平,并采用Pearson相关分析法和多重线性回归法对资料进行统计分析。结果患者PTGI总均分为(65.83±13.28)分,EPQ内外倾向、神经质和精神质3个维度不同得分组间的PTGI得分差异均有统计学意义(F值分别为14.353,9.343,10.534;P<0.01),内外倾向维度与PTGI总分呈正相关(r=0.342,P<0.01),神经质和精神质维度与其呈负相关(r值分别为-0.250,-0.287;P<0.01)。回归分析结果显示,乳腺癌患者的创伤后成长受人格特征内外倾向、神经质、精神质的影响(β值分别为0.343,-0.264,-0.273;P<0.05)。结论乳腺癌术后放疗期患者存在一定程度的创伤后成长,不同人格特征的患者有不同的成长水平。%Objective To understand the relationship between psychological symptoms and personality of breast cancer patients undergoing postoperative radiotherapy .Methods A total of 169 patients with breast cancer undergoing postoperative radiotherapy were investigated with Eysenck personality questionnaire ( EPQ ) and post traumatic growth inventory (PTGI), in order to understand their personality characteristics status and post traumatic growth levels .Pearson correlation analysis and multiple linear regression were used to analyze the data.Results The total score of PTGI was (65.83 ±13.28), and there were statistically significant differences in the PTGI scores among different groups of patients who had different EPQ scores in three dimensions of extraversion, neuroticism and psychoticism (F =14.353,9.343,10.534, respectively; P <0.01).The extraversion of patients was positively

  3. Effects of Acute Normovolemic Hemodilution on Perioperative Coagulation and Fibrinolysis in Elderly Patients Undergoing Hepatic Carcinectomy

    Institute of Scientific and Technical Information of China (English)

    Jian-rong Guo; Jun Yu; Xiao-ju Jin; Jin-man Du; Wei Guo; Xiao-hong Yuan

    2010-01-01

    Objective To observe the effects of acute normovolemie hemodilution (ANH) on coagulation func-tion and fibrinolysis in elderly patients undergoing hepatic carcinectomy.Methods Thirty elderly patients (aged 60-70 years) with liver cancer (American Society of Anesthe-siologists physical status Ⅰ-Ⅱ) scheduled for hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n= 15) and control group (n= 15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (HES) (130/0.4), and basic liquid containing 6% HES and routine Ringer's solution, respectively. In all the studied patients, blood samples were drawn at five different time points: before anesthesia induction (T1), 30 minutes after ANH (T2), I hour after start of operation (T3), immediately after operation (T4), and 24 hours after operation (T5). Then co-agulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (activated GPIIb/GPIIIa and P-selectin) were measured.Results The perioperative blood loss was not significantly different between the two groups (P> 0.05). The volume of allogeneic blood transfusion in ANH group was significantly smaller than that in control group (350.5±70.7 mL vs. 457.8±181.3 mL, P0.05). SFMC and F1 +2 increased in both groups, but without statistical significance. P-selectin expression on the platelet surface of ANH group was significantly low-ered at T2 and T3 compared with the level at T1 (P< 0.05). Compared with control group, P-selectin was sig-nificandy lower in ANH group at T2-T5 (all P<0.05).Conclusions In elderly patients undergoing resection of liver cancer, ANH may not hamper fibri-nolysis and coagulation function. It could therefore be safe to largely reduce allogeneic blood transfusion.

  4. Influence of abdomenal hot compress combined to diet intervention on nausea and vomiting of liver cancer patients after undergoing interventional treatment%腹部热敷联合饮食干预对肝癌介入术后病人恶心、呕吐的影响

    Institute of Scientific and Technical Information of China (English)

    尹秀芬; 尹旭明; 谭李军; 唐桂香; 罗革

    2013-01-01

    介绍了恶心、呕吐的定义及分级,对介入术后恶心、呕吐及胃痛的原因进行分析,从药物、腹部热敷、饮食干预方面对肝癌介入术后病人恶心、呕吐的影响进行综述.%It introduced the definition and classification of nausea and vomiting, and analyzed the causes of nausea and vomiting and stomach ache after the intervention,and reviewed the influence on nausea and vomiting of liver cancer patients after undergoing interventional treatment from aspects of drug,abdomenal hot compress and diet interventions.

  5. Football training in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Hornstrup, Therese; Christensen, Jesper F

    2016-01-01

    PURPOSE: To investigate the activity profile of football training and its short-term effects on bone mass, bone turnover markers (BTMs) and postural balance in men with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT). METHODS: This was a randomised 12-week study in which men...... with PCa undergoing ADT were assigned to a football intervention group [FTG, n = 29, 67 ± 7 (±SD) years] training 2‒3 times per week for 45‒60 min or to a control group (n = 28, 66 ± 5 years). The activity profile was measured using a 5-Hz GPS. The outcomes were total body and leg bone mineral content (BMC...

  6. Rehabilitation of cancer patients.

    Directory of Open Access Journals (Sweden)

    Pandey M

    2001-01-01

    Full Text Available With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.

  7. Patient variables and referral paradigms associated with osteoporosis screening and treatment in neurosurgical patients undergoing kyphoplasty.

    Science.gov (United States)

    Morr, Simon; Shakir, Hakeem J; Lipinski, Lindsay J; Dimopoulos, Vassilios G; Leonardo, Jody; Pollina, John

    2015-12-01

    OBJECT Vertebral fractures are the most common osteoporotic fracture. Bone density testing and medical treatment with bisphosphonates or parathormone are recommended for all patients with an osteoporotic fracture diagnosis. Inadequate testing and treatment of patients presenting with low-impact fractures have been reported in various specialties. Similar data are not available from academic neurosurgery groups. The authors assessed compliance with treatment and testing of osteoporosis in patients with vertebral compression fractures evaluated by the authors' academic neurosurgery service, and patient variable and health-systems factors associated with improved compliance. METHODS Data for patients who underwent percutaneous kyphoplasty for compression fractures was retrospectively collected. Diagnostic and medical interventions were tabulated. Pre-, intra-, and posthospital factors that had been theorized to affect the compliance of patients with osteoporosis-related therapies were tabulated and statistically analyzed. RESULTS Less than 50% of patients with kyphoplasty received such therapies. Age was not found to correlate with other variables. Referral from a specialist rather than a primary care physician was associated with a higher rate of bone density screening, as well as vitamin D and calcium therapy, but not bisphosphonate/parathormone therapy. Patients who underwent preoperative evaluation by their primary care physician were significantly more likely to receive bisphosphonates compared with those only evaluated by a hospitalist. Patients with unprovoked fractures were more likely to undergo multiple surgeries compared with those with minor trauma. CONCLUSIONS These results suggest poor compliance with current standard of care for medical therapies in patients with osteoporotic compression fractures undergoing kyphoplasty under the care of an academic neurosurgery service.

  8. Ovarian stimulation in patients with breast cancer.

    Science.gov (United States)

    Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García

    2015-01-01

    Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer

  9. Study on effects of application of early nutrition support in patients with head and neck cancers undergoing radiotherapy and chemotherapy%早期营养支持在头颈部肿瘤放化疗患者中的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    马艳会; 娄霄; 刘岩杰

    2016-01-01

    Objective:To explore application effects of early nutrition support in patients with head and neck cancers undergo-ing radiotherapy and chemotherapy. Methods: 300 patients with head and neck cancers undergoing radiotherapy and chemotherapy were selected and divided into observation group (150 cases) and control group (150 cases) according to the random number table method. The control group was given the routine nursing intervention, while the observation group was given the early nutrition support based on the routine nursing intervention. After the intervention, the nutritional status, immune index and patients' satisfaction of the two groups were compared. Results:After the radiotherapy and chemotherapy, the nutrition indexes (P<0. 01), immune indexes and total satisfaction rate (P<0. 05) of observation group were significantly better than those of control group. Conclusions:Early nutrition support for the patients with head and neck cancers undergoing radiotherapy and chemotherapy has very positive effects, can improve the nutritional status very well, improve the patients' immune ability and satisfaction, and has a high clinical application and populari-zation value.%目的::探究早期营养支持在头颈部肿瘤放化疗患者中的应用效果。方法:选取300例头颈部肿瘤放化疗患者,采取随机数字表法分为观察组和对照组,每组各150例。对照组患者给予常规护理干预;观察组患者在常规护理基础上进行早期营养支持。对比两组患者干预后患者营养状况、免疫指标及患者满意度。结果:放化疗结束后,两组患者的各项营养指标对比,观察组患者均显著优于对照组(P<0.01);两组患者免疫指标对比,观察组患者明显优于对照组,总满意率明显高于对照组(P<0.05)。结论:早期营养支持对于头颈部肿瘤放化疗患者具有十分重要的影响,可很好改善患者营养状况,增强患者的免疫力,患者

  10. Radiation dose measurement and risk estimation for paediatric patients undergoing micturating cystourethrography.

    Science.gov (United States)

    Sulieman, A; Theodorou, K; Vlychou, M; Topaltzikis, T; Kanavou, D; Fezoulidis, I; Kappas, C

    2007-09-01

    Micturating cystourethrography (MCU) is considered to be the gold-standard method used to detect and grade vesicoureteric reflux (VUR) and show urethral and bladder abnormalities. It accounts for 30-50% of all fluoroscopic examinations in children. Therefore, it is crucial to define and optimize the radiation dose received by a child during MCU examination, taking into account that children have a higher risk of developing radiation-induced cancer than adults. This study aims to quantify and evaluate, by means of thermoluminescence dosimetry (TLD), the radiation dose to the newborn and paediatric populations undergoing MCU using fluoroscopic imaging. Evaluation of entrance surface dose (ESD), organ and surface dose to specific radiosensitive organs was carried out. Furthermore, the surface dose to the co-patient, i.e. individuals helping in the support, care and comfort of the children during the examination, was evaluated in order to estimate the level of risk. 52 patients with mean age of 0.36 years who had undergone MCU using digital fluoroscopy were studied. ESD, surface doses to thyroid, testes/ovaries and co-patients were measured with TLDs. MCU with digital equipment and fluoroscopy-captured image technique can reduce the radiation dose by approximately 50% while still obtaining the necessary diagnostic information. Radiographic exposures were made in cases of the presence of reflux or of the difficulty in evaluating a finding. The radiation surface doses to the thyroid and testes are relatively low, whereas the radiation dose to the co-patient is negligible. The risks associated with MCU for patients and co-patients are negligible. The results of this study provide baseline data to establish reference dose levels for MCU examination in very young patients.

  11. Coexistence of prostate neoplasia in patients undergoing radical cystoprostatectomy due to vesical neoplasia

    Directory of Open Access Journals (Sweden)

    Frederico R. Romero

    2004-08-01

    Full Text Available OBJECTIVE: To assess the incidence of bladder carcinoma infiltrating the prostate and prostate adenocarcinoma in patients undergoing radical cystoprostatectomy due to bladder cancer, as well as to assess if the characteristics of the bladder neoplasia influence the prostatic involvement by this neoplasia. MATERIALS AND METHODS: We retrospectively assessed 60 male patients, who underwent radical cystoprostatectomy between July 1997 and December 2003. Mean age was 66.7 years (40 and 93 years. The product of radical cystoprostatectomies was checked for involvement of urethra and prostate parenchyma by the primary neoplasia, and for the presence of associated prostate adenocarcinoma. Bladder neoplasia characteristics, such as localization, size, multifocality, association with in situ carcinoma and histological grade, were studied in order to assess the possibility of using such characteristics as predictive factors of prostate infiltration by bladder urothelial carcinoma. RESULTS: We observed the presence of 20% of patients with bladder carcinoma infiltrating the prostatic urethra, 23.3% of patients with infiltration of the prostate parenchyma and 28.3% of patients with associate prostate adenocarcinoma, resulting in a total of 55% of patients with prostatic involvement (infiltrative bladder carcinoma and/or adenocarcinoma. We also observed a statistically significant correlation between tumor location in the trigone, the presence of in situ carcinoma and the histological grade of the bladder tumor with prostatic infiltration by the vesical neoplasia. CONCLUSION: The coexistence of prostatic neoplasia in patients operated for bladder neoplasia was frequent in our sample (55%. We observed that the prostatic infiltration by bladder tumors occurs more frequently with tumors located in the trigone, with associated in situ carcinoma and with high histological grade. There was no correlation between neoplastic infiltration of prostate and multifocality

  12. Anaesthesia for the patient with dementia undergoing outpatient surgery

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2009-01-01

    PURPOSE OF REVIEW: Dementia is common in elderly patients, and anaesthesiologists are increasingly challenged in managing these patients who are especially vulnerable. The aim of this article is to highlight some of the most important perioperative issues relating to demented patients, both...

