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Sample records for chemotherapy managing side

  1. Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

    Science.gov (United States)

    ... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. Then ... and anywhere on your body may fall out. Hair loss is called alopecia. When will my hair start ...

  2. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Women

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Sexual and Fertility Changes in Women “Talk with your doctor before you start treatment. Ask how chemotherapy could affect your ability ...

  3. Side Effects of Chemotherapy

    Science.gov (United States)

    ... Men Living with Prostate Cancer Side Effects of Chemotherapy Side Effects Urinary Dysfunction Bowel Dysfunction Erectile Dysfunction ... Side Effects of Hormone Therapy Side Effects of Chemotherapy Side Effects: When to Seek Help PSA Rising ...

  4. Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

    Science.gov (United States)

    Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

    2016-01-01

    Objective: Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient’s lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. Methods: In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Results: Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. Conclusion: This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient’s effective participation in care process improved. PMID:27482134

  5. Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

    Science.gov (United States)

    Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

    2016-01-01

    Objective: Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient’s lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. Methods: In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Results: Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. Conclusion: This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient’s effective participation in care process improved.

  6. Role of nurses in the assessment and management of chemotherapy-related side effects in cancer patients

    Directory of Open Access Journals (Sweden)

    Roe H

    2014-08-01

    Full Text Available Helen Roe,1 Elaine Lennan2 1Department of Clinical Oncology, North Cumbria University Hospitals NHS Trust, Carlisle, 2Chemotherapy Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Chemotherapy services in the UK have been the subject of national policy directives for the past decade. These directives, amongst other things, include the development of nurse-led services; however, progress has been slow. This paper looks at the evidence for nurse-led services and discusses the competencies and skills required. Chemotherapy nurses have been much respected for their drug knowledge, information-giving, and communication skills, but in the past have lacked assessment skills. This paper offers a guide to assessment of chemotherapy patients, including the process of chemotherapy, key information needs, and consent, taking account of the recent 2013 National Cancer Patient Experience Survey. It discusses in detail the common side effects of treatment and their management, outlining international common toxicity criteria to guide assessment. Finally, it briefly outlines a new initiative of acute oncology services that have enhanced not only the quality of services but the safety of patients receiving chemotherapy. Keywords: chemotherapy, nurse-led care, acute oncology service, toxicity management

  7. Impact of an early education multimedia intervention in managing nutrition-related chemotherapy side effects: a pilot study

    OpenAIRE

    Thompson, Julie; Silliman, Kathryn; Clifford, Dawn E

    2013-01-01

    Background The purpose of the educational intervention was to measure changes in knowledge, perceived benefit of nutrition, and perceived self efficacy in handling side effects of chemotherapy before and after viewing a 15 minute DVD among patients with cancer. Methods A convenience sample of 14 (4 male, 10 female, 61 ± 9 years) patients with cancer, early to chemotherapy, participated in the study. Participants completed a survey with demographic, knowledge items, and perceived health belief...

  8. Side Effects (Management)

    Science.gov (United States)

    ... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

  9. Chemotherapy Effects

    Science.gov (United States)

    ... saved articles window. My Saved Articles » My ACS » Chemotherapy Side Effects Chemotherapy drugs are powerful medicines that can cause side ... on the side effects most commonly caused by chemotherapy, this is a good place to start. Managing ...

  10. Managing Chemotherapy Side Effects: Constipation

    Science.gov (United States)

    ... tortillas Fruits and vegetables ••Dried fruit, such as apricots, dates, prunes, and raisins ••Fresh fruit, such as ... liquid should I drink each day? 4. What medicines are okay for me to take? 5. What ...

  11. Nutritional intervention using nutrition care process in a malnourished patient with chemotherapy side effects.

    Science.gov (United States)

    Lee, Hye-Ok; Lee, Jung-Joo

    2015-01-01

    In this case study, the process of nutritional diagnosis and intervention conducted at a hospital on a malnourished patient who underwent treatment for a chronic illness (chemotherapy for cancer treatment) was recorded. The patient received his first round of chemotherapy for colorectal cancer, and then a second round after the cancer metastasized to the liver. The patient was malnourished and had experienced weight loss (17% loss in the most recent 3 months) due to side effects of chemotherapy including stomatitis, nausea, and vomiting. Nutritional diagnosis and intervention via the nutrition care process were implemented through two screening rounds, and the quantity of oral intake increased from 28% to 62% of the recommended daily intake. The patient required continuous monitoring and outpatient care after hospital discharge. It is speculated that if a more active patient education and dietary regimen with respect to chemotherapy side effects had been offered after the patient's first chemotherapy cycle, it might have been possible to treat ingestion problems due to stomatitis during the second cycle of chemotherapy and prevent the weight loss. Henceforth, patients receiving chemotherapy should be educated about nutrition management methods and monitored continuously to prevent malnutrition.

  12. Phytochemicals that counteract the cardiotoxic side effects of cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Anita Piasek

    2009-04-01

    Full Text Available Almost all clinically used antitumor drugs exhibit toxic side effects affecting heart function. Because of cardiotoxicity during anticancer chemotherapy, effective doses of cytostatics have to be limited, which may worsen antitumor efficacy. The cardiotoxicity induced by cytostatics of the anthracycline group in particular results, among others, from massive stimulation of ROS. It has therefore been suggested that some phytochemicals with high antioxidant potential, when administered together with antitumor agents, could decrease the toxic side effects of chemotherapy and reduce the risk of heart failure. This review summarizes findings of studies undertaken to identify edible plants or phytochemicals isolated from them displaying cardioprotective properties during chemotherapy. Such properties have been shown for such foods as grapes, garlic, tomato, spinach, and beetroot. A protective role on the heart is also displayed by melatonin (a hormone synthesized by the pineal gland, but also present in many edible plants, chalcones (precursors of all known flavonoids, some herbal dietary supplements, vitamins A, C, and E, selenium, and semisynthetic flavonoid 7-monohydroxyethylrutoside (monoHER. Although to date only a limited number of investigations have been carried out, their results suggest that dietary intervention with antioxidants found in edible plants may be a safe and effective way of alleviating the toxicity of anticancer chemotherapy and preventing heart failure.

  13. Phytochemicals that counteract the cardiotoxic side effects of cancer chemotherapy

    OpenAIRE

    Anita Piasek; Agnieszka Bartoszek; Jacek Namieśnik

    2009-01-01

    Almost all clinically used antitumor drugs exhibit toxic side effects affecting heart function. Because of cardiotoxicity during anticancer chemotherapy, effective doses of cytostatics have to be limited, which may worsen antitumor efficacy. The cardiotoxicity induced by cytostatics of the anthracycline group in particular results, among others, from massive stimulation of ROS. It has therefore been suggested that some phytochemicals with high antioxidant potential, when administered together...

  14. Managing Chemotherapy Side Effects: Appetite Changes

    Science.gov (United States)

    ... meals and snacks Sweets ••Cream soups ••Soups with lentils or beans (such as black, kidney, pinto, or ... breakfast drinks ••Milkshakes ••Fruit smoothies ••Whole milk ••Chicken ••Lentils or beans (such as black, kidney, pinto, or ...

  15. Mistletoe treatments for minimising side effects of anticancer chemotherapy

    OpenAIRE

    Busse, Reinhard; Velasco Garrido, Marcial; Lange-Lindberg, Anna-Maria

    2006-01-01

    Background: More than 200,000 persons died in 2002 in Germany as a consequence of cancer diseases. Cancer (ICD-9: 140-208, ICD-10: C00-C97) accounted for 28% of all male deaths and for 22% of all female deaths. Cancer treatment consists on surgery, radio- and chemotherapy. During chemotherapy patients may experience a wide variety of toxic effects (including life-threatening toxicity) which require treatment. The type and the intensity of chemotherapy toxicity are one of the limiting factors ...

  16. The prevalence of chemotherapy side effects of cancerous patients on oral health

    OpenAIRE

    EshghyarN; Bateby M

    2001-01-01

    Different methods can be used to treat the malignant disease; surgery, radiotherapy, chemotherapy, and even cryotherapy are different approach to reach the best treatment for patients. The aim of this cross sectional study was to evaluate the prevalence of oral side effects followed by chemotherapy of cancerous patients in Imam Khomeini hospital. This study was conducted on 80 patients who were under chemotherapy more than once and their oral lesions were evaluated considering their physical ...

  17. Mistletoe treatments for minimising side effects of anticancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Busse, Reinhard

    2006-09-01

    Full Text Available Background: More than 200,000 persons died in 2002 in Germany as a consequence of cancer diseases. Cancer (ICD-9: 140-208, ICD-10: C00-C97 accounted for 28% of all male deaths and for 22% of all female deaths. Cancer treatment consists on surgery, radio- and chemotherapy. During chemotherapy patients may experience a wide variety of toxic effects (including life-threatening toxicity which require treatment. The type and the intensity of chemotherapy toxicity are one of the limiting factors in cancer treatment. Toxic effects are also one of the factors affecting health related quality of life (HRQOL during chemotherapy. Mistletoe extracts belong to the group of so called „unconventional methods“ and are used in Germany as complementary cancer treatments. It has been postulated that the addition of mistletoe to chemotherapeutical regimes could help reduce chemotherapy-induced toxicity and enhance treatment tolerability. The German social health insurance covers the prescription of ML I standardized mistletoe extracts when those are prescribed as palliative cancer treatments with the aim of improving HRQOL. Research questions: * Does the addition of mistletoe to chemotherapeutical regimes reduce their toxicity? * Does the addition of mistletoe to chemotherapeutical regimes contribute to improve quality of life? * Has the addition of mistletoe to chemotherapeutical regimes any effects on survival? * Has the addition of mistletoe to chemotherapeutical regimes any effects on tumor-remission? Methods: We conducted a systematic literature search in following databases: The Cochrane Library, DIMDI Superbase and Dissertation Abstracts. We included systematic reviews and randomized controlled trials (RCT. Appraisal of literature was done by two authors independently. Checklists were used to guide literature appraisal. The Jadad-Score was used to score quality of RCT. Evidence was summarized in tables and in narrative form. Results and discussion: The

  18. Early and Late Side Effects Associated with Photo(chemotherapy

    Directory of Open Access Journals (Sweden)

    Günseli Öztürk

    2010-12-01

    Full Text Available Phototherapy (PUVA ve UVB is a widely used and effective treatment method for a variety of dermatological diseases. Adverse effects associated with phototherapy can be classified as acute and chronic side effects. Acute side effects are mostly related with UV doses and drug intolerance, and include itching, nausea, erythema, edema and phototoxic reactions that sometimes blister formation is seen. Acute side effects are usually moderate and transient. Chronic side effects of phototherapy are early aging of skin, pigmentary changes and increased risk of skin carcinogenesis. The major concern is development of skin cancer. This risk is especially related to long-term exposure and high cumulative doses of PUVA, increase in time and is persistent. Therefore, risk/advantage ratio of phototherapy should be carefully evaluated in each patient, and treatment protocols with minimal UV exposure should be chosen according to the phototherapy guides. Follow-up of the patients for long terms is important in prevention or in reduction of this risk by detecting and treating any premalignant or malignant lesion early. In this article, acute and chronic side effects of phototherapy are reviewed with recent literature findings.

  19. Herbal Medicines for the Treatment of Cancer Chemotherapy-Induced Side Effects

    OpenAIRE

    Shunsuke eOhnishi; Hiroshi eTakeda

    2015-01-01

    Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents o...

  20. Herbal medicines for the treatment of cancer chemotherapy-induced side effects

    OpenAIRE

    Ohnishi, Shunsuke; TAKEDA, HIROSHI

    2015-01-01

    Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents o...

  1. Management of chemotherapy-induced nausea and vomiting.

    LENUS (Irish Health Repository)

    Zubairi, Ishtiaq H

    2006-08-01

    Chemotherapy-induced nausea and vomiting are symptoms that cause major concern to oncology patients. This article explores the types of nausea and vomiting in the context of chemotherapy, and discusses their pathogenesis and management.

  2. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    OpenAIRE

    Sharmila Gurung; Radha Acharya Pandey

    2016-01-01

    jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial) side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sec...

  3. Uncaria tomentosa for Reducing Side Effects Caused by Chemotherapy in CRC Patients: Clinical Trial

    Directory of Open Access Journals (Sweden)

    I. L. G. Farias

    2012-01-01

    Full Text Available To evaluate the effectiveness of Uncaria tomentosa in minimizing the side effects of chemotherapy and improving the antioxidant status of colorectal cancer (CRC patients, a randomized clinical trial was conducted. Patients (43 undergoing adjuvant/palliative chemotherapy with 5-Fluorouracil/leucovorin + oxaliplatin (FOLFOX4 were split into two groups: the UT group received chemotherapy plus 300 mg of Uncaria tomentosa daily and the C group received only FOLFOX4 and served as a control. Blood samples were collected before each of the 6 cycles of chemotherapy, and hemograms, oxidative stress, enzymes antioxidants, immunologic parameters, and adverse events were analyzed. The use of 300 mg of Uncaria tomentosa daily during 6 cycles of FOLFOX4 did not change the analyzed parameters, and no toxic effects were observed.

  4. Uncaria tomentosa for Reducing Side Effects Caused by Chemotherapy in CRC Patients: Clinical Trial.

    Science.gov (United States)

    Farias, I L G; Araújo, M C S; Farias, J G; Rossato, L V; Elsenbach, L I; Dalmora, S L; Flores, N M P; Durigon, M; Cruz, I B M; Morsch, V M; Schetinger, M R C

    2012-01-01

    To evaluate the effectiveness of Uncaria tomentosa in minimizing the side effects of chemotherapy and improving the antioxidant status of colorectal cancer (CRC) patients, a randomized clinical trial was conducted. Patients (43) undergoing adjuvant/palliative chemotherapy with 5-Fluorouracil/leucovorin + oxaliplatin (FOLFOX4) were split into two groups: the UT group received chemotherapy plus 300 mg of Uncaria tomentosa daily and the C group received only FOLFOX4 and served as a control. Blood samples were collected before each of the 6 cycles of chemotherapy, and hemograms, oxidative stress, enzymes antioxidants, immunologic parameters, and adverse events were analyzed. The use of 300 mg of Uncaria tomentosa daily during 6 cycles of FOLFOX4 did not change the analyzed parameters, and no toxic effects were observed.

  5. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    Directory of Open Access Journals (Sweden)

    Sharmila Gurung

    2016-01-01

    Full Text Available jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sectional study was conducted among 200 cancer patients, using purposive sampling technique and data was collected via face to face interview. Descriptive as well as inferential statistics (T-test was used to see the significant difference between dependent and independent variables.Results: The overall perceived side effects of chemotherapy include: affects work and home duties (non physical side effect, followed by anxiety, loss of appetite, affects family, affect partner, feel constantly tired (fatigue, affects social activities, feel irritable, nausea and constipation respectively. There is significant difference between perception of side effects of chemotherapy and gender of respondents.Conclusion: The perceptions of side effects of chemotherapy are different from individual to individual. Patient’s perception of side effects of chemotherapy is concerned with non physical side effects rather than physical side effects.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 14-19

  6. Biomaterial-based regional chemotherapy: Local anticancer drug delivery to enhance chemotherapy and minimize its side-effects.

    Science.gov (United States)

    Krukiewicz, Katarzyna; Zak, Jerzy K

    2016-05-01

    Since the majority of anticancer pharmacological agents affect not only cancer tissue but also normal cells, chemotherapy is usually accompanied with severe side effects. Regional chemotherapy, as the alternative version of conventional treatment, leads to the enhancement of the therapeutic efficiency of anticancer drugs and, simultaneously, reduction of toxic effects to healthy tissues. This paper provides an insight into different approaches of local delivery of chemotherapeutics, such as the injection of anticancer agents directly into tumor tissue, the use of injectable in situ forming drug carriers or injectable platforms in a form of implants. The wide range of biomaterials used as reservoirs of anticancer drugs is described, i.e. poly(ethylene glycol) and its copolymers, polyurethanes, poly(lactic acid) and its copolymers, poly(ɛ-caprolactone), polyanhydrides, chitosan, cellulose, cyclodextrins, silk, conducting polymers, modified titanium surfaces, calcium phosphate based biomaterials, silicone and silica implants, as well as carbon nanotubes and graphene. To emphasize the applicability of regional chemotherapy in cancer treatment, the commercially available products approved by the relevant health agencies are presented. PMID:26952500

  7. The prevalence of chemotherapy side effects of cancerous patients on oral health

    Directory of Open Access Journals (Sweden)

    EshghyarN

    2001-09-01

    Full Text Available Different methods can be used to treat the malignant disease; surgery, radiotherapy, chemotherapy, and even cryotherapy are different approach to reach the best treatment for patients. The aim of this cross sectional study was to evaluate the prevalence of oral side effects followed by chemotherapy of cancerous patients in Imam Khomeini hospital. This study was conducted on 80 patients who were under chemotherapy more than once and their oral lesions were evaluated considering their physical conditions. Mucositis was the common problem (66.2% and the most involvement area was observed in tongue (55%. High percentage of this lesion in adult and senile might be due to deficiency in their immune system.

  8. Dietetic management in gastrointestinal complications from antimalignant chemotherapy.

    Science.gov (United States)

    Calixto-Lima, L; Martins de Andrade, E; Gomes, A P; Geller, M; Siqueira-Batista, R

    2012-01-01

    Antineoplastic chemotherapy (CT) represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading to compromised nutritional status and which may lead to cachexia. The main toxic effects of chemotherapy in the gastrointestinal tract include nausea, vomiting -these are the most frequent- constipation, diarrhea, xerostomia, mucositis, dysphagia and anorexia. Given the high frequency of such effects, nutritional intervention should be an integral part of cancer treatment, to maintain and/or improve the patient's nutritional status and reduce or minimize the side effects caused by treatment. Accordingly, the goal of this study is to review dietetic conduct in the process of caring for patients undergoing cancer chemotherapy.

  9. Communication technologies for demand side management

    Energy Technology Data Exchange (ETDEWEB)

    Uuspaeae, P. [VTT Energy, Espoo (Finland)

    1998-08-01

    The scope of this research is data communications for electric utilities, specifically for the purposes of Demand Side Management (DSM). Demand Side Management has the objective to change the customer`s end use of energy in a manner that benefits both the customer and the utility. For example, peak demand may be reduced, and the peak demand may be relocated to off peak periods. Thus additional investments in generation and network may be avoided. A number of Demand Side Management functions can be implemented if a communication system is available between the Electric Utility and the Customer. The total communication capacity that is needed, will depend on several factors, such as the functions that are chosen for DSM, and on the number and type of customers. Some functions may be handled with one-way communications, while some other functions need to have two-way communication

  10. The Role of Evidence Based Nursing in Prevention of Gastrointestinal Side Effects of Chemotherapy in Children with Cancer

    Directory of Open Access Journals (Sweden)

    Z Pouresmail

    2014-04-01

    Full Text Available Introduction: Today, due to the broad spectrum of pediatric cancers are treated by the chemotherapy drugs, but these drugs have side effects and gastrointestinal toxicity is the most prevalent. One of the main roles of nurses is to better health through patient education and care for him. Evidence-based nursing is a process during which the nurse can use the available research evidence, their clinical expertise and the patient has to take appropriate decisions. This study reviews the role of evidence-based nursing in the prevention of gastrointestinal side effects of chemotherapy in children with cancer was conducted.   Materials and Methods: Seeking information was performing through databases PubMed, SID, Since Direct, magiran, Ovid and etc. Within the years 2014-2002, the key issues in terms of evidence-based nursing, gastrointestinal side effect, chemotherapy was performed and 20 were studied English equivalents.   Results: The most common gastrointestinal side effects in children undergoing chemotherapy are oral ulcers, vomiting, diarrhea, and dysphagia. Different strategies for prevention studies suggest that these effects need to perform their roles in teaching and nursing care. Nurses can use the results of studies such as music, ginger, semi sitting positions during chemotherapy, use of ice and etc. To prevent vomiting, the use of  Persica for oral wound healing, hygiene perform especially hand washing for preventing diarrhea. The most important roles of nursing are recommended, Education on prevention of chemotherapy complications, adverse effects of proper nutrition and etc.   Conclusion: Nurses can play an effective role in the education and care to relieve symptoms and prevent progression of gastrointestinal side effects of chemotherapy.   Key words: Evidence-based nursing, Gastrointestinal side effects, Chemotherapy, Cancer  

  11. Clinical study of Shenqi Fuzheng injection decreasing side-effects of chemotherapy for patients with ovarian epithelial cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Zhang; Jing Wan; Yuebo Yang; Xiaomao Li

    2013-01-01

    Objective:The aim of the study was to observe the clinical ef ects of Shenqi Fuzheng injection decreasing side-ef ects of chemotherapy for patients with ovarian epithelial cancer. Methods:The 36 cases of ovarian epithelial cancer in The Third Af iliated Hospital of SUN Yat-sen University (Guangzhou, China) from June 2010 to June 2013, were randomly divided into the study group and the control group. The study group contained 18 cases using Shenqi Fuzheng injection combined with TP (Taxol+Carboplatin/cisplatin) chemotherapy, and the control group contained 18 cases only using TP chemotherapy without Shenqi Fuzheng injection. During and after chemotherapy, the side-ef ects and therapy ef ects were observed. Re-sults:The grade II of nausea and vomit were less in the study group than that in the control group, which was significantly dif-ferent (P0.05). There was less degree of decrease of lymphocyte in the study group than that in the control group, which was significantly dif erent (P0.05). There was no significant dif erence in chemotherapy ef ect between the two groups (P>0.05). Conclusion:Shenqi Fuzheng injection can in some degree relieve the side ef ects of TP chemotherapy for the patients with ovarian epithelial cancer, including relieving nausea and vomiting, protecting lymphocytes, and has no conflict ef ect on chemotherapy ef icacy.

  12. [Prevention and management of appetite loss during cancer chemotherapy].

    Science.gov (United States)

    Tsujimura, Hideki; Yamada, Mitsugi; Asako, Eri; Kodama, Yukako; Sato, Tsuneo; Nabeya, Yoshihiro

    2014-10-01

    Appetite loss during cancer chemotherapy may lead to malnutrition and a decreased quality of life. To overcome this problem, evidence-based guidelines have been established for chemotherapy-induced emesis and mucositis. However, unsolved issues such as taste alimentation remain. Since the clinical picture of appetite loss is complex, individual management strategies depending on the type of the disease and treatment are required. PMID:25335699

  13. Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy

    OpenAIRE

    Vardy, J.; Chiew, K S; Galica, J; Pond, G R; Tannock, I F

    2006-01-01

    The role of dexamethasone to reduce delayed emesis following highly emetogenic chemotherapy is proven, but there is less evidence of benefit after mild–moderately emetogenic regimens. Here, we develop and evaluate a Dexamethasone Symptom Questionnaire (DSQ) to assess the side effects of dexamethasone in the week after patients receive moderately emetogenic chemotherapy. The DSQ was first optimised with the aid of a focus group. Sixty patients receiving oral dexamethasone for prophylaxis of de...

  14. Palonosetron in the management of chemotherapy-induced nausea and vomiting in patients receiving multiple-day chemotherapy

    International Nuclear Information System (INIS)

    Prevention of chemotherapy-induced nausea and vomiting (CINV) is a key component of treatment for patients with cancer. Guidelines are available to assist prescribers in the management of CINV associated with single-day chemotherapy regimens. However, currently there are no clear guidelines for management of CINV in patients receiving multiple-day chemotherapy regimens. Serotonin (5-HT3) receptor antagonists are a mainstay in preventing CINV, and palonosetron, given its longer half-life and duration of action relative to other 5-HT3 receptor antagonists, may be a useful option for managing CINV in multiple-day chemotherapy. Here we provide an overview of CINV and CINV treatment options, with a focus on palonosetron. We describe existing challenges in managing CINV, and discuss two patients receiving multiple-day chemotherapy, in whom CINV was managed successfully with palonosetron

  15. Demand Side Management in non-residential buildings; Demand Side Management in Nichtwohngebaeuden

    Energy Technology Data Exchange (ETDEWEB)

    Jungwirth, Johannes [Technische Univ. Muenchen (DE). Lehrstuhl fuer Energiewirtschaft und Anwendungstechnik (IfE)

    2011-07-01

    Due to the fluctuating supply characteristics and a paradigm shift, the strong expansion of renewable energy generators expect the structure of the concept of energy supply. An integration of renewables into the electricity grid requires new ways to compensate the discrepancy between production and consumption. The implementation of a demand-side management requires an electrical load and the possibility to control consumers in response to an external signal. From this perspective, the author of the contribution under consideration reports on innovative systems for the realization of a demand-side management in non-residential buildings.

  16. Chemotherapy

    Science.gov (United States)

    ... whose cancer is being treated with chemotherapy, your doctors, nurses, and other members of the cancer treatment team ... takes to follow their dreams. Talk with your doctors, nurses, family, and friends if you have any questions ...

  17. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Mohammed Osman

    2014-09-01

    Full Text Available Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT, but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm to IIIB (tumor extending to the pelvic wall and/or hydronephrosis. Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ≤2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated

  18. Industrial demand side management: A status report

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, M.F.; Conger, R.L.; Foley, T.J. [and others

    1995-05-01

    This report provides an overview of and rationale for industrial demand side management (DSM) programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential energy savings in kilowatt hours. The report presents types and examples of programs and explores elements of successful programs. Two in-depth case studies (from Boise Cascade and Eli Lilly and Company) illustrate two types of effective DSM programs. Interviews with staff from state public utility commissions indicate the current thinking about the status and future of industrial DSM programs. A comprehensive bibliography is included, technical assistance programs are listed and described, and a methodology for evaluating potential or actual savings from projects is delineated.

  19. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Men

    Science.gov (United States)

    ... I told him I would like to have children one day. I’m glad I learned about my choices before treatment started.” Ask what changes you may ... have children? If you would like to have children after treatment, talk ... you about your choices and refer you to a fertility specialist. Questions ...

  20. Managing Chemotherapy Side Effects: Fatigue (Feeling Weak and Very Tired)

    Science.gov (United States)

    ... Make a bedtime routine. Bathing or listening to music before you go to sleep may help you ... Revised February 2012 How can we help? National Cancer Institute’s Cancer Information Service Phone: 1-800-422- ...

  1. Incentives for demand-side management

    Energy Technology Data Exchange (ETDEWEB)

    Reid, M.W.; Brown, J.B. [Barakat and Chamberlin, Inc., Oakland, CA (United States)

    1992-01-01

    This report is the first product of an ongoing project to monitor the efforts of states to remove regulatory barriers to, and provide financial incentives for, utility investment in demand-side management (DSM) resources. The project was commissioned by the National Association of Regulatory Utility Commissioners (NARUC) in response to growing interest among regulators for a comprehensive survey of developments in this area. Each state report beings with an overview of the state`s progress toward removing regulatory barriers and providing incentives for DSM. Information is organized under five headings: status; IRP regulations and practice; current treatment of DSM, directions and trends; commission contact person. Where applicable, each overview is followed by one or more sections that report on specific incentive proposals or mechanisms within the state. Information on each proposal or mechanism is organized under eight headings. A notation on each page identifies the utility or other group associated with the proposal or mechanism. The eight headings are as follows: status; background; treatment of cost recovery; treatment of lost revenues/decoupling; treatment of profitability; other features; issues, and additional observations.

  2. Incentives for demand-side management

    Energy Technology Data Exchange (ETDEWEB)

    Reid, M.W.; Brown, J.B. (Barakat and Chamberlin, Inc., Oakland, CA (United States))

    1992-01-01

    This report is the first product of an ongoing project to monitor the efforts of states to remove regulatory barriers to, and provide financial incentives for, utility investment in demand-side management (DSM) resources. The project was commissioned by the National Association of Regulatory Utility Commissioners (NARUC) in response to growing interest among regulators for a comprehensive survey of developments in this area. Each state report beings with an overview of the state's progress toward removing regulatory barriers and providing incentives for DSM. Information is organized under five headings: status; IRP regulations and practice; current treatment of DSM, directions and trends; commission contact person. Where applicable, each overview is followed by one or more sections that report on specific incentive proposals or mechanisms within the state. Information on each proposal or mechanism is organized under eight headings. A notation on each page identifies the utility or other group associated with the proposal or mechanism. The eight headings are as follows: status; background; treatment of cost recovery; treatment of lost revenues/decoupling; treatment of profitability; other features; issues, and additional observations.

  3. The Role of Evidence Based Nursing in Prevention of Gastrointestinal Side Effects of Chemotherapy in Children with Cancer

    OpenAIRE

    Z Pouresmail; S Sharafi; Razi, M.

    2014-01-01

    Introduction: Today, due to the broad spectrum of pediatric cancers are treated by the chemotherapy drugs, but these drugs have side effects and gastrointestinal toxicity is the most prevalent. One of the main roles of nurses is to better health through patient education and care for him. Evidence-based nursing is a process during which the nurse can use the available research evidence, their clinical expertise and the patient has to take appropriate decisions. This study reviews the role of ...

  4. 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

    The aim of this study was to evaluate the effects of a 6-week intervention with structured physical activity, relaxation, body-awareness techniques and massage on the symptoms/side-effects of cancer patients undergoing chemotherapy. The study was prospective and exploratory, and 54 patients...... completed assessments for all 6 weeks of the intervention. In order to obtain a continuous record of side-effects, a diary was developed for the patients' use throughout the intervention. The patients scored their symptoms/side-effects on a scale from 0 to 4, using the Common Toxicity Criteria and reported...... 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...

  5. Radiation Therapy: Preventing and Managing Side Effects

    Science.gov (United States)

    ... yourself during radiation therapy Radiation therapy can damage healthy body tissues in or near the area being treated, which can cause side effects. Many people worry about this part of their cancer treatment. Before ...

  6. Metallic taste in cancer patients treated with chemotherapy

    NARCIS (Netherlands)

    Ijpma, I.; Renken, R. J.; ter Horst, G. J.; Reyners, A. K. L.

    2015-01-01

    Background: Metallic taste is a taste alteration frequently reported by cancer patients treated with chemotherapy. Attention to this side effect of chemotherapy is limited. This review addresses the definition, assessment methods, prevalence, duration, etiology, and management strategies of metallic

  7. Demand-side management process evaluations - the management perspective

    International Nuclear Information System (INIS)

    A demand-side management (DSM) process evaluation is a qualitative, expert assessment of how a utility marketing program is being conducted. It reviews the efficiency and effectiveness in which a utility plans, manages, executes, and monitors the delivery of DSM programs to its marketplace. Process evaluations,which includes load impact, customer satisfaction and cost-effectiveness analysis, are becoming an increasingly significant component. The process evaluation focus is on the program planning and delivery process as opposed to the energy impacts resulting from the specific measures or products of the program. Because of this process-oriented focus, such evaluations can identify important opportunities for improving the cost-effectiveness of a program without significantly changing product lines. The evaluation may identify administrative or delivery process improvements. In addition, the evaluation may identify ways of improving the degree to which the customer is satisfied with the program or the utility. Since process evaluations are usually conducted as part of a utility's mandated DSM measurement and evaluation plan, they tend to focus mainly on the stated needs of the regulator as opposed to company management. This can be a problem. Although the regulatory perspective is important, in an increasingly competitive business environment, utilities must not overlook management's business and operational needs for specific information regarding DSM program planning, control, execution, and evaluation. This paper discusses some of the conflicts that exist between the regulator's and management's needs for DSM program evaluation results and presents some approaches for assuring that both needs are met. It is organized to first discuss the scope of a process evaluation, then the evaluation issues, the management concerns, and finally reporting of results

  8. Intraperitoneal chemotherapy in the management of ovarian cancer: focus on carboplatin

    Directory of Open Access Journals (Sweden)

    Maurie Markman

    2009-02-01

    Full Text Available Maurie MarkmanUniversity of Texas MD Anderson Cancer Center, Houston, Texas, USAAbstract: Both pre-clinical studies and phase 1–2 clinical trials have provided strong support for the potential role of regional drug delivery in the management of epithelial ovarian cancer, a disease process whose major manifestations remain largely localized to the peritoneal cavity in the majority of individuals with this malignancy. The results of 3 phase 3 randomized trials have revealed the favorable impact of primary cisplatin-based intraperitoneal chemotherapy in women who initiate drug treatment with small-volume residual ovarian cancer following an attempt at optimal surgical cytoreduction. Concerns have been raised regarding the toxicity of regional treatment, particularly the side-effect profile associated with cisplatin. One rational approach to improving the tolerability of intraperitoneal chemotherapy is to substitute carboplatin for cisplatin. This review discusses the rationale for and data supporting regional treatment of epithelial ovarian cancer, and highlights the potential role for intraperitoneal carboplatin in this clinical setting.Keywords: ovarian cancer, intraperitoneal chemotherapy, cisplatin, carboplatin

  9. Protective effect of Yashtimadhu (Glycyrrhiza glabra) against side effects of radiation/chemotherapy in head and neck malignancies.

    Science.gov (United States)

    Das, Debabrata; Agarwal, S K; Chandola, H M

    2011-04-01

    One of the very common side effects of Radiation/Chemotherapy especially of the head and neck malignancies is mucositis. Cancer therapy or the cancer itself may cause changes in the body chemistry that results in loss of appetite, pain, nausea, vomiting, diarrhea and very common mucositis which makes eating difficult. Loss of appetite is followed by an undesirable loss of weight due to insufficient amount of calories every day which can lead to loss of muscle mass and strength and other complications by causing interruptions of medical therapy, impeding effective cancer therapy. Mucositis cause decreased immunity and quality of life as well as poor tolerance to surgery and altered efficacy of Chemotherapy and Radiotherapy. The present study is designed with the objective to minimize the radiation induced mucositis, skin reaction, xerostomia, change in voice etc. with an Ayurvedic preparation Yashtimadhu Ghrita (processed ghee). Total 75 patients were randomly divided into four groups and drugs were administered: Group A with local application of Yashtimadhu powder and honey in the oral cavity for few minutes prior to radiotherapy along with oral intake of Yashtimadhu Ghrita; Group B with only local application of the Yashtimadhu powder and honey in the oral cavity; Group C patients administered with only local application of honey in the oral cavity; Group D on conventional modern medication controlled group. All these patients under four groups had received Radiotherapy and Chemotherapy for maximum duration of 7 weeks. Mucositis and Skin reactions were observed in 100% of patients with varying degree. The intensity of Radiation and Chemotherapy induced mucositis was reduced to a great extent by the trial drug. Yashtimadhu (Glycyrrhiza glabra) can be used effectively in prevention and treatment of oral mucositis post radiation and chemotheraphy in patients of cancer, especially of the head and neck region. It proves beneficial in two ways: (i) there were no

  10. U.S. electric utility demand-side management 1993

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    This report presents comprehensive information on electric power industry demand-side management activities in the United States at the national, regional, and utility levels. Data is included for energy savings, peakload reductions, and costs.

  11. Demand-side management for energy in the region

    OpenAIRE

    Lazar Davidovich Gitelman; Boris Evgenyevich Ratnikov; Mikhail Viktorovich Kozhevnikov

    2013-01-01

    The article deals with a promising approach to solving the problem of investment in the regional electric power industry — the application of demand-side management, the essence of which lies in proactive interaction of energy companies with customers, based on the balance of economic interests. The features of the concept and its tools are revealed, positive results of its implementation for energy market players and the region are shown, and examples of demand-side management pr...

  12. Managing Change: the people side of implementing CRM processes

    OpenAIRE

    Hann, David

    2006-01-01

    This report has been produced with the remit of analysing the people side of change management with regard to a Customer Relationship Management (CRM) process implementation at Jupiter Design (Jupiter). An increasing churn of clients and 12- years of growth has made Jupiter realise they must maximise revenues from existing clients. The adoption of a CRM approach has been suggested as a possible solution.

  13. Management of metastatic apocrine hidradenocarcinoma with chemotherapy and radiation

    Directory of Open Access Journals (Sweden)

    Daniel H. Miller

    2015-10-01

    Full Text Available Hidradenocarcinoma is a rare aggressive form of cutaneous adnexal skin carcinoma originating from the sweat gland. Due to its low incidence, prognostic and treatment strategies are still being explored both for primary and advanced disease. This tumor most often presents as either solid or cystic appearing subcutaneous nodules, which may be associated with pruritus or ulceration. To date the mainstay of treatment for local disease has been surgical excision; however, the paucity of historical data available has shown that these tumors often behave aggressively with high rates of local recurrence, metastasis, and poor overall outcomes. There are few case reports describing the utility of radiation therapy in the treatment of hidradenocarcinoma. Herein, we present a case of metastatic apocrine hidradenocarcinoma in a 32-year-old Caucasian male. The patient initially underwent excisional biopsy which confirmed the diagnosis of poorly differentiated, highly infiltrative, apocrine hidradenocarcinoma. He received systemic chemotherapy for metastatic disease, followed by radiation therapy to areas of grossly palpable adenopathy. Prior to radiation therapy the patient had an enlarged hypermetabolic conglomerate of lymph nodes in the right axilla, and borderline enlarged low activity nodes within the left axilla. He received 3 cycles of chemotherapy followed by tamoxifen and radiation therapy (50.4 Gy in 28 fractions to areas of progressive disease in the bilateral axilla, lower neck, and axillary skin. Following treatment, the patient had complete resolution of skin nodules and improvement of his pruritus. While the role of radiation therapy in the treatment of hidradenocarcinoma has not been well established, this case report demonstrated the potential benefit of external beam radiotherapy in the management of this rare disease

  14. Management of pregnancy associated breast cancer with chemotherapy in a developing country

    OpenAIRE

    Emmanuel A. Sule; Festus Ewemade

    2015-01-01

    Context: Although breast cancer is a common cancer, Pregnancy associated breast cancer is uncommon. Adjuvant chemotherapy administered intrapartum has been resolved to be safe from the second trimester. Objective: To review cases of pregnancy associated breast cancer managed with adjuvant intrapartum chemotherapy. Patients and method: Gravid patients diagnosed with breast cancer had chemotherapy administered by a slow infusion protocol at 3 weekly interval from the second trimester till...

  15. [Prevention of neuro- and cardiotoxic side effects of tuberculosis chemotherapy with noopept].

    Science.gov (United States)

    Mordyk, A V; Lysov, A V; Kondria, A V; Gol'dzon, M A; Khlebova, N V

    2009-01-01

    The study evaluated clinical efficiency of noopept used to prevent adverse side effects of antituberculous agents. It included 60 patients with newly diagnosed respiratory tuberculosis. Those in group 1 (n = 30) received 10 mg of noopept twice daily during the first month. The treatment promoted functional normalization of vegetative nervous system and antioxidative systems, reduced manifestations of anxiety, decreased frequency of adverse neuro- and cardiotoxic responses to antituberculous drugs. PMID:19565831

  16. U.S. electric utility demand-side management 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-01-01

    The US Electric Utility Demand-Side Management report is prepared by the Coal and Electric Data and Renewables Division; Office of Coal, Nuclear, Electric and Alternative Fuels; Energy Information Administration (EIA); US Department of Energy. The report presents comprehensive information on electric power industry demand-side management (DSM) activities in the US at the national, regional, and utility levels. The objective of the publication is to provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it relates to the US electric power industry. The first chapter, ``Profile: US Electric Utility Demand-Side Management``, presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions and costs attributable to DSM. 9 figs., 24 tabs.

  17. U.S. electric utility demand-side management 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    The US Electric Utility Demand-Side Management report presents comprehensive information on electric power industry demand-side management (DSM) activities in the US at the national, regional, and utility levels. The objective of the publication is to provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it related to the US electric power industry. The first chapter, ``Profile: U.S. Electric Utility Demand-Side Management,`` presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions and costs attributable to DSM. 9 figs., 24 tabs.

  18. Fosaprepitant dimeglumine for the management of chemotherapy-induced nausea and vomiting: patient selection and perspectives

    OpenAIRE

    Candelario, Nellowe

    2016-01-01

    Nellowe Candelario, Marvin Louis Roy Lu Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA Abstract: Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of antineoplastic agents. Several treatment regimens are used to address this problem. Fosaprepitant is a neurokinin-1 receptor blocker used in the prevention and treatment of CINV, especially for moderately and severely emetogenic chemotherapy. It is highly effective in the treatment of ...

  19. US electric utility demand-side management, 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-26

    The report presents comprehensive information on electric power industry demand-side management (DSM) activities in US at the national, regional, and utility levels. Objective is provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it relates to the US electric power industry. The first chapter, ``Profile: US Electric Utility Demand-Side Management,`` presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions, and costs attributable to DSM.

  20. Integrated resource strategic planning and power demand-side management

    CERN Document Server

    Hu, Zhaoguang; Wen, Quan

    2013-01-01

    Integrated Resource Strategic Planning and Power Demand-Side Management elaborates two important methods - Integrated Resource Strategic Planning (IRSP) and Demand Side Management (DSM) - in terms of methodology modeling, case studies and lessons learned. This book introduces a prospective and realistic theory of the IRSP method and includes typical best practices of DSM for energy conservation and emission reduction in different countries. It can help energy providers and governmental decision-makers formulate policies and make plans for energy conservation and emission reduction, and can hel

  1. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT COST-SHARED DEMONSTRATIONS

    Science.gov (United States)

    The paper discusses an investigation of how photovoltaics (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utilit...

  2. U.S. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT PROJECT

    Science.gov (United States)

    The paper discusses an investigation of how photovoltaic (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utiliti...

  3. Demand-side management programs and electric competition in USA

    International Nuclear Information System (INIS)

    As state regulators, and perhaps the federal government, move to implement competition among generators for retail sales, demand-side management programs as designed will become unsustainable. But while retail competition threatens them, it may eliminate the value to perpetuating those programs as well

  4. Chemotherapy for Testicular Cancer

    Science.gov (United States)

    ... chemotherapy and stem cell transplant for testicular cancer Chemotherapy for testicular cancer Chemotherapy (chemo) is the use ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  5. 发电侧如何促进需求侧管理%How to Improve Demand Side Management in Generation Side

    Institute of Scientific and Technical Information of China (English)

    劳德容

    2002-01-01

    Combining with the practice of DSM in China, the paper analyzes the role of engaging demand side management in generation side. Also it deeply studies how to promote demand side management in generation side, which rarelyinvolves in the published literature all over the world. Besides, it discovers the interactions of interdependence and competition between demand side managenent and generation side operation. Lastly it studies the example of demand side management in generation side in Shenzhen.

  6. Chemotherapy of onchocerciasis with high doses of diethylcarbamazine or a single dose of ivermectin: microfilaria levels and side effects.

    Science.gov (United States)

    Albiez, E J; Newland, H S; White, A T; Kaiser, A; Greene, B M; Taylor, H R; Büttner, D W

    1988-03-01

    Fifty adult male subjects with moderate to heavy onchocerciasis from the Liberian rain forest were selected for a double-blind placebo-controlled chemotherapy study. The effects of high doses of diethylcarbamazine (DEC) - 30 mg/kg/d - over one week preceded by a one week initial treatment with normal oral doses of DEC or DEC lotion were compared with a single dose of ivermectin (150 micrograms/kg) and placebo. During the initial treatment DEC tablets or lotion caused distinctly more frequent and severe reactions than did invermectin. The reactions to ivermectin did not differ from those of the placebo patients. High doses of DEC caused, in about half of the patients, headache, dizziness, nausea or vomiting. DEC markedly increased the number of corneal microfilariae and of corneal opacities compared to ivermectin. All changes resolved with a return to pretreatment findings two months after treatment. The three treatment groups showed no differences at the ten months follow-up. In all treated patients skin microfilaria counts fell almost to zero by the end of the two week therapy. In the ivermectin group microfilaria counts remained significantly lower than in the DEC patients at the two and ten months examinations. In summary, ivermectin was much better tolerated than DEC and had a longer lasting effect on the microfilariae in the skin. Since high doses of DEC were less effective and caused more frequent and severe side effects, this approach cannot be recommended for treatment of onchocerciasis.

  7. Demand-Side Management Programs Under Retail Electricity Competition

    OpenAIRE

    Brennan, Timothy

    1998-01-01

    Demand-side management programs comprise subsidies from franchised electric utilities for the purchase of high-efficiency appliances, e.g., air conditioners. Competition in power generation threatens the viability of these programs. However, it should also reduce the warrant for them. Under regulation, the justification for such programs depends, somewhat paradoxically, on below marginal-cost pricing. Eliminating regulation should permit pricing flexibility to discourage excessive on-peak ene...

  8. Demand Side Management in Pellet Production: Internal and External Factors

    Directory of Open Access Journals (Sweden)

    Vigants Haralds

    2014-12-01

    Full Text Available This paper demonstrates a demand side management case study: how to save energy and how research and data analysis help to create an energy management system in a pellet production facility; and shows ways to implement the EU energy efficiency directive in production facilities. The study carried out in this research serves as a far-reaching step that can be taken to improve energy efficiency during the operation mode of technological equipment. The benchmarking methodology is used for analysis of results.

  9. Beta-blocker therapy: identification and management of side effects.

    Science.gov (United States)

    Dennis, K E; Froman, D; Morrison, A S; Holmes, K D; Howes, D G

    1991-09-01

    The purpose of this study was to develop and test a new beta-Blocker Visual Analog Scale designed to identify and quantify the impact that the side effects of beta-blocker therapy have on people's lives, and the self-management practices people use to mediate their influence. Instruments included the 20-item beta-Blocker Visual Analog Scale and the Profile of Mood States. Subjects had hypertension; 51 men were involved in a larger study involving antihypertensive medications and exercise, and 19 men and women were receiving beta-blocker therapy as first-line drug of choice. Estimates of internal consistency reliability, content validity, and concurrent and discriminant validity were moderately strong. The most problematic side effects were related to lack of sleep, vivid or active dreams, lack of energy and pep, diminished interest in sexual activity, and changes in vision. Among self-management practices used to mediate side effects were planning rest and activity periods, thinking carefully before reacting, and seeking out others for support. PMID:1680114

  10. Evidence-based management of chemotherapy-induced nausea and vomiting: a position statement from a European cancer nursing forum

    Science.gov (United States)

    Vidall, C; Dielenseger, P; Farrell, C; Lennan, E; Muxagata, P; Fernández-Ortega, P; Paradies, K

    2011-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a common, but now often overlooked side effect of cancer treatment, and one that can be largely prevented through the implementation of international evidence-based guidelines. The European CINV Forum, comprising nurses from France, Germany, Portugal, Spain and the UK, discussed the use of CINV preventive strategies in routine practice, and the factors that affect optimal delivery of antiemetic therapies. Based on these discussions, they developed a series of recommendations for optimal, evidence-based management of CINV. These state that all patients receiving chemotherapy should undergo full assessment of their risk of CINV and receive appropriate prophylactic treatment based on guidelines from the Multinational Association of Supportive Care in Cancer (MASCC) and the National Comprehensive Cancer Network (NCCN), which were both updated in 2011. Other recommendations, aimed at raising awareness of CINV and its management, include timely updates of relevant local practice guidelines and protocols, translation of the MASCC and NCCN guidelines into all European languages and their dissemination through accessible articles in nursing journals and newsletters and via nursing conferences and study days, improved training for nurses on CINV, collaboration between the European Oncology Nursing Society and national nursing organisations to promote consistent practice, the development of a CINV toolkit, information provision for patients, local audits of CINV management, and a survey of CINV management between and within European countries. PMID:22276054

  11. Managing a live music performance: A supply-side analysis

    OpenAIRE

    Bianca Manners; Melville Saayman; Martinette Kruger

    2015-01-01

    Purpose and objective: The purpose of this research is to determine what managers regard as important critical success factors in ensuring a memorable visitor experience at a live music performance.Problem investigated: When organising a live music performance, it is evident that the various characteristics that form part of the visitor experience have to be considered. The critical success factors of live music performances from the supply side are fundamental, since the costs of organising ...

  12. Neutropenia: occurrence and management in women with breast cancer receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Talita Garcia do Nascimento

    2014-04-01

    Full Text Available OBJECTIVES: to identify the prevalence, and describe the management of, neutropenia throughout the chemotherapy treatment among women with breast cancer.METHODS: observational study, cycles of chemotherapy. 116 neutropenic events were recorded, and 63.3% of the patients presented neutropenia at some point of their treatment, 46.5% of these presenting grade II. The management used was temporary suspension between the cycles and the mean number of delays was 6 days. The study was prospective and longitudinal, where the evaluation of the hematological toxicities was undertaken at each cycle of chemotherapy, whether neoadjuvant or adjuvant.RESULTS: 79 women were included, who received 572 cycles. However, the reasons for the suspensions were the lack of a space in the chemotherapy center, followed by neutropenia.CONCLUSION: neutropenia is one of the most common and serious adverse events observed during the chemotherapy. Nursing must invest in research regarding this adverse event and in management strategies for organizing the public health system, so as to offer quality care.

  13. Management of Inflammatory Breast Cancer After Neoadjuvant Chemotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the benefit of breast surgery for inflammatory breast cancer (IBC). Methods and Materials: This retrospective series was based on 232 patients treated for IBC. All patients received primary chemotherapy followed by either exclusive radiotherapy (118 patients; 51%) or surgery with or without radiotherapy (114 patients; 49%). The median follow-up was 11 years. Results: The two groups were comparable apart from fewer tumors <70 mm (43% vs. 33%, p = 0.003), a higher rate of clinical stage N2 (15% vs. 5%, p = 0.04), and fewer histopathologic Grade 3 tumors (46% vs. 61%, p <0.05) in the no-surgery group. The addition of surgery was associated with a significant improvement in locoregional disease control (p = 0.04) at 10 years locoregional free interval 78% vs. 59% but with no significant difference in overall survival rates or disease-free intervals. Late toxicities were not significantly different between the two treatment groups except for a higher rate of fibrosis in the no-surgery group (p <0.0001) and more lymphedema in the surgery group (p = 0.002). Conclusion: Our data suggest an improvement in locoregional control in patients treated by surgery, in conjunction with chemotherapy and radiotherapy, for IBC. Efforts must be made to improve overall survival.

  14. Demand Side Management in Pellet Production: Internal and External Factors

    Science.gov (United States)

    Vigants, Haralds; Blumberga, Dagnija; Veidenbergs, Ivars

    2014-12-01

    This paper demonstrates a demand side management case study: how to save energy and how research and data analysis help to create an energy management system in a pellet production facility; and shows ways to implement the EU energy efficiency directive in production facilities. The study carried out in this research serves as a far-reaching step that can be taken to improve energy efficiency during the operation mode of technological equipment. The benchmarking methodology is used for analysis of results. Internal and external factors and indicators, which affect energy management potential in pellet production are analysed. Analysis of external factors is based on the state legal framework regulating the development of the energy sector. Methodology on the analysis of energy demand includes the internal energy management of an enterprise. The experimental results discussed in this paper show that particular steps, which are oriented to specific use of technological equipment, could play significant role in energy efficiency improvement in industry which is illustrated by the pre-milling process in the pellet production system using power.

  15. Cytotoxic chemotherapy in the contemporary management of metastatic castration-resistant prostate cancer (mCRPC).

    Science.gov (United States)

    Sonpavde, Guru; Wang, Christopher G; Galsky, Matthew D; Oh, William K; Armstrong, Andrew J

    2015-07-01

    For several years, docetaxel was the only treatment shown to improve survival of patients with metastatic castration-resistant prostate cancer (mCRPC). There are now several novel agents available, although chemotherapy with docetaxel and cabazitaxel continues to play an important role. However, the increasing number of available agents will inevitably affect the timing of chemotherapy and therefore it may be important to offer this approach before declining performance status renders patients ineligible for chemotherapy. Patient selection is also important to optimise treatment benefit. The role of predictive biomarkers has assumed greater importance due to the development of multiple agents and resistance to available agents. In addition, the optimal sequence of treatments remains undefined and requires further study in order to maximize long-term outcomes. We provide an overview of the clinical data supporting the role of chemotherapy in the treatment of mCRPC and the emerging role in metastatic castration-sensitive prostate cancer. We review the key issues in the management of patients including selection of patients for chemotherapy, when to start chemotherapy, and how best to sequence treatments to maximise outcomes. In addition, we briefly summarise the promising new chemotherapeutic agents in development in the context of emerging therapies. PMID:25046451

  16. Modeling Supermarket Refrigeration Systems for Demand-Side Management

    Directory of Open Access Journals (Sweden)

    Jakob Stoustrup

    2013-02-01

    Full Text Available Modeling of supermarket refrigeration systems for supervisory control in the smart grid is presented in this paper. A modular modeling approach is proposed in which each module is modeled and identified separately. The focus of the work is on estimating the power consumption of the system while estimating the cold reservoir temperatures as well. The models developed for each module as well as for the overall integrated system are validated by real data collected from a supermarket in Denmark. The results show that the model is able to estimate the actual electrical power consumption with a high fidelity. Moreover a simulation benchmark is introduced based on the produced model for demand-side management in smart grid. Finally, a potential application of the proposed benchmark in direct control of the power/energy consumption is presented by a simple simulation example.

  17. Indirect Control for Demand Side Management – A Conceptual Introduction

    DEFF Research Database (Denmark)

    Heussen, Kai; You, Shi; Biegel, Benjamin;

    2012-01-01

    correct definition, either as a control or a market concept. This paper aims to provide a conceptual introduction to "indirect control" for management of small and distributed demand side resources. A review of control concepts and an analysis of "indirectness" features are provided to create a framework......The concept of “indirect control” has become a relevant discussion term in relation to activation distributed and small-scale demand and generation units to provide resources for power system balancing. The term and its association with price signals has, however caused some confusion as to its...... for systematic classification of indirect control strategies. The concepts developed then enable a discussion of control performance and valuation of direct- and indirect control strategies....

  18. Managing a live music performance: A supply-side analysis

    Directory of Open Access Journals (Sweden)

    Bianca Manners

    2015-02-01

    Full Text Available Purpose and objective: The purpose of this research is to determine what managers regard as important critical success factors in ensuring a memorable visitor experience at a live music performance.Problem investigated: When organising a live music performance, it is evident that the various characteristics that form part of the visitor experience have to be considered. The critical success factors of live music performances from the supply side are fundamental, since the costs of organising live music performances are high, the needs of the visitors are constantly changing and competition plays a major role in the success of such events. Management furthermore constantly needs to be aware of the ever-changing external environment by determining what factors visitors consider to be vital for a rewarding experience at a major music event. This is extremely important since the concept of experience has become more pervasive, mainly given that the event sector, such as live music performances, has adopted experience as a tool to make individual businesses more competitive, as the organisations operating within this sector exist to provide consumers with an experience.Design and/or methodology and/or approach: A qualitative research method, by means of interviews, was used to obtain the relevant information from the selected participants. All the data collected in the process were transcribed into text and presented in narrative form. The six steps of data analysis and interpretation were applied to analyse the data.Findings and impications: The following four major themes emerged from the analysis; each theme was differentiated in terms of various categories and subcategories. Theme 1:The most important aspects for a memorable visitor experience; Theme 2:Main purpose when organising a live music performance; Theme 3:Important aspects regarding the management of a live music performance; Theme 4:Timing of event management. Based

  19. Intelligent demand side management of residential building energy systems

    Science.gov (United States)

    Sinha, Maruti N.

    Advent of modern sensing technologies, data processing capabilities and rising cost of energy are driving the implementation of intelligent systems in buildings and houses which constitute 41% of total energy consumption. The primary motivation has been to provide a framework for demand-side management and to improve overall reliability. The entire formulation is to be implemented on NILM (Non-Intrusive Load Monitoring System), a smart meter. This is going to play a vital role in the future of demand side management. Utilities have started deploying smart meters throughout the world which will essentially help to establish communication between utility and consumers. This research is focused on investigation of a suitable thermal model of residential house, building up control system and developing diagnostic and energy usage forecast tool. The present work has considered measurement based approach to pursue. Identification of building thermal parameters is the very first step towards developing performance measurement and controls. The proposed identification technique is PEM (Prediction Error Method) based, discrete state-space model. The two different models have been devised. First model is focused toward energy usage forecast and diagnostics. Here one of the novel idea has been investigated which takes integral of thermal capacity to identify thermal model of house. The purpose of second identification is to build up a model for control strategy. The controller should be able to take into account the weather forecast information, deal with the operating point constraints and at the same time minimize the energy consumption. To design an optimal controller, MPC (Model Predictive Control) scheme has been implemented instead of present thermostatic/hysteretic control. This is a receding horizon approach. Capability of the proposed schemes has also been investigated.

  20. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer

    Directory of Open Access Journals (Sweden)

    Palesh O

    2012-12-01

    Full Text Available Oxana Palesh,1 Luke Peppone,2 Pasquale F Innominato,3–5 Michelle Janelsins,2 Monica Jeong,1 Lisa Sprod,7 Josee Savard,6 Max Rotatori,1 Shelli Kesler,1 Melinda Telli,1 Karen Mustian21Stanford University School of Medicine, Stanford, CA, USA; 2University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 3INSERM, UMRS 776, Biological Rhythms and Cancers, Villejuif, France; 4Faculty of Medicine, Universite Paris Sud, le Kremlin-Bicêtre, France; 5APHP, Chronotherapy Unit, Department of Oncology, Paul Brousse Hospital, Villejuif, France; 6Laval University, Quebec, Canada; 7University of North Carolina, Wilmington, NC, USAAbstract: Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients

  1. Equivalent chemotherapy efficacy against leukemia in mice treated with topical vasoconstrictors to prevent cancer therapy side effects.

    Science.gov (United States)

    Graul-Conroy, Amanda; Hicks, Emily J; Fahl, William E

    2016-06-15

    Topically applied vasoconstrictor is a new strategy to prevent oral mucositis and alopecia, two complications of chemotherapy and stem-cell transplant. We sought to determine whether mice treated with topical vasoconstrictor minutes before chemotherapy to suppress L1210 leukemia would develop a vasoconstrictor-induced L1210 cell sanctuary, and with it, significantly worse survival outcomes. B6D2F1 mice received 10(4) mouse L1210 leukemia cells via retro-orbital intravenous injection and were then divided into treatment groups, which included: (i) no further treatment, (ii) a single, sub-curative, intraperitoneal dose of cyclophosphamide (90 µg/gm bw) 24 hr after L1210 cell inoculation, (iii) topical epinephrine (25-400 mM) to clipped dorsal backs 20 min before cyclophosphamide or (iv) orotopical phenylephrine (16-130 mM), epinephrine (10 mM) or norepinephrine (25 mM) 20 min before cyclophosphamide. All mice were then followed until day of death. Differences in median survival time and percent survival between mice receiving cyclophosphamide alone and mice treated with either orotopical phenylephrine, epinephrine or norepinephrine; or topical epinephrine before cyclophosphamide were not significantly different. A discernible leukemia sanctuary was not created by topical vasoconstrictor treatment prior to chemotherapy; there was no significant difference in leukemia progression between untreated mice and those treated with either orotopical or topical vasoconstrictor before chemotherapy. We have opened a Phase I/IIa dose escalation trial to evaluate the safety and efficacy of orotopical phenylephrine in preventing oral mucositis in subjects undergoing hematopoietic stem cell transplant conditioning with cyclophosphamide plus total body irradiation. This could provide a cost-effective and convenient method to prevent oral mucositis.

  2. Chemotherapy and its evolving role in the management of advanced prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Michael T Schweizer; Emmanuel S Antonarakis

    2014-01-01

    prostate cancer has been recognized as being responsive to androgen deprivation since the 1940s when Charles Huggins ifrst described the role of surgical castration in managing these patients. However, androgen deprivation only results in transient disease control for the vast majority of men, with those progressing in spite of castrate testosterone levels labeled as having castrate-resistant prostate cancer (CRPC). Until 2004, the therapeutic arena for these patients had remained stagnant, with no agent having shown a survival gain in the CRPC setting. Two landmark publications changed the prostate cancer treatment landscape by providing‘level-1 evidence’ that docetaxel-based chemotherapy led to prolongation in overall survival (OS). This was followed by the approval of cabazitaxel in 2010 on the basis of Phase III data demonstrating its efifcacy in patients pretreated with docetaxel. More recently, a number of next-generation androgen-directed agents (e.g. abiraterone and enzalutamide) have also been shown to lead to a survival beneift in men with CRPC. With so many new treatment options available, a number of questions remain. These include:how to best sequence chemotherapy with these newer hormonal agents, the clinical implication of cross-resistance between taxanes and androgen-directed agents and which subsets of patients may beneift most from early use of chemotherapy. This review will provide an overview of the evolving role of chemotherapy in the management of advanced prostate cancer in the current era.

