WorldWideScience

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. [Management of the cutaneous side effects of chemotherapies and targeted therapies].

    Science.gov (United States)

    Delyon, Julie; Gerard, Maud; Nicodeme, Marguerite; Fromantin, Isabelle; Loirat, Delphine

    2015-06-01

    The treatments used in oncology cause frequent cutaneous side effects. The different types of cutaneous toxicities depend on the class of anti-tumour therapies and can involve the skin, mucosa, nails and hair. Effectively managing these cutaneous toxicities requires adapted preventive and curative measures in order to reduce their impact, notably on patients' quality of life. PMID:26146316

  6. 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...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. Combined radiotherapy and chemotherapy: pulmonary side effects

    International Nuclear Information System (INIS)

    Systemic chemotherapy and lung irradiation have very similar effects on lung tissue. Several mechanisms are involved, mainly: - cytotoxic effects on lung cells (type II pneumocytes, capillary endothelial cells, and connective tissue); - enhancement of infection; - hypersensitivity and auto-immune phenomena. Acute pneumonitis of chronic lung sclerosis develops which may or may not be compatible with life, depending on the lung volume involved and the clinical course. These effects are dose dependent for radiotherapy, and for most of the chemotherapeutic drugs. In some cases however, the dose-effect relationship is not clear, especially with some drugs such as methotrexate, and sometimes with radiotherapy even when it can be assumed that there is no mistake in dose calculation. It must be stressed that we still lack basic knowledge on the pharmacokinetics and actual concentration of drugs in lung tissue. Additive or supra-additive effects are likely when chemotherapy is combined with lung irradiation, but current relevant data does not allow any firm conclusions to be drawn on the quantitative changes resulting from the association. Prevention of lung complications is however possible if the tolerance doses and the optimal distribution of each agent with time are respected. Combined lung irradiation and bleomycin administration must be avoided

  11. 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.

  12. 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...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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

  17. 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.

  18. 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...

  19. 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...

  20. 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.

  1. 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...

  2. Management of chemotherapy induced diarrhea (abstract)

    International Nuclear Information System (INIS)

    Diarrhoea is seen with many tumors and following several chemotherapy regimen esp. those containing 5-fluorouracil and high dose folinic acid it causes debility even death, delays cancer treatment, reduces compliance increases cost. It causes dehydration, renal failure volume depletion. Quality of life is worsened and hospitalization may be needed in multifactorial, with secretion; absorption imbalance due to mucosal damage, necrosis or inflammation. Local infection is set up by opportunistic organism and cell necrosis. The large volume of fluid and electrolytes overwhelms colonic absorptive capacity. Agent usually used for treatment is opioids (such as Diphenoxylate / Loperamide]. Bismuth (for inflammatory diarrhea). NSAIDs or alpha 2-agonists. For optimal management, the cause and severity should be assessed and treatment planned. Advice is given about certain dietary restraints and avoidance of some drugs. Fever, infection, dehydration and electrolyte losses are treated, pain relieved. Diphenoxylate / Loperamide (later is more effective; 4 mg, STAT, then 2mg every 4 hours or even 2 hourly) may be used. It is moderately effective in CID. Octreotide is useful in carcinoid. VIPoma, AIDS idiopathic secretary diarrhea, ileostomy, dumping syndrome. It acts directly on epithelial cells to reduce secretin, motilin pancreatic polypeptide. It slows transit time, reduces fluid and electrolyte secretin, increases absorption of electrolytes. It is effective in 5 FU and high dose chemotherapy with a 90% response rates seen after 3 days treatment. High Dose Chemotherapy and total body irradiation - induced diarrhea usually resolves within 72 hours. (author)

  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. 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

  5. ORAL AND SYSTEMIC SIDE EFFECTS OF CANCER CHEMOTHERAPY AND EFFECT OF BENZYDAMINE MOUTHWASH IN ORAL MUCOSITIS

    OpenAIRE

    Anagha Shete et al

    2012-01-01

    Aim: To check the effectiveness of 0.15% Benzydamine hydrochloride on oral mucositis secondary to cancer chemotherapyMethods: In the past few years, multiple cases were referred to our department for the management of oral manifestations of cancer chemotherapy for various malignancies. Out of these patients, we selected 5 patients and used a simple, inexpensive treatment modality in consideration with patient’s affordability and convenience. They were prescribed 0.15% Benzydamine hydrochlorid...

  6. 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.

  7. Prevention and management of chemotherapy-induced diarrhea in patients with colorectal cancer: a consensus statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea

    OpenAIRE

    Maroun, J A; Anthony, L.B.; Blais, N; Burkes, R.; Dowden, S.D.; Dranitsaris, G; Samson, B.; Shah, A.; Thirlwell, M.P.; Vincent, M D; Wong, R.

    2007-01-01

    Chemotherapy-induced diarrhea (cid) is a common side effect of cancer treatment and can cause significant morbidity and mortality. Diarrhea is frequently severe enough to require a dose reduction of, a delay in, or a discontinuation of chemotherapy. Diarrhea-associated mortality has been reported to be as high as 3.5% in clinical trials of irinotecan and bolus 5-fluorouracil in colorectal cancer. The frequency of cid and its impact on patient management are frequently under-recognized in clin...

  8. 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

  9. Hematological side-effect profiles of individualized chemotherapy regimen for recurrent ovarian cancer.

    Science.gov (United States)

    Breidenbach, Martina; Rein, Daniel T; Schöndorf, Thomas; Schmidt, Torsten; König, Ellen; Valter, Markus; Kurbacher, Christian M

    2003-06-01

    The long-term results for patients with recurrent ovarian cancer (ROC) are poor. There is a need to optimize treatment strategies to improve outcome by avoiding ineffective regimens which are often associated with exacerbated side-effects. Individualized chemotherapy regimens guided by a chemosensitivity assay (ATP-tumor chemosensitivity assay) have already been used successfully to direct chemotherapy. Taking the results of this assay into account, application of drug combinations appears more advisable. Here we present a systematic evaluation of toxicities seen with individualized chemotherapy for ROC. A total of 62 patients who received 314 cycles of antineoplastic therapies were evaluated. Three single agents (topotecan, paclitaxel and gemcitabine) and five combinations (cisplatin/gemcitabine, carbopatin/gemcitabine, gemcitabine/treosulfan, mitoxantrone/paclitaxel and carboplatin/paclitaxel) were examined. With respect to myelotoxicity, most single agents except topotecan revealed favorable results in comparison to drug combinations. However, this observation lacks statistical significance. Generally, severe myelosuppression was rare. The highest incidence of leukopenia was seen in regimens with mitoxantrone/paclitaxel or gemcitabine/treosulfan, respectively. Thrombocytopenia accompanied most commonly a topotecan therapy. In the present study combination regimens tend to be more toxic than monotherapies. When response rates are comparable, empirically chosen treatment combination therapies should only be practiced in carefully planned clinical studies. PMID:12782939

  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. Modulation of radiotherapy- and chemotherapy-induced normal tissue response as prophylaxis of their side effects

    International Nuclear Information System (INIS)

    Background. Ionising radiation and cytostatic agents used in cancer therapy induce an immune response in normal tissues mediated by cytokines and adhesion molecules. Strategies modulating this response may downregulate cancer therapy side effects. The data published on the given topic have been reviewed. Conclusions. The strategies influencing the tissue immune response with the aim to reduce the side effects of chemotherapy and radiotherapy are conflicting. Some of them inhibit this response supposing that an exaggerated reaction may have a damaging effect (e.g. corticosteroids, nonsteroidal anti-inflammatory drugs (NSAID), lisofylline, anti-cytokine antibodies, anti-sense oligonucleotides, sialyl Lewis X analogues), others promote this reaction by inducing endogenous production of cytokines (AS101) or use recombinant forms of appropriate cytokines involved in this response in order to intensify the physiologic tissue response. In clinical practice, corticosteroids and NSAID are widely used to modulate this response, while other agents are still experimental. (author)

  12. Staggercast: Demand-Side Management for ISPs

    OpenAIRE

    Tyson, Gareth; Sastry, Nishanth; Mortier, Richard; Feamster, Nick

    2016-01-01

    The continuing expansion of Internet media consumption has increased traffic volumes, and hence congestion, on access links. In response, both mobile and wireline ISPs must either increase capacity or perform traffic engineering over existing resources. Unfortunately, provisioning timescales are long, the process is costly, and single-homing means operators cannot balance across the last mile. Inspired by energy and transport networks, we propose demand-side management of users to reduce the ...

  13. [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

  14. 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...

  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. 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...... in the scoring for 10 out of the 12 side-effects was found. Statistical significance was observed in the pain score (P=0.046) and the arbitrary-derived sum of the scores for symptoms and side-effects (P=0.036) respectively. Patients with evidence of disease (n=26) had significantly higher levels of...... symptoms/side-effects than patients with no evidence of disease (n=28) (P=0.027). The results indicate that a six weeks multidimensional exercise intervention undertaken by cancer patients with or without residual disease while undergoing chemotherapy can lead to a reduction in treatment-related symptoms....

  17. 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

  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. 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 ...

  20. 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

  1. 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- ...

  2. 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 ...

  3. Demand side management: Benefits and challenges

    International Nuclear Information System (INIS)

    In this paper, the major benefits and challenges of electricity demand side management (DSM) are discussed in the context of the UK electricity system. The relatively low utilisation of generation and networks (of about 50%) means that there is significant scope for DSM to contribute to increasing the efficiency of the system investment. The importance of the diversity of electricity load is discussed and the negative effects of DSM on load diversity illustrated. Ageing assets, the growth in renewable and other low-carbon generation technologies and advances in information and communication technologies are identified as major additional drivers that could lead to wider applications of DSM in the medium term. Potential benefits of DSM are discussed in the context of generation and of transmission and distribution networks. The provision of back-up capacity by generation may not be efficient as it will be needed relatively infrequently, and DSM may be better placed to support security. We also present an analysis of the value of DSM in balancing generation and demand in a future UK electricity system with significant variable renewable generation. We give a number of reasons for the relatively slow uptake of DSM, particularly in the residential, commercial and small business sectors. They include a lack of metering, information and communication infrastructure, lack of understanding of the benefits of DSM, problems with the competitiveness of DSM when compared with traditional approaches, an increase in the complexity of system operation and inappropriate market incentives

  4. Demand side management. Benefits and challenges

    International Nuclear Information System (INIS)

    In this paper, the major benefits and challenges of electricity demand side management (DSM) are discussed in the context of the UK electricity system. The relatively low utilisation of generation and networks (of about 50%) means that there is significant scope for DSM to contribute to increasing the efficiency of the system investment. The importance of the diversity of electricity load is discussed and the negative effects of DSM on load diversity illustrated. Ageing assets, the growth in renewable and other low-carbon generation technologies and advances in information and communication technologies are identified as major additional drivers that could lead to wider applications of DSM in the medium term. Potential benefits of DSM are discussed in the context of generation and of transmission and distribution networks. The provision of back-up capacity by generation may not be efficient as it will be needed relatively infrequently, and DSM may be better placed to support security. We also present an analysis of the value of DSM in balancing generation and demand in a future UK electricity system with significant variable renewable generation. We give a number of reasons for the relatively slow uptake of DSM, particularly in the residential, commercial and small business sectors. They include a lack of metering, information and communication infrastructure, lack of understanding of the benefits of DSM, problems with the competitiveness of DSM when compared with traditional approaches, an increase in the complexity of system operation and inappropriate market incentives. (author)

  5. Evaluation of demand-side management programs

    International Nuclear Information System (INIS)

    Over the past few years, the attention accorded to demand-side management (DSM) measures has called into question the traditional cost minimization approach for evaluating such programs. Two broad approaches to DSM seem to be generally used: one examining the problem from multiple perspectives and the other including various practical methods used in-house by utility planners. Whatever the standard used to evaluate DSM, there remains at least one problem which cannot be quantified. The customers who participate in a DSM program cannot only take into account the effects of DSM on their electricity bills; their comfort can also be affected. This lowering of comfort constitutes a legitimate cost which can explain why some apparently sensible DSM measures are not adopted. A method is proposed to incorporate this cost. It establishes a way to evaluate DSM program tradeoffs that, from the perspective of standard economic theory, maximizes social welfare; explains why at least one of the perspectives in the multiple perspective approach needs to be modified to incorporate all customer costs; and outlines how the proposed standard can be implemented. 8 refs

  6. 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 ...

  7. 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 ...

  8. 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

  9. The characteristics of side effects of different modes of chemotherapy for breast cancer

    Directory of Open Access Journals (Sweden)

    Bondarenko I.M.

    2016-03-01

    Full Text Available The vast majority of breast cancer patients have logged phenomenon of systemic toxicity during the period of chemotherapy, the frequency and severity of which increases through special courses of drug therapy. The authors of the study set out to examine the changes in the major features of hematological parameters in different regimes of chemotherapy for breast cancer; to evaluate the nature and manifestations of hepato- and nephrotoxicity in these patients; to explore the major trends in blood clotting in this group of patients. In retrospect, 8237 common blood tests indicators were analyzed, 4048 biochemical blood tests and 1909 coagulation tests in 440 patients. Depending on the mode of treatment, the patients were divided into two groups: patients receiving paclitaxel in monochemotherapy ± Herceptin; patients receiving combinated chemotherapy in the mode of docetaxel, doxorubicin, cyclophosphamide ±Herceptin. It has been proven that chemotherapy for breast cancer with the use of the above combination of drugs is characterized by the higher profile of haematological toxicity (neutropenia, thrombocytopenia and anemia. At the same time the both groups had the same incidence of hepato- and nephrotoxicity. The monochemotherapy with paclitaxel is determined by the high incidence of hypercoagulation changes. Coagulation disorders during the use of combination of docetaxel, doxorubicin, cyclophosphamide ± Herceptin have no typical pattern of coagulation (characterized by both hypo- and hypercoagulation changes.

  10. 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

  11. 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.

  12. Cost benefit analysis of the demand side management programs

    International Nuclear Information System (INIS)

    The several cost and benefit components of the demand side management programs for the society groups, including the concessionaire, consumers and society as a whole are studied. The rule evaluations of management programs by demand side, used by North American concessionaire are also discussed. Finally, the numerical examples, that consolidating the concepts and rules evaluation are presented. (C.G.C.). 5 refs, 1 fig, 3 tabs

  13. 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...

  14. 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.

  15. 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

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

    International Nuclear Information System (INIS)

    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 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.

  18. 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.

  19. 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

  20. [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

  1. 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 ...

  2. 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...

  3. 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...