  13. Clinical study of Xihuang Capsules as an adjuvant therapy for breast-cancer patients undergoing chemotherapy%西黄胶囊辅助乳腺癌患者全程化疗的临床研究

    Institute of Scientific and Technical Information of China (English)

    张杰; 张颖; 孟惠彦; 李航; 杨帅; 姚天; 张风华

    2015-01-01

    目的:观察西黄胶囊对于乳腺癌患者全程化疗毒副反应的影响及化疗后生活质量、体力状况的临床前瞻性研究。方法按随机数字表法随机抽取河北省人民医院普外一科2012年9月至2014年8月乳腺癌患者90例,完全随机分为治疗组与对照组,治疗组45例,空白对照组45例,均采用Anthracycline and Cyclophosphamide (AC)×4→Taxol(T)×4方案化疗,治疗组加用口服西黄胶囊,8粒/次,2次/天辅助全程化疗。化疗结束后,对近期疗效进行评估,评估指标包括两组患者的体力状况、生活质量以及化疗毒副反应。结果研究发现应用西黄胶囊治疗组体力状况稳定及提高率明显高于对照组,具有统计学差异( P<0.05);生活质量评价中,治疗组各项指标均优于对照组,具有统计学差异( P<0.05);对两组患者毒副反应发生情况分别进行统计学分析,治疗组较对照组部分化疗毒副反应明显减轻( P<0.05)。结论全程化疗中应用西黄胶囊可以降低乳腺癌患者部分化疗药物的毒副作用,改善患者的体力状况及生活质量。%Objective This prospective study aimed to examine the effect of Xihuang Capsules on the adverse reactions of chemotherapy in breast-cancer patients and on their quality of life and physical con-ditions..Methods According to the random number table method , 90 cases with breast cancer were se-lected among the patients from those who received treatment in Hebei general hospital from September 2012 to August 2014, and were randomly assigned to the treatment group and control group , with 45 cases in each group.Both groups underwent Anthracycline (Pirarubicin) and Cyclophosphamide (AC) ×4→Taxol (Docetaxel, T) ×4 chemotherapy protocol.In addition, the treatment group received Xihuang Capsules , 8 capsules a time, 2 times a day for the whole-course chemotherapy treatment .Short-term efficacy was

  14. Stress reduction through music in patients undergoing cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, N.; Becker, H. [Dept. of Neuroradiology, Hannover Medical School (Germany); Schedlowski, M. [Dept. of Clinical Psychiatry and Psychotherapy, Hannover Medical School (Germany); Schuermeyer, T.H. [Dept. of Endocrinology, Hannover Medical School (Germany)

    2001-06-01

    We studied the influence of music on stress reaction of patients during cerebral angiography. We randomised 30 patients to a music or a control group. We measured stress hormones, blood pressure, heart rate and psychological parameters. Patients examined without music showed rising levels of cortisol in plasma, indicating high stress levels, while cortisol in patients examined with music remained stable. Systolic blood pressure was significantly lower listening to music. Patients with a high level of fear did appear to benefit particularly from the music. (orig.)

  15. Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery

    NARCIS (Netherlands)

    Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam

    2011-01-01

    Purpose: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Methods: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthe

  16. The association between radiographic severity and pre-operative function in patients undergoing primary knee replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Dowsey, Michelle M; Dieppe, Paul; Lohmander, Stefan

    2012-01-01

    To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement.......To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement....

  17. Sequential study of radiotherapy and hormonal therapy in breast cancer patients undergoing mastectomy or conservative surgery%乳腺癌术后放射治疗与内分泌治疗的时序研究

    Institute of Scientific and Technical Information of China (English)

    王希成; 黄晓波; 张卫东; 刘孟忠; 管迅行; 刘晓清

    2009-01-01

    目的 探讨乳腺癌术后放射治疗和辅助内分泌治疗的优化时序.方法 回顾性分析中山大学肿瘤防治中心1998年1月至2003年12月间接受术后放疗与辅助内分泌治疗的乳腺癌患者163例,分为三苯氧胺(TAM)和芳香化酶抑制剂(AI)序贯、同期四组各65和52例,27和21例,随访分析治疗并发症和疗效预后.结果 TAM和AJ序贯、同期四组的中位随访时间分别是84、79个月和67、63个月.肺、皮肤纤维化发生率在TAM、AI的序贯和同期组分别为3.2%与7.7%(P=0.407)、4.8%与9.6%(P=0.464)和7.4%与4.8%(P=0.595),11.1%与9.5%(P=0.594),亚组间的轻微差异不利于TAM同期组.局部复发率和远处转移率在TAM、AI的序贯和同期组分别为28.6%与25.0%(P=0.668)、33.3%与32.7%(P=0.942)和22.2%与9.5%(P=0.437)、25.9%与19.0%(P=0.733),局部复发率的轻微差异不利于AI序贯组.单因素分析显示不同亚组间的无复发生存率和总生存率差异无统计学意义(P>0.05),多因素分析显示放疗同期AI治疗是对无复发生存率有利的独立预后因素(P=0.025).结论 同期或序贯使用术后放疗与辅助内分泌治疗特别是TAM治疗对局部控制和生存均无显著影响,但术后放疗同期TAM治疗略增加纤维化发生率,建议与术后放疗序贯使用TAM治疗,同期使用AJ治疗,仍须开展进一步的前瞻性随机研究.%Objective To investigate the optimal sequence of adjuvant radiotherapy and hormonal therapy in patients with breast cancer. Methods From January 1998 to December 2003, 163 patients with breast cancer at our Cancer Center were eligible for this retrospective study. They underwent mastectomy or conservative surgery and received both adjuvant radiotherapy and hormonal therapy with either tamoxifen (TAM) or aromatase inhibitors (AI). According to whether hormonal therapy was administered sequentially after completion of radiotherapy or concurrently with radiotherapy, the patients were grouped as TAM

  18. Impact of Intraoperative Events on Cerebral Tissue Oximetry in Patients Undergoing Cardiopulmonary Bypass

    NARCIS (Netherlands)

    Severdija, E.E.; Vranken, N.P.; Teerenstra, S.; Ganushchak, Y.M.; Weerwind, P.W.

    2015-01-01

    Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A t

  19. Daily Sodium Butyrate Enema for the Prevention of Radiation Proctitis in Prostate Cancer Patients Undergoing Radical Radiation Therapy: Results of a Multicenter Randomized Placebo-Controlled Dose-Finding Phase 2 Study

    Energy Technology Data Exchange (ETDEWEB)

    Maggio, Angelo, E-mail: maggio.angelo@gmail.com [Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Magli, Alessandro [Department of Radiotherapy, Ospedale S. Maria della Misericordia, Udine (Italy); Rancati, Tiziana [Prostate Cancer Programme, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Fiorino, Claudio [Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Valvo, Francesca [Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Fellin, Giovanni [Department of Radiotherapy, Ospedale Santa Chiara, Trento (Italy); Ricardi, Umberto [University of Turin, Department of Oncology, Torino (Italy); Munoz, Fernando [Radiotherapy Unit, AO Città della Salute e della Scienza di Torino, Torino (Italy); Cosentino, Dorian; Cazzaniga, Luigi Franco [Ospedale S. Anna, Como (Italy); Valdagni, Riccardo [Prostate Cancer Programme, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Division of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Vavassori, Vittorio [Department of Radiotherapy, Ospedale di Circolo, Varese (Italy)

    2014-07-01

    Purpose: To evaluate the efficacy of sodium butyrate enemas (NABUREN) in prostate cancer radiation therapy (RT) in reducing the incidence, severity, and duration of acute RT-induced proctitis. Methods and Materials: 166 patients, randomly allocated to 1 of 4 groups (rectal sodium butyrate 1 g, 2 g, or 4 g daily or placebo), were treated with NABUREN during and 2 weeks after RT. The grade of proctitis was registered in a daily diary. The correlation between NABUREN and proctitis was investigated through χ{sup 2} statistics. The toxicity endpoints considered were as follows: total number of days with grade ≥1 proctitis (≥G1); total number of days with grade ≥2 proctitis (≥G2); ≥G1 and ≥G2 proctitis lasting at least 3 and 5 consecutive days starting from week 4 (≥G1+3d, ≥G2+3d); damaging effects of RT on rectal mucosa as measured by endoscopy. The relationship between endpoints and pretreatment morbidities, hormonal therapy, presence of diabetes or hypertension, abdominal surgery, or hemorrhoids was investigated by univariate analysis. Results: The patients were randomly allocated to the 4 arms. No difference in the distribution of comorbidities among the arms was observed (P>.09). The mean ≥G1 and ≥G2 proctitis were 7.8 and 4.9 for placebo and 8.9 and 4.7 for the NABUREN group, respectively. No favorable trend in reduction of incidence, severity, and duration of ≥G1 and ≥G2 proctitis was observed with NABUREN use. In univariate analysis, ≥G1+3d toxicity was found to be related to hemorrhoids (P=.008), and a slight correlation was found between ≥G2 proctitis and hormonal therapy (P=.06). The RT effects on rectal mucosa as based on endoscopic assessment were mainly related to diabetes (P<.01). Endoscopy data at 6 week showed no significant difference between the placebo and butyrate arms. The other investigated endpoints were not correlated with any of the clinical risk factors analyzed. Conclusion: There was no evidence of efficacy

  20. Management of postoperative pain in patients undergoing total knee

    Directory of Open Access Journals (Sweden)

    Sonia Marchán Espinosa

    2011-09-01

    Full Text Available The postoperatory pain after total prothesis of knee is a special type of agony, of great repercussion in the health area, since it affects the surgical patients who suffer it, the family that "suffer" together with the patient, the responsible doctors, the nursing personnel and the involved institutions. Aim: To value the pain degree for the immediate postoperatory of the prothesis of knee surgical patients during his stay at the Post-anesthesic Recovery Unit.Material and method: There was realized a descriptive study at the Valdepeña´s Hospital at the Post-anesthesic Recovery Unit for 7 months. The sample was formed by the prothesis of knee surgical patients during this period. There was designed a multiple answers questionnaire to which the patients answered during his stay in the unit and there was in use as instrument of measure of the pain the visual analogical scale.Results: 50 % of the patients suffered an intense pain after the anesthesic effect disappear. Almost the totality of the patients (90 % needed an analgesic rescue. In spite of it, the satisfaction that the patients expressed with the relief of his pain was very high.Conclusions: The patients experience high pain levels during the immediate postoperatory. The results reveal the need to design analgesic protocols more adapted to the individual patients need.

  1. Management of oral anticoagulation in patients undergoing minor dental procedures.

    Science.gov (United States)

    Alaali, Yathreb; Barnes, Geoffrey D; Froehlich, James B; Kaatz, Scott

    2012-08-01

    Approximately 4.2 million patients in the United States are taking warfarin, making it the 11th most prescribed drug. Warfarin is primarily used for treatment of venous thromboembolic disease and stroke prevention in patients with atrial fibrillation and mechanical heart valves. Dentists frequently encounter anticoagulated patients and are faced with management decisions in these patients who require dental procedures. Observational studies suggest the risk of thrombosis if anticoagulation is suspended during dental procedures is higher than the risk of bleeding if anticoagulation is not suspended. Several groups now offer guidelines that recommend most minor dental procedures should be performed while on therapeutic warfarin. The recent approval of several new oral anticoagulants has introduced greater complexity to the management of the anticoagulated patient, and this narrative review will discuss current guidelines, the scientific underpinnings of the guidelines, and offer some practical suggestions for patients that are receiving the new agents.

  2. EVALUATION OF UPPER GASTROINTESTINAL ENDOSCOPY IN PATIENTS UNDERGOING BARIATRIC SURGERY

    OpenAIRE

    2015-01-01

    Background: Obesity has become epidemic, and is associated with greater morbidity and mortality. Treatment is multidisciplinary. Surgical treatment is a consistent resource in severe obesity. The indication of preoperative upper gastrointestinal endoscopy in asymptomatic patients is controversial; however, most studies recommend its implementation in all patients. Aim: To analyze endoscopic performance in patients who were in preoperative for bariatric surgery and compare them with control gr...

  3. 以放疗的前列腺癌患者淋巴细胞微核率评价生物照射剂量%Micronuclei in lymphocytes of prostate cancer patients undergoing radiation therapy

    Institute of Scientific and Technical Information of China (English)

    李同光

    2000-01-01

    目的进一步验证微核率作为测量生物照射剂量的可行性.方法8例未经放疗(xRT)和化疗的前列腺癌,经标准分区骨盆xRT治疗方案,收集前列腺癌患者xRT前和xRT中外周血,测定阻滞胞质分裂的外周血淋巴细胞(PBL)微核率.检测项目包括:(1)检查微核率和估计的等效全身吸收剂量之间的关系;(2)评价xRT前PBL微核率的辐射剂量效应关系的个体差异.结果(1)患者PBL微核率随估算的全身吸收射线量[y=1.46+9.2D(R2=0.7,P=0.072)]增加而呈线性增加;微核呈广泛分布;每1000个双核PBL微核率相应增加的比例分别高于基线水平0.9~8.2倍(中位数4.1).(2)xRT前,微核率也随体外照射剂量增加而增加,每1照射剂量下,大多数患者微核率呈高度离散分布.3例因xRT引起的早期副反应患者中,2例的PBL微核率明显高于无xRT引起副反应者.结论PBL微核率可用来测定体外生物照射剂量.因xRT前PBL微核率与体外辐射剂量效应关系存在着显著的个体差异,开始应用xRT前可用PBL微核率判定患者个体固有的放射敏感性.%Objective To further verify the applicability of the micronueleus (MN) assay in biodosimetry.Methods The MN yield in cytokinesis-blocked peripheral blood lymphocytes(PBL) of eight prostate cancer patients were measured . These patients had no previous chemotherapy or radiotherapy(xRT). They were treated with standardized schemes of fractionated pelvic xRT. Before xRT and at one random time-point during the course of xRT, blood samples were collected from each patient for the following purposes: (1) to verify the relationship between the MN yidd in PBL and the estimated equivalent (EQ) total-body absorbed dose; and (2) to evaluate the individual differences of ex vivo radiation dose-response(1 -4Gy) relationship of MN yidd in PBL before xPT. The number of xRT fractions, cumulative tumor dose, and EQ total-body absorbed doses of these patients represented a wide range

  4. Mycoplasma in urine and blood following catheterisation of patients undergoing vascular surgery

    DEFF Research Database (Denmark)

    Levi, N; Eiberg, J; Skov Jensen, J;

    1997-01-01

    The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment.......The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment....