  3. Anaesthetic Considerations in the Perioperative Management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

    Science.gov (United States)

    Sheshadri, Deepak B; Chakravarthy, Murali R

    2016-06-01

    Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has emerged as one of the primary modalities of treatment of diffuse peritoneal malignancies. It is a complex surgical procedure with the patients facing major and potentially life threatening alterations of haemodynamic, respiratory, metabolic and thermal balance with significant fluid losses and the perioperative management is challenging for anaesthesiologists and intensive care physicians. Though the alterations are short lived, these patients require advanced organ function monitoring and support perioperatively. The anaesthesiologist is involved in the management of haemodynamics, respiratory function, coagulation, haematologic parameters, fluid balance, thermal variations, and metabolic and nutritional support perioperatively. The chemotherapy instillate used are known to cause nephrotoxicity, cardiotoxicity, dyselectrolytemia and lactic acidosis. The preoperative polypharmacy for pain control, previous surgery and/or chemotherapy, malnourished status secondary to feeding problems and tumour wasting syndrome make the task all the more challenging. The anaesthesiologist also needs to consider the perioperative care from a quality of life perspective and proper preoperative counselling is important. The present overview summarizes the challenges faced by the anaesthesiologist regarding the pathophysiological alterations during the Cytoreductive surgery and Hyperthermic intraperitoneal chemotherapy in the preoperative, intraoperative and postoperative periods. PMID:27065715

  4. Electricity deregulation, spot price patterns and demand-side management

    International Nuclear Information System (INIS)

    This paper examines extensive hourly or half-hourly power price data from 14 deregulated power markets. It analyzes average diurnal patterns, relationship to system load, volatility, and consistency over time. Diurnal patterns indicate the average price spread between off-peak and on-peak and weekend vs. weekday power consumption. Volatility is measured by price velocity: the average normalized hourly change in power price, calculated daily. The calculated price velocity is broken down into an expected component that arises from the diurnal pattern and an unexpected component that arises from unknown factors. The analysis reveals significant differences among markets, suggesting that demand-side management (DSM) of power consumption is far more difficult in some markets than in others. At one extreme, Spain, Britain and Scandinavia show consistent diurnal price patterns, a stable relationship between price and system load, and a low unexplained component of price volatility. A power consumer in these markets could form a reasonable expectation of a reward for DSM of elective power consumption. At the other extreme, two markets in Australia show erratic diurnal price patterns from year to year, low correlation between price and system load, and a high amount of unexpected price velocity. A power consumer in these markets would have far greater difficulty in realizing a benefit from DSM. Markets that experienced one period of very high prices without a clear external cause, such as California and Alberta, appear to have a significant longer-term erosion of public support for deregulation. (author)

  5. Demand-side management pricing options in electric utilities

    International Nuclear Information System (INIS)

    In 1989 Ontario Hydro implemented optional time-of-use (TOU) rates at the wholesale level for all municipal utilities in the province. At the same time, mandatory TOU rates were implemented for large users (customers with loads in excess of 5 MW) served by municipal utilities and Ontario Hydro's direct customers. To fully explore the potential of rate structures as demand-side management (DSM) tools, Ontario Hydro retained a consulting firm to carry out a survey of innovative rate structures in other jurisdications. The survey was intended to identify: the status quo of rate structures in other jurisdictions that were designed specifically to encourage DSM; a profile of the cost basis of the rate structures, for example whether traditional embedded cost of service analyses or contentious methods such as marginal cost pricing were used; whether innovative rates have been successful, and customer reactions and attitudes; and how innovative rates fit into the overall strategy of the utilities. It was found that TOU, interruptible and end-use targeted rates are the rate structures of choice for many utilities. Most are concerned with deferring capacity, reducing peak demand, and shifting load out of peak periods. Most utilities report success with their programs and satisfaction with the present form of the programs. 5 tabs

  6. Integrating Chemotherapy in the Management of Cervical Cancer: A Critical Appraisal.

    Science.gov (United States)

    Kumar, Lalit; Gupta, Sudeep

    2016-01-01

    The management of locally advanced cervix cancer has undergone a paradigm shift during the last decade. Concurrent chemoradiation (CCRT) (with cisplatin alone or in combination) is currently the standard treatment approach. CCRT results in a 5-year overall survival rate of 66% and a disease-free survival of 58%. About 30-40% of patients with locally advanced cervical cancer fail to achieve complete response to CCRT; alternative approaches are needed to improve the outcome for such patients. Weekly paclitaxel and carboplatin for 4-6 weeks as dose-dense chemotherapy prior to CCRT could be one such potential approach. The role of adjuvant chemotherapy after CCRT in patients with positive lymph nodes, larger tumor volume and stage III-IVA disease needs further exploration. Adjuvant chemotherapy is also being investigated for early-stage (stages IA2, IB1 or IIA) cervical cancer with presence of risk factors such as lymph node metastasis, lymphovascular space invasion and invasion depth of more than 10 mm, microscopic parametrial invasion, non-squamous histology and positive surgical margins. For patients with early-stage disease (IA2-IIA), short-course chemotherapy prior to surgery is associated with an improved outcome in many studies. Neo-adjuvant chemotherapy followed by fertility preservation surgery is feasible in carefully selected young patients with bulky stage IB1 disease. Recently, a number of molecular pathways have been identified as potential therapeutic targets. Bevacizumab - an inhibitor of vascular endothelial growth factor - is associated with improved survival in patients with recurrent/metastatic cervical cancer. Whether bevacizumab and other similar novel agents targeting molecular pathways could be used in front-line treatment along with cytotoxic chemotherapy is likely to be an area of research in future studies. PMID:27464068

  7. CLINICAL STUDY ON THE TIME OF TREATING CHEMOTHERAPY-INDUCED TOXIC AND SIDE EFFECTS IN MALIGNANT TUMOR PATIENTS BY ACUPOINT-INJECTION OF ASTRAGALUS ROOT INJECTIONShanghai University of TCM and Pharmacy, Shanghai 200032

    Institute of Scientific and Technical Information of China (English)

    范钰; 吴学飞; 颜吉丽; 杨兆民; 万铭

    2001-01-01

    Objective: To investigate the suitable time of treating virulent and side effects of chemotherapy for malignant tumor by acupoint-injection of Astragalus Root injection. Methods: Sixty-three patients with malignant tumor were divided into three groups: prevention treatment (PT) group (n = 23 cases), post-chemotherapy treatment (PCT) group( n=22 cases), Western medicine (WM) group ( n= 18 cases). The patients in PT, PCT and WM groups were treated respectively from the fifth day on before chemotherapy and from the first day on after chemotherapy, 18 days in all. The patients in WM group were administered Batilol and Leucogen from the first day on after chemotherapy. Changes of leukocytes and immunoglobulin before and after treatment were observed. Results: 1 ) Acupoint-injection of Astragalus Root injectio could increase the number of leukocytes and immunoglobulin content and its effect was better than that of Western medicine (P< 0.05); 2) The effect of PT group was better than that of PCT group in preventing and treating virulent and side effects of chemotherapy (P< 0.05). Conclusion: It should be stressed on prevention of malignant tumor by using acupoint-injection of Astragalus Root for relieving virulent and side effects of chemotherapy.

  8. Psychoneuroimmunology-Based Stress Management during Adjuvant Chemotherapy for Early Breast Cancer.

    Science.gov (United States)

    Robins, Jo Lynne W; McCain, Nancy L; Elswick, R K; Walter, Jeanne M; Gray, D Patricia; Tuck, Inez

    2013-01-01

    Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL), and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method. The sample consisted of 145 women aged 27-75 years; 75% were Caucasian and 25% African American. A total of 109 participants completed the study, yielding a 75% retention rate. Grounded in a psychoneuroimmunology framework, the overarching hypothesis was that both interventions would reduce perceived stress, enhance QOL and psychosocial functioning, normalize levels of stress-related neuroendocrine mediators, and attenuate immunosuppression. Results. While interesting patterns were seen across the sample and over time, the interventions had no appreciable effects when delivered during the period of chemotherapy. Conclusions. Findings highlight the complex nature of biobehavioral interventions in relation to treatment trajectories and potential outcomes. Psychosocial interventions like these may lack sufficient power to overcome the psychosocial or physiological stress experienced during the chemotherapy treatment period. It may be that interventions requiring less activity and/or group attendance would have enhanced therapeutic effects, and more active interventions need to be tested prior to and following recovery from chemotherapy.

  9. Psychoneuroimmunology-Based Stress Management during Adjuvant Chemotherapy for Early Breast Cancer

    Directory of Open Access Journals (Sweden)

    Jo Lynne W. Robins

    2013-01-01

    Full Text Available Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL, and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method. The sample consisted of 145 women aged 27–75 years; 75% were Caucasian and 25% African American. A total of 109 participants completed the study, yielding a 75% retention rate. Grounded in a psychoneuroimmunology framework, the overarching hypothesis was that both interventions would reduce perceived stress, enhance QOL and psychosocial functioning, normalize levels of stress-related neuroendocrine mediators, and attenuate immunosuppression. Results. While interesting patterns were seen across the sample and over time, the interventions had no appreciable effects when delivered during the period of chemotherapy. Conclusions. Findings highlight the complex nature of biobehavioral interventions in relation to treatment trajectories and potential outcomes. Psychosocial interventions like these may lack sufficient power to overcome the psychosocial or physiological stress experienced during the chemotherapy treatment period. It may be that interventions requiring less activity and/or group attendance would have enhanced therapeutic effects, and more active interventions need to be tested prior to and following recovery from chemotherapy.

  10. The emerging role of exercise and health counseling in patients with acute leukemia undergoing chemotherapy during outpatient management

    DEFF Research Database (Denmark)

    Jarden, Mary; Adamsen, Lis; Kjeldsen, Lars;

    2013-01-01

    This study investigates the feasibility, safety and benefits of a 6-week exercise and health counseling intervention in patients with acute leukemia undergoing consolidation chemotherapy during outpatient management. Seventeen of twenty patients completed study requirements (85%), adherence...

  11. [Reducing the side effects of aggressive chemotherapy (cisplatin and epirubicin) with xenogenic peptides (factor AF2) in patients with hormone refractory metastatic prostate cancer. A prospective, randomized study].

    Science.gov (United States)

    Papadopoulos, I; Wand, H

    1989-06-01

    The indication of a chemotherapy is advisable with patients who are suffering from a progressively metastasised, secondarily hormone refractory carcinoma of the prostate. In search of efficient chemotherapy protocols we combined cisplatin with epirubicin (PE scheme) in our clinic. Massive side effects of that aggressive chemotherapy scheme like gastro-intestinal trouble and myelotoxicity are the limiting factors of the scheme. With measures like reducing the dosage, delaying the next cycle, or breaking off the therapy the effective dosage can often not be achieved. The anti-emetics which are usually used today exclusively give anti-emetic protection. The additional administration of xenogenic peptides (Factor AF2) had additionally myeloprotective effect in former studies. In this study we examined whether, by additionally giving Factor AF2, the patients' subjective condition, and above all their hemogram, could be stabilised in order to achieve the effective dosage or dosage intensity. For that, the patients were prospectively randomised in two groups by means of a random selection board. The analysis of the data gained in the protocol showed that the additional administration of Factor AF2 improves the patients' subjective conditions significantly. Apart from that, we noticed a considerable reduction of the vomiting frequency. Concerning the objective measured parameters of the leukocytes, thrombocytes, erythrocytes, and the hemoglobin level, the significantly myeloprotective effect of Factor AF2 could be proved. Due to the fact that in the verum group there were considerably fewer cases of breaking off or delays of the treatment than in the control group, the effective dosage intensity could be achieved with a higher number of patients in that group. PMID:2691943

  12. Management of stage one and two-E gastric large B-cell lymphoma: chemotherapy alone or surgery followed by chemotherapy?

    Directory of Open Access Journals (Sweden)

    Kadiri Habiba

    2010-06-01

    Full Text Available Abstract Management of localized primary gastric B lymphoma (PGL remains controversial. The aim of this study is to compare two treatments: chemotherapy alone and surgery plus chemotherapy. Materials Records of all patients with a diagnosis of gastric lymphoma and which were treated in the National Institute of Oncology, between 1999 and 2006, were reviewed and patients fulfilling the following criteria were included in this study: histologically proven large-cell B lymphoma of the stomach; complete clinical information stage I/II disease according to the Musshoff staging; patients who received surgery followed by chemotherapy (group I or chemotherapy alone (group II. Results This study included 82 patients who were treated for cancer in our Institute. All clinical and pathological features were similar between the two groups, except that patients of group-I had significantly more stage II disease (P = 0.023 than that of group II. Among the 52 patients who could be evaluated for response to chemotherapy, there were 45 who had complete response to treatment, 3 had partial response to the treatment and 4 had progressive disease. The projected 5-year relapse-free survival (RFS and overall survival (OS of group I were 86.69% (95% CI, 57.9 - 97.7% and 90.0% (95% CI, 58.0 - 97.8%, respectively. And the projected 5-year relapse-free survival RFS and OS of group II were 86.67% (95% CI, 57.0 - 88.2% and 93.33% (95% CI, 73.3 - 98.7% respectively. There were no statistically significant differences in RFS (P = 0.485 and OS (P = 0.551 between the two groups. Conclusion Our data suggest that chemotherapy alone may be a reasonable alternative treatment for stage I/II gastric large-cell lymphoma but this result must be confirmed by prospective randomized clinical trials.

  13. Towards a systematic characterization of the potential of demand side management

    CERN Document Server

    Kleinhans, David

    2014-01-01

    With an increasing share of electric energy produced from non-dispatchable renewable sources both energy storage and demand side management might gain tremendously in importance. While there has been significant progress in general properties and technologies of energy storage, the systematic characterization of features particular to demand side management such as its intermittent, time-dependent potential seems to be lagging behind. As a consequence, the development of efficient and sustainable strategies for demand side management and its integration into large-scale energy system models are impeded. This work introduces a novel framework for a systematic time-resolved characterization of the potential for demand side management. It is based on the specification of individual devices both with respect to their scheduled demand and their potential of load shifting. On larger scales sector-specific profiles can straightforwardly be taken into account. The potential for demand side management is then specifie...

  14. Complementary strategies for the management of radiation therapy side effects.

    Science.gov (United States)

    Stubbe, Christine E; Valero, Meighan

    2013-07-01

    Patients with cancer utilize complementary and alternative medicine (CAM) for a variety of purposes, one of which is the reduction of side effects of conventional treatment. With a large number of their patients using CAM, it is important for advanced practitioners in oncology to have an understanding of these therapies to better guide their patients. Side effects of radiation therapy that may have dose-limiting poten-tial include diarrhea, mucositis, skin toxicity, and xerostomia. A com-mon side effect that is not necessarily dose-limiting but considerably troublesome to patients is cancer- and treatment-related fatigue. The CAM therapies that may alleviate some of the side effects of radiation therapy include probiotics, psyllium, exercise, melatonin, honey, acu-puncture, and calendula. Therapies that require more research or have been shown to be ineffective include aloe vera, glutamine, and deglyc-yrrhizinated licorice. This article provides an overview of these thera-pies as well as related research and analysis. PMID:25032003

  15. Managing chemotherapy induced anemia with darbepoetin alfa and other erythropoiesis stimulating agents: a nurse's perspective

    Directory of Open Access Journals (Sweden)

    Derbyshire L

    2013-11-01

    Full Text Available Loraine Derbyshire, Colin W Thain School of Health, University of Central Lancashire, Preston, United Kingdom Abstract: Chemotherapy induced anemia (CIA is a frequent complication of anticancer treatment, but often remains untreated. The main presenting symptom of CIA is fatigue, and this can have profound implications upon chemotherapy treatment compliance and patients' quality of life (QoL. Nevertheless, a tendency has been seen in both patients and physicians to underestimate the consequences of fatigue. As nurses are taking on greater responsibilities for identifying, monitoring, and in some cases even treating CIA, it is important that they have a clear understanding of the treatment options at their disposal. Erythropoiesis stimulating agents (ESAs have been available as a tool for the treatment of CIA for many years. However, the vast majority of literature on this topic has been targeted towards physicians. Hence, the purpose of this review is to summarize the key ESA studies, with an emphasis on material that is of interest to the nursing community. Herein we present a brief chronological review of the development of ESAs to illustrate how the currently available treatment options for anemia arose. For conciseness, darbepoetin alfa (DA has been used as a model to represent all ESAs; however, important findings from studies of other ESAs have also been included for completeness. We also discuss the management of CIA, based on the available literature and our experience of routine clinical practice in the UK. In conclusion, CIA is important in the context of maintaining QoL in patients undergoing chemotherapy and its effective management needs to be considered as part of their holistic care. Available studies show that ESA treatment can decrease fatigue levels and reduce the need for transfusions. ESAs, such as DA, may therefore be an important treatment option for patients with CIA. DA is well tolerated when used according to current

  16. Nursing-led management of side effects of radiation: evidence-based recommendations for practice

    Directory of Open Access Journals (Sweden)

    Poirier P

    2013-03-01

    Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

  17. [Integrative management of operation, perioperative rehabilitation and postoperative adjuvant chemotherapy in elderly patients with colorectal carcinoma].

    Science.gov (United States)

    Xu, Dong; Jiao, Yurong; Ding, Kefeng

    2016-05-01

    With the aging of the Chinese population, it seems obvious that the number of elderly patients with the disease of colorectal carcinoma grows significantly. Meanwhile, no evidence-based practical guideline for the treatment of colorectal carcinoma are available in this particular age group. Therefore, the concept of integrative management has been brought up by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University, which combines the processes of surgery, perioperative rehabilitation and adjuvant chemotherapy together. In this way, the cooperation and complementarity between different clinical departments could cooperate and complete tasks together to integrate the treatment processes into a cohesive one. To achieve the goal of integrative management, the project is divided into horizontal and vertical aspects. The horizontal integration means the cooperation between different clinical departments, which is also known as multi-discipline treatment (MDT). The vertical integration reflects the completeness of the entire treatment under the goal of consistency, strictness and job separation, which could also be explained as the clinical pathway. Furthermore, this review stresses on the integrative strategy of both clinical and biochemical indexes rehabilitation, as well as the operation and postoperative adjuvant chemotherapy which has been put in execution several years by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University. PMID:27215515

  18. [Integrative management of operation, perioperative rehabilitation and postoperative adjuvant chemotherapy in elderly patients with colorectal carcinoma].

    Science.gov (United States)

    Xu, Dong; Jiao, Yurong; Ding, Kefeng

    2016-05-01

    With the aging of the Chinese population, it seems obvious that the number of elderly patients with the disease of colorectal carcinoma grows significantly. Meanwhile, no evidence-based practical guideline for the treatment of colorectal carcinoma are available in this particular age group. Therefore, the concept of integrative management has been brought up by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University, which combines the processes of surgery, perioperative rehabilitation and adjuvant chemotherapy together. In this way, the cooperation and complementarity between different clinical departments could cooperate and complete tasks together to integrate the treatment processes into a cohesive one. To achieve the goal of integrative management, the project is divided into horizontal and vertical aspects. The horizontal integration means the cooperation between different clinical departments, which is also known as multi-discipline treatment (MDT). The vertical integration reflects the completeness of the entire treatment under the goal of consistency, strictness and job separation, which could also be explained as the clinical pathway. Furthermore, this review stresses on the integrative strategy of both clinical and biochemical indexes rehabilitation, as well as the operation and postoperative adjuvant chemotherapy which has been put in execution several years by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University.

  19. Achieving demand side management through eco-industrial networks

    International Nuclear Information System (INIS)

    This Power Point presentation describes the progress made by the Greater Vancouver Regional District (GVRD) in achieving sustainable development. The GVRD provides regional level infrastructure for drinking water, liquid waste treatment and solid waste management. Member municipalities provide the complementary services to businesses and residents of the communities. Particular emphasis has been given to protecting the green zone, building complete communities, achieving a compact Metropolitain region, and increasing transportation choices. The GVRD has also adopted a Livable Region Strategic Plan (LRSP) which encompasses economic, social and environmental issues. All member municipalities of the GVRD have prepared statements that indicate how their local policies will help achieve the LRSP goals. This presentation also includes a review of the region's air quality in order to emphasize the link between air quality and the pattern of urban development and transportation choices. The GVRD air quality management is unique in Canada. tabs., figs

  20. High-dose chemotherapy: is it standard management for any common solid tumor?

    Science.gov (United States)

    MacNeil, M; Eisenhauer, E A

    1999-10-01

    High-dose chemotherapy with stem-cell support had as its basis the observation of dose-response relationships for many chemotherapeutic agents in laboratory models. The rationale to explore high-dose treatment in the clinic was further enhanced by several retrospective reviews in the 1980s which suggested delivered dose intensity of treatment was an important determinant of patient outcome. The availability of hematopoietic growth factors and technologic advances in the efficiency of stem-cell collection and administration have made the evaluation of exploring high-dose therapy safe and feasible. However, real questions remain regarding the apparently superior results of this treatment in the management of solid tumors. This paper reviews the results of high-dose chemotherapy in breast, ovarian and small cell lung cancers. Firstly the evidence for a dose-response relationship to chemotherapeutic agents in the 'standard' dosage range is examined. Secondly results of non-randomized and, where available, randomized trials of high-dose chemotherapy (HDCT) with stem-cell support are summarized and finally conclusions regarding the weight of the evidence for use of HDCT as 'standard' treatment are given. In none of these tumors is there sufficient evidence from randomized trials to consider HDCT a standard to be offered to all patients with a given stage of disease. The apparent benefit of HDCT seen in phase II trials could well be explained by such phenomena as stage shifts and patient selection. Many randomized trials in ovary and breast cancer are either ongoing or presented only as abstracts so final results must be awaited to quantify the benefit, if any of HDCT. It is acknowledged, however, that some practitioners already utilize this treatment. We speculate about the differences in philosophical approaches to cancer treatment which might contribute to early acceptance of novel therapies in the absence of adequate randomized data.

  1. Clinical Application of Magnetic Resonance Imaging in Management of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Jeon-Hor Chen

    2013-01-01

    Full Text Available Neoadjuvant chemotherapy (NAC, also termed primary, induction, or preoperative chemotherapy, is traditionally used to downstage inoperable breast cancer. In recent years it has been increasingly used for patients who have operable cancers in order to facilitate breast-conserving surgery, achieve better cosmetic outcome, and improve prognosis by reaching pathologic complete response (pCR. Many studies have demonstrated that magnetic resonance imaging (MRI can assess residual tumor size after NAC, and that provides critical information for planning of the optimal surgery. NAC also allows for timely adjustment of administered drugs based on response, so ineffective regimens could be terminated early to spare patients from unnecessary toxicity while allowing other effective regimens to work sooner. This review article summarizes the clinical application of MRI during NAC. The use of different MR imaging methods, including dynamic contrast-enhanced MRI, proton MR spectroscopy, and diffusion-weighted MRI, to monitor and evaluate the NAC response, as well as how changes of parameters measured at an early time after initiation of a drug regimen can predict final treatment outcome, are reviewed. MRI has been proven a valuable tool and will continue to provide important information facilitating individualized image-guided treatment and personalized management for breast cancer patients undergoing NAC.

  2. Evidence-based management of chemotherapy-induced nausea and vomiting: a position statement from a European cancer nursing forum

    OpenAIRE

    Vidall, C; Dielenseger, P; Farrell, C.; Lennan, E; Muxagata, P; Fernández-Ortega, P; Paradies, K

    2011-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a common, but now often overlooked side effect of cancer treatment, and one that can be largely prevented through the implementation of international evidence-based guidelines. The European CINV Forum, comprising nurses from France, Germany, Portugal, Spain and the UK, discussed the use of CINV preventive strategies in routine practice, and the factors that affect optimal delivery of antiemetic therapies. Based on these discussions, they deve...

  3. Foundation and economic consistency framework for demand side management actions

    International Nuclear Information System (INIS)

    Since the first oil crisis, energy management constitutes one of the main lines of France's energy policy, together with the development of the national supply and the diversification of the origin of imported energy products. The priority given to petroleum product savings, the effort already made in the field of electro technologies and rational use of electricity, and the temporary surplus of nuclear generation capacity have resulted in less attention given by the players to energy conservation concerning electricity uses, or at least take this into account mainly for competitive uses. The evolution of the stakes involved makes it necessary today to re-examine the role of electricity DSM in the French energy system. This should be done particularly by identifying, through experimentation, the potentials and methods of electricity DSM programs that are desirable from the economic, social and environmental viewpoint. (au)

  4. Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma.

    Science.gov (United States)

    Zhu, Guopei; Lin, Jin-Ching; Kim, Sung-Bae; Bernier, Jacques; Agarwal, Jai Prakash; Vermorken, Jan B; Thinh, Dang Huy Quoc; Cheng, Hoi-Ching; Yun, Hwan Jung; Chitapanarux, Imjai; Lertsanguansinchai, Prasert; Reddy, Vijay Anand; He, Xia

    2016-01-27

    With increasing numbers of patients with unresectable locoregionally advanced (LA) head and neck squamous cell carcinoma (HNSCC) receiving cetuximab/radiotherapy (RT), several guidelines on the early detection and management of skin-related toxicities have been developed. Considering the existing management guidelines for these treatment-induced conditions, clinical applicability and standardization of grading methods has remained a cause of concern globally, particularly in Asian countries. In this study, we attempted to collate the literature and clinical experience across Asian countries to compile a practical and implementable set of recommendations for Asian oncologists to manage skin- and mucosa-related toxicities arising from different types of radiation, with or without the addition of cetuximab or chemotherapy. In December 2013, an international panel of experts in the field of head and neck cancer management assembled for an Asia-Pacific head and neck cancer expert panel meeting in China. The compilation of discussion outcomes of this meeting and literature data ultimately led to the development of a set of recommendations for physicians with regards to the approach and management of dermatological conditions arising from RT, chemotherapy/RT and cetuximab/RT, and similarly for the approach and management of mucositis resulting from RT, with or without the addition of chemotherapy or cetuximab. These recommendations helped to adapt guidelines published in the literature or text books into bedside practice, and may also serve as a starting point for developing individual institutional side-effect management protocols with adequate training and education.

  5. Demand side management opportunities for a typical South African cement plant / Raine Tamsin Lidbetter

    OpenAIRE

    Lidbetter, Raine Tamsin

    2010-01-01

    The South African electrical system is under threat of supply shortage. This is because, in the last decade, the maximum electrical demand has been encroaching on the net maximum capacity and the reserve storage margin has become smaller. Eskom, the country’s electricity utility, has implemented a demand side management (DSM) programme in an attempt to alleviate the threat. Investigations into demand side reductions have been encouraged by the utility in sectors with high electric...

  6. Lipegfilgrastim in the management of chemotherapy-induced neutropenia of cancer patients

    Directory of Open Access Journals (Sweden)

    Guariglia R

    2016-01-01

    Full Text Available Roberto Guariglia,1 Maria Carmen Martorelli,1 Rosa Lerose,2 Donatella Telesca,2 Maria Rita Milella,2 Pellegrino Musto3 1Unit of Hematology and Stem Cell Transplantation, 2Pharmacy Service, 3Scientific Direction, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Potenza, Italy Abstract: Neutropenia and febrile neutropenia (FN are frequent and potentially fatal toxicities of myelosuppressive anticancer treatments. The introduction of granulocyte colony-stimulating factors (G-CSFs in clinical practice has remarkably reduced the duration and severity of neutropenia, as well as the incidence of FN, thus allowing the administration of chemotherapeutic agents at the optimal dose and time with lower risk. The current scenario of G-CSFs in Europe includes filgrastim, lenograstim, some G-CSF biosimilars, and pegfilgrastim. Recently, a novel long-acting G-CSF, lipegfilgrastim, became available. Lipegfilgrastim is a glycopegylated G-CSF, alternative to pegfilgrastim, and has shown in randomized trials, to be equivalent to pegfilgrastim in reducing the incidence of severe neutropenia and FN in patients with breast cancer receiving chemotherapy, with a similar safety profile. Furthermore, lipegfilgrastim was more effective than the placebo in reducing the incidence of severe neutropenia, its duration, and time to absolute neutrophil count recovery, in patients with non-small cell lung cancer receiving myelosuppressive therapy. Although the number of studies currently published is still limited, lipegfilgrastim seems to be a promising drug in the management of chemotherapy-induced neutropenia. Keywords: neutropenia, febrile neutropenia, granulocyte colony-stimulating factors, G-CSF, pegfilgrastim, lipegfilgrastim

  7. Optimal Load Response to Time-of-Use Power Price for Demand Side Management in Denmark

    DEFF Research Database (Denmark)

    Hu, Weihao; Chen, Zhe; Bak-Jensen, Birgitte

    2010-01-01

    -of-use power price for demand side management in order to save the energy costs as much as possible. 3 typical different kinds of loads (industrial load, residential load and commercial load) in Denmark are chosen as study cases. The energy costs decrease up to 9.6% with optimal load response to time......-of-use power price for different loads. Simulation results show that the optimal load response to time-of-use power price for demand side management generates different load profiles and reduces the load peaks. This kind of load patterns may also have significant effects on the power system normal operation....

  8. Management of side effects of BCR/ABL-negative chronic myeloproliferative neoplasm therapies. Focus on anagrelide.

    Science.gov (United States)

    Antelo, María Luisa; de Las Heras, Natalia; Gonzalez Porras, Jose Ramón; Kerguelen, Ana; Raya, Jose María

    2015-12-01

    Although hydroxyurea is considered the first-line cytoreductive therapy in high-risk patients with polycythemia vera or essential thrombocythemia, approximately 20-25% of patients develop resistance or intolerance and they need an alternative therapy. Anagrelide is the treatment of choice in patients with essential thrombocythemia intolerant or with resistance to hydroxyurea. Anagrelide is usually well tolerated. Although there is concern about the increased risk of cardiac side effects, in most cases these are mild, and easily manageable. In this paper, the available evidence about the management of patients with myeloproliferative neoplasms, with a special focus on the side effects of drug therapies is reviewed.

  9. Neurotoxicity of cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Miyoung Yang; Changjong Moon

    2013-01-01

    There is accumulating clinical evidence that chemotherapeutic agents induce neurological side effects, including memory deficits and mood disorders, in cancer patients who have undergone chemotherapeutic treatments. This review focuses on chemotherapy-induced neurodegeneration and hippocampal dysfunctions and related mechanisms as measured by in vivo and in vitro approaches. These investigations are helpful in determining how best to further explore the causal mechanisms of chemotherapy-induced neurological side effects and in providing direction for the future development of novel optimized chemotherapeutic agents.

  10. Hollow silicon microneedle array based trans-epidermal antiemetic patch for efficient management of chemotherapy induced nausea and vomiting

    Science.gov (United States)

    Kharbikar, Bhushan N.; Kumar S., Harish; Kr., Sindhu; Srivastava, Rohit

    2015-12-01

    Chemotherapy Induced Nausea and Vomiting (CINV) is a serious health concern in the treatment of cancer patients. Conventional routes for administering anti-emetics (i.e. oral and parenteral) have several drawbacks such as painful injections, poor patient compliance, dependence on skilled personnel, non-affordability to majority of population (parenteral), lack of programmability and suboptimal bioavailability (oral). Hence, we have developed a trans-epidermal antiemetic drug delivery patch using out-of-plane hollow silicon microneedle array. Microneedles are pointed micron-scale structures that pierce the epidermal layer of skin to reach dermal blood vessels and can directly release the drug in their vicinity. They are painless by virtue of avoiding significant contact with dermal sensory nerve endings. This alternate approach gives same pharmacodynamic effects as par- enteral route at a sparse drug-dose requirement, hence negligible side-effects and improved patient compliance. Microneedle design attributes were derived by systematic study of human skin anatomy, natural micron-size structures like wasp-sting and cactus-spine and multi-physics simulations. We used deep reactive ion etching with Bosch process and optimized recipe of gases to fabricate high-aspect-ratio hollow silicon microneedle array. Finally, microneedle array and polydimethylsiloxane drug reservoir were assembled to make finished anti-emetic patch. We assessed microneedles mechanical stability, physico-chemical properties and performed in-vitro, ex- vivo and in-vivo studies. These studies established functional efficacy of the device in trans-epidermal delivery of anti-emetics, its programmability, ease of use and biosafety. Thus, out-of-plane hollow silicon microneedle array trans-epidermal antiemetic patch is a promising strategy for painless and effective management of CINV at low cost in mainstream healthcare.

  11. A System Architecture for Autonomous Demand Side Load Management in Smart Buildings

    DEFF Research Database (Denmark)

    Costanzo, Giuseppe Tommaso; Zhu, Guchuan; Anjos, Miguel F.;

    2012-01-01

    This paper presents a system architecture for load management in smart buildings which enables autonomous demand side load management in the smart grid. Being of a layered structure composed of three main modules for admission control, load balancing, and demand response management...... in multiple time-scales and allows seamless integration of diverse techniques for online operation control, optimal scheduling, and dynamic pricing. The design of a home energy manager based on this architecture is illustrated and the simulation results with Matlab/Simulink confirm the viability...

  12. Demand side management in households. Potentials and restraints of short-term power supply; Demand Side Management in Haushalten. Potenziale und Hemmnisse fuer kurzfristige Leistungsbereitstellung

    Energy Technology Data Exchange (ETDEWEB)

    Roon, Serafin von; Gobmaier, Thomas [FfE Forschungsstelle fuer Energiewirtschaft e.V., Muenchen (Germany); Huck, Malte

    2010-07-01

    Within the project ''Wind energy - balancing forecast errors'' we examine potentials, restraints and costs of various options for balancing forecast errors of wind power generation. One possibility of providing this backup power could be to practice Demand Side Management (DSM) of household appliances. The integration of these appliances in a DSM network is facilitated by standardized data transmission procedures and the increasing deployment of microprocessors. Due to the low power consumption of the switchable devices no DSM measures are implemented in the household sector so far, despite the numerous appliances. (orig.)

  13. Summary of Characteristics and Energy Efficiency Demand-side Management Programs in the Southeastern United States

    Energy Technology Data Exchange (ETDEWEB)

    Glatt, Sandy [BCS Inc., Laurel, MD (United States)

    2010-04-01

    This report is the first in a series that seeks to characterize energy supply and industrial sector energy consumption, and summarize successful industrial demand-side management (DSM) programs within each of the eight North American Electric Reliability Corporation (NERC) regions.

  14. Energy Demand-Side Management: New Perspectives for a New Era

    Science.gov (United States)

    Carley, Sanya

    2012-01-01

    Over the past decade and a half, state governments have assumed greater responsibility over demand-side management (DSM) operations. Whereas DSM programs formerly were initiated primarily by utilities or state public utility commissions, they are now becoming increasingly state-initiated and incentivized through funding mechanisms or…

  15. The incidence, management, and evolution of rapamycin-related side effects in kidney transplant recipients

    NARCIS (Netherlands)

    Verhave, J.C.; Boucher, A.; Dandavino, R.; Collette, S.; Senecal, L.; Hebert, M.J.; Girardin, C.; Cardinal, H.

    2014-01-01

    Conversion from a calcineurin-inhibitor-based immunosuppression to a rapamycin-based immunosuppression may preserve kidney graft function. The side effects of rapamycin can limit its usefulness, but their management and evolution are rarely reported in clinical trials. We performed a retrospective c

  16. The evolving role of cytotoxic chemotherapy in the management of patients with metastatic prostate cancer.

    Science.gov (United States)

    Diamond, Elan; Garcias, María del Carmen; Karir, Beerinder; Tagawa, Scott T

    2015-02-01

    Prostate cancer (PC) is the most common cancer in men in the United States. Although outcomes are excellent for early-stage disease, survival for men with metastatic PC is limited. While older studies did not supported the use of chemotherapy in PC, the efficacy of taxane chemotherapy plus prednisone is now well established in men with metastatic castration resistant PC (CRPC). The results of CHAARTED trial have further expanded the use of chemotherapy to patients with metastatic hormone-sensitive disease. The clinical efficacy of taxanes over other chemotherapeutics may be a result of its ability to inhibit microtubule-dependent trafficking of proteins such as the androgen-receptor (AR). Ongoing research uses chemotherapy earlier in the disease course as well as explores the utility of combining cytotoxic chemotherapy with biologic agents. PMID:25762124

  17. Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

    Science.gov (United States)

    Sammartino, Paolo; Biacchi, Daniele; Cornali, Tommaso; Cardi, Maurizio; Accarpio, Fabio; Impagnatiello, Alessio; Sollazzo, Bianca Maria; Di Giorgio, Angelo

    2016-06-01

    An integrated treatment strategy using peritonectomy procedures plus hyperthermic intraperitoneal chemotherapy (HIPEC) is now a clinical standard of care in selected patients with peritoneal metastases and primary peritoneal tumors. This comprehensive approach can offer many patients, who hitherto had no hope of cure, a good quality of life and survival despite limited morbidity. The increasingly successful results and chance of interfering in the natural history of disease has prompted research to develop for some clinical conditions a therapeutic strategy designed to prevent malignant peritoneal dissemination before it becomes clinically evident and treat it microscopically (tertiary prevention). The main factor governing successful cytoreductive surgery and predicting outcome is the extent of peritoneal spread assessed with the peritoneal cancer index (PCI). In peritoneal metastases from colorectal and gastric cancer the PCI score acquires a specific role acting as the cut-off between patients who can undergo curative surgery or palliation. Long-term results show that the only group enjoying favorable results are patients with limited disease (a statistical minority). By applying to appropriately selected patients with primary malignancies a proactive management strategy including HIPEC we can treat patients with microscopic peritoneal dissemination and therefore at PCI 0. Among treated conditions pseudomyxoma peritonei enjoys the best results. But a major future advance comes from identifying among lesions at major risk of pseudomyxoma. PMID:27065712

  18. An Overview of Demand Side Management Control Schemes for Buildings in Smart Grids

    DEFF Research Database (Denmark)

    Kosek, Anna Magdalena; Costanzo, Giuseppe Tommaso; Bindner, Henrik W.;

    2013-01-01

    demand is needed. The research area of demand side management is still very much in flux and several options are being presented which can all be used to manage loads in order to achieve a flexible and more responsive demand. These different control schemes are developed with different organization...... of the power sector in mind and thus can differ significantly in their architecture, their integration into the various markets, their integration into distribution network operation and several other aspects. This paper proposes a classification of load control policies for demand side management in smart......The increasing share of distributed energy resources and renewable energy in power systems results in a highly variable and less controllable energy production. Therefore, in order to ensure stability and to reduce the infrastructure and operation cost of the power grid, flexible and controllable...

  19. Management of chemotherapy-induced nausea and vomiting: A pilot randomised controlled trial using Nevasic audio programme.

    OpenAIRE

    Moradian, Saeed

    2013-01-01

    Major advances in antiemetic therapy have been made over the past two decades. Despite these advances in antiemetic management, nausea and vomiting are still important problems in clinical practice, and approximately 50% of patients receiving chemotherapy still experience nausea and/or vomiting, highlighting the need for further developments in the field. Non-pharmacological interventions are suggested as possible adjuncts to standard anti-emetic therapy. A recently developed non-pharmacologi...

  20. Colon Carcinoma with Unusual Metastasis to the Esophagus Manifesting as Multiple Nodules and Dysphagia: Management with Systemic Chemotherapy

    Directory of Open Access Journals (Sweden)

    Pankaj G. Vashi

    2012-07-01

    Full Text Available We present here the rare clinical case of a 44-year-old gentleman with metastasis from colon carcinoma to the esophagus presenting with multiple nodules and dysphagia, which was successfully managed with systemic chemotherapy. The patient presented at our institution with 3-month history of dysphagia almost 4 years after being operated for stage III carcinoma in the sigmoid colon. Endoscopic findings showed multiple nodules at the gastroesophageal junction and mid esophagus. Histological features and immunostains confirmed the diagnosis of metastatic colon carcinoma. Because of evidence of extensive metastatic disease in the spine and liver requiring systemic therapy, the patient was treated with chemotherapy with irinotecan and cetuximab, with subsequent improvement in tumor markers, liver metastasis and symptoms of dysphagia. Even though repeat endoscopy showed no improvement in esophageal nodules, the overall response to chemotherapy was positive. In conclusion, we present a very rare, previously unreported case of metastases from colon cancer to the esophagus presenting as non-obstructive nodules and dysphagia that responded to systemic chemotherapy.

  1. Understanding Chemotherapy

    Science.gov (United States)

    N ational C ancer I nstitute Understanding Chemotherapy What is chemotherapy? Chemotherapy is a cancer treatment that uses drugs to destroy cancer cells. It is also called “chemo.” Today, there are ...

  2. Balancing opioid-induced gastrointestinal side effects with pain management: Insights from the online community.

    Science.gov (United States)

    Whitman, Cynthia B; Reid, Mark W; Arnold, Corey; Patel, Haridarshan; Ursos, Lyann; Sa'adon, Roee; Pourmorady, Jonathan; Spiegel, Brennan M R

    2015-01-01

    Opioids cause gastrointestinal (GI) symptoms such as nausea, vomiting, pain, and (in 40 percent) constipation that diminish patients' quality of life. Outside traditional surveys, little is known about the opioid-induced constipation (OIC) patient experience and its impact on pain management. The purpose of this study was to use data from social media platforms to qualitatively examine patient beliefs about OIC and other prominent GI side effects, their impact on effective pain management and doctor-patient interaction. The authors collected Tweets from March 25 to July 31, 2014, and e-forum posts from health-related social networking sites regardless of timestamp. The authors identified specific keywords related to opioids and GI side effects to locate relevant content in the dataset, which was then manually coded using ATLAS.ti software. The authors examined 2,519,868 Tweets and more than 1.8 billion e-forum posts, of which, 88,586 Tweets and 9,767 posts satisfied the search criteria. Three thousand three individuals experienced opioidinduced GI side effects, mostly related to phenanthrenes (n = 1,589), and 1,274 (42.4 percent) individuals described constipation. Over-the-counter medications and nonevidence-based natural approaches were most commonly used to alleviate constipation. Many individuals questioned, rotated, reduced, or stopped their opioid treatments as a result of their GI side effects. Investigation of social media reveals a struggle to balance pain management with opioid-induced GI side effects, especially constipation. Individuals are often unprepared to treat OIC, to modify opioid regiments without medical advice, and to resort to using natural remedies and treatments lacking scientific evidence of effectiveness. These results identify opportunities to improve physician-patient communication and explore effective treatment alternatives. PMID:26535966

  3. The demand-side management program development process: A utility perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, A.K. [Oak Ridge National Lab., TN (United States); Yourstone, N.E. [Yourstone (Evelin), Albuquerque, NM (United States)

    1992-03-01

    This report describes an aspect of DSM that has received little attention, namely, how utilities develop DSM programs. The selection of utilities to study purposely was biased in favor of those with reputations for being experienced DSM program developers so as to optimize the chances to obtain detailed information. The DSM planning process is affected by organizational factors and external influences: (1) the location of the demand-side planning department within the utility; (2) the demand-side planning group`s functional responsibilities; (3) upper management participation in the DSM program development process; and (4) the organizational relationship between (or, separation of) supply-side and demand-side planning. Organizational factors reflect utilities` views of DSM programs and thus can affect the adoption of a technology- or customer-oriented approach. Despite repeated claims of the uniqueness of the demand- side planning process and its resistance to standardization, two general approaches to program development were discerned, namely technology- or customer-orientation. Although utilities consider customer related and technological factors in their DSM program development process, utilities can be differentiated by their emphasis on one or the other approach. 25 refs.

  4. The demand-side management program development process: A utility perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, A.K. (Oak Ridge National Lab., TN (United States)); Yourstone, N.E. (Yourstone (Evelin), Albuquerque, NM (United States))

    1992-03-01

    This report describes an aspect of DSM that has received little attention, namely, how utilities develop DSM programs. The selection of utilities to study purposely was biased in favor of those with reputations for being experienced DSM program developers so as to optimize the chances to obtain detailed information. The DSM planning process is affected by organizational factors and external influences: (1) the location of the demand-side planning department within the utility; (2) the demand-side planning group's functional responsibilities; (3) upper management participation in the DSM program development process; and (4) the organizational relationship between (or, separation of) supply-side and demand-side planning. Organizational factors reflect utilities' views of DSM programs and thus can affect the adoption of a technology- or customer-oriented approach. Despite repeated claims of the uniqueness of the demand- side planning process and its resistance to standardization, two general approaches to program development were discerned, namely technology- or customer-orientation. Although utilities consider customer related and technological factors in their DSM program development process, utilities can be differentiated by their emphasis on one or the other approach. 25 refs.

  5. IRP, fuel switching, and demand side management DOE/NARUC national conference on natural gas use

    International Nuclear Information System (INIS)

    Integrated resource planning (IRP), fuel switching, and demand side management as each of these topics apply to operations at Northwest Natural Gas Company, (NNGC), are discussed. NNGC has 360,000 customers in Oregon and Washington. NNGC's utility commissions require of the company to implement integrated resource planning, or at least cost planning, in 1989. The first plan was successfully completed in both states in 1991 and the second one is being worked on. Secondly, cost-effective demand side management is required by each state's IRP rules so more aggressive conservation programs are being developed. Finally, Oregon formally investigated the economics of fuel switching and endorsed the idea in 1991. This was a direct result of requiring both gas and electric utilities to do IRP's

  6. Double-sided fuzzy chance-constrained linear fractional programming approach for water resources management

    Science.gov (United States)

    Cui, Liang; Li, Yongping; Huang, Guohe

    2016-06-01

    A double-sided fuzzy chance-constrained fractional programming (DFCFP) method is developed for planning water resources management under uncertainty. In DFCFP the system marginal benefit per unit of input under uncertainty can also be balanced. The DFCFP is applied to a real case of water resources management in the Zhangweinan River Basin, China. The results show that the amounts of water allocated to the two cities (Anyang and Handan) would be different under minimum and maximum reliability degrees. It was found that the marginal benefit of the system solved by DFCFP is bigger than the system benefit under the minimum and maximum reliability degrees, which not only improve economic efficiency in the mass, but also remedy water deficiency. Compared with the traditional double-sided fuzzy chance-constrained programming (DFCP) method, the solutions obtained from DFCFP are significantly higher, and the DFCFP has advantages in water conservation.

  7. Exercise for the Management of Side Effects and Quality of Life among Cancer Survivors

    OpenAIRE

    Mustian, Karen M.; Sprod, Lisa K.; Palesh, Oxana G.; Peppone, Luke J.; Janelsins, Michelle C.; Mohile, Supriya G.; Carroll, Jennifer

    2009-01-01

    Physical activity may play an important role in the rehabilitation of cancer survivors during and following treatment. Current research suggests numerous beneficial outcomes are experienced in cancer survivors undergoing exercise interventions during or following cancer treatment. Exercise not only plays a role in managing side effects but also improves functional capacity and quality of life. The purpose of this article is to provide an overview of the oncology literature supporting the use ...

  8. Demand Side Management in Smart Grids using a Repeated Game Framework

    OpenAIRE

    Song, Linqi; Xiao, Yuanzhang; van der Schaar, Mihaela

    2013-01-01

    Demand side management (DSM) is a key solution for reducing the peak-time power consumption in smart grids. To provide incentives for consumers to shift their consumption to off-peak times, the utility company charges consumers differential pricing for using power at different times of the day. Consumers take into account these differential prices when deciding when and how much power to consume daily. Importantly, while consumers enjoy lower billing costs when shifting their power usage to o...

  9. Marketplaces for Energy Demand-Side Management based on Future-Internet Technology

    OpenAIRE

    Briguglio, Luigi; Eichinger, Frank; Nigrelli, Massimiliano; Ruiz-Andino, Javier Lucio

    2013-01-01

    Renewable energies become more important, and they contribute to the EU's goals for greenhouse-gas reduction. However, their fluctuating nature calls for demand-side-management techniques, which balance energy generation and consumption. Such techniques are currently not broadly deployed. This paper describes the latest results from the FINSENY project on how Future-Internet enablers and market mechanisms can be used to realise such systems.

  10. A Scheme Design of Cloud + End Technology in Demand Side Management

    OpenAIRE

    Ge, Leijiao; Xu, Xiandong

    2015-01-01

    Demand Side Management (DSM) plays an important role in Smart Grid. It has large scale access points, massive users, heterogeneous infrastructure and dispersive participants. Moreover, cloud computing which is a service model is characterized by resource on-demand, high reliability and large scale integration and so on and the game theory is a useful tool to the dynamic economic phenomena. In this study, a scheme design of cloud + end technology is proposed to solve technical and economic pro...

  11. Demand side management scheme in smart grid with cloud computing approach using stochastic dynamic programming

    Directory of Open Access Journals (Sweden)

    S. Sofana Reka

    2016-09-01

    Full Text Available This paper proposes a cloud computing framework in smart grid environment by creating small integrated energy hub supporting real time computing for handling huge storage of data. A stochastic programming approach model is developed with cloud computing scheme for effective demand side management (DSM in smart grid. Simulation results are obtained using GUI interface and Gurobi optimizer in Matlab in order to reduce the electricity demand by creating energy networks in a smart hub approach.

  12. Exploring Tradeoffs in Demand-side and Supply-side Management of Urban Water Resources using Agent-based Modeling and Evolutionary Computation

    Science.gov (United States)

    Kanta, L.; Berglund, E. Z.

    2015-12-01

    Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS) framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger (1) increases in the volume of water pumped through inter-basin transfers from an external reservoir and (2) drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

  13. Chemotherapy induced nausea AND vomiting (CINV

    Directory of Open Access Journals (Sweden)

    Bannur R. Nandeesh

    2012-06-01

    Full Text Available Chemotherapy is the first line treatment in management of many cancers, both for cure and palliation; hence it’s crucial to minimize the unpleasant side effects of chemotherapy to increase tolerability to chemotherapy. Most of the conventional anti cancer drugs are emetogenic. Patients receiving chemotherapy experience different degrees of nausea and vomiting depending on the emetogenic potential of the anti cancer drugs given and the patient characteristics. With a better understanding of the pathophysiology, distinct phases of chemotherapy-induced nausea and vomiting (CINV i.e., acute emesis, delayed emesis and anticipatory emesis have been identified. Identification of various mediators has led to the development of different drugs acting through different mechanisms which are useful in the prevention and treatment of CINV. Serotonin receptor three (5-HT3 antagonists, corticosteroids and neurokinin type one receptor (NK-1 antagonists are of proven usefulness and have wide therapeutic indexes in the prevention of CINV. Other drugs like dopamine receptor antagonists & benzodiazepines are not routinely used because of their narrow therapeutic index. Practice guidelines for prevention of CINV will not only improve patient’s tolerability to chemotherapy & wellbeing, but also decrease hospital stay and overall cost of treatment of the patient. [Int J Basic Clin Pharmacol 2012; 1(3.000: 125-131

  14. Challenges of using model predictive control for active demand side management

    DEFF Research Database (Denmark)

    Zong, Yi; You, Shi; Hu, Junjie;

    2015-01-01

    architecture design for Model Predictive Controller (MPC), and discusses the challenges encountered during the implementation of MPC for active demand side management. The two different pilot case studies show that energy savings and load shifting can be achieved by applying MPC with weather forecast......When there is a high penetration of renewables in the power system, it requires coordinated management of large numbers of distributed and demand response resources, intermittent resources to maintain the grid reliability and improve operational economics. This paper presents a hierarchical...

  15. Multidisciplinary management of stage III breast cancer: chemotherapy, surgery and radiotherapy

    International Nuclear Information System (INIS)

    A prospective study, in which women with clinically stage III breast cancer underwent multidisciplinary therapy by using primary (neoadjuvant) chemotherapy, followed randomly by loco-regionally therapy, either with surgery or radiotherapy; and postoperative systemic chemotherapy, in both groups of treatment, was conduced at the Peruvian Institute of Neoplasic Diseases. This is a randomized, prospective, descriptive, interventionist and analytical clinical study. Clinical response to primary chemotherapy was positive in 80,23% of cases, complete resolution was observed in 18,60% of cases, partial resolution in 61,63% of cases and there was absolutely no response in 19,77% of cases. No residual neoplasm, pathologically proven, was observed in 8,33% of surgical cases. We demonstrated that high-dose primary chemotherapy, using only 2 drugs (cyclophosphamide and 5-fluorouracil), used here because of its lower price, brought similar results compared to anthracycline-containing regimens. Recurrence rates were similar and showed no significative differences in both groups of treatment. Both, the disease-free survival (DFS) and overall survival (OS), were similar in both groups of treatment. We also demonstrated that in patients who underwent surgery, the lower the number of axillary lymph node metastases, the higher the overall survival (OS) time. Patients with clinically stage III (A or B) breast cancer, showed similar clinical responses to neoadjuvant chemotherapy, they also showed similar recurrence rates, DFS and OS, when treated with radical mastectomy or radiotherapy. (authors)

  16. Dietetic management in gastrointestinal complications from antimalignant chemotherapy Dietoterapia en complicaciones gastrointestinales de quimioterápicos

    Directory of Open Access Journals (Sweden)

    L. Calixto-Lima

    2012-02-01

    Full Text Available Antineoplastic chemotherapy (CT represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading to compromised nutritional status and which may lead to cachexia. The main toxic effects of chemotherapy in the gastrointestinal tract include nausea, vomiting -these are the most frequent- constipation, diarrhea, xerostomia, mucositis, dysphagia and anorexia. Given the high frequency of such effects, nutritional intervention should be an integral part of cancer treatment, to maintain and/or improve the patient´s nutritional status and reduce or minimize the side effects caused by treatment. Accordingly, the goal of this study is to review dietetic conduct in the process of caring for patients undergoing cancer chemotherapy.La quimioterapia (QT representa el tratamiento antineoplásico sistémico de los tumores malignos. Puede ser utilizada solo o combinada con la cirugía y / o radioterapia. Los agentes quimioterápicos actúan en las células cancerosas y las células normales del cuerpo, siendo por lo general muy tóxicos. La agresividad de la quimioterapia afecta especialmente rápida replicación celular en el tracto digestivo, dando lugar a efectos adversos que impiden la ingesta de alimentos, dando lugar al estado nutricional comprometido y puede conducir a la caquexia. Los principales efectos tóxicos de la quimioterapia, el tracto gastrointestinal, como náuseas, vómitos estos son los más frecuentes- estreñimiento, diarrea, sequedad de boca, mucositis disfagia y anorexia. Dada la alta frecuencia de tales efectos, la intervención nutricional debe

  17. Management of chemotherapy-induced nausea and vomiting by risk profile: role of netupitant/palonosetron

    Directory of Open Access Journals (Sweden)

    Lorusso V

    2016-06-01

    Full Text Available Vito Lorusso National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy Abstract: As recommended by most recent antiemetic guidelines, the optimal prophylaxis of chemotherapy-induced nausea and vomiting (CINV requires the combination of 5-HT3 receptor antagonist (RA with an NK1-RA. Moreover, the major predictors of acute and delayed CINV include: young age, female sex, platinum- or anthracycline-based chemotherapy, nondrinker status, emesis in the earlier cycles of chemotherapy, and previous history of motion/morning sickness. Despite improved knowledge of the pathophysiology of CINV and advances in the availability of active antiemetics, an inconsistent compliance with their use has been reported, thereby resulting in suboptimal control of CINV in several cases. In this scenario, a new antiemetic drug is now available, which seems to be able to guarantee better prophylaxis of CINV and improvement of adherence to guidelines. In fact, netupitant/palonosetron (NEPA is a ready-to-use single oral capsule, combining an NK1-RA (netupitant and a 5-HT3-RA (palonosetron, which is to be taken 1 hour before the administration of chemotherapy, ensuring the coverage from CINV for 5 days. We reviewed the role of NEPA in patients at high risk of CINV receiving highly emetogenic chemotherapy. In these patients, NEPA plus dexamethasone, as compared to standard treatments, achieved superior efficacy in all primary and secondary end points during the acute, delayed, and overall phases, including nausea assessment. Moreover, these results were also achieved in female patients receiving anthracycline plus cyclophosphamide-based chemotherapy. NEPA represents a real step forward in the prophylaxis of CINV. Keywords: NEPA, netupitant, NK1, CINV, vomiting, risk factors

  18. An Appreciative View of the Brighter Side of Terror Management Processes

    Directory of Open Access Journals (Sweden)

    Kenneth E. Vail, III

    2015-10-01

    Full Text Available Physical death is an inevitable part of life. From the perspective of terror management theory (TMT, people’s efforts to manage the awareness of death can sometimes have harmful social consequences. However, those negative consequences are merely one side of the existential coin. In considering the other side of the coin, the present article highlights the more beneficial trajectories of the terror management process. For example, the awareness of mortality can motivate people to prioritize their physical health; uphold prosocial values; build loving relationships and peaceful, charitable communities; and foster open-mindedness. Further, the article explores the possible balance between defense and growth motivations, including the motivations toward integrative self-expansion, creativity, and well-being. And finally, we tentatively consider the potential positive impacts of direct confrontations with mortality on terror management processes. In sum, the present analysis suggests that although death awareness can sometimes produce some harmful outcomes, at least under certain conditions it can also motivate attitudes and behaviors that have positive personal and social consequences.

  19. Incidence, severity and management of cancer chemotherapy related oral mucositis in Eastern Cape and Western Cape

    Directory of Open Access Journals (Sweden)

    Johanna E. Maree

    2012-10-01

    Full Text Available This study explored the incidence, duration and severity of oral mucositis in patients receiving chemotherapy in the Eastern and Western Cape, how this symptom was managed and whether the patients considered the management to be effective. An exploratory, contextual, quantitative survey was conducted. The sampling method was convenience. One hundred and sixty patients were recruited, with 106, (66.3% participating. Data were collected by means of self-reports, using a self-administered questionnaire. Oral mucositis was a common problem, with 71.7% (n = 76 reporting to have had mucositis. Pain was not effectively managed, as 69.8% (n = 53 of respondents experienced pain whilst only 17.1% (n = 13 reported to have used analgesics. More than half of the respondents used prescribed mouth and throat preparations, whilst 28.9% (n = 22 used non-prescribed self-care measures including potentially harmful products. A significant difference was found between using non-prescribed self-care measures and the duration of oral mucositis (χ² = 0.81; p = 0.01. The reported grade of mucositis did not influence the use of non-prescribed self-care measures, whilst the more pain patients experienced the less inclined they were to use these measures. The management of oral mucositis remains a challenge. Failure to palliate this distressing symptom can lead to the use of potentially harmful self-care measures. Die studie het die insidensie, tydsduur en intensiteit van orale mukositis in Oos en Wes Kaapse pasiënte wat kankerchemoterapie ontvang verken asook hoe hierdie simptoom hanteer is en die sukses hiervan volgens die pasiënte. ‘n Kwantitatiewe, ekploratiewe, kontekstuele opname is onderneem. ‘n Gerieflikheidsteekproef is gebruik om die deelnemers te verkry. Een hondered en sestig persone is genader en 66.3% (n = 106 het aan die studie deelgeneem. Die datainsamelingsmetode was self-rapportering met behulp van ’n vraelys en beskrywende statistiek is gebruik

  20. Energy efficiency and demand side management. Complement or contradiction? The impact of energy efficiency measures on the potential for demand side management; Energieeffizienz und Lastflexibilisierung. Partner oder Gegenspieler? Der Einfluss von Energieeffizienzmassnahmen auf das Lastflexibilisierungspotenzial

    Energy Technology Data Exchange (ETDEWEB)

    Peraus, Sebastian [TU Muenchen (Germany). Maschinenwesen; Gruber, Anna; Roon, Serafin von [Forschungsgesellschaft fuer Energiewirtschaft mbH, Muenchen (Germany)

    2013-02-01

    The success of the so called ''Energiewende'' in Germany is based on two major elements: the improvements in energy efficiency and the increase of renewable energy sources (RES). But the supply of RES cannot always be regulated according to the electricity demand. As a result both flexible electricity generation and demand side management will become increasingly important. Consequently, it has to be discussed, whether the improvement of energy efficiency and demand side management could interfere. This publication will illustrate the possible impact of energy efficiency measures on the potential for demand side management.

  1. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Bossi, Paolo; Majorana, Alessandra; Gastaldi, Giorgio; Berruti, Alfredo; Trippa, Fabio; Nicolai, Pietro; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-06-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is a well-known radical treatment for head and neck cancer patients. Nevertheless acute side effects (such as moist desquamation, skin erythema, loss of taste, mucositis etc.) and in particular late toxicities (osteoradionecrosis, xerostomia, trismus, radiation caries etc.) are often debilitating and underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met in Milan with the aim of reaching a consensus on a clinical definition and management of these toxicities. The Delphi Appropriateness method was used for this consensus and external experts evaluated the conclusions. The paper contains 20 clusters of statements about the clinical definition and management of stomatological issues that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecrosis (10 clusters of statements), whereas this second part deals with trismus and xerostomia (10 clusters of statements). PMID:27061883

  2. Compliance and Effective Management of the Hand-Foot Syndrome in Colon Cancer Patients Receiving Capecitabine as Adjuvant Chemotherapy

    OpenAIRE

    Son, Hyun-Sook; Lee, Woo Yong; Lee, Won-Suk; Yun, Seong Hyeon; Chun, Ho-Kyung

    2009-01-01

    Purpose Physicians and oncology nurses must continue to update their knowledge on treatment and treatment-related side effects, while searching for effective methods to prevent or manage side effects. The objective of our study was to describe the incidence and response to treatment of the hand-foot syndrome (HFS) and the compliance with treatment of patients with stage IIB, IIIA, IIIB, and IIIC colon cancer that were treated with capecitabine alone as adjuvant therapy. Materials and Methods ...