  4. Modeling Supermarket Refrigeration Systems for Demand-Side Management

    DEFF Research Database (Denmark)

    Shafiei, Seyed Ehsan; Rasmussen, Henrik; Stoustrup, Jakob

    2013-01-01

    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....

  5. 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

  6. 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.

  7. 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 ...

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

    OpenAIRE

    Heussen, Kai; You, Shi; Biegel, Benjamin; Hansen, L.H.; Andersen, K B

    2012-01-01

    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 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 ...

  9. 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...

  10. Determining optimum levels of DSM [demand-side management] as a supply-side resource

    International Nuclear Information System (INIS)

    San Diego Gas and Electric Company (SDGE) recommends the evaluation of demand-side management as a supply-side resource. The advantages of concurrent economic analysis of DSM options with other traditional sources represents a significant improvement over analysis either before or after the development of a resource plan. The evaluation of utility-sponsored DSM programs that provide system benefits that include deferment of capacity additions and improvements in more efficient system operation should be evaluated side-by-side with traditional resources that provide similar benefits. The utility decision to either provide capital costs to construct a power plant or make demand payments for a power purchase is directly analogous to the decision to provide funding for a DSM program that would defer these same investments. Both types of decision represent utility control over investment decisions that allow the utility to provide reliable, low-cost power to its customers. SDGE has also had experience with using generation expansion scenarios to test different levels of pre-selected packages of DSM programs, attempting to evaluate the total costs of system expansion for each of the different packages. This method was fraught with problems, and the best information that could be gained was if the selection of DSM packages happened to bracket a lower cost scenario, when it could reasonably be assumed that both smaller and larger levels of DSM were not as cost effective as the intermediate level. However, in many cases the selection of DSM programs did not produce this result and the important question of whether individual DSM programs were worthwhile when evaluated individually, or whether the lowest cost scenario would be improved with more or less DSM, could not be answered

  11. 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.

  12. 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...

  13. [Rare side effects in management of hyperthyroidism. Case report].

    Science.gov (United States)

    Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

    2016-05-01

    The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism. Orv. Hetil., 2016, 157(22), 869-872. PMID:27211356

  14. 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 ...

  15. Natural Products for Management of Oral Mucositis Induced by Radiotherapy and Chemotherapy.

    Science.gov (United States)

    Aghamohamamdi, Azar; Hosseinimehr, Seyed Jalal

    2016-03-01

    Oral mucositis is a common side effect of systemic chemotherapy and radiotherapy of head and neck in patients with cancer. Severe oral mucositis is painful and affects oral functions, including intake of food and medications and speech. Prevention of oral mucositis affects the life quality of patients. Recent studies have been focused on natural products to improve or reduce this complication. Many clinical trials have been performed to assess natural products for treatment of mucositis and their results are promising. The authors reviewed the evidence for natural products in the prevention and treatment of oral mucositis induced by radiation therapy and chemotherapy. PMID:26306626

  16. 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

  17. 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.

  18. 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

  19. Development of planning methods for demand-side management (DSM)

    International Nuclear Information System (INIS)

    The interest of utilities and governmental agencies in Demand-side management (IDSM) and Integrated Resource Planning (IRP) has increased during recent years also in Finland. From the governmental point of view, the main reason for this has been concern about the environmental effects of electricity supply and consumption. Utilities are mainly interested in cost reductions in electricity supply and distribution caused by DSM. Also improved service to the customer due to DSM has increasing value to utilities. In this project, the main target has been to develop and assess methods for DSM planning from the utility point of view. The final goal is to integrate these methods into the strategic planning of electric utilities

  20. 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.

  1. Air pollution impacts from demand-side management

    International Nuclear Information System (INIS)

    Air-polluting emission rates and energy-efficiency ratings vary widely among power plants, depending on location, age and whether the power plant is repowered. Traditional regulations require installation of specified emission control equipment that varies among power plants. These regulations do not specify that utilities first dispatch the cleanest power plants as demand varies from peak to off-peak periods. This empirical analysis shows, for 2 years out of 20, that demand-side management (DSM) programs increase air pollution. One reason for this result is that regulations require installation of specific emission-control technology but do not provide the incentive to take actual emissions or their air quality impacts into account when operating the system. For certain types of air pollutants and in some regions, regulatory programs now include markets for tradable emission credits. Such programs may alter this incentive. (author)

  2. 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

  3. 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.

  4. Chemotherapy principles of managing stage IV breast cancer in the United States.

    Science.gov (United States)

    Hernandez-Aya, Leonel F; Ma, Cynthia X

    2016-06-01

    The therapeutic landscape for metastatic breast cancer (MBC) has expanded greatly over the last three decades with an increasing availability of targeted therapies for specific breast cancer subtypes. However, cytotoxic chemotherapy remains an essential component for the management of endocrine refractory or triple negative MBC. Multiple chemotherapy agents have demonstrated activity in MBC as single agents and in combination. While taxanes are frequently recommended as the initial treatment of metastatic disease, capecitabine is a convenient oral therapy with well received toxicity profile. Eribulin is the only agent that demonstrated overall survival (OS) benefit in a phase III clinical trial when compared to treatment of physician choice in heavily pre-treated patients. Ixabepilone, gemcitabine, vinorelbine and platinum agents have demonstrated activity and, therefore, constitute additional therapeutic options. In this review, we will discuss the data supporting the use of different cytotoxic agents and the general principles in guiding the use of chemotherapy. PMID:27164855

  5. 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

  6. 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)

  7. Supply side energy management for sustainable energy ( development in Pakistan

    International Nuclear Information System (INIS)

    Pakistan is an energy deficient country. Indigenous reserves of oil and gas are limited and the country heavily depends on imported energy. The indigenous coal is of poor quality. Environmental pollution and greenhouse gas emissions from energy use are becoming significant environmental issues in the country. Sustainability is regarded as a major consideration for both urban and rural development in Pakistan. People in the country have been exploiting the natural resources with no consideration to the effects-both short term (environmental) and long term (resource crunch). The urban areas of the country depend to a large extent on commercial energy sources. The rural areas use non-commercial sources like firewood, agricultural wastes and animal dung. Even this is decreasing over the years, with the villagers wanting to adopt the ready to use sophisticated technology. The debate now is to identify a suitable via media. The option that fills this gap aptly is the renewable energy source. This paper analyses the supply side management of energy resources in relation to sustainable energy development. The present study shows that for achieving long-term environmental sustainable development, renewable energy is the major option that could meet the growing energy needs in Pakistan. (author)

  8. 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

  9. DSM [demand-side management] financing: Risks and incentives

    International Nuclear Information System (INIS)

    Opportunities to make investments in demand side management (DSM) are widespread, especially among large, complex, energy-intensive customers. Acceptable economics are found for energy efficiency improvements, new construction or renovation, replacement of failing or obsolete equipment, and retrofit of existing facilities with more efficient equipment and operations. Market imperfections and technical limitations intrude on the DSM investment process. These intrusions are examined from a financial viewpoint by considering the return on investment and risks faced by the three potential investors in DSM opportunities: the customer, the utility, and the third party contractor or financier. These risks are illustrated by examining the cash flow of a typical project depicting a comprehensive energy efficiency installation in a medium to large industrial or institutional facility. The spread between the customer's risk/return ratio and that of the other two investors is shown to be surprisingly large. A utility role in marketing and financing, as opposed to direct subsidizing of customers or direct purchase of DSM resources from third parties, is explored as an efficient response to these realities. 2 figs., 3 tabs

  10. 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. PMID:26860340

  11. 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.

  12. 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

  13. 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

  14. Effects of utility demand-side management programs on uncertainty

    International Nuclear Information System (INIS)

    Electric utilities face a variety of uncertainties that complicate their long-term resource planning. These uncertainties include future economic and load growths, fuel prices, environmental and economic regulations, performance of existing power plants, cost and availability of purchased power, and the costs and performance of new demand and supply resources. As utilities increasingly turn to demand-side management (DSM) programs to provide resources, it becomes more important to analyze the interactions between these programs and the uncertainties facing utilities. This paper uses a dynamic planning model to quantify the uncertainty effects of supply-only vs DSM + supply resource portfolios. The analysis considers four sets of uncertainties: economic growth, fuel prices, the costs to build new power plants, and the costs to operate DSM programs. The two types of portfolios are tested against these four sets of uncertainties for the period 1990 to 2010. Sensitivity, scenario, and worst-case analysis methods are used. The sensitivity analyses show that the DSM + supply resource portfolio is less sensitive to unanticipated changes in economic growth, fuel prices, and power-plant construction costs than is the supply-only portfolio. The supply-only resource mix is better only with respect to uncertainties about the costs of DSM programs. The base-case analysis shows that including DSM programs in the utility's resource portfolio reduces the net present value of revenue requirements (NPV-RR) by 490 million dollars. The scenario-analysis results show an additional 30 million dollars (6%) in benefits associated with reduction in these uncertainties. In the worst-case analysis, the DSM + supply portfolio again reduces the cost penalty associated with guessing wrong for both cases, when the utility plans for high needs and learns it has low needs and vice versa. 20 refs

  15. 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.

  16. Does chemotherapy have a role in low-grade astrocytoma management? A report of 13 cases.

    Science.gov (United States)

    Castello, M A; Schiavetti, A; Padula, A; Varrasso, G; Properzi, E; Trasimeni, G; Operamolla, P; Gualdi, G F; Clerico, A

    1995-08-01

    Surgery is the treatment of choice for low-grade astrocytoma while radiotherapy is carried out only when total resection is not possible. This study assessed the effectiveness of chemotherapy in nonresectable cases. Thirteen children with nonresectable astrocytoma were treated with carboplatin and etoposide and after four cycles the response to treatment was evaluated according to radiologic criteria. The results were: one with complete response (CR), three with minor response (MR), six with stable disease (SD), and three with progressive disease (PD). Moreover, in 77% there was an improvement in the neurologic picture. In particular, two cases with hypothalamic astrocytoma showed a regression of the diencephalic syndrome following chemotherapy. In six cases chemotherapy was carried out, at reduced dosage, after the first four cycles either because there was clinical improvement or because it was necessary to postpone radiotherapy in very young patients. After a follow-up period ranging between 11 and 63 months (average: 30 months), nine of the 13 patients are alive (69%) while four died of disease progression. Further studies would be useful to evaluate the role of chemotherapy in the management of low-grade astrocytoma. PMID:7603393

  17. 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...

  18. [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

  19. 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

  20. 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.

  1. Waste Management: The Brown Side of Green Economy

    OpenAIRE

    Massarutto Antonio

    2011-01-01

    The article presents a framework for assessing integrated waste management opportunities adopting an economic life-cycle analysis approach. Results show that greening the waste management sector represents an opportunity for sustainable development. However, this will hardly occur without considering that waste exists and has to be dealt with, not necessarily with the «soft» solutions advocated by supporters of the «zero waste» strategy alone. Industrial management of waste must include eithe...

  2. Symptom management in patients with cancer of the female reproductive system receiving chemotherapy.

    Science.gov (United States)

    Phianmongkhol, Yupin; Suwan, Natthawan

    2008-01-01

    This study was conducted to examine the feelings, symptom management, and needs of patients with gynecological cancer receiving chemotherapy at Chiang Mai University Hospital, Chiang Mai, Thailand. During the period July 2006 and June 2007, 286 patients were recruited. The most common chemotherapeutic regimen was paclitaxel and carboplatin followed by single carboplatin and weekly cisplatin. Five severe and frequent complications were as follows: alopecia, anorexia, fatigue, nausea, and vomiting. Some 41.9% could well tolerate with such complications but 50.3% had various feelings including irritability, boredom, dejection, fear, stress, and anxiety. Anorexia was the symptom that the majority of them could best manage, 17.4% by eating as much as they can and 32.6% by selecting different foods from normal, such as fruit, sweetmeats, noodles, milk. For nausea and vomiting, 31.3% managed by eating fruit, drinking sour juice, and holding sour fruit in mouth, and 16.0% used the breathing method, eating something cold, such as ice-cream, or hot food like noodles. For health needs, 41.0% needed encouragement, care, health education, and information from doctors and nurses, and 5.0% needed care and encouragement from their family, and sympathy from neighbors and colleagues. In conclusion, gynecological cancer patients receiving chemotherapy experience a variety of feelings, symptom management. and health needs. Nurses need to explain the pathology of the occurring symptoms so that the patients can understand and accept the symptoms to lessen their negative impact. PMID:19256770

  3. 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

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

    OpenAIRE

    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 sustain...

  5. [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

  6. 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

  7. Music Downloads and the Flip Side of Digital Rights Management

    OpenAIRE

    Dinah A. Vernik; Devavrat Purohit; Preyas S. Desai

    2011-01-01

    Digital rights management (DRM) is an important yet controversial issue in the information goods markets. Although DRM is supposed to help copyright owners by protecting digital content from illegal copying or distribution, it is controversial because DRM imposes restrictions on even legal users, and there are many industry practitioners who believe that the industry would be better off without DRM. In this paper, we model consumers' utilities and their incentives to purchase legal products v...

  8. [Side effects in aesthetic medicine. Spectrum, management and avoidance].

    Science.gov (United States)

    Wollina, U; Goldman, A; Naoum, C

    2013-03-01

    Aesthetic medicine has become increasingly popular in the last two decades. The same trend has occurred in dermatology. Aesthetic dermatology prefers minimally invasive procedures. Nevertheless, even these procedures are not free of possible adverse effects. The spectrum of possible adverse effects, their management and prevention are discussed for four popular procedures in aesthetic dermatology, i.e. chemical peels, mesotherapy, botulinum toxin, and dermal fillers. Aesthetic procedures should only be performed by well-educated, well-trained medical doctors with an excellent medical background, never by lay persons. PMID:23430168

  9. 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)

  10. 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...

  11. 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.

  12. 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...

  13. 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

    2016-01-01

    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. PMID:26817597

  14. 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...

  15. 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....

  16. Managing Radiation Therapy Side Effects: What to Do about Feeling Sick to Your Stomach and Throwing Up (Nausea and ...

    Science.gov (United States)

    ... Radiation Therapy Side Effects What To Do About Feeling Sick to Your Stomach and Throwing Up (Nausea ... you eat it. Managing Radiation Therapy Side Effects: Feeling Sick to Your Stomach and Throwing Up (Nausea ...

  17. 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

  18. 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.

  19. 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.)

  20. 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…

  1. 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

    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...