  5. Inflammatory bowel diseases activity in patients undergoing pelvic radiation therapy

    Science.gov (United States)

    Seisen, Thomas; Klotz, Caroline; Mazeron, Renaud; Maroun, Pierre; Petit, Claire; Deutsch, Eric; Bossi, Alberto; Haie-Meder, Christine; Chargari, Cyrus; Blanchard, Pierre

    2017-01-01

    Background Few studies with contradictory results have been published on the safety of pelvic radiation therapy (RT) in patients with inflammatory bowel disease (IBD). Methods From 1989 to 2015, a single center retrospective analysis was performed including all IBD patients who received pelvic external beam radiation therapy (EBRT) or brachytherapy (BT) for a pelvic malignancy. Treatment characteristics, IBD activity and gastrointestinal (GI) toxicity were examined. Results Overall, 28 patients with Crohn’s disease (CD) (n=13) or ulcerative colitis (n=15) were included in the present study. Median follow-up time after irradiation was 5.9 years. Regarding IBD activity, only one and two patients experienced a severe episode within and after 6 months of follow-up, respectively. Grade 3/4 acute GI toxicity occurred in 3 (11%) patients, whereas one (3.6%) patient experienced late grade 3/4 GI toxicity. Only patients with rectal IBD location (P=0.016) or low body mass index (BMI) (P=0.012) experienced more severe IBD activity within or after 6 months following RT, respectively. Conclusions We report an acceptable tolerance of RT in IBD patients with pelvic malignancies. Specifically, a low risk of uncontrolled flare-up was observed. PMID:28280621

  6. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

    OpenAIRE

    2015-01-01

    Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory dis...

  7. Age as a prognostic variable in patients undergoing transurethral prostatectomy

    DEFF Research Database (Denmark)

    Krogh, J; Jensen, J S; Iversen, H G;

    1993-01-01

    In a retrospective study the outcome of transurethral prostatectomy (TURP) for benign prostatic hyperplasia (BPH) in patients more than 80 years old was compared to a control group of patients with a mean age ten years younger. The elderly had significantly more tissue resected and presented...

  8. Oral manifestation and salivary changes in renal patients undergoing hemodialysis

    Science.gov (United States)

    Honarmand, Marieh; Nakhaee, Alireza; Sargolzaie, Fahimeh

    2017-01-01

    Background Salivary changes in hemodialysis patients may result in various oral manifestations. This research intended to determine oral manifestations and some salivary markers in hemodialysis patients. Material and Methods This cross-sectional study was conducted on 30 hemodialysis patients (the patient group) and 30 healthy individuals (the control group). Saliva urea and calcium levels and pH values of the participants were measured, and oral manifestations such as pale mucosa, xerostomia, halitosis, changes in the sense of taste, increased calculus formation, gingival bleeding, etc. were recorded in the information collection form. The data was analyzed using T-test and chi-square, and pHalitosis, xerostomia, and increased calculus were the most prevalent manifestations, and gum bleeding was the least prevalent among the patients. Conclusions Advanced chronic renal insufficiency can increase salivary urea level, pH value, halitosis, xerostomia, and calculus formation, and may cause pale mucosa. Key words:Renal dialysis, biomarkers, oral manifestation, saliva. PMID:28210437

  9. RISK OF PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY UNDERGOING NONCARDIAC SURGERY

    Institute of Scientific and Technical Information of China (English)

    Tian-ming Xuan; Yong Zeng; Wen-ling Zhu

    2007-01-01

    To determine the risk of noncardiac surgery in patients with hypertrophic cardiomyopathy.Methods We reviewed the medical records of all patients who were diagnosed as hypertrophic cardiomyopathy at Peking Union Medical College Hospital from January 1998 to August 2006 and identified 24 patients who subsequently underwent noncardiac surgery.Results There were no intraoperative cardiac events. Postoperative cardiac events were identified in 3 patients including 1 death due to acute myocardial infarction and 2 episodes of transient hypotension.Conclusions The risk of anesthesia and noncardiac surgery is low in patients with hypertrophic cardiomyopathy.During the perioperative period, beta-blockers and/or calcium channel blockers should be given; vasodilator and inotropic agents should be avoided due to the side effects on hemodynamics.

  10. Cancer patients' evaluation of communication

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit;

    2013-01-01

    The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication.......The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication....

  11. Effects on the self-efficacy with continuing care programme for rectal cancer patients undergoing perma-nent colostomy%延续护理干预对直肠癌永久性结肠造口患者自我效能的影响

    Institute of Scientific and Technical Information of China (English)

    朱笑葳; 张红; 唐梦宇

    2016-01-01

    ①目的探讨延续护理干预对永久性结肠造口患者自我效能的影响。②方法直肠癌永久性结肠造口患者70例,按照入院先后顺序分为对照组和干预组,各35例,两组均接受术后常规护理6个月,干预组在常规护理基础上给予延续护理干预。干预前后分别采用造口自我效能量表进行评定,比较两组患者的自我效能得分水平。③结果护理干预前两组患者的自我效能维度得分及6条目得分差异均无统计学意义(P >0.05),干预后两组患者的自我效能维度得分及6条目得分比较差异有统计学意义(P <0.05)。④结论延续护理能够有效增强患者的自我效能感。%Objective To explore the effects on the self - efficacy with continuing care pro-gramme for rectal cancer patients undergoing permanent colostomy.Methods According to the order of admission,70 colostomy patients were divided into control group(n =35)and intervention group(n=35).Patients in both groups were received routine care for six months,while the intervention group received additional continuing care intervention.The self- efficacy for the patients was evaluated ac-cording to Stoma Self-efficacy Scale before and after the intervention.And the differences between the two groups were compared.Results Before intervention,there were no significant differences in the score of two dimensions and 6 entries of self-efficacy between the two groups(P >0.05).Significant differences were observed in the score of two dimensions and 6 entries of self- efficacy between the two groups after the continuing care intervention(P <0.05).Conclusion Continuing care programme can effectively improve the self-efficacy for rectal cancer patients undergoing permanent colostomy.

  12. Clinicopathological analysis of patients with gastric cancer in 1200 cases

    Institute of Scientific and Technical Information of China (English)

    Wei Xin Niu; Xin Yu Qin; Han Liu; Cheng Pei Wang

    2001-01-01

    @@INTRODUCTION Gastric cancer is one of the most common fatal malignancies in the world. The prognosis is generally poor in advanced gastric cancer .The low survival is related to delayed diagnosis, metastasis and recurrence after operation .The aim of this paper was to find correlation between clinical factors was to find correlation between clinical factors and biologic behavior of gastric cancer in a series of 1200 patients undergoing surgical resection.

  13. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review.

    Science.gov (United States)

    Eijzenga, Willem; Hahn, Daniela E E; Aaronson, Neil K; Kluijt, Irma; Bleiker, Eveline M A

    2014-04-01

    Approximately 25% of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial problems experienced by counselees. The aim of this review was to investigate the specific psychosocial issues encountered by individuals undergoing genetic counseling for cancer, and to identify overarching themes across these issues. A literature search was performed, using four electronic databases (PubMed, PsychInfo, CINAHL and Embase). Papers published between January 2000 and January 2013 were selected using combinations, and related indexing terms of the keywords: 'genetic counseling', 'psychology' and 'cancer'. In total, 25 articles met our inclusion criteria. We identified the specific issues addressed by these papers, and used meta-ethnography to identify the following six overarching themes: coping with cancer risk, practical issues, family issues, children-related issues, living with cancer, and emotions. A large overlap in the specific issues and themes was found between these studies, suggesting that research on specific psychosocial problems within genetic counseling has reached a point of saturation. As a next step, efforts should be made to detect and monitor these problems of counselees at an early stage within the genetic counseling process.

  14. Role of quantitative CT in predicting postoperative FEV1 and chronic dyspnea in patients undergoing lung resection

    Directory of Open Access Journals (Sweden)

    Papageorgiou Chrysovalantis V

    2010-06-01

    Full Text Available Abstract Lung resection is the mainstay of treatment in patients with early stage non-small cell lung cancer. However, lung cancer patients often suffer from comorbidities and the respiratory reserve should be carefully evaluated preoperatively in order to avoid postoperative complications. Forced expiratory volume in 1 second (FEV1 is considered to be an index that depicts the patient's respiratory efficacy and its prediction has a key role in the preoperative evaluation of lung cancer patients with impaired lung function. Prediction of postoperative FEV1 is currently possible with the use of perfusion radionuclide lung scanning. Quantitative CT is the analysis of data acquired during normal chest CT scan using the system's software. By applying a dual threshold of -500 to -910 Hounsfield Units, functional lung volumes are estimated and postoperative FEV1 can be predicted by reducing the preoperative measurement by the fraction of the part to be resected. Studies have shown that preoperative predictions correlate well with the actual postoperative measurements. Additionally, quantitative CT results are in good agreement with perfusion scintigraphy predictions. Newer radiological techniques such as perfusion MRI and co-registered SPECT/CT have also been used in the preoperative evaluation with similar results. In conclusion, chest CT which is obligatory for staging, can be used for quantitative analysis of the already available data. It is technically simple, providing an accurate prediction of postoperative FEV1. Thus, quantitative CT appears to be a useful tool in the preoperative evaluation of lung cancer patients undergoing lung resection.

  15. Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Hatzidakis, A.A.; Charonitakis, E.; Athanasiou, A.; Tsetis, D.; Chlouverakis, G.; Papamastorakis, G.; Roussopoulou, G.; Gourtsoyiannis, N.C

    2003-02-01

    AIM: To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage. MATERIALS AND METHODS: This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2 mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1 mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3 h later to complete a visual 10-degree pain score scale. RESULTS: The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted. CONCLUSION: According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia. Hatzidakis, A. A. et al. (2003). Clinical Radiology58, 121-127.

  16. Effect of public knowledge, attitudes, and behavior on willingness to undergo colorectal cancer screening using the health belief model

    Directory of Open Access Journals (Sweden)

    Majid A Almadi

    2015-01-01

    Full Text Available Background/Aims: Success of colorectal cancer (CRC screening is dependent in part on the proportion of uptake by the targeted population. We aimed in this study to identify factors that were associated with willingness to undergo CRC screening based on the health belief model (HBM. Patients and Methods: This was a cross-sectional study among citizens of Riyadh, Saudi Arabia. Demographic data collected included gender, age, education, marital status, employment status, a history of CRC in the family or knowing a friend with CRC, as well as income. A questionnaire was developed in Arabic based on the HBM and included enquiries on knowledge about CRC symptoms and risk factors, types of CRC screening tests, perceived risk of CRC, previously undergoing CRC screening, intent to undergo CRC screening, perceived barriers to CRC screening, perceived severity of CRC, as well as attitudes toward CRC and its screening. Results: Five hundred participants were included. The mean age was 41.0 years (SD 10.7. Males were 50% and only 6.7% of those between 50 and 55 years of age had undergone CRC screening. Of those surveyed, 70.7% were willing to undergo CRC screening. Also, 70.5% thought that CRC is curable, 73.3% believed it was preventable, whereas 56.7% thought it was a fatal disease. Neither gender, level of education, occupation, income, marital status, nor general knowledge about CRC was found to be associated with the willingness to undergo CRC screening. Recognizing that colonoscopy was a screening test (OR 1.55, 95% CI; 1.04-2.29 was associated with a strong desire to undergo CRC screening while choosing a stool-based test was associated with not willing to undergo CRC screening (OR 0.59, 95%CI; 0.38-0.91. Conclusion: We found that the majority of those interviewed were willing to undergo CRC screening and identified a number of barriers as well as potential areas that could be targeted in the promotion of CRC screening uptake if such a national

  17. [Patient with a Fontan circulation undergoing caesarean section: Anesthesiological management].

    Science.gov (United States)

    Schneck, E; Mann, V; Körner, C; Jost, A; Thul, J; Engel, J B; Müller, M F

    2015-07-01

    Adults suffering from congenital heart diseases (CHD) represent a challenge to anesthesiologists because of the diverse pathologies, complex pathophysiology and special treatment strategies. Due to improved therapeutic options for CHD, patient quality of life and life expectancy is increasing, leaving them as a growing population including pregnant patients with CHD. This article presents the main principles of the pathophysiology and anesthesiological management of pregnant patients living with a Fontan circulation based on a case report, which was complicated by an aortic coarctation and atonic uterine hemorrhage.