  3. [Efficacy of Levofloxacin Hydrate in Febrile Neutropenia for Outpatient Chemotherapy].

    Science.gov (United States)

    Inagaki, Manato; Sato, Junya; Nihei, Satoru; Kashiwaba, Masahiro; Kudo, Kenzo

    2016-05-01

    Management of febrile neutropenia (FN) is important for the safety of patients undergoing outpatient chemotherapy. Oral antimicrobials are usually prescribed as the initial treatment for FN, and outpatients are instructed to begin medication prior to chemotherapy. However, the effectiveness and safety of the use of these oral antibiotics have not yet been established. In this study, we investigated the effectiveness and safety of levofloxacin hydrate (LVFX) for breast cancer patients with FN, and the factors associated with the onset of FN in 134 breast cancer patients who underwent chemotherapy including the anticancer drug anthracycline (total, 513 courses), in an outpatient chemotherapy department. The effectiveness and safety of LVFX were defined respectively as defervescence within 5 days, and the appearance of side effects such as diarrhea and rashes. Fever was observed in 89 (66%) of the 134 patients, and during 164 (32%) of 513 courses. Defervescence was observed with the LVFX medication in 149 (93%) of 160 courses. The primary side effect was the development of rashes, and only 2 (1%) of the 160 courses were discontinued. Onset of stomatitis during chemotherapy was observed as a factor of FN (odds ratio: 1.36, p<0.05). Our results suggest that the use of LVFX according to the patients' discretion might be an effective and safe option for the management of FN during outpatient chemotherapy.

  4. How Do Nurses Manage Their Occupational Exposure to Cytotoxic Drugs? A Descriptive Survey in Chemotherapy Settings, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    M Askarian

    2013-04-01

    Full Text Available Occupational exposure to cytotoxic drugs is a global concern. We conducted this cross-sectional study in 2012 to describe the adverse effects experienced by nurses working in one of chemotherapy facilities affiliated to Shiraz University of Medical Sciences, Shiraz, southern Iran, and their proper use of personal protective equipment and educational programs. The frequency of side effects reported by participants was noticeably high. Approximately, 60% of the nurses used all personal protective equipment. There were air conditioner ventilation systems in all facilities, but they were not standard. Clinics did not have any dedicated room. Lack of adequate training was noticeable among all participants. We concluded that establishment of safety regulations, health care workers safety surveillance systems as well as continuous training for nurses are of paramount importance.

  5. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Uuspaeae, P. [VTT Energy, Espoo (Finland)

    1996-12-31

    The scope of this research is data communications for electric utilities. Demand Side Management (DSM) calls for communication between the Electric Utility and the Customer. The communication capacity needed will depend on the functions that are chosen for DSM, and on the number of customers. Some functions may be handled with one-way communications, some functions require two-way communication. Utility Communication Architecture looks for an overall view of the communications needs and communication systems in an electric utility. The objective is to define and specify suitable and compatible communications procedures within the Utility and also to outside parties. (27 refs.)

  6. Exploring Tradeoffs in Demand-Side and Supply-Side Management of Urban Water Resources Using Agent-Based Modeling and Evolutionary Computation

    Directory of Open Access Journals (Sweden)

    Lufthansa Kanta

    2015-11-01

    Full Text Available Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger: (1 increases in the volume of water pumped through inter-basin transfers from an external reservoir; and (2 drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

  7. Challenges in management of patients with intracranial germ cell tumor and diabetes insipidus treated with cisplatin and/or ifosfamide based chemotherapy.

    Science.gov (United States)

    Afzal, Samina; Wherrett, Diane; Bartels, Ute; Tabori, Uri; Huang, Annie; Stephens, Derek; Bouffet, Eric

    2010-05-01

    Patients with intracranial germ cell tumor (IGCT) often present with pituitary dysfunction, including diabetes insipidus (DI). Recent protocols have used pre-radiation chemotherapy with combinations of etoposide, carboplatin and/or cisplatin, and ifosfamide. Management of DI in these patients requires monitoring of electrolytes and fluids during chemotherapy and hyperhydration. All consecutive patients treated with chemotherapy for an IGCT during the period 1990-2007 at the Hospital for Sick Children, Toronto were reviewed. Out of 32 patients who received chemotherapy, 21 had DI. Only cycles containing cisplatin and/or ifosfamide and hyperhydration were considered. DI and non-DI patients were compared for each cycle of chemotherapy. Patients were studied for number of days in hospital per chemotherapy course, daily fluid input and output, changes in dose, schedule and route of administration of desmopressin (DDAVP) during chemotherapy, daily variations in sodium level, electrolyte monitoring requirements per day, and complications related to fluid and electrolyte disturbances. Fifty-four cycles of chemotherapy in DI patients were compared to 25 cycles in non DI patients. All 21 patients with DI required daily change in dosage and schedule of DDAVP. Marked variations in daily sodium level were observed in the DI group. Seventeen courses required prolonged admission in the DI group (one in non DI patients) and 6 patients experienced serious complications. In conclusion, DI is a risk factor for complications when cisplatin and/or ifosfamide based protocols are used. The role of these agents in the management of ICGT should be carefully evaluated and guidelines for management of DI established. PMID:19820898

  8. An Enhanced System Architecture for Optimized Demand Side Management in Smart Grid

    Directory of Open Access Journals (Sweden)

    Anzar Mahmood

    2016-04-01

    Full Text Available Demand Side Management (DSM through optimization of home energy consumption in the smart grid environment is now one of the well-known research areas. Appliance scheduling has been done through many different algorithms to reduce peak load and, consequently, the Peak to Average Ratio (PAR. This paper presents a Comprehensive Home Energy Management Architecture (CHEMA with integration of multiple appliance scheduling options and enhanced load categorization in a smart grid environment. The CHEMA model consists of six layers and has been modeled in Simulink with an embedded MATLAB code. A single Knapsack optimization technique is used for scheduling and four different cases of cost reduction are modeled at the second layer of CHEMA. Fault identification and electricity theft control have also been added in CHEMA. Furthermore, carbon footprint calculations have been incorporated in order to make the users aware of environmental concerns. Simulation results prove the effectiveness of the proposed model.

  9. Management of metastatic malignant thymoma with advanced radiation and chemotherapy techniques: report of a rare case

    OpenAIRE

    D’Andrea, Mark A; Reddy, G. Kesava

    2015-01-01

    Malignant thymomas are rare epithelial neoplasms of the anterior superior mediastinum that are typically invasive in nature and have a higher risk of relapse that may ultimately lead to death. Here we report a case of an advanced malignant thymoma that was successfully treated with neoadjuvant chemotherapy followed by surgical resection and subsequently with advanced and novel radiation therapy techniques. A 65-year-old male was diagnosed with a stage IV malignant thymoma with multiple metast...

  10. Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies

    Directory of Open Access Journals (Sweden)

    Rodríguez Américo David

    2006-01-01

    Full Text Available OBJECTIVE: To assess household acceptability and perceived side effects of residual indoor pyrethroid (PYR, carbamate and organophosphate insecticides sprayed by annual rotation (ROT, spatial mosaic (MOS, and a single insecticide (DDT or PYR in communities of the coastal plain of Chiapas, Mexico. MATERIAL AND METHODS: A questionnaire to assess the acceptability and perceived side effects of indoor insecticides was administered to one member of 30% of the families in eight villages of Chiapas. The association of different insecticide treatments with their responses was evaluated (Chi-square. The intensity of side effects indicated under different treatments was compared in an ordered logistic model, using a severity index as the response variable. RESULTS: Insecticide spraying as a probable cause of symptoms was identified by 2.1% of interviewees. A significantly high percentage of persons with blurred vision, dizziness, sneezing, coughing, numbness, watery eyes, and itching lived in villages under MOS and ROT and a high severity index was significantly associated with ROT treatment. Reduction of mosquito bites and cockroaches were the perceived main benefits, and most villagers that perceived no benefits lived in DDT treated villages. Most of the interviewees welcomed spraying (83.7%, but the smell and having to remove furniture from houses were the main arguments against it. CONCLUSIONS: Acceptability correlated with insecticide spray coverage, although the most frequent suggestion for improvement was to increase the understanding of the objectives of spraying in the communities. The frequency of side effects was low, but higher in localities where a combination of insecticides was applied. This is a limitation for the use of this type of resistance management strategy in public health.

  11. Total colectomy: Options in management of acute obstruction of the left-side colon

    Directory of Open Access Journals (Sweden)

    Vuković Milivoje

    2008-01-01

    Full Text Available Introduction. Emergency colorectal surgery has been associated with a high morbidity and mortality rate. The current trend for the management of obstruction of left-sided colorectal carcinoma favours primary resection and anastomosis, as a safe and acceptable approach to selected patients. Method Retrospective review of 81 patients (46 male and 35 female, mean 64 years. Results Morbidity after emergency total colectomy was 21%, and mortality was 6%. There were 6 anastomotic complications (2 an-astomotic disruptions and 4 anastomotic leaks. Mean hospital stay was 13 days. 82% patients had adequate continence. Discussion: Traditional approach for left-sided colon obstruction is three-stage procedure (Bloch-Paul-Mikulicz. The idea of removing dilated colon proximal to an obstructing tumor is not new, since Lane suggested this option in 1914. In 1965 Hughes and Cuthberson described their experience with 12 patients. At the moment of laparotomy 20% patients had advanced malignant disease. The cumulative morbidity and mortality are high in three-stage procedure. Three-stage approach is associated with high permanent colostomy rate. One-stage resection with primary anastomosis of the obstructed left-sided colon is a safe alternative to staged procedures. Emergency radical resection can be safely performed in majority of patients with left-colon obstruction. Conclusions Total colectomy with anastomosis is a suitable procedure for treating left-sided colonic obstruction provided that pelvic floor is adequate. Total colectomy has low mortality, acceptable morbidity and good quality of life. The success of the surgery depends on the selection of patients. .

  12. Demand-side management and European environmental and energy goals: An optimal complementary approach

    International Nuclear Information System (INIS)

    Demand side management (DSM) in electricity markets could improve energy efficiency and achieve environmental targets through controlled consumption. For the past 10 years or so DSM programmes have registered significant results. However, detailed analysis of its real impact as observed by a large number of pilot studies suggests that such programmes need to be fine-tuned to suit clearly identified conditions. This study aims to provide recommendations for the instruments to be used to prompt demand response with a view to maximizing energy and environmental efficiencies of various countries. The present study suggests that different DSM models should be deployed depending on the specific generation mix in any given country. Beside the natural benefits from cross-borders infrastructures, DSM improves the flexibility and reliability of the energy system, absorbing some shock on generation mix. We show efficiency increases with demand response but at a decreasing rate. So, according to rebound and report effects, simple DSM tools could be preferred. - Highlights: • Demand side management could improve energy and environmental efficiency. • Several instruments should be used to achieve significant load-shedding. • DSM models should be deployed depending on generation mix. • Efficiency increases with demand response but at a decreasing rate. • Rebound and report effects reduce positive impacts

  13. Optimization Models and Methods for Demand-Side Management of Residential Users: A Survey

    Directory of Open Access Journals (Sweden)

    Antimo Barbato

    2014-09-01

    Full Text Available The residential sector is currently one of the major contributors to the global energy balance. However, the energy demand of residential users has been so far largely uncontrollable and inelastic with respect to the power grid conditions. With the massive introduction of renewable energy sources and the large variations in energy flows, also the residential sector is required to provide some flexibility in energy use so as to contribute to the stability and efficiency of the electric system. To address this issue, demand management mechanisms can be used to optimally manage the energy resources of customers and their energy demand profiles. A very promising technique is represented by demand-side management (DSM, which consists in a proactive method aimed at making users energy-efficient in the long term. In this paper, we survey the most relevant studies on optimization methods for DSM of residential consumers. Specifically, we review the related literature according to three axes defining contrasting characteristics of the schemes proposed: DSM for individual users versus DSM for cooperative consumers, deterministic DSM versus stochastic DSM and day-ahead DSM versus real-time DSM. Based on this classification, we provide a big picture of the key features of different approaches and techniques and discuss future research directions.

  14. Public perceptions of demand-side management and a smarter energy future

    Science.gov (United States)

    Spence, Alexa; Demski, Christina; Butler, Catherine; Parkhill, Karen; Pidgeon, Nick

    2015-06-01

    Demand-side management (DSM) is a key aspect of many future energy system scenarios. DSM refers to a range of technologies and interventions designed to create greater efficiency and flexibility on the demand-side of the energy system. Examples include the provision of more information to users to support efficient behaviour and new `smart’ technologies that can be automatically controlled. Key stated outcomes of implementing DSM are benefits for consumers, such as cost savings and greater control over energy use. Here, we use results from an online survey to examine public perceptions and acceptability of a range of current DSM possibilities in a representative sample of the British population (N = 2,441). We show that, although cost is likely to be a significant reason for many people to take up DSM measures, those concerned about energy costs are actually less likely to accept DSM. Notably, individuals concerned about climate change are more likely to be accepting. A significant proportion of people, particularly those concerned about affordability, indicated unwillingness or concerns about sharing energy data, a necessity for many forms of DSM. We conclude substantial public engagement and further policy development is required for widespread DSM implementation.

  15. A Novel Prosumer-Based Energy Sharing and Management (PESM Approach for Cooperative Demand Side Management (DSM in Smart Grid

    Directory of Open Access Journals (Sweden)

    Sohail Razzaq

    2016-10-01

    Full Text Available Increasing population and modern lifestyle have raised energy demands globally. Demand Side Management (DSM is one important tool used to manage energy demands. It employs an advanced power infrastructure along with bi-directional information flow among utilities and users in order to achieve a balanced load curve and minimize demand-supply mismatch. Traditionally, this involves shifting the electricity demand from peak hours to other times of the day in an optimized manner. Multiple users equipped with renewable resources work in coordination with each other in order to achieve mutually beneficial energy management. This, in turn, has generated the concept of cooperative DSM. Such users, called prosumers, consume and produce energy using renewable resources (solar, wind etc.. Prosumers with surplus energy sell to the grid as well as to other consumers. In this paper, a novel Prosumer-based Energy Sharing and Management (PESM scheme for cooperative DSM has been proposed. A simulation model has been developed for testing the proposed method. Different variations of the proposed methodology have been experimented with different criteria. The results show that the proposed energy sharing scheme achieves DSM purposes in a useful manner.

  16. Multicriteria evaluation of demand side management (DSM) implementation strategies in the Indian power sector

    Energy Technology Data Exchange (ETDEWEB)

    Vashishtha, Sanjay [Centre for Renewable Energy and Environmental Development (CREED), BITS, Pilani, Rajasthan 333031 (India); Ramachandran, M. [BITS Pilani Dubai Centre, Dubai (United Arab Emirates)

    2006-09-15

    In recent years, demand side management (DSM) has emerged as an efficient utility planning strategy for reducing capacity shortages and improving system load factors. The Indian government is adopting various policies to implement DSM programs. DSM implementation involves a variety of interests with conflicting objectives, and a range of possible implementation strategies with varying implications for effectiveness, cost, feasibility, efficiency and stakeholder acceptance. This necessitates a critical comparison of the strategies to determine a preferred strategy or combination of strategies from each specific stakeholder's point of view. The present study evaluates DSM implementation strategies from a multiobjective perspective using the Analytic Hierarchy Process (AHP). Eight strategies and six criteria were considered. Forty utility, regulator, and consumer stakeholders were surveyed. The most highly ranked strategies involved creating dedicated funds and providing technical support to end users for effective implementation of DSM. (author)

  17. Principles concerning the progress of the gas demand side management in Romania

    International Nuclear Information System (INIS)

    The consequences of the application of demand side management (DSM) and integrated resources planning (IRP) notions for natural gas are analysed. Present socio-economic context in Romania - from a geopolitical point of view - obviously highlights a set of difficult gas supply problems in our country related to: the impossibility of satisfying the consumption demand from internal resources; the necessity of ensuring by imports of an important quantity of gas, which entails an important foreign currency expenditure and possible political pressures which an unique supplier could exert; the requirement of alignment to the western European country legislation, at an institutional and economical practice level. Each of these problems related to the gas-based power production and all together impose the tackling of DSM and IRP requirements from a strategic point of view. Some conclusions and proposals are presented. (author) 1 fig., 4 refs

  18. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Kaerkkaeinen, S.; Kekkonen, V. [VTT Energy, Espoo (Finland); Rissanen, P. [Tietosavo Oy (Finland)

    1996-12-31

    In this project the main target is to develop and assess methods for DSM (Demand Side Management) and distribution automation planning from the utility`s point of view. The final goal is to integrate these methods for the strategic planning of electric utilities. In practice the project is divided into four main parts: The development and assessment of DSM/IRP planning methods and cost/benefit analysis as a part of international co-operation (IEA DSM Agreement: Annex IV, European Cost/Benefit analysis of DSM, EUBC, and Finnish SAVE-project started in 1995 in co-operation with SRC International and six electric utilities in Finland); Development of PC-based DSM planning and assessment tools at VTT; Development of a decision support system of distribution network planning including DSM options at Tietosavo Oy and Integration of DSM planning and network planning tools in co-operation with VTT Energy and Tietosavo Oy

  19. Power System Transient Stability Improvement Using Demand Side Management in Competitive Electricity Markets

    DEFF Research Database (Denmark)

    Hu, Weihao; Wang, Chunqi; Chen, Zhe;

    2012-01-01

    price is proposed. A 102-bus power system which represents a simplified model of the western Danish power system is chosen as the study case. Simulation results show that the optimal load response to electricity prices is an effective measure to improve the power system transient stability with high......Since the hourly spot market price is available one day ahead in Denmark, the price could be transferred to the consumers and they may shift some of their loads from high price periods to the low price periods in order to save their energy costs. The optimal load response to an electricity price...... for demand side management generates different load profiles and may provide an opportunity to improve the transient stability of power systems with high wind power penetrations. In this paper, the idea of the power system transient stability improvement by using optimal load response to the electricity...

  20. Incentive-compatible demand-side management for smart grids based on review strategies

    Science.gov (United States)

    Xu, Jie; van der Schaar, Mihaela

    2015-12-01

    Demand-side load management is able to significantly improve the energy efficiency of smart grids. Since the electricity production cost depends on the aggregate energy usage of multiple consumers, an important incentive problem emerges: self-interested consumers want to increase their own utilities by consuming more than the socially optimal amount of energy during peak hours since the increased cost is shared among the entire set of consumers. To incentivize self-interested consumers to take the socially optimal scheduling actions, we design a new class of protocols based on review strategies. These strategies work as follows: first, a review stage takes place in which a statistical test is performed based on the daily prices of the previous billing cycle to determine whether or not the other consumers schedule their electricity loads in a socially optimal way. If the test fails, the consumers trigger a punishment phase in which, for a certain time, they adjust their energy scheduling in such a way that everybody in the consumer set is punished due to an increased price. Using a carefully designed protocol based on such review strategies, consumers then have incentives to take the socially optimal load scheduling to avoid entering this punishment phase. We rigorously characterize the impact of deploying protocols based on review strategies on the system's as well as the users' performance and determine the optimal design (optimal billing cycle, punishment length, etc.) for various smart grid deployment scenarios. Even though this paper considers a simplified smart grid model, our analysis provides important and useful insights for designing incentive-compatible demand-side management schemes based on aggregate energy usage information in a variety of practical scenarios.

  1. Hawaii demand-side management resource assessment. Final report: DSM opportunity report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    The Hawaii Demand-Side Management Resource Assessment was the fourth of seven projects in the Hawaii Energy Strategy (HES) program. HES was designed by the Department of Business, Economic Development, and Tourism (DBEDT) to produce an integrated energy strategy for the State of Hawaii. The purpose of Project 4 was to develop a comprehensive assessment of Hawaii`s demand-side management (DSM) resources. To meet this objective, the project was divided into two phases. The first phase included development of a DSM technology database and the identification of Hawaii commercial building characteristics through on-site audits. These Phase 1 products were then used in Phase 2 to identify expected energy impacts from DSM measures in typical residential and commercial buildings in Hawaii. The building energy simulation model DOE-2.1E was utilized to identify the DSM energy impacts. More detailed information on the typical buildings and the DOE-2.1E modeling effort is available in Reference Volume 1, ``Building Prototype Analysis``. In addition to the DOE-2.1E analysis, estimates of residential and commercial sector gas and electric DSM potential for the four counties of Honolulu, Hawaii, Maui, and Kauai through 2014 were forecasted by the new DBEDT DSM Assessment Model. Results from DBEDTs energy forecasting model, ENERGY 2020, were linked with results from DOE-2.1E building energy simulation runs and estimates of DSM measure impacts, costs, lifetime, and anticipated market penetration rates in the DBEDT DSM Model. Through its algorithms, estimates of DSM potential for each forecast year were developed. Using the load shape information from the DOE-2.1E simulation runs, estimates of electric peak demand impacts were developed. 10 figs., 55 tabs.

  2. Correlation Analysis of Nutrition Status, Quality of Life and Chemotherapy Side-effects in Digestive Tract Cancer Patients Receiving Chemotherapy%消化道肿瘤化疗患者营养状况与生活质量及化疗不良反应的相关性分析

    Institute of Scientific and Technical Information of China (English)

    周婉; 许勤; 言克莉; 任驹茗; 严凤

    2015-01-01

    Objective To explore the relationships of nutrition status, quality of life and chemotherapy side-effects for digestive tract cancer patients receiving chemotherapy. Methods With convenience sample method, 150 digestive tract cancer patients receiving chemotherapy were taken as subjects. Nutrition risk screening, quality of life and chemotherapy side-effect were respectively assessed by Patient Generated Subjective Global Assessment (PG-SGA), European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (QLQ-C30) scales and The Common Terminology Criteria for Adverse Events (CTCAE) scales. Results The scores of nutrition were 4.97 ±2.77 and the prevalence of malnutrition was 54.0%. The scores of nutrition were negatively correlated with physical function, role function, emotional function, cognitive function and general health status, and positively correlated with fatigue, nausea and vomiting, pain, insomnia, appetite loss, constipation and diarrhea. The scores of nutrition were positively correlated with leukopenia, anemia, nausea and vomiting of chemotherapy side-effects. Conclusion The nutrition status of patients remains poor. A high prevalence of malnutrition in digestive tract cancer patients receiving chemotherapy is observed which is closely correlated with various functional dimensions of QOL and chemotherapy side-effect. Therefore, a better nutrition status of patients contributed by early nutritional support and diet care can result in the improved quality of life and reduced chemotherapy side-effects.%目的:了解消化道肿瘤化疗患者营养状况,并探讨其营养状况与生活质量及化疗不良反应的相关性。方法采用方便抽样法,使用患者自评主观整体营养评估量表、癌症患者生活质量量表、通用不良反应事件评价标准及自行设计一般资料调查问卷,对某三级甲等医院肿瘤科150例消化道肿瘤化疗患者进行调查。结果150例

  3. Chemotherapy of lung cancer.

    OpenAIRE

    Papac, R J

    1981-01-01

    The potential for substantial improvement in the outcome of patients with carcinoma of the lung seem most likely to develop in the field of chemotherapy. In the past decade, striking advances in the management of small cell carcinoma have yielded response rates and longer survival. While the greatest improvement can be predicted for patients whose disease is limited in extent, combination chemotherapy and combined modality therapy generally are effective in causing tumor regression for the ma...

  4. New vision of demand side management strategy as the main tool in cooperation suppliers and consumers of electrical energy

    International Nuclear Information System (INIS)

    The paper presents the complex proposal for the implementation of the demand side management in the Polish energy sector. The issue of demand side management is well known in the world, European and domestic dimensions. The experience of western countries shows that at least to some extent, the demand side management strategy is already implemented there. However, Polish experience is far too insufficient. Demand side management consists in efficient management of energy demand as well as adoption of this demand i.e. changing the load. The decrease of energy consumption in the moment of its peak demand leads to the balance between the demand and supply in the system, which influences the market price of energy. If certain mechanisms are implemented that will cause that final receivers will be willing to adjust their demand for energy, we will create the Demand Response, which is an efficient tool in the demand side management strategy. It is assumed that electronic meters will bring a real quality change. The undertakings based on initiatives of the Polish Energy Regulatory Office that promote the concept of implementation of electronic metering in the Polish energy sector prove that Poland is determined to improve its energy efficiency. The report describes the concept of the electronic meters that enables the realisation of the demand side management strategy as well as other complementary solutions that make the strategy even more efficient. In this field, it is planned to establish a dedicated loyalty programmes for energy receivers. The concept includes also the combination of the model solutions with the campaign 'energy efficiency' organised by the Ministry of Economy, which aims at fulfilling the requirements of the directive 2006/32/EC on energy end-use efficiency and energy services. As complementary solution in this new vision to add the system of recycling of waste heat home appliance devices. (Author)

  5. Acute skin toxicity management in head and neck cancer patients treated with radiotherapy and chemotherapy or EGFR inhibitors : Literature review and consensus

    NARCIS (Netherlands)

    Russi, Elvio G.; Moretto, Francesco; Rampino, Monica; Benasso, Marco; Bacigalupo, Almalina; De Sanctis, Vitaliana; Numico, Gianrnauro; Bossi, Paolo; Buglione, Michela; Lombardo, Antonino; Airoldi, Mario; Merlano, Marco C.; Licitra, Lisa; Denaro, Nerina; Pergolizzi, Stefano; Pinto, Carmine; Bensadoun, Rene-Jean; Girolomoni, Giarnpiero; Langendijk, Johannes A.

    2015-01-01

    The adverse effects of radiation therapy, often integrated with chemotherapy and/or targeted therapies, on the skin include severe acute and chronic dermatitis associated with pain, discomfort, itching, and burning, and may heavily affect patients' quality of life. The management of these skin adver

  6. DSM [demand-side management] opportunities in Alberta: An economist's perspective

    International Nuclear Information System (INIS)

    In Alberta, utility companies are placing increasing attention on demand-side management (DSM) as one option for meeting future demand. Some basic economic principles are provided to yield a guideline on how much a utility should be spending on DSM initiatives. For the case of financial incentives to customers, it is shown that subsidies based on sound economic principles will enable the utility to charge lower overall rates to customers receiving the subsidy without raising other customers' rates. Moving outside of a well-understood market-based system and into a fully centralized planning approach to DSM eliminates a critical link between utilities and their customers. In Alberta, DSM measures appropriate in other regions will not be appropriate due to the province's unique supply and demand characteristics. Most of Alberta's electricity supply comes from low-cost coal-fired plants. On the demand-side, there is a significant concentration of large industrial and commercial consumers, notably in the oil and gas industry, and there is essentially no demand for electric heating in homes since natural gas is very abundant. The Alberta integrated power system currently operates at a load factor of ca 77%, reflecting the large industrial demand and the absence of a winter peaking effect associated with electrical heating requirements. A relatively small difference in embedded and incremental electricity supply costs means that utilities have little to spend on DSM programs. The identification of cost-effective DSM opportunities, most of which are likely to be found in the industrial sector, requires a considerable amount of detailed information on consumer behavior and close collaboration between utility and customer

  7. Demand side management for commercial buildings using an in line heat pump water heating methodology

    International Nuclear Information System (INIS)

    Most of the sanitary hot water used in South African buildings is heated by means of direct electrical resistance heaters. This is one of the major contributors to the undesirably high morning and afternoon peaks imposed on the national electricity supply grid. For this reason, water heating continues to be of concern to the electricity supplier, ESCOM. Previous studies, conducted by the Potchefstroom University for Christian Higher Education in South Africa, indicated that extensive application of the so called inline heat pump water heating methodology in commercial buildings could result in significant demand side management savings to ESKOM. Furthermore, impressive paybacks can be obtained by building owners who choose to implement the design methodology on existing or new systems. Currently, a few examples exist where the design methodology has been successfully implemented. These installations are monitored with a fully web centric monitoring system that allows 24 h access to data from each installation. Based on these preliminary results, a total peak demand reduction of 108 MW can be achieved, which represents 18% of the peak load reduction target set by ESKOM until the year 2015. This represents an avoided cost of approximately MR324 (ZAR) [Int J Energy Res 25(4) (1999) 2000]. Results based on actual data from the monitored installations shows a significant peak demand reduction for each installation. In one installation, a hotel with an occupancy of 220 people, the peak demand contribution of the hot water installation was reduced by 86%, realizing a 36% reduction in peak demand for the whole building. The savings incurred by the building owner also included significant energy consumption savings due to the superior energy efficiency of the heat pump water heater. The combined savings result in a conservatively calculated straight payback period of 12.5 months, with an internal rate of return of 98%. The actual cost of water heating is studied by

  8. Domestic demand-side management (DSM): Role of heat pumps and thermal energy storage (TES) systems

    International Nuclear Information System (INIS)

    Heat pumps are seen as a promising technology for load management in the built environment, in combination with the smart grid concept. They can be coupled with thermal energy storage (TES) systems to shift electrical loads from high-peak to off-peak hours, thus serving as a powerful tool in demand-side management (DSM). This paper analyzes heat pumps with radiators or underfloor heating distribution systems coupled with TES with a view to showing how a heat pump system behaves and how it influences the building occupants' thermal comfort under a DSM strategy designed to flatten the shape of the electricity load curve by switching off the heat pump during peak hours (16:00–19:00). The reference scenario for the analysis was Northern Ireland (UK). The results showed that the heat pump is a good tool for the purposes of DSM, also thanks to the use of TES systems, in particular with heating distribution systems that have a low thermal inertia, e.g. radiators. It proved possible to achieve a good control of the indoor temperature, even if the heat pump was turned off for 3 h, and to reduce the electricity bill if a “time of use” tariff structure was adopted. -- Highlights: ► Heat pump heating systems with thermal energy storage are considered. ► System behavior is investigated during a DSM strategy for reducing peak energy demand. ► Heat pump heating systems demonstrate to be able to have an active role in DSM programs. ► A TES system must be coupled with the heat pump in presence of low thermal inertia heating distribution systems. ► Central role played by incentives schemes to promote this technology

  9. SmartBuildings. Implementation of demand-side-management systems; SmartBuildings. Implementierung von Lastmanagementsystemen

    Energy Technology Data Exchange (ETDEWEB)

    Jungwirth, Johannes; Saenger, Florian; Grahovac, Milica [TU Muenchen (Germany). Lehrstuhl fuer Energiewirtschaft und Anwendungstechnik; Roessel, Timm; Schneegans, Jakob; Herzog, Simon [TU Muenchen (Germany). Lehrstuhl fuer Bauklimatik und Haustechnik; Mikulovic, Vesna [Siemens Building Technologies Headquarters, Zug (Switzerland)

    2012-07-01

    A transition to flexible consumer load can contribute significantly to the integration of renewable energies. Precisely controllable electrical consumers from the building sector (heating, ventilation, air conditioning) are applicable for demand-side-management by using the thermal inertia of the building. In order to incentivize a load shift scenarios of flexible electricity rates are developed. Flexible users can shift their operation to times of lower prices and therefore minimize their electricity costs. Within a simulation of the building and the building services the impact of modified operation mode on thermal comfort of the room is analyzed and times of operation are optimized. The implementation of resulting theoretical potential of a load shift in a real building necessitates a simulation model of the building. Since the creation of these models is very complex, universally applicable adaptive models of the buildings are developed. After a training process those adaptive models have acquired the skill to predict the building behaviour. Now they are able to forecast effects of various modes of operation and provide a cost-optimized operation schedule for building technology. Neural networks used to build adaptive models deliver promising results. However, initial measurements and training periods are to be optimized. (orig.)

  10. The past, present, and future of U.S. utility demand-side management programs

    International Nuclear Information System (INIS)

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers' energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests

  11. Analysis of Cool Roof Coatings for Residential Demand Side Management in Tropical Australia

    Directory of Open Access Journals (Sweden)

    Wendy Miller

    2015-06-01

    Full Text Available Cool roof coatings have a beneficial impact on reducing the heat load of a range of building types, resulting in reduced cooling energy loads. This study seeks to understand the extent to which cool roof coatings could be used as a residential demand side management (DSM strategy for retrofitting existing housing in a constrained network area in tropical Australia where peak electrical demand is heavily influenced by residential cooling loads. In particular this study seeks to determine whether simulation software used for building regulation purposes can provide networks with the ‘impact certainty’ required by their DSM principles. The building simulation method is supported by a field experiment. Both numerical and experimental data confirm reductions in total consumption (kWh and energy demand (kW. The nature of the regulated simulation software, combined with the diverse nature of residential buildings and their patterns of occupancy, however, mean that simulated results cannot be extrapolated to quantify benefits to a broader distribution network. The study suggests that building data gained from regulatory simulations could be a useful guide for potential impacts of widespread application of cool roof coatings in this region. The practical realization of these positive impacts, however, would require changes to the current business model for the evaluation of DSM strategies. The study provides seven key recommendations that encourage distribution networks to think beyond their infrastructure boundaries, recognising that the broader energy system also includes buildings, appliances and people.

  12. Cost-effectiveness of trees for demand-side management Washington, DC

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1992-12-01

    Trees can reduce demand for air conditioning to cool buildings by shading residences and lowering summertime air temperatures. During winter, trees can reduce heating needs by lowering wind speeds and thereby reducing infiltration of cold air. On the otherhand, winter shade from improperly located trees can increase heating requirements. Projections from computer simulations indicate that 100 million mature trees in U.S. cities (3 trees for every other single family home) could reduce energy use for heating and cooling by 30 billion kWh and reduce carbon dioxide emissions by as much as 9 million tons per year. This energy analysis is part of a larger study that quantifies costs and benefits of proposed tree plantings in 12 U.S. cities. While energy savings is an important benefit from community forests, other benefits (e.g., air quality improvement, reduced stormwater runoff, increased property values) can have equal or greater value. Tree planting, care, and other costs (e.g., water-sewer line repair, green waste disposal, litigation/liability, program administration) from the cost-benefit study can be used to help estimate costs associated with a tree planting program for demand-side management. Data from this energy analysis should be of direct value to local utilities, urban foresters, planners, landscape designers, and non-profit tree planting groups.

  13. Industrial operations and maintenance demand-side management resource development: Literature and data review

    Energy Technology Data Exchange (ETDEWEB)

    Parker, S.A.; Gaustad, K.L.; Szydlowski, R.F.; Winiarski, D.W.

    1994-01-01

    Industry in the Pacific Northwest consumes a significant percentage of the total regional electric load; however, industrial demand-side management resource development activities in this sector are underdeveloped. One such opportunity for electricity resource development is through maintenance (O&M) activities. Despite the importance of industry in the Pacific Northwest, little information has been available on the DSM resource potential, particularly through O&M activities. To obtain this information, the Bonneville Power Administration commissioned Pacific Northwest Laboratory to study the DSM resource potential that may be achieved through O&M practices in Pacific Northwest industries. The information from this report will be used to identify one or more specific O&M activities or industries having significant opportunity for reducing electricity consumption for further evaluation in future tasks to this project. The overall goal of this project is to determine, confirm, and develop the conservation resources that can be achieved from O&M practices in Pacific Northwest industries. This project is developmental in nature because its scope involves a sizable task whose path and direction is difficult to define in advance. The primary focus of this report is to summarize the major findings of the literature and datareview. Detailed analysis and use of all data gathered in the review are beyond the scope this study. However, the reported findings in this analysis provide an extensive framework for identifying and estimating the electric resource potential available in the industrial manufacturing sector.

  14. Proceedings of the CEATI demand side management workshop on understanding customer response. CD-ROM ed.

    International Nuclear Information System (INIS)

    Demand for electricity continues to increase in the midst of environmental concerns, deregulation and the rapid evolution of technology. In order to succeed in a changing environment, utilities must be both adaptive and innovative. Growing concerns over supply and the environmental effects of rising consumption rates have led many utilities to establish demand side management (DSM) programs. However, some utilities have failed to consider the importance of customer behaviour in the success of DSM programs. This conference examined various successful initiatives to encourage customers to reduce their individual or corporate demands for energy. The influence of branding, technology, information prices signals and various other strategies were explored. Issues concerning energy efficiency and customer feedback were discussed. The effect of alternative pricing regimes on DSM programs was investigated. Various information system tools were also examined, and the value of real time electricity monitoring was evaluated. Various DSM initiatives in North America were used to establish benchmarks for the successful implementation of DSM strategies. The conference was divided into 3 sessions: (1) involving the customer in reducing demand; (2) the success of energy efficiency and demand response programs : the impact of branding and the impact of price signals; and (3) the technologies and innovations needed to make it work. The conference featured 13 presentations, of which 8 have been catalogued separately for inclusion in this database. refs., tabs., figs

  15. Meeting customer and utility needs in Guam through demand side management service delivery

    Energy Technology Data Exchange (ETDEWEB)

    Comacho, B. [Guam Power Authority, Agana, (Guam); Ryan, P. [SRC International Pty Ltd., Melbourne, VIC (Australia)

    1995-12-31

    The Guam Power Authority (GPA) is implementing several Demand Side Management (DSM) programs as a result of in-depth analysis of the benefits to this island community. The first four of these programs have been launched to the residential and business community in August 1994. Two programs, high efficiency hot water and high efficiency air conditioning, target the residential sector. Two programs target the commercial sector, high efficiency lighting and high efficiency cooling. The design of energy efficiency programs that meet the needs of the customer and the utility economic criteria requires the collection and analysis of data which is unique to the utilities service area, such as end use equipment types, efficiency levels, annual sales and customer awareness, decision making criteria and expectations. The paper examines the differing marketing approaches applied to the programs and target markets, with a close examination of the results obtained and the predictions made during the design phase. In addition, the methodology used to evaluate the programs is discussed. The paper details the latest results of the four programs and provides an assessment of the program`s success in meeting the needs of the GPA and its customers. Lessons learned from the design and implementation of the programs are also illustrated. (author). 3 tabs., 2 figs.

  16. The past, present, and future of U.S. utility demand-side management programs

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J. [Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.

    1996-12-01

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.

  17. Distributed demand side management via smart appliances contributing to frequency control

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wei-chen

    2015-01-01

    Nowadays renewable energy has become a trend for energy production but its variable nature has made balancing of demand and supply of the power grid difficult. Dynamic demand management using smart appliances is proposed to serve as a way that part of the regulation burden of balancing demand and supply is shifted to the demand side. However, if all appliances respond to the same frequency deviation, they may start to synchronize, causing large power overshoots and instability of the power grid. Therefore, the idea of implementing randomness into the frequency control of the appliances is proposed and this is what we call a stochastic approach. Simulators are built from scratch to model both scenarios. The effect of synchronization is analyzed and the parameters that can affect the synchronization are investigated. It has been found that the larger the contribution from the smart appliances to the power grid, the easier and faster the synchronization takes place. The stochastic approach solves the problem of synchronization and averages out the large power overshoot. However, the overall performance of stochastic operations is unacceptable due to the randomness in the operation though the mean and variance are as expected. More advanced feedback policies and schemes may be designed to achieve a better performance.

  18. Dietetic management in gastrointestinal complications from antimalignant chemotherapy Dietoterapia en complicaciones gastrointestinales de quimioterápicos

    OpenAIRE

    L. Calixto-Lima; E. Martins de Andrade; Gomes, A. P.; Geller, M.; R. Siqueira-Batista

    2012-01-01

    Antineoplastic chemotherapy (CT) represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading t...

  19. [Chemotherapy for prostate cancer].

    Science.gov (United States)

    Rauchenwald, Michael; De Santis, Maria; Fink, Eleonore; Höltl, Wolfgang; Kramer, Gero; Marei, Isabella-Carolina; Neumann, Hans-Jörg; Reissigl, Andreas; Schmeller, Nikolaus; Stackl, Walter; Hobisch, Alfred; Krainer, Michael

    2008-01-01

    For many years the benefit of chemotherapy in patients with prostate cancer was thought to be limited to palliation of late-stage disease, and thus this treatment option only became involved in patient care towards the end of the disease process, if at all. However, two landmark phase-III trials with docetaxel-based therapy (TAX 327 and Southwest Oncology Group, SWOG, 9916) have shown a survival benefit for patients with hormone refractory prostate cancer (HRPC) thus prompting a change in patterns of care. With raising interest for chemotherapeutic options and clinical trials for new drugs and new indications (neoadjuvant therapy, adjuvant therapy, increasing PSA levels after local treatment, and hormone sensitive cancer) under way our goal was to review within the context of a multidisciplinary team the available evidence and explore the standard for the medical treatment of prostate cancer outside of clinical trials. We are carefully evaluating the current treatment recommendations based on the available evidence and highlight potential future treatment options but also discuss important clinical topics (treatment until progression versus the advantage of chemo holidays, definition of particular patient subgroups and potential second line options) for which there are no clear cut answers to date. The role and importance of radiotherapy, biphosphonate treatment and the medical management of pain and side effects is also discussed. The multitude of treatment options for patients with advanced prostate cancer clearly asks for a close collaboration between urologists, medical oncologists and radiation therapists. PMID:18726672

  20. Topic controversies in the endoscopic management of malignant hilar strictures using metal stent: side-by-side versus stent-in-stent techniques.

    Science.gov (United States)

    Moon, Jong Ho; Rerknimitr, Rungsun; Kogure, Hirofumi; Nakai, Yousuke; Isayama, Hiroyuki

    2015-09-01

    Endoscopic management of unresectable hilar malignant biliary stricture (MBS) is currently challenging, and the best approach is still controversial. Liver volume is the key to adequate biliary drainage in hilar MBS and multiple stenting is mandatory to drain over 50% of liver volume in most cases. The self-expandable metallic stent (SEMS) has shown superior patency to plastic stents in recent reports. There are two methods of multiple stenting for hilar MBS: stent-in-stent (SIS) and side-by-side (SBS). Advantages of SIS include multiple SEMS placement in one stent caliber at the common bile duct (CBD), which is considered physiologically ideal. The through-the-mesh (TTM) technique with guidewires and the SEMS delivery system can be technically difficult in SIS, although the recent development of dedicated SEMSs having a loose portion facilitating the TTM technique makes SIS technically feasible both at stent deployment and re-interventions. Conversely, the SBS technique, if placed across the papilla, is technically simple at initial placement and re-intervention at stent occlusion. However, SBS has potential disadvantages of overexpansion of the CBD because of parallel placement of multiple SEMS, which can lead to portal vein thrombosis. Given the limited evidence available, a well-designed randomized controlled trial comparing these two techniques is warranted. PMID:26136361

  1. Nursing-led management of side effects of radiation: evidence-based recommendations for practice

    OpenAIRE

    Poirier P

    2013-01-01

    Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lea...

  2. Assessing clinicians' perspectives about the identification and management of antipsychotic medication side-effects: Psychometric evaluation of a survey questionnaire.

    Science.gov (United States)

    Stomski, Norman J; Morrison, Paul; Meehan, Tom

    2016-04-01

    Eliciting clinicians' views about antipsychotic medication side-effects may assist in understanding strategies that could enhance the identification and management of these side-effects. The present paper details the development and psychometric evaluation of a questionnaire that captures clinicians' perceptions about these issues. An initial item set was derived from a literature review, and then refined by an expert content validity panel that assessed the relevance of the items. The online questionnaire was distributed to Australian mental health nurses and 140 fully completed questionnaires were returned. Principal components analysis yielded two robust scales that conceptually tapped "system responsibility" and "personal confidence". These scales may be used to advance knowledge about how mental health nurses' attitudes towards the assessment and management of antipsychotic medication side-effects influences their clinical behaviour.

  3. Role of radiotherapy in the chemotherapy-containing multidisciplinary management of patients with resected pancreatic adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sole, Claudio V. [Instituto de Radiomedicina (IRAM), Department of Radiation Oncology, Santiago (Chile); Complutense University, School of Medicine, Madrid (Spain); Calvo, Felipe A. [Complutense University, School of Medicine, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Atahualpa, Freddy; Gonzalez-Bayon, Luis; Garcia-Sabrido, Jose Luis [Complutense University, School of Medicine, Madrid (Spain); Hospital General Universitario Gregorio Maranon, General Surgery Service III, Madrid (Spain); Berlin, Alejandro [Clinica Alemana de Santiago, Department of Radiation Oncology, Santiago (Chile); Herranz, Rafael [Hospital General Universitario Gregorio Maranon, Department of Radiation Oncology, Madrid (Spain)

    2014-10-08

    To analyze prognostic factors associated with long-term outcomes in patients with resected pancreatic cancer treated with chemotherapy (CT) and surgery with or without external beam radiotherapy (EBRT). From January 1995 to December 2012, 95 patients with adenocarcinoma of the pancreas and locoregional disease [clinical stage IB-IIA (n = 45; 47 %), IIB-IIIC (n = 50; 53 %)] were treated with curative resection [R0 (n = 52; 55 %), R1 (n = 43, 45 %)] and CT with (n = 60; 63 %) or without (n = 35; 37 %) EBRT (45-50.4 Gy). Additionally, 29 patients (48 %) also received a pre-anastomosis IOERT boost (applicator diameter size, 7-10 cm; dose, 10-15 Gy; beam energy, 9-18 MeV). With a median follow-up of 17.2 months (range, 1-182), 2-year overall survival (OS), disease-free survival (DFS), and locoregional control were 28, 20, and 53 %, respectively. Univariate analyses showed that IIB-IIIC stage (HR, 2.23; p = 0.04), R1 margin resection status (HR, 2.09; p = 0.04), no vascular resection (HR, 0.42; p = 0.02), and not receiving external beam radiotherapy (HR, 2.70; p = 0.004) were associated with locoregional recurrence. In the multivariate analysis, only R1 margin resection status (HR, 2.63; p = 0.009) and not receiving EBRT (HR, 2.91; p = 0.002) retained significance with regard to locoregional recurrence. We observed no difference in toxicity between patients treated with or without EBRT (p = 0.44). Overall treatment mortality was 3 %. No long-term treatment-related death occurred. Although adjuvant CT is still the standard of care for resected pancreatic tumors, OS remains modest owing to the high risk of distant metastases. Locoregional treatment needs to be tested in the context of more efficient systemic therapy. (orig.) [German] Zur Evaluierung von Prognosefaktoren im Rahmen von Langzeitresultaten bei Patienten mit reseziertem Pankreaskarzinom und verabreichter Chemotherapie (CT) mit oder ohne zusaetzlicher externer Radiotherapie (EBRT). Von Januar 1995 bis Dezember

  4. DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS

    Science.gov (United States)

    This study investigated the pollutant emission reduction and demand-side management potential of 16 photovoltaic (PV) systems installed across the U.S. in 1993 and 1994. The project was sponsored by the U.S. Environmental Protection Agency (EPA) and 11 electric utilities. This ar...

  5. Anticancer chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1988-10-01

    Despite troubled beginnings, anticancer chemotherapy has made significant contribution to the control of cancer in man, particularly within the last two decades. Early conceptual observations awakened the scientific community to the potentials of cancer chemotherapy. There are now more than 50 agents that are active in causing regression of clinical cancer. Chemotherapy's major conceptual contributions are two-fold. First, there is now proof that patients with overt metastatic disease can be cured, and second, to provide a strategy for control of occult metastases. In man, chemotherapy has resulted in normal life expectancy for some patients who have several types of metastatic cancers, including choriocarcinoma, Burkitt's lymphomas, Wilm's tumor, acute lymphocytic leukemia, Hodgkins disease, diffuse histiocytic lymphoma and others. Anticancer chemotherapy in Veterinary medicine has evolved from the use of single agents, which produce only limited remissions, to the concept of combination chemotherapy. Three basic principles underline the design of combination chemotherapy protocols; the fraction of tumor cell killed by one drug is independent of the fraction killed by another drug; drugs with different mechanisms of action should be chosen so that the antitumor effects will be additive; and since different classes of drugs have different toxicities the toxic effects will not be additive.

  6. Orem自理理论在减轻肿瘤患者化疗副作用的应用研究%Effect of Orem's self-nursing theory in lightening side effect of chemotherapy for patients with tumor

    Institute of Scientific and Technical Information of China (English)

    江锦芳; 劳永聪; 陈梅忠; 岑绍芳; 陈壮斌; 陈丽君; 许璐; 胡晓桦

    2009-01-01

    Objective To discuss the significance of Orem ' s self-care theory of nursing on the prevention of side effect after chemotherapy in tumorous patients. Methods 100 tumorous patients in chemotherapy were randomly divided into the control group adopted the conventional nursing method and the test group adopted Orem's self-care theory of nursing, with each group having 50 patients. We carried out EORTC QLO-C30 ( European Organization for Research and Treatment of Cancer) Chinese version to evaluate the nursing efficacy. Results The score of overall health status in the test group was obviously higher than that in the control group. The scores of physical function, cognitive function, emotional function and social function in the test group were significantly higher than those in the control group. The scores of fatigue, nausea and vomit in the test group were significantly lower than those in the control group. In special items, sleeping disturbance and constipation in the test group were significantly lower than those in the control group; and appetite in the test group was better than that in the control group. All the diffirences had a statistical meaning. Conclusions The application of Orem' s self-care theory of nursing greatly contributes to lessening the side effect of chemotherapy and improving the quality of life of tumorous patients.%目的 探讨Orem自理理论在减轻肿瘤患者化疗副作用方面的应用.方法 将100例肿瘤化疗患者随机分为实验组和对照组各50例.实验组采用Orem自理理论构建的护理模式,对照组进行常规护理.化疗结束3 d后,采用欧洲癌症患者生命质量测定量表EORTC QLQ-C30评价护理效果.结果 实验组总体健康状况明显高于对照组;在功能领域方面,实验组的躯体、认知、情绪和社会功能明显高于对照组;在症状领域方面,实验组的疲劳、恶心、呕吐明显低于对照组;在特异性项目方面,实验组的失眠、便秘明显低于对

  7. Chemotherapy and Your Mouth

    Science.gov (United States)

    ... Health > Chemotherapy and Your Mouth Chemotherapy and Your Mouth Main Content Are You Being Treated With Chemotherapy ... Back to Top How Does Chemotherapy Affect the Mouth? Chemotherapy is the use of drugs to treat ...

  8. Chemotherapy for Melanoma.

    Science.gov (United States)

    Wilson, Melissa A; Schuchter, Lynn M

    2016-01-01

    Prior to the recent therapeutic advances, chemotherapy was the mainstay of treatment options for advanced-stage melanoma. A number of studies have investigated various chemotherapy combinations in order to expand on the clinical responses achieved with single-agent dacarbazine, but these have not demonstrated an improvement in overall survival. Similar objective responses were observed with the combination of carboplatin and paclitaxel as were seen with single-agent dacarbazine. The combination of chemotherapy and immunotherapy, known as biochemo-therapy, has shown high clinical responses; however, biochemo-therapy has not been shown to improve overall survival and resulted in increased toxicities. In contrast, palliation and long-term responses have been observed with localized treatment with isolated limb perfusion or infusion in limb-isolated disease. Although new, improved therapeutic options exist for first-line management of advanced-stage melanoma, chemotherapy may still be important in the palliative treatment of refractory, progressive, and relapsed melanoma. We review the various chemotherapy options available for use in the treatment and palliation of advanced-stage melanoma, discuss the important clinical trials supporting the treatment recommendations, and focus on the clinical circumstances in which treatment with chemotherapy is useful.

  9. From demand side management (DSM) to energy efficiency services: A Finnish case study

    International Nuclear Information System (INIS)

    Energy conservation is expected to contribute significantly to climate change mitigation and energy security. Traditionally, energy companies have had strong role in providing Demand Side Management (DSM) measures. However, after energy market liberalization in Europe, energy companies' DSM activities declined. In response, the EU issued Directive (2006/32/EC) on energy end-use efficiency and energy services (ESD) to motivate energy companies to promote energy efficiency and conservation, closely followed by Directive (2012/27/EU) on energy efficiency (EED), requiring the setting up energy efficiency obligation schemes. Despite strong political and economic motivation, energy companies struggle to develop energy efficiency services in liberalised energy markets due to conflicting institutional demands, which arise from contradicting policy requirements and customer relations. The main challenges in developing new innovative energy efficiency services, evidenced by an in-depth case study, were (1) the unbundling of energy company operations, which makes it difficult to develop services when the contribution of several business units is required and (2) the distrust among energy end-users, which renders the business logic of energy saving contract models self-contradictory. On the basis of the research, avenues out of these dilemmas are suggested. -- Highlights: •Energy companies struggle to become energy service provides •We explore the development of new energy saving business solutions •Dispersed organisational structure leaves energy saving business as isolated function •Strong consumer scepticism towards energy companies as providers of energy saving •More emphasis on the changing company-customer relationship is needed

  10. Conical-Shaped Titania Nanotubes for Optimized Light Management in DSSCs Reach Back-side Illumination Efficiencies > 8%

    CERN Document Server

    So, Seulgi; Peschel, Ulf; Schmuki, Patrik

    2016-01-01

    In the present work, we introduce the anodic growth of conical shaped TiO2 nanotube arrays. These titania nanocones provide a scaffold for dye-sensitized solar cell (DSSC) structures with significantly improved photon management, providing an optimized absorption profile compared with conventional cylindrical nanotube arrays. Finite difference time domain (FDTD) modelling demonstrates a drastically changed power-absorption characteristic over the tube length. When used in a back-side illumination DSSC configuration, nanocone structures can reach over 60 % higher solar cell conversion efficiency than conventional tubes. The resulting {\\eta} of ca. 8 % represents one of the highest reported values for Graetzel type DSSCs used under back-side illumination.

  11. BR 02-2 HYPERTENSION MANAGEMENT IN CANCER PATIENTS UNDERGOING CHEMOTHERAPY.

    Science.gov (United States)

    Stern, Naftali

    2016-09-01

    As both the rate of hypertension and cancer rise with age, concomitant hypertension in patients receiving treatment for cancer is very common. Increase in blood pressure during cancer treatment requires careful clinical assessment. Distinction between discontinuation or malabsorption of antihypertensive treatment due to factors such as nausea/vomiting/diarrhea and anti-cancer drug specific effects must be first made. De-novo hypertension during cancer treatment is likely related to anticancer drugs per se. Classical chemotherapeutic agents such as cyclophosphamide, cisplatin and busulfan have been previously linked to rising blood pressure. The concomitant use of high doses of glucocorticoids in some chemotherapy protocols may have a contributory role. However, the recent surge of interest in cancer treatment-related hypertension has been generated by the use of growth receptors' signaling cascade inhibitors. Hypertension or deterioration in the control of hypertension may be seen in as much as 80% of patients receiving VEGF signaling pathway inhibitors. Agents may target one or more types of VEGF receptors, FGF-, PDGF- and hepatic growth factor receptors; RET and/or signaling elements such as RAF, BRAF, Flt3 and c-KIT. Indeed, at least some rise in blood pressure is actually expected in every patient subjected to this treatment but the rate of evolution of hypertension is variable. Risk factors for significant increase in BP include the type of agent and its dosage, the existence of preceding hypertension, age>60yrs and overweight/obesity. Hypertension may also be more common in subjects previously treated with programmed cell death 1 (PD-1) pathway inhibitors. Potential mechanisms of hypertension include impaired endothelial cell function with decreased NO synthesis and effect with increased endothelin-1 formation; decreased capillary density; increased salt sensitivity; and renal impairment. Hypertension due to VEGF/tyrosine kinase inhibitors is not only common

  12. The energy efficiency and demand side management programs as implemented by the energy efficiency division of the department of energy

    International Nuclear Information System (INIS)

    The thrust of the Philippine energy sector. specifically the government side, is to involve the active participation of not only all the government agencies involved in energy activities but the private sector as well. This participation shall mean technical and financial participation, directly and indirectly. The Department of Energy is on the process involving the continuing update and development of a Philippine Energy Plan (PEP) which has a 30-year time scope, which will help the country monitor and determine energy supply and demand vis-a-vis the growing demands of an industrializing country like the Philippines. Among the most vital component of the PEP is the thrust to pursue national programs for energy efficiency and demand-side management. Seven energy efficiency sub-programs have been identified for implementation, with a target savings of 623 million barrels of fuel oil equivalent (MMBFOE). A cumulative net savings of 237 billion pesos shall be generated against a total investment cost of 54.5 billion pesos. The Philippine energy sector will continue to develop and implement strategies to promote the efficient utilization of energy which will cover all aspects of the energy industry. The plan is focussed on the training and education of the various sectors on the aspects involved in the implementation of energy efficiency and demand-side management elements on a more aggressive note. The implementation of technical strategies by the department will continue on a higher and more extensive level, these are: energy utilization monitoring, consultancy and engineering services, energy efficiency testing and labelling program, and demand-side management programs for each sector. In summary, the PEP, as anchored in energy efficiency and demand-side management tools, among others, will ensure a continuous energy supply at affordable prices while incorporating environmental and social considerations. (author)

  13. The prevalence and management of side effects of lithium and anticonvulsants as mood stabilizers in bipolar disorder from a clinical perspective: a review.

    Science.gov (United States)

    Dols, Annemiek; Sienaert, Pascal; van Gerven, Heleen; Schouws, Sigfried; Stevens, Anja; Kupka, Ralph; Stek, Max L

    2013-11-01

    Side effects are among the most frequent reasons preventing patients from taking their medication. Although the management of side effects is an important issue in clinical practice, particularly in patients with physical comorbidities, research on clinical management of side effects is rather scattered. The aim of this article was to provide an overview on the prevalence and management of various side effects of mood-stabilizing drugs. In December 2012, we carried out a PubMed search for publications reporting side effects in patients with bipolar disorder. Naturalistic studies describing the prevalence of side effects in treatment with mood stabilizers are sparse. We describe the prevalence of neurological, gastrointestinal, metabolic, thyroid, dermatological, nephrogenic, cognitive, sexual, hematological, hepatogenic, and teratogenic side effects of lithium, valproate, carbamazepine, and lamotrigine and discuss their clinical management. There are specific strategies that aim at reducing side effects, but, to date, studies on the efficacy of these interventions are lacking. With age, the renal elimination and hepatic metabolism of drugs reduce and comedication and somatic comorbidity increase, making elderly patients particularly susceptible to side effects. Most side effects can be managed by striving for the lowest possible dose without losing efficacy by lowering the dose below the therapeutic window. Specific measurements to limit certain side effects are available and may ameliorate treatment adherence.

  14. Left-sided portal hypertension: Successful management by laparoscopic splenectomy following splenic artery embolization

    Directory of Open Access Journals (Sweden)

    Damiano Patrono

    2014-01-01

    CONCLUSION: Splenic artery embolization may be a valuable adjunct in case of left-sided portal hypertension requiring splenectomy, allowing a safe dissection of the splenic vessels even by laparoscopy.