  2. Demand Side Management by controlling refrigerators and its effects on consumers

    International Nuclear Information System (INIS)

    Highlights: ► The yearly energy cost of a refrigerator can be decreased up to 11.4% with DSM. ► The multiple pricing tariff provides 5.4% discount compared to the single pricing tariff. ► 37.9% of refrigerator’s demand in peak times can be shifted to the other periods. ► DSM applications will work efficiently, if they are widely used by consumers. ► Defrost control contributed to savings by 1.7%. - Abstract: Demand Side Management in power grids has become more and more important in recent years. Continuously growing energy demand both increases the need for distributed generation from renewable energy sources and brings out the topic of Demand Side Management. One of the major application areas of Demand Side Management in smart grids is cooling systems. In this paper, Demand Side Management with control of a refrigerator and its economic effects on consumers are analyzed. With a refrigerator model based on real measurements, several cooling schedules are simulated and annual energy fees for different pricing methods in use in Turkey are calculated and discussed. The results revealed that, 37.9% of refrigerator’s demand in peak period can be shifted to other periods and annual electricity bills for customers can be reduced by 11.4%.

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

    International Nuclear Information System (INIS)

    Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC). Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy. Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS) and those who underwent surgery alone (S) respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable

  8. Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

    Directory of Open Access Journals (Sweden)

    Hawkes Eliza A

    2012-08-01

    Full Text Available Abstract Background Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC. Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy. Methods Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Results Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS and those who underwent surgery alone (S respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Conclusions Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable.

  9. 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, this...... architecture can encapsulate the system functionality, assure the interoperability between various components, allow the integration of different energy sources, and ease maintenance and upgrading. Hence it is capable of handling autonomous energy consumption management for systems with heterogeneous dynamics...... 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 and...

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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...

  17. 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.

  18. 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 ...

  19. The use of scalp cooling for chemotherapy-induced hair loss.

    Science.gov (United States)

    Young, Annie; Arif, Azra

    2016-05-26

    Chemotherapy-induced hair loss is a common and distressing side effect of cancer therapy and is one of the major unmet challenges in cancer management. Scalp cooling can prevent chemotherapy-induced hair loss in some cancer patients with solid tumours receiving certain chemotherapy regimens. Recent evidence indicates that this technique does not increase the risk of scalp metastasis. A reduction in post-chemotherapy infusion duration of scalp cooling and the advancement in cool cap technology may assist clinicians in promoting scalp cooling to cancer patients. This article discusses recent research, scalp cooling guidelines, products available and implications for nurses and their organisations in providing scalp cooling. It also considers recent advancements in identifying genes associated with chemotherapy-induced hair loss and international research collaborations including a registry and a 'chemotherapy-induced hair loss action group'-all striving to improve the patient experience of chemotherapy-induced hair loss. PMID:27231746

  20. 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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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 and...

  2. 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 ...

  3. The use of parenteral nutrition for the management of PKU patient undergoing chemotherapy for lymphoma: a case report.

    Science.gov (United States)

    Salvarinova-Zivkovic, R; Hartnett, C; Sinclair, G; Dix, D; Horvath, G; Lillquist, Y; Stockler-Ipsiroglu, S

    2012-04-01

    The metabolic control of phenylalanine levels is a challenge during illness. We present the metabolic management of a 6 year old boy with classical PKU who was diagnosed with stage III intraabdominal Burkit's lymphoma and underwent surgical resection and chemotherapy. The metabolic control during chemotherapy was achieved by the use of parenteral custom made amino acid solution and pro-active adjustment of intake. From the 94 obtained plasma phenylalanine (Phe) levels, 18.4% were above our clinic's recommended upper limit (360 μmol/L, 6 mg/dL) while 52.7% of Phe levels were below the recommended lower limit (120 μmol/L, 2 mg/dL). Phe levels above recommended range were associated with low caloric/protein intake, while levels below recommended range reflected the difficulty in achieving the full prescribed Phe intake. We recommend early institution of custom made amino acid solution with maximum amino acid content and caloric intake to provide optimal phenylalanine control. Administration of phenylalanine via regular intravenous amino acid solution may assist in avoiding low Phe levels when prescribed intake is compromised due to vomiting and other disease related illnesses. Use of custom made, phenylalanine free amino acid solution proved beneficial in the management of blood phenylalanine levels in a PKU patient during chemotherapy for Burkitt lymphoma. PMID:22305856

  4. 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.

  5. Understanding the side effects of emission trading: implications for waste management.

    Science.gov (United States)

    Braschel, Nina; Posch, Alfred; Pierer, Magdalena

    2014-01-01

    The trading of emission allowances is an important market instrument in climate policy. However, the inclusion of certain branches of industry in the trading system not only provides incentives for emission reduction, it also entails unwanted side effects. Thus, the objective of the present study is to identify such side effects-positive and negative-by examining the potential impact of waste management inclusion in the European Union Emissions Trading Scheme (EU ETS). Desk research was supplemented with qualitative and quantitative empirical analysis (based on expert interviews and a questionnaire) in order to analyse the related perceptions and expectations of actors and stakeholders. The impact of waste management inclusion in the EU ETS is analysed in terms of the following three areas: (i) costs and cost pass-through, (ii), competitiveness and market position, and (iii) carbon leakage. Concerning expectations in the area of costs, both the interviewed experts and the practitioners surveyed thought that costs were likely to increase or that they could be passed on to customers. However, experts and practitioners differed with respect to the possibility of carbon leakage. Clearly, increased knowledge of the possible impact arising from inclusion of the waste sector in the EU ETS would enable managers to become more proactive and to manage waste streams and treatment options more economically. PMID:24323330

  6. 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.

  7. 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)

  8. The impact of demand side management strategies in the penetration of renewable electricity

    International Nuclear Information System (INIS)

    High fuel costs, increasing energy security and concerns with reducing emissions have pushed governments to invest in the use of renewable energies for electricity generation. However, the intermittence of most renewable resources when renewable energy provides a significant share of the energy mix can create problems to electricity grids, which can be minimized by energy storage systems that are usually not available or expensive. An alternative solution consists on the use of demand side management strategies, which can have the double effect of reducing electricity consumption and allowing greater efficiency and flexibility in the grid management, namely by enabling a better match between supply and demand. This work analyzes the impact of demand side management strategies in the evolution of the electricity mix of Flores Island in the Azores archipelago which is characterized by high shares of renewable energy and therefore the introduction of more renewable energy sources makes it an interesting case study for testing innovative solutions. The electricity generation system is modeled in TIMES, a software which optimizes the investment and operation of wind and hydro plants until 2020 based on scenarios for demand growth, deployment of demand response technologies in the domestic sector and promotion of behavioral changes to eliminate standby power. The results show that demand side management strategies can lead to a significant delay in the investment on new generation capacity from renewable resources and improve the operation of the existing installed capacity. -- Highlights: ► Energy efficiency can help reduce the need for investment in more renewable energy. ► Dynamic demand helps increase the use of renewable energy in low demand periods. ► Around 40% of total consumption by domestic appliances is used as dynamic demand. ► The load of domestic appliances is mainly shifted to the 5:00 to 9:00 period.

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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 ...

  14. Development of assessment model for demand-side management investment programs in Korea

    International Nuclear Information System (INIS)

    The goal of this study is the development of the assessment model for demand-side management investment programs (DSMIPs) in the areas of natural gas and district heating. Demand-side management (DSM) is the process of managing the consumption of energy to optimize available and planned generation resources and DSMIPs are the actions conducted by energy suppliers to promote investment in the DSM. In this research, the analytic hierarchy process (AHP) method was used to develop a scientific and rational assessment model for DSMIPs. To apply the AHP method, assessment indicators for the assessment have been identified by using the concept of 'plan, do, see' and the decision-making hierarchy was established. Then AHP model was developed to set up the priorities of assessment indicators and a survey of experts from government and energy suppliers was carried out. Finally, the priorities of assessment indicators were calculated based on the result of survey using the AHP method. The assessment model developed from this research will actually be used to assess the results of DSMIPs, which is being carried out by Korea gas corporation (KOGAS) and Korea district heating corporation (KDHC). The use of the assessment model developed by this research is expected to contribute to enhance efficiency in planning, execution, and assessment of DSMIPs

  15. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Sottocornola, Lara; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Paganelli, Corrado; Majorana, Alessandra; Gastaldi, Giorgio; Bossi, Paolo; Berruti, Alfredo; Pavanato, Giovanni; Nicolai, Piero; Maroldi, Roberto; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-01-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis, hypo-salivation and xerostomia, trismus, radiation caries etc.), are often debilitating. These effects tend to be underestimated and insufficiently addressed in the medical community. A multidisciplinary group of head and neck cancer specialists met in Milan with the aim of reaching a consensus on clinical definitions and management of these toxicities. The Delphi Appropriateness method was used for developing the consensus, and external experts evaluated the conclusions. This paper contains 10 clusters of statements about the clinical definitions and management of head and neck cancer treatment sequels (dental pathologies and osteo-radionecroses) 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-radionecroses (10 clusters of statements), whereas this second part deals with trismus and xerostomia. PMID:26318095

  16. 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

  17. 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.)

  18. 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.

  19. 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 to...... exercise was 73% and for health counseling 92%. There were improvements in the 6-min-walk-distance (p=0.0013), sit-to-stand test (p=0.0062), the right and left biceps arm-curl tests p=0.0002 and p=0.0002, respectively; health-related quality of life (p=0.0209) (FACT-An), vitality (p=0.0015), mental health...

  20. 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.

  1. [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. PMID:27210089

  2. 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.

  3. 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. .

  4. Are Agonistic Autoantibodies against G-Protein Coupled Receptors Involved in the Development of Long-Term Side Effects of Tumor Chemotherapy?

    Science.gov (United States)

    Haberland, Annekathrin; Santos, Robson A S; Schimke, Ingolf; Wallukat, Gerd

    2013-01-01

    Metabolic syndrome and cardiomyopathies are long-term consequences of chemo- and radiotherapy and develop long after completing the initial tumor treatment. The slow progression of such late effects might be an indication of the involvement of autoimmune processes in the development of such follow-up consequences. Functionally active autoantibodies, which permanently stimulate relevant cell receptors, might be a crucial component. Here, we report the detection of functionally active agonistic autoantibodies such as the autoantibody against the adrenergic alpha1-receptor, the muscarinic M2-receptor, and the newly discovered autoantibody against the Mas-receptor in the plasma of a cancer survivor following chemotherapy treatment. PMID:23569443

  5. 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

  6. Demand Side Management for the European Supergrid: Occupancy variances of European single-person households

    International Nuclear Information System (INIS)

    The prospect of a European Supergrid calls for research on aggregate electricity peak demand and Europe-wide Demand Side Management. No attempt has been made as yet to represent a time-related demand curve of residential electricity consumption at the European level. This article assesses how active occupancy levels of single-person households vary in single-person household in 15 European countries. It makes use of occupancy time-series data from the Harmonised European Time Use Survey database to build European occupancy curves; identify peak occupancy periods; construct time-related electricity demand curves for TV and video watching activities and assess occupancy variances of single-person households. - Highlights: ► Morning peak occupancies of European single households tale place between 7h30 and 7h40. ► Evening peaks take place between 20h10 and 20h20. ► TV and video activities during evening peaks make up about 3.1 GWh of European peak electricity load. ► Baseline and peak occupancy variances vary across countries. ► Baseline and peak occupancy variances can be used as input for Demand Side Management choices.

  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. 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...

  9. Chemotherapy targeting cancer stem cells

    OpenAIRE

    Liu, Haiguang; Lv, Lin; Yang, Kai

    2015-01-01

    Conventional chemotherapy is the main treatment for cancer and benefits patients in the form of decreased relapse and metastasis and longer overall survival. However, as the target therapy drugs and delivery systems are not wholly precise, it also results in quite a few side effects, and is less efficient in many cancers due to the spared cancer stem cells, which are considered the reason for chemotherapy resistance, relapse, and metastasis. Conventional chemotherapy limitations and the cance...

  10. Bulk electric system reliability evaluation incorporating wind power and demand side management

    Science.gov (United States)

    Huang, Dange

    correlations and the interactive effects of wind power and load forecast uncertainty on system reliability are examined. The concept of the security cost associated with operating in the marginal state in the well-being framework is incorporated in the economic analyses associated with system expansion planning including wind power and load forecast uncertainty. Overall reliability cost/worth analyses including security cost concepts are applied to select an optimal wind power injection strategy in a bulk electric system. The effects of the various demand side management measures on system reliability are illustrated using the system, load point, and well-being indices, and the reliability index probability distributions. The reliability effects of demand side management procedures in a bulk electric system including wind power and load forecast uncertainty considerations are also investigated. The system reliability effects due to specific demand side management programs are quantified and examined in terms of their reliability benefits.

  11. Optimal Multi-scale Demand-side Management for Continuous Power-Intensive Processes

    Science.gov (United States)

    Mitra, Sumit

    With the advent of deregulation in electricity markets and an increasing share of intermittent power generation sources, the profitability of industrial consumers that operate power-intensive processes has become directly linked to the variability in energy prices. Thus, for industrial consumers that are able to adjust to the fluctuations, time-sensitive electricity prices (as part of so-called Demand-Side Management (DSM) in the smart grid) offer potential economical incentives. In this thesis, we introduce optimization models and decomposition strategies for the multi-scale Demand-Side Management of continuous power-intensive processes. On an operational level, we derive a mode formulation for scheduling under time-sensitive electricity prices. The formulation is applied to air separation plants and cement plants to minimize the operating cost. We also describe how a mode formulation can be used for industrial combined heat and power plants that are co-located at integrated chemical sites to increase operating profit by adjusting their steam and electricity production according to their inherent flexibility. Furthermore, a robust optimization formulation is developed to address the uncertainty in electricity prices by accounting for correlations and multiple ranges in the realization of the random variables. On a strategic level, we introduce a multi-scale model that provides an understanding of the value of flexibility of the current plant configuration and the value of additional flexibility in terms of retrofits for Demand-Side Management under product demand uncertainty. The integration of multiple time scales leads to large-scale two-stage stochastic programming problems, for which we need to apply decomposition strategies in order to obtain a good solution within a reasonable amount of time. Hence, we describe two decomposition schemes that can be applied to solve two-stage stochastic programming problems: First, a hybrid bi-level decomposition scheme with

  12. 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.

  13. 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.