  18. Compensatory renal hypertrophia in patients undergoing unilateral nephrectomy

    DEFF Research Database (Denmark)

    Mogensen, P; Munck, O; Tonnesen, K H;

    1977-01-01

    Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function...... of the remaining kidney and the preoperative estimate. In 23 patients where the removed kidney had some function, the mean GFR increased by 32% and 22% after one week and three months, respectively. In 5 patients where the removed kidney had no function, no compensatory hypertrophy occurred....

  19. Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    A. Thaler

    2013-01-01

    Full Text Available Background. Adipose tissue is an important endocrine organ that secretes cytokines, including adiponectin, levels of which are negatively correlated with the severity of the inflammatory process. Aim. To assess the time course of adiponectin levels following open heart surgery with cardiopulmonary bypass and its correlation with early postoperative outcomes. Materials and Methods. Blood samples were obtained from 24 children undergoing cardiac surgery and analyzed for adiponectin, C-reactive protein, and other inflammatory markers. Results. Baseline adiponectin levels were negatively correlated with patients’ preoperative weight and age. Postoperative adiponectin levels decreased compared to baseline ( and correlated negatively with duration of cardiopulmonary bypass (, , length of stay in the pediatric intensive care unit (, , and the inotropic score (, . Adiponectin levels were positively correlated with sVCAM 1 levels; however, there was no correlation between adiponectin levels and sP selectin, tPA, MCP1, and sCD40. Conclusions. The inflammatory response after open heart surgery with cardiopulmonary bypass is associated with a reduction in adiponectin levels. Prolonged or more complicated surgery induced a more substantial inflammatory process characterized by a significant reduction in adiponectin levels over time and a delayed return to baseline levels.

  20. Prophylactic cranial irradiation in patients with small cell lung cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Tietze, Anna; Khalil, Azza Ahmed

    2012-01-01

    BACKGROUND: Prophylactic cerebral irradiation (PCI) is a standard treatment for all small cell lung cancer (SCLC) patients with response to chemotherapy. The aims of this study were: to evaluate patients undergoing PCI with regard to cerebral recurrence rate, site of recurrence, and overall...

  1. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  2. Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

    DEFF Research Database (Denmark)

    Bøtker, M T; Vang, M L; Grøfte, T;

    2014-01-01

    with focused ultrasonography in patients undergoing urgent surgical procedures. Methods We performed pre-operative focused cardiopulmonary ultrasonography in patients aged 18 years or above undergoing urgent surgical procedures at pre-defined study days. Known and unexpected cardiopulmonary pathology...... was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered. Results A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society....... Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3. Conclusion Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical...

  3. The prevalence of iron deficiency anaemia in patients undergoing bariatric surgery.

    Science.gov (United States)

    Khanbhai, M; Dubb, S; Patel, K; Ahmed, A; Richards, T

    2015-01-01

    As bariatric surgery rates continue to climb, anaemia will become an increasing concern. We assessed the prevalence of anaemia and length of hospital stay in patients undergoing bariatric surgery. Prospective data (anaemia [haemoglobin bariatric surgery. Results from a prospective database of 1530 patients undergoing elective general surgery were used as a baseline. Fifty-seven patients (14%) were anaemic pre-operatively, of which 98% were females. Median MCV (fL) and overall median ferritin (μg/L) was lower in anaemic patients (83 vs. 86, p=0.001) and (28 vs. 61, psurgery patients, prevalence of anaemia was similar (14% vs. 16%) but absolute iron deficiency was more common in those undergoing bariatric surgery; microcytosis pbariatric surgery. In bariatric patients with anaemia there was an overall increased length of hospital stay.

  4. Recovery of older patients undergoing ambulatory anaesthesia with isoflurane or sevoflurane.

    LENUS (Irish Health Repository)

    Mahajan, V A

    2007-06-01

    Delayed recovery of cognitive function is a well-recognized phenomenon in older patients. The potential for the volatile anaesthetic used to contribute to alterations in postoperative cognitive function in older patients following minor surgical procedures has not been determined. We compared emergence from isoflurane and sevoflurane anaesthesia in older surgical patients undergoing urological procedures of short duration.

  5. [Nursing care in patients undergoing radiological surgery. A case report].

    Science.gov (United States)

    Armero-Barranco, David; Ruiz-Mateos, María; Alcaraz-Baños, Miguel; Bernal-Páez, Fernando Luis

    2007-01-01

    We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patient's hospital stay easier, more comfortable and less traumatic.

  6. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Chertow, Glenn M; Block, Geoffrey A; Correa-Rotter, Ricardo

    2012-01-01

    Disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute to extraskeletal (including vascular) calcification among patients with chronic kidney disease. It has been hypothesized that treatment with the calcimimetic agent cinacalcet might reduce the risk...

  7. Anaesthetic challenges in a patient with mitochondrial cytopathy undergoing surgery

    Directory of Open Access Journals (Sweden)

    D N Dhananjay

    2007-01-01

    Full Text Available This article will highlight certain basic aspects in the management of a case of mitochondrial cytopathy that is unknown to most of us. Clinical condition of the patient is the most important aspect in the management, as the patients with mild disease may be at lower risk for complications while those with severe disease are at a higher risk. We managed a 45year old lady posted for incisional hernia repair

  8. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

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    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  9. Pain in patients with cancer

    NARCIS (Netherlands)

    Vissers, K.C.P.; Besse, K.; Wagemans, M.; Zuurmond, W.; Giezeman, M.J.; Lataster, A.; Mekhail, N.; Burton, A.W.; Kleef, M. van; Huygen, F.

    2011-01-01

    Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate

  10. Economic considerations of antifungal prophylaxis in patients undergoing surgical procedures

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    Maria Adriana Cataldo

    2011-01-01

    Full Text Available Maria Adriana Cataldo, Nicola PetrosilloSecond Infectious Diseases Division, National Institute for Infectious Diseases, “Lazzaro Spallanzani”, Rome, ItalyAbstract: Fungi are a frequent cause of nosocomial infections, with an incidence that has increased significantly in recent years, especially among critically ill patients who require intensive care unit (ICU admission. Among ICU patients, postsurgical patients have a higher risk of Candida infections in the bloodstream. In consideration of the high incidence of fungal infections in these patients, their strong impact on mortality rate, and of the difficulties in Candida diagnosis, some experts suggest the use of antifungal prophylaxis in critically ill surgical patients. A clinical benefit from this strategy has been demonstrated, but the economic impact of the use of antifungal prophylaxis in surgical patients has not been systematically evaluated, and its cost–benefit ratio has not been defined. Whereas the costs associated with treating fungal infections are very high, the cost of antifungal drugs varies from affordable (ie, the older azoles to expensive (ie, echinocandins, polyenes, and the newer azoles. Adverse drug-related effects and the possibly increased incidence of fluconazole resistance and of isolates other than Candida albicans must also be taken into account. From the published studies of antifungal prophylaxis in surgical patients, a likely economic benefit of this strategy could be inferred, but its usefulness and cost–benefits should be evaluated in light of local data, because the available evidence does not permit general recommendations.Keywords: antifungal prophylaxis, cost-effectiveness, economics, surgery, fungal infection 

  11. Efficacy, safety, and lack of interactions with the use of raltegravir in HIV-infected patients undergoing antineoplastic chemotherapy

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    Sara Bañón

    2014-11-01

    Full Text Available Introduction: Concomitant use of combination antiretroviral regimen (cART and cancer chemotherapy is difficult due to complex interactions and increased toxicity. Raltegravir could be an adequate option through its favourable drug-drug interaction profile. Methods: Prospective longitudinal study of HIV patients with cancer, AIDS related or not, undergoing chemotherapy. Patients without resistance or previous failure were switched or initiated raltegravir plus two nucleoside analogues. Plasma trough levels of raltegravir were measured. Results: Overall, 28 patients receiving a raltegravir-based regimen (4 naive with tenofovir-emtricitabine (18 cases or abacavir-lamivudine (10 cases were included. Mean age was 46.2 years (IQR, 39–52.7, and 79% were male. Median time of HIV was 201.7 months, CD4+ nadir was 268 cells/mm3, and 75% had previous AIDS. At the diagnosis of neoplasia, 17 were on protease inhibitors and 4 with efavirenz. Ten patients had a non-HIV-related cancer (three breast, two pancreatic, one Ewing sarcoma, one myeloblastic leukemia, one melanoma, one parotid adenocarcinoma, one lung, and 18 had an HIV-related cancer (nine non-Hodgkin lymphoma, seven Hodgkin disease, two anal. Overall, 43% of patients received more than one line of chemotherapy, including antimetabolites in 12 patients (5-FU, capecitabine, methotrexate, gemcitabine, alkylating agents in 12 cases (ciclophosphamide, iphosphamide, vinca alkaloids in 20 patients (vincristine, vinblastine, vindesine, antitumor antibiotics in 16 cases (adriamycin, cisplatin o carboplatin in six and monoclonal antibodies in six patients (rituximab, trastuzumab, cetuximab. Six patients modified the doses of antineoplastic agents due to toxicity (four neutropenia, not related to raltegravir. During a median follow up of 12.7 patients-year in concomitant therapy, there was only 1 case of virological failure and no patient discontinued raltegravir. Plasma concentrations of raltegravir in eight

  12. Trough Concentrations of Vancomycin in Patients Undergoing Extracorporeal Membrane Oxygenation.

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    So Jin Park

    Full Text Available To investigate the appropriateness of the current vancomycin dosing strategy in adult patients with extracorporeal membrane oxygenation (ECMO, between March 2013 and November 2013, patients who were treated with vancomycin while on ECMO were enrolled. Control group consisted of 60 patients on vancomycin without ECMO, stayed in medical intensive care unit during the same study period and with the same exclusion criteria. Early trough levels were obtained within the fourth dosing, and maintenance levels were measured at steady state. A total of 20 patients were included in the analysis in ECMO group. Sixteen patients received an initial intravenous dose of 1.0 g vancomycin followed by 1.0 g every 12 hours. The non-steady state trough level of vancomycin after starting administration was subtherapeutic in 19 patients (95.00% in ECMO group as compared with 40 patients (66.67% in the control group (p = 0.013. Vancomycin clearance was 1.27±0.51 mL/min/kg, vancomycin clearance/creatinine clearance ratio was 0.90 ± 0.37, and elimination rate constant was 0.12 ± 0.04 h-1. Vancomycin dosingfrequency and total daily dose were significantly increased after clinical pharmacokinetic services of the pharmacist based on calculated pharmacokinetic parameters (from 2.10 ± 0.72 to 2.90 ± 0.97 times/day, p = 0.002 and from 32.54 ± 8.43 to 42.24 ± 14.62mg/kg, p = 0.014 in ECMO group in contrast with those (from 2.11 ± 0.69 to 2.37 ± 0.86 times/day, p = 0.071 and from 33.91 ± 11.85 to 31.61 ± 17.50 mg/kg, p = 0.350 in the control group.Although the elimination rate for vancomycin was similar with population parameter of non ECMO patients, the current dosing strategy of our institution for vancomycinin our ICU was not sufficient to achieve the target trough in the initial period in most patients receiving ECMO.

  13. Evaluation of secondary hyperparathyroidism in patients undergoing hemodialysis.

    Science.gov (United States)

    Rahimian, Mohammad; Sami, Ramin; Behzad, Fariba

    2008-01-01

    Renal osteodystrophy is a complication of chronic kidney disease (CKD) that present in low and high turnover patterns. This disorder has a key role in the disability of CKD patients in whom early diagnosis and treatment can result in better outcome. We studied hyperparathyroidism prevalence and its relationship with renal osteodystrophy in our advanced CKD population. We included 80 patients (of whom 44 (55%) were diabetic) during 6 months period. The patients answered a questionnaire about symptoms related to bone disease and blood levels of parathormone (PTH), calcium, phosphorus, and alkaline phosphatase were obtained, in addition to hand and skull radiographs in all the study patients. Prevalence of clinically evident hyperparathyroidism in our patients was 45%. Hyperparathyroidism had significant relationship with alkaline phosphatase and radiological findings, but did not have a significant relationship with dialysis duration, age, sex, familial history, diabetes mellitus, or hypertension. We conclude that secondary hyperparathyroidism is prevalent in our dialysis population and has high correlation with serum alkaline phosphatase levels and radiological changes.

  14. 右美托咪啶与咪达唑仑复合舒芬太尼用于肝癌微波治疗术患者麻醉效果的比较%Comparison of anesthetic efficacy of dexmedetomidine and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer

    Institute of Scientific and Technical Information of China (English)

    吴晓丹; 陈彦青; 邹聪华

    2014-01-01

    Objective To compare the anesthetic efficacy of dexmedetomidine and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer.Methods Forty ASA Ⅱ male patients (aged 35-62 years and weighing 45-70 kg) scheduled for percutaneous microwave coagulation therapy were randomly divided into two groups (n =20 each):midazolam group (group Ⅰ) and dexmedetomidine group (group Ⅱ).A loading dose of midazolam 40 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by midazolam infusion at 40 μg·kg-1 · h-1 in group Ⅰ.And a loading dose of dexmedetomidine 1 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by dexmedetomidine at 0.5 μg· kg-1 · h-1 in group Ⅱ.At 5 minutes after administration of the loading dose of midazolam or dexmedetomidine,a loading dose of sufentanil 0.2 μg/kg was given,and then patient-controlled intravenous anesthesia (PCIA) with sufentanil (with the background infusion of 0.1 μg·kg-1 · h-1,bolus dose of 0.1 μg/kg and lockout interval of 3 minutes) was used.The operation was started 2 minutes after administration of the loading dose of sufentanil.The incidences of bradycardia,tachycardia,hypotension,hypertension and respiratory depression were recorded.The total attempts and effective pressing times of PCIA were also recorded.Results There was no significant difference in the incidences of bradycardia,tachycardia,hypotension,and hypertension between the two groups (P > 0.05).The incidence of respiratory depression was significantly lower,and the total attempts and effective pressing times were smaller in group Ⅱ than in group Ⅰ (P < 0.05).Conclusion The anesthetic efficacy of dexmedetomidine and sufentanil is better than that of midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.