  15. Solar radiation management - on feasibility, side effects, and reaching the 2 degree target

    Science.gov (United States)

    Korhonen, Hannele; Laakso, Anton; Ekholm, Tommi; Maalick, Zubair; Partanen, Antti-Ilari; Kokkola, Harri; Romakkaniemi, Sami

    2015-04-01

    Solar radiation management (SRM), i.e. artificially increasing the reflectivity of the Earth, has been suggested as a fast-response, low-cost method to mitigate the impacts of potential rapid future climate change. We have used 1) large eddy simulations as well as an aerosol-climate model and an earth system model to investigate the feasibility and side effects of two types of SRM (marine cloud brightening and stratospheric sulfur injections) and 2) a sequential decision-making approach to determine strategies that combine emission reductions and an uncertain SRM option to limit global mean temperature increase to 2 degree. Regarding stratospheric injections, we find that a large explosive volcanic eruption taking place while SRM is in full force would result in overcooling of the planet, as expected; however, the radiative and climate effects would be clearly smaller than could be expected from the sum of the effects from volcanic eruption alone or SRM alone. In addition, the stratospheric sulphur load would recover from the eruption faster under SRM and natural conditions. If the eruption took place in the high latitudes, the resulting global forcing would be highly dependent on the season of the eruption. Furthermore, regarding marine cloud brightening we find that the spraying of sea water drops leads to cooling due to evaporation and leads to delay in particle dispersion. This delay enhances particle scavenging, and can influence the efficacy of cloud seeding. In terms of combining emission reductions and SRM to reach the 2° C warming target, we find that before the termination risk for SRM can be completely excluded, the acceptable greenhouse gas emission pathways remain only slightly higher than in scenarios without SRM. More generally, the uncertainties in SRM start time, acceptable magnitude and sustainability mean that it can be only a limited substitute to greenhouse gas (GHG) emission reductions. If an additional constraint for CO2 concentration to

  16. An analysis of the factors influencing demand-side management activity in the electric utility industry

    Science.gov (United States)

    Bock, Mark Joseph

    Demand-side management (DSM), defined as the "planning, implementation, and monitoring of utility activities designed to encourage consumers to modify their pattern of electricity usage, including the timing and level of electricity demand," is a relatively new concept in the U.S. electric power industry. Nevertheless, in twenty years since it was first introduced, utility expenditures on DSM programs, as well as the number of such programs, have grown rapidly. At first glance, it may seem peculiar that a firm would actively attempt to reduce demand for its primary product. There are two primary explanations as to why a utility might pursue DSM: regulatory mandate, and self-interest. The purpose of this dissertation is to determine the impact these influences have on the amount of DSM undertaken by utilities. This research is important for two reasons. First, it provides insight into whether DSM will continue to exist as competition becomes more prevalent in the industry. Secondly, it is important because no one has taken a comprehensive look at firm-level DSM activity on an industry-wide basis. The primary data set used in this dissertation is the U.S. Department of Energy's Annual Electric Utility Report, Form EIA-861, which represents the most comprehensive data set available for analyzing DSM activity in the U.S. There are four measures of DSM activity in this data set: (1) utility expenditures on DSM programs; (2) energy savings by DSM program participants; and (3) the actual and (4) the potential reductions in peak load resulting from utility DSM measures. Each is used as the dependent variable in an econometric analysis where independent variables include various utility characteristics, regulatory characteristics, and service territory and customer characteristics. In general, the results from the econometric analysis suggest that in 1993, DSM activity was primarily the result of regulatory pressure. All of the evidence suggests that if DSM continues to

  17. A Midwest utility's perspective of DSM [demand-side management]: Balancing the needs of customers, shareholders and the environment

    International Nuclear Information System (INIS)

    PSI Energy, a predominately coal-burning Indiana electric utility, is very concerned about the environment and is using demand-side management (DSM) as part of a strategy to balance the sometimes conflicting interests of the environment, the economy, customers and shareholders. Faced with slow growth within its service territory, an abundance of low-cost, high sulfur coal burning baseload capacity, massive future expenditures for acid rain mitigation and a weakened financial state due to a cancelled nuclear project, PSI Energy has taken a novel approach to preserving value for customers, shareholders, the economy and environment. To accomodate Indiana's goal of least cost utility planning, PSI initiated an all-source bidding program in which it solicited bids for peaking capacity or the equivalent. Four parallel but separate solicitations were pursued: combustion turbine manufacturers for PSI owned and operated capacity, other utilities and non-utility generators for purchased power and third parties for demand-side management. PSI's philosophy with respect to bidding can be expressed as: simplicity, flexibility, creativity, partnerships, expeditious and fairness. There is a minimum bid of 5 MW of summer peak demand reduction, and the minimum contract length is 10 years. The entire 550 MW capacity block available to be filled in the program is open to demand-side resources. The ten major evaluation criteria involved in the program are: price, sponsor qualifications, operational impact, marketing plan, technology, financing plan, verification and measurement, form of security, project management plan, and project cost estimates

  18. Prognostic value and clinical impact of 18FDG-PET in the management of children with Burkitt lymphoma after induction chemotherapy.

    Directory of Open Access Journals (Sweden)

    clement eBailly

    2014-12-01

    Full Text Available Objective: Burkitt Lymphoma (BL is a rare and aggressive form of B cell lymphoma that is curable using intensive chemotherapy. Obtaining a complete response (CR at the end of induction chemotherapy is a major prognostic factor. This study retrospectively evaluates the potential impact of 18FDG-PET in the management of children with BL after induction chemotherapy, and the prognostic performance of the Deauville criteria.Methods: 19 children with BL treated according to the French LMB2001 protocol between 2005 and 2012 were included. 18FDG-PET and conventional imaging (CI were performed after induction chemotherapy to confirm CR. 18FDG-PET was interpreted according to Deauville criteria with follow up and/or histology as the gold standard.Results: 18FDG-PET was negative in 15 cases, in agreement with CI in 9/15 cases. The six discordant cases confirmed to be negative by histology, were considered as true negative for 18FDG-PET. Negative predictive value (NPV of CI and 18FDG-PET were 73 and 93% respectively. The five-year PFS was significantly higher in patients with negative 18FDG-PET than those with positive 18FDG-PET (p=0.011. Conclusion: 18FDG-PET interpreted using Deauville criteria can help confirm CR at the end of induction chemotherapy, with a prognostic impact on five-year PFS. Its high NPV could limit the use of residual mass biopsy. Given the small size of our population, these results need to be confirmed by future prospective studies on a larger population.

  19. Clinical management of clozapine patients in relation to efficacy and side-effects.

    Science.gov (United States)

    Naber, D; Holzbach, R; Perro, C; Hippius, H

    1992-05-01

    Medical charts of 480 schizophrenic in-patients (581 treatments) were analysed to evaluate the efficacy and side-effects of clozapine. Clozapine treatment lasted for mean 49 (s.d. 38) days. Of the sample, 11.0% showed worsening or no change, 31.5% slight improvement, 53.0% marked improvement and 4.5% almost total reduction of symptoms. At least one major side-effect occurred in 68.0% of patients. A combination of clozapine with classical neuroleptics, antidepressants, benzodiazepines or lithium is tolerated by most patients, but increases the incidence of some side-effects. Clozapine treatment had to be discontinued because of severe side-effects in 8.6% of patients. In 81 schizophrenic out-patients, clozapine significantly reduced the days of in-patient treatment and number of hospital readmissions. Two patients developed leucopenia but had no complications after clozapine withdrawal. This study indicates a satisfactory benefit/risk ratio and compliance in most of the patients. PMID:1358128

  20. Cancer Chemotherapy

    Science.gov (United States)

    ... and how your body reacts. Some common side effects are fatigue, nausea, vomiting, pain, and hair loss. There are ways to prevent or control some side effects. Talk with your health care provider about how ...

  1. The side effects of docetaxel with cyclophosphamide as postoperative adjuvant chemotherapy for elderly breast cancer patients%老年乳腺癌术后多西紫杉醇联合环磷酰胺辅助化疗的毒副作用研究

    Institute of Scientific and Technical Information of China (English)

    Lingqin Song; Yinbin Zhang; Jianjun He; Xijing Wang; Hongbing Ma; Wentao Xi; Liang Liang

    2011-01-01

    Objective: The aim of this study was to investigate the side effects of docetaxel with cyclophosphamide as postoperative adjuvant chemotherapy for elderly breast cancer patients. Methods: Thirty-six operable elderly breast cancer patients at intermediate risk based on the St Gallen risk classification underwent modified radical mastectomy and then were given four cycles of TC regimen (docetaxe175 mg/m2 i.v. on day 1; cyclophosphamide 600 mg/m2 i.v. on day 1; every 21 days ). Primary prophylaxis granulocyte colony stimulating factor (G-CSF) 200tμg i.h. was administered on day 4-6. Results: The main side effect was neutropenia. Grade 3 neutropenia developed in 36.1% and G4 in 19.4%.respectively. Most of the other side effects were G1-2. Dose reduction occurred in 11.1% patients. The completion rate of chemotherapy was 100%. Conclusion: Docetaxel with cyclophosphamide as postoperative adjuvant chemotherapy regimen with G-CSF primary prophylaxis is tolerable for elderly patients in general good condition.

  2. Chemotherapy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Chemotherapy KidsHealth > For Parents > Chemotherapy Print A A A ... have many questions and concerns about it. About Chemotherapy Chemotherapy (often just called "chemo") refers to medications ...

  3. Oral Chemotherapy: What You Need to Know

    Science.gov (United States)

    ... ACS » Your Local Offices Close + - Text Size Oral Chemotherapy: What You Need to Know There are many ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  4. An Integrated Decentralized Energy Planning Model considering Demand-Side Management and Environmental Measures

    Directory of Open Access Journals (Sweden)

    Seyed Mahmood Kazemi

    2013-01-01

    Full Text Available Decentralized energy planning (DEP is looked upon as an indisputable opportunity for energy planning of villages, isolated islands, and far spots. Nonetheless, at this decentralized planning level, the value of demand-side resources is not fairly examined, despite enjoying great advantages. Therefore, the core task of this study is to integrate demand-side resources, as a competing solution against supply-side alternatives, with decentralized energy planning decisions and demonstrate the rewarding role it plays. Moreover, sustainability indicators (SIs are incorporated into DEP attempts in order to attain sustainable development. It is emphasized that unless these indicators are considered at lower energy planning levels, they will be ignored at higher planning levels as well. Hence, to the best knowledge of the authors, this study for the first time takes into account greenhouse gas (GHG emissions produced by utilization of renewable energies in DEP optimization models. To address the issues mentioned previously, multiobjective linear programming model along with a min-max goal programming approach is employed. Finally, using data taken from the literature, the model is solved, and the obtained results are discussed. The results show that DSM policies have remarkably contributed to significant improvements especially in terms of environmental indicators.

  5. Preparing the Host Country Workforce for Expatriate Managers: The Neglected Other Side of the Coin.

    Science.gov (United States)

    Vance, Charles M.; Ring, Peter Smith

    1994-01-01

    Using an instructional systems development approach, ways to prepare the host country workforce for the assignment of an expatriate manager are discussed. The model is based on a number of perspectives: exchange theory, participatory management, corporate social responsibility, communication theory, and strategic human resource planning. (SK)

  6. The Legal Side of Campus Threat Assessment and Management: What Student Counselors Need to Know

    Science.gov (United States)

    Nolan, Jeffrey J.; Moncure, Thomas M., Jr.

    2012-01-01

    This article identifies what student mental health professionals need to know about legal issues of relevance to threat assessment and management. The article summarizes the common law duties and the common law and statutory standards of care that are likely to apply to the work of college and university threat assessment and management teams. The…

  7. Self-organization versus self-management: two sides of the same coin?

    Science.gov (United States)

    Clancy, Thomas R

    2009-03-01

    As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the eighth in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the author explores self-organization as it relates to self-management in complex social organizations.

  8. Supply shortage forecast in Ontario: The significance of demand-side management (DSM); its tools and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Saini, S.

    2004-06-01

    Aspects of the recent report by the Ontario Electricity Conservation and Supply Task Force and Independent Market Operator which forecasts acute power supply shortages in Ontario, are discussed. Immediate action is recommended to avert the problem. The principal recommendation concerns the adoption of Demand Side Management as a tool to reduce the widening gap between supply and demand, citing supply shortage, imports, high prices, deregulated market and environmental concerns as the driving forces which push for the adoption of DSM. It is claimed that DSM, through its tools such as Demand/Load Response Programs and Time-of-Use rates has the capacity to create the necessary balance between supply and demand more efficiently, and in a more timely fashion than supply side management. The demand for adoption of DSM is justified on the basis of a careful examination of the magnitude and significance of each of the driving forces affecting the electricity supply in Ontario, as well as the benefits and techniques of DSM designed to manage power shortages. Energy Conservation and Efficiency and Demand/Load Response Programs are discussed as the principal DSM techniques, while Dynamic/Real Time Pricing, Time-of-Use Rates, Automated /Smart Metering, Web-based/Communication Systems, Reliability-based Programs, Market/Price-based programs, and Types of Load Control are described as the principal tools used by DSM. DSM program approaches and strategies are also reviewed, along with a brief list of successful examples of DSM applications. 3 figs.

  9. USE OF HEMATOPOIETIC GROWTH FACTOR IN THE MANAGEMENT OF HEMATOLOGICAL SIDE EFFECTS ASSOCIATED TO ANTIVIRAL TREATMENT FOR HCV HEPATITIS

    Directory of Open Access Journals (Sweden)

    Paola Mancino

    2010-03-01

    Full Text Available Haematological abnormalities are common during combination antiviral therapy for chronic hepatitis C. Although dose reduction or discontinuation can easily treat these side effects, they can adversely affect the efficacy of combination antiviral therapy reducing the likelihood of a sustained viral response (SVR. To avoid potentially diminishing a patient’s chance of response, many physicians have begun using growth factors off-label to manage anaemia and neutropenia in hepatitis C. Haematopoietic growth factors are generally well tolerated and they may be useful for managing haematological side effects of anti-HCV therapy improving patients’ quality of life. To date, the role and benefit of these agents during anti-HCV therapy and their positive impact on SVR have not conclusively determined in the published studies. However, the possibility of a benefit to individual outpatients remains, and an individualized approach is recommended. This review explores the incidence, clinical significance, and management of anaemia, neutropenia and thrombocytopenia associated with combination therapy for HCV infection.

  10. The dark side of management, causing mobbing situations, recognizing and dealing with them

    OpenAIRE

    Naseva, Gabriela

    2013-01-01

    In the world there are many books explaining the way how to become successful, and quite a few books that will teach you how to recognize bad managers, how to avoid cooperating with them and how best to confront. Bad (quasi) managers create unpleasant situations, the employee’s fear them and they make them un-interested for work by killing their motivation, suffocating their creativity, reducing their daily working potential, which results in low work outcomes. In work organ...

  11. Neuropsychiatric side-effects of interferon alfa therapy for hepatitis C and their management: A review

    Directory of Open Access Journals (Sweden)

    Al-Huthail Yaser

    2006-01-01

    Full Text Available Background:Interferon-Alfa (IFN-α has been the mainstay of treatment for chronic hepatitis C. It has the potential to alter the course of chronic hepatitis C and prevent complications. Aims: This review summarizes current knowledge about the presentation, mechanism, course, and treatment of neuropsychiatric problems associated with interferon alfa (IFN-α treatment. Methods: Studies were identified by computerized searches, and further references were obtained from bibliographies of the reviewed articles. Results: Neuropsychiatric symptoms frequently occur in hepatitis C patients treated with IFNAlfa. These side effects are troublesome and frequently account for dose reduction or treatment discontinuation. Sometimes, they could be serious and possibly life threatening. Frequent psychiatric evaluations of high risk individuals and, when required, early administration of antidepressants could possibly help to avoid the development of an impending depression or reduce its severity and duration and thus increase adherence to treatment. Conclustion: Greater cooperation between psychiatrists and hepatologists would mean less risk of having the serious side effects with more importance needs to be given to the identification of patients at risk.

  12. Evolution of Wisconsin Public Service's solar demand-side management program

    International Nuclear Information System (INIS)

    Wisconsin Public Service Corporation (WPSC), in partnership with Public Energy Systems (PES), has implemented an innovative solar program that is revitalizing the solar industry in Northeast Wisconsin. The program includes three components: (1) an orphan solar program to repair existing solar heating systems, (2) a solar incentive program to provide rebates and financing for new systems, and (3) a solar leasing program to offer long-term leases for new solar domestic hot water (SDHW) systems. The Orphan Solar Program and Solar Incentive Program began in mid-1993. Under the Orphan Solar Program, 373 systems have been repaired at an average cost of $274 per system with an estimated total savings of 200 coincident kW and 486 MWh on the electric side and 53,400 therms on the gas side. By contrast, only 14 customers have taken advantage of the incentive program despite extensive marketing efforts. High first costs are the primary barrier, and WPSC is currently implementing a Solar Leasing Program that avoids the up-front costs and creates a favorable cash flow for the customer

  13. Chemotherapy of osteoarticular tuberculosis

    OpenAIRE

    Hazra Avijit; Laha Baisakhi

    2005-01-01

    Tuberculosis (TB) of the bones and joints is rampant in India with the dorsolumbar spine as the most common site of osseous involvement. For diagnosis, clinical suspicion needs to be confirmed through appropriate laboratory and imaging investigations, and increasingly nowadays, nucleic acid amplification techniques. Chemotherapy remains the cornerstone of management complemented by rest, nutritional support and splinting, as necessary. Operative intervention is required if response to chemoth...

  14. DSM的政府行动%Gove ental Behavior in Demand Side Management

    Institute of Scientific and Technical Information of China (English)

    杨志荣; 胡兆光; 周伏秋; 李为正

    2002-01-01

    With the accelerating market-oriented reform process in China, vertically integrated, government centeredenergy conservation administration system and operation mechanism as well as management approach based upon energyconsumption control have all lost ground of existence, and could not work effectively as before. From the perspective of thegovernment, it is necessary to transfer functions, adopt market-oriented operation nechanism and incentive policies, therebyfostering a ever-growing, sustainable energy efficiency market. DSM is a proved energy efficiency management technique andoperation mechanism adequate to narket economy, and a franework of laws, regulations and policies should be created tofacilitate its application.

  15. Impact on energy requirements and emissions of heat pumps and micro-cogenerators participating in demand side management

    International Nuclear Information System (INIS)

    The potential impacts of participating in demand side management (DSM) on the performance of air source heat pumps (ASHP) and micro-combined heat and power (mCHP) units are considered by this study. As significant consumers and generators of electricity at the distribution level, large numbers of heat pumps and micro-cogenerators would provide considerable scope for participation in DSM systems. However, it is possible that operating regimes which are optimised for grid considerations will not achieve the maximum performance that is possible from the units. Modelling has been conducted to investigate the significance of this effect, considering the case where local distribution constraints are the main driver for demand side interventions. A model of domestic electrical demand has been adapted to consider a neighbourhood of 128 dwellings in order to identify when interventions are necessary. This has been combined with dynamic models of two combustion engine micro-cogenerators, a solid oxide fuel cell micro-cogenerator and two ASHPs. A simple thermal model of each building is combined with a range of user preferences in order to determine the preferred operating profiles of the heating units. The DSM scheme analysed here is likely to have minimal impact on the emissions and energy requirements associated with each heating unit. Its effect is similar to that which occurs without DSM if the control system gain is relaxed such that equivalent thermal comfort is achieved. DSM can reduce the peak electrical demand of the neighbourhood. However, in the scenarios investigated, it is unlikely that the peaks can be reduced sufficiently such that they do not exceed the capacity of the local distribution transformer if ASHPs are used in all dwellings. By using a combination of mCHP units with ASHPs, it is possible to supply heating to all dwellings without exceeding this capacity. In this case, the use of DSM can increase the ratio of ASHPs used. In the context of a low

  16. Why commercial customers are SIC of DSM [demand-side management] marketing

    International Nuclear Information System (INIS)

    Studies have shown that the success of demand management programs, which have demonstrated economic benefits, depends on the level of customer participation. In order to have a better understanding of the decisionmaking process of commercial customers with respect to demand management programs, a study was undertaken to determine the preferences and the behavior of this class of clientele. This clientele, whose power consumption has been increasing at a faster rate than that of other sectors, represents a vast range of enterprises producing and supplying all kinds of products. Many of them operate from numerous geographic points on local, regional, national, and even world scales and are generally hierarchically organized. Because of these characteristics, their decisionmaking processes and their needs are equally complex, more so than in the residential sector. A multidimensional approach has been adopted to ensure that their needs are determined according to a quantitative and qualitative research method. The conclusions of the quantitative research have demonstrated that the frameworks representing different organizations respond differently to questions on their needs. It is also noted that certain commercial enterprises are of a cohesive nature (i.e. there is a consistency in understanding of corporate strategic and operational requirements at all hierarchical levels), while others are more diffuse. Those responsible for marketing demand management programs therefore must improve their understanding of the strategic and operational needs of their commercial customers in order to make their demand management programs productive in the view of the appropriate personnel at the hierarchical level applicable to the company concerned

  17. Utilizing Multimedia Case Studies to Teach the Professional Side of Project Management

    Science.gov (United States)

    Elrod, Cassandra C.; Murray, Susan L.; Flachsbart, Barry B.; Burgher, Karl E.; Foth, Drew M.

    2010-01-01

    This research was conducted to evaluate the effectiveness of using a LITEE multimedia case study to teaching concepts in engineering courses. The LITEE Superstar case study was implemented in an engineering Project Management course. Numerous surveys regarding student expectations, outcomes, and attitudes were collected and results are presented…

  18. Predictive Factors and Management of Rectal Bleeding Side Effects Following Prostate Cancer Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Price, Jeremy G. [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stone, Nelson N. [Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States)

    2013-08-01

    Purpose: To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥grade 2 proctitis. Methods and Materials: A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, and treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. Results: Actuarial risk of ≥grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. Conclusions: Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following

  19. Indications for Treatment: Is Observation or Chemotherapy Alone a Reasonable Approach in the Management of Low-Grade Gliomas?

    Science.gov (United States)

    Schaff, Lauren R; Lassman, Andrew B

    2015-07-01

    The treatment of newly diagnosed low-grade gliomas remains controversial. Recently published results from the long-term follow-up of Radiation Therapy Oncology Group (RTOG) trial 9802 demonstrated medically meaningful and statistically significant survival prolongation by adding chemotherapy with procarbazine, lomustine (CCNU), and vincristine after radiotherapy (RT) vs RT alone for "high"-risk patients (median 13.3 vs 7.8 years, hazard ratio = 0.59, P = 0.03). However, in the 17 years since that trial was launched, there have been advances in the understanding of low-grade gliomas biology and patient heterogeneity, an increased recognition of late neurocognitive injury from early RT, and the emergence of temozolomide as an alternative chemotherapy to procarbazine, lomustine (CCNU), and vincristine. These and other changes in the treatment landscape make the applicability of results from RTOG 9802 to all patients less clear. Moreover, in some patients, especially those at the lowest risk for early disease progression, deferred RT in favor of active surveillance or chemotherapy alone may remain a reasonable treatment approach. PMID:26050591

  20. A future Demand Side Management (DSM) opportunity for utility as variable renewable penetrate scale up using agriculture.

    Science.gov (United States)

    Ines, A.; Bhattacharjee, A.; Modi, V.; Robertson, A. W.; Lall, U.; Kocaman Ayse, S.; Chaudhary, S.; Kumar, A.; Ganapathy, A.; Kumar, A.; Mishra, V.

    2015-12-01

    Energy demand management, also known as demand side management (DSM), is the modification of consumer demand for energy through various methods such as smart metering, incentive based schemes, payments for turning off loads or rescheduling loads. Usually, the goal of demand side management is to encourage the consumer to use less power during periods of peak demand, or to move the time of energy use to off-peak times. Peak demand management does not necessarily decrease total energy consumption, but could be expected to reduce the need for investments in networks and/or power plants for meeting peak demands. Electricity use can vary dramatically on short and medium time frames, and the pricing system may not reflect the instantaneous cost as additional higher-cost that are brought on-line. In addition, the capacity or willingness of electricity consumers to adjust to prices by altering elasticity of demand may be low, particularly over short time frames. In the scenario of Indian grid setup, the retail customers do not follow real-time pricing and it is difficult to incentivize the utility companies for continuing the peak demand supply. A question for the future is how deeper penetration of renewable will be handled? This is a challenging problem since one has to deal with high variability, while managing loss of load probabilities. In the case of managing the peak demand using agriculture, in the future as smart metering matures with automatic turn on/off for a pump, it will become possible to provide an ensured amount of water or energy to the farmer while keeping the grid energized for 24 hours. Supply scenarios will include the possibility of much larger penetration of solar and wind into the grid. While, in absolute terms these sources are small contributors, their role will inevitably grow but DSM using agriculture could help reduce the capital cost. The other option is of advancing or delaying pump operating cycle even by several hours, will still ensure

  1. Beluga coal field development: social effects and management alternatives. [West side of Cook Inlet

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, M.; Cluett, C.; Trimble, J.; Brody, S.; Howell, C.; Leman, L.; Svendsen, G.

    1979-05-01

    Plans are under way to mine the Beluga coal fields on the west side of Cook Inlet. The coal will be strip-mined for export, or to supply local electric generating plants, or both. Over the next 20 years, this coal development activity is likely to generate social and economic impacts at the local, regional, and state levels. The purpose of this study is to assess the potential social and economic effects of coal development, including employment and population growth, regional impacts, and the facility and service needs of a new settlement in the Beluga area. Of special concern is identifying the role of various governmental agencies in the development process. Potential effects on the natural environment are not examined in detail since they are expected to be controlled to acceptable levels through existing Federal and state laws. This report examines three possible levels of coal-field development and the settlement requirements associated with each. The most probable regional impacts associated with this development will include effects on the regional labor force, the market for coal, and the generation and distribution of revenues. The main regional labor force impacts will be positive in nature. The rate of regional unemployment is likely to decline slightly for the duration of the project, with an increase in wage income available for reinvestment in the region and a reduction in the number of individuals receiving unemployment insurance payments. Coal development is not expected to induce any significant inmigration of workers from outside the region.The development of the Beluga coal resources and the production of electricity from coal would add to the Kenai Peninsula Borough's tax base. The assessed value of coal lands around Beluga would likely increase and, in addition, Cook Inlet Region, Inc. would be the recipient of royalties from coal leases. A number of recommendations for research and governmental activities are presented.

  2. Local government involvement in long term resource planning for community energy systems. Demand side management

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    A program was developed to coordinate governmental, research, utility, and business energy savings efforts, and to evaluate future potential actions, based on actual field data obtained during the implementation of Phase I of the State Resource Plan. This has lead to the establishment of a state conservation and energy efficiency fund for the purpose of establishing a DSM Program. By taking a state wide perspective on resource planning, additional savings, including environmental benefits, can be achieved through further conservation and demand management. This effort has already blossomed into a state directive for DSM programs for the natural gas industry.

  3. EORTC 24051 : Unexpected side effects in a phase I study of TPF induction chemotherapy followed by chemoradiation with lapatinib, a dual EGFR/ErbB2 inhibitor, in patients with locally advanced resectable larynx and hypopharynx squamous cell carcinoma

    NARCIS (Netherlands)

    Lalami, Yassine; Specenier, Pol M.; Awada, Ahmad; Lacombe, Denis; Liberatoscioli, Cecilia; Fortpied, Catherine; El-Hariry, Iman; Bogaerts, Jan; Andry, Guy; Langendijk, J. A.; Vermorken, Jan B.

    2012-01-01

    Background: In this phase I/II study, the addition of lapatinib (LAP) was investigated in combination with the sequential use of both approaches TPF induction chemotherapy (ICT) followed by chemoradiation (CRT) in locally advanced larynx or hypopharynx squamous cell carcinoma. Patients and methods:

  4. Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes

    Directory of Open Access Journals (Sweden)

    Faiman B

    2016-05-01

    Full Text Available Beth Faiman, Jason Valent Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA Abstract: Improved understanding as to the biology of multiple myeloma (MM and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus requiring clinicians to become more astute in assessment, monitoring, and intervention of side effects as well as monitoring response to therapy. Appropriate diagnosis and monitoring strategies are essential to ensure that patients receive the appropriate chemotherapy and supportive therapy at relapse, and that side effects are appropriately managed to allow for continued therapy and adherence to the regimen. Multiple drugs with complex regimens are currently available with varying side effect profiles. Knowledge of the drugs used to treat MM and the common adverse events will allow for preventative strategies to mitigate adverse events and prompt intervention. The purpose of this paper is to review updates in the diagnosis and management of MM, and to provide strategies for assessment and monitoring of patients receiving chemotherapy for MM. Keywords: multiple myeloma, treatment, symptoms, assessment, monitoring, symptom management, targeted therapies

  5. Risk management algorithm for rear-side collision avoidance using a combined steering torque overlay and differential braking

    Science.gov (United States)

    Lee, Junyung; Yi, Kyongsu; Yoo, Hyunjae; Chong, Hyokjin; Ko, Bongchul

    2015-06-01

    This paper describes a risk management algorithm for rear-side collision avoidance. The proposed risk management algorithm consists of a supervisor and a coordinator. The supervisor is designed to monitor collision risks between the subject vehicle and approaching vehicle in the adjacent lane. An appropriate criterion of intervention, which satisfies high acceptance to drivers through the consideration of a realistic traffic, has been determined based on the analysis of the kinematics of the vehicles in longitudinal and lateral directions. In order to assist the driver actively and increase driver's safety, a coordinator is designed to combine lateral control using a steering torque overlay by motor-driven power steering and differential braking by vehicle stability control. In order to prevent the collision while limiting actuator's control inputs and vehicle dynamics to safe values for the assurance of the driver's comfort, the Lyapunov theory and linear matrix inequalities based optimisation methods have been used. The proposed risk management algorithm has been evaluated via simulation using CarSim and MATLAB/Simulink.

  6. Types of chemotherapy

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000910.htm Types of chemotherapy To use the sharing features on this page, ... or on cancer cells. How Doctors Choose Your Chemotherapy The type and dose of chemotherapy your doctor ...

  7. Chemotherapy for Thyroid Cancer

    Science.gov (United States)

    ... cancer Next Topic Targeted therapy for thyroid cancer Chemotherapy for thyroid cancer Chemotherapy (chemo) uses anti-cancer drugs that are injected ... vein or muscle, or are taken by mouth. Chemotherapy is systemic therapy, which means that the drug ...

  8. After chemotherapy - discharge

    Science.gov (United States)

    ... Chemotherapy - home care discharge; Chemotherapy - discharge mouth care; Chemotherapy - preventing infections discharge ... Take care not to get infections for up to 1 year or more after ... eat or drink anything that may be undercooked or spoiled. Make ...

  9. The effects of evidence - based nursing on prevention of the side - effect of chemotherapy assisted by amifostine%循证护理在预防氨磷汀配合化疗治疗副作用中的应用

    Institute of Scientific and Technical Information of China (English)

    韩卫丽

    2012-01-01

    目的 探讨循证护理干预能否减轻氨磷汀配合化疗治疗的副作用.方法 运用循证护理和常规护理对66例次恶性肿瘤患者使用氨磷汀配合化疗副作用进行干预,未干预组(33例次)采用常规护理措施,干预组(33例次)实施循证护理,比较未干预组和干预组化疗副作用.结果 干预组低血压、恶心、呕吐、头晕、乏力、低血钙副作用较未干预组减少(P <0.000),两组发热无明显差异(P>0.05).结论 通过应用循证护理,利用循证支持,制订并实施行之有效的预防措施,可减少氨磷汀配合化学治疗副作用的发生.%Objective To study if the evidence - based nursing could relieve the side - effect of chemotherapy assisted by amifosfine.Methods Evidence - based nursing and usual care were used to interfere the side - effects of chemotherapy assisted by amifostine in 66patients with cancer.The patients were divided into non - intervention group with accepted usual care ( 33 cases) and intervention group (33 cases) with evidence -based nursing.And side- effects of the chemotherapy of the two groups were compared.Results The incidence of hypotension,nausea,vomiting,dizziness,anergy,hypocalcemia in the intervention group were lower than those in non - intervention group (P =0.00) besides the fever index (t =1.0,P =0.32).Conclusions Evidence - based nursing and related prognostic treatments could decrease the side - effects of chemotherapy assisted by amifostine.

  10. Self-consumption enhancement with storage system and demand-side management. GeDELOS-PV system

    Energy Technology Data Exchange (ETDEWEB)

    Castillo-Cagigal, M. [Instituto de Energia Solar, Madrid (Spain); ETSI Telecomunicacion, Madrid (Spain). Dept. Tecnologias Especiales Aplicadas a la Telecomunicacion; Matallanas, E.; Gutierrez, A.; Monasterio, F. [ETSI Telecomunicacion, Madrid (Spain). Dept. Tecnologias Especiales Aplicadas a la Telecomunicacion; Masa-Bote, D.; Caamano-Martin, E. [Instituto de Energia Solar, Madrid (Spain); Jimenez-Leube, J. [ETSI Telecomunicacion, Madrid (Spain). Dept. Tecnologia Electronica

    2010-07-01

    Because of the recent technological developments within the field of power conditioning and the progressive decrease of incentives for PV electricity in grid-connected markets, new operation modes for PV systems should be explored beyond the traditional maximization of PV electricity feed-in. We have developed the GeDELOS-PV system as an example of added value for PV electricity which arises from the combination of modern hybrid PV technology with a lead-acid battery storage system and Demand Side Management strategies in the residential sector. We carry out simulations for long-time experiments (yearly studies) and real measurements for short and mid-time experiments (daily and weekly studies.) Results show that the relationship between electricity flows and storage capacity is not linear and therefore, it becomes an important design criterion. (orig.)

  11. Distributed demand-side management optimisation for multi-residential users with energy production and storage strategies

    Directory of Open Access Journals (Sweden)

    Emmanuel Chifuel Manasseh

    2014-12-01

    Full Text Available This study considers load control in a multi-residential setup where energy scheduler (ES devices installed in smart meters are employed for demand-side management (DSM. Several residential end-users share the same energy source and each residential user has non-adjustable loads and adjustable loads. In addition, residential users may have storage devices and renewable energy sources such as wind turbines or solar as well as dispatchable generators. The ES devices exchange information automatically by executing an iterative distributed algorithm to locate the optimal energy schedule for each end-user. This will reduce the total energy cost and the peak-to-average ratio (PAR in energy demand in the electric power distribution. Users possessing storage devices and dispatchable generators strategically utilise their resources to minimise the total energy cost together with the PAR. Simulation results are provided to evaluate the performance of the proposed game theoretic-based distributed DSM technique.

  12. Electric Boiler and Heat Pump Thermo-Electrical Models for Demand Side Management Analysis in Low Voltage Grids

    DEFF Research Database (Denmark)

    Diaz de Cerio Mendaza, Iker; Bak-Jensen, Birgitte; Chen, Zhe

    2013-01-01

    on the power system control and operation, created by this unstable way of generation, Demand Side Management turns to be a promising solution. The storage capacity from thermo-electric units, like electric boilers and heat pumps, allows operating them with certain freedom. Hence they can be employed under...... certain coordination, to actively respond to the power system fluctuations. The following paper presents two simple thermo-electrical models of an electrical boiler and an air-source CO2 heat pump system. The purpose is using them in low voltage grids analysis to assess their capacity and flexibility...... as active loads. The models were simulated under different Danish daily domestic hot water and space heating profiles. Results showed that under high heating demand conditions the flexibility of this kind of units may be drastically restricted due to their continuous operation....

  13. Potential of Demand Side Management to Reduce Carbon Dioxide Emissions Associated with the Operation of Heat Pumps

    Directory of Open Access Journals (Sweden)

    Samuel J. G. Cooper

    2013-06-01

    Full Text Available This work considers the potential reduction in the carbon dioxide emissions associated with the operation of Air Source Heat Pump which could be achieved by using demand side management. In order to achieve significant reductions in carbon dioxide emissions, it is widely envisioned that electrification of the heating sector will need to be combined with decarbonisation of the electrical supply. By influencing the times at when electric heat pumps operate such that they coincide more with electricity generation which has a low marginal carbon emissions factor, it has been suggested that these emissions could be reduced further. In order to investigate this possibility, models of the UK electrical grid based on scenarios for 2020 to 2050 have been combined with a dynamic model of an air source heat pump unit and thermal models of a population of dwellings. The performance and carbon dioxide emissions associated with the heat pumps are compared both with and without demand side management interventions intended to give preference to operation when the marginal emissions factor of the electricity being generated is low. It is found that these interventions are unlikely to be effective at achieving further reductions in emissions. A reduction of around 3% was observed in scenarios based around 2035 but in other scenarios the reduction was insignificant. In the scenarios with high wind generation (2050, the DSM scheme considered here tends to improve thermal comfort (with minimal increases in emissions rather than achieving a decrease in emissions. The reasons for this are discussed and further recommendations are made.

  14. Demand side management in a day-ahead wholesale market: A comparison of industrial & social welfare approaches

    International Nuclear Information System (INIS)

    Highlights: • We compare two demand side management in a day-ahead electricity wholesale market. • We develop and reconcile social welfare & industrial DSM mathematical models. • We show the industrial netload has an additional forecast quantity of baseline. • We analytically and numerically show the model equivalence with accurate baseline. • We numerically demonstrate the baseline errors lead to higher and costlier dispatch. - Abstract: The intermittent nature of renewable energy has been discussed in the context of the operational challenges that it brings to electrical grid reliability. Demand side management (DSM) with its ability to allow customers to adjust electricity consumption in response to market signals has often been recognized as an efficient way to mitigate the variable effects of renewable energy as well as to increase system efficiency and reduce system costs. However, the academic & industrial literature have taken divergent approaches to DSM implementation. While the popular approach among academia adopts a social welfare maximization formulation, the industrial practice compensates customers according to their load reduction from a predefined electricity consumption baseline that would have occurred without DSM. This paper rigorously compares these two different approaches in a day-ahead wholesale market context analytically and in a test case using the same system configuration and mathematical formalism. The comparison of the two models showed that a proper reconciliation of the two models might make them mitigate the stochastic netload in fundamentally the same way, but only under very specific conditions which are rarely met in practice. While the social welfare model uses a stochastic net load composed of two terms, the industrial DSM model uses a stochastic net load composed of three terms including the additional baseline term. DSM participants are likely to manipulate the baseline in order to receive greater financial

  15. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk

    2016-02-01

    Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

  16. Evolving concepts in the management of drug resistant ovarian cancer: dose dense chemotherapy and the reversal of clinical platinum resistance.

    Science.gov (United States)

    Pinato, David J; Graham, Janet; Gabra, Hani; Sharma, Rohini

    2013-04-01

    Despite the initially high response rate to standard front-line debulking surgery followed by platinum-based chemotherapy, the relapse rate in ovarian cancer is high and many patients will recur within 6 months of completing platinum based treatment. These patients may still require further chemotherapy despite being considered "platinum resistant". In this setting, response rates to conventionally scheduled second line platinum and non-platinum agents is low, ranging between 5% and 15%. There is an emerging body of evidence that in this scenario, chemotherapeutic activity can be enhanced using unconventionally scheduled "dose-dense" platinum and non-platinum based regimens with improved response rates of up to 65%. Randomised studies to evaluate the impact of this approach on survival in recurrent, platinum resistant disease are urgently required to confirm the promising phase II findings if there is to be a change in the standard of care of patients with platinum resistant disease. In this review we discuss the evolving strategies to overcome resistance in patients with platinum resistant ovarian cancer with a particular focus on alterations in dose schedule as a means of reversing platinum resistance. PMID:22595680

  17. Anticancer chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1991-10-01

    This document examines chemotherapeutic agents for use in veterinary oncology. It lists some of the most common categories of chemotherapeutic drugs, such as alkylating agents and corticosteroids. For each category, the paper lists some example drugs, gives their mode of action, tumors usually susceptible to the drug, and common side effects. A brief discussion of mechanisms of drug resistance is also provided. (MHB)

  18. A new approach to ensure successful implementation of sustainable demand side management (DSM) in South African mines

    Energy Technology Data Exchange (ETDEWEB)

    Pelzer, R.; Mathews, E.H.; Roux, D.F. le; Kleingeld, M. [Centre for Research and Continued Engineering Development, North West University, Suite 92, Private Bag x 30, Lynnwood Ridge 0040 (South Africa)

    2008-08-15

    Demand side management (DSM) is seen as a short-term solution to the imminent problem of electricity supply shortages in South Africa. DSM aims to reduce peak loads with immediate results in a short time. The mining sector in South Africa is a large energy user with pumping one of the largest consuming systems. Therefore, DSM potential (load shift) should be investigated on these pumping systems. For sustainable load shift, a system is required that simulates, optimises and controls the actual on-site situation. As no such equipment that performs all these processes could be found for deep South African mines, it was developed by HVAC International (Pty) Ltd. It is called the Real-time Energy Management System (REMS). With this system, maximum results can be obtained on a sustainable basis. In this study, four similar DSM projects were investigated. These are described as case studies at gold mines in the Free State Province. For each of these studies a different new innovation was implemented. The innovations described include the adaptation of REMS to handle multi-level intricate pump systems, mines without any instrumentation and control infrastructure, as well as Three Chamber Piped Feeder Systems (3CPFSs). (author)

  19. Clinical application of self-expanding metallic stent in the management of acute left-sided colorectal malignant obstruction

    Institute of Scientific and Technical Information of China (English)

    You-Ben Fan; Ying-Sheng Cheng; Ni-Wei Chen; Hui-Min Xu; Zhe Yang; Yue Wang; Yu-Yao Huang; Qi Zheng

    2006-01-01

    AIM: To summarize our experience with the application of self-expanding metallic stent (SEMS) in the management of acute left-sided colorectal malignant obstruction.METHODS: A retrospective chart review of all patients undergoing placement of SEMS between April 2000 and January 2004 was performed.RESULTS: Insertion of SEMS was attempted in 26patients under fluoroscopic guidance with occasional endoscopic assistance. The sites of lesions were located in splenic flexure of two patients, left colon of seven patients, sigmoid colon of eight patients and rectum of nine patients. The intended uses of SEMS were for palliation in 7 patients and as a bridge to elective surgery in 19 patients. In the latter group, placement of SEMS allowed for preoperative systemic and bowel preparation and the following one-stage anastomosis. Successful stent placement was achieved in 22 (85%) of the 26patients. The clinical bowel obstruction resolved 24 hours after successful stent placement in 21 (95%) patients.Three SEMS-related minor complications occurred, two stents migrated and one caused anal pain.CONCLUSION: SEMS represents an effective and safe tool in the management of acute malignant colorectal obstruction. As a bridge to surgery, SEMS can provide time for systematic support and bowel preparation and obviate the need for fecal diversion or on-table lavage.As a palliative measure, SEMS can eliminate the need for emergent colostomy.

  20. Simulation of the Demand Side Management impacts: resolution enhancement of the input parameters at the local scale

    International Nuclear Information System (INIS)

    Following the integrated energy planning paradigm in the 90's and the recent renewal of decentralized energy planning interests, Demand Side Management (DSM) actions are expected to take a significant role on energy planning activities in the future. Indeed the DSM actions represent a relevant option to achieve environmental and energy commitments or to alleviate some specific problems of electricity supply. DSM actions at the local scale at least in the French context is observed today. There is a need for appropriate methods and tools to assess the impacts of such MDE programs at local level. The local scale involves taking into account the specificities of the territories (physical, social, geographical, economical, institutional, etc.) The objective of this thesis is to improve the spatial resolution of input variables for the use in DSM action simulation tools. Based on a case study in France (PREMIO project: smart architecture for load management applied to a district) and an existing simulation tool we will study the impacts of this local experience to several municipalities. (author)

  1. The Role of Intestinal Microbiota in the Development and Severity of Chemotherapy-Induced Mucositis

    NARCIS (Netherlands)

    van Vliet, Michel J.; Harmsen, Hermie J. M.; de Bont, Eveline S. J. M.; Tissing, Wim J. E.

    2010-01-01

    Mucositis, also referred to as mucosal barrier injury, is one of the most debilitating side effects of radiotherapy and chemotherapy treatment. Clinically, mucositis is associated with pain, bacteremia, and malnutrition. Furthermore, mucositis is a frequent reason to postpone chemotherapy treatment,

  2. Pulmonary blastoma: remission with chemotherapy

    DEFF Research Database (Denmark)

    Nissen, Mogens Holst; Jacobsen, M; Vindeløv, L;

    1984-01-01

    A 59-year-old man with pulmonary blastoma, who had undergone right-sided pneumonectomy, had a relapse of the tumour 7 months later. Light-microscopic and ultrastructural studies were consistent with recurrence from the primary tumour. Cell kinetic studies revealed a high fraction of tumour cells ...... in the S-phase. Complete remission of the recurrence was obtained within 16 days after initiation of combination chemotherapy consisting of CCNU, vincristine, VP-16 and cyclophosphamide....

  3. Is neo-adjuvant chemotherapy a better option for management of cervical cancer patients of rural India?

    Directory of Open Access Journals (Sweden)

    G A Dastidar

    2016-01-01

    Full Text Available Objectives: To explore alternate modality of treatment in patients of advanced cancer cervix by neo-adjuvant chemotherapy (NACT followed by External Beam Radiotherapy (ERT and Brachytherapy (BT. Short- (6 months and long- (12 months term follow-up data from these patients were compared with the retrospective data from an urban cancer centre, where standard protocol of concurrent chemo-radiotherapy is practiced. Materials and Methods: Two hundred patients of advanced cervical cancer, treated at our rural cancer centre between January 2007 and December 2007, were included in the study arm (Group A. These patients received three cycles of neo-adjuvant chemotherapy with Cisplatin, Bleomycin, and Vincristine before External-Beam Radiotherapy (EBT followed by brachytherapy. Patients in the control arm (Group B of an urban cancer centre, received EBT with weekly concomitant Cisplatin, followed by brachytherapy. Short- (6 months and long- (12 months term follow-up data from our patients were compared with the retrospective data from the urban cancer centre. Results and Analysis: Complete response rate was comparatively higher among patients of Group A, also correspondingly proportion of patients showing progressive disease and stable disease was lower among them. Local treatment failure was 87.5% among patients from Group A and 94.4% in Group B patients. Concomitant chemoradiation (CRT was associated with more GI toxicities. Conclusion: Our result suggests NACT arm is as effective as CRT arm in respect of complete response with less pelvic failure and G.I toxicities. Further follow-up data are needed before arriving at a definite conclusion.

  4. BiOsimilaRs in the management of anaemia secondary to chemotherapy in HaEmatology and Oncology: results of the ORHEO observational study

    Science.gov (United States)

    2014-01-01

    Background The approval of epoetin biosimilars in the European Union requires extensive scientific evaluation and stringent regulatory procedures, including post-marketing studies. The ORHEO (place of biOsimilaRs in the therapeutic management of anaemia secondary to chemotherapy in HaEmatology and Oncology) study was an observational, longitudinal, multicentre study performed in France to evaluate the efficacy and safety of biosimilar epoetins for the treatment of chemotherapy-induced anaemia (CIA) in the clinical setting. Methods Patients >18 years with CIA (haemoglobin [Hb] 18 years (mean age 66.5 years) with CIA (haemoglobin [Hb] <11 g/dL) in association with solid tumours, lymphoma or myeloma and eligible for biosimilar epoetin treatment were included. 99.9% of patients received epoetin zeta (median dose 30,000 IU/week). Mean baseline Hb was 9.61 g/dL, with 35.6% of patients having moderate anaemia (Hb 8–9.5 g/dL). Hb response was achieved in 81.6% and 86.5% of patients at 3 and 6 months, respectively. Overall mean change in Hb level was 1.52 ± 1.61 and 1.72 ± 1.61 g/dL at 3 and 6 months, respectively. Transfusion and thromboembolic event rates were 9.4% and 2.4% at 3 months, and 5.8% and 1.5% at 6 months, respectively. Conclusions Epoetin zeta was effective and well tolerated in the management of CIA in patients with solid tumours, lymphoma and myeloma. Trial registration Trial registration number: NCT02140736 (date of registration: 14 May 2014). PMID:25011615

  5. Chromonychia Secondary to Chemotherapy

    Directory of Open Access Journals (Sweden)

    Marien Lopes

    2013-06-01

    Full Text Available Chemotherapy drugs can affect the skin and its appendages. Several clinical presentations can be observed, depending on the affected structure. The most common dermatological side effect is chromonychia. The main causative agents are: (1 cyclophosphamide, which can provoke a diffuse, black pigmentation, longitudinal striae and dark grey pigmentation located proximally on the nails; (2 doxorubicin, which promotes dark brown bands alternating with white striae and dark brown pigmentation in transverse bands, and (3 hydroxyurea, which produces a distal, diffuse, dark brown pigmentation. In the majority of cases, the effects are reversible after the suspension of the causative agent for a few months. We report a patient who developed chromonychia while undergoing treatment with cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine for acute lymphocytic leukemia.

  6. Enabling symptom self-management via use of an electronic patient-reported outcomes (ePRO system to increase self-efficacy of patients with cancer receiving active chemotherapy treatment

    Directory of Open Access Journals (Sweden)

    Grigorios Kotronoulas

    2015-10-01

    Full Text Available Background: In recent years, the shift in cancer services from traditional tertiary care to care delivered within communities has increased the need for patients to engage in self-care activities in order to prevent or reduce the severity of numerous and complex-side effects (McCorkle et al., 2011 and make important health decisions when at home in the absence of clinicians (Butow et al., 2012. The actual degree of engagement in self-management may be dependent on patients’ perceived competence or self-efficacy to perform such activities (Fenlon et al., 2015. Self-efficacy has been defined as “a person’s belief to execute courses of action required to deal with a prospective situation” (Bandura, 1977, 2001. One’s beliefs in their capability to successfully manage tasks and consequently influence situations that impact their lives constitutes a central part of human agency, and can be influenced by performance accomplishments (Bandura, 1989, 2001. Whilst self-efficacy can enable engagement in self-management, actual participation in self-management activities can further increase one’s perceived ability to undertake such activities; it is thus obvious that a bi-directional association between self-management and self-efficacy exists. Supporting a shift in clinical practice with innovative technological systems affords a solution to the increasing demands placed on acute care by enabling the delivery of care in the home and community setting (Basch et al., 2011; Carpenter et al., 2008. Such remote monitoring systems facilitate the provision of clear lines of real-time communication between patients and their health care providers (Basch et al., 2011, and can deliver organised self-management advice tailored to the individual’s clinical characteristics and severity/distress of symptoms of anti-cancer treatment. Aim(s: Funded by the European Union (FP7 programme, a multi-centre European project (the eSMART study has been designed to

  7. Effectiveness of Nursing Interventions on Physical and Psychological Outcome among Cancer Patients Undergoing Chemotherapy

    Directory of Open Access Journals (Sweden)

    T. Sivabalan

    2016-04-01

    Full Text Available Background: Cancer patient's undergoing chemotherapy experiences a variety of side effects which has influence on prognosis of illness, activity of daily living and the quality of life. There is a need of nursing care interventions for management and prevention of problem among cancer patients. Aim & Objectives: The present study aimed to assess the effectiveness of nursing interventions on physical and psychological outcome among cancer patients undergoing chemotherapy. Material and Methods: A true experimental study, post test only design with control group approach was conducted among 130 cancer patients undergoing chemotherapy at oncology ward of Pravara Rural Hospital, Loni (Bk, Ahmednagar, Maharashtra. Cancer patients who are 18 years old or older were selected with systematic random sampling method. Pre tested semi structured interview schedule was used to gather data. The assessment of health status before start of chemotherapy was carried out, followed by the nursing interventions was implemented based on patient needs and problems, and the post test was conducted after the period of interventions. The collected data was tabulated and analyzed using appropriate statistical methods wherever required. Results: The results revealed that the cancer patients experienced a wide range of physical and psychological problems prior to chemotherapy treatment. Cancer patients who received nursing interventions had improved post test mean scores on chemotherapy symptoms, pain and fatigue; emotional well being, anxiety and depression than the patients who received routine care, notably it was statistically significant at p<0.05 level. A significant association was observed between physical, psychological outcome variables and the socio demographic characteristics like sex, site of cancer, stage of cancer, duration of cancer, metastasis of cancer and the regimen of chemotherapy at p<0.05 level. Conclusion: This study demonstrated that the nursing

  8. Chemotherapy for intraperitoneal use: a review of hyperthermic intraperitoneal chemotherapy and early post-operative intraperitoneal chemotherapy.

    Science.gov (United States)

    Goodman, Martin D; McPartland, Sarah; Detelich, Danielle; Saif, Muhammad Wasif

    2016-02-01

    Peritoneal spread of tumors is a major problem in cancer management. Patients develop a marked deterioration in quality of life and shortened survival. This is in part due to bowel obstructions, marked ascites, and overall increase debilitation. Standard medical management has shown to be inadequate for the treatment of these problems. Surgery can palliate symptoms, however, it is unable to be complete at the microscopic level by a significant spillage of tumor cells throughout the abdomen. Chemotherapy can have some improvement in symptoms however it is short lived due to poor penetration into the peritoneal cavity. The role of intraperitoneal chemotherapy is to maximize tumor penetration and optimize cell death while minimizing systemic toxicity. Hyperthermic intraperitoneal chemotherapy (HIPEC) and early post-operative intraperitoneal chemotherapy (EPIC) are two treatment methods that serve this role and have been shown to improve survival. This review will discuss different chemotherapies used for both of these treatment options. PMID:26941983

  9. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Science.gov (United States)

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. PMID:25752741

  10. Meta-analysis of the effect of nutritional support on nutrition and chemotherapy-related side effects in GI cancer patients%营养支持对胃肠道肿瘤化疗患者营养及不良反应影响的meta分析

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective: To assess the effect of nutritional support on nutrition and chemotherapy-related side effects in GI cancer patients undergoing chemotherapy.Methods:Randomized clinical trials (RCTs) on comparison of nutrition, immunity and chemotherapy-related side effects between the GI cancer patients with or without additional nutritional support were searched through Pubmed, Scopus, CNKI and WANFANG databases. Qualified trials published from 1990 to 2014 were included in the study. Meta-analysis was used to compare nutrition, immunity and chemotherapy-related side effects between the two groups.Results: Finally 17 RCTs with 955 patients were included in the study. Among them, 486 patients received chemotherapy plus nutritional support and 492 patients received chemotherapy only. The patients who received nutritional support had significant improvement in transferring (SMD=0.61, 95% CI, 0.40~0.82,P<0.05), IgG (SMD=0.65, 95% CI, 0.45~0.84,P<0.05) and IgA (SMD=0.62, 95% CI, 0.10~1.13,P<0.05). The incidences of side-effects related to chemotherapy including leukopenia (RR=0.57, 95% CI, 0.39~0.82,P<0.05), nausea and vomiting (RR=0.54, 95% CI, 0.40~0.72,P<0.05) and anorexia (RR=0.50, 95% CI, 0.30~0.83,P<0.05) were significantly decreased in the patients with nutritional support.Conclusion:Nutritional intervention can improve nutritional status and immunity and decrease incidence of chemotherapy-related side-effects in GI cancer patients undergoing chemotherapy.%目的:通过meta分析研究营养支持对胃肠道肿瘤患者营养状况和化疗不良反应的影响。方法:应用Pubmed、Scopus、CNKI和万方数据知识服务平台数据库检索1990至2014年发表的关于胃肠道肿瘤患者化疗期间行营养支持与单纯化疗对比的随机对照研究(randomized clinical trials,RCT),进行meta分析。结果:检索出相关文献922篇,纳入17篇。共纳入患者955例,实验组486例,对照组479例。结果显示化疗期间营养支

  11. An Algorithmic Game Approach for Demand Side Management in Smart Grid with Distributed Renewable Power Generation and Storage

    Directory of Open Access Journals (Sweden)

    Ren-Shiou Liu

    2016-08-01

    Full Text Available In this paper, the problem of minimizing electricity cost and the peak system load in smart grids with distributed renewable energy resources is studied. Unlike prior research works that either assume all of the jobs are interruptible or power-shiftable, this paper focuses on more challenging scenarios in which jobs are non-interruptible and non-power-shiftable. In addition, as more and more newly-built homes have rooftop solar arrays, it is assumed that all users are equipped with a solar-plus-battery system in this paper. Thus, power can be drawn from the battery as needed to reduce the cost of electricity or to lower the overall system load. With a quadratic load-dependent cost function, this paper first shows that the electricity cost minimization problem in such a setting is NP-hard and presents a distributed demand-side management algorithm, called DDSM, to solve this. Experimental results show that the proposed DDSM algorithm is effective, scalable and converges to a Nash equilibrium in finite rounds.

  12. A New Method to Plan the Capacity and Location of Battery Swapping Station for Electric Vehicle Considering Demand Side Management

    Directory of Open Access Journals (Sweden)

    Wenxia Liu

    2016-06-01

    Full Text Available Compared to electric vehicle (EV charging mode, battery swapping mode can realize concentrated and orderly charging. Therefore battery swapping stations (BSS can participate in the demand side management (DSM as an integrated form. In this context, a new method to plan the capacity and location of BSS for EV, considering DSM, is proposed in this paper. Firstly, based on the original charging power of BSS with the rule of “First-In First-Out”, a bi-level optimal configuration model of BSS, in which net profit of BSS is maximized in the upper model and operating cost of Distribution Company is minimized in the lower model, is developed to decide the rated power, number of batteries, contract pricing and dispatched power of BSS for DSM. Then, the optimal locating model of BSS with the objective of minimizing network loss is built. A mesh adaptive direct search algorithm with YALMIP toolbox is applied to optimize the bi-level model. Simulation calculation was carried on IEEE-33 nodes distribution system and the results show that participating in DSM can improve the economic benefits of both BSS and distribution network and promote the consumption of distributed generation, verifying the feasibility and effectiveness of the proposed method.

  13. A semi-distributed electric demand-side management system with PV generation for self-consumption enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Castillo-Cagigal, M., E-mail: manuel.castillo@ies-def.upm.e [ETSI Telecomunicacion, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain); Gutierrez, A., E-mail: aguti@etsit.upm.e [ETSI Telecomunicacion, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain); Monasterio-Huelin, F., E-mail: felix.monasteriohuelin@upm.e [ETSI Telecomunicacion, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain); Caamano-Martin, E., E-mail: estefan@ies-def.upm.e [Instituto de Energia Solar, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain); Masa, D., E-mail: dmasa@ies-def.upm.e [Instituto de Energia Solar, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain); Jimenez-Leube, J., E-mail: jleube@etsit.upm.e [ETSI Telecomunicacion, Universidad Politecnica de Madrid, Av. Complutense 30, 28040 Madrid (Spain)

    2011-07-15

    Highlights: {yields} We have developed a DSM system with PV electricity and battery storage. {yields} To implement the DSM system, we have developed a modular architecture. {yields} Simulations and real experiments have been executed for different weather conditions. {yields} The use of theses technologies increase the self-consumed energy. -- Abstract: This paper presents the operation of an Electrical Demand-Side Management (EDSM) system in a real solar house. The use of EDSM is one of the most important action lines to improve the grid electrical efficiency. The combination between the EDSM and the PV generation performs a new control level in the local electric behavior and allows new energy possibilities. The solar house used as test-bed for the EDSM system owns a PV generator, a lead-acid battery storage system and a grid connection. The electrical appliances are controllable from an embedded computer. The EDSM is implemented by a control system which schedules the tasks commanded by the user. By using the control system, we define the house energy policy and improve the energy behavior with regard to a selected energy criterion, self-consumption. The EDSM system favors self-consumption with regard to a standard user behavior and reduces the energy load from the grid.

  14. Impact of group psychotherapy in chemotherapy induced vomiting for treatment of advanced breast and lungs cancer

    International Nuclear Information System (INIS)

    To assess the effect of group psychotherapy in the management of the side effects of chemotherapy treatment in advanced breast and lung cancer. One hundred patients treated with chemotherapy for advanced stage (IIIB and IV) breast and lung cancer were selected with ECOG performance status of 0 or 1. All patients received anti-emetic medications half an hour before chemotherapy. All those patients in this category who completed fist line chemotherapy with 6 cycles were included. Fifty were subjected to group discussions with other patients, family members and medical staff. This was labeled group A. The other 50 were not included in group discussion and were labeled group B. Both the group received similar standard chemotherapy and pre-medication for vomiting as per their disease and chemotherapy schedule. Breast and lung cancer patients were 29 and 21 in each arm respectively. At the end of the discharge, grade 2 and above of vomiting, according to common terminology criteria for adverse events (CTCAE) was counted for all patients in both the arms A and B, over full length of treatment for 6 cycles, and then were compared statistically. Mean with standard deviation for adverse event (vomiting) in group A and B was 6.2 + 2.6 and 13.4 + 3.8 respectively per cycle of treatment. It was observed that group psychotherapy had statistically significant effect (p-value <0.05) on the management of vomiting. Group psychotherapy can be used to reduce the incidence of vomiting in advanced breast and lung cancer patients treated with chemotherapy. (author)

  15. DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS SITED ON MILITARY BASES

    Science.gov (United States)

    The report gives results of an investigation into the pollutant emission reduction and demand-side management potential of three photovoltaic (PV) systems installed at Ft. Huachuca, AZ, Ft. Dix, NJ, and Hickam Air Force Base, HI, which began operation between January and July 199...

  16. Retinoblastoma: Achieving new standards with methods of chemotherapy

    Directory of Open Access Journals (Sweden)

    Swathi Kaliki

    2015-01-01

    Full Text Available The management of retinoblastoma (RB has dramatically changed over the past two decades from previous radiotherapy methods to current chemotherapy strategies. RB is a remarkably chemotherapy-sensitive tumor. Chemotherapy is currently used as a first-line approach for children with this malignancy and can be delivered by intravenous, intra-arterial, periocular, and intravitreal routes. The choice of route for chemotherapy administration depends upon the tumor laterality and tumor staging. Intravenous chemotherapy (IVC is used most often in bilateral cases, orbital RB, and as an adjuvant treatment in high-risk RB. Intra-arterial chemotherapy (IAC is used in cases with group C or D RB and selected cases of group E tumor. Periocular chemotherapy is used as an adjunct treatment in eyes with group D and E RB and those with persistent/recurrent vitreous seeds. Intravitreal chemotherapy is reserved for eyes with persistent/recurrent vitreous seeds. In this review, we describe the various forms of chemotherapy used in the management of RB. A database search was performed on PubMed, using the terms "RB," and "treatment," "chemotherapy," "systemic chemotherapy," "IVC," "IAC," "periocular chemotherapy," or "intravitreal chemotherapy." Relevant English language articles were extracted, reviewed, and referenced appropriately.

  17. Nutritional consequences in children undergoing chemotherapy for malignant disease

    OpenAIRE

    Skolin, Inger

    2005-01-01

    Background: Chemotherapy has side effects that may interfere with food intake. Children suffering from a malignant disease are subjected to treatment with chemotherapy. They may therefore become at risk of undernutrition during the period of treatment. This in turn may increase the risk of infections, delayed therapy and influence the outcome of treatment. Few studies have investigated how children undergoing chemotherapy for cancer perceive food and eating. Attempts to improve food intake an...