  14. Efficacy and side effects of glyceryl trinitrate in management of chronic anal fissure

    International Nuclear Information System (INIS)

    Background: Various options are available for treatment of chronic anal fissure, each with its own associated complications. This study aimed to evaluate the efficacy of topical Glyceryl Trinitrate (GTN) for anal fissures in an outpatient setting. Methods: A prospective experimental study was carried out at the outpatient department of Surgical Unit IV, Liaquat University Hospital from Aug 2004 to Jul 2005. Total 100 patients fulfilling the criteria of chronic anal fissure were included in the study. Patients presenting with chronic anal fissure but with associated comorbidities were excluded. Data were collected on a designed questionnaire, and analysed using SPSS-10. Results: Sixty women and 46 men were included in the study with a mean age of 30 years. After the end of 8 weeks of treatment, 76 showed healing of fissure and relief in symptoms whereas 20 patients either had improvement in symptoms or did not heal. The commonest side-effect was headache reported by 21 patients. The minimum period of follow-up was one year, and 7 patients had recurrence. Conclusion: Topical 0.2% GTN is an effective first-line agent in managing chronic anal fissure. The associated side effects and recurrence remains a matter of concern. (author)

  15. Optimal energy efficiency policies and regulatory demand-side management tests: How well do they match?

    International Nuclear Information System (INIS)

    Under conventional models, subsidizing energy efficiency requires electricity to be priced below marginal cost. Its benefits increase when electricity prices increase to finance the subsidy. With high prices, subsidies are counterproductive unless consumers fail to make efficiency investments when private benefits exceed costs. If the gain from adopting efficiency is only reduced electricity spending, capping revenues from energy sales may induce a utility to substitute efficiency for generation when the former is less costly. This goes beyond standard 'decoupling' of distribution revenues from sales, requiring complex energy price regulation. The models' results are used to evaluate tests in the 2002 California Standard Practice Manual for assessing demand-side management programs. Its 'Ratepayer Impact Measure' test best conforms to the condition that electricity price is too low. Its 'Total Resource Cost' and 'Societal Cost' tests resemble the condition for expanded decoupling. No test incorporates optimality conditions apart from consumer choice failure.

  16. Public involvement in integrated resource planning: A study of demand-side management collaboratives

    Energy Technology Data Exchange (ETDEWEB)

    Raab, J. (Raab (J.), Boston, MA (United States)); Schweitzer, M. (Oak Ridge National Lab., TN (United States))

    1992-02-01

    Many utilities and nonutility parties (NUPs) across the country have tried a new approach to reaching agreement on Demand-Side Management (DSM) program design and policy issues. Through this, which is called the DSM collaborative process, parties who have often been adversaries in the past attempt to reach consensus rather than using traditional litigation to resolve differences. We examined nine cases of DSM collaboration involving 24 utilities and approximately 50 NUPs in 10 states. This is the first comprehensive, in-depth review and assessment of collaboratives and it allows conclusions to be drawn about the collaborative process and the factors that contribute to successful efforts of this type. Collaboratives are described in terms of four major contextual and organizational characteristics: regulatory and legal history, parties involved and parties excluded, collaborative scope, and the collaborative process itself.

  17. Demand side management for remote area power supply systems incorporating solar irradiance model

    International Nuclear Information System (INIS)

    This paper presents a technique for generating the daily electricity load profile for remote areas in the Middle East from first principles, using diversified demand. The generated load profile includes the energy required to run a small desalination unit to provide the necessary freshwater. Demand side management (DSM) is used in this study to smooth out the daily peaks and fill valleys in the load curve to make the most efficient use of energy resources. Finally, the load profile is compared with real data for six houses collected from Safri area in the Sultanate of Oman. These data may be used as the basis to obtain load profiles of other remote areas of the Middle East since the weather and social factors are similar. The modified hourly variation factor based on weather and economic and social factors of the Middle East is obtained. (author)

  18. 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

  19. 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)

  20. Screening demand-side management programs with a value-based test

    International Nuclear Information System (INIS)

    In this paper a value-based test is presented for economic screening of electric utility demand-side management (DSM) programs. The widely used least cost test is valid only if the programs do not alter the amount or value of energy services provided to customers. But, in general, DSM programs have such effects and, as a result, the value consumers receive is changed. A more general economic efficiency test, the most value test, provides a practical method for considering the effects of DSM on customer value. The version presented here allows for multiple load periods and can account for rate impacts upon several customer classes. Four typical DSM programs are evaluated as illustrations

  1. 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

  2. Demand-side management and demand response in the Ontario energy sectors

    International Nuclear Information System (INIS)

    In June 2003, the Ontario Energy Board was asked by the Minister of Energy to identify and review options for the delivery of demand-side management (DSM) and demand response (DR) activities within the electricity sector, by consulting with stakeholders. The role of local distribution company (distributor) in such activities was also to be determined. The objective was to balance implementation costs with the benefits to consumers and the entire system. The preliminary research and ideas were presented in this discussion paper. Definitions of both DSM and DR were provided, followed by an overview of economic theory and competitive markets. The framework for discussion was presented, along with a list of issues and other considerations. A spectrum of potential approaches to a DSM and DR framework was included and jurisdictional examples provided. A brief overview of the concept of load aggregation was presented and the next steps for consultations were outlined. 30 refs., 7 tabs

  3. Cancer Chemotherapy

    Science.gov (United States)

    ... controlled way. Cancer cells keep growing without control. Chemotherapy is drug therapy for cancer. It works by killing the cancer ... It depends on the type and amount of chemotherapy you get and how your body reacts. Some ...

  4. Cancer Chemotherapy

    Science.gov (United States)

    ... cells grow and die in a controlled way. Cancer cells keep forming without control. Chemotherapy is drug ... Your course of therapy will depend on the cancer type, the chemotherapy drugs used, the treatment goal ...

  5. 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.

  6. 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.

  7. Trends in the use of radiation and chemotherapy in the initial management of patients with carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: The Commission on Cancer of the American College of Surgeons conducts Patient Care Evaluation studies to describe practice patterns and trends in disease management. This report surveys changing strategies in the initial treatment of patients with invasive cancer of the uterine cervix. Methods and Materials: Using a standard data collection form designed by a multidisciplinary committee of specialists, cancer registrars at 703 hospitals submitted anonymous data on 11,721 total cervical cancer patients diagnosed in 1984 and 1990. Results: Between the two study years, the use of radiation as all, or a component, of the initial course of therapy declined from 70 to 60.3%, coincident with a 32.3% increase in the use of hysterectomy alone and a 33.7% reduction in the use of radiation alone. The percentage of all patients receiving combined hysterectomy and radiation (preoperative or postoperative) remained virtually unchanged--10.2% in 1984, and 9.3% in 1990. However, women who were treated by hysterectomy in 1990 were less likely to receive radiation as part of their treatment than patients treated by hysterectomy in 1984. Among patients treated by radiation without hysterectomy, the use of intracavitary brachytherapy techniques substantially exceeded interstitial brachytherapy techniques in both study years. Among patients treated by local radiation without hysterectomy, the frequency of adjunctive chemotherapy use increased from 6.9% in 1984 to 24.8% in 1990, with chemotherapy and radiation increasingly administered concurrently rather than sequentially. Although differences based on age, histology, race/ethnicity, and insurance status were observed, these general management trends were seen in all groups. Conclusions: Changes in the utilization of radiation and surgery may reflect the increasing surgical involvement of gynecologic oncologists in the management of early stage cervical cancer, rather than significant alterations in the demographics of the

  8. Demand-side management and demand response in the Ontario energy sectors

    International Nuclear Information System (INIS)

    A directive from the former Minister of Energy was received by the Ontario Energy Board (OEB), directing the Board to consult with stakeholders on options for the delivery of demand-side management (DSM) and demand response (DR) activities within the electricity sector, including the role of local distribution companies in such activities. The implementation costs were to be balanced with the benefits to both consumers and the entire system. The scope of the review was expanded by the Board to include the role of gas distribution companies in DSM. A consultation process was implemented and stakeholders were invited to participate. A series of recommendations was made, including: (1) a hybrid framework utilizing market-based and public-policy approaches should deliver DSM and DR activities in Ontario's energy markets, (2) DSM and DR activities should come under the responsibility of a central agency, (3) DSM and DR activities should be coordinated through cooperation between the Ministry of Energy, the Independent Electricity Market Operator (IMO) and the Ontario Energy Board, (4) regulatory mechanisms to induce gas distributors, electricity transmitters and electricity distributors to reduce distribution system losses should be put in place, (5) all electricity consumers should fund electricity DSM and some retail DR initiatives through a transparent, non-bypassable consumption charge, and (6) the Board should design, develop and deliver information to consumers regarding energy conservation, energy efficiency, load management, and cleaner sources of energy. refs., 4 figs

  9. 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)

  10. 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

  11. Impact of energy storage in buildings on electricity demand side management

    International Nuclear Information System (INIS)

    Research highlights: → Phase change material (PCM) application for space heating has been implemented and assessed for built environment. → Real-Time Pricing (RTP) is assessed as tool to implement Demand Side Management programs effectively. → Two buildings, with and without PCM, have been compared for space heating using RTP in functional electricity market. → PCM found to offer peak load shifting, energy conservation, and reduction in price of electricity. -- Abstract: This paper assesses impact of using phase change materials (PCM) in buildings to leverage its thermal energy storage capability. The emphasis is from an electricity demand side perspective with case studies that incorporates wholesale electricity market data of New Zealand. The results presented in this paper show that for space heating application significant advantages could be obtained using PCM built structures. These positive impacts include peak load shifting, energy conservation and reduction in peak demand for network line companies and potential reduction in electricity consumption and savings for residential customers. This paper uses a testing facility that consists of two identically designed and shaped offices built at Tamaki Campus location of the University of Auckland, New Zealand. The walls and ceilings of one office are finished with ordinary gypsum boards while the interior of the other office is finished with PCM impregnated gypsum boards. Controlled heating facility is provided in both the offices for maintaining temperature within the range of human comfort. This facility is equipped with advanced data acquisition equipment for data monitoring and archiving both locally within the offices and also remotely. Through actual observations and analysis this paper demonstrates two major impacts of DSM. First, the application of phase change material (PCM) in building environment enabling efficient thermal storage to achieve some reduction in the overall electrical energy

  12. A novel microgrid demand-side management system for manufacturing facilities

    Science.gov (United States)

    Harper, Terance J.

    Thirty-one percent of annual energy consumption in the United States occurs within the industrial sector, where manufacturing processes account for the largest amount of energy consumption and carbon emissions. For this reason, energy efficiency in manufacturing facilities is increasingly important for reducing operating costs and improving profits. Using microgrids to generate local sustainable power should reduce energy consumption from the main utility grid along with energy costs and carbon emissions. Also, microgrids have the potential to serve as reliable energy generators in international locations where the utility grid is often unstable. For this research, a manufacturing process that had approximately 20 kW of peak demand was matched with a solar photovoltaic array that had a peak output of approximately 3 KW. An innovative Demand-Side Management (DSM) strategy was developed to manage the process loads as part of this smart microgrid system. The DSM algorithm managed the intermittent nature of the microgrid and the instantaneous demand of the manufacturing process. The control algorithm required three input signals; one from the microgrid indicating the availability of renewable energy, another from the manufacturing process indicating energy use as a percent of peak production, and historical data for renewable sources and facility demand. Based on these inputs the algorithm had three modes of operation: normal (business as usual), curtailment (shutting off non-critical loads), and energy storage. The results show that a real-time management of a manufacturing process with a microgrid will reduce electrical consumption and peak demand. The renewable energy system for this research was rated to provide up to 13% of the total manufacturing capacity. With actively managing the process loads with the DSM program alone, electrical consumption from the utility grid was reduced by 17% on average. An additional 24% reduction was accomplished when the microgrid

  13. 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

  14. Chemotherapy induced Hyponatraemia

    OpenAIRE

    Yeoh, Kheng-Wei; Camilleri, Philip; Patel, Kinnari

    2010-01-01

    We present a case report of chemotherapy induced renal salt wasting syndrome (RSWS) that was initially diagnosed and managed as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), based on osmolality values as well as hydration status. The patient was receiving chemotherapy for metastatic testicular cancer. Progressive deterioration of electrolyte balance prompted the diagnosis of RSWS. This was confirmed by a high urinary sodium concentration, a simple but important investig...

  15. 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...

  16. 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

  17. 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

  18. 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.

  19. 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

  20. Electricity storage and demand-side management : is their co-existence possible?

    International Nuclear Information System (INIS)

    Opening of electricity markets can cause actual generation costs to be reflected in prices, which become more variable and tend to follow the patterns of load peaks. Generating electricity at peak times is expensive and therefore, there might be an opportunity for electricity storage systems to alleviate grid congestion. This paper explored the financial and technical performance of electricity storage when demand-side management (DSM) measures are in action at the same time. It presented an analysis that is based on scenarios for DSM implementation in the current level of the Greek market opening to competition. Three major storage technologies were used in the analysis for comparison. The initial load and wholesale price data sets were derived from the Greek Transmission System Operator, referring to the years 2004 and 2005 and were in the form of hourly values. The analysis showed that under the assumptions made and conditions posed, a substantial amount of DSM had only a small effect on storage profits for all technologies, as the maximization of the electricity discharged was achieved by all. 4 refs., 2 tabs., 3 figs

  1. 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.

  2. 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.

  3. Albedo and vegetation demand-side management options for warm climates

    International Nuclear Information System (INIS)

    For electric utilities, demand-side management (DSM) can reduce electric load and shift load from peak to off-peak periods. In general, the investor in DSM collects the reward with lower electric bills, excepting a positive externality because of reduced tropospheric and stratospheric air pollution from fossil fuel power plants. In warm climates, DSM options include increasing albedo and vegetation, respectively, by painting surfaces white and planting trees; these DSM options are distinguished from all other DSM options because of ecosystem effects. Ambient temperature falls, mitigating the urban 'heat island', which reduces electric load and ozone formation. The investor in albedo and vegetation DSM options does not collect all of the reward from lower electric bills, since the lower ambient temperature provides savings to all customers who use electricity for air conditioning and refrigeration. Similar to other DSM options, air pollution is also reduced as a result of lower power plant emissions. Complex airshed models and electric utility system dispatch models are applied in this paper to account for some of these ecosystem effects. Unaccounted ecosystem effects remain, stymieing cost effectiveness analysis

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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...

  9. 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...

  10. 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...