  15. Anti-ENA antibody profile in hepatitis C patients undergoing hemodialysis.

    Science.gov (United States)

    Batchoun, Raymond G; Al-Najdawi, Malek A; Al-Taamary, Sameh

    2011-07-01

    Infection with hepatitis C virus (HCV) is increasing all over the world, especially among hemodialysis patients. HCV is one of the major autoantibody inducing viruses, where anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-liver kidney microsome antibodies (LKM-1), and rheumatoid factor (RF) have been related to HCV. Few studies have investigated the presence of anti-extractable nuclear antigens (ENA) antibodies in chronic liver diseases, especially in chronic hepatitis C cases, but none investigated its immunostimulation role in hemodialysis units. The aim of the study was to assess the prevalence of HCV among chronic kidney disease- Stage 5 (CKD5) patients undergoing hemodialysis and the prevalence of ENA antibodies among them. Sera of 134 patients with chronic kidney disease undergoing hemodialysis, were screened for HCV antibodies and ENA antibodies profile, using ELISA and Immunoblot technique. 41 HCV-positive blood bank donors were used as controls. Sixty-four (47.7%) of 134 patients undergoing hemodialysis were infected with HCV. Thirty-three (51.6%) of 64 patients with HCV infection undergoing hemodialysis had anti-ENA antibodies: 9 (27.3%) showed anti-SSA antibodies and 22 (66.7%) had anti-SSB antibodies. The prevalence of anti-ENA antibodies was significantly higher in the patients with HCV infection, undergoing hemodialysis, compared with both control groups (hepatitis C-positive blood bank donors and hepatitis C-negative patients undergoing hemodialysis). Seventeen of 33 HCV antibodies-positive males undergoing hemodialysis had anti-ENA antibodies, compared with 16 of 31 females, indicating no sex related difference. This study emphasizes the high prevalence of HCV infection in our hemodialysis patients, comparable to that of other Middle Eastern countries, but higher than Western ones. A strong association was observed between anti-HCV positivity and hemodialysis duration, as well as anti-ENA antibody profile. However, these

  16. Exploring the experiences patients who undergo 24hour Video- electroencephalography

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    Antigoni Fountouki

    2012-07-01

    Full Text Available Epilepsy is a frequent neurological disorder well-known by ancient times. The most accurate and valid diagnostic tool for epilepsy, is electroencephalography which provides details on the brain's function by recording brain cells' waves. Aim of the study was the exploration of the patients' total experience at a psychological and emotional level during a 24hour EEG. Materials and Methods: The sample included 40 subjects aged 18-40 years with a history or suspicion of epileptic symptoms. Due to the study's explorative/explicative nature, a qualitative research design was used. Data collection was performed through semi-structured interviews, direct observations and field notes. Following patients' permission, the interviews were recorded and the verbatim data was analyzed via thematic content analysis. Results: The verbatim text was the raw material where key words or phrases with autonomous meaning, relevant to the study's aims where subsequently organized in 4 major themes and 20 sub-categories, namely: Emotional-Psychological state (Positive: Joy, Optimism, Positive Thinking, Self-Confidence. Negative: Sadness, Anxiety, Fear, Panic, Pessimism. Behavior of patients (Calmness, Comfort, Nervousness, Aggravation. Options for patient involvement (TV, Reading, Music, Sleep, Lack of internet. Interpersonal relationships (family, friendly. Conclusions: During achieving the study's aims, many methodological and practical obstacles have been encountered as it proved to be particularly challenging to encompass patients' emotions and accurately cite their experiences during the EEG. However, results that have been revealed are adequate in formulating a holistic picture about the psychological state and the emotions that patients experience during the procedure.

  17. 体重指数对前列腺癌检出率及 G leaso n评分的影响%Effect of boby mass index on positive rate of prostate cancer and Gleason score in the patients undergoing transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    周峰; 浦金贤; 欧阳骏; 李纲; 平季根; 裴昌松; 黄玉华; 侯建全

    2016-01-01

    Objective To investigate the effect of body mass index (BMI) on the positive rate of prostate cancer and Gleason score in the patients undergoing transrectal prostate biopsy .Methods A total of 290 patients underwent prostatic biopsy for the first time was assigned into two groups of A(with BMI≥25 kg/m2 ,143 cases) and B(with BMI0 .05) .The percentage of patients with high Gleason score (Gleason score ≥ 7 points ) was higher in group A than that in group B (44.76% vs .38.10% ) (P0 .05);高BMI组的高Gleason评分(≥7分)比例高于正常BMI组(44.76% vs .38.10% )(P<0 .05).结论 前列腺穿刺活检患者的BM I对前列腺癌检出率没有显著影响 ,但BM I是影响前列腺穿刺活检Gleason评分的重要因素.

  18. Effect of intravenous clonidine premedication in patients undergoing laparoscopic cholecystectomy

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    S. K. Gvalani

    2016-09-01

    Results: Data was analysed by Pearson's chi-square test. Clonidine significantly attenuated the rise in heart rate, and the blood pressure. The incidence of postoperative nausea and vomiting was less in the clonidine group. It also reduced shivering. Conclusions: 2 microgm/kg of clonidine iv can be reasonably recommended as a premedicant for laparoscopic procedures in otherwise healthy patients. However further study is required to test its efficacy in patients with compromised cardiovascular function. [Int J Res Med Sci 2016; 4(9.000: 3806-3811

  19. Adequacy of oxygenation parameters in elderly patients undergoing mechanical ventilation

    OpenAIRE

    Guedes, Luana Petruccio Cabral Monteiro; Delfino,Fabrício Costa; de Faria, Flavia Perassa; de Melo, Gislane Ferreira; Carvalho, Gustavo Azevedo

    2013-01-01

    ABSTRACT Objective: To compare ideal PaO2 with PaO2 found, ideal PaO2/FiO2 of room air with the one found, and ideal FiO2 with FiO2 found in mechanically ventilated elderly patients. Methods: Cross-sectional study that evaluated elderly mechanically ventilated patients for at least 72 hours and who underwent three subsequent blood gas analyses. Results: The sample consisted of 48 elderly with mean age of 74.77±9.36 years. There was a significant difference between the ideal PaO2 and the one f...

  20. Hepatitis Viral Markers in Patients Undergoing Primary Liver Transplants

    OpenAIRE

    1993-01-01

    The purpose of the study was to determine the prevalence in liver transplant (OLTx) patients of the hepatitis markers (anti-A, anti-B, anti-C, anti-D and HBsAg) and the interrelationships between markers and patients’ sexes, ages, dates of transplant, clinicopathological diagnoses, and short-term survivals. Slightly more than half of the patients were male. Anti-A and anti-B were about evenly distributed between male and female. Anti-C, anti-D, and HBsAg were far more common in males. Age and...

  1. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

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    Amirthagadeswar

    2015-02-01

    Full Text Available Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory disease, for whom there may be advantages in avoiding general anesthesia. The absence of post - operative sedation or drowsiness allows early ambulation and diminishes the requirement for recovery facilities with inguinal nerve block.

  2. Galectin-3 in patients undergoing ablation of atrial fibrillation

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    Nicolas Clementy

    2014-11-01

    Conclusions: Persistent type of atrial fibrillation is an independent predictor of higher Galectin-3 concentration. This biomarker of fibrosis may be implied in the mechanisms of atrial remodeling and maintenance of atrial fibrillation, and thus be helpful for the design of therapeutic strategy in patients with atrial fibrillation.

  3. Characterization of Chronic Kidney Disease Patients Undergoing Hemodialysis

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    Niovis Sosa Barberena

    2016-08-01

    Full Text Available Background: Cienfuegos has a high prevalence of chronic kidney disease, which is a health problem of great social and economic impact. Objective: to characterize patients with chronic kidney disease receiving hemodialysis. Methods: a cross-sectional study was conducted in 80 patients treated at the Specialized Outpatient Center of Cienfuegos in 2013. General variables such as age, sex, and place of origin were analyzed, in addition to the causes of the disease, length of time on hemodialysis, type of vascular access, and prevalence of hepatitis C. Absolute frequencies, percentages, and rates were calculated. Results: the 45 to 54 age group was the most affected by the condition. Males accounted for 63.7%. Cienfuegos municipality showed the highest prevalence with 27.6 per 100 000 inhabitants. The most common cause of chronic kidney disease was nephroangiosclerosis (33.3%. Seventy three percent of patients started hemodialysis as an emergency therapy. The time on hemodialysis was less than one year and one to two years in more than half of patients. An arteriovenous fistula was used in 81.3% of cases. Hepatitis C showed a high prevalence. Conclusion: renal disease is more common in men of working age in Cienfuegos municipality. The major causes of this disease are associated with hypertension and diabetes mellitus.

  4. Activation of AIFM2 enhances apoptosis of human lung cancer cells undergoing toxicological stress.

    Science.gov (United States)

    Lu, Jun; Chen, Jian; Xu, Nianjun; Wu, Jun; Kang, Yani; Shen, Tingting; Kong, Hualei; Ma, Chao; Cheng, Ming; Shao, Zhifeng; Xu, Ling; Zhao, Xiaodong

    2016-09-01

    Application of cisplatin (DDP) for treating lung cancer is restricted due to its toxicity and lung cancer's drug resistance. In this study, we examined the effect of Jinfukang (JFK), an effective herbal medicine against lung cancer, on DDP-induced cytotoxicity in lung cancer cells. Morphologically, we observed that JFK increases DDP-induced pro-apoptosis in A549 cells in a synergistic manner. Transcriptome profiling analysis indicated that the combination of JFK and DDP regulates genes involved in apoptosis-related signaling pathways. Moreover, we found that the combination of JFK and DDP produces synergistic pro-apoptosis effect in other lung cancer cell lines, such as NCI-H1975, NCI-H1650, and NCI-H2228. Particularly, we demonstrated that AIFM2 is activated by the combined treatment of JFK and DDP and partially mediates the synergistic pro-apoptosis effect. Collectively, this study not only offered the first evidence that JFK promotes DDP-induced cytotoxicity, and activation of AIFM2 enhances apoptosis of human lung cancer cells undergoing toxicological stress, but also provided a novel insight for improving cytotoxicity by combining JFK with DDP to treat lung cancer cells.

  5. Olmesartan, other anti-hypertensives, and chronic diarrhea among patients undergoing endoscopic procedures; a case-control study

    Science.gov (United States)

    Greywoode, Ruby; Braunstein, Eric D.; Arguelles-Grande, Carolina; Green, Peter H.R.; Lebwohl, Benjamin

    2014-01-01

    Objective To investigate a recent association between use of the angiotensin receptor-blocker (ARB) olmesartan and a severe enteropathy resembling celiac disease. Patients and Methods We searched our endoscopy database for all outpatient esophagogastroduodenoscopy (EGD) or colonoscopy examinations in patients at least 50 years of age during the dates January 1, 2007 to March 31, 2013. Cases were those whose examination indication was diarrhea, and controls were those whose examination indication was esophageal reflux (EGD) or colorectal cancer screening (colonoscopy). We compared cases to controls with regard to the proportion of those listing olmesartan among their medications. Secondary exposures were the proportion of those taking non-olmesartan ARBs or other anti-hypertensive medications. We also examined biopsy results to determine if there were histologic changes associated with olmesartan use. Results We identified 2088 patients undergoing EGD and 12428 patients undergoing colonoscopy meeting inclusion criteria. On multivariate analysis, there was no statistically-significant association between olmesartan and diarrhea among those undergoing EGD (OR 1.99 95% CI 0.79–5.00) or colonoscopy (OR 0.63 95% CI 0.23–1.74). Review of pathology reports of the EGD and colonoscopy groups showed no association between olmesartan use and the histologic diagnosis of celiac disease (p=0.61) or microscopic colitis (p=1.0), respectively. Conclusions Our findings suggest that neither olmesartan nor other ARBs were associated with diarrhea among patients undergoing endoscopy. The sprue-like enteropathy recently associated with olmesartan is likely a rare adverse effect and milder presentations are unlikely. PMID:25023670

  6. Anaesthesia for patients undergoing ventricular assist-device implantation.

    Science.gov (United States)

    Feussner, Markus; Mukherjee, Chirojit; Garbade, Jens; Ender, Joerg

    2012-06-01

    In the last 10 years, implantation of ventricular-assist devices has become an interesting option as either bridge-to-transplantation or destination procedure for patients with end-stage congestive heart failure. In the future, the number of ventricular assist device implantations is expected to increase furthermore. In general, this patient cohort is associated with significant co-morbidities, for example, pulmonary hypertension, peripheral vascular disease and renal insufficiency. Anaesthetic management for implantation of ventricular assist devices can be challenging for cardiac anaesthesiologists. Even minor changes in their haemodynamics and physiological parameters can cause significant morbidity and mortality. Experience in haemodynamic monitoring including echocardiography and pharmacological management (use of inotropes, phosphodiesterase inhibitors and vasopressors) is a requirement. Particularly, the diagnosis and therapy of right-sided heart failure after implantation of left-ventricular assist devices should be addressed.