  18. Distress, anxiety, and depression in cancer patients undergoing chemotherapy

    OpenAIRE

    Thomas Bejoy C; Devi Nandkumar; Sarita Gangadharan P; Pandey Manoj; Hussain Badridien M; Krishnan Rita

    2006-01-01

    Abstract Background Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. Patients and methods A total of 117 patients were evaluated by using distress inventory for cancer (DIC2) and hospital anxiety and depression scale (HADS). Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%). Results The mean distress score was 24, 18 (15.38%...

  19. Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

    Science.gov (United States)

    Gosman, Nathaniel

    For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity

  20. Novel effects of demand side management data on accuracy of electrical energy consumption modeling and long-term forecasting

    International Nuclear Information System (INIS)

    Highlights: • Novel effects of DSM data on electricity consumption forecasting is examined. • Optimal ANN models based on IPSO and SFL algorithms are developed. • Addition of DSM data to socio-economic indicators data reduces MAPE by 36%. - Abstract: Worldwide implementation of demand side management (DSM) programs has had positive impacts on electrical energy consumption (EEC) and the examination of their effects on long-term forecasting is warranted. The objective of this study is to investigate the effects of historical DSM data on accuracy of EEC modeling and long-term forecasting. To achieve the objective, optimal artificial neural network (ANN) models based on improved particle swarm optimization (IPSO) and shuffled frog-leaping (SFL) algorithms are developed for EEC forecasting. For long-term EEC modeling and forecasting for the U.S. for 2010–2030, two historical data types used in conjunction with developed models include (i) EEC and (ii) socio-economic indicators, namely, gross domestic product, energy imports, energy exports, and population for 1967–2009 period. Simulation results from IPSO-ANN and SFL-ANN models show that using socio-economic indicators as input data achieves lower mean absolute percentage error (MAPE) for long-term EEC forecasting, as compared with EEC data. Based on IPSO-ANN, it is found that, for the U.S. EEC long-term forecasting, the addition of DSM data to socio-economic indicators data reduces MAPE by 36% and results in the estimated difference of 3592.8 MBOE (5849.9 TW h) in EEC for 2010–2030

  1. Mechanisms of chemotherapy-induced behavioral toxicities

    Directory of Open Access Journals (Sweden)

    Elisabeth G Vichaya

    2015-04-01

    Full Text Available While chemotherapeutic agents have yielded relative success in the treatment of cancer, patients are often plagued with unwanted and even debilitating side-effects from the treatment which can lead to dose reduction or even cessation of treatment. Common side effects (symptoms of chemotherapy include (i cognitive deficiencies such as problems with attention, memory and executive functioning; (ii fatigue and motivational deficit; and (iii neuropathy. These symptoms often develop during treatment but can remain even after cessation of chemotherapy, severely impacting long-term quality of life. Little is known about the underlying mechanisms responsible for the development of these behavioral toxicities, however, neuroinflammation is widely considered to be one of the major mechanisms responsible for chemotherapy-induced symptoms. Here, we critically assess what is known in regards to the role of neuroinflammation in chemotherapy-induced symptoms. We also argue that, based on the available evidence neuroinflammation is unlikely the only mechanism involved in the pathogenesis of chemotherapy-induced behavioral toxicities. We evaluate two other putative candidate mechanisms. To this end we discuss the mediating role of damage-associated molecular patterns (DAMPs activated in response to chemotherapy-induced cellular damage. We also review the literature with respect to possible alternative mechanisms such as a chemotherapy-induced change in the bioenergetic status of the tissue involving changes in mitochondrial function in relation to chemotherapy-induced behavioral toxicities. Understanding the mechanisms that underlie the emergence of fatigue, neuropathy, and cognitive difficulties is vital to better treatment and long-term survival of cancer patients.

  2. 穴位按揉综合干预对恶性肿瘤化疗不良反应的疗效探讨%Acupuncture Point According to Knead Comprehensive Therapy of Malignant Tumor Side Effects of Chemotherapy Curative Effect Observation

    Institute of Scientific and Technical Information of China (English)

    周钰

    2015-01-01

    目的:探讨穴位按揉综合干预改善恶性肿瘤患者化疗不良反应的效果。方法将182例恶性肿瘤化疗患者随机分为实验组和对照组各91例,两组均实施穴位艾灸,实验组在此基础上进行穴位按揉、情绪宽慰及情景影响。结果两组治疗后临床症状缓解比较、两组疼痛疗效比较、两组治疗前后体重变化的比较,差异有统计学意义(χ2=6.80、χ2=4.10、χ2=15.1,P<0.05)。结论穴位按揉综合干预可以明显地改善肿瘤化疗不良反应,且病人的耐受性好。%Objective Discussion points with comprehensive treatment to improve the effect of side effects of chemotherapy in pa-tients with malignant tumors.Methods The 182 patients with malignant tumor chemotherapy were randomly divided into experi-mental group and the control group, 91 cases each, Both groups to implement plant moxibustion, the experimental group on the basis of meridians by rubbing, emotional comfort and scenarios.Results Two groups of clinical symptoms after treatment compari-son, comparison of two groups of pain, the comparison of two groups of weight changes before and after the treatment, there are significant difference (χ2=6.8、χ2=4.10、χ2=15.1,P<0.05).Conclusions Acupuncture point with comprehensive therapy can obviously improve the tumor chemotherapy side effects, and the patient's tolerance.

  3. Cost-effectiveness of primary debulking surgery when compared to neoadjuvant chemotherapy in the management of stage III C and IV epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Forde GK

    2016-08-01

    Full Text Available Gareth K Forde,1 Jenny Chang,2 Argyrios Ziogas,21Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA, USA; 2Department of Epidemiology, University of California, Irvine, CA, USA Objectives: To examine the cost-effectiveness of primary debulking surgery (PDS when compared to neoadjuvant chemotherapy (NACT in the management of epithelial ovarian cancer (EOC using Surveillance, Epidemiology, and End Results data linked to Medicare claims (SEER-Medicare. Methods: Using a Markov model, the cost-effectiveness of PDS was compared to that of NACT. We modeled cost and survival inputs using data from women in the SEER-Medicare database with ovarian cancer treated by either PDS or NACT between 1992 and 2009. Direct and indirect costs were discounted by an annual rate of 3%. Utility weights were obtained from published data. The incremental cost-effectiveness ratio (ICER of PDS compared to NACT was calculated. Results: In our model, women with stage IIIC EOC had a higher mean adjusted treatment cost for PDS when compared to NACT ($31,945 vs $30,016 but yielded greater quality-adjusted life-years (QALYs (1.79 vs 1.69. The ICER was $19,359/QALY gained. Women with stage IV EOC had a higher mean adjusted treatment cost following PDS when compared to NACT ($31,869 vs $27,338 but yielded greater QALYs (1.69 vs 1.66. The ICER was $130,083/QALY gained. A sensitivity analysis showed that for both PDS and NACT the ICER was sensitive to incremental changes in the utility weight. Conclusion: PDS is significantly more cost-effective for women with stage IIIC when compared to NACT. In women with stage IV EOC, PDS is also more cost-effective though the QALYs gained are much more costly and exceed a $50,000 willingness to pay. Keywords: Markov model, gynecologic cancer, chemotherapy, up front surgery

  4. Safe chemotherapy in the home environment.

    Science.gov (United States)

    Chavis-Parker, Paula

    2015-05-01

    The Oncology Nursing Society and the American Society of Clinical Oncology have established guidelines for the safe and effective use of chemotherapeutic medications in the acute and outpatient care settings. A review of literature was performed to determine the safe and effective administration of chemotherapy in the home environment. The administration of oral and intravenous chemotherapy in the home has become a common intervention for patients being treated for cancer based on patient preference, cost-effectiveness of healthcare delivery, and increasing demand for oncology services. Home healthcare nurses can greatly impact the management of adverse effects of chemotherapy in the home, increasing the quality of life and improving patient outcomes.

  5. Effective Management of an Advanced Gastric Cancer Patient by TS-1 Combined Chemotherapy Using Nasojejunal Tube and Successful Transfer to Home Care after Percutaneous Transesophageal Gastro-tubing (PTEG: A Case Report

    Directory of Open Access Journals (Sweden)

    Miyade,Yoshio

    2010-02-01

    Full Text Available A 67-year-old woman with debilitation and massive ascites was admitted to our hospital and diagnosed with stage IV scirrhous gastric cancer with peritoneal dissemination. After successful nasojejunal tube feeding because of oral intake disability, TS-1 combined with paclitaxel chemotherapy was selected. TS-1 at 80mg/m2 was given daily via nasojejunal tube for 2 weeks, followed by a 1-week rest, and paclitaxel at 50mg/m2 was administered intravenously on day 1 and 8. There were no serious side effects. After 4 cycles, a partial response was observed and percutaneous transesophageal gastro-tubing (PTEG was placed. After the fifth cycle, she was transferred to her home and received chemotherapy in an outpatient clinic. After 7 cycles, the disease progressed, and TS-1 combined with low-dose cisplatin was administered for 3 cycles. However, the patient died 16 weeks after discharge. PTEG was useful not only for a route of TS-1 administration, but also for receiving chemotherapy at home to maintain her quality.

  6. Electricity decision-making: New techniques for calculating statewide economic impacts from new power supply and demand-side management programs

    Science.gov (United States)

    Tegen, Suzanne Isabel Helmholz

    This dissertation introduces new techniques for calculating and comparing statewide economic impacts from new coal, natural gas and wind power plants, as well as from demand-side management programs. The impetus for this work was two-fold. First, reviews of current literature and projects revealed that there was no standard way to estimate statewide economic impacts from new supply- and demand-side electricity options. Second, decision-makers who were interviewed stated that they were overwhelmed with data in general, but also lacked enough specific information about economic development impacts to their states from electricity, to make informed choices. This dissertation includes chapters on electricity decision-making and on economic impacts from supply and demand. The supply chapter compares different electricity options in three states which vary in natural resource content: Arizona, Colorado and Michigan. To account for differing capacity factors, resources are compared on a per-megawatt-hour basis. The calculations of economic impacts from new supply include: materials and labor for construction, operations, maintenance, fuel extraction, fuel transport, as well as property tax, financing and landowner revenues. The demand-side chapter compares residential, commercial and industrial programs in Iowa. Impact calculations include: incremental labor and materials for program planning, installation and operations, as well as sales taxes and electricity saved. Results from supply-side calculations in the three states analyzed indicate that adding new wind power can have a greater impact to a state's economy than adding new gas or coal power due to resource location, taxes and infrastructure. Additionally, demand-side management programs have a higher relative percentage of in-state dollar flow than supply-side solutions, though demand-side programs typically involve fewer MWh and dollars than supply-side generation. Methods for this dissertation include researching

  7. Side Payments in Marketing

    OpenAIRE

    John R. Hauser; Duncan I. Simester; Birger Wernerfelt

    1997-01-01

    Side payments, known politely as gainsharing and pejoratively as bribery, are prevalent in marketing. Indeed, many management schools have added ethics modules to their basic marketing courses to discuss these issues and there is much discussion of side payments in the literature (e.g., Adams 1995, Borrus [Borrus, Amy. 1995. A world of greased palms. (November 6) 36–38.], Mauro [Mauro, Paolo. 1997. Why worry about corruption? . Washington, D.C.], Mohl [Mohl, Bruce. 1996. Auto dealers color su...

  8. Repopulation of Ovarian Cancer Cells After Chemotherapy

    OpenAIRE

    Telleria, Carlos M.

    2013-01-01

    The high mortality rate caused by ovarian cancer has not changed for the past thirty years. Although most patients diagnosed with this disease respond to cytoreductive surgery and platinum-based chemotherapy and undergo remission, foci of cells almost always escape therapy, manage to survive, and acquire the capacity to repopulate the tumor. Repopulation of ovarian cancer cells that escape front-line chemotherapy, however, is a poorly understood phenomenon. Here I analyze cancer-initiating ce...

  9. Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Al-Niaimi Amjad

    2011-02-01

    Full Text Available Abstract Introduction Docetaxel is a chemotherapeutic agent used alone or in combination for the management of many neoplastic conditions. Numerous side effects are well described as a consequence. Palmar-plantar erythrodysesthesia, although a relatively common side effect of some types of chemotherapy, occurs infrequently with docetaxel and is often attributed to other drug agents. Case Presentation We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management. Conclusion Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.

  10. Chemotherapy of osteoarticular tuberculosis

    Directory of Open Access Journals (Sweden)

    Hazra Avijit

    2005-01-01

    Full Text Available Tuberculosis (TB of the bones and joints is rampant in India with the dorsolumbar spine as the most common site of osseous involvement. For diagnosis, clinical suspicion needs to be confirmed through appropriate laboratory and imaging investigations, and increasingly nowadays, nucleic acid amplification techniques. Chemotherapy remains the cornerstone of management complemented by rest, nutritional support and splinting, as necessary. Operative intervention is required if response to chemotherapy is unsatisfactory and for spinal stabilization. The drugs and regimens are fundamentally similar to those for pulmonary TB. However, there is lack of consensus on the appropriate duration of treatment. The prevailing practice of extending treatment till radiological evidence of healing is complete, may be unnecessary in view of recent reports that 6-9 months of therapy is sufficient for the majority of cases. Relapse rates are not drastically improved by extending treatment to 12 months or even longer, except perhaps in pediatric cases. However, prolonged treatment may be required if surgical debridement is indicated but cannot be done. Multidrug-resistant TB should be suspected if disease activity shows no signs of abating after 4-6 months of uninterrupted therapy. These cases are therapeutically challenging and will require second line or experimental antiTB drugs, supported by resistance testing where feasible. Coexistent HIV/AIDS may also necessitate prolonged treatment. Interactions between first line antiTB drugs and antiretroviral medication can complicate matters. Close monitoring is essential in all cases, with dechallenge and cautious reinstitution of drugs in the event of toxicity. While awaiting the arrival of long overdue new antiTB medication, existing drugs and regimens must be used in an informed manner with emphasis on patient compliance.

  11. Intrathecal chemotherapy. Selection of cytostatic agents.

    Science.gov (United States)

    Hayakawa, T; Yamada, R; Kanai, N; Kuroda, R; Ushio, Y; Higashi, H; Mogami, H

    1970-09-01

    Selection of cytostatic agents for intrathecal administration is the subject of this paper.Both the toxic side effects-destruction of blood-brain barrier and change of body weight-and the cytostatic effects on intracranially transplanted Yoshida ascites sarcoma were investigated of intrathecal administration of various cytostatic agents. As a result, it may be concluded that Methotrexate and Endoxan and lower dose of mitomycin C are suitable drugs for intrathecal chemotherapy.Based on these findings, clinical cases of malignant brain tumours were treated with intrathecal chemotherapy.Grateful acknowledgement is made to Professor Dennosuke Jinnai for his constant interest and guidance in this investigation.

  12. 3D Radiotherapy Can Be Safely Combined With Sandwich Systemic Gemcitabine Chemotherapy in the Management of Pancreatic Cancer: Factors Influencing Outcome

    International Nuclear Information System (INIS)

    Purpose: The aim of this Phase II study was to examine whether concurrent continuous infusion 5-fluorouracil (CI 5FU) plus three-dimensional conformal planning radiotherapy sandwiched between gemcitabine chemotherapy is effective, tolerable, and safe in the management of pancreatic cancer. Methods and Materials: Patients were enrolled in two strata: (1) resected pancreatic cancer at high risk of local relapse (postsurgery arm, n = 22) or (2) inoperable pancreatic cancer in head or body without metastases (locally advanced arm, n = 41). Gemcitabine was given at 1,000 mg/m2 weekly for 3 weeks followed by 1 week rest then 5-6 weeks of radiotherapy and concurrent CI 5FU (200 mg/m2/day). After 4 weeks' rest, gemcitabine treatment was reinitiated for 12 weeks. Results: For the two arms combined, treatment-related Grade 3 and 4 toxicities were reported by 25 (39.7%) and 7 (11.1%) patients, respectively. No significant late renal or hepatic toxicity was observed. In the postsurgery arm (R1 54.5%), median time to progressive disease from surgery was 11.0 months, median time to failure of local control was 32.9 months, and median survival time was 15.6 months. The 1- and 2-year survival rates were 63.6% and 31.8%. No significant associations between outcome and mutations in K-ras or TP53 or microsatellite instability were identified. Post hoc investigation of cancer antigen 19-9 levels found baseline levels and increases postbaseline were associated with shorter survival (p = 0.0061 and p < 0.0001, respectively). Conclusions: This three-dimensional chemoradiotherapy regimen is safe and promising, with encouraging local control for a substantial proportion of patients, and merits testing in a randomized trial

  13. Analysis of Demand Side Management Tasks in Smart Power Grid%浅析智能电网下的电力需求侧管理

    Institute of Scientific and Technical Information of China (English)

    曹京津; 秦立军

    2014-01-01

    需求侧管理(Demand Side Management, DSM)是未来智能电网中最重要的一个部分。 DSM算法帮助消费者成为电力系统更积极的贡献者,通过可移动的负载来达到系统调度的目的。文章首先介绍了智能电网,接着概括了智能电网下DSM的新变化,最后通过将DSM分为4个重要部分来探讨了智能电网下它所面临的新的挑战。%Demand Side Management (DSM) will be one of the most important parts of future smart power grid. The DSM algorithms help consumers to be more active contributors in the power system in order to achieve system objectives by scheduling their shift able load. This paper first introduced the smart grid, then introduces the new change of demand side management under the smart grid, finally discuss the new challenges which DSM may face under the smart grid by dividing it into four important parts.

  14. Chemotherapy in Prostate Cancer.

    Science.gov (United States)

    Hurwitz, Michael

    2015-10-01

    For approximately a decade, chemotherapy has been shown to prolong life in patients with metastatic castration-resistant prostate cancer (mCRPC). Since that time, however, only two agents have proven to prolong life (docetaxel and cabazitaxel). However, in the last year, the addition of chemotherapy to primary hormonal therapy became a standard of care for high-volume castration-sensitive metastatic disease. Here I will review current prostate cancer chemotherapies, mechanisms of resistance to those therapies, and ongoing clinical studies of chemotherapy combinations and novel chemotherapeutics. PMID:26216506

  15. Effect of nutritional support on therapy-related side effects in acute lymphoblastic leukemia children undergoing chemotherapy%急性淋巴细胞白血病患儿化疗初期营养支持对化疗并发症的影响

    Institute of Scientific and Technical Information of China (English)

    周宇晨; 李斯丹; 周翾

    2015-01-01

    ,and the difference was statistically significant.On the other hand,the Z scores of W/H and BMI kept stable after chemotherapy in the intervention group,the albumin level raised from (40.53 ±3.96) g/L to (44.36 ± 3.31) g/L (t =-4.500,P < 0.001) and the pre-albumin level raised from (126.55 ± 39.28) g/L to (189.55 ± 51.81) g/L(t =2.710,P =0.010),which was of statistical difference.The albumin level(t =5.020,P < 0.001),pre-albumin level (t =3.036,P =0.040) and the Z scores of W/H (t =2.790,P =0.010),BMI (t =3.370,P < 0.001),weight for age (W/A,t =2.830,P =0.010) were all higher in the intervention group,and the differences in statistical significance were found.(3)Side effects of chemotherapy:patients in the intervention group had higher hemoglobin (t =2.070,P =0.043) and platelet (Z =-2.19,P =0.033) level during the chemotherapy which induce less platelet [(0.50 ± 1.00) U vs (2.00 ± 2.00) U ; Z =-3.53,P =0.003] and red blood cells [(3.87 ± 2.01) U vs (5.25 ± 1.87) U ;t =-2.810,P =0.007] transfusion.Period of neutrophil deficiency [(15.67 ± 8.85)d vs (25.94 ±8.72) d;t =-4.601,P <0.001]was also shorter than that in the control group.Other complications had no difference between two groups exclude mild liver function abnormality was found more in the controls(x2 =6.680,P =0.010).(4)Safety:the complete remission rate 15 days after chemotherapy was 83.3% in the intervention group and 81.2% in the control group (x2 =0.046,P =0.830).All patients got complete remission on day 33.There was no significant difference.No pancreatitis happened in both groups during the chemotherapy.Conclusions Malnutrition rate is high among newly diagnosed ALL pediatric patients,and the nutritional status will deteriorate during the chemotherapy.Enteral nutritional support contributes to maintaining the stability of nutritional status.Enteral nutritional support improves the tolerance of hematopoietic system to chemotherapy.The effect for other complications remains to be

  16. Effects of complete nursing management for the breast cancer patients with chemotherapy%完全护理管理在乳腺癌化疗患者中的应用效果

    Institute of Scientific and Technical Information of China (English)

    秦晓红

    2016-01-01

    目的:探讨完全护理管理在乳腺癌化疗患者中的应用效果。方法选取2009年5月—2014年12月收治的90例乳腺癌化疗患者作为研究对象,按照随机数字表法将患者分为观察组和对照组。对照组采用常规护理模式,观察组在对照组的基础上使用完全护理管理模式护理,比较两组患者治疗前后并发症程度、治疗后依从性和治疗前后的生活质量。结果护理后,观察组不良反应轻度患者多于对照组,中度和重度患者少于对照组,差异有统计学意义(χ2值分别为3.916,5.024,6.635;P<0.05)。护理后观察组患者不良反应评分为(31.62±7.21)分,低于对照组的(36.76±10.32)分,差异有统计学意义(t=2.268,P=0.025)。观察组护理后的依从性良好和一般的患者均多于对照组,差异有统计学意义(χ2值分别为4.876,7.832;P <0.05);依从性差的患者少于对照组,差异有统计学意义(χ2=-8.234,P=0.001)。护理后,观察组患者的角色、认知、情绪、社会功能及总体生活质量评分优于对照组,差异有统计学意义(P<0.05)。结论完全护理管理应用于乳腺癌化疗患者,能够有效减少患者化疗并发症,提高患者的治疗依从性,改善患者的生活质量。%Objective To explore the effects of complete nursing management for the breast cancer patients with chemotherapy. Methods From May 2009 to December 2014, 90 cases breast cancer patients were randomly divided into control group and observation group. The patients of control group were used traditional nursing methods, and the patients of observation group were added complete nursing management method based on nursing intervention of control group. We compared the differences between these two groups by the degree of complication, treatment compliance and quality of life before and after the treatment. Results After nursing treatment, The incidences of slight side effects were more and moderate-severe were less in the

  17. Chemotherapy for Soft Tissue Sarcomas

    Science.gov (United States)

    ... Next Topic Targeted therapy for soft tissue sarcoma Chemotherapy for soft tissue sarcomas Chemotherapy (chemo) is the use of drugs given into ... Depending on the type and stage of sarcoma, chemotherapy may be given as the main treatment or ...

  18. Extravasation of chemotherapy

    DEFF Research Database (Denmark)

    Langer, Seppo W

    2010-01-01

    Extravasation of chemotherapy is a feared complication of anticancer therapy. The accidental leakage of cytostatic agents into the perivascular tissues may have devastating short-term and long-term consequences for patients. In recent years, the increased focus on chemotherapy extravasation has led...

  19. 供给侧改革视角下管理会计的创新%Management accounting innovation under supply side reform

    Institute of Scientific and Technical Information of China (English)

    陈笛

    2016-01-01

    供给侧改革的实质是通过产业结构调整来解决中国经济现阶段存在的供需错配的问题。管理会计的供给侧改革,则是企业在适应新常态下价值管理的创新战略。管理会计的创新即以信息决策和内部控制为工具和基础,以价值增量为目的,在微观层面上为国家的供给侧改革提供实践依据,促使企业在管理层面上能够和国家改革目标一致,为经济发展做出贡献。%The essence of the supply side reform is through the adjustment of industrial structure to solve the mis-match between supply and demand of the problems of China’s economy at this stage. The supply side reform of man-agement accounting is the innovation strategy of enterprise under the new normal economic environment. The innova-tion of the management accounting is based on information for the decision and the internal control tool,for the pur-pose of value increment,and in micro level,provides the practice basis for the supply side reform of the country,to urge enterprises to match the national reform goals in the aspect of management and contribute to economic develop-ment.

  20. Implementation and Control of a Residential Electrothermal Microgrid Based on Renewable Energies, a Hybrid Storage System and Demand Side Management

    OpenAIRE

    Julio Pascual; Pablo Sanchis; Luis Marroyo

    2014-01-01

    This paper proposes an energy management strategy for a residential electrothermal microgrid, based on renewable energy sources. While grid connected, it makes use of a hybrid electrothermal storage system, formed by a battery and a hot water tank along with an electrical water heater as a controllable load, which make possible the energy management within the microgrid. The microgrid emulates the operation of a single family home with domestic hot water (DHW) consumption, a heating, ventilat...

  1. Hodgkin lymphoma: MOPP chemotherapy to PD-1 blockade and beyond.

    Science.gov (United States)

    Ansell, Stephen M

    2016-01-01

    Hodgkin lymphoma is a rare lymphoid malignancy affecting ∼9,200 new patients in the United States annually. Progress in the management of this disease over the past 50 years has been remarkable and the prognosis of this malignancy has changed from a uniformly fatal process to one in which the vast majority of patients are expected to be cured. This remarkable progress has been due to the use of combination approaches incorporating chemotherapy and radiation therapy, and now more recently antibody-drug conjugates and immune checkpoint inhibitors. The goal for the future is to develop treatment combinations that successfully treat all patients and markedly decrease the long-term side effects. PMID:26505486

  2. Chemotherapy-Related Neurotoxicity.

    Science.gov (United States)

    Taillibert, Sophie; Le Rhun, Emilie; Chamberlain, Marc C

    2016-09-01

    Chemotherapy may have detrimental effects on either the central or peripheral nervous system. Central nervous system neurotoxicity resulting from chemotherapy manifests as a wide range of clinical syndromes including acute, subacute, and chronic encephalopathies, posterior reversible encephalopathy, acute cerebellar dysfunction, chronic cognitive impairment, myelopathy, meningitis, and neurovascular syndromes. These clinical entities vary by causative agent, degree of severity, evolution, and timing of occurrence. In the peripheral nervous system, chemotherapy-induced peripheral neuropathy (CIPN) and myopathy are the two main complications of chemotherapy. CIPN is the most common complication, and the majority manifest as a dose-dependent length-dependent sensory axonopathy. In severe cases of CIPN, the dose of chemotherapy is reduced, the administration delayed, or the treatment discontinued. Few treatments are available for CIPN and based on meta-analysis, duloxetine is the preferred symptomatic treatment. Myopathy due to corticosteroid use is the most frequent cause of muscle disorders in patients with cancer. PMID:27443648

  3. MTHFR C677T基因多态性与晚期非小细胞肺癌化疗不良反应的关系%Relationship between MTHFR C677T gene polymorphisms and chemotherapy side effects in advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    寇军燕; 洪卫; 洪丹; 苏丹; 娄广媛; 张沂平

    2014-01-01

    背景与目的:亚甲基四氢叶酸还原酶(methylene tetrahydrofolate reductase,MTHFR)是叶酸代谢的关键酶,在DNA甲基化中起重要作用。本研究旨在探讨MTHFR C677T多态性与晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗不良反应的关系。方法:收集2007年6月-2009年5月在浙江省肿瘤医院经病理学确诊的晚期NSCLC患者100例。所有患者均接受铂类药物联合吉西他滨的方案化疗。用等位基因特异-PCR技术检测患者MTHFR基因型。结果:100例晚期NSCLC患者中,MTHFR C677T T/T、T/C和C/C基因型频率分别为20%、44%和36%。在血液学不良反应中,C/C基因型血小板减少发生率较T/T、T/C基因型低,差异有统计学意义(P=0.039)。本研究未发现MTHFR各基因型与化疗后恶心、呕吐不良反应相关。结论:MTHFR C677T基因多态性对预测晚期NSCLC含铂类药物方案化疗后不良反应有临床意义。%Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene

  4. 护理风险管理在乳腺癌化疗病房的应用%Effect of implementing risk management in the breast cancer chemotherapy ward

    Institute of Scientific and Technical Information of China (English)

    陈国珍; 郑婉婷; 陈殷琴

    2012-01-01

    Objective To explore the effect of implementing risk management in the breast cancer chemotherapy ward.Methods The breast cancer chemotherapy patients between January 2011 and June 2011 were retrospectively surveyed and analyzed the factors that may caused drug extravasation and took the appropriate care risk management measures,nurses received the intervention between July 2011 and December 2011,the situation of drug leaking was investigated and the nurses' cognition on drug chemotherapy before and after intervention was assessed,Results After implementing care risk management,the leakage rate of chemotherapy drug was decreased 5.7%,and no skin necrosis occurred.The nurses' professional knowledge about the usage of chemotherapy drug was obviously improved than that before intervention,and the difference was statistically significant (x2 =4.727,6.190,4.887,4.887 ; P < 0.05).Conclusions Implementing risk management in breast cancer chemotherapy ward can reduce the risk of care in chemotherapy and improve the nurses' professional knowledge.%目的 探讨在乳腺癌化疗病房实施护理风险管理的效果.方法 对2011年1-6月行乳腺癌化疗的患者进行回顾性调查,分析可能引起药物外渗的因素并采取相应的护理风险管理措施;并于201 1年7-12月对护理人员进行干预,对药物渗出情况进行前瞻性调查,分别评估干预前及干预后护士对化疗药物的认知情况.结果 实施护理风险管理后,化疗药物的渗出率较干预前下降了5.7%,无皮肤坏死的情况发生;护士对化疗药物使用的专业知识认知水平较干预前明显提高,两者比较差异有统计学意义(x2值分别为4.727,6.190,4.887,4.887;P<0.05).结论 在乳腺癌化疗病房实施护理风险管理有助于减少化疗过程中的护理风险,提高护士的专业知识认知水平.

  5. Chemotherapy against cancer during pregnancy

    Science.gov (United States)

    Esposito, Susanna; Tenconi, Rossana; Preti, Valentina; Groppali, Elena; Principi, Nicola

    2016-01-01

    Abstract Background: The concomitant incidence of cancer and pregnancy has increased in recent years because of the increase in maternal age at the time of the 1st pregnancy. The diagnosis of cancer in a pregnant woman causes ethical and therapeutic problems for both the patient and the physician. The main aim of this paper is to describe the available evidence concerning the short- and long-term neonatal impact of chemotherapy given to pregnant women. Methods: The relevant publications in English were identified by a systematic review of MEDLINE and PubMed for the last 15 years. The search strategy included “cancer[Title/Abstract] OR tumor[Title/Abstract] AND pregnancy[Title/Abstract] OR pregnant[Title/Abstract] AND embryo[Title/Abstract] or fetus[Title/Abstract] or neonate[Title/Abstract] or newborn[Title/Abstract] or pediatric[Title/Abstract] or child[Title/Abstract] AND English[lang].” Results: An analysis of the literature showed that only the administration of chemotherapy during the embryonic stage of conceptus is dangerous and can lead to the termination of the pregnancy. When the disease is diagnosed in the 2nd or 3rd trimester of gestation or when it is possible to delay the initiation of chemotherapy beyond the 14th week, the risk of severe problems for the fetus are low, and pregnancy termination is not required. Conclusion: Data regarding the final outcome of children who have received in utero chemotherapy seem reassuring. Only the administration in the embryonal stage of conceptus is dangerous and can lead to the termination of pregnancy. When the disease is diagnosed in the 2nd or 3rd trimester of gestation or when it is possible to delay the initiation of chemotherapy beyond the 14th week, the risk of severe problems for the fetus are low and pregnancy termination is not needed. Increased knowledge of how to minimize the risks of chemotherapy can reduce improper management including unnecessary termination of pregnancy, delayed maternal

  6. Role of Neoadjuvant Chemotherapy in the Management of Stage IIIC-IV Ovarian Cancer Survey Results from the Members of the European Society of Gynecological Oncology

    NARCIS (Netherlands)

    Cornelis, Sarah; Van Calster, Ben; Amant, Frederic; Leunen, Karin; van der Zee, Ate Gerard Jan; Vergote, Ignace

    2012-01-01

    Objective: The aim of this study is to evaluate the current opinion of the members of the European Society of Gynecological Oncology (ESGO) on the use of neoadjuvant chemotherapy (NACT) in stage IIIC and IV ovarian cancer. Methods: A link to a 21-item questionnaire, with questions about the manageme

  7. Simple models of district heating systems for load and demand side management and operational optimisation; Simple modeller for fjernvarmesystemer med henblik pae belastningsudjaevning og driftsoptimering

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, B. [Technical Univ. of Denmark, Dept. of Mechanical Engineering, Kgs. Lyngby (Denmark); Larsen, H.V. [Risoe National Lab., System Analysis Dept., Roskilde (DK)

    2004-12-01

    The purpose of this research project has been to further develop and test simple (aggregated) models of district heating (DH) systems for simulation and operational optimization, and to investigate the influence of Load Management and Demand Side Management (DMS) on the total operational costs. The work is based on physical-mathematical modelling and simulation of DH systems, and is a continuation of previous EFP-96 work. In the present EFP-2001 project the goals have been to improve the Danish method of aggregation by addressing the problem of aggregation of pressure losses, and to test the methods on a much larger data set than in the EFP-1996 project. In order to verify the models it is crucial to have good data at disposal. Full information on the heat loads and temperatures not only at the DH plant but also at every consumer (building) is needed, and therefore only a few DH systems in Denmark can supply such data. (BA)

  8. Implementation and Control of a Residential Electrothermal Microgrid Based on Renewable Energies, a Hybrid Storage System and Demand Side Management

    Directory of Open Access Journals (Sweden)

    Julio Pascual

    2014-01-01

    Full Text Available This paper proposes an energy management strategy for a residential electrothermal microgrid, based on renewable energy sources. While grid connected, it makes use of a hybrid electrothermal storage system, formed by a battery and a hot water tank along with an electrical water heater as a controllable load, which make possible the energy management within the microgrid. The microgrid emulates the operation of a single family home with domestic hot water (DHW consumption, a heating, ventilation and air conditioning (HVAC system as well as the typical electric loads. An energy management strategy has been designed which optimizes the power exchanged with the grid profile in terms of peaks and fluctuations, in applications with high penetration levels of renewables. The proposed energy management strategy has been evaluated and validated experimentally in a full scale residential microgrid built in our Renewable Energy Laboratory, by means of continuous operation under real conditions. The results show that the combination of electric and thermal storage systems with controllable loads is a promising technology that could maximize the penetration level of renewable energies in the electric system.

  9. Adjuvant Bidirectional Chemotherapy Using an Intraperitoneal Port

    Directory of Open Access Journals (Sweden)

    Paul H. Sugarbaker

    2012-01-01

    Full Text Available Cytoreductive surgery (CRS and hyperthermic intraperitoneal chemotherapy (HIPEC have been established as treatment options for patients with peritoneal metastases or peritoneal mesothelioma. However, this novel treatment strategy remains associated with a large percentage of local-regional treatment failures. These treatment failures are attributed to the inadequacy of HIPEC to maintain a surgical complete response. Management strategies to supplement CRS and HIPEC are indicated. A simplified approach to the intraoperative placement of an intraperitoneal port for adjuvant bidirectional chemotherapy (ABC was devised. Four different chemotherapy treatment plans were utilized depending upon the primary site of the malignancy. Thirty-one consecutive patients with an intraoperative placement of the intraperitoneal port were available for study. The incidence of adverse events that caused an early discontinuation of the bidirectional chemotherapy occurred in 75% of the 8 patients who had an incomplete cytoreduction and in 0% of patients who had a complete cytoreduction. All of the patients who had complete cytoreduction completed at least 5 of the scheduled 6 bidirectional chemotherapy treatments. Adjuvant bidirectional chemotherapy is possible following a major cytoreductive surgical procedure using a simplified method of intraoperative intraperitoneal port placement.

  10. Use of the cytoprotector amifostine in patients under chemotherapy and/or radiotherapy; Utilizacao do citoprotetor amifostina em pacientes durante tratamento oncologico com quimioterapia e/ou radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Zanchi, Clarissa; Suyenaga, Edna Sayuri; Perassolo, Magda Susana [Centro Universitario Feevale, Novo Hamburgo, RS (Brazil). Curso de Ciencias Farmaceuticas]. E-mails: clarissazanchi@gmail.com; suyenaga@feevale.br; magdaperassolo@feevale.br

    2008-07-01

    In recent years, several cytoprotective agents have been developed o protect normal cells form the toxic effects of chemotherapy and radiotherapy. The ideal cytoprotectant agent would be that one able to allow the intensification of chemotherapy's dose.; to protect largest number of normal tissues and organs when used with a variety of chemotherapy agents; to confer specific protection for normal tissues; to preserve anti tumor effect and to have little and/or manageable toxicity and side effects. Amifostine fits in on these questions also presenting a broad spectrum of action. This paper aims the discussion of the use of cryoprotective amifostine, their main characteristics/functions, adverse effects, action mechanism, administration and recommended dosage. (author)

  11. Kemoterapija raka in kognitivne motnje: Cancer chemotherapy and cognitive dysfunction:

    OpenAIRE

    Kores-Plesničar, Blanka; Plesničar, Andrej

    2012-01-01

    Background: Cancer chemotherapy is associated with numerous side effects, one of them being cognitive impairment, which is poorly known and insufficiently recognised in clinical practice. Memory, concentration, attention, and executive function deficits are associated with chemotherapy, hormone therapy,and also with treatments using biological response modifiers. Cognitive disorders may be either mild or more severely pronounced, and they often prevent the patients to return to their previous...

  12. Protective effect of Curcumin on chemotherapy-induced intestinal dysfunction

    OpenAIRE

    Yao, Qinghua; Ye, Xiaozheng; Wang, Lu; Gu, Jianzhong; Fu, Ting; Wang, Yun; LAI, YUEBIAO; Wang, Yuqi; Wang, Xian; Jin, Hongchuan; Guo, Yong

    2013-01-01

    Objective: Chemotherapy is one of most important treatments for human cancers. However, side effects such as intestine dysfunction significantly impaired its clinical efficacy. This study aimed to investigate the protective effect of Curcumin on chemotherapy-induced intestinal dysfunction in rats. Methods: Sixty healthy Wistar rats were randomly divided into control group (normal saline), 5-FU group and 5-FU+Curcumin group. The weight, serum level of endotoxin, DAO and D-lactate were determin...

  13. [Collateral effects of intraoperative hyperthermic chemotherapy in peritoneal carcinomatosis].

    Science.gov (United States)

    Izzo, L; Galati, G; D'Aprile, M R; Stasolla, A; Kharrub, Z; Maccioni, F; Sassayannis, P G; D'Arielli, D; Marini, M; Gazzanelli, S; Caputo, M

    2004-01-01

    The association between chemotherapy and hypertermia produces a synergic effect. In this study the Authors present their experience, by the analysis of the results. From 1993 to 2000, 17 patients have been treated with surgery associated with hypertermic chemotherapy for peritoneal carcinomatosis. For the management of these patients a constant cooperation among surgeon, cardiologist and anaesthetist is very important. PMID:15112761

  14. Anaerobic side-stream reactor for excess sludge reduction: 5-year management of a full-scale plant.

    Science.gov (United States)

    Velho, V F; Foladori, P; Andreottola, G; Costa, R H R

    2016-07-15

    The long-term performances of a full-scale anaerobic side-stream reactor (ASSR) aimed at sludge reduction have been monitored for the first time, in comparison with a conventional activated sludge process (CAS). The plant was integrated with an ASSR treatment of 2293-3293 m(3). Operational parameters in the ASSR were: ORP -250 mV, interchange ratio of 7-10%, hydraulic retention time of 7 d. No worsening of effluent quality was observed in the ASSR configuration and removal efficiency of COD and NH4 was above 95%. A slight increase in the Sludge Volume Index did not cause worsening in effluent solids concentration. The observed sludge yield (Yobs) passed from 0.44 kgTSS/kgCOD in the CAS to 0.35 in the ASSR configuration. The reduction of Yobs by 20% is lower than expected from the literature where sythetic wastewater is used, indicating that sludge reduction efficiency is largely affected by inert mass fed with influent real wastewater. An increase by 45% of the ASSR volume did not promote a further reduction of Yobs, because sludge reduction is affected not solely by endogenous decay but also by other factors such as interchange ratio and aerobiosis/anaerobiosis alternation. PMID:27107390

  15. Perceived control systems, work conditions, and efficiency among Swedish dentists: interaction between two sides of human resource management.

    Science.gov (United States)

    Bejerot, E; Söderfeldt, B; Aronsson, G; Härenstam, A; Söderfeldt, M

    1999-02-01

    Two aspects of Human Resource Management (HRM), a main trend in modern personnel management, are considered in this study: A 'hard' version stressing performance monitoring and competition, and a 'soft' version stressing communication with employees. The aim of the investigation was to examine whether these two aspects of modern management are reflected in dentists' perceptions of differences in work conditions compared with other professionals. A questionnaire was answered by 312 publicly employed dentists and 3,600 other professionals in Sweden. The response rate was 66-77%. Effects from HRM on work, conditions and perceived efficiency were confirmed. The interaction effects, reflecting the duality of HRM, resulted in poorer work conditions, e.g. worse balance between effort and reward and worse opportunities for developing competence and collaboration in the workplace. This pertains especially in the case of dentists, where the positive effects of 'soft' HRM did not compensate for the negative effects of 'hard' HRM. Dentists in Sweden's Public Dental Health Service appear as a vulnerable group among Swedish professionals. PMID:10207536

  16. Effect of integrated health management on chemotherapy compliance of patients with gynecological malignancies%一体化健康管理对妇科恶性肿瘤患者化疗依从性的影响

    Institute of Scientific and Technical Information of China (English)

    刘俊华

    2015-01-01

    Objective To investigate the impact of integrated health management on chemotherapy compliance of patients with gynecological malignancies. Methods A total of 120 patients with gynecologic malignancies who admitted to our hospital for chemotherapy were selected. They were divided into the experimental group and the control group, with 60 cases in each group. The control group received routine care and health management, while the experimental group underwent integrated health management on the basis of the routine care. Then the disease-related cognitive status and chemotherapy compliance of the two groups were compared and analyzed. Results Before the intervention, there were no significant differences between the two groups in disease-related cognitive status and chemotherapy compliance (P>0. 05). After the intervention, the scores of disease-related cognitive status and chemotherapy compliance were (76. 2 ± 14. 0) and (83. 3 ± 12. 7) in the control group, and (84. 8 ± 12. 3) and (83. 3 ± 12. 7) in the experimental group. There were statistically significant differences between two groups (t=3. 574 6,8. 257 1;P<0. 05). Conclusions Integrated health management can significantly improve both the cognition of disease-related knowledge and adherence to chemotherapy of patients with gynecologic malignancies, so it is worthy of promotion.%目的:探讨一体化健康管理对妇科恶性肿瘤患者化疗依从性的影响。方法选取2013年2月—2014年1月妇科恶性肿瘤化疗患者120例,随机分为观察组和对照组,各60例。对照组予常规护理及健康管理,观察组在此基础上引入一体化健康管理,比较两组患者的疾病相关认知程度与依从性。结果干预后,对照组疾病认知为(76.2±14.0)分,依从性为(83.3±12.7)分;观察组疾病认知为(84.8±12.3)分,依从性为(83.3±12.7)分;观察组优于对照组,组间比较差异有统计学意义( t 值分别为3.5746,8.2571;P<0.05)。结论一体化

  17. After chemotherapy - discharge

    Science.gov (United States)

    ... sugar-free popsicles or sugar-free hard candies. Take care of your dentures, braces, or other dental products. ... Take care not to get infections for up to 1 year or more after your chemotherapy. Practice safe ...

  18. Colonic stenting as bridge to surgery versus emergency surgery for management of acute left-sided malignant colonic obstruction: a multicenter randomized trial (Stent-in 2 study

    Directory of Open Access Journals (Sweden)

    Scholten Pieter

    2007-07-01

    Full Text Available Abstract Background Acute left-sided colonic obstruction is most often caused by malignancy and the surgical treatment is associated with a high mortality and morbidity rate. Moreover, these operated patients end up with a temporary or permanent stoma. Initial insertion of an enteral stent to decompress the obstructed colon, allowing for surgery to be performed electively, is gaining popularity. In uncontrolled studies stent placement before elective surgery has been suggested to decrease mortality, morbidity and number of colostomies. However stent perforation can lead to peritoneal tumor spill, changing a potentially curable disease in an incurable one. Therefore it is of paramount importance to compare the outcomes of colonic stenting followed by elective surgery with emergency surgery for the management of acute left-sided malignant colonic obstruction in a randomized multicenter fashion. Methods/design Patients with acute left-sided malignant colonic obstruction eligible for this study will be randomized to either emergency surgery (current standard treatment or colonic stenting as bridge to elective surgery. Outcome measurements are effectiveness and costs of both strategies. Effectiveness will be evaluated in terms of quality of life, morbidity and mortality. Quality of life will be measured with standardized questionnaires (EORTC QLQ-C30, EORTC QLQ-CR38, EQ-5D and EQ-VAS. Morbidity is defined as every event leading to hospital admission or prolonging hospital stay. Mortality will be analyzed as total mortality as well as procedure-related mortality. The total costs of treatment will be evaluated by counting volumes and calculating unit prices. Including 120 patients on a 1:1 basis will have 80% power to detect an effect size of 0.5 on the EORTC QLQ-C30 global health scale, using a two group t-test with a 0.05 two-sided significance level. Differences in quality of life and morbidity will be analyzed using mixed-models repeated measures

  19. Present situation and development of chemotherapy of nasopharyngeal carcinoma%鼻咽癌化疗现状及进展

    Institute of Scientific and Technical Information of China (English)

    冼献清; 谢民强; 江刚

    2013-01-01

    Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy,concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.

  20. Side Effects of Chemotherapy and Radiation (For Parents)

    Science.gov (United States)

    ... your doctor which, if any, over-the-counter medicines might be helpful. continue Pain Some chemo drugs are known to cause headaches, ... help. Never use over-the-counter or herbal medicines without your doctor's ... and an increased risk of tooth decay. The doctor may prescribe a mouth rinse ...

  1. Server Side Applications And Plugins Architecture For The Analysis Of Geospatial Information And The Management Of Water Resources

    Science.gov (United States)

    Pierleoni, Arnaldo; Casagrande, Luca; Bellezza, Michele; Casadei, Stefano

    2010-05-01

    The need for increasingly complex geospatial algorithms dedicated to the management of water resources, the fact that many of them require specific knowledge and the need for dedicated computing machines has led to the necessity of centralizing and sharing all the server applications and the plugins developed. For this purpose, a Web Processing Service (WPS) that can make available to users a range of geospatial analysis algorithms, geostatistics, remote sensing procedures and that can be used simply by providing data and input parameters and download the results has been developed. The core of the system infrastructure is a GRASS GIS, which acts as a computational engine, providing more than 350 forms of analysis and the opportunity to create new and ad hoc procedures. The implementation of the WPS was performed using the software PyWPS written in Python that is easily manageable and configurable. All these instruments are managed by a daemon named "Arcibald" specifically created for the purpose of listing the order of the requests that come from the users. In fact, it may happen that there are already ongoing processes so the system will queue the new ones registering the request and running it only when the previous calculations have been completed. However, individual Geoprocessing have an indicator to assess the resources necessary to implement it, enabling you to run geoprocesses that do not require excessive computing time in parallel. This assessment is also made in relation to the size of the input file provided. The WPS standard defines methods for accessing and running Geoprocessing regardless of the client used, however, the project has been developed specifically for a graphical client to access the resources. The client was built as a plugin for the GIS QGis Software which provides the most common tools for the view and the consultation of geographically referenced data. The tool was tested using the data taken during the bathymetric campaign at the

  2. [Tyrosine kinase inhibiting the VEGF pathway and elderly people: Tolerance, pre-treatment assessment and side effects management].

    Science.gov (United States)

    Bretagne, Marie; Boudou-Rouquette, Pascaline; Huillard, Olivier; Thomas-Schoemann, Audrey; Chahwakilian, Anne; Orvoen, Galdric; Arrondeau, Jennifer; Tlemsani, Camille; Cessot, Anatole; Cabanes, Laure; Blanchet, Benoit; Coriat, Romain; Alexandre, Jérôme; Goldwasser, François

    2016-03-01

    Angiogenesis inhibition is a major antitumor strategy that has emerged during the last decade. Oral tyrosine kinase inhibitors (TKI) targeting the VEGF receptor, including sunitinib, sorafenib, axitinib, regorafenib, pazopanib, and vandetanib reduce tumor growth and metastasis. These agents are approved for the treatment of metastatic diseases in first or second-line. They display a narrow therapeutic index. However, data in the elderly and/or in patients with multiple illnesses remain scarce. This population is classically excluded from clinical trials. The aim of this review is to provide an overview of existing literature regarding antiangiogenic TKI tolerance in the elderly (>70 years old). We also highlight key points of the pre-therapeutic evaluation and summarize the management of common toxicities. PMID:26832420

  3. Antiemetic therapy options for chemotherapy-induced nausea and vomiting in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Chan VTC

    2011-11-01

    Full Text Available Vicky TC Chan, Winnie YeoDepartment of Clinical Oncology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, ChinaAbstract: Chemotherapy-induced nausea and vomiting (CINV continues to be one of the most distressing side effects of chemotherapy in breast cancer patients, which can result in poor compliance to therapy that may, in turn, affect overall survival. The extent of CINV is dependent on the emetogenic potential of the individual cytotoxic agents or regimens employed as well as certain patient factors. Advances in our understanding in the pathophysiology of CINV and the identification of risk factors have enabled the utilization of appropriate antiemetic regimens to improve the control of CINV. Most of the chemotherapy regimens used in this patient population are considered to be moderately emetogenic; 60%–90% of chemotherapeutic regimens used in breast cancer patients cause nausea and vomiting, amongst which regimens doxorubicin-cyclophosphamide (AC combination is commonly regarded as of relatively higher emetogenicity. Currently, corticosteroids, 5-hydroxytryptamine 3 (5-HT3 receptor antagonists, and neurokinin 1 (NK-1 receptor antagonists are the three classes of antiemetic agents with the highest therapeutic index, which have been supported by data from large-scale randomized clinical trials. Treatment guidelines enable physicians to integrate the latest research data into their clinical practices. This review focuses on the three classes of antiemetic therapy options for CINV in breast cancer patients, as well as their safety and tolerability profiles. Recommendations from major guidelines/consensus including from the Multinational Association for Supportive Care in Cancer/European Society of Medical Oncology (MASCC/ESMO, the American Society of Clinical Oncology (ASCO, and the US National Comprehensive Cancer Network (NCCN, are also discussed. With the correct use of antiemetic regimens, chemotherapy

  4. Innovative Soft-Sided Waste Packaging System Implementation at a Small Department of Energy Environmental Restoration/Waste Management (ER/WM) Site

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, J.

    2002-02-28

    Weiss Associates (WA) performs a broad range of environmental restoration/waste management (ER/WM) activities for the U.S. Department of Energy (DOE) at the former Laboratory for Energy-Related Health Research (LEHR), University of California, Davis (UC Davis). Over the last three years, the LEHR ER/WM program transitioned from a baseline packaging system of steel, 2.7 cubic meter (3.5-cubic yard) B-25 boxes to a 7.0 cubic meter (9.1-cubic yard) soft-sided container (Lift Liner) system. The transition increased efficiencies in processing, packaging, and storage, and when combined with decreased procurement costs, achieved a $402,000 cost savings (Table I). Additional disposal costs between $128,600 and $182,600 were avoided by minimizing void space. Future cost savings by the end of fiscal year 2003 are projected between $250,640 and $1,003,360.

  5. Optimizing initial chemotherapy for metastatic pancreatic cancer.

    Science.gov (United States)

    Mantripragada, Kalyan C; Safran, Howard

    2016-05-01

    The two combination chemotherapy regimens FOLFIRINOX and gemcitabine plus nab-paclitaxel represent major breakthroughs in the management of metastatic pancreatic cancer. Both regimens showed unprecedented survival advantage in the setting of front-line therapy. However, their application for treatment of patients in the community is challenging because of significant toxicities, thus limiting potential benefits to a narrow population of patients. Modifications to the dose intensity or schedule of those regimens improve their tolerability, while likely retaining survival advantage over single-agent chemotherapy. Newer strategies to optimize these two active regimens in advanced pancreatic cancer are being explored that can help personalize treatment to individual patients.

  6. Optimizing initial chemotherapy for metastatic pancreatic cancer.

    Science.gov (United States)

    Mantripragada, Kalyan C; Safran, Howard

    2016-05-01

    The two combination chemotherapy regimens FOLFIRINOX and gemcitabine plus nab-paclitaxel represent major breakthroughs in the management of metastatic pancreatic cancer. Both regimens showed unprecedented survival advantage in the setting of front-line therapy. However, their application for treatment of patients in the community is challenging because of significant toxicities, thus limiting potential benefits to a narrow population of patients. Modifications to the dose intensity or schedule of those regimens improve their tolerability, while likely retaining survival advantage over single-agent chemotherapy. Newer strategies to optimize these two active regimens in advanced pancreatic cancer are being explored that can help personalize treatment to individual patients. PMID:26939741

  7. Low-enthalpy geothermal resources for electricity production: A demand-side management study for intelligent communities

    International Nuclear Information System (INIS)

    The geological conditions in Greece contributed to the creation of important low-enthalpy geothermal energy resources (LEGERs). The resources are divided into low, medium and high enthalpy, or temperature, based on criteria that are generally based on the energy content of the fluid. LEGERs are those sources of the hot water whose temperature is between 25 and 100 °C, which are used for heating residences and in the agricultural or industrial sector. The investigation for the exploitation of low-enthalpy geothermal fluids, which began around 1980, intensified in the last two decades. The low-enthalpy geothermal potential in Greece is rather significant as most of the geothermal fields have been found in regions with favourable developmental conditions, and it seems that they do not present serious environmental or technical exploitation problems. LEGER areas are abundant in Greece, mainly in the eastern and northern part of the country, as well as in many of the Aegean Islands. The aim of this work is to review the options for managing wind load by using low-enthalpy geothermal energy for electricity (through heat pump utilisation) according to the local energy demand. -- Highlights: •Approximately 45.43 GWh per year of electricity can be covered from low-enthalpy geothermal energy resources (LEGERs). •In particular, 10% of the electricity demand can be covered from the LEGER N. Kessani (NK). •The needs for LEGER contribution were increased when wind turbine (WT) production was low. •In winter, where there is abundance of wind, LEGER can be used mostly for heating. •During summer, LEGER can assist more in electricity when heating is not needed

  8. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management

    Directory of Open Access Journals (Sweden)

    Smith Jeffrey Michael

    2013-02-01

    Full Text Available Abstract Background Pre-eclampsia/eclampsia is one of the most common causes of maternal and perinatal morbidity and mortality in low and middle income countries. Magnesium sulfate is the drug of choice for prevention of seizures as part of comprehensive management of the disease. Despite the compelling evidence for the effectiveness of magnesium sulfate, concern has been expressed about its safety and potential for toxicity, particularly among providers in low- and middle-income countries. The purpose of this review was to determine whether the literature published in these global settings supports the concerns about the safety of use of magnesium sulfate. Methods An integrative review of the literature was conducted to document the known incidences of severe adverse reactions to magnesium sulphate, and specific outcomes of interest related to its use. All types of prospective clinical studies were included if magnesium sulfate was used to manage pre-eclampsia or eclampsia, the study was conducted in a low- or middle-income country, and the study included the recording of the incidence of any adverse side effect resulting from magnesium sulfate use. Results A total of 24 studies that compared a magnesium sulfate regimen against other drug regimens and examined side effects among 34 subject groups were included. The overall rate of absent patellar reflex among all 9556 aggregated women was 1.6%, with a range of 0-57%. The overall rate of respiratory depression in 25 subject groups in which this outcome was reported was 1.3%, with a range of 0–8.2%. Delay in repeat administration of magnesium sulfate occurred in 3.6% of cases, with a range of 0-65%. Calcium gluconate was administered at an overall rate of less than 0.2%. There was only one maternal death that was attributed by the study authors to the use of magnesium sulfate among the 9556 women in the 24 studies. Conclusion Concerns about safety and toxicity from the use of magnesium sulfate

  9. Neoadjuvant and Adjuvant Chemotherapy of Cervical Cancer.

    Science.gov (United States)

    Mallmann, Peter; Mallmann, Christoph

    2016-01-01

    Neoadjuvant chemotherapy is indicated in patients who can tolerate the side effects of a chemotherapy and with preoperative presentation of one of the following clinical risk situations: bulky disease with a maximal tumor diameter of > 4 cm, suspicious lymph nodes in magnetic resonance imaging (MRI), computed tomography (CT) scan or endosonography, histopathologically confirmed lymph node metastasis, or histopathologically documented risk factors such as G3 and L1V1. A neoadjuvant chemotherapy followed by surgery should be performed with cisplatin at a dosage of > 25 mg/m2 per week and an application interval of < 14 days. The previously published data suggests an improved rate of complete resection and reduced incidences of positive lymph nodes and parametric infiltration. Accordingly, the percentage of patients in need for adjuvant radiochemotherapy after operation can be significantly reduced. Some studies demonstrated a prolongation of progression-free and overall survival. Following the previously published studies, adjuvant chemotherapy after operation or after radiochemotherapy has no significant effect on the overall survival and, following the current guidelines, should be avoided. PMID:27614740

  10. Why, After Chemotherapy, is it Necessary to Assess Memory Using Translational Testing?

    OpenAIRE

    Acevedo, Summer F.

    2012-01-01

    As the number of cancer survivors rises, so does the importance of understanding what happens post-chemotherapy. The evidence is clear that chemotherapy affects not only cancer cells, but also healthy cells including neurons, leading to long-term cognitive dysfunction in a large portion of survivors. In order to understand the mechanism of action and in the hope of reducing the potential neurocognitive side effects of chemotherapy, pre-clinical testing should be used more effectively. However...

  11. Efficacy of HPA Lanolin® in treatment of lip alterations related to chemotherapy

    OpenAIRE

    Paulo Sergio da Silva Santos; Jose Endrigo Tinoco-Araujo; Lucas Monteiro de Vasconcelos Alves de Souza; Rafael Ferreira; Maura Rosane Valerio Ikoma; Ana Paula Ribeiro Razera; Marcia Mirolde Magno de Carvalho Santos

    2013-01-01

    The side effects of chemotherapy on the lips may cause esthetic and functional impact and increase the risk of infection. HPA Lanolin® is an option for supportive therapy because it has anti-inflammatory, antimicrobial and moisturizing properties. Objective: To evaluate the efficacy of this product in the prevention of lip alterations in a population of patients undergoing chemotherapy. Material and Methods: Patients undergoing chemotherapy (n = 57) were examined and distributed into two g...

  12. Capecitabine Induced Multifocal Leukoencephalopathy: Do We Have Always to Switch off the Chemotherapy?

    Directory of Open Access Journals (Sweden)

    Anastasia Bougea

    2016-01-01

    Full Text Available Capecitabine is a well tolerated and safe 5-fluorouracil agent for adjuvant, neoadjuvant chemotherapy or metastatic cases. Neurological side effects require discontinuation of chemotherapy. We report this unique case of a 50-year-old female, who presented an isolated episode of dysarthria and ataxia under bevacizumab, capecitabine, and oxaliplatin treatment due to reversible multifocal leukoencephalopathy that did not recur after readministration of chemotherapy.

  13. Smart grids, demand-side management and decentralised electricity production: Mounting a national R and D programme

    International Nuclear Information System (INIS)

    of investment RTE, ERDF and EDF-R and D dispose of teams that can identify future R and D needs, pilot and conduct research, and integrate the results, often obtained in collaboration with other parties, in innovative demonstration projects set up by operators. This is no longer the case for many of their European counterparts where research teams have shrunk to a minimum, following cost-cutting decisions and 'rationalisation' of grid activities (decisions made on the basis of short-term business policies, often encouraged by regulators 3). These encouraging observations notwithstanding, transmission and distribution grid operators in France consider that they must acquire further knowledge pertaining to the sizing and operation of electricity networks. Five policy options underlie this vision extending to 2020, a vision aimed at validating new directions for the evolution of these networks: 1 - Strengthen the capacity of the transmission grid to integrate an energy bouquet that complies with European commitments for de-carbonising electricity generation, via the development of renewable energy, 2 - Make the distribution grid flexible and reliable enough to meet the consumer demand and the requirements of energy service vendors, 3 - Coordinate interaction between transmission operators and distributors so as to reinforce the reliability of the grid in France, optimise its energy performance and contribute to building the single electricity market in Europe, 4 - Encourage electricity demand management as an additional source of supply and economic competitiveness, 5 - Expand decentralised generation, particularly to help further reduce energy demand in commercial and residential buildings

  14. Combination Chemotherapy for Influenza

    Directory of Open Access Journals (Sweden)

    Robert G. Webster

    2010-07-01

    Full Text Available The emergence of pandemic H1N1 influenza viruses in April 2009 and the continuous evolution of highly pathogenic H5N1 influenza viruses underscore the urgency of novel approaches to chemotherapy for human influenza infection. Anti-influenza drugs are currently limited to the neuraminidase inhibitors (oseltamivir and zanamivir and to M2 ion channel blockers (amantadine and rimantadine, although resistance to the latter class develops rapidly. Potential targets for the development of new anti-influenza agents include the viral polymerase (and endonuclease, the hemagglutinin, and the non-structural protein NS1. The limitations of monotherapy and the emergence of drug-resistant variants make combination chemotherapy the logical therapeutic option. Here we review the experimental data on combination chemotherapy with currently available agents and the development of new agents and therapy targets.