  11. 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

  12. Financial incentives for DSM [demand-side management]: Theory and practice

    International Nuclear Information System (INIS)

    Recent efforts to provide incentives for electric utilities in the USA to undertake demand-side management (DSM) programs are reviewed. The major need for incentives is seen as the overcoming of disincentives inherent in traditional regulation that affect utilities' interest in, and motivation for, DSM programs. These disincentives include the failure to recover all program costs, loss of revenues, and loss of financial opportunity. In addition, utilities seldom perceive DSM as a low-risk proposition; principal areas of concern include regulatory risk, competitive risk, and balance sheet risk. In view of these disincentives and risks, any DSM program therefore should provide for full and timely recovery of all program costs; adjust for DSM-induced revenue losses; and counterbalance risk and loss of financial opportunity by providing a bonus above cost. Three utility-specific incentive proposals are presented for the case of utilities in New York, Massachusetts, and Pennsylvania. Each of these programs meets the goal of overcoming the disincentives that surround utility DSM programs. The most significant differences across the mechanisms are found in the bonus component. Mechanisms that reduce the utility's uncertainty about the receipt of a bonus by providing it in a lump sum will likely prove more powerful motivators than those that spread the bonus out over a period of years. Use of preapproved per-unit or per-customer impact measurements reduces uncertainty and thus increases the apparent value of the bonus. Annual review of program plans and assumed impacts, supported by continuing evaluation activities, minimizes the risk that the utilities will gamble with the system or receive excessive awards. 6 refs

  13. Demand Side Management in a competitive European market: Who should be responsible for its implementation?

    International Nuclear Information System (INIS)

    Demand side management (DSM), more specifically energy efficiency, is standing in the spotlight due to the Kyoto commitments. An additional factor, the liberalization of the electricity markets, causes every country to review its own DSM activities. Especially in Europe, where the directive for opening the electricity market has a direct impact on the current DSM frameworks, governments will have to consider a change in this framework. In order to achieve this, much research has been done in the past years on how to change the DSM framework in a way that the requirements of both liberalization and the Kyoto Protocol will be met. In this paper, we review the current DSM activities and ongoing research from the starting point 'who should be responsible for implementing DSM'. We conclude that countries have to make explicit choices on how to arrange their DSM activities for the different customers groups. They have to be aware of the fact that some combinations of DSM activities will lead to counter-productive results and therefore inefficiency. This paper also investigates which of these DSM activities fits best in the open market; a critical review of Integrated Resource Planning (IRP) is used as a starting point. We agree with various proponents of IRP that planning towards minimal societal costs is theoretically appropriate, looking from a societal point of view. We also indicate in this paper that the planning process IRP is partly applicable in the open market. But looking at the practical application of IRP in the past, we must conclude that there are better alternatives for achieving energy efficient goals in a liberalized market

  14. 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

  15. 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)

  16. 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.

  17. Combined chemotherapy of malignant gliomas

    International Nuclear Information System (INIS)

    A controlled study of 226 age-matched patients with histologically proven grade 3 and 4 supratentorial gliomas with maximum feasible tumour resection, postoperative Karnofsky performance over 50 and minimum survival of 8 weeks compares the results of supportive care (45 cases), high-dose irradiation of 40 to 66 Gy (59 cases), COMP protocol (CCNU, procarbazine, vincristine, methotrexate, prednisone in 15 day cycles-42 cases) and simultaneous irradiation and COMP chemotherapy (80 cases including 30 survivors). Median recurrent-free intervals in the treatment groups (7 to 11.7 months) were significantly longer than after supportive care (4.4 months). Median survival with supportive care (6.7 months) was significantly shorter than after radiation or COMP treatment (11.7 and 12.3 months) and 14.9 to over 19.9 months with combined treatment, where the two-year survival rates were 33 and 67% (for survivors), and the 3-year survival rates 13 to 30%. Toxic side effects of multimodality treatment were more frequent than after chemotherapy. In addition to space-occupying intracranial cysts often simulating tumour recurrence (12%) and rare radiation necrosis, about 15% of long-term survivors developed progressive intellectual dysfunction with brain atrophy, in the absence of tumour regrowth. Despite some promising results of multimodality approaches towards the management of malignant supratentorial gliomas, the overall results are unsatisfactory and need further optimization. (Author)

  18. 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 ...

  19. 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

  20. 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

  1. Game-theoretic Demand-side Management Robust to Non-Ideal Consumer Behavior in Smart Grid

    OpenAIRE

    Mediwaththe, Chathurika P.; Smith, David B.

    2016-01-01

    This paper investigates effects of realistic, non-ideal, decisions of energy users as to whether to participate in an energy trading system proposed for demand-side management of a residential community. The energy trading system adopts a non-cooperative Stackelberg game between a community energy storage (CES) device and users with rooftop photovoltaic panels where the CES operator is the leader and the users are the followers. Participating users determine their optimal energy trading start...

  2. Demand side management on an intricate multi-shaft pumping system from a single point of control / Shane Thein

    OpenAIRE

    Thein, Shane

    2007-01-01

    Eskom, the sole supplier of electricity in South Africa is facing an energy crisis. This is due to the steady increase in demand for electricity in South Africa. Low electricity prices in South Africa have helped the energy intensive industries of South Africa to be more competitive. Unfortunately this has resulted in poor energy efficiency practices and has hampered incentives to save energy. To address this problem, Eskom initiated a Demand Side Management (DSM) programme....

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. Model Predictive Controller for Active Demand Side Management with PV Self-consumption in an Intelligent Building

    DEFF Research Database (Denmark)

    Zong, Yi; Mihet-Popa, Lucian; Kullmann, Daniel;

    2012-01-01

    This paper presents a Model Predictive Controller (MPC) for electrical heaters’ predictive power consumption including maximizing the use of local generation (e.g. solar power) in an intelligent building. The MPC is based on dynamic power price and weather forecast, considering users’ comfort set...... for Active Demand Side Management (ADSM) can dramatically save energy and improve grid reliability, when there is a high penetration of Renewable Energy Sources (RESs) in the power system. © 2012 IEEE...... settings to meet an optimization objective such as minimum cost and minimum reference temperature error. It demonstrates that this MPC strategy can realize load shifting, and maximize the PV self-consumption in the residential sector. With this demand side control study, it is expected that MPC strategy...

  8. 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)

  9. 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.

  10. 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.

  11. 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 ...

  12. 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...

  13. Demand side management program evaluation based on industrial and commercial field data

    International Nuclear Information System (INIS)

    Demand Response is increasingly viewed as an important tool for use by the electric utility industry in meeting the growing demand for electricity. There are two basic categories of demand response options: time varying retail tariffs and incentive Demand Response Programs. is applying the time varying retail tariffs program, which is not suitable according to the studied load curves captured from the industrial and commercial sectors. Different statistical studies on daily load curves for consumers connected to 22 kV lines are classified. The load curve criteria used for classification is based on peak ratio and night ratio. The data considered here is a set of 120 annual load curves corresponding to the electric power consumption (the western area in the King Saudi Arabia (KSA)) of many clients in winter and some months in the summer (peak period). The study is based on real data from several Saudi customer sectors in many geographical areas with larger commercial and industrial customers. The study proved that the suitable Demand Response for the ESC is the incentive program. - Highlights: → Study helps in selecting the proper demand side program. → A credit will be given for the customers during summer months. → Reduction in the electric bill. → Monthly bill credit is decreased based on customers' peak load reduction. → Guide for applying the proper demand side program suitable for the utility and customers.

  14. 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.

  15. 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

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

    Science.gov (United States)

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

    2015-10-01

    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 adverse effects in head and neck cancer patients (HNCPs) are very heterogeneous due to the lack of shared rigorous classification systems and evidence based treatments. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of dermatitis in HNCPs treated with radiotherapy with or without systemic therapies in order to improve skin toxicity management. The Delphi Appropriateness Method was used. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. This paper offers contains seven clusters of statements about the management of dermatitis in HNCPs and a review of recent literature on these topics. PMID:26187236

  17. 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 ...

  18. Side Effects

    Science.gov (United States)

    Home Fact Sheet Categories Internet Bookmarks on AIDS Have Questions? Printing & ... Effects WHAT ARE SIDE EFFECTS? WHO GETS SIDE EFFECTS? HOW TO DEAL WITH SIDE EFFECTS WHICH SIDE EFFECTS ARE THE MOST ...

  19. 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.

  20. 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

  1. 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…

  2. 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

  3. 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

  4. 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...

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. Management of side effects of mTOR inhibitors in tuberous sclerosis patients.

    Science.gov (United States)

    Sadowski, Krzysztof; Kotulska, Katarzyna; Jóźwiak, Sergiusz

    2016-06-01

    mTOR inhibitors represent a relatively new therapeutic option in the management of patients affected by tuberous sclerosis complex (TSC). Randomized clinical trials support the use of everolimus in the treatment of subependymal giant cell astrocytomas (SEGA) and renal angiomyolipomas (AML) related to TSC. Accumulating data suggest also systemic disease-modifying potential of mTOR inhibitors. Given that increasing number of patients with TSC receive mTOR inhibitors, the issue of adverse events associated with this therapy becomes practically important. In the present study we provide the overview of clinical manifestations and therapeutic options for the most common adverse events related to mTOR inhibitors in TSC patients. PMID:26891243

  10. 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.

  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. 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

  14. 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:

  15. 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

  16. 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.

  17. 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)

  18. Economic and environmental impacts from the implementation of an intelligent demand side management system at the European level

    International Nuclear Information System (INIS)

    This paper presents the results of an analysis on the economic and environmental impacts of the application of an intelligent demand side management system, called the Energy Consumption Management System (ECMS), in the European countries. The ECMS can be applied for the control of individual, widely distributed electric loads, using the power distribution network as the command communication channel. The system can be applied in public lighting, in the tertiary and residential sectors, as well as in the industry. A top-down analysis investigates the possible penetration levels in each application area. The long-term impacts following the application of system are evaluated using the LEAP2006 platform. The WASP IV model is also used for the optimization of the power generation expansion and the corresponding calibration of LEAP2006. Several operational strategies combining variable market penetration of the ECMS and expected energy savings are examined. Results show that, under a logical market penetration, a reduction of 1-4% in primary energy, of 1.5-5% in CO2 emissions and a 2-8% saving in investment costs for power generation expansion is to be expected for the EU-15. The results also justify that innovative devices may be attractive to end users and also help in the implementation of global energy-saving policies

  19. 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)

  20. Metering systems and demand-side management models applied to hybrid renewable energy systems in micro-grid configuration

    International Nuclear Information System (INIS)

    This paper proposes a demand-side management model integrated to a metering system for hybrid renewable energy systems in micro-grid configuration. The proposal is based on the management problems verified in most of this kind of renewable hybrid systems installed in Brazil. The main idea is the implementation of a pre-paid metering system with some control functions that directly act on the consumer demand, restricting the consumption proportionally to the monthly availability of renewable energy. The result is a better distribution of the electricity consumption by month and by consumer, preventing that only one user, with larger purchasing power, consumes all the renewable energy available at some time period. The proportionality between the consumption and the renewable energy's availability has the objective to prevent a lack of energy stored and a high use of the diesel generator-set on months of low renewable potential. This paper also aims to contribute to the Brazilian regulation of renewable energy systems supplying micro-grids. - Highlights: ► Review of the Brazilian electricity regulation for small-scale isolated systems. ► Renewable systems are the most feasible option in several isolated communities. ► One proposal is to guarantee government subsidies for renewable energy systems. ► Smart electronic meters to create electricity restrictions for the consumers.

  1. Utilizing a programmatic focus on energy efficiency and customer feedback to improve the effectiveness of demand side management

    International Nuclear Information System (INIS)

    A project to encourage effective demand side management (DSM) programs through price-responsive load management was presented. The project was conducted through literature searches, surveys of utility programs and interviews with experts. National security, environmental awareness and economic factors were identified as the primary drivers for DSM. A overview of DSM strategies included details of: price responsive programs; power buyback; direct load control; and conservation-based rebates. Target sectors for DSM programs were divided into 4 sectors: (1) residential; (2) agricultural; (3) commercial/industrial; and (4) institutional. A customer decision cycle for DSM was presented, and various programs were evaluated. A comparison between DR and energy efficiency programs in the United States suggested that an increased focus on energy efficiency will benefit DR programs. However, perception of risk due to pricing exposure and the potential for loss of comfort are significant barriers to effective DSM. Studies have shown that DSM is most effective when participants receive direct feedback on consumption. Simple mechanisms for alerting participants of peak periods were recommended, as well as disaggregation tools to highlight areas of high energy usage and spotlight corrective measures. National and regional coordination of DSM activities was also recommended. It was concluded that DSM programs are successful when both customers and suppliers have an equal stake in their success. refs., tabs., figs

  2. 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.

  3. Types of chemotherapy

    Science.gov (United States)

    Chemotherapy is the use of medicine to treat cancer. Chemotherapy kills cancer cells. It may be used to ... people are treated with a single type of chemotherapy. But often, people get more than one type ...

  4. 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 ...

  5. 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 ...

  6. 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

  7. 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.

  8. 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)

  9. Foresighted Demand Side Management

    OpenAIRE

    Xiao, Yuanzhang; van der Schaar, Mihaela

    2014-01-01

    We consider a smart grid with an independent system operator (ISO), and distributed aggregators who have energy storage and purchase energy from the ISO to serve its customers. All the entities in the system are foresighted: each aggregator seeks to minimize its own long-term payments for energy purchase and operational costs of energy storage by deciding how much energy to buy from the ISO, and the ISO seeks to minimize the long-term total cost of the system (e.g. energy generation costs and...

  10. 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 ...... 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....

  11. 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.

  12. 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

  13. 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.

  14. 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.

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

    International Nuclear Information System (INIS)

    Highlights: → We have developed a DSM system with PV electricity and battery storage. → To implement the DSM system, we have developed a modular architecture. → Simulations and real experiments have been executed for different weather conditions. → 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.

  16. A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

    Science.gov (United States)

    Nwosu, Benjamin U.; Meltzer, Bruce; Maranda, Louise; Ciccarelli, Carol; Reynolds, Daniel; Curtis, Laura; King, Jean; Frazier, Jean A.; Lee, Mary M.

    2014-01-01

    Second-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a five-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their financial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best ways to address them. Studies that examined lifestyle modification and pharmaceutical agents have yielded mixed results. Therefore, clinical studies using agents, such as vitamin D, which are inexpensive, readily available, with low side effects profile, and have mechanisms to counteract the metabolic side effects of SGA agents, are warranted. Vitamin D is a prohormone with skeletal and extraskeletal properties that could potentially reduce the severity of these metabolic side effects. Its role as an adjunctive therapy for the management of metabolic side effects of SGA agents has not been adequately studied. Effective strategies to curb these side effects will improve the overall health of youths with psychiatric illnesses who receive SGAs. Herein we present a pilot study on the use of vitamin D in patients on treatment with SGAs. PMID:22145446

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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)

  3. 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

  4. 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.

  5. 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...

  6. 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%...