  7. [Clinical study of patients undergoing paperless electroencephalography in emergency room].

    Science.gov (United States)

    Inoue, Takeshi; Kawawaki, Hisashi; Nukui, Megumi; Kuki, Ichiro; Okazaki, Shin; Tomiwa, Kiyotaka; Amo, Kiyoko; Togawa, Masao; Rinka, Hiroshi; Shiomi, Masashi

    2012-07-01

    Fifty-eight patients who visited the emergency room of our center with febrile convulsions and impaired consciousness, and underwent paperless electroencephalography soon after arrival. They consisted of 25 male and 33 female children, ranging in age from 5 months to 15 years and 4 months, with a mean age of 4 years and 10 months. The final diagnoses were poor responsiveness associated with fever and febrile delirium in 5 patients, febrile convulsions in 26, encephalitis/encephalopathy in 24, convulsions associated with mild gastroenteritis in 2, and aseptic meningitis in 1. The appearance of spindle wave within 24 hours after admission was considered to be a favorable prognostic factor, whereas generalized high-amplitude delta waves without fast-wave components and dysrhythmic flat basic waves were considered poor prognostic factors. We conclude that bed-side paperless electroencephalography is useful for the evaluation of changes in the brain function and course of treatment.

  8. HEARING ASSESSMENT IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

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    Arjun Singh

    2014-01-01

    Full Text Available The auditory sensitivity of 63 patient of chronic renal failure on hemodialysis was assessed in order to know the effect of dialysis on hearing threshold. All selected patient were non diabetic with normal tympanic membrane and with no history of ototoxic drug and any hereditary hearing problems. Pure tone audiometry was done before and after dialys is and all cases were followed for 3 month. A high incidence of high frequency sensorineural hearing loss was obtained which could not be attributed to age , noise exposure and ottotoxicity. An association between high frequency sensorineural hearing loss a nd hemodialysis is thus suggested KEYWORDS: Hemodialysis ; Pure tone audiometry ; High frequency sensorineural hearing loss ; Duration of disease ; Chronic renal failure

  9. SUPPRESSION OF TINNITUS IN PATIENTS UNDERGOING COCHLEAR IMPLANTATION

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    M. T. Khorsandi

    1999-07-01

    Full Text Available 7 'innitus is a frequent complaint in patients with sensorineural deafness. Different reports suggest that electrical stimulation caused by cochlear implant devices "upn"ises tinnitus to a considerable degree. In a longitudinal -.mdv we have evaluated the severity and duration of tinnitus in both ears of J 7 cochlear implant patients before and after operation. Severity of tinnitus was reduced in both implanted and not implanted ears after the implantation (P=0.003 and p - 0.00-1 respectively. Duration of tinnitus, however, was not affected significantly. No significant difference in tinnitus suppression was observed between the implanted and not implanted ears. This might be attributed to both the electrical stimulation caused by the device and the psychogenic stability provided by return to the world of sound.

  10. 食管癌根治术患者低流量麻醉单肺通气对肺内分流的影响%Effect of low volume anesthesia on intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection

    Institute of Scientific and Technical Information of China (English)

    徐银秀; 李利

    2012-01-01

    目的 观察对食管癌根治术患者低流量麻醉单肺通气对肺内分流的影响.方法 择期行食管癌根治术患者50例,年龄在42~75岁,ASA分级Ⅰ或Ⅱ级,随机分为低流量组(A组)和常流量组(B组),每组25例.单肺通气时A组氧流量1.0 L·min-1,B组氧流量3.0 L·min-1,分别测定麻醉诱导后(T1)及单肺通气15 min (T2)、30 min (T3) 、45 min (T4) 、60 min (T5)及恢复双肺通气30 min(T6)时CVP、HR、MAP和气道平均压(Pmean),同时采集颈内静脉和桡动脉血样,进行血气分析,计算肺内分流率(Qs/Qt).结果 与T1时比较,两组T2~5时Pmean和Qs/Qt升高(P0.05).结论 食管癌根治术患者低流量麻醉单肺通气对肺内分流无明显影响.%Objective To evaluate the effect of low volume anesthesia on intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection. Methods Fifty ASA I or II patients of both sexes aged 42 ~ 75 yr undergoing esophageal cancer resection were randomly divided into low volume anesthesia group ( group A ) and normal volume anesthesia group ( group B ), each group of 25 patients. In group A,oxygen supply was administered with 1.0 L · Min-1 during OLV,while in group B,oxygen supply was administered with 3. 0 L · Min-1 during OLV. Left radial artery and right internal jugular vein were cannulated for MAP and CVP monitoring and blood sampling. MAP,HR,CVP,mean airway pressure were monitored and recorded after induction of anesthesia ( T1 ),at 15,30 min,45 min and 60 min of OLV ( T2,3,4,5 ) and 30 rain after re-expansion of the collapsed lung ( T6 ). Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt ( Qs/Qt )was calculated. Results Mean airway pressure and Qs/Qt was significantly increased during OLV compared with two-lung ventilation ( TLV ) in two groups( P < 0. 05 ). There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs

  11. KIR2DS2 and KIR2DS4 Promoter hypomethylation patterns in patients undergoing hematopoietic cell transplantation (HCT)

    OpenAIRE

    Gallez-Hawkins, Ghislaine M.; Li, Xiuli; Franck, Anne E.; Gendzekhadze, Ketevan; Nakamura, Ryotaro; Forman, Stephen J.; Senitzer, David; Zaia, John A.

    2012-01-01

    The killer cell Ig-like receptor (KIR)-MHC class I pathway is an integral part of natural killer cell immunity, and its role in host protection from both cancer and infection is important In addition, we have shown elevated KIR2DS2 and 2DS4 expression in PBMCs of patients undergoing hematopoietic cell transplantation (HCT) [1]. Since all inhibitory KIR promoters are known to be heavily methylated, the question asked here is how and when KIR2DS2 and 2DS4 promoters had changed their methylation...

  12. Treatment of Hepatitis C in Patients Undergoing Immunosuppressive Drug Therapy

    Science.gov (United States)

    Ooka, Kohtaro; Lim, Joseph K.

    2016-01-01

    Abstract With 185 million people chronically infected globally, hepatitis C is a leading bloodborne infection. All-oral regimens of direct acting agents have superior efficacy compared to the historical interferon-based regimens and are significantly more tolerable. However, trials of both types of regimens have often excluded patients on immunosuppressive medications for reasons other than organ transplantation. Yet, these patients—most often suffering from malignancy or autoimmune diseases—could stand to benefit from these treatments. In this study, we systematically review the literature on the treatment of hepatitis C in these neglected populations. Research on patients with organ transplants is more robust and this literature is reviewed here non-systematically. Our systematic review produced 2273 unique works, of which 56 met our inclusion criteria and were used in our review. The quality of data was low; only 3 of the 56 studies were randomized controlled trials. Sustained virologic response was reported sporadically. Interferon-containing regimens achieved this end-point at rates comparable to that in immunocompetent individuals. Severe adverse effects and death were rare. Data on all-oral regimens were sparse, but in the most robust study, rates of sustained virologic response were again comparable to immunocompetent individuals (40/41). Efficacy and safety of interferon-containing regimens and all-oral regimens were similar to rates in immunocompetent individuals; however, there were few interventional trials. The large number of case reports and case series makes conclusions vulnerable to publication bias. While firm conclusions are challenging, given the dearth of high-quality studies, our results demonstrate that antiviral therapy can be safe and effective. The advent of all-oral regimens offers patients and clinicians greatly increased chances of cure and fewer side effects. Preliminary data reveal that these regimens may confer such benefits in

  13. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    OpenAIRE

    Levitzky, Benjamin E; Vargo, John J.

    2008-01-01

    Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP), a prodrug of propofol with a slower pharmacokin...

  14. Femoral nerve block for patient undergoing total knee arthroplasty

    Science.gov (United States)

    Heo, Bong Ha; Lee, Hyeon Jung; Lee, Hyung Gon; Kim, Man Young; Park, Keun Suk; Choi, Jeong Il; Yoon, Myung Ha; Kim, Woong Mo

    2016-01-01

    Abstract Background: The existence of peripheral opioid receptors and its effectiveness in peripheral nerve block remain controversial. The aim of this prospective, randomized, double-blinded study was to examine the analgesic effects of adding fentanyl to ropivacaine for continuous femoral nerve block (CFNB) using patient-controlled analgesia after total knee arthroplasty (TKA). Methods: The patients were divided into 2 groups, each with n = 40 in ropivacaine (R) group and n = 42 in R with fentanyl (R + F) group. After operation, the patients in each group received R + F and R alone via a femoral nerve catheter, respectively. We assessed the visual analog scale (VAS) pain immediately before administration (baseline) and at 15, 30, and 60 minutes on postanesthesia care unit (PACU), and resting and ambulatory VAS score up to 24 hours. Results: Overall, the average VAS scores in the R + F group were slightly lower than those of the R group. However, the VAS score differences between groups were not statistically significant, except for 30 minutes (P = 0.009) in PACU. R group showed higher supplemental analgesics consumption in average compared with R + F group, but not significant. Conclusion: Additional fentanyl did not show prominent enhancement of analgesic effect in the field of CFNB after TKA. PMID:27603376

  15. Prevention of venous thromboembolism in patients undergoing bariatric surgery

    Directory of Open Access Journals (Sweden)

    Bartlett MA

    2015-08-01

    Full Text Available Matthew A Bartlett, Karen F Mauck, Paul R Daniels Division of General Internal Medicine, Mayo Clinic Thrombophilia Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA Abstract: Bariatric surgical procedures are now a common method of obesity treatment with established effectiveness. Venous thromboembolism (VTE events, which include deep vein thrombosis and pulmonary embolism, are an important source of postoperative morbidity and mortality among bariatric surgery patients. Due to an understanding of the frequency and seriousness of these complications, bariatric surgery patients typically receive some method of VTE prophylaxis with lower extremity compression, pharmacologic prophylaxis, or both. However, the optimal approach in these patients is unclear, with multiple open questions. In particular, strategies of adjusted-dose heparins, postdischarge anticoagulant prophylaxis, and the role of vena cava filters have been evaluated, but only to a limited extent. In contrast to other types of operations, the literature regarding VTE prophylaxis in bariatric surgery is notable for a dearth of prospective, randomized clinical trials, and current professional guidelines reflect the uncertainties in this literature. Herein, we summarize the available evidence after systematic review of the literature regarding approaches to VTE prevention in bariatric surgery. Identification of risk factors for VTE in the bariatric surgery population, analysis of the effectiveness of methods used for prophylaxis, and an overview of published guidelines are presented. Keywords: bariatric surgery, venous thromboembolism, prophylaxis, vena cava filter, heparin

  16. Prevention of venous thromboembolism in patients undergoing bariatric surgery.

    Science.gov (United States)

    Bartlett, Matthew A; Mauck, Karen F; Daniels, Paul R

    2015-01-01

    Bariatric surgical procedures are now a common method of obesity treatment with established effectiveness. Venous thromboembolism (VTE) events, which include deep vein thrombosis and pulmonary embolism, are an important source of postoperative morbidity and mortality among bariatric surgery patients. Due to an understanding of the frequency and seriousness of these complications, bariatric surgery patients typically receive some method of VTE prophylaxis with lower extremity compression, pharmacologic prophylaxis, or both. However, the optimal approach in these patients is unclear, with multiple open questions. In particular, strategies of adjusted-dose heparins, postdischarge anticoagulant prophylaxis, and the role of vena cava filters have been evaluated, but only to a limited extent. In contrast to other types of operations, the literature regarding VTE prophylaxis in bariatric surgery is notable for a dearth of prospective, randomized clinical trials, and current professional guidelines reflect the uncertainties in this literature. Herein, we summarize the available evidence after systematic review of the literature regarding approaches to VTE prevention in bariatric surgery. Identification of risk factors for VTE in the bariatric surgery population, analysis of the effectiveness of methods used for prophylaxis, and an overview of published guidelines are presented.

  17. Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant.

    Science.gov (United States)

    Ucar, Muharrem; Erdil, Feray; Sanlı, Mukadder; Aydogan, Mustafa Said; Durmus, Mahmut

    2016-04-01

    Kidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on examination of a 28-year-old man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardio-pulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant.