  15. Demand side management framework for Ontario : Canadian Energy Efficiency Alliance policy paper submitted to the Ontario Energy Board with respect to RP-2003-0144

    International Nuclear Information System (INIS)

    This paper presents the position of the Canadian Energy Efficiency Alliance (CEEA) on certain aspects of governance requiring demand side management for electricity reform. It also describes the components that should be included in Ontario's DSM framework. In November 2003, the Ontario government announced legislation to ensure a fair and predictable approach to electricity pricing and energy conservation. An interim pricing structure raises the existing price cap for electricity. On March 1, 2005, local electricity distribution companies will be able to achieve their full commercial return conditional on their reinvestment of one year's worth of monies in conservation and demand management initiatives. The CEEA supports the government's commitment to DSM. The CEEA is also in agreement with a report released by Ontario's Energy Minister in January 2004 which reveals that all reforms for the electricity sector would be focused on: energy conservation; reliability, diversity, and affordability; effective consumer protection; new investment in conservation, generation and transmission; and, clean air by eliminating coal fired generation and replacing it with cleaner sources of energy. This report outlined some of the barriers to efficient energy use and the components that would ensure effective and efficient delivery of DSM programs. It was emphasized that energy prices should reflect true costs in order to address market barriers to efficient energy use

  16. Chemotherapy-induced polyneuropathy

    DEFF Research Database (Denmark)

    Zedan, Ahmed; Vilholm, Ole Jakob

    2014-01-01

    Chemotherapy-induced polyneuropathy (CIPN) is a common, but underestimated, clinical challenge. Incidence varies depending on many factors that are equally as important as the type of chemotherapeutic agent itself. Moreover, the assessment of CIPN is still uncertain, as several of the most...... frequently used scales do not rely on a formal neurological evaluation and depend on patients' reports and examiners' interpretations. Therefore, the aim of this MiniReview was to introduce the most common chemotherapies that cause neuropathy, and in addition to this, highlight the most significant...

  17. Efficacy of neoadjuvant chemotherapy and radiotherapy for the histology-confirmed intracranial germinoma-preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Young Ju; Kim, Hak Jae; Heo, Dae Seog; Shin, Hee Yung; Kim, Il Han [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2002-06-15

    experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

  18. Management of inflammatory breast cancer after neo-adjuvant chemotherapy; Traitement locoregional du cancer du sein inflammatoire apres chimiotherapie neo-adjuvante

    Energy Technology Data Exchange (ETDEWEB)

    Abrous-Anane, S.; Daveau, C.; Dendale, R.; Campana, F.; Kirova, Y.; Fourquet, A.; Bollet, M.A. [Service d' onco-radiotherapie, institut Curie, 26, rue d' Ulm, 75005 Paris cedex 05 (France); Savignoni, A.; Gautier, C. [Service de biostatistique, institut Curie, 26, rue d' Ulm, 75248 Paris cedex 05 (France); Pierga, J.Y. [Service d' oncologie medicale, institut Curie, 26, rue d' Ulm, 75248 Paris cedex 05 (France); Reyal, F. [Service de chirurgie, institut Curie, 26, rue d' Ulm, 75248 Paris cedex 05 (France)

    2011-12-15

    Purpose. - To assess the benefit of breast surgery for inflammatory breast cancer. Patients and methods. - This retrospective series was based on 232 patients treated for inflammatory breast cancer. All patients received primary chemotherapy followed by either exclusive radiotherapy (118 patients, 51%) or surgery with or without radiotherapy (114 patients, 49%). The median follow-up was 11 years. Results. - The two groups were comparable apart from fewer tumors smaller than 70 mm (43% vs 33%, P = 0.003), a higher rate of clinical stage N2 (15% vs 5%, P = 0.04) and fewer histopathological grade 3 tumors (46% vs 61%, P < 0.05) in the no-surgery group. The addition of surgery was associated with a significant improvement in locoregional disease control (P = 0.04) but with no significant difference in overall survival rates or disease-free intervals. Late toxicities were not significantly different between the two treatment groups except for a higher rate of fibrosis in the no-surgery group (P < 0.0001), and more lymphedema in the surgery group (P = 0.002). Conclusion. - Our data suggest an improvement in locoregional control in patients treated by surgery, in conjunction with chemotherapy and radiotherapy, for inflammatory breast cancer. (authors)

  19. Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, Corey [Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72211 (United States); Emory, Cynthia [Wake Forest School of Medicine, Medical Center Blvds, Winston-Salem, NC 27157 (United States); Adams, Sheila [Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Cedars Medical Center, 1400 NW 12th Avenue (R-12), Miami, FL 33136 (United States); Cohen, Jonathan [Division of Psychology, University of Miami Miller School of Medicine, 1695 N.W. 9th Ave. (D-29), Miami, FL 33136 (United States); Pitcher, John David [Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, 1400 NW 12th Avenue (R-12), Miami, FL 33136 (United States); Potter, Benjamin Kyle [Department of Orthopaedic Surgery, Walter Reed Army Medical Center, 6900 Georgia Avenue North West, Washington, D.C., 20307 (United States); Temple, H. Thomas [Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1600 N.W. 10th Avenue (R-12), Miami, FL 33136 (United States)

    2011-08-25

    Fibromatosis, or extra-abdominal desmoid tumor, is a benign disease which often has an aggressive clinical course that can be difficult to treat. We performed a retrospective review of 16 patients (12 females and four males) with a mean age of 34.2 years treated with methotrexate and vinblastine for newly diagnosed or recurrent extra-abdominal desmoid tumor. The mean age of our patient cohort was 34.2 years (range 11–70), and the mean tumor size was 11.5 cm (range 2.5–21.2 cm). The mean duration of therapy was 12 months with an average follow-up of 43 months (range 1–149 months). Fourteen of 16 patients demonstrated a clinical response to treatment. Eight of 14 patients demonstrated a radiologic decrease in tumor size. Only one patient progressed on therapy. Six patients developed recurrent symptoms after discontinuation of treatment. Chemotherapy-related symptoms including neutropenia, nausea, and vomiting were common and observed in most patients, however these side effects were mild and transient. Five patients developed peripheral neuropathy that prompted a change from vinblastine to vinorelbine during treatment. One potentially life-threatening complication (pneumocystis pneumonia) occurred which was diagnosed early and successfully treated. The use of methotrexate and vinblastine/vinorelbine in the management of fibromatosis appears to be an effective treatment with minimal treatment-related side effects.

  20. Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

    Directory of Open Access Journals (Sweden)

    H. Thomas Temple

    2011-08-01

    Full Text Available Fibromatosis, or extra-abdominal desmoid tumor, is a benign disease which often has an aggressive clinical course that can be difficult to treat. We performed a retrospective review of 16 patients (12 females and four males with a mean age of 34.2 years treated with methotrexate and vinblastine for newly diagnosed or recurrent extra-abdominal desmoid tumor. The mean age of our patient cohort was 34.2 years (range 11–70, and the mean tumor size was 11.5 cm (range 2.5–21.2 cm. The mean duration of therapy was 12 months with an average follow-up of 43 months (range 1–149 months. Fourteen of 16 patients demonstrated a clinical response to treatment. Eight of 14 patients demonstrated a radiologic decrease in tumor size. Only one patient progressed on therapy. Six patients developed recurrent symptoms after discontinuation of treatment. Chemotherapy-related symptoms including neutropenia, nausea, and vomiting were common and observed in most patients, however these side effects were mild and transient. Five patients developed peripheral neuropathy that prompted a change from vinblastine to vinorelbine during treatment. One potentially life-threatening complication (pneumocystis pneumonia occurred which was diagnosed early and successfully treated. The use of methotrexate and vinblastine/vinorelbine in the management of fibromatosis appears to be an effective treatment with minimal treatment-related side effects.

  1. “Souls of the ancestor that knock us out” and other tales. A qualitative study to identify demand-side factors influencing malaria case management in Cambodia

    Directory of Open Access Journals (Sweden)

    O’Connell Kathryn A

    2012-10-01

    Full Text Available Abstract Background Appropriate case management of suspected malaria in Cambodia is critical given anti-malarial drug resistance in the region. Improving diagnosis and the use of recommended malarial treatments is a challenge in Cambodia where self-treatment and usage of drug cocktails is widespread, a notable difference from malaria treatment seeking in other countries. This qualitative study adds to the limited evidence base on Cambodian practices, aiming to understand the demand-side factors influencing treatment-seeking behaviour, including the types of home treatments, perceptions of cocktail medicines and reasons for diagnostic testing. The findings may help guide intervention design. Methods The study used in-depth interviews (IDIs (N = 16 and focus group discussions (FGDs (N = 12 with Cambodian adults from malaria-endemic areas who had experienced malaria fever in the previous two weeks. Data were analysed using NVivo software. Results Findings suggest that Cambodians initially treat suspected malaria at home with home remedies and traditional medicines. When seeking treatment outside the home, respondents frequently reported receiving a cocktail of medicines from trusted providers. Cocktails are perceived as less expensive and more effective than full-course, pre-packaged medicines. Barriers to diagnostic testing include a belief in the ability to self-diagnose based on symptoms, cost and reliance on providers to recommend a test. Factors that facilitate testing include recommendation by trusted providers and a belief that anti-malarial treatment for illnesses other than malaria can be harmful. Conclusions Treatment-seeking behaviour for malaria in Cambodia is complex, driven by cultural norms, practicalities and episode-related factors. Effective malaria treatment programmes will benefit from interventions and communication materials that leverage these demand-side factors, promoting prompt visits to facilities for suspected

  2. Chemotherapy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Javier Sastre; Jose Angel García-Saenz; Eduardo Díaz-Rubio

    2006-01-01

    Metastatic gastric cancer remains a non-curative disease.Palliative chemotherapy has been demonstrated to prolong survival without quality of life compromise. Many single-agents and combinations have been confirmed to be active in the treatment of metastatic disease. Objective response rates ranged from 10-30% for single-agent therapy and 30-60% for polychemotherapy. Results of phase Ⅱ and Ⅲ studies are reviewed in this paper as well as the potential efficacy of new drugs. For patients with localized disease, the role of adjuvant and neoadjuvant chemotherapy and radiation therapy is discussed.Most studies on adjuvant chemotherapy failed to demonstrate a survival advantage, and therefore, it is not considered as standard treatment in most centres. Adjuvant immunochemotherapy has been developed fundamentally in Korea and Japan. A meta-analysis of phase Ⅲ trials with OK-432 suggested that immunochemotherapy may improve survival of patients with curatively resected gastric cancer. Based on the results of US Intergroup 0116study, postoperative chemoradiation has been Accepted as standard care in patients with resected gastric cancer in North America. However, the results are somewhat confounded by the fact that patients underwent less than a recommended D1 lymph node dissection and the pattern of recurrence suggested a positive effect derived from local radiotherapy without any effect on micrometastatic disease.Neoadjuvant chemotherapy or chemoradiation therapy remains experimental, but several phase Ⅱstudies are showing promising results. Phase Ⅲ trials are needed.

  3. Medical visits for chemotherapy and chemotherapy-induced neutropenia: a survey of the impact on patient time and activities

    Directory of Open Access Journals (Sweden)

    Moore Kelley

    2004-05-01

    Full Text Available Abstract Background Patients with cancer must make frequent visits to the clinic not only for chemotherapy but also for the management of treatment-related adverse effects. Neutropenia, the most common dose-limiting toxicity of myelosuppressive chemotherapy, has substantial clinical and economic consequences. Colony-stimulating factors such as filgrastim and pegfilgrastim can reduce the incidence of neutropenia, but the clinic visits for these treatments can disrupt patients' routines and activities. Methods We surveyed patients to assess how clinic visits for treatment with chemotherapy and the management of neutropenia affect their time and activities. Results The mean amounts of time affected by these visits ranged from approximately 109 hours (hospitalization for neutropenia and 8 hours (physician and chemotherapy to less than 3 hours (laboratory and treatment with filgrastim or pegfilgrastim. The visits for filgrastim or pegfilgrastim were comparable in length, but treatment with filgrastim requires several visits per chemotherapy cycle and treatment with pegfilgrastim requires only 1 visit. Conclusions This study provides useful information for future modelling of additional factors such as disease status and chemotherapy schedule and provides information that should be considered in managing chemotherapy-induced neutropenia.

  4. Clozapine reinitiation following a "red result" secondary to chemotherapy

    Directory of Open Access Journals (Sweden)

    Munshi T

    2013-08-01

    Full Text Available Tariq Munshi, Mir Mazhar, Tariq HassanDepartment of Psychiatry, Kingston General Hospital, Kingston, ON, CanadaAbstract: We describe a case of a patient whose clozapine was discontinued after a "red result" following R-CHOP (rituximab with cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone chemotherapy for large B-cell lymphoma. In some cases, manufacturers grant permission, on compassionate grounds, for clozapine to be continued or reinitiated following assessment by their consultant hematologist. Other than a recent case report, there is not much literature surrounding this medical issue. However, since the two leading causes of mortality in schizophrenia are cancer and cardiac disease, this is not an uncommon occurrence. Clinicians are reluctant to prescribe clozapine in view of its side-effect profile, despite its proven efficacy for managing treatment-resistant schizophrenia. The alternative is to prescribe two antipsychotics to manage symptoms. This approach may be associated with increased side effects, and evidence for actual benefits is scant. The consequences were disastrous in this case, as the individual not only relapsed following clozapine discontinuation, but the therapy for this treatable form of lymphoma had to be delayed. He was eventually admitted to an inpatient unit after having been stable for 15 years. We managed to stabilize him with olanzapine and aripiprazole which enabled the heme-oncology group to resume R-CHOP therapy with filgrastim (granulocyte colony-stimulating factor. Even so, he continued to exhibit severe psychotic symptoms, with religious delusions and auditory hallucinations. We therefore applied for permission to rechallenge him on clozapine. Permission was granted when protocol conditions were met, and reinitiation went without any adverse events. The patient's symptoms showed improvement within a few weeks, and the other antipsychotics were discontinued once clozapine was titrated up to 300

  5. Unusually Located Stroke After Chemotherapy in Testicular Germ Cell Tumors

    Directory of Open Access Journals (Sweden)

    Braulio Alexander Martinez MD

    2015-06-01

    Full Text Available Testicular cancer is a type of malignancy that affects young adults and has high rates of cure; however, as any malignancy, it is associated with an increased risk of ischemic or hemorrhagic cerebrovascular disease, given the systemic tumor effects or side effects of chemotherapy, which in turn increases morbidity, functional impairment, and additional risk of early death.

  6. Safety of indwelling pleural catheter use in patients undergoing chemotherapy: a five-year retrospective evaluation

    OpenAIRE

    Chan Wah Hak, Charleen; Sivakumar, Parthipan; Ahmed, Liju

    2016-01-01

    Background Indwelling pleural catheters (IPC) are increasingly becoming a first-line treatment in the management of malignant pleural effusions. Ambulatory management using IPC are increasingly used in this patient group whilst they are receiving concurrent chemotherapy. There are currently no prospective trials examining IPC safety in chemotherapy. This study’s objective is to determine if IPC insertion is safe in patients undergoing chemotherapy. Methods We conducted a retrospective analysi...

  7. Demand-side management energy saving potential in commercial and governmental/institutional sectors and its impact on power planning : a case study of central grid of Oman

    Energy Technology Data Exchange (ETDEWEB)

    Malik, A.S.; Al-Khrousi, A.R.; Al-Hindi, M.; Al-Mahrouqi, Y. [Sultan Qaboos Univ., Al-Khod (Oman). College of Engineering

    2006-07-01

    The results of Demand-Side Management (DSM) energy saving potential in commercial, government and institutional sectors of Oman were presented along with an evaluation of its impact on generation capacity and energy savings. DSM was defined as electricity demand management by methods such as peak clipping, valley filling, load shifting, and strategic conservation. Peak clipping reduces electricity demand during on-peak periods of the day, thus lowering the peak demand that utilities must meet. In contrast, valley filling increases the electrical load during off-peak periods. Load shifting refers to the movement of loads from peak periods to off-peak periods without any shift in energy use. Strategic load growth aims to increase the load in the future, while strategic conservation aims to decrease the load in the future without any shift in demand to another time. The purpose of DSM is to influence the amount or timing of customers' energy use. It has a positive environmental outlook and provides the best solution between load growth and increasing constraints on new and existing generation, transmission and distribution capacity. Resource options for DSM include energy efficiency options, such as energy efficient appliances, lighting, high efficiency heating, ventilating and air conditioning. Other options include load management and tariffs such as time-of-use incentives. The goal of electricity planning is to meet the load forecast with high reliability at a minimum cost. DSM economic energy savings potential is worked out from both the customer point of view and the electric utility's point of view. The study showed that the use of DSM in commercial and government sectors is economically justified from the customer point of view. DSM programs in the government and commercial sectors reduced the energy consumption to 21 and 38 per cent respectively. The discounted payback period of investment in efficient lighting and air-conditioning was between 4

  8. Update on Intra-Arterial Chemotherapy for Retinoblastoma

    Directory of Open Access Journals (Sweden)

    Mario Zanaty

    2014-01-01

    Full Text Available The tools for managing retinoblastoma have been increasing in the past decade. While globe-salvage still relies heavily on intravenous chemotherapy, tumors in advanced stage that failed chemotherapy are now referred for intra-arterial chemotherapy (IAC to avoid enucleation. However, IAC still has many obstacles to overcome. We present an update on the indications, complications, limitations, success, and technical aspects of IAC. Given its safety and high efficacy, it is expected that IAC will replace conventional strategies and will become a first-line option even for tumors that are amenable for other strategies.

  9. Prevent Infections During Chemotherapy

    Centers for Disease Control (CDC) Podcasts

    2011-10-24

    This podcast discusses the importance of preventing infections in cancer patients who are undergoing chemotherapy. Dr. Lisa Richardson, CDC oncologist, talks about a new Web site for cancer patients and their caregivers.  Created: 10/24/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 10/24/2011.

  10. Adult medulloblastoma: multiagent chemotherapy.

    OpenAIRE

    Greenberg, H. S.; Chamberlain, M. C.; Glantz, M J; Wang, S.

    2001-01-01

    In this study, the records of 17 adult patients with medulloblastoma treated with craniospinal radiation and 1 of 2 multiagent chemotherapy protocols were reviewed for progression-free survival, overall survival, and toxicity, and the patients were compared with each other and with similarly treated children and adults. Records of patients treated at 3 institutions were reviewed. Seventeen medulloblastoma patients (11 female, 6 male) with a median age of 23 years (range, 18-47 years) were tre...

  11. Combination Chemotherapy for Influenza

    OpenAIRE

    Robert G. Webster; Govorkova, Elena A.

    2010-01-01

    The emergence of pandemic H1N1 influenza viruses in April 2009 and the continuous evolution of highly pathogenic H5N1 influenza viruses underscore the urgency of novel approaches to chemotherapy for human influenza infection. Anti-influenza drugs are currently limited to the neuraminidase inhibitors (oseltamivir and zanamivir) and to M2 ion channel blockers (amantadine and rimantadine), although resistance to the latter class develops rapidly. Potential targets for the development of new anti...

  12. Pen-side testing

    International Nuclear Information System (INIS)

    Pen-side diagnostic testing is often required to provide real time information about the health status of an animal or herd. The rapid results are generally needed in the face of a disease outbreak where the diagnostician/clinician is presented with dead or dying animals. Another use of pen-side tests is as part of a preventive medicine/herd health programme, where the information can be used for determining pathogen incidence and prevalence in the herd, identifying potential carrier animals or evaluating subtle changes in overall herd health as a result of management changes. Still another area is as a part of health certification before sale or stocking, or during processing following slaughter. Advanced testing methods, which in the past were only appropriate for use in a laboratory setting, have now been formatted for use in the field. Enzyme immunoassays (EIAs) and immunochromatorgraphy have greatly enhanced diagnostic pen-side capabilities. These test systems allow for the rapid, sensitive and specific detection of target antigen or antibody and require little or no scientific equipment. Because of the wide format flexibility these immunochemical technologies allow, they have come to dominate the diagnostic industry, both in the laboratory and in the field. Using liquid phase or precipitating chromogens, the tests can be visually interpreted and do not need instrumentation. Immunochromatography, a simplified assay system, has found widespread application as a field or pen-side test. The entire assay takes only one or two steps, and the results appear within 5-10 minutes. In the future, DNA based diagnostics will become more adaptable for use in the field. The DNA hybridization systems are at present cumbersome and require elevated temperatures. Companies are currently working to develop fast formulas that provide results in less than an hour, have a limited number of steps and can be performed at lower temperatures. (author)

  13. Modeling Chemotherapy-Induced Hair Loss: From Experimental Propositions toward Clinical Reality.

    Science.gov (United States)

    Botchkarev, Vladimir A; Sharov, Andrey A

    2016-03-01

    Chemotherapy-induced hair loss is one of the most devastating side effects of cancer treatment. To study the effects of chemotherapeutic agents on the hair follicle, a number of experimental models have been proposed. Yoon et al. report that transplantation of human scalp hair follicles onto chemotherapy-treated immunodeficient mice serves as an excellent in vivo model for chemotherapy-induced hair loss. Yoon et al. demonstrate that (i) the response of human hair follicles grafted onto immunodeficient mice to cyclophosphamide resembles the key features of the chemotherapy-induced hair loss seen in patients with cancer and (ii) this human in vivo model for chemotherapy-induced hair loss is closer to clinical reality than to any earlier models. Undoubtedly, this model will serve as a valuable tool for analyses of the mechanisms that underlie this devastating side effect of anti-cancer therapy. PMID:26902124

  14. Novel management strategy for coronary steal syndrome: case report of occlusion of a LIMA graft side branch with a combination of drug-eluting and covered-stent deployment.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2009-11-01

    We report a novel percutaneous therapeutic approach to the management of suspected coronary artery steal syndrome resulting from a large side branch of the left internal mammary artery bypass graft, using a combination of coated and drug-eluting stents. We demonstrate the feasibility and long-term efficacy of this strategy in a case report.

  15. Photo(chemotherapy for Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Nahide Onsun

    2010-12-01

    Full Text Available Atopic dermatitis is an inflammatory skin disease with a chronic relapsing course. The benefical effects of ultraviolet light on atopic dermatitis has been appreciated for many years. Along with topical and systemic treatment,photo(chemotherapy is one of the three fundamental alternatives for managing atopic dermatitis. While broadband UVB and psoralen UVA (PUVA have been the mainstay of phototherapy more new modalities including UVA-1 and narrow-band UVB have been used succesfully in recent years.

  16. Glutamine: A novel approach to chemotherapy-induced toxicity

    Directory of Open Access Journals (Sweden)

    Kumar Gaurav

    2012-01-01

    Full Text Available Treatment of cancer is associated with short- and long-term side-effects. Cancer produces a state of glutamine deficiency, which is further aggravated by toxic effects of chemotherapeutic agents leading to increased tolerance of tumor to chemotherapy as well as reduced tolerance of normal tissues to the side-effects of chemotherapy. This article reviews the possible role of glutamine supplementation in reducing the serious adverse events in patients treated with anticancer drugs. The literature related to the possible role of glutamine in humans with cancer and the supportive evidence from animal studies was reviewed. Searches were made and the literature was retrieved using PUBMED, MEDLINE, COCHRANE LIBRARY, CENAHL and EMBASE, with a greater emphasis on the recent advances and clinical trials. Glutamine supplementation was found to protect against radiation-induced mucositis, anthracycline-induced cardiotoxicity and paclitaxel-related myalgias/arthralgias. Glutamine may prevent neurotoxicity of paclitaxel, cisplatin, oxaplatin bortezomib and lenolidamide, and is beneficial in the reduction of the dose-limiting gastrointestinal toxic effects of irinotecan and 5-FU-induced mucositis and stomatitis. Dietary glutamine reduces the severity of the immunosuppressive effect induced by methotrexate and improves the immune status of rats recovering from chemotherapy. In patients with acute myeloid leukemia requiring parenteral nutrition, glycyl-glutamine supplementation could hasten neutrophil recovery after intensive myelosuppressive chemotherapy. Current data supports the usefulness of glutamine supplementation in reducing complications of chemotherapy; however, paucity of clinical trials weakens the clear interpretation of these findings.

  17. Pathobiology of cancer chemotherapy-induced peripheral neuropathy (CIPN

    Directory of Open Access Journals (Sweden)

    Yaqin eHan

    2013-12-01

    Full Text Available Chemotherapy induced peripheral neuropathy (CIPN is a type of neuropathic pain that is a major dose-limiting side-effect of potentially curative cancer chemotherapy treatment regimens that develops in a ‘stocking and glove’ distribution. When pain is severe, a change to less effective chemotherapy agents may be required, or patients may choose to discontinue treatment. Medications used to alleviate CIPN often lack efficacy and/or have unacceptable side-effects. Hence the unmet medical need for novel analgesics for relief of this painful condition has driven establishment of rodent models of CIPN. New insights on the pathobiology of CIPN gained using these models are discussed in this review. These include mitochondrial dysfunction and oxidative stress that are implicated as key mechanisms in the development of CIPN. Associated structural changes in peripheral nerves include neuronopathy, axonopathy and/or myelinopathy, especially intra-epidermal nerve fiber (IENF degeneration. In patients with CIPN, loss of heat sensitivity is a hallmark symptom due to preferential damage to myelinated primary afferent sensory nerve fibers in the presence or absence of demyelination. The pathobiology of CIPN is complex as cancer chemotherapy treatment regimens frequently involve drug combinations. Adding to this complexity, there are also subtle differences in the pathobiological consequences of commonly used cancer chemotherapy drugs, viz platinum compounds, taxanes, vincristine, bortezomib, thalidomide and ixabepilone, on peripheral nerves.

  18. Enrichment of osteosarcoma stem cells by chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Qing-Lian Tang; Yi Liang; Xian-Biao Xie; Jun-Qiang Yin; Chang-Ye Zou; Zhi-Qiang Zhao; Jing-Nan Shen; Jin Wang

    2011-01-01

    Osteosamoma is the most common primary malignant bone cancer in children and adolescents. Emerging evidence has suggested that the capability of a tumor to grow is driven by a small subset of cells within a tumor, termed cancer stem cells (CSCs). Although several methods have been explored to identify or enrich CSCs in osteosarcoma, these methods sometimes seem impractical, and chemotherapy enrichment for CSCs in osteosarcoma is rarely investigated. In the present study, we found that short exposure to chemotherapy could change the morphology of osteosarcoma cells and increase sarcosphere formation in vitro, as well as increase tumor formation in vivo. Furthermore, methotrexate (MTX)-resistant U2OS/MTX300 osteosarcoma cells were larger in size and grew much more tightly than parental U2OS cells. More importantly, U2OS/MTX300 cells possessed a higher potential to generate sarcospheres in serum-free conditions compared to parental U2OS cells. Also, U2OS/MTX300 cells exhibited the side population (SP) phenotype and expressed CSC surface markers CD117 and Stro-1. Notably, U2OS/ MTX300 cells showed a substantially higher tumorigenicity in nude mice relative to U2OS cells. Therefore, we conclude that chemotherapy enrichment is a feasible and practical way to enrich osteosamoma stem cells.

  19. Treatment of oral mucositis due to chemotherapy

    Science.gov (United States)

    Bagán-Sebastián, José V

    2016-01-01

    Introduction The management of oral mucositis is a challenge, due to its complex biological nature. Over the last 10 years, different strategies have been developed for the management of oral mucositis caused by chemotherapy in cancer patients. Material and Methods An exhaustive search was made of the PubMed-Medline, Cochrane Library and Scopus databases, crossing the key words “oral mucositis”, “prevention” and “treatment” with the terms “chemotherapy” and “radiotherapy” by means of the boolean operators “AND” and “NOT”. A total of 268 articles were obtained, of which 96 met the inclusion criteria. Results Several interventions for the prevention of oral mucositis, such as oral hygiene protocols, amifostine, benzidamine, calcium phosphate, cryotherapy and iseganan, among others, were found to yield only limited benefits. Other studies have reported a decrease in the appearance and severity of mucositis with the use of cytoprotectors (sucralfate, oral glutamine, hyaluronic acid), growth factors, topical polyvinylpyrrolidone, and low power laser irradiation. Conclusions Very few interventions of confirmed efficacy are available for the management of oral mucositis due to chemotherapy. However, according to the reviewed literature, the use of palifermin, cryotherapy and low power laser offers benefits, reducing the incidence and severity of oral mucositis – though further studies are needed to confirm the results obtained. Key words:Chemotherapy-Induced Oral Mucositis Treatment. PMID:27034762

  20. Spontaneously resolving periocular erythema and ciliary madarosis following intra-arterial chemotherapy for retinoblastoma

    Directory of Open Access Journals (Sweden)

    Marr Brian

    2010-01-01

    Full Text Available Purpose and Design: To describe an unusual clinical finding seen in children undergoing intra-arterial chemotherapy for retinoblastoma. Materials and Methods: A retrospective review of 69 eyes of 63 patients receiving intra-arterial chemotherapy over a 3-year period. Charts and photographs of 69 consecutive cases were reviewed, and data were collected on patients with clinical evidence of a hyperemic cutaneous periocular abnormality following the procedure. Results: A blanching erythematous and edematous patch was noted in the periocular region in 16% (11 of 69 of the children who received intraarterial chemotherapy. The plaque extended into the region of the supertrochlear and medial marginal artery distribution on the ipsilateral side of the intra-arterial chemotherapy. All patches of erythema spontaneously resolved within 3 months following completion of the intra-arterial chemotherapy. Conclusion: Periocular erythema and swelling is a self-limited clinical finding associated with intra-arterial chemotherapy in a small number of patients.

  1. Ginger as a miracle against chemotherapy-induced vomiting

    Science.gov (United States)

    Yekta, Zohreh Parsa; Ebrahimi, Seyyed Meisam; Hosseini, Mostafa; Nasrabadi, Alireza Nikbakht; Sedighi, Sanambar; Surmaghi, Mohammad-Hosein Salehi; Madani, Hossein

    2012-01-01

    Background: Vomiting is one of the most prevalent side effects of chemotherapy in cancer patients. The aim of this study was to evaluate the effect of ginger plant on chemotherapy-induced vomiting, since the previous studies were somehow imperfect and have provided controversial results. Materials and Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 80 women with breast cancer undergoing chemotherapy and suffering from vomiting in Imam Khomeini Hospital, Tehran, Iran, between July and December 2009. During a convenience sampling the participants were randomly allocated into treatment and placebo groups after taking a written informed consent. Two groups were matched based on the age and emetic risk of chemotherapy drugs. The treatment group received 250 mg ginger powder capsules (Zintoma) and placebo group 250 mg starch capsules 4 times a day (1 g/day) for 6 days since 3 days before chemotherapy session. A two-part self-made questionnaire was used to assess the effect of ginger. Patients completed the instrument every day. Then by STATA software version 8, the gathered data were analyzed using Fisher’s exact, Kruskal-Wallis, and Chi-square tests. Results: The 2 groups had no significant age differences and were matched (ginger: 41.8±8.4 vs placebo: 45.1±10, P = 0.1). Vomiting cases were significantly lower in ginger group at anticipatory (P = 0.04), acute (P = 0.04), and delayed (P = 0.003) phases. Also, heartburn was the only and venial reported side effect (P > 0.05). Conclusions: Taking ginger capsules (for 6 days since 3 days before chemotherapy) accompanied by the routine antiemetic treatment could relieve chemotherapy-induced vomiting in all phases. PMID:23853643

  2. Imaging enhancement of malignancy by cyclophosphamide: surprising chemotherapy opposite effects

    Science.gov (United States)

    Yamauchi, Kensuke; Yang, Meng; Hayashi, Katsuhiro; Jiang, Ping; Xu, Mingxu; Yamamoto, Norio; Tsuchiya, Hiroyuki; Tomita, Katsuro; Moossa, A. R.; Bouvet, Michael; Hoffman, Robert M.

    2008-02-01

    Although side effects of cancer chemotherapy are well known, "opposite effects" of chemotherapy which enhance the malignancy of the treated cancer are not well understood. We have observed a number of steps of malignancy that are enhanced by chemotherapy pre-treatment of mice before transplantation of human tumor cells. The induction of intravascular proliferation, extravasation, and colony formation by cancer cells, critical steps of metastasis was enhanced by pretreatment of host mice with the commonly-used chemotherapy drug cyclophosphamide. Cyclophosphamide appears to interfere with a host process that inhibits intravascular proliferation, extravasation, and extravascular colony formation by at least some tumor cells. Cyclophosphamide does not directly affect the cancer cells since cyclophosphamide has been cleared by the time the cancer cells were injected. Without cyclophosphamide pretreatment, human colon cancer cells died quickly after injection in the portal vein of nude mice. Extensive clasmocytosis (destruction of the cytoplasm) of the cancer cells occurred within 6 hours. The number of apoptotic cells rapidly increased within the portal vein within 12 hours of injection. However, when the host mice were pretreated with cyclophosphamide, the cancer cells survived and formed colonies in the liver after portal vein injection. These results suggest that a cyclophosphamide-sensitive host cellular system attacked the cancer cells. This review describes an important unexpected "opposite effects" of chemotherapy that enhances critical steps in malignancy rather than inhibiting them, suggesting that certain current approaches to cancer chemotherapy should be modified.

  3. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    International Nuclear Information System (INIS)

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients

  4. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, L; Quirk, S; Smith, WL [The University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Yeung, R; Phan, T [The University of Calgary, Calgary, AB (Canada); Hudson, A [Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients.

  5. Graphene Side Gate Engineering

    OpenAIRE

    Chen, Ching-Tzu; Low, Tony; Chiu, Hsin-Ying; Zhu, Wenjuan

    2014-01-01

    Various mesoscopic devices exploit electrostatic side gates for their operation. In this paper, we investigate how voltage-biasing of graphene side gates modulates the electrical transport characteristics of graphene channel. We explore myriads of typical side gated devices such as symmetric dual side gates and asymmetric single side gate biasing, in monolayer and bilayer graphene. The side gates modulate the electrostatic doping in the graphene channel whose effect is reflected in transport ...

  6. Nutritional Status and Nutrition Management of Cancer Inpatients Undergoing Chemotherapy%广州市某5家医院肿瘤化疗患者营养状况及其管理分析

    Institute of Scientific and Technical Information of China (English)

    蔡文智; 盛小燕; 周瑾; 周小平; 曹文静; 王丽; 缪景霞

    2013-01-01

    Objective To explore the nutritional status and nutrition management of cancer inpatients undergoing chemotherapy. Methods A self-designed questionnaire including information of general demographic information, weight and height and nutrition management was used among 400 cancer inpatients undergoing chemotherapy who met the inclusion criteria from 5 hospitals in Guangzhou. Results The incidence of malnutrition was up to 40.5%, and that of mild, moderate and severe under-nutrition were 12.7%,6.8%and 3.3%, respectively. While the incidence of overweight or obese was 17.7%and that of nutrition management among the mild, moderate and severe under-nutrition, and overweight or obese inpatients were 15.4%, 7.4%, 0, 13.4%and 7.0%, respectively;the utilization incidence of intralipid, amino acids, vitamin, albumin and blood plasma among inpatients with normal nutrition were 5.9%, 20.6%, 65.1%, 4.2% and 1.3% respectively, while severe under-nutrition inpatients that did not apply these accounted for 61.5%, 46.2%, 23.1%, 92.3%and 100%respectively. Conclusion A large proportion of cancer inpatients receiving chemotherapy is malnutrition but the nutrition management remains poor. Evidence-based nutrition support guideline is needed.%目的:调查住院肿瘤化疗患者的营养状况及其管理现状。方法对广州市5家医院400例住院肿瘤化疗患者进行营养现状调查,内容包括人口学资料、体质量、身高及营养管理情况。结果本组营养不良的总发生率为40.5%,其中轻度营养不足占12.7%,中度营养不足占6.8%,重度营养不足占3.3%,超重或肥胖占17.7%;重度营养不足、中度营养不足、轻度营养不足、营养正常、超重或肥胖患者营养管理率分别为15.4%、7.4%、0、13.4%和7.0%;营养正常的患者中,使用脂肪乳、氨基酸、维生素、白蛋白及血浆的概率分别为5.9%、20.6%、65.1%、4.2%和1.3%,而重度营养不良患者没有使用上述5

  7. Impact of Gemcitabine Chemotherapy and 3-Dimensional Conformal Radiation Therapy/5-Fluorouracil on Quality of Life of Patients Managed for Pancreatic Cancer

    International Nuclear Information System (INIS)

    Purpose: To report quality of life (QOL) results for patients receiving chemoradiation therapy for pancreatic cancer. Methods and Materials: Eligible patients (n=41 locally advanced, n=22 postsurgery) entered the B9E-AY-S168 study and received 1 cycle of induction gemcitabine (1000 mg/m2 weekly ×3 with 1-week break) followed by 3-dimensional conformal radiation therapy (RT) (54 Gy locally advanced and 45 Gy postsurgery) and concomitant continuous-infusion 5-fluorouracil (5FU) (200 mg/m2/d throughout RT). After 4 weeks, patients received an additional 3 cycles of consolidation gemcitabine chemotherapy. Patients completed the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-PAN26 questionnaires at baseline, before RT/5FU, at end of RT/5FU, before consolidation gemcitabine, and at treatment completion. Results: The patterns of change in global QOL scores differed between groups. In the locally advanced group global QOL scores were +13, +8, +3, and +1 compared with baseline before RT/5FU (P=.008), at end of RT/5FU, before consolidation gemcitabine, and at treatment completion, respectively. In the postsurgery group, global QOL scores were −3, +4, +15, and +17 compared with baseline at the same time points, with a significant improvement in global QOL before consolidation gemcitabine (P=.03). No significant declines in global QOL were reported by either cohort. Conclusions: This study demonstrates that global QOL and associated function and symptom profiles for pancreatic chemoradiation therapy differ between locally advanced and postsurgery patients, likely owing to differences in underlying disease status. For both groups, the treatment protocol was well tolerated and did not have a negative impact on patients' global QOL.

  8. Impact of Gemcitabine Chemotherapy and 3-Dimensional Conformal Radiation Therapy/5-Fluorouracil on Quality of Life of Patients Managed for Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Short, Michala [Discipline of Medical Radiation Sciences, University of Sydney, Sydney, New South Wales (Australia); Western Australia Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia (Australia); Goldstein, David [Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales (Australia); Halkett, Georgia [Western Australia Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia (Australia); Reece, William [Covance Asia Pacific, Sydney, New South Wales (Australia); Borg, Martin [Adelaide Radiotherapy Centre, Adelaide, South Australia (Australia); Zissiadis, Yvonne [Department of Radiation Oncology, Royal Perth Hospital, Perth, Western Australia (Australia); Kneebone, Andrew [Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Spry, Nigel, E-mail: Nigel.Spry@health.wa.gov.au [Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia (Australia); Faculty of Medicine, University of Western Australia, Perth, Western Australia (Australia)

    2013-01-01

    Purpose: To report quality of life (QOL) results for patients receiving chemoradiation therapy for pancreatic cancer. Methods and Materials: Eligible patients (n=41 locally advanced, n=22 postsurgery) entered the B9E-AY-S168 study and received 1 cycle of induction gemcitabine (1000 mg/m{sup 2} weekly Multiplication-Sign 3 with 1-week break) followed by 3-dimensional conformal radiation therapy (RT) (54 Gy locally advanced and 45 Gy postsurgery) and concomitant continuous-infusion 5-fluorouracil (5FU) (200 mg/m{sup 2}/d throughout RT). After 4 weeks, patients received an additional 3 cycles of consolidation gemcitabine chemotherapy. Patients completed the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-PAN26 questionnaires at baseline, before RT/5FU, at end of RT/5FU, before consolidation gemcitabine, and at treatment completion. Results: The patterns of change in global QOL scores differed between groups. In the locally advanced group global QOL scores were +13, +8, +3, and +1 compared with baseline before RT/5FU (P=.008), at end of RT/5FU, before consolidation gemcitabine, and at treatment completion, respectively. In the postsurgery group, global QOL scores were -3, +4, +15, and +17 compared with baseline at the same time points, with a significant improvement in global QOL before consolidation gemcitabine (P=.03). No significant declines in global QOL were reported by either cohort. Conclusions: This study demonstrates that global QOL and associated function and symptom profiles for pancreatic chemoradiation therapy differ between locally advanced and postsurgery patients, likely owing to differences in underlying disease status. For both groups, the treatment protocol was well tolerated and did not have a negative impact on patients' global QOL.

  9. 鼻咽癌IMRT同期化疗的疼痛管理%Pain management of nasopharyngeal carcinoma with IMRT concurrent chemotherapy

    Institute of Scientific and Technical Information of China (English)

    黄中; 邵汛帆; 郑乃莹

    2014-01-01

    Objective Through the analysis of oxycodone pain treatment opportunity to investigate how to improve the analgesic effect of radioactive oral mucositis of NPC patients with IMRT concurrent chemotherapy. Methods 102 cases of patients with nasopharyngeal carcinoma from January 2012 to March 2014 treated in our hospital were selected,received the same IMRT concurrent chemoradiotherapy,nutrition interventions and oral care,chemotherapy injury pain in oral mucositis were scored according to the visual analog scale(VAS),were randomly divided into the first,second and third group,the first group of patients began to oral oxycodone zyban with mild pain(1 to 3 points);The second group of patients began to oral oxycodone zyban with moderate pain(4-6 points);The third group of patients started to oral oxycodone zyban with moderate to severe pain(7 to 9 points);The changes in pain scores,improved quality of life,nutritional status,the average amount of pain medication and adverse drug reactions,etc between three groups of patients were observed and compared. Results After the first seven weeks long radiotherapy,the differences of VAS score and QOL scores of the first group compared with the second or third group were significant(P<0.05),the incidence of malnutrition,nausea,vomiting,constipation,drowsiness,dizziness,headache and other drugs reactions of the first group were significantly less than the second group and the third group,the difference was statistically significant(P<0.05),patients of three groups had no serious adverse effects such as respiratory depression as opioid analgesic drug used ,analgesic drug average usage amount of the first group was significantly less than the second or third group,with statistically significant difference(P < 0.05). Conclusion Patients with pain of nasopharyngeal IMRT concurrent chemoradiotherapy-induced oral mucosal injury, are given early analgesic treatment,the analgesic effect is obvious,less adverse drug reactions,patients with

  10. Chemotherapie von Hirntumoren bei Erwachsenen

    OpenAIRE

    Weller, M.

    2008-01-01

    Chemotherapy has become a third major treatment option for patients with brain tumors, in addition to surgery and radiotherapy. The role of chemotherapy in the treatment of gliomas is no longer limited to recurrent disease. Temozolomide has become the standard of care in newly diagnosed glioblastoma. Several ongoing trials seek to define the role of chemotherapy in the primary care of other gliomas. Some of these studies are no longer only based on histological diagnoses, but take into consid...

  11. Chemotherapy for Gallbladder Cancer

    Science.gov (United States)

    ... Gemcitabine (Gemzar ® ) Cisplatin (Platinol ® ) 5-fluorouracil (5-FU) Capecitabine (Xeloda ® ) Oxaliplatin (Eloxatin ® ) In some cases, 2 of these ... given with radiation, most often 5-FU or capecitabine is used. Possible side effects Chemo drugs attack ...

  12. Super-selective interventional chemotherapy combined with systemic chemotherapy for the treatment of postoperative gliomas:a clinical study

    International Nuclear Information System (INIS)

    Objective: To evaluate super-selective interventional chemotherapy combined with systemic chemotherapy in treating postoperative gliomas. Methods: During the period of 2005-2009, a total of 46 patients with glioma were encountered in our hospital. According to the principle of patient's free will the involved patients were divided into two groups. Study group (n = 25): after operation the patients received routine radiotherapy, which was followed by super-selective interventional chemotherapy combined simultaneously with systemic chemotherapy. Control group (n = 21): after operation the patients received routine radiotherapy, which was followed by systemic chemotherapy only. The patients were regularly followed up. Cranial CT checkups were made to determine the tumor size, and the results were evaluated with Karnofsky scores. The clinical data were analyzed and compared between two groups. Results: In the study group, the side-effects and complications included epileptic seizures (n = 3), eye pain (n = 5), headache (n = 9), nausea and vomiting (n = 8) and thrombopenia (n = 1). In the control group,the side-effects and complications were as follows: epileptic seizures (n = 1), headache (n = 7), nausea and vomiting (n = 6) and thrombopenia(n = 3). No death occurred in either of the two groups. The patients were followed up for an average period of 2.3 years. Before chemotherapy no statistically significant difference in tumor size existed between two groups (P > 0.05). One year after the chemotherapy, the tumor volume in study group was reduced by 67.11%, while it was 45.79% in control group. By using independent sample t test analysis, the difference between two groups was of statistical significance (P < 0.05). Wilcoxon rank sum test and Karnofsky prognostic score analysis indicated that the prognosis of study group was much better than that of control group (P < 0.05). Conclusion: In comparison with routine radiotherapy plus simple systemic chemotherapy, routine

  13. Managing Intraoral Lesions in Oral Cancer Patients in a General Dental Practice: An Overview.

    Science.gov (United States)

    Kim, Reuben Han-Kyu; Yang, Paul; Sung, Eric C

    2016-02-01

    As medical technology advances in the area of cancer therapeutics, dental practitioners will encounter patients with active cancer or a history of cancer. Typically, these patients may have had or are undergoing therapies such as surgery, radiation, chemotherapy or a combination of therapies. These patients may present with multiple side effects that dental practitioners can manage or prevent. We discuss some of these concerns and provide management strategies.

  14. [Prostate cancer and chemotherapy].

    Science.gov (United States)

    Gravis, Gwenaelle; Salem, Naji; Bladou, Franck; Viens, Patrice

    2007-07-01

    Androgen deprivation in patients with metastatic prostate cancer produces palliation of symptoms, PSA decrease and tumoral regression in most patients. After a brief period of disease regression lasting 18 to 24 months nearly all pts will progress to androgen independence disease (HRPC) with progressive clinical deterioration and ultimately death. Chemotherapy with mitoxantrone has been shown to palliate symptoms but did not extend survival. Two large randomized trials showed a survival benefit for pts with HRPC treated with docetaxel with a reduction risk of death by 21-24%, and significant improvement in palliation of symptoms and quality of life. New agents targeting angiogenesis, apoptosis, signal transduction pathway, used alone or in combination with docetaxel currently are under trial in an attempt to provide much needed improvements in outcome. Questions remains in suspend when and who need to be treated, earlier, in high risk as in adjuvant setting? Current data have demonstrated that neoadjuvant or adjuvant chemotherapy is relatively safe and feasible. Further investigation through prospective randomize trials is critical to define the precise role of this modality in high risk populations. PMID:17845990

  15. Role of myeloid growth factors in chemotherapy induced neutropenia

    Directory of Open Access Journals (Sweden)

    Ravinutala Srinath Bharadwaj

    2016-10-01

    Full Text Available Neutropenia is a major dose limiting toxicity of many chemo therapeutic regimens. Haemopoietic colony - stimulating factors (CSFs have been shown to reduce the duration and severity of chemotherapy induced neutropenia (CIN and risk of febrile neutropenia. Supportive care with myeloid growth factors improve chemotherapy delivery by minimizing chemotherapy dose reductions or treatment delays by enabling the delivery of full dose chemotherapy (dose dense in short time intervals. The goal of this article is to give comprehensive review of current literature regarding medical practice guidelines and risk assessment models for appropriate use of myeloid growth factors and management of febrile neutropenia. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1715-1721

  16. Distress, anxiety, and depression in cancer patients undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Thomas Bejoy C

    2006-09-01

    Full Text Available Abstract Background Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. Patients and methods A total of 117 patients were evaluated by using distress inventory for cancer (DIC2 and hospital anxiety and depression scale (HADS. Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%. Results The mean distress score was 24, 18 (15.38% were found to have anxiety while 19 (16.23% had depression. High social status was the only factor found to influence distress while female gender was the only factor found to influence depression in the present study. Conclusion The study highlights high psychological morbidity of cancer patients and influence of gender on depression. Construct of distress as evaluated by DIC 2 may have a possible overlap with anxiety.

  17. Effects of Video Games on the Adverse Corollaries of Chemotherapy in Pediatric Oncology Patients: A Single-Case Analysis.

    Science.gov (United States)

    Kolko, David J.; Rickard-Figueroa, Jorge L.

    1985-01-01

    Assessed effects of video games on adverse corollaries of chemotherapy in three pediatric oncology patients. Results indicated that access to video games resulted in reduction in the number of anticipatory symptoms experienced and observed, as well as a diminution in the aversiveness of chemotherapy side effects. (Author/NRB)

  18. Effect of class IV laser therapy on chemotherapy-induced oral mucositis: a clinical and experimental study.

    Science.gov (United States)

    Ottaviani, Giulia; Gobbo, Margherita; Sturnega, Mauro; Martinelli, Valentina; Mano, Miguel; Zanconati, Fabrizio; Bussani, Rossana; Perinetti, Giuseppe; Long, Carlin S; Di Lenarda, Roberto; Giacca, Mauro; Biasotto, Matteo; Zacchigna, Serena

    2013-12-01

    Oral mucositis (OM) is a serious and acute side effect in patients with cancer who receive chemotherapy or radiotherapy, often leading to the suspension of therapy and a need for opioid analgesic and enteral/parenteral nutrition, with an effect on patient survival. Among the various interventions proposed in OM management, laser therapy is becoming a recommended treatment option but has limitations due to its heterogeneous laser parameters. Here, we report on our successful clinical experience on the use of class IV laser therapy to treat OM induced by different chemotherapy regimens. To shed light on the mechanisms of action of laser therapy in improving OM resolution, we have developed an animal model of chemotherapy-induced OM, in which we compare the efficacy of the standard low-power laser therapy protocol with an innovative protocol, defined as high-power laser therapy. We show that high-power laser therapy is more effective than low-power laser therapy in improving OM lesion healing, reducing the inflammatory burden, and preserving tissue integrity. In addition, high-power laser therapy has been particularly effective in promoting the formation of new arterioles within the granulation tissue. Our results provide important insights into the mechanism of action of biostimulating laser therapy on OM in vivo and pave a way for clinical experimentation with the use of high-power laser therapy.

  19. Intra-arterial Chemotherapy for Adult Onset Retinoblastoma in a 32-Year-Old Man.

    Science.gov (United States)

    Magan, Tejal; Khoo, Chloe T L; Jabbour, Pascal M; Fuller, Dwain G; Shields, Carol L

    2016-01-01

    A 32-year-old man with active unilateral group D retinoblastoma that was recurrent following external beam radiotherapy was treated with intra-arterial chemotherapy, leading to tumor regression. Additional plaque radiotherapy and intravitreal chemotherapy were required for complete control. Final visual acuity was 20/40. In selected cases, adult-onset retinoblastoma can be managed with intra-arterial chemotherapy. [J Pediatr Ophthalmol Strabismus. 2016;53:e43-e46.]. PMID:27486894

  20. Monitoramento e avaliação dos efeitos colaterais da quimioterapia em pacientes com câncer de cólon Monitoreo y evaluación de los efectos colaterales de la quimioterapia en pacientes con neoplasia de colon Monitoring and evaluation of side effects of chemotherapy in patients with colon cancer

    Directory of Open Access Journals (Sweden)

    Elizabeth Pinto Magalhães de Almeida

    2004-10-01

    guías con informaciones de cómo manejarlos. Las informaciones y seguimiento de los pacientes fueron realizados por la enfermera del sector durante la consulta de enfermería. Los resultados evidenciaron que la mayoría de los pacientes (82,4% presentó por lo menos uno de los síntomas estudiados, entre el primero y 21º día del ciclo de tratamiento. La náusea fue el síntoma más frecuente (76,5%, presentando pico en el 4º y 5º días del ciclo. Enseguida la diarrea (70,5% con pico en el 7º día y, por ultimo, el vómito (53,0% con pico en el 5º día. Cuanto al grado de intensidad de los síntomas, la mayoría de los pacientes se situó en el grado 1, establecido como aceptable para este estudio, indicando que las orientaciones de enfermería y el seguimiento continuo contribuyeron para la mayor efectividad del manejo de esos síntomas por parte de los pacientes.This study aimed to monitor and evaluate the occurrence and intensity level of nausea, vomiting and diarrhea in patients with colon cancer, submitted to outpatient chemotherapy, who received nursing information for handling these symptoms. Study participants were 17 patients, who were treated with 5-Fluorouracil and low doses of folinic acid, at the Adult Outpatient Chemotherapy Clinic of the Hospital São Paulo/Federal University of São Paulo, Brazil. Instruments were elaborated for registering these symptoms' occurrence and intensity level and a patient guide for handling them. The information and patient monitoring were carried out by the nurse during the consultations. The results showed that most of the patients (82.4% displayed at least one of the signs and symptoms under study between the first and the 21st day of the treatment cycle. Nausea was the most frequent symptom (76.5%, with a peak on the 4th and 5th day of the cycle, followed by diarrhea (70.5%, with a peak on the 7th day, and vomiting (53.0%, with a peak on the 5th day. Regarding the intensity of these symptoms, most patients were

  1. Supraselective intra-arterial chemotherapy: evaluation of treatment-related complications in advanced retinoblastoma

    Directory of Open Access Journals (Sweden)

    Lejla Mutapcic Vajzovic

    2011-02-01

    Full Text Available Lejla Mutapcic Vajzovic1, Timothy G Murray1, Mohammad A Aziz-Sultan2, Amy C Schefler1, Stacey Quintero Wolfe2, Ditte Hess1, Cristina E Fernandes3, Sander R Dubovy1,41Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA; 3Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA; 4Florida Lions Oculopathology Laboratory, Miami, FL, USA Purpose: The purpose of this study is to report the complication profile and safety evaluation of supraselective intra-arterial melphalan chemotherapy in children undergoing treatment with advanced retinoblastoma.Methods: Twelve eyes of 10 children with advanced retinoblastoma (Reese-Ellsworth Group Vb or International Classification Group D were treated with supraselective intra-ophthalmic artery infusion of melphalan. Eleven eyes of nine children had previously failed traditional management with systemic chemotherapy and laser ablation and underwent intra-ophthalmic artery infusion of melphalan as an alternative to enucleation. Serial ophthalmic examinations, retinal photography, and ultrasonographic imaging were used to evaluate treatment regime.Results: Ophthalmic artery cannulation was successfully performed in 12 eyes of 10 patients (total 16 times. Striking regression of tumor, subretinal and vitreous seeds were seen early in each case. No severe systemic side effects occurred. Grade III neutropenia was seen in one patient. No transfusions were required. Three patients developed a vitreous hemorrhage obscuring tumor visualization. One patient developed periocular edema associated with inferior rectus muscle inflammation per orbital MRI. This same patient had scattered intraretinal hemorrhages and peripapillary cotton wool spots consistent with a Purtscher’s-like retinopathy that resolved spontaneously. At the 6-month follow-up examination

  2. 'Side-by-side'

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-07-01

    France is a nuclear power nation. And this is not going to change. However, at the same time, the country is also pursuing massive investments in the expansion of renewable energies. According to France's President Nicolas Sarkozy, the motto should be: 'side-by-side' rather than 'one or the other'. For the PV sector, whose success was unbroken during the crisis in 2009, the signal is positive and could mean sustained growth. (orig.)

  3. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    International Nuclear Information System (INIS)

    Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments

  4. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    Directory of Open Access Journals (Sweden)

    Marc Mansour

    2011-08-01

    Full Text Available Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments.

  5. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    Energy Technology Data Exchange (ETDEWEB)

    Weir, Genevieve M. [Suite 411, 1344 Summer St., Immunovaccine Inc., Halifax, NS, B3H 0A8 (Canada); Room 11-L1, Sir Charles Tupper Building, Department of Microbiology & Immunology, Dalhousie University, 5850 College St, Halifax, NS, B3H 1X5 (Canada); Liwski, Robert S. [Room 11-L1, Sir Charles Tupper Building, Department of Microbiology & Immunology, Dalhousie University, 5850 College St, Halifax, NS, B3H 1X5 (Canada); Room 206E, Dr. D. J. Mackenzie Building, Department of Pathology, Dalhousie University, 5788 University Avenue, Halifax, NS, B3H 2Y9 (Canada); Mansour, Marc [Suite 411, 1344 Summer St., Immunovaccine Inc., Halifax, NS, B3H 0A8 (Canada)

    2011-08-05

    Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments.

  6. Chemotherapy-induced peripheral neuropathy: an update on the current understanding.

    Science.gov (United States)

    Addington, James; Freimer, Miriam

    2016-01-01

    Chemotherapy-induced peripheral neuropathy is a common side effect of selected chemotherapeutic agents. Previous work has suggested that patients often under report the symptoms of chemotherapy-induced peripheral neuropathy and physicians fail to recognize the presence of such symptoms in a timely fashion. The precise pathophysiology that underlies chemotherapy-induced peripheral neuropathy, in both the acute and the chronic phase, remains complex and appears to be medication specific. Recent work has begun to demonstrate and further clarify potential pathophysiological processes that predispose and, ultimately, lead to the development of chemotherapy-induced peripheral neuropathy. There is increasing evidence that the pathway to neuropathy varies with each agent. With a clearer understanding of how these agents affect the peripheral nervous system, more targeted treatments can be developed in order to optimize treatment and prevent long-term side effects.

  7. [PIPAC--Pressurized intraperitoneal aerosol chemotherapy. A novel treatment for peritoneal carcinomatosis].

    Science.gov (United States)

    Hübner, Martin; Teixeira, Hugo; Boussaha, Tarek; Cachemaille, Matthieu; Lehmann, Kuno; Demartines, Nicolas

    2015-06-17

    Peritoneal carcinomatosis remains a diagnostic challenge with sparse treatment options. The effect of systemic chemotherapy remains limited inside the peritoneum due to low penetration and a relative resistance of peritoneal nodules. Heated IntraPeritoneal Chemotherapy (HIPEC) improves survival in selected patients but entails a high incidence of complications. Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) allows to disperse the active agents inside the peritoneal cavity by laparoscopy. Distribution and tissue penetration of chemotherapy by PIPAC are superior to HIPEC and systemic chemotherapy despite of lower doses. Systemic side effects are uncommon and surgical trauma is limited. Histological and clinical response rates in platinum-resistant patients approach 70% and survival data appear to be favorable compared with standard therapy. PMID:26255492

  8. Complications associated with intraventricular chemotherapy in patients with leptomeningeal metastases.

    Science.gov (United States)

    Chamberlain, M C; Kormanik, P A; Barba, D

    1997-11-01

    reservoirs are convenient and pharmacologically rational systems for administering intraventricular chemotherapy. Overall, serious complications requiring surgery are infrequent (6%) and most often secondary to catheter infections, Ommaya reservoir exposure, or initial catheter malpositioning. In the majority of instances, catheter infections may be managed medically, as may the most common complications of intraventricular chemotherapy including aseptic meningitis (43% of patients) and myelosuppression (18%). PMID:9347977

  9. Chemotherapy-induced peripheral neurotoxicity and complementary and alternative medicines: progress and perspective

    OpenAIRE

    Cheng, Xiao L.; Liu, Hong Q.; Wang, Qi; Huo, Jie G.; Wang, Xiao N.; Cao, Peng

    2015-01-01

    Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe and dose-limiting side effect of antineoplastic drugs. It can cause sensory, motor and autonomic system dysfunction, and ultimately force patients to discontinue chemotherapy. Until now, little is understood about CIPN and no consistent caring standard is available. Since CIPN is a multifactorial disease, the clinical efficacy of single pharmacological drugs is disappointing, prompting patients to seek alternative treatment opti...

  10. Chemotherapy-Induced Peripheral Neurotoxicity and Complementary and Alternative Medicines: Progress and Perspective

    OpenAIRE

    Xiao-Lan eCheng; Hong-Quan eLiu; Jie-Ge eHuo; Xiao-Ning eWang; Peng eCao

    2015-01-01

    Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe and dose-limiting side effect of antineoplastic drugs. It can cause sensory, motor and autonomic system dysfunction, and ultimately force patients to discontinue chemotherapy. Until now, little is understood about CIPN and no consistent standard of care is available. Since CIPN is a multifactorial disease, the clinical efficacy of single pharmacological drugs is disappointing, prompting patients to seek out alternative treatment...