  7. 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

    International Nuclear Information System (INIS)

    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: Objectives were to assess maximum tolerated dose, dose-limiting toxicity (DLT) and to recommend a safe dose of LAP when administered with 4 cycles of TPF followed by CRT. Results: Seven male patients were included. Three patients were included in the first cohort, at dose level 1 (LAP 500 mg daily plus TPF). Renal toxicity was observed among these three patients (grade 3 [n = 1], grade 2 [n = 1] and grade 1 [n = 1]), with 1 DLT, leading to treatment interruption in this group. Nephrotoxicity was reversible after stopping LAP and hydration of the patients. In a second cohort of four patients administering docetaxel from the second cycle, 3 more DLTs were observed (grade 2 renal toxicity and grade 3 diarrhea, grade 3 anorexia and grade 3 stomatitis, and grade 4 neutropenia). Based on the occurrence of 4 DLTs at the first dose level of LAP, patient recruitment was closed. Conclusion: These data indicate that LAP cannot be combined safely with full dose TPF.

  8. Optimization of the in-line sanitary water heating system for demand side management in the South African commercial and industrial sectors / by Riaan Rankin

    OpenAIRE

    Rankin, Riaan

    2005-01-01

    It is currently estimated that South Africa will be running out of surplus electrical capacity by the year 2007. This estimate is based on the current growth in economy that primarily includes the electrification of half-a-million new households per year, with a final target of 5 Million households by 2007. This situation is forcing ESKOM to take action to reduce peak electrical demand by initiatives such as the implementation of Demand Side Management (DSM) programs. These DSM pr...

  9. 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.

  10. 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

  11. 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

  12. Grey-box Modelling of a Household Refrigeration Unit Using Time Series Data in Application to Demand Side Management

    DEFF Research Database (Denmark)

    Sossan, Fabrizio; Lakshmanan, Venkatachalam; Costanzo, Giuseppe Tommaso;

    2016-01-01

    ) to shift the electricity consumption of a freezer in demand response experiments, thereby addressing the model selection problem also from the application point of view and showing in an experimental context the ability of MPC to exploit the freezer as a demand side resource (DSR)....

  13. 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.

  14. European Palliative Care Research collaborative pain guidelines. Central side-effects management: what is the evidence to support best practice in the management of sedation, cognitive impairment and myoclonus?

    Science.gov (United States)

    Stone, Patrick; Minton, Ollie

    2011-07-01

    This is a systematic review examining the management of opioid-induced central side effects. It has been conducted as part of a larger European Palliative Care Research collaborative review into the use and role of opioids in cancer pain. The review process identified 26 studies that met the inclusion criteria. The overall quality of the data was low and the few recommendations that can be made are weak and require confirmatory studies. The main central side effects examined were sedation, cognitive failure, sleep disturbance and myoclonus. Overall there is limited evidence for the use of methylphenidate in counteracting opioid-induced sedation and cognitive disturbance. No clear recommendations can be made concerning other individual drugs for the management of any of the central side effects examined. Given the lack of available data from this review there need to be further prospective controlled trials to confirm or refute these findings. PMID:20870687

  15. 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.

  16. 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.

  17. Contract Lifecycle Management on the sell-side : a case study in upstream Oil and Gas industry

    OpenAIRE

    Nguyen, Phan Huyen My

    2013-01-01

    Contract lifecycle management (CLM) is becoming a powerful tool for business optimization as pressure grows on modern organizations to develop contract competence. In the context of upstream oil and gas industry, complex contract landscape and escalating burden of regulatory compliance have further driven the demand for effective management of contractual agreements. This thesis examines the implementation of customer contract management in an oilfield services company. The goal set out is...

  18. 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...

  19. 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

  20. 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.

  1. 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...

  2. 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

  3. Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab

    Energy Technology Data Exchange (ETDEWEB)

    Boelke, E.; Mueller-Homey, A.; Pape, H.; Giro, C.; Matuschek, C.; Gripp, S.; Budach, W. [Dept. of Radiation Oncology, Univ. of Duesseldorf (Germany); Gerber, P.A.; Bruch-Gerharz, D.; Homey, B. [Dept. of Dermatology, Univ. of Duesseldorf (Germany); Lammering, G. [Dept. of Radiation Oncology (MAASTRO Clinic), Univ. Hospital Maastricht (Netherlands); Peiper, M. [Dept. of Surgery, Univ. of Duesseldorf (Germany); Hoffmann, T.K. [Dept. of Otorhinolarynogology, Univ. of Duesseldorf (Germany)

    2008-02-15

    Background: the concurrent administration of cetuximab to radiotherapy has recently been shown to improve the clinical outcome of head-and-neck cancer (HNC) patients. An aggravation of the radiation-induced skin toxicity was not described. Here, however, two cases with severe skin toxicity during the combined treatment are reported. Clinical observations: in a small group of five patients with locally advanced HNC treated with irradiation and concurrent cetuximab, two cases of unusually severe radiation dermatitis were observed. Both patients developed confluent moist desquamations confined to the irradiation field at a dose of 40 Gy (CTC - Common Toxicity Criteria, grade 3), which progressed into an ulcerative dermatitis (grade 4) at 58 Gy and 46 Gy, respectively. Histopathology showed a vacuolic degeneration of basal keratinocytes, subepidermal blister formation, and mixed perivascular and interstitial inflammatory infiltrates leading to a complete loss of the epidermis. These cutaneous side effects led to the discontinuation of radiotherapy. Topical corticosteroids and systemic antibiotic treatment resulted in wound healing, which allowed the continuation of radiotherapy. Conclusion: these findings indicate that cetuximab may have the potential to enhance the severity of radiation dermatitis in HNC patients. A systematic monitoring of cutaneous side effects during radiotherapy plus cetuximab is advised in order to reliably estimate the frequency of severe (grade 3/4) radiation dermatitis. (orig.)

  4. Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: Experience of 370 consecutive cases

    International Nuclear Information System (INIS)

    To investigate the outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) after induction chemotherapy, with or without concomitant chemotherapy. Between August 2003 and March 2007, 370 patients with locoregionally advanced NPC were treated with IMRT. Presenting stages were stage IIB in 62, stage III in 197, and stage IVA/B in 111 patients. All patients except for 36 patients with cervical lymphadenopathy of 4 cm or less in diameter received 2 cycles of cisplatin-based neoadjuvant chemotherapy. Forty-eight patients received cisplatin-based concurrent chemotherapy as well. With a median follow-up time of 31 months (range 5 to 61 months), the 3-year local control, regional control, metastasis-free survival (MFS), disease-free survival (DFS) and overall survival (OS) rates were 95%, 97%, 86%, 81% and 89%, respectively. Multivariate analyses revealed that both age (≤ 60 vs. >60) and N-classification are significant prognosticators for OS (P = 0.001, hazard ratio [HR] 2.395, 95% confidence interval [CI] 1.432-4.003; P = 0.012, hazard ratio [HR] 2.614, 95% confidence interval [CI] 1.235-5.533); And N-classification is the only significant predicative factor for MFS (P = 0.002, [HR] 1.99, 95% CI 1.279-3.098). T-classification and concurrent chemotherapy were not significant prognostic factors for local/regional control, MFS, DFS, or OS. Subgroup analysis revealed that concurrent chemotherapy provided no significant benefit to IMRT in locoregionally advanced NPC, but was responsible for higher rates of grade 3 or 4 acute toxicities (50% vs. 29.8%, P < 0.005). No grade 3 or 4 late toxicity including xerostomia was observed. However, two patients treated with IMRT and neoadjuvant but without concurrent and adjuvant chemotherapy died of treatment related complications. IMRT following neoadjuvant chemotherapy produced a superb outcome in terms of local control, regional control, MFS, DFS, and OS rates in

  5. 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)

  6. 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.

  7. 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

  8. 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...

  9. 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 ...

  10. 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

  11. Hair growth modulation by topical immunophilin ligands: induction of anagen, inhibition of massive catagen development, and relative protection from chemotherapy-induced alopecia.

    OpenAIRE

    Maurer, M.; Handjiski, B.; R Paus

    1997-01-01

    Selected immunophilin ligands (IPLs) are not only potent immunosuppressants but also modulate hair growth. Their considerable side effects, however, justify at best topical applications of these drugs for the management of clinical hair growth disorders. Therefore, we have explored hair growth manipulation by topical cyclosporin A (CsA) and FK 506 in previously established murine models that mimic premature hair follicle regression (catagen) or chemotherapy-induced alopecia, two major pathome...

  12. [Quality insurance system establishment in the management of home-based chemotherapy: example of hospital at home "Assistance publique-Hôpitaux de Paris"].

    Science.gov (United States)

    Benizri, F; Balladur, E; Darse, J; Guérin, J; Boudy, V; Echard, M; Brodin, M; Hagenmüller, J B; Prognon, P; Bonan, B

    2010-09-01

    While home-based chemotherapy improves comfort and quality of life of patients, quality and safety conditions must be equivalent to hospital settings. In addition, organization is much more complex. At the hospital at home "Assistance publique-Hôpitaux de Paris", prescribers are potentially spread across 21 health facilities. The administration of chemotherapy is performed by about 300 nurses at the patient's home in Paris and its suburbs. Centralized preparations of chemotherapy began in September 2009 by the pharmacy department of Georges-Pompidou European hospital, with a progressive increase of the activity. This article describes the quality insurance system established with this new organization to meet the specific challenges of home therapy: choice of eligible anticancer drugs, computerized information systems and networking with other heath facilities, secure transport conditions, traceability from the prescription to the administration, security of administration. This experience can offer an important support for other centres in their approach of quality insurance for home chemotherapy. PMID:20807693

  13. 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

  14. 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

  15. 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

  16. Does induction chemotherapy have a role in the management of nasopharyngeal carcinoma? results of treatment in the era of computerized tomography

    International Nuclear Information System (INIS)

    Purpose: To assess the outcomes of patients with nasopharyngeal carcinoma (NPC) whose treatment was determined by computerized tomography (CT) and/or magnetic resonance imaging staging and to analyze the impact of induction chemotherapy and accelerated fractionated radiotherapy. Methods and Materials: The analysis is based on 122 of 143 previously untreated patients with NPC treated with radiation therapy at The University of Texas M.D. Anderson Cancer Center between 1983 and 1992. Excluded were 4 patients treated with palliative intent, 4 children, 12 patients not staged with CT, and 1 patient who died of a cerebrovascular accident prior to completion of treatment. The stage distribution was as follows: AJCC Stage I--2, Stage II--7, Stage III--12, Stage IV--101; T1-15, T2-33, T3-22, T4-52; N0-32, N1-10, N2-47, N3-32, Nx-1. Fifty-nine (48%) patients had squamous cell carcinoma; 63 (52%) had lymphoepitheliomas, undifferentiated NPC or poorly differentiated carcinoma, NOS (UNPC). Sixty-seven patients (65 with Stage IV disease) received induction chemotherapy. Fifty-eight patients (24 of whom had induction chemotherapy) were treated with the concomitant boost fractionation schedule. The median follow-up for surviving patients was 57 months. Results: The overall actuarial 2- and 5-year survival rates were 78 and 68%, respectively. Forty-nine patients (40%) had disease recurrence. Thirty-three (27%) had local regional failures; 19 at the primary site only, 8 in the neck and 6 in both. Local failure occurred in 31% of patients staged T4 compared to 13% of T1-T3 (p = 0.007). Sixteen patients failed at distant sites alone. Among Stage IV patients the 5-year actuarial rates for patients who did and did not receive induction chemotherapy were as follows: overall survival: 68 vs. 56% (p = 0.02), freedom from relapse: 64 vs. 37% (p = 0.01), and local control: 86 vs. 56% (p = 0.009). The actuarial 5-year distant failure rate in patients with UNPC who were treated with induction

  17. 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

  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. Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer

    International Nuclear Information System (INIS)

    Objective: To describe the experience at the National Cancer Institute (NCI) on the use of neoadjuvant chemotherapy as primary treatment for epithelial ovarian cancer among patients in stages IIIC and IV. Methods: We conducted a descriptive retrospective study (case series type) of patients diagnosed with epithelial ovarian cancer in stages IIIC and IV, treated at the NCI from January 1, 2003 to December 31,2006, who underwent neoadjuvant chemotherapy as primary treatment. Demographic characteristics and clinical outcomes are described. Results: Seventeen patients who fulfilled the above mentioned criteria were selected. Once neoadjuvant chemotherapy ended, 5 patients (29.4%) achieved complete or partial clinical response; 4 (23.8%) remained in stable condition, and 8 (47.6%) showed signs of progressive illness. Interval debulking surgery was performed on objective response patients. Maximum cytoreduction was achieved in 5 patients (100%); first relapse was reported at month 18 of follow-up; 2 disease-free survivors were identified in December, 2007; 8 (49%) reported some degree of non-severe chemotherapy-related toxicity. No mortality was related to chemotherapy, no post surgical complications were observed and no patient required advanced support management. Conclusions: Neoadjuvant chemotherapy, followed by optimal interval debulking surgery among selected patients, can be an alternative treatment for advanced epithelial ovarian cancer among women with irresecability or the critically ill. Further studies with improved design are required to confirm these findings.

  20. 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.

  1. [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

  2. 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

  3. 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)

  4. 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...

  5. [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

  6. 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.

  7. 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 ...

  8. 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 ...

  9. 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.

  10. Road and Rail Side Vegetation Management Implications of Habitat Use by Moose Relative to Brush Cutting Season

    Science.gov (United States)

    Rea, Roy V.; Child, Kenneth N.; Spata, David P.; MacDonald, Douglas

    2010-07-01

    Plants cut at different times produce resprouts that vary in their nutritional value relative to when they are cut. To determine how vegetation management in transportation (road and rail) corridors at different times of the year could influence browse quality in the years following cutting, and how this could potentially influence encounters between herbivores and vehicles, we undertook a 3-year study. In 2001, at a wildlife viewing area near Prince George, British Columbia, Canada, we established a control area and treatment areas where shrubs and trees that are used as food by moose ( Alces alces) were cut at the beginning of June, July, August, September, and October. In the fall, moose were most often observed browsing the resprouts of plants cut in August (years 1 and 2 post-treatment) and September (year 3). Cumulative winter track counts were highest in the uncut control area in the years following cutting. Spring pellet counts revealed that most pellets were deposited in the uncut (years 1 and 2) and August-cut (year 3) areas during winter. With the exception of the first year after cutting, browse removal by moose was highest for plants cut later in the growing season. Overall, our findings suggest that following cutting, plants cut later in the year are selected more often by moose relative to those cut earlier. To reduce browse use of corridor vegetation in areas where concerns for moose-vehicle collisions exist, we recommend that vegetation maintenance activities be conducted in the early summer months of June and July.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Vascular Complications of Cancer Chemotherapy.