  18. GASTRIC AND JEJUNAL HISTOPATHOLOGICAL CHANGES IN PATIENTS UNDERGOING BARIATRIC SURGERY

    Science.gov (United States)

    RODRIGUES, Rosemary Simões Nomelini; ALMEIDA, Élia Cláudia de Souza; CAMILO, Silvia Maria Perrone; TERRA-JÚNIOR, Júverson Alves; GUIMARÃES, Lucinda Calheiros; DUQUE, Ana Cristina da Rocha; ETCHEBEHERE, Renata Margarida

    2016-01-01

    ABSTRACT Background: Morbid obesity is a multifactorial disease that increasingly is being treated by surgery. Aim: To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery. Methods: This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative. Results: In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9% (77.1% and 20.1%, respectively, in the postoperative). The postoperative group had a significant reduction in H. pylori infection (p=0.0001). A longer length of the gastric stump and a time since surgery of more than two years were associated with Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed slight nonspecific chronic inflammation in 8.6%. Conclusion: There was a reduction in the incidence of Helicobacter pylori infection in the postoperative group. A longer length of the gastric stump and longer time elapsed since surgery were associated with Helicobacter pylori infection. The jejunal mucosa was considered normal in an absolute majority of patients. PMID:27683773

  19. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

  20. APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

    Institute of Scientific and Technical Information of China (English)

    Hong Zhao; Tie-hu Ye; Zhi-yi Gong; Yang Xue; Zhang-gang Xue; Wen-qi Huang

    2005-01-01

    Objective To assess the efficacy and safety of lomoxicam, one non-steroidal anti-inflammatory drug (NSAID) in patientcontrolled analgesia (PCA) in patients undergoing abdominal surgeries.Methods Thirty-nine patients scheduled for abdominal surgeries were randomly assigned to different PCA treatment groups using either lomoxicam or fentanyl postoperatively. Pain intensity difference (PID) and sum of pain intensity difference (SPID) were used to assess the analgesic efficacy of both drugs during a 24-hour period.Results The analgesic efficacy of lornoxicam is 1/66 of fentanyl, which was shown by SPID value of 3.250 and 3.058,respectively (P > 0.05). Lornoxicam caused fewer adverse events than fentanyl (33% vs. 68%, P < 0.05).Conclusion In clinic, we can use lomoxicam to treat postoperative pain effectively and with less adverse reactions compared with fentanyl.

  1. Patient Beliefs About Colon Cancer Screening.

    Science.gov (United States)

    Ely, John W; Levy, Barcey T; Daly, Jeanette; Xu, Yinghui

    2016-03-01

    Only about half of eligible individuals undergo colon cancer screening. We have limited knowledge about the patient beliefs that adversely affect screening decisions and about which beliefs might be amenable to change through education. As part of a clinical trial, 641 rural Iowans, aged 52 to 79 years, reported their beliefs about colon cancer screening in response to a mailed questionnaire. Consenting subjects were randomized into four groups, which were distinguished by four levels of increasingly intensive efforts to promote screening. Two of the groups received mailed educational materials and completed a follow-up questionnaire, which allowed us to determine whether their beliefs about screening changed following the education. We also completed a factor analysis to identify underlying (latent) factors that might explain the responses to 33 questions about readiness, attitudes, and perceived barriers related to colon cancer screening. The strongest predictors of a patient's stated readiness to be screened were a physician's recommendation to be screened (1 point difference on 10-point Likert scale, 95 % confidence interval [CI], 0.5 to 1.6 point difference), a family history of colon cancer (0.85-point Likert scale difference, 95 % CI, 0.1 to 1.6), and a belief that health-care decisions should be mostly left to physicians rather than patients (Spearman correlation coefficient 0.21, P beliefs, 11 (33 %) changed favorably following the educational intervention. In the factor analysis, the 33 items were reduced to 8 underlying factors, such as being too busy to undergo screening and worries about screening procedures. We found a limited number of underlying factors that may help explain patient resistance to colon cancer screening.

  2. [Infectious complications in patients undergoing a heart transplant].

    Science.gov (United States)

    Bouza, E; Muñoz, P

    1995-01-01

    Infectious complications are, with rejection, the main cause of morbidity and mortality in heart transplantation recipients. Adequate management of these patients requires an adequate knowledge of risk factors, of most common infectious syndromes and of relevant microorganism, as long as of their resistance pattern. Among the first group, we may mention lower respiratory tract infections, mediastinitis and meningitis, and among the microorganisms, Citomegalovirus, Aspergillus and Toxoplasma gondii. The impressive development of diagnostical techniques and of prophylactic and therapeutical possibilities suggest the convenience of a multidisciplinar approach to these complications.

  3. Management of patients with hematological malignancies undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Deepak Borde

    2013-01-01

    Full Text Available The number of patients with a previously diagnosed malignancy who need cardiac surgery is increasing. Patients with hematological malignancies represent only 0.38% of all patients undergoing cardiac surgery. The literature in this subset of patients is limited to only a few retrospective case series, with limited number of patients undergoing emergency cardiac surgery. We describe three cases with hematological malignancies namely chronic myelogenous leukemia, acute promyelocytic leukemia and chronic lymphocytic leukemia presenting for coronary artery bypass grafting (CABG. Two patients were taken up for emergency CABG in view of ongoing ischemia, one of them was on preoperative intra-aortic balloon pump support. No mortality was observed. Two patients needed transfusion of blood products which was guided by thromboelastography. One patient developed superficial sternal wound infection requiring antibiotic therapy.

  4. Postoperative Infection Rates in Patients with a Negative Baseline Urine Culture Undergoing Ureteroscopic Stone Removal

    DEFF Research Database (Denmark)

    Martov, Alexey; Gravas, Stavros; Etemadian, Masoud;

    2015-01-01

    Abstract Purpose: To examine the effects of antibiotic prophylaxis on postoperative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS). Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database...... in both groups. Factors predictive of postoperative UTI or fever were female gender, Crohn's and cardiovascular disease, a high stone burden, and an ASA score of II or higher. Conclusions: In patients with a negative baseline urine culture undergoing URS for ureteral or renal stones, rates......, patients with a negative baseline urine culture undergoing URS for ureteral stones (n=1141) or kidney stones (n=184) not receiving antibiotic prophylaxis were matched with those who were predefined by risk factors, including gender, American Society of Anesthesiologists (ASA) score, and ureteral stent...

  5. Investigation and analysis of incidence of awareness in patients undergoing cardiac surgery in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    WANG Yun; YUE Yun; SUN Yong-hai; WU An-shi; WU Qi-wei; ZHANG Yong-qian; FENG Chun-sheng

    2005-01-01

    Background Awareness under general anesthesia is a serious complication which leads to psychiatric disorders. The incidence of awareness in patients undergoing cardiac surgery has been reported in as many as 1.5%-23% in foreign countries. But so far, medical literature about awareness during cardiac surgery is still rare in China. Therefore, we investigated the incidence of awareness in patients undergoing different kinds of cardiac surgery, the phases when awareness occured and the effect of cardiopulmonary bypass on the incidence of awareness in coronary artery bypass grafting in Beijing.Methods Patients' recall of awareness during cardiac surgery was assessed. One hundred patients undergoing coronary artery bypass grafting (CABG) in Chaoyang Hospital, Beijing, one hundred patients undergoing CABG and one hundred patients undergoing valve replacement or septal defect repair in Fuwai Hospital, Beijing, were interviewed 3-6 days after surgery. Every report obout patients on recall of awareness was recorded. An independent research team, blinded to patients' surgery and anesthesia, assessed every report of awareness.Results The incidence of awareness of patients received CABG under cardiopulmonary bypass (CPB), off -pump CABG, septal repair or valve replacement under CPB was 4.7% (5 of 106 cases), 9.6% (9 of 94 cases) and 4% (4 of 100 cases), respectively. CPB did not greatly affect the incidence of awareness during the period of CABG (P>0.05). The incidence of awareness of patients who received CABG under CPB did not increase significantly, in comparison with that of patients who received septal repair or valve replacement under CPB in Fuwai Hospital (P>0.05). Awareness easily occurred before bypass grafting or CPB.Conclusions Awareness mainly occurs before bypass grafting or CPB in cardiac surgery. Most cases with awareness have auditory perceptions. CPB is not a main factor which affects the incidence of awareness of CABG. Surgical types do not affect the

  6. Effect of common herbal medicines on patients undergoing anaesthesia

    Directory of Open Access Journals (Sweden)

    Yatindra Kumar Batra

    2007-01-01

    Full Text Available Herbal medicines are the oldest known remedies to mankind. Herbs have been used by all cultures throughout history but India has one of the oldest, and most diverse cultural living traditions associated with the use of medicinal plants. The use of these agents may have perioperative implications, which often is a result of various factors. The constituents of these medications may not be adequately described. Conventional agents like ste-roids, oral hypoglycaemic agent, nonsteroidal anti-inflammatory agents and antihistamines are frequently added to herbal medicines. Toxic materials like arsenic, mercury, lead, etc. have been detected from time to time in some herbs. The use of herbal medicines can result in drug interactions, most of which are less well defined. The interactions that are most important in the perioperative period include sympathomimetic, sedative, and coagulopathic effects. Less than 50% of patients admit to taking these medicines, which compounds the prob-lem. It is imperative that anaesthesiologists obtain a history of herbal medicine use from patients and anticipate the adverse drug interactions. In case of any doubt, it may be prudent to stop these herbal medicines atleast 2-3 weeks prior to anaesthesia and surgery.

  7. Apathy and Cognitive Test Performance in Patients Undergoing Cardiac Testing

    Directory of Open Access Journals (Sweden)

    Lynn Reese Kakos

    2013-01-01

    Full Text Available Background. Psychiatric comorbidity is common in patients with cardiovascular disease, with the literature indicating that this population may be at risk for apathy. The current study examined the prevalence of apathy in patients with cardiovascular disease and its relation to aspects of cognitive function. Methods. 123 participants from an outpatient cardiology clinic completed a brief neuropsychological battery, a cardiac stress test, and demographic information, medical history, and depression symptomatology self-report measures. Participants also completed the Apathy Evaluation Scale to quantify apathy. Results. These subjects reported limited levels of apathy and depression. Increased depressive symptomatology, history of heart attack, and metabolic equivalents were significantly correlated with apathy (P<0.05. Partial correlations adjusting for these factors revealed significant correlations between behavioral apathy and a measure of executive function and the other apathy subscale with a measure of attention. Conclusion. Findings revealed that apathy was not prevalent in this sample though associated with medical variables. Apathy was largely unrelated to cognitive function. This pattern may be a result of the mild levels of cardiovascular disease and cognitive dysfunction in the current sample. Future studies in samples with severe cardiovascular disease or neuropsychological impairment may provide insight into these associations.

  8. Efficacy of crushed lanthanum carbonate for hyperphosphatemia in hemodialysis patients undergoing tube feeding.

    Science.gov (United States)

    Kitajima, Yukie; Takahashi, Taeko; Sato, Yuzuru; Nakaya, Yutaka

    2011-08-01

    Lanthanum carbonate (LaC) is a non-calcium-based phosphate binder used to treat hyperphosphatemia in patients with chronic kidney disease. Oral administration of LaC is difficult in patients undergoing tube feeding or those who are of advanced age because it is essential to chew the LaC tablet sufficiently before swallowing it. We report two cases in whom crushed LaC was used in hemodialysis patients undergoing tube feeding. In both cases, previously crushed LaC was mixed into enteral nutrients. We found that LaC administered this way was effective for decreasing serum phosphorus levels.

  9. Psychosocial disorders in women undergoing postoperative radiation and chemotherapy for breast cancer in India

    Directory of Open Access Journals (Sweden)

    M A Khan

    2010-01-01

    Full Text Available Background: Breast cancer is the most common cancer in urban India, but no study has been carried out on psychosocial disorders in breast cancer patients. Aims: The present study has been undertaken to evaluate behavioural and psychosocial impacts before and after treatment of women with breast cancer. Settings and Design: The study was carried out in a reputed hospital in Delhi. Patients and Methods: A total of 97 breast cancer patients matched for age and economic status were divided into group A (66 and group B (31 on the basis of treatment modalities offered to the patient. These women were interviewed, before and after the treatment, and the observations were recorded in a pre-tested structured questionnaire. Statistical Analysis: Chi-square test and Fisher′s exact test were used to calculate statistical significance. Results: Although the extent of sociobehavioral disorders were higher in patients on postoperative adjuvant chemotherapy and radiotherapy when compared with those on postoperative adjuvant chemotherapy alone, the difference was, however, not statistically significant. Psychological reactions were observed in 31% of patients but after intervention, 65% showed adjustment within 4 to 12 weeks, whereas the rest showed late adjustments. Conclusions: Breast disfigurement and sexuality were found to be least important, but psychological and social support appears to significantly influence the treatment outcome and rehabilitation of breast cancer patients in India.