  11. The Role of Intestinal Microbiota in the Development and Severity of Chemotherapy-Induced Mucositis

    OpenAIRE

    van Vliet, Michel J.; Hermie J M Harmsen; Eveline S. J. M. de Bont; Tissing, Wim J. E.

    2010-01-01

    Mucositis, also referred to as mucosal barrier injury, is one of the most debilitating side effects of radiotherapy and chemotherapy treatment. Clinically, mucositis is associated with pain, bacteremia, and malnutrition. Furthermore, mucositis is a frequent reason to postpone chemotherapy treatment, ultimately leading towards a higher mortality in cancer patients. According to the model introduced by Sonis, both inflammation and apoptosis of the mucosal barrier result in its discontinuity, th...

  12. The role of intestinal microbiota in the development and severity of chemotherapy-induced mucositis.

    OpenAIRE

    van Vliet, Michel J.; Hermie J M Harmsen; Eveline S. J. M. de Bont; Tissing, Wim J. E.

    2010-01-01

    Mucositis, also referred to as mucosal barrier injury, is one of the most debilitating side effects of radiotherapy and chemotherapy treatment. Clinically, mucositis is associated with pain, bacteremia, and malnutrition. Furthermore, mucositis is a frequent reason to postpone chemotherapy treatment, ultimately leading towards a higher mortality in cancer patients. According to the model introduced by Sonis, both inflammation and apoptosis of the mucosal barrier result in its discontinuity, th...

  13. [Chemotherapy-induced peripheral neuropathy: characteristics, diagnosis and treatment].

    Science.gov (United States)

    Istenes, Ildikó; Nagy, Zsolt; Demeter, Judit

    2016-06-01

    Longer remissions and better overall survival rates can be achieved with the introduction of new, effective treatments and targeted therapies in the past 1-2 decades, however, the incidence of side effects is also increasing parallelly. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially debilitating side effect due to peripheral somatic or autonomic nerve dysfunction. CIPN becomes increasingly important, as it affects patients' quality of life, and it is very often a dose limiting factor with the potential for reduced treatment efficacy. The pathomechanism, diagnosis, prevention and treatment possibilities are described in this review with special attention to the different groups of drugs. PMID:27275643

  14. Drug cocktail optimization in chemotherapy of cancer.

    Directory of Open Access Journals (Sweden)

    Saskia Preissner

    Full Text Available BACKGROUND: In general, drug metabolism has to be considered to avoid adverse effects and ineffective therapy. In particular, chemotherapeutic drug cocktails strain drug metabolizing enzymes especially the cytochrome P450 family (CYP. Furthermore, a number of important chemotherapeutic drugs such as cyclophosphamide, ifosfamide, tamoxifen or procarbazine are administered as prodrugs and have to be activated by CYP. Therefore, the genetic variability of these enzymes should be taken into account to design appropriate therapeutic regimens to avoid inadequate drug administration, toxicity and inefficiency. OBJECTIVE: The aim of this work was to find drug interactions and to avoid side effects or ineffective therapy in chemotherapy. DATA SOURCES AND METHODS: Information on drug administration in the therapy of leukemia and their drug metabolism was collected from scientific literature and various web resources. We carried out an automated textmining approach. Abstracts of PubMed were filtered for relevant articles using specific keywords. Abstracts were automatically screened for antineoplastic drugs and their synonyms in combination with a set of human CYPs in title or abstract. RESULTS: We present a comprehensive analysis of over 100 common cancer treatment regimens regarding drug-drug interactions and present alternatives avoiding CYP overload. Typical concomitant medication, e.g. antiemetics or antibiotics is a preferred subject to improvement. A webtool, which allows drug cocktail optimization was developed and is publicly available on http://bioinformatics.charite.de/chemotherapy.

  15. Agriculture, irrigation, and drainage on the west side of the San Joaquin Valley, California: Unified perspective on hydrogeology, geochemistry and management

    Energy Technology Data Exchange (ETDEWEB)

    Narasimhan, T.N.; Quinn, N.W.T.

    1996-03-01

    The purpose of this report is to provide a broad understanding of water-related issues of agriculture and drainage on the west side of the San Joaquin Valley. To this end, an attempt is made to review available literature on land and water resources of the San Joaquin Valley and to generate a process-oriented framework within which the various physical-, chemical-, biological- and economic components of the system and their interactions are placed in mutual perspective.

  16. Effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion treatment on malignant molecule expression in gastric cancer patients with ascites as well as side effect assessment

    Institute of Scientific and Technical Information of China (English)

    Shuo Jian

    2016-01-01

    Objective:To study the effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion on malignant molecule expression in gastric cancer patients with ascites as well as the related side effect.Methods: Gastric cancer patients with ascites who were treated in our hospital from February 2012 to July 2015 were selected as research subjects and randomly divided into perfusion chemotherapy group and routine chemotherapy group, and then overall chemotherapy conditions, ascites FGF molecule content, peripheral blood immune function indexes and the degree of side effect were compared between two groups. Results:Average treatment cycles of perfusion chemotherapy group were more than those of routine chemotherapy group, and ascites drainage volume within two cycles of chemotherapy was significantly less than that of routine chemotherapy group; after two cycles of chemotherapy, bFGF, FGF-2, FGF19 and FGFR4 content in ascites of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group, CD3+CD4+, CD3+CD56+ and CD3-CD56+ cell content in peripheral blood were higher than those of routine chemotherapy group, and CD3+CD8+ cell content was lower than that of routine chemotherapy group; during chemotherapy, the number of cases with decreased numeration of leukocyte, abnormal liver function, abnormal kidney function and diarrhea of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group.Conclusions: S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion chemotherapy can more effectively improve treatment compliance, suppress ascites, kill gastric cancer cells and improve immune function. It has fewer side effect and is the ideal way to treat gastric cancer with ascites.

  17. Acute emesis: moderately emetogenic chemotherapy

    DEFF Research Database (Denmark)

    Herrstedt, Jørn; Rapoport, Bernardo; Warr, David;

    2011-01-01

    This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the third Perugia Consensus Conference, which took place in June 2009. The review will focus on new studies appearing since the Second consensus conference...... version of the guidelines) are as follows: the best prophylaxis in patients receiving moderately emetogenic chemotherapy (not including a combination of an anthracycline plus cyclophosphamide) is the combination of palonosetron and dexamethasone on the day of chemotherapy, followed by dexamethasone...... on days 2-3. In patients receiving a combination of an anthracycline plus cyclophosphamide, a combination of a serotonin(3) receptor antagonist plus dexamethasone, plus the neurokinin(1) receptor antagonist aprepitant on the day of chemotherapy, followed by aprepitant days 2-3, is recommended....

  18. Current approaches to improve the anticancer chemotherapy with alkylating agents: state of the problem in world and Ukraine.

    Directory of Open Access Journals (Sweden)

    Iatsyshyna A. P.

    2012-01-01

    Full Text Available Alkylating agents are frequently used in many established anticancer chemotherapies. They alkylate the genomic DNA at various sites. Alkylation of the guanine at the O6-position is cytotoxic, it has the strongest mutagenic potential, as well as can cause the tumor development. Alkyl groups at the O6-position of guanine are removed by the DNA repair enzyme O6-methylguanine-DNA methyltransferase (MGMT. The effectiveness of alkylating chemotherapy is limited by MGMT in cancer cells and adverse toxic side effects in normal cells. Different approaches consisting in the modulation of the MGMT expression and activity are under development now to improve the cancer chemotherapy. They include two main directions, in particular, the increase in chemosensitivity of cancer cells to alkylating drugs and the protection of normal cells from the toxic side effects of chemotherapy. This review is focused on current attempts to improve the alkylating chemotherapy of malignant tumours worldwide and state of the issue in Ukraine

  19. EFFECT OF NEOADJUVANT CHEMOTHERAPY USING PACLITAXEL COMBINED WITH CARBOPLATIN ON ADVANCED NON-SMALL CELL LUNG CANCER

    Institute of Scientific and Technical Information of China (English)

    XIONG Hong-chao; CHEN Jin-feng; ZHANG Li-jian

    2006-01-01

    Objective: To assess the therapeutic effectiveness of preoperative neoadjuvant chemotherapy using a combination of paclitaxel and carboplatin on local advanced non-small cell lung cancer (NSCLC). Methods: Twenty-five patients with advanced NSCLC were treated with paclitaxel and carboplatin for 2 to 4 cycles before undergoing tumor resection and then postoperative chemotherapy/radiotherapy therapy for 2 to 4 cycles. Results: Following neoadjuvant chemotherapy, the most prominent side-effect was bone marrow restraint. The overall response rate of preoperative chemotherapy was 56%. The mean survival time was 26.5 months, with 1-, 2- and 5-year survival rates of 55%, 25%, and 16%, respectively. All NSCLC patients survived the perioperative period. Conclusion: Preoperative neoadjuvant chemotherapy combining paclitaxel and carboplatin produced minimal side-effect while increasing the probability that advanced NSCLC patients would be able to undergo surgery thus improving their prognosis.

  20. Research and Design of Demand Side Energy Efficiency Management and Demand Response System%电力需求侧能效管理与需求响应系统的研究与设计

    Institute of Scientific and Technical Information of China (English)

    闫华光; 陈宋宋; 钟鸣; 蒋利民

    2015-01-01

    为引导需求侧优化用能管理水平、参与电网高峰负荷削减,实现能源利用效率的整体提升,简述了电力需求侧能效管理与需求响应系统建设的背景、意义;概述了系统在监测用户能源消耗数据、控制用户关键用能系统或设备的运行状态、响应电网侧需求响应事件方面功能;提出了系统的层次结构并描述了各层之间的关系;详细设计了系统的物理架构、功能架构,并分析了系统关键技术。本设计方案已应用于国家电力需求侧管理平台、国家电网公司电能服务管理平台的研发建设,为国家电力需求侧管理工作提供了技术支撑。未来,将对为能效管理与需求响应业务在国内的推广实施奠定技术基础。%To guide the optimization of demand side energy utilization management level and to participate the peak load shaving of power grid to overall improve the energy utilization efficiency, both the background and the meaning of constructing the demand side energy efficiency management and demand response system are briefly explained; the functions of the demand side energy efficiency management and demand response system in following aspects such as monitoring user energy consumption data, controlling operating states of user’s key energy utilization system or devices, responding grid-side demand response event are summarized; the hierarchical structure of this system is proposed and the relationship among hierarchies are described; both physical architecture and functional structure of this system are designed in detail and key technologies of this system are analyzed. The design scheme presented in this paper has been applied in the development and construction of national power demand side management platform and electric energy service management platform of China State Power Grid Corp. to provide technical support for national electric power demand side management. In future, the

  1. Prophylactic and therapeutic management of oral complications related to chemotherapy and radiotherapy: role of dental oncology in cancer patient supportive therapy; Manejo profilatico e terapeutico das complicacoes orais associadas a quimioterapia e radioterapia: o papel da odontologia oncologica na terapia de suporte ao paciente com cancer

    Energy Technology Data Exchange (ETDEWEB)

    Buffarah, Henry Bittar [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Centro de Oncologia. Servico de Medicina Bucal]. E-mail: hbittar@terra.com.br

    2008-07-01

    Cancer patients under treatment of head and neck tumors as well as those under chemotherapy for hematologic cancers, such as lymphoma and leukemia, and those about to receive bone marrow grafts, do require preventive oral and dental care (prior to cancer treatment), as well as oral care during and after oncological treatment. Furthermore, chemo and radiotherapy-related adverse effects are also common in patients with other types of cancer, with an estimated frequency of 10 per cent in adjuvant chemotherapy (QT), 40 per cent in primary QT, 80 per cent in bone marrow transplantation, in which myeloablative regimens are introduced, and 100 per cent in head and neck radiotherapy, in which the targeted fields are those of the oral cavity. The dentist, specialized in dental oncology, works within the multidisciplinary team at the great centers of cancer treatment, contributing to improve the quality of life of these patients. The present review of literature and of the Guidelines for Management of Oral Complications of Chemotherapy and Head and Neck Radiation (US National Cancer Institute) aims to inform the clinical oncologist, the radio therapist, and other professionals about the resources available in Oral Supportive Therapy in both the prevention and managements of such complications. (author)

  2. Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer

    DEFF Research Database (Denmark)

    Sternberg, Cora N; Donat, S Machele; Bellmunt, Joaquim;

    2007-01-01

    To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review...... the published literature on chemotherapy for patients with locally advanced bladder cancer. This article reports the development of international guidelines for the treatment of patients with locally advanced bladder cancer with neoadjuvant and adjuvant chemotherapy. Bladder preservation is also discussed......, as is chemotherapy for patients with metastatic urothelial cancer. The conference panel consisted of 10 medical oncologists and urologists from 3 continents who are experts in this field and who reviewed the English-language literature through October 2004. Relevant English-language literature was identified...

  3. Chemotherapy for neuroendocrine tumors: the Beatson Oncology Centre experience.

    Science.gov (United States)

    Hatton, M Q; Reed, N S

    1997-01-01

    The role of chemotherapy in malignant neuroendocrine tumours is difficult to assess because of their rarity and variation in biological behaviour. We present a retrospective review of chemotherapy given to 18 patients with metastatic and one with locally advanced neuroendocrine tumours. There were eight poorly differentiated neuroendocrine tumours, six thyroid medullary carcinomas, two phaeochromocytomas, two pancreatic islet cell tumours and one undifferentiated neuroblastoma. Four patients were given 3-weekly dacarbazine, vincristine and cyclophosphamide (DOC) chemotherapy. In eight patients, this regimen was modified by substituting the dacarbazine and cisplatin and etoposide (OPEC). A further six patients were treated with dacarbazine reintroduced into the 3-weekly regimen (DOPEC). The remaining patient received cisplatin and etoposide. There were two complete responses (both with OPEC) and eight partial responses (two with DOC, three with OPEC and three with DOPEC). Five patients had stable disease and four progressed. Four received further chemotherapy on relapse, producing one complete and one partial response. The median response duration to initial chemotherapy was 10 months (range 3-34). The median survival was 12 months (range 1-42). The main toxicity was haematological, with grade 3-4 neutropenia in 12 patients; eight suffered episodes of sepsis. One death was treatment related. Other toxicity was mild although three patients discontinued vincristine with grade 2 neurotoxicity. The response rate and side effects of these three regimens appear comparable. We conclude that, although these patient numbers are small, combination chemotherapy produces an encouraging response rate (53%; 95% CI 30-75) in malignant neuroendocrine tumours, with acceptable toxicity. PMID:9448967

  4. Efficacy and safety of casopitant mesylate, a neurokinin 1 (NK1)-receptor antagonist, in prevention of chemotherapy-induced nausea and vomiting in patients receiving cisplatin-based highly emetogenic chemotherapy: a randomised, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Grunberg, Steven M; Rolski, Janusz; Strausz, Janos;

    2009-01-01

    BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) remains a clinical management problem after treatment with highly emetogenic chemotherapy (HEC). We therefore designed and carried out a multicentre, randomised, double-blind, placebo-controlled trial to assess whether a three-drug antie......BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) remains a clinical management problem after treatment with highly emetogenic chemotherapy (HEC). We therefore designed and carried out a multicentre, randomised, double-blind, placebo-controlled trial to assess whether a three...

  5. PHASE Ⅱ STUDY OF GEMCITABINE COMBINED WITH PLATINUM CHEMOTHERAPY FOR RECURRENT EPITHELIAL OVARIAN CANCER

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.Methods Phase Ⅱ study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50. 5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractor. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.Results A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10. 0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy.There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0. 061 ). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8 % of patients. Grade Ⅱ/Ⅲ anemia (54.5%) and grade Ⅲ/Ⅳ neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia,and 8 (36. 4% ) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treatment-associated death.Conclusion Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.

  6. One-sided arguments

    NARCIS (Netherlands)

    van Laar, J.A.

    2007-01-01

    When is an argument to be called one-sided? When is putting forward such an argument fallacious? How can we develop a model for critical discussion, such that a fallaciously one-sided argument corresponds to a violation of a discussion rule? These issues are dealt with within 'the limits of the dial

  7. Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy.

    Science.gov (United States)

    Hashiguchi, Yasunori; Kasai, Mari; Fukuda, Takeshi; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki

    2015-11-01

    Chemotherapy-induced neutropenia is a common complication in cancer treatment. In this study, we investigated chemotherapy-induced neutropenia that was recently detected in all patients with gynecologic malignancy. Between January 2009 and December 2011, we examined cases of chemotherapy-induced neutropenia reported in our hospital. We analyzed the incidence and clinical features of chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. During the study period, we administered over 1614 infusions (29 regimens) to 291 patients. The median age of the patients was 60 years (range 24-84 years). Chemotherapy-induced neutropenia occurred in 147 (50.5%) patients over 378 (23.4%) chemotherapy cycles. Febrile neutropenia occurred in 20 (6.9%) patients over 25 (1.5%) cycles. The mean duration of neutropenia and fever was 3.6 days (range 1-12 days) and 3.4 days (range 1-9 days), respectively. The source of fever was unexplained by examination or cultures in 14 (56.0%) cycles. There were two cases of neutropenia-related death. Chemotherapy-induced neutropenia was associated with older age (over 70 years) (PFebrile neutropenia was associated with poor performance status (Pneutropenia nor febrile neutropenia was associated with bone marrow metastases or previous radiotherapy. By identifying risk factors for febrile neutropenia, such as performance status, no previous chemotherapy, disseminated disease, and distant metastatic disease, the safe management of chemotherapy-induced neutropenia may be possible in patients with gynecologic malignancy.

  8. Salvage chemotherapy and surgery for radio recurrent carcinoma glottis

    Directory of Open Access Journals (Sweden)

    Varghese B

    2003-01-01

    Full Text Available Chemoradiotherapy is increasingly used in advanced laryngeal cancers. Failures are generally managed by surgery. They include histologically confirmed recurrent or residual disease or a symptomatic life threatening treatment sequelae. Tumour recurrence or residivism can be managed by chemotherapy when radical surgery is either refused by the patient or if the general condition of the patient do not permit it. However surgery becomes inevitable when life threatening treatment sequelae like absolute pharyngo-oesophageal stricture and aspiration sets in.

  9. Alterations of nutritional status: impact of chemotherapy and radiation therapy

    International Nuclear Information System (INIS)

    The nutritional status of a cancer patient may be affected by the tumor, the chemotherapy and/or radiation therapy directed against the tumor, and by complications associated with that therapy. Chemotherpay-radiotherapy is not confined exclusively to malignant cell populations; thus, normal tissues may also be affected by the therapy and may contribute to specific nutritional problems. Impaired nutrition due to anorexia, mucositis, nausea, vomiting, and diarrhea may be dependent upon the specific chemotherapeutic agent, dose, or schedule utilized. Similar side effects from radiation therapy depend upon the dose, fractionation, and volume irradiated. When combined modality treatment is given the nutritional consequences may be magnified. Prospective, randomized clinical trials are underway to investigate the efficacy of nutritional support during chemotherapy-radiotherapy on tolerance to treatment, complications from treatment, and response rates to treatment. Preliminary results demonstrate that the administration of total parenteral nutrition is successful in maintaining weight during radiation therapy and chemotherapy, but that weight loss occurs after discontinuation of nutritional support. Thus, longterm evaluation is mandatory to learn the impact of nutritional support on survival, diease-free survival, and complication rates, as well as on the possible prevention of morbidity associated with aggressive chemotherapy-radiation therapy

  10. Chemotherapy and radiotherapy in locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Brunet, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Alonso, C. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Llanos, M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Lacasta, A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Fuentes, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Mendoza, L.A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Badia, J.M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Delgado, E. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Ojeda, B. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain)

    1995-12-31

    Radiotherapy has been standard therapy for locally advanced squamous cell cervical cancer. Neoadjuvant chemotherapy is being studied to improve responses and survival. We report a phase II study in locally advanced squamous cell cervical cancer (FIGO stages III and IV A) using chemotherapy with bleomycin, methotrexate and cisplatin (BMP) followed by radical radiotherapy. Of the 35 patients, 31 in stage III and 4 in stage IV A, 3 complete responses (CR) and 22 partial responses (PR) were achieved after chemotherapy treatment. Thirty-one patients completed radiotherapy; 19 achieved CR and 4 PR. Five-year actuarial survival for the entire group was 45% (95% confidence interval, 37-53%) with a median survival of 56 months. Patients with CR had a significantly better survival: The 5-year actuarial survival was 74% (95% CI, 59-89%). Recurrence developed at 4 to 19 patients. The most frequent side-effects were nausea and vomiting. Myelosuppression and impaired renal function also occurred. There was no evidence of radiotherapy toxicity enhancement. The stage and Karnofsky index were significant prognostic factors. It is concluded that MBP chemotherapy in advanced cervical cancer is effective and, followed by radiotherapy, allows a good control of this tumor. The group of patients with complete response have a low rate of recurrences and a long survival chance. (orig.).

  11. Hybrid surgical management of a patient with an aneurysm of the arch and descending portion of the right-sided aorta combined with type B dissection and decompensated tracheal stenosis.

    Science.gov (United States)

    Belov, Yu V; Abugov, S A; Komarov, R N; Puretskiĭ, M V; Stepanenko, A B; Stogniĭ, N Yu; Magamadov, Ya U

    2011-01-01

    The right-sided aorta is a rare congenital abnormality of the cardiovascular system encountered in 0.05-0.1% of cases during roentgenological examinations and in 0.04-0.1% of cases of autopsy series. Given utterly low prevalence of this pathology, we considered it wise to present herein our own case report dealing with hybrid surgical management of a patient suffering from an aneurysm of both the arch and descending portion of the right-sided aorta combined with type B dissection thereof and decompensated tracheal stenosis. The first stage of the operation consisted in prosthetic repair of the distal third of the arch and the descending portion of the aorta with the "Vascutek" stent graft 20 mm with type 1 haemodynamical correction (i. e., re-establishing the blood flow into the true channel in the zone of the distal anastomosis) in the conditions of extracorporeal circulation (EC) and bihemispheric antegrade cerebral perfusion ACP, followed by replantation of the left subclavian artery ostium into the left common carotid artery. An aneurysmal growth rate of more than 1 cm a year was considered an absolute indication for the second stage of correction of the aortic pathology concerned. The second stage included stenting of the thoracic portion of the aorta. The TF262C150X Valiant thoracic stent graft was implanted into the area of the distal anastomosis with a conduit, followed by positioning the TF 323C150X Valiant thoracic system inserted into the distal end of the first stent. The use of hybrid techniques (a combination of open and endovascular interventions) predetermined the success of surgical management of the patient presenting with dissection of the right-sided aorta. PMID:22616242

  12. Adjuvant chemotherapy, a valuable alternative option in selected patients with cervical cancer.

    Directory of Open Access Journals (Sweden)

    Shuang Li

    Full Text Available Radiotherapy is the standard treatment for cervical cancer, but causes radiotherapy-induced complications. Recently, chemotherapy has been more extensively utilized. Here, we perform a large-scale comparison of chemotherapy and radiotherapy. From 2002 to 2008, 2,268 patients were grouped according to adjuvant radiotherapy or chemotherapy before and/or after surgery, and we compared the 5-year overall survival (OS and disease-free survival (DFS rates, recurrence rates, side effects, quality of life (QoL, and sexual activity. There were no significant differences between the treatment groups for the 5-year OS and DFS rates (OS: p = 0.053, DFS: p = 0.095, although marginally improved outcomes were observed in the chemotherapy group (OS: 86.5% vs. 82.8%; DFS: 84.5% vs. 81.4%. However, patients with early-stage disease, clinical response, and younger age had increased 5-year OS and DFS rates following chemotherapy compared to radiotherapy (p<0.05. The chemotherapy group exhibited significantly lower 5-year recurrence and distant failure rates compared to the radiotherapy group (p<0.001 and p = 0.007, respectively. Nausea and vomiting were the most frequent short-term complications of chemotherapy, whereas bowel and urinary complications were more frequent in the radiotherapy group. Compared to the chemotherapy group, patients who received radiotherapy reported a lower QoL, less frequent sexual activity, and more severe menopausal symptoms (p<0.05. Cervical cancer patients treated with chemotherapy, especially those with early-stage disease, clinical responses, and younger ages, have more positive outcomes, fewer complications, better QoL and sexual activity, suggesting that chemotherapy may be a valuable alternative option for selected patients.

  13. A meta-analysis of bevacizumab combined with chemotherapy in the treatment of ovarian cancer

    Directory of Open Access Journals (Sweden)

    T S Wang

    2014-01-01

    Full Text Available Introduction: Angiogenesis plays an important role in the biology of ovarian cancer. The clinical efficacy and side effects of bevacizumab, the vascular endothelial growth factor inhibitor, on survival and toxicity in women with this ovarian cancer, was not conclusive. We performed this systematic review and meta-analysis in order to clarify the efficacy of bevacizumab combined with chemotherapy in the treatment of ovarian cancer. Materials and Methods: We searched the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CNKI for clinical controlled trials of comparing bevacizumab combined with chemotherapy and chemotherapy alone in the treatment of ovarian cancer. The primary outcomes of eligible studies included median progression-free survival (PFS, overall survival (OS, and toxicities such as enterobrosis, hypertension, albuminuria, congestive heart failure (CHF, neutrophils, thrombosis, and bleeding. The Hazard ratio (HR and relative risk were used for the meta-analysis and were expressed with 95% confidence intervals (CIs. All the statistical analyses were carried out by  Stata 11.0 software (http://www.stata.com; Stata Corporation, College Station, TX, USA. Results: We included 5 studies with 1798 cases in the bevacizumab combined with the chemotherapy group and 1810 subjects in the chemotherapy alone group. The pooled results showed that bevacizumab + chemotherapy compared with chemotherapy alone can significant prolong the median PFS (HR, 0.64; 95% CI, 0.46-0.82; P 0.05; the toxicity analysis showed that the enterobrosis, hypertension, albuminuria, neutrophils, thrombosis, and bleeding were significantly increased in the bevacizumab + chemotherapy group compared with chemotherapy alone (Pall 0.05. Conclusion: Bevacizumab combined with chemotherapy prolonged the median PFS in patients with ovarian cancer but also increase the risk of developing enterobrosis, hypertension, albuminuria, neutrophils

  14. Side-wall sampler

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, B.

    1969-11-01

    A side-wall sampler which is capable of taking samples from the walls of test holes to a depth of 1,000 ft or more is described. Samples have been extracted from till, clay, silt, and fine- to coarse-grained sands in drift and nonindurated bedrock from more than 1,000 test holes in S. Saskatchewan. Side-hole sampling is faster and cheaper than conventional sampling methods and is ideally suited for geological investigations. Mineralogical paleonto- locical and radiocarbon analyses have been determined on side-hole cores.

  15. The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study

    NARCIS (Netherlands)

    Groot, S. de; Vreeswijk, M.P.; Welters, M.J.; Gravesteijn, G.; Boei, J.J.; Jochems, A.; Houtsma, D.; Putter, H.; Hoeven, J.J.M. van der; Nortier, J.W.; Pijl, H.; Kroep, J.R.

    2015-01-01

    BACKGROUND: Preclinical evidence shows that short-term fasting (STF) protects healthy cells against side effects of chemotherapy and makes cancer cells more vulnerable to it. This pilot study examines the feasibility of STF and its effects on tolerance of chemotherapy in a homogeneous patient group

  16. [Chemotherapy for CRPC].

    Science.gov (United States)

    Ozono, Seiichiro; Furuse, Hiroshi

    2014-12-01

    Cabazitaxel, new chemotherapeutic agent for castration resistant prostate cancer (CRPC) treated after docetaxel, was developed. In addition, new hormonal drugs for CRPC, such as enzalutamide and abiraterone were also approved in Japan recently. Treatment strategy for CRPC using these drugs is still controversial, therefore we need much more clinical data of Japanese patients with CRPC. Management of this severe condition and future of prostate cancer were discussed. PMID:25518353

  17. Special forest products: An east-side perspective. Interior Columbia Basin ecosystem management project: Scientific assessment. Forest Service general technical report

    Energy Technology Data Exchange (ETDEWEB)

    Schlosser, W.E.; Blatner, K.

    1997-02-01

    The special forest products industry has gained increasing attention, as timber harvest levels in the Pacific Northwest have declined, and has been heralded, at least by some, as a partial solution to the employment problems common throughout the rural areas of Washington, Oregon, Idaho, and Montana. To date, relatively little work has been published on those portions of the industry located east of the Cascade Range. Yet the east side produced about 48 percent of the total wild edible mushroom harvest (about 1.9 million pounds worth $11.8 million) during 1992. The region also accounts for all of the baby`s breath harvested in the Pacific Northwest and has the potential to produce large quantities of other foral products. It also seems to have the potential to become an important producer of other edibles and medicinal products; however, relatively little is known about this segment of the industry. The following report provides overview of the special forest products industry east of the Cascade Range and evaluates its potential for expansion.

  18. Neoadjuvant chemotherapy as ovarian cancer treatment

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Ottesen, Bent; Kehlet, Henrik;

    2012-01-01

    INTRODUCTION: The traditional first-line treatment for patients with advanced ovarian cancer with primary debulking surgery (PDS) and adjuvant chemotherapy is controversial as some authors report a potential benefit from the alternative treatment with neoadjuvant chemotherapy (NACT) and interval...

  19. Chemotherapy-related cognitive impairment in older patients with cancer

    Science.gov (United States)

    Loh, Kah Poh; Janelsins, Michelle C.; Mohile, Supriya G.; Holmes, Holly M.; Hsu, Tina; Inouye, Sharon K.; Karuturi, Meghan S.; Kimmick, Gretchen G.; Lichtman, Stuart M.; Magnuson, Allison; Whitehead, Mary I.; Wong, Melisa L.; Ahles, Tim A.

    2016-01-01

    Chemotherapy-related cognitive impairment (CRCI) can occur during or after chemotherapy and represents a concern for many patients with cancer. Among older patients with cancer, in whom there is little clinical trial evidence examining side effects like CRCI, many unanswered questions remain regarding risk for and resulting adverse outcomes from CRCI. Given the rising incidence of cancer with age, CRCI is of particular concern for older patients with cancer who receive treatment. Therefore, research related to CRCI in older patients with cancers is a high priority. In this manuscript, we discuss current gaps in research highlighting the lack of clinical studies of CRCI in older adults, the complex mechanisms of CRCI, and the challenges in measuring cognitive impairment in older patients with cancer. Although we focus on CRCI, we also discuss cognitive impairment related to cancer itself and other treatment modalities. We highlight several research priorities to improve the study of CRCI in older patients with cancer. PMID:27197918

  20. Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Georg, P.; Georg, D.; Poetter, R.; Doerr, W. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre; Boni, A.; Ghabuous, A. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Goldner, G.; Schmid, M.P. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre

    2013-07-15

    Background and purpose: To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof. Patients and methods: A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue - Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point). Results: Median follow-up was 44 months. Side effects (grade 1-4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively. Conclusion: Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information. (orig.)

  1. Chemotherapy and You: Support for People with Cancer

    Science.gov (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Chemotherapy and You: Support for People With Cancer Chemotherapy ... ePub This booklet covers: Questions and answers about chemotherapy. Answers common questions, such as what chemotherapy is ...

  2. The role of iron and zinc in chemotherapy-induced alopecia

    Science.gov (United States)

    Buyukavci, Mustafa; Gurol, Ali; Karabulut, Abdulhalik; Budak, Gokhan; Karacan, Mehmet

    2005-10-01

    Chemotherapy-induced alopecia is a common and distressing side effect in children with cancer. Iron and zinc are the well known trace elements which are associated with hair shedding. In this study, we investigated the hair content of iron and zinc in children with cancer consists of two groups: group A, newly diagnosed patients; group B, the patients received a course of chemotherapy. We compared the results between each others and healthy controls. Hair content of iron and zinc was not different between the patient groups. Iron concentrations of patient samples, either at diagnosis or after chemotherapy, were significantly lower than healthy controls. However, there was no statistically significant difference between the groups regarding the zinc values. In conclusion, hair content of iron and zinc do not have a role in chemotherapy-induced alopecia.

  3. Research Progress of Nutrition Support for Patients with Lung Cancer 
During Chemotherapy

    Directory of Open Access Journals (Sweden)

    Yiqiao LUO

    2014-12-01

    Full Text Available Primary lung cancer is one of the most common malignancies. Nowadays, both its morbidity and mortality rank first, patients with lung cancer are often goes with some affiliating symptoms such as malnutrition and weight loss. The side effects of cytotoxicity during chemotherapy may lead to further deteriorate of the nutritional status and worsen the anti-tumor therapy’s efficacy and the patients’ quality of life. With the development of palliative treatment and the higher request of patients for quality of life, nutritional support will be an important adjunctive treatment to maintain a good nutritional status and enhance the patients’ immunity during chemotherapy. It will play an active role in improving tolerability of chemotherapy and prognosis for patients with lung cancer. Here is a review about research progress of nutrition support treatment during chemotherapy for the patients with lung cancer.

  4. Changes in the gastric potential difference during chemotherapy in patients with metastatic breast cancer

    DEFF Research Database (Denmark)

    Fabrin, B; Højgaard, L; Mouridsen, H T

    1991-01-01

    Nausea and vomiting are frequent side-effects of intravenous cancer chemotherapy. How these complications were related to the gastric mucosal function was investigated by measuring the gastric mucosal potential difference (PD). Eight patients with metastatic breast cancer receiving chemotherapy...... were investigated. The liquid junction-corrected gastric PD and pH were measured with a newly developed microelectrode. The measurements started half an hour before chemotherapy and continued for 4-5 hours. Nausea, vomiting, psychological stress and sleeping episodes were registered. The initial PD...... values were -34 mV +/- 8 mV (mean +/- SD). During the observation period 6 of 8 patients had one or more episodes of nausea and vomiting. All episodes were preceded by a significant decline in PD. The magnitude of the decline in PD was unrelated to the time-lag between administration of chemotherapy...

  5. Chemotherapy-associated recurrent pneumothoraces in lymphangioleiomyomatosis.

    LENUS (Irish Health Repository)

    Kelly, Emer

    2012-02-01

    Lymphangioleiomyomatosis is a rare cause of pneumothorax in women. We present the case of a 48-year-old woman with lymphangioleiomyomatosis, who had never had a pneumothorax prior to commencing chemotherapy for breast cancer. During chemotherapy she developed 3 pneumothoraces and 2 episodes of pneumomediastinum. We suggest that the pneumothoraces were caused by the chemotherapy. To our knowledge, this is the first reported case of chemotherapy triggering pneumothoraces in a woman with lymphangioleiomyomatosis.

  6. Chemotherapy of human african trypanosomiasis.

    Science.gov (United States)

    Bacchi, Cyrus J

    2009-01-01

    Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  7. Chemotherapy of Human African Trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Cyrus J. Bacchi

    2009-01-01

    Full Text Available Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  8. [Psychoanalysis and Side Effect].

    Science.gov (United States)

    Shirahase, Joichiro

    2015-01-01

    A study of psychoanalysis from the perspective of side effects reveals that its history was a succession of measures to deal with its own side effects. This, however, does not merely suggest that, as a treatment method, psychoanalysis is incomplete and weak: rather, its history is a record of the growth and development of psychoanalysis that discovered therapeutic significance from phenomena that were initially regarded as side effects, made use of these discoveries, and elaborated them as a treatment method. The approach of research seen during the course of these developments is linked to the basic therapeutic approach of psychoanalysis. A therapist therefore does not draw conclusions about a patient's words and behaviors from a single aspect, but continues to make efforts to actively discover a variety of meanings and values from them, and to make the patient's life richer and more productive. This therapeutic approach is undoubtedly one of the unique aspects of psychoanalysis. I discuss the issue of psychoanalysis and side effects with the aim of clarifying this unique characteristic of psychoanalysis. The phenomenon called resistance inevitably emerges during the process of psychoanalytic treatment. Resistance can not only obstruct the progress of therapy; it also carries the risk of causing a variety of disadvantages to the patient. It can therefore be seen as an adverse effect. However, if we re-examine this phenomenon from the perspective of transference, we find that resistance is in fact a crucial tool in psychoanalysis, and included in its main effect, rather than a side effect. From the perspective of minimizing the character of resistance as a side effect and maximizing its character as a main effect, I have reviewed logical organization, dynamic evaluation, the structuring of treatment, the therapist's attitudes, and the training of therapists. I conclude by stating that psychoanalysis has aspects that do not match the perspective known as a side

  9. Synthesis of prodrugs of anthracyclines and evaluation of their use in selective chemotherapy

    NARCIS (Netherlands)

    Leenders, R.G.G.

    1998-01-01

    This thesis is devoted to the synthesis and biological evaluation of prodrugs of anthracycline anti-tumor antibiotics designed for use in selective chemotherapy. The severe side effects caused by conventional cancer chemotherapeutic agents arises from the lack of distinction between tumor and normal

  10. When Combined with Chemotherapy, Bevacizumab Is Associated with Increased Risk of Death

    Science.gov (United States)

    Cancer patients who receive the targeted therapy bevacizumab (Avastin) in combination with chemotherapy are at increased risk of serious side effects that may lead to death, according to a meta-analysis of 16 clinical trials that was published February 2,

  11. Chemotherapy e-prescribing: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Elsaid KA

    2015-05-01

    Full Text Available Khaled A Elsaid,1,2 Steven Garguilo,1 Christine M Collins2 1Department of Pharmaceutical Sciences, School of Pharmacy, MCPHS University, Boston, MA, 2Pharmacy Services, Rhode Island Hospital, Providence, RI, USA Abstract: Chemotherapy drugs are characterized by low therapeutic indices and significant toxicities at clinically prescribed doses, raising serious issues of drug safety. The safety of the chemotherapy medication use process is further challenged by regimen complexity and need to tailor treatment to patient status. Errors that occur during chemotherapy prescribing are associated with serious and life-threatening outcomes. Computerized provider order entry (CPOE systems were shown to reduce overall medication errors in ambulatory and inpatient settings. The adoption of chemotherapy CPOE is lagging due to financial cost and cultural and technological challenges. Institutions that adopted infusional or oral chemotherapy electronic prescribing modified existing CPOE systems to allow chemotherapy prescribing, implemented chemotherapy-specific CPOE systems, or developed home-grown chemotherapy electronic prescribing programs. Implementation of chemotherapy electronic prescribing was associated with a significant reduction in the risk of prescribing errors, most significantly dose calculation and adjustment errors. In certain cases, implementation of chemotherapy CPOE was shown to improve the chemotherapy use process. The implementation of chemotherapy CPOE may increase the risk of new types of errors, especially if processes are not redesigned and adapted to CPOE. Organizations aiming to implement chemotherapy CPOE should pursue a multidisciplinary approach engaging all stakeholders to guide system selection and implementation. Following implementation, organizations should develop and use a risk assessment process to identify and evaluate unanticipated consequences and CPOE-generated errors. The results of these analyses should serve to

  12. Complex changes in the apoptotic and cell differentiation programs during initiation of the hair follicle response to chemotherapy

    OpenAIRE

    Sharova, Tatyana Y.; Poterlowicz, Krzysztof; Botchkareva, Natalia V.; Kondratiev, Nikita A.; Aziz, Ahmar; Spiegel, Jeffrey H.; Botchkarev, Vladimir A.; Sharov, Andrey A.

    2014-01-01

    Chemotherapy has severe side-effects for normal rapidly proliferating organs, such as hair follicle, and causes massive apoptosis in hair matrix keratinocytes followed by hair loss. To define the molecular signature of hair follicle response to chemotherapy, human scalp hair follicles cultured ex vivo were treated with doxorubicin and global microarray analysis was performed 3 hours after treatment. Microarray data revealed changes in expression of 504 genes in doxorubicin-treated hair follic...

  13. Usability and Acceptability of a Web-Based Program for Chemotherapy-Induced Peripheral Neuropathy.

    Science.gov (United States)

    Tofthagen, Cindy; Kip, Kevin E; Passmore, Denise; Loy, Ian; Berry, Donna L

    2016-07-01

    Chemotherapy-induced neuropathy is a painful and debilitating adverse effect of certain chemotherapy drugs. There have not been any patient-centered, easily accessible Web-based interventions to assist with self-management of chemotherapy-induced neuropathy. The aims of this study were to evaluate usability and acceptability and to estimate an effect size of a Web-based intervention for assessing and managing chemotherapy-induced neuropathy. Participants (N = 14) were instructed to complete the Creativity, Optimism, Planning, and Expert Information for Chemotherapy-Induced Peripheral Neuropathy program and provide verbal responses to the program. Participants completed the Chemotherapy Induced Peripheral Neuropathy Assessment Tool and Post-Study System Usability Questionnaire. Iterative changes were made to the COPE-CIPN. Participants were asked to provide feedback on the revised COPE-CIPN, repeat the Chemotherapy Induced Peripheral Neuropathy Assessment Tool, and evaluate acceptability using the Acceptability e-Scale. The COPE-CIPN demonstrated high usability (mean, 1.98 [SD, 1.12]) and acceptability (mean, 4.40 [SD, 0.52]). Comments indicated that the interface was easy to use, and the information was helpful. While neuropathy symptoms continued to increase in this group of patients receiving neurotoxic chemotherapy, there was a decrease in mean level of interference with activities from 53.71 to 39.29 over 3 to 4 months, which indicated a moderate effect (d = 0.39) size. The COPE-CIPN may be a useful intervention to support self-management of chemotherapy-induced neuropathy. PMID:27116414

  14. Working the Dark Side

    DEFF Research Database (Denmark)

    Bjering, Jens Christian Borrebye

    half—dark side—documents the making and nature of the dark side by analyzing a series of legal memos from the Department of Justice's Office of Legal Council and from the White House and concludes by relating its findings to traditional ideas about emergency action, national security, and torture....... By analyzing official reports and testimonies from soldiers partaking in the War On Terror, the dissertation's second part—dark arts—focuses on the transformation of the dark side into a productive space in which “information” and the hunt for said information overshadowed all legal, ethical, or political...

  15. Residential Demand-Side Valuation of Interruptible Load Management for Air Conditioner%居民空调可中断管理的需求侧价值评估

    Institute of Scientific and Technical Information of China (English)

    赵媛; 俞炜华; 逄金栋; 沈淑琳; 李国平; 吴锴

    2012-01-01

    智能电网可以实现针对居民家庭不同电器终端的控制.评估不同电器终端的使用价值对于寻找目标人群和目标终端,从而细化需求侧管理(demand side management,DSM)具有重要意义.应用假设市场调研法(contingent valuation model,CVM)研究西安市居民在夏季用电高峰期使用空调的愿受价值(willingness to accept,WTA).在4种情景下分析管理的目标人群及影响因素,指出针对目标人群的调控可以以低成本提高用户响应,单纯的经济刺激可能难以实现既定的调峰目标.%Smart grid makes the control of residential end users possible. Measuring the value of different end users contributes to finding target population and further improve demand side management (DSM). This paper estimates the value of households' willingness-to-accept (WTA) for air conditioner in summer peak load period of Xi'an city by using of the contingent valuation method (CVM). Four scenarios are considered respectively to identify the target population and influencing factors. Calculation results show that cost-effective and better households' response could be implemented by DSM directing to target population, and pure economic incentive such as price signal may fail to fulfill the established object of peak load regulation.

  16. Development and application of information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province%江西省晚期血吸虫病人治疗救助信息管理系统开发与应用

    Institute of Scientific and Technical Information of China (English)

    毛远华; 李东; 宁安; 邱凌; 熊继杰

    2011-01-01

    Objective To develop the information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province. Methods Based on Access 2003, the system was programmed by Visual Basic 6. 0 and packaged by Setup Factory 8.0. Results In the system, advanced schistosomiasis data were able to be input, printed, indexed, and statistically analyzed. The system could be operated and maintained easily and timely. Conclusion The information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province is successfully developed.%目的 开发江西省晚期血吸虫病人治疗救助信息管理系统.方法 采用Access 2003数据库,利用Visual Basic 6.0程序设计语言编写应用程序,采用Setup Factory 8.0打包发布.结果 系统具有输入、输出、查询、统计和分析晚期血吸虫病人治疗救助数据的功能.系统操作简单,易于使用,维护成本低,数据查询和调用方便.结论成功开发了江西省晚期血吸虫病人治疗救助信息管理系统.

  17. Immunology of Photo(chemotherapy

    Directory of Open Access Journals (Sweden)

    Ekin Şavk

    2010-12-01

    Full Text Available Perhaps the oldest empirical therapeutic modality in the history of medicine, photo(chemotherapy has well documented benefits but its mode of action is not fully elucidated. Today, thanks to advances in photoimmunology and molecular biology we are provided with important clues as to how photo(chemotherapy works. Initial research on UV light and skin cancer has brought about the groundbreaking discovery of the immunological effects UV. UVB is the UV light most frequently used for therapeutic purposes and its mechanisms of action are best demonstrated. UV light has several distinct effects on various components of the innate and acquired immune systems, especially T lymphocyte functions the common endpoint of which is immune supression. The antiproliferative and antifibrotic therapeutic effects of UVA and UVB have so far not been directly associated with immunological mechanisms.

  18. Optimal Operation for Demand Side Management Based on Load-storage Microgrid%基于荷-储型微网的需求侧管理系统运行优化

    Institute of Scientific and Technical Information of China (English)

    何舜; 郑毅; 蔡旭; 吴小东; 时珊珊

    2015-01-01

    A novel demand-side dispatching method is put forward aiming at reducing electric cost and shifting load.According to Shanghai high-tech park”s microgrid,functions of controllable resources in the microgrid operation are analyzed.The demand-side management system uses storage resources and shiftable load resources to shed and optimize whole-day load curve in advance.Considering that the optimization is the nonlinear mixed integer programming,the particle swarm optimization (PSO) algorithm is employed to solve the problems.In addition,heuristic rules and iteration algorithm are combined to speed up the calculation and get better conclusion.Example indicates that by using the optimization of demand-side management system,not only the overall load peak is shifted,but also the electricity costs are reduced by the time of use price policy,the speed is more quickly,and the results are close to the conclusion delivered by centralization method.%以上海某科技园区微网为例,针对能源网节约用电费用和降低负荷峰值等目标,提出一种包含储能和可调控负荷资源的需求侧管理优化方法。该方法通过优化计算,预先制定储能资源和可平移负荷资源24 h 的运行状态,实现全天负荷的整体削减。考虑到整个优化过程为强非线性混合整数规划问题,求解困难,在粒子群优化算法基础上,提出经济性启发式规则和分解迭代思路相结合的求解策略。算例表明,文中提出的优化策略不仅降低了能源网整体负荷峰值,而且减少了能源网的用电费用。相对集中式算法,所给出的优化算法计算速度快,且结果与集中式算法接近。

  19. Induction Chemotherapy in Locally Advanced Pharyngolaryngeal Cancers with Stridor: Is It Feasible and Safe?

    Directory of Open Access Journals (Sweden)

    Vijay Maruti Patil

    2012-01-01

    Full Text Available Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.

  20. Colorectal cancers choosing sides

    NARCIS (Netherlands)

    Albuquerque, Cristina; Bakker, Elvira R. M.; van Veelen, Wendy; Smits, Ron

    2011-01-01

    In contrast to the majority of sporadic colorectal cancer which predominantly occur in the distal colon, most mismatch repair deficient tumours arise at the proximal side. At present, these regional preferences have not been explained properly. Recently, we have screened colorectal tumours for mutat

  1. Side effects of ergotamine

    NARCIS (Netherlands)

    Meyler, WJ

    1996-01-01

    Ergotamine has been used for many years in the treatment of migraine, although there is Little formal clinical evidence that it is significantly more efficacious than placebo. A number of side effects associated with ergotamine have been reported in the literature, including myocardial infarction, i

  2. Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma

    OpenAIRE

    Joshi, P.; V Patil; Joshi, A; V Norohna; Chaturvedi, P.; Chaukar, D.; P Pai; D Nair; Juvekar, S; Agarwal, J. P.; A K D′cruz; Prabhash, K

    2013-01-01

    Objective: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients. Materials and Methods: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 w...

  3. Cytologic changes of ovarian epithelial cancer induced by neoadjuvant chemotherapy

    OpenAIRE

    Wang, Yiying; Wang, Yue; Zheng, Wenxin

    2013-01-01

    Objective: Neoadjuvant chemotherapy (NACT) followed by cytoreduction has now become a part of standard care for patients with advanced ovarian cancer. Cytologic changes of the cancer cells induced by NACT, however, sometimes may cause confusion in terms of pathologic diagnosis and therefore inappropriate management. The objective of this study was to characterize the histologic or cytologic features of the ovarian cancers from those patients who received NACT in order to improve the diagnosti...

  4. Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study

    OpenAIRE

    Upasana Baruah; Debabrata Barmon; Amal Chandra Kataki; Pankaj Deka; Munlima Hazarika; Bhargab J Saikia

    2015-01-01

    Context: Patients with advanced ovarian cancer have a poor prognosis in spite of the best possible care. Primary debulking surgery has been the standard of care in advanced ovarian cancer; however, it is associated with high mortality and morbidity rates as shown in various studies. Several studies have discussed the benefit of neoadjuvant chemotherapy in patients with advanced ovarian cancer. Aims: This study aims to evaluate the survival statistics of the patients who have been managed with...

  5. Locally advanced pancreatic cancer. Looking beyond traditional chemotherapy and radiation.

    Science.gov (United States)

    Savir, Guy; Huber, Kathryn E; Saif, Muhammad Wasif

    2013-07-01

    About a third of all pancreatic cancer is found to be locally advanced at the time of diagnosis, where the tumor is inoperable but remains localized to the pancreas and regional lymphatics. Sadly, this remains a universally deadly disease with progression to distant disease being the predominant mode of failure and average survival under one year. Optimal treatment of these patients continues to be an area of controversy, with chemotherapy alone being the treatment preference in Europe, and chemotherapy followed by chemoradiation in selected patients, preferred in the USA. The aim of this paper is to summarize the key abstracts presented at the 2013 ASCO Annual Meeting that address evolving approaches to the management of locally advanced pancreatic cancer. The late breaking abstract (#LBA4003) provided additional European data showing non-superiority of chemoradiation compared to chemotherapy in locally advanced pancreatic cancer patients without distant progression following 4 months of chemotherapy. Another late breaking abstract, (#LBA4004), unfortunately showed a promising new complement to gemcitabine and capecitabine using immunotherapy in the form of a T-helper vaccine did not translate to improved survival in the phase III setting. PMID:23846922

  6. Systemic chemotherapy in inoperable or metastatic bladder cancer.

    Science.gov (United States)

    Bamias, A; Tiliakos, I; Karali, M-D; Dimopoulos, M A

    2006-04-01

    Urothelial cancer is a common malignancy. The management of patients with recurrent disease after cystectomy or initially metastatic or unresectable disease represents a therapeutic challenge. Systemic chemotherapy prolongs survival but long-term survival remains infrequent. During recent years there has been improvement due to the use of novel chemotherapeutic agents, mainly gemcitabine and the taxanes. The long-considered-standard MVAC has been challenged by combinations showing more favourable toxicity profiles and equal (gemcitabine-cisplatin) or even improved (dose-dense, G-CSF-supported MVAC) efficacy. Specific interest has also been generated in specific groups of patients (elderly patients, patients with renal function impairment or comorbidities), who are not fit for the standard cisplatin-based chemotherapy but can derive significant benefit from carboplatin- or taxane-based treatment. Retrospective analyses have enabled the identification of groups of patients with different prognoses, who possibly require different therapeutic approaches. Modern chemotherapy offers a chance of long-term survival in patients without visceral metastases, possibly in combination with definitive local treatment. Finally, the progress of targeted therapies in other neoplasms seems to be reflected in advanced bladder cancer by recent studies indicating that biological agents can be combined with modern chemotherapy. The true role of such therapies is currently being evaluated. PMID:16303860

  7. Communicating about chemotherapy-induced anemia.

    Science.gov (United States)

    Davidson, Brad; Blum, Diane; Cella, David; Hamilton, Heidi; Nail, Lillian; Waltzman, Roger

    2007-01-01

    Many validated instruments exist for determining the impact of chemotherapy-induced anemia and related fatigue on patient quality of life, but few studies analyze how healthcare providers actually discuss these subjects with patients. The authors share their study results on patterns of communication between participating patients and their physicians and allied health professionals. Letters of invitation were mailed to over 1,000 community-based oncologists, 15 of whom met the criteria and agreed to participate in this study on a first-enrolled basis until sufficient participation was ensured. In total, 36 of their patients were audio- and/or video-recorded during their regularly scheduled visits. Post-visit interviews were conducted separately with patients and participating healthcare professionals. Interviews were transcribed and analyzed using sociolinguistic techniques. Although 52% of visit time was spent discussing side effects and symptoms, most discussions of anemia and fatigue lacked specificity necessary to determine their true impact on patients' lives. Physician inquiries regarding fatigue also tended to be too brief to elicit patients' chief concerns. Vocabulary used to discuss anemia and related fatigue was variable and imprecise, and no fatigue assessment instrument was used or referenced in any visit. Community-based oncologists are encouraged to modify their vocabulary and consider incorporating a validated fatigue instrument, either within or before the consultation, to improve the quality of such communication. PMID:17265785

  8. Gerenciamento do lado da demanda no bombeamento de água para perímetro irrigado Demand side management for water pumping for irrigated perimeter

    Directory of Open Access Journals (Sweden)

    Maria J. de Moraes

    2011-09-01

    ´s load and the motor pump set performance. It is concluded that the frequency inverter use and the management of the availability of the number of hours of irrigation secure energy savings that varies around 7 to 62% for the studied combinations.

  9. Optimal Intermittent Dose Schedules for Chemotherapy Using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Nadia ALAM

    2013-08-01

    Full Text Available In this paper, a design method for optimal cancer chemotherapy schedules via genetic algorithm (GA is presented. The design targets the key objective of chemotherapy to minimize the size of cancer tumor after a predefined time with keeping toxic side effects in limit. This is a difficult target to achieve using conventional clinical methods due to poor therapeutic indices of existing anti-cancer drugs. Moreover, there are clinical limitations in treatment administration to maintain continuous treatment. Besides, carefully decided rest periods are recommended to for patient’s comfort. Three intermittent drug scheduling schemes are presented in this paper where GA is used to optimize the dose quantities and timings by satisfying several treatment constraints. All three schemes are found to be effective in total elimination of cancer tumor after an agreed treatment length. The number of cancer cells is found zero at the end of the treatment for all three cases with tolerable toxicity. Finally, two of the schemes, “Fixed interval variable dose (FIVD and “Periodic dose” that are periodic in characteristic have been emphasized due to their additional simplicity in administration along with friendliness to patients. responses to the designed treatment schedules. Therefore the proposed design method is capable of planning effective, simple, patient friendly and acceptable chemotherapy schedules.

  10. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy 
in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer

    Directory of Open Access Journals (Sweden)

    Pengfei LUO

    2011-07-01

    Full Text Available Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg, when patients’ general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times. Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 oC-41.5 oC for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m2 and vinorelbine (50 mg/m2. Results The complete remission rate (CR of malignant pericardial effusion was 54.3% and the response rate (RR was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05. After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05. The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosup-pression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia

  11. Demand side management strategy on multistep electricity price using Genetic Algo-rithm%遗传算法的阶梯电价用电需求管理方案

    Institute of Scientific and Technical Information of China (English)

    杨曦华; 胡晓敏

    2014-01-01

    Demand side management plays an important role in smart grid business, which allows consumers to choose a suitable electricity consuming strategy according to their demand, lowers the peak load in smart grid, and makes the load curve even. These characteristics lead to a more sustainable, economical smart grid, and a reduction on carbon emission. A demand side management strategy based on a load-shifting technique is proposed, which will be able to manage the demand that comes from large quantities and types of devices. The strategy is carried out with an improved genetic algorithm which imports a new operator. Simulation shows that the resulting strategy generated by the proposed algorithm saves appreciable cost, and reduces the peak load of the smart grid when involving a multistep electricity price.%用电需求管理是智能电网中的重要部分,能让消费者根据自己的用电量做出合适的决策,帮助供电者减少峰值负载,让负载的时空分布更为均衡,从而增加智能电网的可持续性,并减少运营成本和碳排放量。一种基于负载转移技术的用电需求管理方案可以满足对大量、多种设备的调节需求。用电需求管理的解决方案使用改进的遗传算法,并引入了一个新的算子,模拟测试的结果显示通过改进的算法获得的方案节省了可观的成本,并且在使用阶梯式电价的情况下,减少了智能电网的峰值负载。

  12. 遗传算法的阶梯电价用电需求管理方案%Demand side management strategy on multistep electricity price using Genetic Algo-rithm

    Institute of Scientific and Technical Information of China (English)

    杨曦华; 胡晓敏

    2014-01-01

    用电需求管理是智能电网中的重要部分,能让消费者根据自己的用电量做出合适的决策,帮助供电者减少峰值负载,让负载的时空分布更为均衡,从而增加智能电网的可持续性,并减少运营成本和碳排放量。一种基于负载转移技术的用电需求管理方案可以满足对大量、多种设备的调节需求。用电需求管理的解决方案使用改进的遗传算法,并引入了一个新的算子,模拟测试的结果显示通过改进的算法获得的方案节省了可观的成本,并且在使用阶梯式电价的情况下,减少了智能电网的峰值负载。%Demand side management plays an important role in smart grid business, which allows consumers to choose a suitable electricity consuming strategy according to their demand, lowers the peak load in smart grid, and makes the load curve even. These characteristics lead to a more sustainable, economical smart grid, and a reduction on carbon emission. A demand side management strategy based on a load-shifting technique is proposed, which will be able to manage the demand that comes from large quantities and types of devices. The strategy is carried out with an improved genetic algorithm which imports a new operator. Simulation shows that the resulting strategy generated by the proposed algorithm saves appreciable cost, and reduces the peak load of the smart grid when involving a multistep electricity price.

  13. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

    Energy Technology Data Exchange (ETDEWEB)

    Selle, F.; Gligorov, J. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Pierre & Marie Curie University (UPMC Paris VI), Paris (France); Richard, S.; Khalil, A. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Alexandre, I. [Medical Oncology Department, Hospital Centre of Bligny, Briis-sous-Forges (France); Avenin, D.; Provent, S.; Soares, D.G. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Lotz, J.P. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Pierre & Marie Curie University (UPMC Paris VI), Paris (France)

    2014-11-04

    Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.

  14. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

    International Nuclear Information System (INIS)

    Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis

  15. Engineered Ionizable Side Chains.

    Science.gov (United States)

    Cymes, Gisela D; Grosman, Claudio

    2015-01-01

    One of the great challenges of mechanistic ion-channel biology is to obtain structural information from well-defined functional states. In the case of neurotransmitter-gated ion channels, the open-channel conformation is particularly elusive owing to its transient nature and brief mean lifetime. In this Chapter, we show how the analysis of single-channel currents recorded from mutants engineered to contain single ionizable side chains in the transmembrane region can provide specific information about the open-channel conformation without any interference from the closed or desensitized conformations. The method takes advantage of the fact that the alternate binding and unbinding of protons to and from an ionizable side chain causes the charge of the protein to fluctuate by 1 unit. We show that, in mutant muscle acetylcholine nicotinic receptors (AChRs), this fluctuating charge affects the rate of ion conduction in such a way that individual proton-transfer events can be identified in a most straightforward manner. From the extent to which the single-channel current amplitude is reduced every time a proton binds, we can learn about the proximity of the engineered side chain to the lumen of the pore. And from the kinetics of proton binding and unbinding, we can calculate the side-chain's affinity for protons (pK a), and hence, we can learn about the electrostatic properties of the microenvironment around the introduced ionizable group. The application of this method to systematically mutated AChRs allowed us to identify unambiguously the stripes of the M1, M2 and M3 transmembrane α-helices that face the pore's lumen in the open-channel conformation in the context of a native membrane. PMID:26381938

  16. Ginger effects on control of chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Seyyed Meisam Ebrahimi

    2013-09-01

    Full Text Available Background : Chemotherapy-induced nausea (CIN in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem. Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally four times a day (1 gr/d and the same samples from the placebo group received starch capsules (250 mg, orally for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software. Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively. Also, the intensity (P=0.0001 and number (P=0.0001 of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications. Conclusion: Consuming ginger root powder capsules (1 gr/d from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can

  17. Revelations of supply-side structural reform to hospital management%供给侧结构性改革对医院管理的几点启示

    Institute of Scientific and Technical Information of China (English)

    唐羽

    2016-01-01

    The supply-side structural reform is a major adjustment of macroeconomic policy by the decision-making level under the adaption to “new normal” of economy and has far-reaching impact on future economy of China. Understanding and digestion of the policies of supply-side structural reform and its guidance to hospital management practices are of vital signiifcance to promoting scientiifc development of hospitals. 3 revelations are provided for hospital management by analyzing the theory of supply-side structural reform: 1. We should intensify the strategic vision and deepen and innovate development. We must firmly grasp the supply-side structural reform and accelerate the policy dividends distributed by new medical reform; 2. We should stick to starting from the supply-end, take provision of effective medical service as a key point of hospital development and take various measures to keep improving the total factor productivity of hospitals and enhance core competitiveness; and 3. We should stick to starting from the demand-end. With a foothold at the strategic orientation of hospitals, we should consolidate the target requirements, mine potential demands and solidify driving source for sustainable development of hospitals.%供给侧结构性改革是适应经济新常态下,决策层在宏观经济政策上的一次重大调整,其对未来中国经济的影响深远。了解供给侧结构性改革的政策主张,融会贯通,以此指导医院管理实践,对于推动医院科学发展意义重大。通过对供给侧结构性改革理论的分析,提出对医院管理的3点启示:一是要强化战略眼光,深化创新发展,牢牢把握供给侧结构性改革,加速新医改进程派发的政策红利;二是要坚持供给端发力,把提供有效的医疗服务作为医院发展的关键抓手,多措并举,不断提高医院总和要素生产率,提升核心竞争力;三是要坚持需求端发

  18. Effect of Neoadjuvant Chemotherapy on Improvement of Surgical Resectibility and Survival of Patients with Stage ⅢA Non Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    LIJian; YULichao; 等

    2002-01-01

    Ojbective To assess the effect of neoadjuvant chemotherapy on surgical resectibility and survival in patients with stage ⅢA non small cell lung cancer(NSCLC).Methods 42 patients with stage ⅢA NSCLC were randomized to receive either two cycles chemotherapy followed by surgery(neoadjuvant chemotherapy group)or surgery alone(surgery alone group).All patients received four cycles chemotherapy after surgery.Results The overall response to chemotherapy was 42.9%(38.1% partial response and 4.8% complete response).Toxicity of chemotherapy was minor and consisted mainly of gastroenterological side effects and myelosuppression.Patients treated with neoadjuvant chemotherapy had estimated surgical resection rate of 95.2%(n=20)and a complete resection rate in 52.4%(n=11) compared to 66.7%(n=14)and 28.6%(n=6)respectively,for patients with surgery alone(P<0.05).None of the patients died from the operation.The median survival was 24.6 months in the neoadjuvant chemotherapy group as compared to only 10.8 months in the surgery alone group(P<0.05).The 2-year survival rate was 57.1% in the chemotherapy group as compared to 28.6% in the surgery alone group(P<0.05).Conclusion Neoadjuvant chemotherapy improves the surgical resectibility and increases the median survival and 2-year survival rate of patients with stage ⅢA NSCLC.