    Science.gov (United States)

    Cameron, Alan C; Touyz, Rhian M; Lang, Ninian N

    2016-07-01

    Development of new anticancer drugs has resulted in improved mortality rates and 5-year survival rates in patients with cancer. However, many of the modern chemotherapies are associated with cardiovascular toxicities that increase cardiovascular risk in cancer patients, including hypertension, thrombosis, heart failure, cardiomyopathy, and arrhythmias. These limitations restrict treatment options and might negatively affect the management of cancer. The cardiotoxic effects of older chemotherapeutic drugs such as alkylating agents, antimetabolites, and anticancer antibiotics have been known for a while. The newer agents, such as the antiangiogenic drugs that inhibit vascular endothelial growth factor signalling are also associated with cardiovascular pathology, especially hypertension, thromboembolism, myocardial infarction, and proteinuria. Exact mechanisms by which vascular endothelial growth factor inhibitors cause these complications are unclear but impaired endothelial function, vascular and renal damage, oxidative stress, and thrombosis might be important. With increasing use of modern chemotherapies and prolonged survival of cancer patients, the incidence of cardiovascular disease in this patient population will continue to increase. Accordingly, careful assessment and management of cardiovascular risk factors in cancer patients by oncologists and cardiologists working together is essential for optimal care so that prolonged cancer survival is not at the expense of increased cardiovascular events. PMID:26968393

  16. 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

  17. [Adjuvant chemotherapy of adults soft tissue sarcomas].

    Science.gov (United States)

    Bui-Nguyen, B; Italiano, A; Delva, F; Toulmond, M

    2010-06-01

    The main progress in the management of soft tissue sarcomas have been obtained in the field of local control. Although the main evolutive, vital, risk of these diseases is metastatic dissemination, efficacy of adjuvant chemotherapy remains a controversial issue. Thus, adjuvant chemotherapy cannot be considered as a standard for any situation. The last results of clinical trials, meta-analysis and population studies are presented and discussed in this article. New therapeutic strategies are to be developed to prevent metastases in soft tissue sarcomas. This needs a better understanding of the biology of those tumors, of metastases risk factors and of the determinants of systemic therapies efficacy in these tumors. PMID:20547481

  18. 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

  19. “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

  20. 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

  1. 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...

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

    OpenAIRE

    Paulo Sérgio da Silva Santos; José Endrigo Tinôco-Araújo; Lucas Monteiro de Vasconcelos Alves de Souza; Rafael Ferreira; Maura Rosane Valério Ikoma; Ana Paula Ribeiro Razera; Márcia 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 t...

  3. 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...

  4. 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.

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

    Science.gov (United States)

    Bougea, Anastasia; Voskou, Panagiota; Kilidireas, Constantinos; Andreadou, Elisabeth

    2016-01-01

    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. PMID:26966603

  6. 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.

  7. Hyperthermia and chemotherapy agent

    International Nuclear Information System (INIS)

    The use of chemotherapeutic agents for the treatment of cancer dates back to the late 19th century, but the modern era of chemotherapy drugs was ushered in during the 1940's with the development of the polyfunctional alkylating agent. Since then, numerous classes of drugs have evolved and the combined use of antineoplastic agents with other treatment modalities such as radiation or heat, remains a large relatively unexplored area. This approach, combining local hyperthermia with chemotherapy agents affords a measure of targeting and selective toxicity not previously available for drugs. In this paper, the effects of adriamycin, bleomycin and cis-platinum are examined. The adjuvant use of heat may also reverse the resistance of hypoxic cells noted for some chemotherapy agents

  8. 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)

  9. Demand side management and conservation

    International Nuclear Information System (INIS)

    This presentation outlined operations at Direct Energy with particular reference to its progress in the North American market and the lessons it has learned from British-based Centrica. Direct energy business services were also discussed along with private sector involvement in conservation, results oriented incentives and education. Direct Energy operates as both a regulated and competitive energy supplier in North America with more than 5 million customers across Ontario, Alberta, Manitoba, Texas, Ohio, Pennsylvania and Michigan. The utility serves natural gas and electricity to about 1.9 million households in Ontario and also offers heating, ventilation and air conditioning (HVAC) equipment installation, maintenance and service plans. Direct Energy has adopted a holistic approach to reducing energy costs and replacing equipment with energy efficient and innovative solutions. Direct Energy Business Services (DEBS) has pioneered an automation system that proved useful in addressing the needs of several large customers during the August 2003 blackout. DEBS believes that the private sector is the key to offering innovative and effective conservation initiatives. 1 fig

  10. Side Effects and Their Management

    Science.gov (United States)

    ... Pediatric Caregiver Resource Center About Us Our Founders Board of Directors Staff Leadership Strategic Plan Financials News Careers Brain Tumor Information Brain Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors Tumor Grade Risk Factors Brain Tumor Statistics ABTA Publications Brain Tumor ...

  11. 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...

  12. Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

    International Nuclear Information System (INIS)

    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

  13. 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.

  14. 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.

  15. 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.

  16. Chemotherapy-induced peripheral neuropathy in patients treated with taxanes and platinum derivatives

    DEFF Research Database (Denmark)

    Ewertz, Marianne; Qvortrup, Camilla; Eckhoff, Lise

    2015-01-01

    BACKGROUND: Chemotherapy with taxanes and platinum compounds has resulted in substantial survival benefits both in adjuvant and metastatic settings. However, as a side effect, such chemotherapy may cause peripheral neuropathy (CIPN) which may result in discontinuation of treatment, and if it...

  17. Hawaii Energy Strategy: Program guide. [Contains special sections on analytical energy forecasting, renewable energy resource assessment, demand-side energy management, energy vulnerability assessment, and energy strategy integration

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    The Hawaii Energy Strategy program, or HES, is a set of seven projects which will produce an integrated energy strategy for the State of Hawaii. It will include a comprehensive energy vulnerability assessment with recommended courses of action to decrease Hawaii's energy vulnerability and to better prepare for an effective response to any energy emergency or supply disruption. The seven projects are designed to increase understanding of Hawaii's energy situation and to produce recommendations to achieve the State energy objectives of: Dependable, efficient, and economical state-wide energy systems capable of supporting the needs of the people, and increased energy self-sufficiency. The seven projects under the Hawaii Energy Strategy program include: Project 1: Develop Analytical Energy Forecasting Model for the State of Hawaii. Project 2: Fossil Energy Review and Analysis. Project 3: Renewable Energy Resource Assessment and Development Program. Project 4: Demand-Side Management Program. Project 5: Transportation Energy Strategy. Project 6: Energy Vulnerability Assessment Report and Contingency Planning. Project 7: Energy Strategy Integration and Evaluation System.

  18. Climate-related electricity demand-side management in oil-exporting countries--the case of the United Arab Emirates

    International Nuclear Information System (INIS)

    The oil crisis of the 1970s has increased the concern about the continuity of oil imports flow to major oil-importing developed countries. Numerous policy measures including electricity demand-side management (DSM) programs have been adopted in such countries. These measures aim at reducing the growing need for electricity power that increases the dependency on imported foreign oil and damages the environment. On the other hand, the perception that energy can be obtained at very low cost in oil-rich countries led to less attention being paid to the potential of DSM policies in these countries. This paper discusses such potential using the case of the United Arab Emirates (UAE). Since air conditioning is a major source of electric energy consumption, the relationship between climate conditions and electric energy consumption is considered. An electricity demand model is constructed using time series techniques. The fitted model seems to represent these relationships rather well. Forecasts for electricity consumption using the estimated model indicate that a small reduction in cooling degrees requirement might induce a significant reduction in electric energy demand. Hence, a DSM program is proposed with policy actions to include, among others, measures to reduce cooling degrees requirement

  19. Report of the advisory group on demand-side management and demand response in Ontario in response to the Minister's directive to the Ontario Energy Board

    International Nuclear Information System (INIS)

    The Ontario Energy Board was directed in June 2003 to consult with stakeholders to identify and review options for the delivery of demand-side management (DSM) and demand response (DR) activities within the electricity sector, including the role of local distribution companies (distributors) in such activities. A total of 118 stakeholders participated in the consultation process, and 31 representatives from all sectors were then invited to take part in an advisory working group to develop options to be considered by the Board when preparing the recommendations to the Minister. This report presents a consolidation of the Group's working documents and the results of deliberations both as a unit and in small groups. The best way to present the many newly developed models was as a single Central Agency model demonstrating variations in the role of the Central Agency and other players in the electricity market. The paper was divided into the following six sections: introduction; market issues; demand response framework option; central agency framework-alternative models; Ontario Energy Board-wires companies DSM framework; and, general issues

  20. 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.

  1. 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

  2. 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

  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. 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.

  5. 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)

  6. 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.

  7. 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

  8. 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...

  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. 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 ...

  12. 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.

  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. 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.

  15. Multimodal treatment combining chemotherapy, hyperthermia and radiotherapy for ovarian cancer

    International Nuclear Information System (INIS)

    There has been increasing interest in the use of heat in the treatment of cancer. Theoretically cells are the most sensitive to ionizing radiation at mitosis, whereas the cycle phase that is the most resistant to ionizing radiation namely late in the DNA. Synthetic phase (late S) is the most sensitive to hyperthermia. Hyperthermia has been reported to enhance the cytocidal effects of several active chemotherapeutic agents. When thermal potentiation of chemotherapeutic agents against malignant cells is contemplated, normal tissues have a relatively high ambient blood flow which increases in response to thermal stress, thereby dissipating heat, compared to tumors. Tumors, with relatively poor blood flow and a responsive neovasculature, are in capable of augmenting flow and acting as a heat reservoir. This is the phenomenon of a heat reservoir which is one factor to enhance the cytocidal effects of several active anticancer agents for enhancing the uptake in tumor. The importance is in the adjuvant chemotherapy treated for post operative, advanced and recurrent ovarian cancer. Heating enhances the effects of radiotherapy and chemotherapy. Thirty patients with ovarian cancer were subjected to the multidisciplinary treatment with combination of hyperthermochemotherapy and radiation. The 30 patients consisted of 18 with endometrioid adenocarcinoma and 7 with serious post operative or recurrent status. Two types of equipments with rediofrequencies of 70 MHz (BSD-1000) or 434 MHZ (TAG MED·HS 434) were used for hyperthermia. Chemotherapeutic agents such as adriamycin, cis DDP, cyclophosphamide and etoposide were injected intravenously. Arterial infusion with reservoir was very effective in advanced stage of ovarian cancer. No severe or fatal side effects were observed. Hyperthermochemotherapy is useful and effective for the postoperative management or the treatment of recurrent cancer of the ovary. (J.P.N.)

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  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. 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...

  4. 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 ...

  5. 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

    OpenAIRE

    Grigorios Kotronoulas; Eileen Furlong; Jo Armes; Christine Miaskowski; Elisabeth Patiraki; Kathi Apostolidis

    2015-01-01

    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 compet...

  6. Treatment of oral mucositis due to chemotherapy

    OpenAIRE

    Chaveli-López, Begonya; 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 bool...

  7. 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

  8. [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

  9. PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

    Directory of Open Access Journals (Sweden)

    Thales Paulo BATISTA

    2013-09-01

    Full Text Available Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

  10. '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.)

  11. 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)

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. Prevention and treatment of oral mucositis in patients receiving chemotherapy

    OpenAIRE

    Alvariño Martín, Carlos; Sarrión, Gracia

    2014-01-01

    Oral mucositis is one of the most common side effects of cancer treatment (chemotherapy and/or radiotherapy). It is an inflammatory process that affects the mucosa of the oral cavity, giving rise to erythematous areas in combination with ulcers that can reach a large size. The true importance of oral mucositis is the complications it causes – fundamentally intense pain associated to the oral ulcers, and the risk of overinfection. This in turn may require reduction or even suspension of the an...

  18. [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

  19. SOLVING TRAFFIC CONGESTION FROM THE DEMAND SIDE

    OpenAIRE

    Ge, Ying-En; Prentkovskis, Olegas; Tang, Chunyan; Saleh, Wafaa; G. H. Bell, Michael; Junevičius, Raimundas

    2015-01-01

    It is nowadays widely accepted that solving traffic congestion from the demand side is more important and more feasible than offering more capacity or facilities for transportation. Following a brief overview of evolution of the concept of Travel Demand Management (TDM), there is a discussion on the TDM foundations that include demand-side strategies, traveler choice and application settings and the new dimensions that ATDM (Active forms of Transportation and Demand Management) bring to TDM, ...

  20. [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

  1. Induction chemotherapy followed by radiotherapy and adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma treated

    International Nuclear Information System (INIS)

    Objective: To summarize the efficacy and toxicities of induction chemotherapy followed by radiotherapy and adjuvant chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods: From Oct. 1997 to Nov. 2000, 77 patients with histologically proven locally advanced NPC, staged according to the Fuzhou stage classification, were retrospectively studied. Before radical radio- therapy, the patients received 1-3 cycles cisplatin(PDD) 20 mg/m2 on Days 1-3 and fluorouracil(5-Fu) 500 nag/ma on Days 1-3 repeated every two weeks. Sixty-two patients also received calcium folinate (CF) 100 mg/m2 on Days 1-3. Two to four cycles of adjuvant chemotherapy was given 21 days after the completion of radiotherapy. All patients received radical radiotherapy by 60 Co to the nasopharynx and neck with a total dose of 64-78 Gy at 1.8-2.0 Gy per fraction over 7.0-7. 5 weeks to the primary site. The dose to the lymph nodes was 60-68 Gy. After-loading radiotherapy was given to the residual disease in 1 patient (20 Gy in 2 fractions). Results: The median follow-up was 60 months (ranged from 3 to 103 months). The 5-year overall urvival rate (OS), disease-free survival rate (DFS), relapse-free survival rate (RFS) and distant metastasis-free survival rate (DMSF) were 68%, 58%, 81% and 75%. The patients who received more than 3 cycles of chemotherapy or not had no significant effects on the OS (χ2=0.05, P=0.831). The incidence of grade 3 or 4 acute side-effects of radiotherapy was vomiting 1%, leukopenia 3%, mucositis 23% and skin reaction 5%, all of which eventually resolved. The most frequent late toxicities were hearing impairment (51% ). Patients with more than 3 cycles chemotherapy were more likely to have late hearing loss (z=2.06, P=0.039). Only one patient had radiation-induced brain damage. Conclusions: Induction chemo- therapy, radiotherapy and adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma would result in a comparable outcome, but may

  2. 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...

  3. 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...

  4. A survey of chinese medicinal herbal treatment for chemotherapy-induced oral mucositis

    OpenAIRE

    Sven Schröder; Matthias Rostock; Henry Johannes Greten; Thomas Efferth; Janine Radtke; Gesa Meyer-Hamme; Kathrin Beckmann

    2013-01-01

    Oral mucositis is one of the common side effects of chemotherapy treatment with potentially severe implications. Despite several treatment approaches by conventional and complementary western medicine, the therapeutic outcome is often not satisfactory. Traditional Chinese Medicine (TCM) offers empirical herbal formulas for the treatment of oral ulceration which are used in adaptation to chemotherapy-induced mucositis. While standard concepts for TCM treatment do not exist and acceptance by co...