  10. Influence of Continuous Nursing on the Psychological State and Coping Style of Patients Undergoing Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Xin LIU

    2015-10-01

    Full Text Available Background: Patients undergoing pacemaker implantation often experience anxiety and fear. As such, studies have focused on the mechanisms that relieve the negative emotions caused by the intervention. Continuous nursing is a safe and effective nursing mode. In this study, continuous nursing intervention was provided for elderly patients undergo-ing pacemaker implantation and an empirical investigation was performed to determine the effects of their negative emotion and disease-coping ability.Methods: Overall, 114 (68 males and 46 females elderly patients who were undergoing pacemaker implantation from Harbin City (China, were enrolled in the study. The patients were divided into two groups, namely, the control group and the intervention group, based on different nursing methods. Routine nursing was applied to the control group; continuous nursing support was provided for the intervention group from January 2014 to January 2015. The nursing results of the two groups were compared. These results were also evaluated using self-rating depression scale, self-rating anxiety scale, and trait coping style questionnaire.Result: The effects of depression and anxiety intervention were significant in the intervention group (P<0.05. Com-pared with the control group, the intervention group did not significantly differ. The coping style of the intervention group elicited significant effects. Compared with the control group, the intervention group was significantly different (P < 0.05.Conclusion: Continuous nursing can relieve the negative emotion and improve the negative coping style of patients undergoing pacemaker implantation.

  11. Clinical impact of intracoronary abciximab in patients undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Gu, Youlan L; Iversen, Allan Zeeberg;

    2012-01-01

    The aim of this study was to perform an individual patient-level pooled analysis of randomised trials, comparing intracoronary versus intravenous abciximab bolus use in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI)....

  12. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    NARCIS (Netherlands)

    Mastenbroek, Mirjam H; van t Sant, Jetske; Versteeg, Henneke; Cramer, MJ; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT-defibrilla

  13. Hemodynamic, ventilator, and ECG changes in pediatric patients undergoing extraction

    Directory of Open Access Journals (Sweden)

    Y K Sanadhya

    2013-01-01

    Full Text Available Background: Dental treatment induces pain anxiety and fear. This study was conducted to assess the changes in hemodynamic, ventilator, and electrocardiograph changes during extraction procedure among 12-15-year-old children and compare these changes with anxiety, fear, and pain. Materials and Methods: A purposive sample of 60 patients selected based on inclusion and exclusion criteria underwent study procedure in the dental OPD of a medical college and hospital. The anxiety, fear, and pain were recorded by dental anxiety scale, dental fear scale, and visual analogue scale, respectively, before the start of the procedure. The systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and electrocardiogram changes were monitored during the extraction procedure. The recording was taken four times (preinjection phase, injection, extraction, and postextraction and was analyzed. Results: At the preinjection phase the mean vales were systolic blood pressure (128 ± 11.2, diastolic blood pressure (85.7 ± 6.3, heart rate (79.7 ± 9.3, and oxygen saturation (97.9 ± 5.8. These values increased in injection phases and decreased in extraction phase and the least values were found after 10 min of procedure and this relation was significant for all parameters except oxygen saturation (P = 0.48, NS. ECG abnormalities were seen among 22 patients and were significant before and after injection of Local anesthetic (P = 0.0001, S. Conclusions: Anxiety, fear, and pain have an effect on hemodynamic, ventilator, and cardiovascular parameters during the extraction procedure and hence behavioral management has to be emphasized among children in dental clinics.

  14. Partial response to cinacalcet treatment in a patient with secondary hyperparathyroidism undergoing hemodialysis: a case report

    Science.gov (United States)

    2012-01-01

    Introduction In the treatment of secondary hyperparathyroidism of chronic kidney disease, calcimimetics - allosteric modulators of the calcium-sensing receptor - inhibit glandular hyperplasia and significantly reduce circulating parathyroid hormone levels. They have a major impact on the management of secondary hyperparathyroidism. Case presentation We present the clinical case of a 41-year-old Caucasian man undergoing chronic hemodialysis, who had a parathyroidectomy to treat severe secondary hyperparathyroidism resistant to cinacalcet treatment. Preoperatively, 24 months after high-dose cinacalcet hydrochloride, we observed a persistently elevated intact parathyroid hormone serum level, and detected clear parathyroid gland hyperplasia regression on ultrasound. We performed a three-gland parathyroidectomy, which was assumed to be total, associated with a hemithyroidectomy. Our patient then entered a hypoparathyroid state. A histopathological examination showed that the removed parathyroid glands were of small size, with a total weight of 1g, associated with a multifocal small papillary thyroid cancer. Conclusion In the management of secondary hyperparathyroidism, cinacalcet hydrochloride effectively reduces total parathyroid gland hyperplasia. However, a persisting elevated intact parathyroid hormone serum level may be observed, demonstrating that reduced parathyroid hyperplastic tissue may still be associated with severe secondary hyperparathyroidism. Even if calcimimetics are very effective in secondary hyperparathyroidism treatment, further studies are necessary for a better understanding of their actions. PMID:23232027

  15. Partial response to cinacalcet treatment in a patient with secondary hyperparathyroidism undergoing hemodialysis: a case report

    Directory of Open Access Journals (Sweden)

    Conzo Giovanni

    2012-12-01

    Full Text Available Abstract Introduction In the treatment of secondary hyperparathyroidism of chronic kidney disease, calcimimetics - allosteric modulators of the calcium-sensing receptor - inhibit glandular hyperplasia and significantly reduce circulating parathyroid hormone levels. They have a major impact on the management of secondary hyperparathyroidism. Case presentation We present the clinical case of a 41-year-old Caucasian man undergoing chronic hemodialysis, who had a parathyroidectomy to treat severe secondary hyperparathyroidism resistant to cinacalcet treatment. Preoperatively, 24 months after high-dose cinacalcet hydrochloride, we observed a persistently elevated intact parathyroid hormone serum level, and detected clear parathyroid gland hyperplasia regression on ultrasound. We performed a three-gland parathyroidectomy, which was assumed to be total, associated with a hemithyroidectomy. Our patient then entered a hypoparathyroid state. A histopathological examination showed that the removed parathyroid glands were of small size, with a total weight of 1g, associated with a multifocal small papillary thyroid cancer. Conclusion In the management of secondary hyperparathyroidism, cinacalcet hydrochloride effectively reduces total parathyroid gland hyperplasia. However, a persisting elevated intact parathyroid hormone serum level may be observed, demonstrating that reduced parathyroid hyperplastic tissue may still be associated with severe secondary hyperparathyroidism. Even if calcimimetics are very effective in secondary hyperparathyroidism treatment, further studies are necessary for a better understanding of their actions.

  16. Clinical observation of low tidal volume with low positive end-expiratory pressure in one-lung ventilation patients undergoing esophageal cancer resection%低潮气量联合低呼气末正压通气用于食管癌根治术患者单肺通气的临床观察

    Institute of Scientific and Technical Information of China (English)

    周荣胜; 刘齐宁; 关正; 毕阳

    2012-01-01

    目的 观察低潮气量联合低呼气末正压通气用于食管癌根治术患者单肺通气的临床效果.方法 32例ASA Ⅰ或Ⅱ级择期行食管癌(中段)根治术患者随机均分为 A、B两组.A组为低潮气量联合低呼气末正压通气组:VT=6ml*kg-1,f=16次/min-1,加5cm H2O PEEP;B组为传统单肺通气组:VT=10ml*kg-1,f=12次/min.观察气管插管后切皮前(T1)、单肺通气后60min(T2)、恢复双肺通气后15min(T3)、拔管后30min(T4)的动脉氧分压(PaO2)、动脉二氧化碳分压( PaCO2)、呼气末二氧化碳分压(PETCO2)、氧合指数(PaO2/FiO2)、平均动脉压(MAP)及术中的气道峰压(Ppeak)、气道平台压力(Pplat)、气道压力(Paw).结果 T2时A组的Ppeak、Pplat及Paw明显低于B组(P0.05).结论 食管癌根治术中应用低潮气量联合低呼气末正压通气能有效改善患者术中低氧血症,减少肺部并发症,有利于患者呼吸功能的恢复,对血流动力学无明显影响,是食管癌根治手术全麻安全、有效的通气方法.%Objective: To investigate the effects of low tidal volume with low positive end - expiratory pressure in one - lung ventilation patients undergoing esophageal cancer resection. Methods: Thirty - two ASA class I or II patients scheduled to undergo esophagectomy for esophageal cancer were randomly assigned into 2 groups ( n = 16 each ). Low VT and low positive end - expiratory pressure( PEEP )mechanical ventilation were applied to the patients in group A( VT = 6ml"kg~ ,f=16, PEEP = 5 cm H2 0 ), while traditional ventilation was used in group B( VT = 10 ml ? Kg"1 ,f = 12, PEEP = 0 ). Arterial blood samples were taken and PaO2 ,PaCO2 ,PETCO2 , PaO2/FiO2 and MAP were recorded at the time points of before operation( Tj ) ,60 min after one - lung ventilation( T2 ), 15 min after double lung ventilation and 30 min after tracheal extubation( T4 ). Peak airway pressure( Ppeak ), Pplat and Paw were recorded during operation. Results: At T2 ,Ppeak,Pplat and Paw in

  17. 'Patient satisfaction' in hospitalized cancer patients.

    Science.gov (United States)

    Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D

    2002-01-01

    Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.

  18. The Synchronous Prevalence of Colorectal Neoplasms in Patients with Stomach Cancer

    OpenAIRE

    Lee, Sang Su; Jung, Woon Tae; Kim, Cha Young; Ha, Chang Yoon; Min, Hyun Ju; Kim, Hyun Jin; Kim, Tae Hyo

    2011-01-01

    Purpose The association between stomach cancer and colorectal cancer is controversial. The purpose of this study was to determine the synchronous prevalence of colorectal neoplasms in patients with stomach cancer. Methods A total of 123 patients with stomach cancer (86 male) and 246 consecutive, age- and sex-matched persons without stomach cancer were analyzed from July 2005 to June 2010. All of them underwent colonoscopy within 6 months after undergoing gastroscopy. Results The prevalence of...

  19. Additional effective dose by patients undergoing NAI-131 capsules therapy

    Energy Technology Data Exchange (ETDEWEB)

    Orlic, M.; Jovanovic, M.; Spasic Jokic, V.; Cuknic, O.; Ilic, Z.; Vranjes Djuric, S. [VINCA - Institute of Nuclear Sciences, Belgrade, Serbia and Montenegro (Yugoslavia)

    2006-07-01

    Capsules or solutions containing Na{sup 131}I are indicated for the therapy of some thyroid carcinomas such as functioning metastatic papillary or follicular carcinoma of the thyroid; and for the treatment of hyperthyroidism (diffuse toxic goiter and single or multiple toxic nodular goiter). The recommended dosage ranges of Na{sup 131}I capsules or solution for the therapy of the average patient (70 kg) are: (3.7-5.55) GBq for ablation of normal thyroid tissue; (3.7-7.4) GBq for subsequent treatments; a (148-370) MBq for hyperthyroidism. The purpose of this paper is to calculate effective dose as a result of iodine-131 capsules remaining in stomach before absorption starts. This result can determine the disadvantage of capsule versus solution containing sodium iodine-131 (Na{sup 131}I) in radionuclide therapy application from radiation protection point of view. The Monte Carlo code MCNP4b was used to model transport of gamma and beta particles emitted by radionuclide {sup 131}I treated as a point source at the bottom of stomach. Absorbed energy per unit transformation in stomach and surrounding organs has been calculated. (authors)

  20. Parenteral nourishment of patients undergoing surgical or traumatic stress.

    Science.gov (United States)

    Gilder, H

    1986-01-01

    Severe surgical or other traumatic stress initiates an integrated central nervous system and metabolic response characterized by catabolism which selectively preserves vital organs, drawing on peripheral tissue proteins for required amino acids. When oral intake is prohibited adequate intravenous nutritional support hastens convalescence and may be life-saving. Intravenous nutrients routinely consist of amino acids for replacement of lost protein, a nonprotein calorie source--usually glucose, and vitamins and minerals. Lipid, infrequently used in routine surgery as part of the calorie source, supplies essential fatty acids and prevents side effects resulting with large amounts of intravenous glucose. Lipid has other benefits. Stress-induced hormones stimulate lipid catabolism. When lipid is used for part of the calorie requirement in intravenous feedings, the plasma insulin level is reduced and peripheral amino acids become available for synthesis of critically needed visceral proteins. Recent work has shown that the branched chain amino acids carnitine and some species of lipid added to intravenous nutrient formulations postoperatively affect the nitrogen retention and may hasten convalescence. Further work should be directed at understanding the unique biochemical changes occurring after injury, devising objective assay procedures to measure the severity of the response and improving intravenous formulations for the acutely ill surgical patient.

  1. [Difficulties facing spouses of in-patients undergoing tocolysis].

    Science.gov (United States)

    Hu, Ya-Ling

    2008-08-01

    When a pregnant woman needs tocolysis to preempt the need for an abortion, there are great impacts on the daily life of her family and on the relationships between the couple and their family members, which negatively influence the balance of the family system. For a pregnant woman under tocolysis in hospital, the spouse indeed plays an important supportive role in helping her to endure many difficulties. Because men are always controllers of power and opinion, being strong and active in attitude to everything, male spouses always suppress their emotions and do not express their feelings to others. These characteristics of men, either in Eastern or Western countries, always cause nursing staff to realize the needs of the male spouse poorly during tocolysis. The current concept of nursing emphasizes family-centered nursing, so the patient's family members are also recipients of treatment, especially male spouses during the process of tocolysis. This is usually neglected, however. In this paper, the author analyzes the characteristics and the roles of male spouses in the family, and the difficulties faced by a pregnant woman during tocolysis in hospital, for the benefit of future clinical nursing practice.