  19. Effects of Combined Chinese Drugs and Chemotherapy in Treating Advanced Non-small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    陈衍智; 李占东; 高非; 张莹; 孙红; 李萍萍

    2009-01-01

    Objective:To evaluate the efficacy and side effects of combined Chinese drugs and chemotherapy in treating advanced non-small cell lung cancer(NSCLC).Methods:Sixty-three patients with stageⅢB andⅣNSCLC hospitalized from October 2001 to October 2008 were enrolled and assigned to two groups using a randomizing digital table,with 33 patients in the treatment group and 30 in the control group. They were all treated with the Navelbine and Cisplatin(NP) chemotherapy,but to the treatment group the Chinese drugs...

  20. Pharmacogenomics in lung cancer chemotherapy: a review of what the oncologist should know.

    Science.gov (United States)

    D'Antonio, Chiara; Milano, Annalisa; Righini, Riccardo; Onesti, Concetta Elisa; Bassanelli, Maria; Falcone, Rosa; Paris, Ida; Lauro, Salvatore; Marchetti, Paolo

    2014-10-01

    Lung cancer is the leading cause of cancer-related death around the world; the addition of chemotherapy to treatment of this disease has been shown to significantly increase progression-free survival and overall survival. Despite newer chemotherapies, it is important to personalize the care (treatment and dose) upon each single patient's susceptibility for controlling and reducing adverse side-effects, at best. The present review describes the current status of pharmacogenomics studies regarding germline DNA variants that may alter response and tolerability to chemotherapeutic agents used to treat lung cancer, including perspective studies.

  1. SEOM clinical guidelines for the treatment of antiemetic prophylaxis in cancer patients receiving chemotherapy.

    Science.gov (United States)

    García Gómez, Jesús; Pérez López, M Eva; García Mata, Jesús; Isla Casado, Dolores

    2010-11-01

    Chemotherapy-induced emesis is one of the most frequent side effects that affect the quality of life of cancer patients undergoing chemotherapy. In recent years, clinical research has allowed us to increase our therapeutic arsenal with new drugs that have increased efficiency in the control of nausea and vomiting associated with chemo. This guide provides and update of the earlier published by our society and represents the continued commitment of SEOM to move forward and improve in the supportive care of cancer patients. PMID:20974571

  2. Chemotherapy-induced nausea, vomiting, and fatigue--the role of individual differences related to sensory perception and autonomic reactivity

    DEFF Research Database (Denmark)

    Zachariae, R; Paulsen, K; Mehlsen, M;

    2007-01-01

    perception, somatosensory amplification, trait anxiety, and expected severity at baseline. Pretreatment distress and posttreatment nausea, vomiting, and fatigue were assessed at the 1st, 4th, 6th and last cycles of chemotherapy. RESULTS: While univariate analyses showed several factors to be associated...... with side effects, only absorption and pretreatment distress remained independent predictors of nausea and fatigue when controlling for the remaining factors. Posttreatment vomiting was only predicted by expected severity of vomiting. CONCLUSION: Chemotherapy-induced side effects are related to increased...

  3. [Chemotherapy for brain tumors in adult patients].

    Science.gov (United States)

    Weller, M

    2008-02-01

    Chemotherapy has become a third major treatment option for patients with brain tumors, in addition to surgery and radiotherapy. The role of chemotherapy in the treatment of gliomas is no longer limited to recurrent disease. Temozolomide has become the standard of care in newly diagnosed glioblastoma. Several ongoing trials seek to define the role of chemotherapy in the primary care of other gliomas. Some of these studies are no longer only based on histological diagnoses, but take into consideration molecular markers such as MGMT promoter methylation and loss of genetic material on chromosomal arms 1p and 19q. Outside such clinical trials chemotherapy is used in addition to radiotherapy, e.g., in anaplastic astrocytoma, medulloblastoma or germ cell tumors, or as an alternative to radiotherapy, e.g., in anaplastic oligodendroglial tumors or low-grade gliomas. In contrast, there is no established role for chemotherapy in other tumors such as ependymomas, meningiomas or neurinomas. Primary cerebral lymphomas are probably the only brain tumors which can be cured by chemotherapy alone and only by chemotherapy. The chemotherapy of brain metastases follows the recommendations for the respective primary tumors. Further, strategies of combined radiochemotherapy using mainly temozolomide or topotecan are currently explored. Leptomeningeal metastases are treated by radiotherapy or systemic or intrathecal chemotherapy depending on their pattern of growth. PMID:18253773

  4. Chemotherapie-induzierte Neuropathien (CIN

    Directory of Open Access Journals (Sweden)

    Vass A

    2009-01-01

    Full Text Available Durch Chemotherapie induzierte Neuropathien manifestieren sich meist als überwiegend sensorische Neuropathien, die zu Koordinationsstörungen und neuropathischen Schmerzen führen. Da es keine kausale Therapie gibt, stellen sie eine dosislimitierende Nebenwirkung der Tumortherapie dar. Hervorgerufen werden sie durch fünf Substanzgruppen: Platinderivate, Taxane, Vinca-Alkaloide sowie Bortezomib und Thalidomid. In dieser Übersicht wird auf die kumulativen Dosen dieser Substanzen und die jeweilige Symptomatik und Häufigkeit der dadurch entstehenden Neuropathien eingegangen.

  5. Chemotherapy

    Science.gov (United States)

    ... able to change the environment around the cell. Hormones—These substances may interfere with tumor growth by blocking the production of certain proteins in the tumor cells. Mitotic inhibitors—These agents are usually plant-based, natural substances that interfere with the production ...

  6. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  7. Environmental Management Accounting - Estimating the Benefit Side

    OpenAIRE

    Csutora, Mária

    2007-01-01

    The presentation focuses on estimating benefits of environmental projects and achievements like image improvement, gaining an environmental award, profit from environmentally benign products, risk reduction benefits, etc. The paper integrates the results and experience gained in three different fields: EMA, evaluation of natural resources and working as a consultant

  8. Demand side management for smart district heating

    DEFF Research Database (Denmark)

    Big, Oovidiu; Li, Hongwei; Svendsen, Svend

    2015-01-01

    The influence on the district heating network design and operation by using the energy storage capability inside the building is studied on different types of buildings under Danish climate. The building envelope has significant role in buildings energy consumption but also in building time const...

  9. Demand side management of electric car charging

    DEFF Research Database (Denmark)

    Finn, P.; Fitzpatrick, C.; Connolly, David

    2012-01-01

    the purchase of alternative energy vehicles in an effort to achieve 10% EV (electric vehicle) penetration in the country's road fleet by 2020. The replacement of ICE (internal combustion engine) vehicles with EV equivalents poses challenges for grid operators while simultaneously offering opportunities...

  10. Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study

    Directory of Open Access Journals (Sweden)

    Upasana Baruah

    2015-01-01

    Full Text Available Context: Patients with advanced ovarian cancer have a poor prognosis in spite of the best possible care. Primary debulking surgery has been the standard of care in advanced ovarian cancer; however, it is associated with high mortality and morbidity rates as shown in various studies. Several studies have discussed the benefit of neoadjuvant chemotherapy in patients with advanced ovarian cancer. Aims: This study aims to evaluate the survival statistics of the patients who have been managed with interval debulking surgery (IDS from January 2007 to December 2009. Materials and Methods: During the period from January 2007 to December 2009, a retrospective analysis of 104 patients who underwent IDS for stage IIIC or IV advanced epithelial ovarian cancer at our institute were selected for the study. IDS was attempted after three to five courses of chemotherapy with paclitaxal (175 mg/m 2 and carboplatin (5-6 of area under curve. Overall survival (OS and progression free survival (PFS were compared with results of primary debulking study from existing literature. OS and PFS rates were estimated by means of the Kaplan-Meier method. Results were statistically analyzed by IBM SPSS Statistics 19. Results: The median OS was 26 months and the median PFS was 18 months. In multivariate analysis it was found that both OS and PFS was affected by the stage, and extent of debulking. Conclusions: Neoadjuvant chemotherapy, followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers.

  11. Putting the Side first

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    SIDE Minerals is a relative newcomer to the South African mining industry. It combines coal and anthracite mining and has base and precious metal interests. Side Minerals has offices in Boksburg from where its mining operations in Delmas, Witbank and Carolina in the Eastern Transvaal, and Newcastle in Natal are controlled. Lakeside Colliery at Witbank -a mine with a life expectancy of 15 years - is both an underground and opencast operation with an annual production capacity of 1,2 Mt of high, medium and low grade coal. Opencast extraction there is by the strip mining method. This is done on contract by Concor Mining Opencast Division, a member of the Concor Holding Group. A high wall face provides entry to the underground operations. Eastside Colliery at Carolina, which has the capacity to produce 480 000 tons of coal a year, is currently an opencast operation with underground mining scheduled to begin during 1994. Westside Colliery near Delmas is on a care and maintenance basis, but it has the capacity to produce 600 000 tons of low grade phosphorous coal which is required by the ferro-alloy and steel industries. 2 figs.

  12. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects.

    Science.gov (United States)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthoj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

    2013-02-01

    Abstract These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful. They are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F) and five levels of recommendation (1-5) ( Bandelow et al. 2008a ,b, World J Biol Psychiatry 9:242, see Table 1 ). This second part of the updated guidelines covers long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of adults suffering from schizophrenia.

  13. Treating gastrointestinal cancer by intervention, intraperitoneal hyperthermic perfusion chemotherapy, intravenous micro-pump chemotherapy

    International Nuclear Information System (INIS)

    157 cases of gastrointestinal cancer patients after resection were randomly divided into treated group and control group. The treated group (intraperitoneal hyperthermic perfusion chemotherapy combined with postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy) consisted of 72 cases, the control group (Intravenous chemotherapy), 85 cases. The peritoneal and hepatic metastasis rates and 3 a survival rate were studied. The intraperitoneal hyperthermic perfusion chemotherapy combined with the postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy is an effective way to control the recurrence on the peritoneal and hepatic metastasis of advanced gastrointestinal neoplasms after operation. (authors)

  14. [A case of secondary sclerosing cholangitis caused by chemotherapy with nab-paclitaxel].

    Science.gov (United States)

    Matsuo, Taku; Nakamura, Yukiko; Suzuki, Koji

    2015-05-01

    A 73-year-old woman had received 9 months of chemotherapy with nab-paclitaxel for locally advanced breast cancer. During the treatment, she was well and showed no major side effects except for alopecia and arthralgia. The tumor showed a tendency to reduction. However, chemotherapy was discontinued because of liver dysfunction. MRCP and ERCP demonstrated multiple stenoses of the hepatic ducts and the intrahepatic bile ducts. We diagnosed chemotherapy-induced sclerosing cholangitis caused by nab-paclitaxel. Treatment with ursodeoxycholic acid and steroid was ineffective. We added bezafibrate, which resulted in a gradual improvement in liver function. To the best of our knowledge, this is the first reported case of nab-paclitaxel-induced secondary sclerosing cholangitis. PMID:25947025

  15. Combination chemotherapy for advanced diffuse non-Hodgkin's lymphomas in relapse following local radiotherapy

    International Nuclear Information System (INIS)

    Eleven patients with advanced diffuse non-Ho-dgkin's lymphoma arising from head and neck in relapse following local radiotherapy were treated with C-MOPP or Adriamycin-based combination chemotherapy. Eight patients had diffuse lymphoma of large cell type, two diffuse lymphoma of medium-sized cell type and one pleomorphic type of lymphoma. Complete remission was obtained in 8 of 11 patients (72.7 %). Three of these had relapsed within two years after completion of combination chemotherapy; all of three expired at 27 months, 41 months and 48 months, respectively. On the other hand, three patients whose complete remission lasted beyond two years still survive 46 months, 48 months, and 66 months without recurrence. The main side-effects during induction chemotherapy was bone marrow suppression and its related infections. (author)

  16. Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic.Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However, the response rates have been highly variable, and are often irreproducible. To improve this low response rate, various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug, generating higher local drug concentrations in tumor cells with lower toxicity.Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and, simultaneously, a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.

  17. Radio-induced oral and pharyngeal mucositis: Management updates

    International Nuclear Information System (INIS)

    Mucositis is a major side effect induced by radiotherapy and/or chemotherapy of head and neck cancer. This toxicity impacts patient's quality of life and may compromise optimal treatments. Pathophysiology, risk factors, incidence and consequences of mucositis will be discussed in this review. Its management remains principally supportive (pain medication and nutritional support); however, in recent years several studies have revealed that the use of low level energy laser is particularly useful in the prevention and treatment of chemo- and radio-induced mucositis. (authors)

  18. Hyperthermic intraperitoneal chemotherapy: Rationale and technique

    OpenAIRE

    González-Moreno, Santiago; González-Bayón, Luis A; Ortega-Pérez, Gloria

    2010-01-01

    The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms, either primary or secondary to digestive or gynecologic malignancy. Hyperthermic intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is finalized, constitutes the most common form of administration of perioperative intrap...

  19. Therapeutic Management of Colon Cancer

    Directory of Open Access Journals (Sweden)

    Ana-Maria Todosi

    2014-09-01

    Full Text Available Colorectal cancer is a major public health problem worldwide, and a major cause of mortality and morbidity. Correct pretherapeutic staging has the role of guiding the management of colon cancer patients. The diagnosis is guided by the clinical symptoms. Chemotherapy is an important part of colon cancer treatment. Chemotherapy regimens are adapted to tumor stage and patient status and have various side effects and variable survival outcomes. International guidelines recommend different treatments depending on the presence or absence of metastases. The primary goal of treatment in nonmetastatic colon cancer is surgical removal of the tumor which could be the first step of the complex therapy or preceded by neoadjuvant therapy, depending on pretherapeutic staging. In resectable nonmetastatic tumors the preferred surgical procedure is colectomy with en bloc removal of regional lymph nodes. The extent of colectomy should be based on tumor location. The management of metastatic colon cancer also targets the therapeutic approach of the metastatic disease. Therapy is standardized and applied according to tumor stage. Surveillance has a major role in therapeutic success, reason why a time schedule and a protocol adapted to the primary lesion are essential. The goal of implementing the recommendations of international guidelines for the treatment of colon cancer is to provide a uniform treatment for this disease in view of improving overall survival of patients.

  20. Comparing Different Antiemetic Regimens for Chemotherapy Induced Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Sayantani Ghosh

    2010-05-01

    patients (76.8% in the ondansetron group and 210 of 254 patients (82.6% in granisetron group. During the delayed phase, 63 patients (67.7% had complete response in the palonosetron group compared with 216 patients (57% in the ondansetron group and 162 patients (63.8% in granisetron group. Main treatment related side effects were constipation and elevation of liver enzymes which was comparable for all the 3 drugs. Conclusion: When administered with dexamethasone before chemotherapy, although palonosetron is found to be more efficacious, cost wise ondansetron may be preferred in highly emetogenic regimens, although palonosetron requires only a single dosing. However in moderately emetogenic regimens, granisetron outshines ondansetron and is further outshined by palonosetron in both acute and delayed emesis and thus the decision should be taken as per patient profile. Study Limitations: The study has fewer numbers of patients taking palonosetron due to financial limitations of the patients, which is present in any developing country. Although we have compared the cost and availability of the 3 drugs, a detailed cost analysis could not be done due to paucity of resources.

  1. Probiotics: Safety and Side Effects

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Probiotics Safety and Side Effects Past Issues / Winter 2016 ... Says About the Safety and Side Effects of Probiotics Whether probiotics are likely to be safe for ...

  2. 电力需求侧管理城市综合试点给电网企业带来的机遇和挑战%Power demand side management opportunities and challenges of integrated and pilot city brought to power grid enterprises

    Institute of Scientific and Technical Information of China (English)

    何湛邦

    2013-01-01

    佛山市全国成为开展电力需求侧管理综合试点工作的首批四个试点城市之一。作为为实施电力需求侧管理工作的主体单位,佛山供电局面临巨大的机遇和挑战。本文通过分析电力需求侧管理优势和现状存在的不足,为电力需求侧管理健康发展提出了具体建议措施。%Foshan City,China has become one of the developing power demand side management pilot work of the first four pilot city.As for the management of the implementation of power demand side body unit,Foshan Power Supply Bureau is facing great opportunities and challenges.By analyzing the deficiency of power de-mand side management advantages and status of existence,the concrete measures for the healthy development of power demand side management put forward.

  3. Chemotherapy of metastatic colon cancer

    Directory of Open Access Journals (Sweden)

    M. Yu. Fedyanin

    2012-01-01

    Full Text Available Colorectal cancer is one of the leading causes of cancer incidence and mortality. In 2008 inRussian Federation55 719 new cases of colorectal cancer were diagnosed and 37 911 patients died of this disease. A significant progress was achieved in metastatic colorectal cancer treatment during the last decades. A lot of treatment options became available: from 5-fluoruracil monotherapy to combined treatment treatment schemes including surgery. A group of patients with isolated liver metastases was distinguished, who can achieve 5-year survival rate of 40 % after systemic treatment and surgery. Today, based on clinical data and molecular analysis, we come close to individualized treatment of this patient group. In this literature review results of metastatic colorectal cancer chemotherapy are being analyzed and rational treatment tactic is proposed based on therapy goals. 

  4. HIV Medicines and Side Effects

    Science.gov (United States)

    Side Effects of HIV Medicines HIV Medicines and Side Effects (Last updated 1/7/2016; last reviewed 1/7/2016) Key Points HIV medicines help people with ... will depend on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people ...

  5. Sustainable complete remission in recurrence yolk sac tumor patient treated with tandem high-dose chemotherapy and autologous stem cell.

    Science.gov (United States)

    Abdullah, N A; Wang, P N; Huang, K G; Adlan, A S; Casanova, J

    2013-01-01

    A 21-year-old lady diagnosed with Stage 3 ovarian yolk sac tumor (YST) underwent primary cytoreductive fertility sparing surgery, followed by conventional courses of platinum-based chemotherapy and etoposide. Recurrence at cul-da-sac was noted after a short period of remission and secondary debulking performed followed by four cycles of conventional chemotherapy. The patient's disease progressed despite courses of treatments. A joint team management including a hematologist was commenced following the failure of conventional chemotherapies. Two cycles of high-dose chemotherapy (HDCT) with ifosfamide/cisplatin/etoposide (ICE) regimen, followed by autologous stem cell transplantation (ASCT) were given. With this salvage treatment, she remained in complete remission and disease-free for more than 30 months, while maintaining her reproductive function. These approaches appear to be effective as a salvage treatment in selected cases of patients with ovarian germ cell tumor, especially those who failed primary conventional chemotherapy. PMID:23781595

  6. Weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer for patients ineligible for 3 weekly maximum tolerable dose chemotherapy

    OpenAIRE

    Vijay Maruti Patil; Vanita Noronha; Amit Joshi; Vamshi Krishna Muddu; Sachin Dhumal; Supreeta Arya; Shashikant Juvekar; P Pai; Pankaj Chatturvedi; Arvind Chaukar Devendra; Sarbani Ghosh; Anil D′cruz; Prabhash Kumar

    2014-01-01

    Objective: To study the safety and efficacy of weekly chemotherapy as part of induction chemotherapy, in locally advanced head and neck cancer for patients, who are unfit for upfront radical treatment. Materials and Methods: It is a retrospective analysis of on-use weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer, who are technically unresectable are unfit for upfront radical treatment. Induction chemotherapy given was a 2 drug combination of paclitaxel (...

  7. Pharmacogenetics in cancer chemotherapy: balancing toxicity and response.

    Science.gov (United States)

    Donnelly, James G

    2004-04-01

    The goal of chemotherapy is the elimination of tumor cells from the host. This is achieved by the use of therapeutic agents that are often more harmful to normal tissues than to the targeted tumor. Many chemotherapeutic agents are designed to damage cell replication machinery either directly at the level of DNA or indirectly, by inhibiting enzymes involved with DNA repair and synthesis. Novel therapeutic agents that exert their effects at signal transduction pathways have advanced chemotherapy; however, a role for the classic chemotherapeutic agents remains. These classic agents are associated with tumor cell resistance, toxicity, and occasionally secondary neoplasia. Current practices for the dosing of therapeutic agents rely on height and body surface measurements or drug monitoring and Bayesian adaptive control. Pharmacogenetics is emerging as an alternate approach to managing chemotherapy that may prevent undertreatment while avoiding overtreatment and associated toxicities. By determining the polymorphic genetic makeup of the host and, in some instances, the altered genetic expression of the tumor, chemotherapy can be tailored for interindividual response and toxicity avoidance. Chemotherapy is particularly applicable to the pharmacogenetic approach to tailored therapy for a number of reasons. The margin of safety is low with chemotherapeutic agents. Some drugs require biotransformation for activation. Drug activation correlates with toxicity. The pathways of drug clearance or inactivation exhibit polymorphic differences. Interindividual, race-specific, and age-related responses to chemotherapeutic agents are common. Last, drug resistance can be inherent to the tumor as a result of the suppression of apoptosis. Variations in response and toxicity to a specific drug can be caused by alterations in drug-metabolizing enzymes or receptor expression. These effects can be classed as pharmacokinetic and pharmacogenetic differences. Some of the genes known to display

  8. Remission rates following preoperative chemotherapy and radiation therapy in patients with breast cancer

    International Nuclear Information System (INIS)

    Seventy-three patients with 74 biopsy-proven invasive breast cancers prospectively entered the protocol. Eighteen patients were treated by neoadjuvant chemotherapy followed by surgery and adjuvant irradiation (chemotherapy group). Fifty-five patients with 56 tumors were treated with combined neoadjuvant chemo-radiotherapy, followed by surgery (chemo-radiotherapy group). Most patients of both treatment groups received 4 cycles of EC chemotherapy. In some patients with large tumors 3 cycles of CMF were added. Chemotherapy was followed by hormonal treatment with tamoxifen or LHRH agonists in case of positive hormone-receptor status. Preoperative radiotherapy was administered using 2 Gy fractions up to a total dose of 50 Gy, followed by a tumor boost of 6 to 11 Gy. The median overall treatment time was 41 days (range: 35 to 55 days). The median time interval between end of neoadjuvant therapy and surgery was 11 weeks (range: 10 to 22 weeks) and 27 weeks (range: 11 to 41 weeks) for the chemotherapy- and chemo-radiotherapy group. The median time interval between end of chemotherapy and the beginning of irradiation ranged between 2 and 8 weeks (median 4 weeks) in the chemo-radiotherapy group. Results: Side-effects due to chemo- or radiotherapy were moderate and reversible. In the chemotherapy group 17/18 patients (94%) achieved a partial (pPR) and 1/18 patients (6%) a complete histopathological response (pCR). In the chemo-radiotherapy group 32/56 (57%) showed a pPR and 24/56 (43%) a pCR. The difference in complete remission is significant (Fisher's Exact Test: p=0.004). In 45/74 cases (61%) the breast was preserved, immediate breast reconstructions with rectus myocutaneous flaps (TRAM) after mastectomy were performed in 8/74 cases (11%) and modified radical mastectomies without reconstruction were required in 21/74 cases (28%). The breast conservation rates were similar in both treatment groups. (orig.)

  9. Long-term follow-up of salvage radiotherapy in Hodgkin's lymphoma after chemotherapy failure

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term results of salvage radiotherapy (SRT) for Hodgkin's lymphoma after chemotherapy failure. Methods and Materials: We reviewed 81 patients undergoing SRT for persistent or recurrent Hodgkin's lymphoma after chemotherapy; 19 also received conventional-dose salvage chemotherapy. Results: At SRT, the median patient age was 31 years. Of the 81 patients, 81% had Stage I-II, 25.9% had B symptoms, 14.8% had bulky disease, and 7.4% had extranodal disease. A less than a complete response (CR) to the last chemotherapy regimen occurred in 47%. SRT was generally limited to one side of the diaphragm, and the median dose was 36 Gy. After SRT, 75% of patients achieved a CR, with 82% retaining durable in-field control. In-field failure was associated with less than a CR to the last chemotherapy regimen (p = 0.0287). Most failures were at distant sites, with 60% in previously involved sites. The 10-year freedom from treatment failure and overall survival rates were 32.8% and 45.7%, respectively. The adverse prognostic factors for freedom from treatment failure were age >50 years (p 50 years (p < 0.001), B symptoms (p = 0.002), and less than a CR to the last chemotherapy regimen (p = 0.002). Favorable cohorts had a 10-year freedom from treatment failure rate of 51% and overall survival rate of 92%. Conclusions: Salvage radiotherapy is effective for selected patients with Hodgkin's lymphoma after chemotherapy failure and should be considered for incorporation into salvage programs

  10. Therapeutic effect analysis of different neoadjuvant chemotherapy on the locally cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Li

    2015-01-01

    Objective:To explore the therapeutic effect of different neoadjuvant chemotherapy on the locally cervical cancer.Methods:A total of 85 patients with cervical cancer for the initial treatment who were admitted in our hospital from January, 2011 to January, 2013 were included in the study and divided into the observation group and the control group according to different chemotherapy regimens. The way of drug administration is by transcatheter arterial chemoembolization (TACE). The patients in the observation group were given Taxol in combined with carboplatin for neoadjuvant chemotherapy, while the patients in the control group were given irinotecan in combined with carboplatin. The remission degree of clinical symptoms, chemotherapeutic effect, toxic and side effect, and operation evaluation 14 and 20 days after chemotherapy were evaluated.Results:The comparison of clinical symptom remission between the two groups was not statistically significant. The occurrence rate of myelosuppression in III-IV degree in the observation was significantly higher than that in the control group, but the occurrence rate of diarrhea was significantly lower than that in the control group. The comparisons of operation time and intraoperative amount of bleeding after chemotherapy between the two groups were not statistically significant. The comparisons of the occurrence rates of parametrial infiltration and lymphatic metastasis and the muscular layer invasion depth were not statistically significant.Conclusions:Arterial embolism neoadjuvant chemotherapy can obviously shorten the tumor volume in patients with local cervical cancer, relieve the clinical symptoms, and enhance the living qualities, but in the clinical application, appropriate chemotherapy regimen should be chosen according to the specific condition.

  11. Efficacy of HPA Lanolin® in treatment of lip alterations related to chemotherapy

    Directory of Open Access Journals (Sweden)

    Paulo Sergio da Silva Santos

    2013-04-01

    Full Text Available The side effects of chemotherapy on the lips may cause esthetic and functional impact and increase the risk of infection. HPA Lanolin® is an option for supportive therapy because it has anti-inflammatory, antimicrobial and moisturizing properties. Objective: To evaluate the efficacy of this product in the prevention of lip alterations in a population of patients undergoing chemotherapy. Material and Methods: Patients undergoing chemotherapy (n = 57 were examined and distributed into two groups: study (used HPA Lanolin® and control (without supportive therapy on the lips. We evaluated the patients two weeks after chemotherapy, registering oral alterations, symptoms of pain, discomfort, limitation of mouth opening and dehydration, classified according to a visual analogue scale. Results: Patients who used HPA Lanolin® had lower dehydration and experienced improvement of lip dryness (p<0.001. The main symptoms were dehydration, discomfort, limitation of mouth opening, pain. The main clinical signs were dry lips, mucositis, cheilitis, hematoma, swelling and cracking. We found no difference concerning the variables of pain, discomfort, and limitation of mouth opening between the study and control group. Conclusions: We suggest that HPA Lanolin® is effective in reducing the symptoms of dehydration and the signs of lip dryness resulting from toxicity of chemotherapy, proving to be an interesting alternative supportive therapy for cancer patients.

  12. Bone Mineral Density, Growth, and Thyroid Function in Long-Term Survivors of Pediatric Hodgkin's Lymphoma Treated with Chemotherapy Only

    NARCIS (Netherlands)

    R.D. van Beek; M.M. van den Heuvel-Eibrink; F.G. Hakvoort-Cammel; C. van den Bos; H.J.H. van der Pal; E.P. Krenning; Y.B. de Rijke; R. Pieters; S.M.P.F. de Muinck Keizer-Schrama

    2009-01-01

    Background: The aim of this study was to investigate the long-term side effects of treatment for childhood Hodgkin's lymphoma with chemotherapy only on growth, bone mineral density (BMD), body composition, and thyroid function. Procedure: A total of 88 patients (56 male, 32 female; 17.6-42.6 yr), tr

  13. Intelligent energy management system in demand-side for energy-saving service%面向节能服务的智能化需求侧能效管理系统

    Institute of Scientific and Technical Information of China (English)

    戴聿雯; 胡健; 林士明; 程周育

    2012-01-01

    当今社会正面临着节能减排的压力和考验,电网企业迫切需要一种科学的方法来综合考虑客户需求和电网体系,并采取有效的节能措施提供优质的节能服务;在此从建设特点、体系架构、业务流程等多方面介绍一种面向节能服务的智能化需求侧能效管理系统,该系统不仅可为电网企业多维度评估客户提供了一种科学而系统的方法和工具,还能综合考虑客户需求和电网复杂性的能力,并有针对性地提供能效方案.%Modern society is facing the pressure and challenge of energy saving. Taking into account of the customers' needs and the whole power grid system, a scientific approach is urgently needed by power companies to exploit effective and superior energy saving measures for high-quality service. An intelligent energy management system in demand-side is introduced in the aspects of system characteristics, architecture, business process and others. The system can not only provide multi-dimensional assessment with scientific and systematic methods,but also offer effective energy scheme that meet both customer needs and the grid capacity.

  14. Surgical technology and pharmacology of hyperthermic perioperative chemotherapy

    Science.gov (United States)

    Van der Speeten, Kurt

    2016-01-01

    Although cytoreductive surgery (CRS) and hyperthermic perioperative chemotherapy (HIPEC) have not been shown to be effective by themselves, as a combined treatment they are now standard of care for peritoneal metastases from appendiceal cancer and from colorectal cancer as well as peritoneal mesothelioma. The timing of the HIPEC in relation to the CRS is crucial in that the HIPEC is to destroy minimal residual disease that remains following the CRS and prevent microscopic tumor emboli within the abdomen and pelvis from implanting within the resection site, within fibrinous clot, or within blood clot. Proper selection of chemotherapy agents is crucial to the long-term benefit of CRS and HIPEC. One must consider the response expected with the cancer chemotherapy agent, its area under the curve (AUC) ratio indicating the amount of dose intensity within the peritoneal space, and the drug retention within the peritoneal space for a prolonged exposure. Hyperthermia will augment the cytotoxicity of the cancer chemotherapy agents and improve drug penetration. Irrigation techniques should not be overlooked as an important means of reducing the cancer cell burden within the abdomen and pelvis. Multiple technologies for HIPEC exist and these have advantages and disadvantages. The techniques vary from a totally open technique with a vapor barrier over the open abdominal space to a totally closed technique whereby the HIPEC is administered at the completion of the surgical procedure. The open techniques depend on a table-mounted retractor for suspension of the skin edges allowing a reservoir to occur within the abdomen and pelvis. There are nearly a dozen commercially available hyperthermia pumps, all of which seem to perform adequately for HIPEC although there is a variable degree of convenience and documentation of the HIPEC procedure. As the management of peritoneal metastases has progressed over three decades, early cases are now seen in which a laparoscopic CRS and HIPEC

  15. Raynaud′s phenomenon in a child with medulloblastoma as a late effect of chemotherapy

    OpenAIRE

    Erman Atas; Nadir Korkmazer; Hatice A Artik; Oguzhan Babacan; Vural Kesik

    2015-01-01

    There are a lot of early or late side effects of chemotherapies. One of them is Raynaud′s phenomenon (RP). Vascular toxicity associated with antineoplastic agents is notified in bleomycin alone therapy or in combination with cisplatin, vinblastine, and vincristine. The mechanism of RP associated with antineoplastic agents is unknown. All children receiving vinblastine, vincristine, bleomycin and cisplatin therapy, are followed and questioned about their complaint on RP. Long-term follow-up of...

  16. Research Progress of Nutrition Support for Patients with Lung Cancer 
During Chemotherapy

    OpenAIRE

    Yiqiao LUO; Zhu, Jiang

    2014-01-01

    Primary lung cancer is one of the most common malignancies. Nowadays, both its morbidity and mortality rank first, patients with lung cancer are often goes with some affiliating symptoms such as malnutrition and weight loss. The side effects of cytotoxicity during chemotherapy may lead to further deteriorate of the nutritional status and worsen the anti-tumor therapy’s efficacy and the patients’ quality of life. With the development of palliative treatment and the higher request of patients f...

  17. Comparison of Growth Impairment in Pediatric Patients with ALL, NHL Treated with Chemotherapy alone and Chemoradiotherapy

    OpenAIRE

    A. Ghasemi; A. Banihashemi; N Ghaemi; Elmi, S.

    2014-01-01

    Introduction: Acute Lymphoblastic Leukemia (ALL) and Non Hodgkin’s Lymphoma(NHL) are the most common cancers in childhood and  adolescence. Most children with ALL and NHL have long term survival (>80%). Endocrinopathy is a common complication in pediatric cancers following the treatment (20-50% prevalence), in addition, cytotoxic chemotherapy and radiotherapy can influence side effect on growth parameters.   Material and Methods:  We evaluated growth percentiles in 50 children wit...

  18. Rehabilitation for Ataxia Following Chemotherapy for Burkitt Lymphoma Involving the Rectum

    OpenAIRE

    Kim, Hyoung Seop; Jung, Chul Oh; Jeon, Ha Ra; Sung, Lee Ho

    2012-01-01

    Burkitt lymphoma is a type of B-cell lymphoma that occurs mostly in children, and rarely in adults. The sporadic type is known to occur mostly at the ileum and cecum. Cytarabine, which is used for central nervous system prophylaxis during chemotherapy for Burkitt lymphoma, has known neurotoxicity, and its side effects include motor ataxia due to cerebellar injury, ataxic dysarthria, dysfunction of ocular movement, confusion, somnolence and lethargy. This case report is about a patient diagnos...

  19. Nongenotoxic p53 activation protects cells against S-phase-specific chemotherapy

    DEFF Research Database (Denmark)

    Kranz, Dominique; Dobbelstein, Matthias

    2006-01-01

    Mutations in the tumor suppressor gene TP53 represent the most frequent genetic difference between tumor cells and normal cells. Here, we have attempted to turn this difference into an advantage for normal cells during therapy. Using the Mdm2 antagonist nutlin-3, we first activated p53 in U2OS an...... a killer to a protector of cells, with the potential to reduce unwanted side effects of chemotherapy....

  20. Ice massage on chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Mehdi Sadeghi Shermeh

    2012-05-01

    Full Text Available Background and Aim: Nausea and vomiting are the most common side effects of chemotherapy. The aim of the current study was to assess the effect of ice massage applied to the pericardium 6 (P6 or Neigaun acupuncture point on nausea– vomiting due to chemotherapy in cancer patient. Materials and Methods: In a randomized clinical trial one- blind, 114 patients were randomly divided into three groups. Ice massage group were massaged gently on the skin around P6 point of the hand with ice cube into a wet gauze pad for 7 minutes twice a day with 12-hours interval for 24 hours by the patient. Placebo group were massaged with wooden cube and the control group received no interventions. Nausea and vomiting in three groups rated by Morrow Assessment of Nausea and Emesis (MANE Questionnaire in 4 periods of time in 24 hours was used for the assessment of nausea and vomiting. Results: There were significant decreases in the frequency of nausea (P<0.01 and vomiting (P<0.03 and a decrease in the intensity of nausea (P=0.63 and vomiting (P=0.34 in the case group. Frequency of nausea was significantly lower among placebo group than the control group (P<0.02. Conclusion: Ice massage on Neigaun point is effective on reducing the frequency of chemotherapy induced nausea and vomiting in cancer patients. Placebos, patient-practitioner relationship, suggestion, and the patient's view on nausea and vomiting and the role of interaction between the therapist and the patient is effective to some extent.

  1. The Effects of Oral Cryotherapy on Chemotherapy-Induced Oral Mucositis in Patients Undergoing Autologous Transplantation of Blood Stem Cells: A Clinical Trial

    OpenAIRE

    Askarifar, Marzieh; Lakdizaji, Sima; Ramzi, Mani; Rahmani, Azad; Jabbarzadeh, Faranak

    2016-01-01

    Background Oral mucositis is one of the irritating side effects of chemotherapy in patients undergoing bone marrow transplantation. However, up until now, the common methods of oral mucositis therapy have failed to show significant effects. Objectives The aim of this study was to investigate the effects of local cryotherapy on the intensity of chemotherapy-induced oral mucositis in autologous bone marrow transplantation patients. Patients and Methods In this single, blinded, randomized clinic...

  2. Effect of Agaricus sylvaticus supplementation on nutritional status and adverse events of chemotherapy of breast cancer: A randomized, placebo-controlled, double-blind clinical trial

    OpenAIRE

    Fabiana Valadares; Maria Rita Carvalho Garbi Novaes; Roberto Cañete

    2013-01-01

    Background: Breast cancer (BC) represents the highest incidence of malignancy in women throughout the world. Medicinal fungi can stimulate the body, reduce side-effects associated with chemotherapy and improve the quality of life in patients with cancer. Aim: To evaluate the effects of dietary supplementation of Agaricus sylvaticus on clinical and nutritional parameters in BC patients undergoing chemotherapy. Materials and Methods: A randomized, placebo-controlled, double-blind, clini...

  3. 基于结构式家庭疗法的随访管理对乳腺癌术后化疗患者癌因性疲乏的影响%Effect of lfow-up management based on Structural Family Therapy for Cancer-Related Fatigue for patients with breast cancer during postoperative chemotherapy period

    Institute of Scientific and Technical Information of China (English)

    陈和月; 肖艳玲; 杨娇弟; 蔡希

    2016-01-01

    [摘 要] 目的:评价基于结构式家庭疗法的随访管理对乳腺癌术后化疗患者癌因性疲乏的效果。方法:将乳腺癌术后化疗患者按数字随机分为对照组(=75)和干预组(=79),对照组化疗期间实施常规随访,干预组实施以结构式家庭疗法为指导的随访,比较干预后两组患者的癌因性疲乏水平。结果:干预后,干预组患者的躯体疲乏(13.29±4.84)分、情感疲乏(8.65±3.01)分、认知疲乏(9.06±3.12)分和癌因性疲乏总分(31.20±11.02)分均低于对照组患者(15.00±4.25、10.04±3.24、10.26±3.08、35.30±10.26),差异有统计学意义(P<0.05)。结论:基于结构式家庭疗法的随访管理能够有效降低乳腺癌术后化疗患者癌因性疲乏水平。%Objective: To discuss the effect of lfow-up management based on Structural Family Therapy for Cancer-Related Fatigue for patients with breast cancer during postoperative chemotherapy period. Methods: Patients with breast cancer during postoperative chemotherapy period were randomly assigned into control group (n=75) and intervention group (n=79). The control group received routine follow-up during chemotherapy period and the intervention group received follow-up based on Structural Family Therapy. Patients' levels of Cancer-Related Fatigue were compared at the end of the study. Results: After intervention, the score of physical fatigue (13.29±4.84), emotional fatigue (8.65±3.01), cognitive fatigue (9.06±3.12) and the total score of Cancer Fatigue Scale (31.20±11.02) were all lower than those of the control group (15.00±4.25, 10.04±3.24, 10.26±3.08, and 35.30±10.26) with statistically signiifcant differences (P<0.05). Conclusion: The lfow-up management based on Structural Family Therapy can effectively decrease the level of Cancer-Related Fatigue for patients with breast cancer during postoperative chemotherapy period.

  4. Recombinant human epoetin beta in the treatment of chemotherapy-related anemia

    Directory of Open Access Journals (Sweden)

    Iain RJ Macpherson

    2009-03-01

    Full Text Available Iain RJ Macpherson, Colin R Lindsay, Nicholas S ReedBeatson West of Scotland Cancer Centre, Glasgow, United KingdomAbstract: Anemia is a common complication of systemic anti-cancer treatment. In this context epoetin beta, like other erythropoiesis-stimulating agents (ESAs, has demonstrable efficacy in raising Hb concentration and reducing the requirement for red cell transfusion. Consequently ESA therapy has gained increasing prominence in the management of chemotherapy-related anemia. However, recent trial data have suggested a higher rate of thromboembolic events, enhanced tumor progression and reduced survival in some patients with cancer who receive ESA therapy. In response, regulatory authorities have mandated increasingly restrictive label changes. In light of these new developments we consider the current role of epoetin beta in the management of chemotherapy-related anemia.Keywords: anemia, cancer, erythropoietin, epoetin, chemotherapy

  5. Clinical outcome of adjuvant chemotherapy plus intensity modulated radiotherapy after breast-conserving surgery

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and side effects of adjuvant chemotherapy plus intensity modulated radiotherapy (IMRT) after breast-conserving surgery for stage I and II breast cancer. Methods: After breast-conserving surgery, 108 patients received six cycles of chemotherapy followed by IMRT. The irradiation dose of the whole breast was 50 Gy given by 25 fractions, followed by 10 Gy boost to the tumor bed given by 5 fractions with electron beams. Patients with positive estrone receptor or progesterone receptor were given endocrine treatment, mostly with tamoxifen. Results: The follow-up rate was 100% by December 2007. The number of patients followed-up at 1-, 2- and 3-year was 108,88 and 58. The 1-, 2- and 3-year over survival rates were 100%, 100% and 98%. Three patients had local recurrence. Different degree of dermatitis occurred with good long-term cosmetic results. No severe side effects occurred such as radiation-induced pneumonitis, pulmonary, fibrosis and heart injury. Conclusions: Breast cancer patients treated by adjuvant chemotherapy plus IMRT after breast-conserving surgery have high survival rate and low side-effect rate. The survival quality and local control can be improved. (authors)

  6. Neo-adjuvant chemotherapy followed by surgery and chemotherapy or by surgery and chemoradiotherapy for patients with resectable gastric cancer (CRITICS)

    International Nuclear Information System (INIS)

    Radical surgery is the cornerstone in the treatment of resectable gastric cancer. The Intergroup 0116 and MAGIC trials have shown benefit of postoperative chemoradiation and perioperative chemotherapy, respectively. Since these trials cannot be compared directly, both regimens are evaluated prospectively in the CRITICS trial. This study aims to obtain an improved overall survival for patients treated with preoperative chemotherapy and surgery by incorporating radiotherapy concurrently with chemotherapy postoperatively. In this phase III multicentre study, patients with resectable gastric cancer are treated with three cycles of preoperative ECC (epirubicin, cisplatin and capecitabine), followed by surgery with adequate lymph node dissection, and then either another three cycles of ECC or concurrent chemoradiation (45 Gy, cisplatin and capecitabine). Surgical, pathological, and radiotherapeutic quality control is performed. The primary endpoint is overall survival, secondary endpoints are disease-free survival (DFS), toxicity, health-related quality of life (HRQL), prediction of response, and recurrence risk assessed by genomic and expression profiling. Accrual for the CRITICS trial is from the Netherlands, Sweden, and Denmark, and more countries are invited to participate. Results of this study will demonstrate whether the combination of preoperative chemotherapy and postoperative chemoradiotherapy will improve the clinical outcome of the current European standard of perioperative chemotherapy, and will therefore play a key role in the future management of patients with resectable gastric cancer. clinicaltrials.gov http://www.clinicaltrials.gov/ct2/show/NCT00407186

  7. [The quality of life after chemotherapy in advanced non-small cell lung cancer patients].

    Science.gov (United States)

    Słowik-Gabryelska, A; Szczepanik, A; Kalicka, A

    1999-01-01

    The intensity of complains, short survival and great number of patients makes many oncologists to apply chemotherapy in advanced non-small cell lung cancer/NSCLC/. The achieved median duration of life after chemotherapy was 6 to 12 month. From the other hand non small cell lung cancer chemotherapy is a big burden even to healthy persons. It can worsen the quality of life. That was the reason we evaluated the quality of life after chemotherapy in advanced non small cell lung cancer patients. Taking into account, that the evaluation of quality of life, used in most diseases is useless in advanced NSCLC patients, for appreciation the quality of life in these cases the lung cancer symptoms scale/LCSS/was adopted. In 110 non small cell lung cancer patients in stage IIIB and IV, who received combined chemotherapy by Le Chevalier/Vindesine, Cisplatin, Cyclophosphamide, Lomustin/or by Rosell/Mitomycin, Cyclophosphamide, Cisplatin/the quality of life was evaluated. In 20-persons control group all patients received the symptomatic treatment. In observed group of 110 patients, tumor regressions after 4 courses of chemotherapy allowed to resect cancer in 14 cases, to apply radiotherapy in 42 and to continue chemiotherapy in 23 persons. In every person from above mentioned group the quality of life was evaluated on the basis of intensity of cancer symptoms, accordingly to LCSS. The intensity of cancer symptoms was compared before and after treatment. There were compared; the innensity of complains, weakness, appetite, malnutrition, and hematological, neurological, performans state as well as respiratory sufficiency, infections, cardiac disorders and pain. Apart it, the side effects of applied therapy were assessed in 5 degree scale. The level of hemoglobin, the number of leucocytes, thrombocytes, bilirubine and transaminases in peripheral blood, hematurie, proteinurie, bleedings, appetite, nausea, vomitings, diarrhea, mucosal lesions, infections, skin lesions, cardiac lesions

  8. Neoadjuvant chemotherapy in cervical cancer in pregnancy.

    Science.gov (United States)

    Ilancheran, Arunachalam

    2016-05-01

    Cervical cancer is the most common gynecological cancer encountered in pregnancy. The standard treatment of early cervical cancer is usually surgical removal of the cervix (in selected cases) or, more commonly, the uterus. However, when cervical cancer develops during pregnancy, definitive surgical treatment often needs to be postponed until the fetus reaches maturity. Neoadjuvant chemotherapy (NACT) is an innovative approach in the management of these patients. It helps in controlling the disease and delaying delivery. The paper presents a literature review of the history of NACT, as well as practice points and agenda for further research. PMID:26536815

  9. Side effects of cancer therapies. International classification and documentation systems

    International Nuclear Information System (INIS)

    The publication presents and explains verified, international classification and documentation systems for side effects induced by cancer treatments, applicable in general and clinical practice and clinical research, and covers in a clearly arranged manner the whole range of treatments, including acute and chronic side effects of chemotherapy and radiotherapy, surgery, or combined therapies. The book fills a long-felt need in tumor documentation and is a major contribution to quality assurance in clinical oncology in German-speaking countries. As most parts of the book are bilingual, presenting German and English texts and terminology, it satisfies the principles of interdisciplinarity and internationality. The tabulated form chosen for presentation of classification systems and criteria facilitate the user's approach as well as application in daily work. (orig./CB)

  10. Alterações oculares induzidas pela quimioterapia Ocular changes induced by chemotherapy

    Directory of Open Access Journals (Sweden)

    Alessandra Pinheiro Chaves

    2007-08-01

    Full Text Available As drogas antineoplásicas proporcionam aumento da sobrevida dos portadores de neoplasias, mas podem induzir efeitos adversos em vários órgãos e tecidos. A mucosite é efeito adverso freqüentemente observado durante a administração de certos quimioterápicos. A toxicidade ocular dessas drogas pode se manifestar por alterações da superfície ocular e do filme lacrimal. O objetivo foi avaliar alterações da superfície ocular induzidas pelos quimioterápicos e estabelecer sua correlação clínica com mucosite e quimioterapia. Trinta e nove pacientes foram submetidos a exame oftalmológico completo, citologia de impressão e estudo microbiológico da conjuntiva. Comparamos 2 grupos: com manifestação de mucosite (caso e sem manifestação de mucosite (controle. Para análise estatística, utilizamos o software Statistical Package for Social Sciences. A mucosite foi identificada em 51,4% dos pacientes avaliados após a quimioterapia. O tempo de quebra do filme lacrimal mostrou redução significativa após a quimioterapia (pAntineoplastic agents offer an increase in the patients' survival rates, but may induce side effects in different organs and tissues. Mucositis is one of the most common side effects during chemotherapy with certain agents. The ocular toxicity induced by these drugs may manifest as changes in the ocular surface and in the tear film. The purpose of this research was to study the ocular surface changes induced by chemotherapy and to establish their clinical correlation with the chemotherapy and mucositis. The 39 selected patients underwent a full ophthalmological examination and supplementary tests. We compared 2 groups of patients: with (case and without mucositis (control. Statistical analysis was performed with the Statistical Package for Social Sciences software. Mucositis was identified in 51.4% of the patients after chemotherapy. The brakeup time showed a statistically significant decrease after chemotherapy (p<0

  11. Axonal Transport Impairment in Chemotherapy-Induced Peripheral Neuropathy

    Directory of Open Access Journals (Sweden)

    Gabriella Nicolini

    2015-08-01

    Full Text Available Chemotherapy-Induced Peripheral Neuropathy (CIPN is a dose-limiting side effect of several antineoplastic drugs which significantly reduces patients’ quality of life. Although different molecular mechanisms have been investigated, CIPN pathobiology has not been clarified yet. It has largely been recognized that Dorsal Root Ganglia are the main targets of chemotherapy and that the longest nerves are the most damaged, together with fast axonal transport. Indeed, this bidirectional cargo-specific transport has a pivotal role in neuronal function and its impairment is involved in several neurodegenerative and neurodevelopmental diseases. Literature data demonstrate that, despite different mechanisms of action, all antineoplastic agents impair the axonal trafficking to some extent and the severity of the neuropathy correlates with the degree of damage on this bidirectional transport. In this paper, we will examine the effect of the main old and new chemotherapeutic drug categories on axonal transport, with the aim of clarifying their potential mechanisms of action, and, if possible, of identifying neuroprotective strategies, based on the knowledge of the alterations induced by each drugs.

  12. Pulmonary Fibrosis Secondary to FOLFOX Chemotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Wai Cheong Soon

    2014-09-01

    Full Text Available A 54-year-old female presented with a 2-week history of increasing shortness of breath and fever. She had a history of a poorly differentiated sigmoid adenocarcinoma for which she underwent an anterior resection 6 months prior to admission, followed by 12 cycles of adjuvant FOLFOX chemotherapy. The patient was treated for a severe community-acquired pneumonia; however, she remained hypoxic. A chest CT revealed extensive right-sided fibrotic changes, tractional dilatation of the airways and ground glass density, which had developed since a staging CT scan performed 2 months previously. Although her symptoms improved with steroid therapy, repeat imaging revealed that right hydropneumothorax had developed, and this required the insertion of a chest drain. Following its successful removal, the patient continues to improve clinically and radiographically. The rapid onset and nature of these changes is consistent with a drug-induced fibrotic lung disease secondary to FOLFOX chemotherapy. The phenomenon is underreported and yet, it is relatively common: it occurs in approximately 10% of patients who are treated with antineoplastic agents, although information specifically relating to FOLFOX-induced pulmonary toxicity is limited. It is associated with significant morbidity and mortality, but is often hard to differentiate from other lung conditions, making the diagnosis a challenge. Pulmonary toxicity is an important complication associated with antineoplastic agents. It should be considered in any patient on a chemotherapeutic regimen who presents with dyspnoea and hypoxia in order to try to reduce the associated morbidity and mortality.

  13. Chemotherapy drug shortages in pediatric oncology: a consensus statement.

    Science.gov (United States)

    Decamp, Matthew; Joffe, Steven; Fernandez, Conrad V; Faden, Ruth R; Unguru, Yoram

    2014-03-01

    Shortages of essential drugs, including critical chemotherapy drugs, have become commonplace. Drug shortages cost significant time and financial resources, lead to adverse patient outcomes, delay clinical trials, and pose significant ethical challenges. Pediatric oncology is particularly susceptible to drug shortages, presenting an opportunity to examine these ethical issues and provide recommendations for preventing and alleviating shortages. We convened the Working Group on Chemotherapy Drug Shortages in Pediatric Oncology (WG) and developed consensus on the core ethical values and practical actions necessary for a coordinated response to the problem of shortages by institutions, agencies, and other stakeholders. The interdisciplinary and multiinstitutional WG included practicing pediatric hematologist-oncologists, nurses, hospital pharmacists, bioethicists, experts in emergency management and public policy, legal scholars, patient/family advocates, and leaders of relevant professional societies and organizations. The WG endorsed 2 core ethical values: maximizing the potential benefits of effective drugs and ensuring equitable access. From these, we developed 6 recommendations: (1) supporting national polices to prevent shortages, (2) optimizing use of drug supplies, (3) giving equal priority to evidence-based uses of drugs whether they occur within or outside clinical trials, (4) developing an improved clearinghouse for sharing drug shortage information, (5) exploring the sharing of drug supplies among institutions, and (6) developing proactive stakeholder engagement strategies to facilitate prevention and management of shortages. Each recommendation includes an ethical rationale, action items, and barriers that must be overcome. Implemented together, they provide a blueprint for effective and ethical management of drug shortages in pediatric oncology and beyond.

  14. Patients’ perspectives on palliative chemotherapy of colorectal and non - colorectal cancer: a prospective study in a chemotherapy- experienced population

    International Nuclear Information System (INIS)

    A better understanding of patients’ views on the benefit and burden obtained from palliative chemotherapy would facilitate shared decision making. We evaluated palliative cancer patients’ reported outcomes (PROs) for toxicity and investigated the survival threshold for which they would repeat chemotherapy (CTx). Patients who had received a minimum of three months of palliative CTx for advanced colorectal (CRC) or non-colorectal (non-CRC: upper gastrointestinal, lung and head-and-neck) cancer were assessed by questionnaire. Patients were questioned about PROs for toxicity, subjective burden from side effects, and were asked for the survival threshold necessary for them to repeat CTx. Expected survival (sum of indicated survival threshold and median survival time with best supportive care) was compared to the patients’ actual survival. One hundred and thirty-four patients (CRC: 58; non-CRC: 76) were surveyed. The most frequent PRO- grade 3/4 toxicities were acne (12.8%), fatigue (9.0%), and diarrhea (8.5%). The symptom causing the highest subjective burden was fatigue and was worse than expected in 29.9% of the patients. The median survival threshold for which patients would repeat CTx was significantly longer in CRC than in non-CRC patients (p=0.01). Median expected survival was significantly longer than actual median survival (CRC: 44.0 months [22.0-65.9] compared with 30.0 months of actual survival [20.9-39.1]; non-CRC: 22.0 months [15.3-28.6] compared with 19.0 months of actual survival [15.1-22.9], p=0.03). Fatigue deserves more attention when toxicity of treatment and symptoms of disease are explained to patients. Patients’ survival expectations from palliative chemotherapy are higher than previously described, exceed the median survival time known from phase III trials, and are significantly longer than their actual survival

  15. Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies Aceptabilidad y efectos secundarios percibidos del rociado residual intradomiciliario de insecticidas bajo diferentes esquemas de manejo de resistencia

    Directory of Open Access Journals (Sweden)

    Américo David Rodríguez

    2006-08-01

    Full Text Available OBJECTIVE: To assess household acceptability and perceived side effects of residual indoor pyrethroid (PYR, carbamate and organophosphate insecticides sprayed by annual rotation (ROT, spatial mosaic (MOS, and a single insecticide (DDT or PYR in communities of the coastal plain of Chiapas, Mexico. MATERIAL AND METHODS: A questionnaire to assess the acceptability and perceived side effects of indoor insecticides was administered to one member of 30% of the families in eight villages of Chiapas. The association of different insecticide treatments with their responses was evaluated (Chi-square. The intensity of side effects indicated under different treatments was compared in an ordered logistic model, using a severity index as the response variable. RESULTS: Insecticide spraying as a probable cause of symptoms was identified by 2.1% of interviewees. A significantly high percentage of persons with blurred vision, dizziness, sneezing, coughing, numbness, watery eyes, and itching lived in villages under MOS and ROT and a high severity index was significantly associated with ROT treatment. Reduction of mosquito bites and cockroaches were the perceived main benefits, and most villagers that perceived no benefits lived in DDT treated villages. Most of the interviewees welcomed spraying (83.7%, but the smell and having to remove furniture from houses were the main arguments against it. CONCLUSIONS: Acceptability correlated with insecticide spray coverage, although the most frequent suggestion for improvement was to increase the understanding of the objectives of spraying in the communities. The frequency of side effects was low, but higher in localities where a combination of insecticides was applied. This is a limitation for the use of this type of resistance management strategy in public health.OBJETIVO: Evaluar la aceptabilidad y los efectos secundarios del rociado intradomiciliar de insecticidas pyrethroides (PYR, carbamato y organophosphato rociados

  16. CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2014-08-01

    Full Text Available The paper considers treatment regimens for metastatic bladder cancer (MBC and gives the data of trials of the efficiency of using different chemotherapy schemes and regimens in patients with MBC.

  17. Novel Combination Chemotherapy for Localized Ewing Sarcoma

    Science.gov (United States)

    In this clinical trial, researchers will test whether the addition of the drug combination vincristine, topotecan, and cyclophosphamide to a standard chemotherapy regimen improves overall survival in patients with extracranial Ewing

  18. Cancer Chemotherapy - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Cancer Chemotherapy URL of this page: https://medlineplus.gov/languages/cancerchemotherapy.html Other topics A-Z A B ...

  19. Individual differences in chemotherapy-induced anticipatory nausea

    Directory of Open Access Journals (Sweden)

    Marcial eRodríguez

    2013-08-01

    Full Text Available Anticipatory Nausea (AN is a severe side effect of chemotherapy that can lead cancer patients to discontinue their treatment. This kind of nausea is usually elicited by the re-exposure of the patients to the clinical context they need to attend to be treated. There has been considerable agreement that AN represents a paradigmatic example of Pavlovian conditioning, and within this framework, several behavioral interventions have been proposed in order to prevent this psychopathology. However, some studies have questioned the validity of the Pavlovian approach, suggesting that CS-US associations are neither necessary nor sufficient for AN to occur. The data and the alternative theories behind such criticisms are discussed. Additionally, it is suggested that animal models of AN could be enriched by taking into account rats’ individual differences.

  20. BNP predicts chemotherapy-related cardiotoxicity and death

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Hasbak, Philip; Kjaer, Andreas

    2014-01-01

    UNLABELLED: Cardiotoxicity is a dose-limiting side-effect of cancer chemotherapeutics such as anthracyclines. The drug-induced cardiac toxicity is currently monitored with repeated assessments of the left ventricular ejection fraction (LVEF) using multigated equilibrium radionuclide......) or death in a population of anthracycline-treated cancer patients. METHODS: We prospectively followed 333 cancer patients referred to our department for routine monitoring of LVEF with MUGA and measurement of BNP, January-December 2004. Study end points were hospitalization for CHF and death during follow...... death. In multivariate Cox analysis both BNP and LVEF were independent predictors of CHF while age remained the only independent predictor of overall death. CONCLUSION: In cancer patients treated with cardiotoxic chemotherapy both BNP and LVEF can significantly predict subsequent hospitalization...