  5. 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...

  6. 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...

  7. 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

  8. 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.

  9. 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.

  10. Hawaii demand-side management resource assessment. Final report, Reference Volume 3 -- Residential and commercial sector DSM analyses: Detailed results from the DBEDT DSM assessment model; Part 1, Technical potential

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    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. Numerous tables and figures illustrating the technical potential for demand-side management are included.

  11. 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...

  12. 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

  13. 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.

  14. The effects of Reiki therapy and companionship on quality of life, mood, and symptom distress during chemotherapy.

    Science.gov (United States)

    Orsak, Gabriela; Stevens, Arlene M; Brufsky, Adam; Kajumba, Mayanja; Dougall, Angela Liegey

    2015-01-01

    This pilot study examined the effects of Reiki therapy and companionship on improvements in quality of life, mood, and symptom distress during chemotherapy. Thirty-six breast cancer patients received usual care, Reiki, or a companion during chemotherapy. First, data were collected from patients receiving usual care. Second, patients were randomized to either receive Reiki or a companion during chemotherapy. Questionnaires assessing quality of life, mood, symptom distress, and Reiki acceptability were completed at baseline and chemotherapy sessions 1, 2, and 4. Reiki was rated relaxing with no side effects. Reiki and companion groups reported improvements in quality of life and mood that were greater than those seen in the usual care group. Interventions during chemotherapy, such as Reiki or companionship, are feasible, acceptable, and may reduce side effects. PMID:25381189

  15. 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)

  16. THE INFORMAL SIDE OF MATHEMATICS

    OpenAIRE

    ANCA CROITORU

    2011-01-01

    For the efficiency of mathematics education, one should constantlyteach mathematics from its both sides perspective: the (formal) scientific side and the (informal) human, spiritual and cultural side.

  17. 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

  18. 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

  19. Discovery and Delivery of Synergistic Chemotherapy Drug Combinations to Tumors

    Science.gov (United States)

    Camacho, Kathryn Militar

    Chemotherapy combinations for cancer treatments harbor immense therapeutic potentials which have largely been untapped. Of all diseases, clinical studies of drug combinations are the most prevalent in oncology, yet their effectiveness is disputable, as complete tumor regressions are rare. Our research has been devoted towards developing delivery vehicles for combinations of chemotherapy drugs which elicit significant tumor reduction yet limit toxicity in healthy tissue. Current administration methods assume that chemotherapy combinations at maximum tolerable doses will provide the greatest therapeutic effect -- a presumption which often leads to unprecedented side effects. Contrary to traditional administration, we have found that drug ratios rather than total cumulative doses govern combination therapeutic efficacy. In this thesis, we have developed nanoparticles to incorporate synergistic ratios of chemotherapy combinations which significantly inhibit cancer cell growth at lower doses than would be required for their single drug counterparts. The advantages of multi-drug incorporation in nano-vehicles are many: improved accumulation in tumor tissue via the enhanced permeation and retention effect, limited uptake in healthy tissue, and controlled exposure of tumor tissue to optimal synergistic drug ratios. To exploit these advantages for polychemotherapy delivery, two prominent nanoparticles were investigated: liposomes and polymer-drug conjugates. Liposomes represent the oldest class of nanoparticles, with high drug loading capacities and excellent biocompatibility. Polymer-drug conjugates offer controlled drug incorporations through reaction stoichiometry, and potentially allow for delivery of precise ratios. Here, we show that both vehicles, when armed with synergistic ratios of chemotherapy drugs, significantly inhibit tumor growth in an aggressive mouse breast carcinoma model. Furthermore, versatile drug incorporation methods investigated here can be broadly

  20. Chemotherapy of the patients with advanced head and neck cancers

    International Nuclear Information System (INIS)

    Purpose: Treatment of advanced head and neck carcinomas are a problem of worldwide. Cancer remains incurable when it is metastatic or unresectable, and only palliative treatment can improve quality of life of these patients. The aim of this retrospective study was to compare patients treated by radio / chemotherapy with a group of patients treated by radiotherapy alone. Patients and methods: 26 patients with advanced inoperable head and neck cancer were treated at our clinic between the years 1991-1995. Medium age was 62 (range 41-78). Primary tumor sites were: oropharynx in 4 cases, hypopharynx in 4 cases, larynx in 8 cases, oral cavity in 6 cases and parotid gland in 2 cases. The primary treatment consisted of radiotherapy alone in 13 patients, and a combination of radio / chemotherapy in 13 patients. Tumor size was T3 (8 patients) and T4 (18 patients), all of patients had metastases in regional lymph nodes (N1-N3). Chemotherapy was started after radiotherapy course and cisplatin was always included. The main side effects were myelotoxicity, nephrotoxicity, nausea and vomiting. Results: There are five patients with partial respons, four patients with stable disease and four patients with progressive disease. Medial stable disease time was 3,5 month in radio / chemotherapy group and 2,7 months in radiotherapy group. Median survival was 13,2 months for patients of radio / chemotherapy group and 11,5 months for patients of radiotherapy group. Conclusion: Addition of chemotherapy to radiotherapy improves survival of patients with advanced head and neck carcinoma and reliefs pain. (Full text)

  1. 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

  2. Perioperative chemotherapy and hepatic resection for resectable colorectal liver metastases.

    Science.gov (United States)

    Beppu, Toru; Sakamoto, Yasuo; Hayashi, Hiromitsu; Baba, Hideo

    2015-02-01

    The role of perioperative chemotherapy in the management of initially resectable colorectal liver metastases (CRLM) is still unclear. The EPOC trial [the European Organization for Research and Treatment of Cancer (EORTC) 40983] is an important study that declares perioperative chemotherapy as the standard of care for patients with resectable CRLM, and the strategy is widely accepted in western countries. Compared with surgery alone, perioperative FOLFOX therapy significantly increased progression-free survival (PFS) in eligible patients or those with resected CRLM. Overall survival (OS) data from the EPOC trial were recently published in The Lancet Oncology, 2013. Here, we discussed the findings and recommendations from the EORTC 40983 trial. PMID:25713806

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.).

  8. Administration of Ratanhia-Based Herbal Oral Care Products for the Prophylaxis of Oral Mucositis in Cancer Chemotherapy Patients: A Clinical Trial

    OpenAIRE

    Mac H. Ramos F.; Michael Toelg; Patric Tiemann

    2007-01-01

    Oral complications are a common side effect of cancer chemotherapy, as antineoplastic agents affect both the immune system and the oral mucosa. This study demonstrates preventive and therapeutic effects of dental treatment and regular use of Weleda Ratanhia-Mundwasser® (herbal mouthwash) and Weleda Pflanzen-Zahngel® (herbal toothgel) on oral mucositis during chemotherapy. Thirty-two female patients with breast cancer starting on chemotherapy were evaluated in this study. Plaque index, gingiva...

  9. Adjuvant chemotherapy and cancer cure

    International Nuclear Information System (INIS)

    The use of chemotherapy as an adjuvant to surgery and/or radiotherapy is well founded in experimental tumor systems and appears to be effective in patients in some circumstances. It is clear from both clinical and experimental studies that (1) the dose is important, (2) the earlier chemotherapy is started after primary therapy the better, and (3) combination chemotherapy may be more effective than single-agent treatment. The better the estimation of risk of recurrence, the better the assessment of the risk-benefit ratio with adjuvant therapy. Salvage therapy as well as relative risk of recurrence are considerations in the choice of patients to be treated. Finally, some evidence is presented to indicate that alkylating agents may not be necessary in combination regimens for adjuvant therapy if effective antimetabolite combinations are available

  10. Side-Channel Oscilloscope

    CERN Document Server

    Chaudhuri, Sumanta

    2011-01-01

    Side-Channel Analysis used for codebreaking could be used constructively as a probing tool for internal gates in integrated circuits. This paper outlines basic methods and mathematics for that purpose

  11. Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    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.)

  12. 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.)

  13. [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

  14. 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

  15. 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.

  16. 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

  17. Treatment of radiation- and chemotherapy-induced stomatitis

    International Nuclear Information System (INIS)

    Severe stomatitis is a common problem encountered during either radiation therapy or chemotherapy. Most therapeutic regimens are empirical, with no scientific basis. The purpose of this study is to determine the efficacy of various topical solutions in the treatment of radiation- or chemotherapy-induced stomatitis. Eighteen patients were entered into a prospective double-blinded study to test several topical solutions: (1) viscous lidocaine with 1% cocaine; (2) dyclonine hydrochloride 1.0% (Dyclone); (3) kaolin-pectin solution, diphenhydramine plus saline (KBS); and (4) a placebo solution. Degree of pain relief, duration of relief, side effects, and palatability were evaluated. The results showed that Dyclone provided the most pain relief. Dyclone and viscous lidocaine with 1% cocaine provided the longest pain relief, which averaged 50 minutes This study provides objective data and defines useful guidelines for treatment of stomatitis

  18. The role of intravitreal chemotherapy for retinoblastoma

    Directory of Open Access Journals (Sweden)

    Fairooz P Manjandavida

    2015-01-01

    Full Text Available Targeted therapy in retinoblastoma (RB is widely accepted as the current management tool with an aim of increasing drug availability at the tumor location. Inevitably the effect is several times higher compared to systemic delivery of chemotherapeutic drugs and carries less systemic toxicity. Despite tremendous advancement in saving life, eye salvage in advanced RB especially with active vitreous seeds remains a challenge. The hypoxic environment of the vitreous and reduced vitreous concentration of the drugs delivered makes these tumor seeds resistant to chemotherapy. Direct delivery of chemotherapeutic drugs into the vitreous cavity aids to overcome these challenges and is progressively being accepted worldwide. However, intraocular procedure in RB was abandoned due to high risk of extraocular tumor dissemination. Recently, the forbidden therapeutic technique was re-explored and modified for safe use. Although eye salvage rate has tremendously improved after intravitreal chemotherapy (IVitC, retinal toxicity, and vision salvage are yet to be validated. In our preliminary report of intravitreal melphalan in 11 eyes, we reported 100% eye salvage and 0% recurrence with an extended 15 months mean follow-up. In this review, we analyzed published reports on IVitC in RB via PubMed, Medline, and conference proceedings citation index, electronic database search, without language restriction that included case series and reports of humans and experimental animal eyes with RB receiving IVitC.

  19. The role of netupitant and palonosetron in chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Abramovitz, Rebecca Briana; Gaertner, Kelly Marie

    2016-06-01

    The combination of netupitant and palonosetron was approved by the Food and Drug Administration in October 2014 for the prevention of acute and delayed chemotherapy-induced nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic chemotherapy. Netupitant and palonosetron is available as a single capsule to be administered prior to each cycle of chemotherapy. The approval was based on phase II and III data in patients undergoing treatment with moderately and highly emetogenic chemotherapy. Netupitant and palonosetron's benefits include a convenient dosage form, dual-targeted mechanism, and favorable side effect profile, while its main limitations are cost and potential logistical issues surrounding administration. More studies are needed to adequately determine its role in therapy as well as which patients will derive the most benefit from its use. PMID:25914408

  20. Therapeutic potential of cannabinoids in counteracting chemotherapy-induced adverse effects: an exploratory review.

    Science.gov (United States)

    Ostadhadi, Sattar; Rahmatollahi, Mahdieh; Dehpour, Ahmad-Reza; Rahimian, Reza

    2015-03-01

    Cannabinoids (the active constituents of Cannabis sativa) and their derivatives have got intense attention during recent years because of their extensive pharmacological properties. Cannabinoids first developed as successful agents for alleviating chemotherapy associated nausea and vomiting. Recent investigations revealed that cannabinoids have a wide range of therapeutic effects such as appetite stimulation, inhibition of nausea and emesis, suppression of chemotherapy or radiotherapy-associated bone loss, chemotherapy-induced nephrotoxicity and cardiotoxicity, pain relief, mood amelioration, and last but not the least relief from insomnia. In this exploratory review, we scrutinize the potential of cannabinoids to counteract chemotherapy-induced side effects. Moreover, some novel and yet important pharmacological aspects of cannabinoids such as antitumoral effects will be discussed. PMID:25504799

  1. 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.

  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. Dilated cardiomyopathy following trastuzumab chemotherapy

    Directory of Open Access Journals (Sweden)

    Saurabh Karmakar

    2012-01-01

    Cardiotoxicity manifesting as dilated cardiomyopathy is a rarely reported adverse effect of trastuzumab. We hereby report a case of dilated cardiomyopathy, which occurred following trastuzumab chemotherapy in a 32-year-old female. The patient responded to discontinuation of trastuzumab and standard medical treatment. Extensive search of Indian literature revealed no reported case of dilated cardiomyopathy occurring due to trastuzumab.

  4. 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.

  5. 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 ...

  6. Effects of nurse-led telephone follow-up for discharged patients treated with chemotherapy

    Directory of Open Access Journals (Sweden)

    Gui Li

    2014-01-01

    Full Text Available Objective: Nurse-led telephone follow-up is effective in meeting information and psycho-social needs. We explored the potential effects of nurse-led telephone follow-up for patients treated with chemotherapy in China. Methods: A quasi-experimental study was employed in the research. 300 cases of cancer inpatients in a cancer hospital in Beijing during July-October 2012 were selected by convenience sampling. To compare the satisfaction and response regarding to chemotherapy adverse side effects, patients who discharged on Monday and Friday were provided with telephone follow-up. Patients who discharged on Tuesday, Wednesday and Thursday received routine care. Results: Via telephone follow-up, patient satisfaction relating to nursing care increased. Moreover, their response to chemotherapy adverse side effects showed a significant difference. Conclusion: Telephone follow-up by specialist nurses may be a feasible option. It was well received by patients, with no physical or psychological disadvantage.

  7. 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.

  8. 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,

  9. 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。

  10. 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

  11. Working the Dark Side

    DEFF Research Database (Denmark)

    Bjering, Jens Christian Borrebye

    A few days after the terror attacks of 9/11, then Vice President Dick Cheney appeared on television with a call for “working the dark side.” While still unclear what this expression entailed at the time, Cheney's comment appears in retrospect to almost have been prophetic for the years to come...... – years where parts of the U.S. Army and intelligence community set up a rampant torture regime all across the world. Yet, the connection between a so-called “dark side,” “working” this “dark side,” and the torture that followed is not a given, but, instead, a consequence of a set of very specific legal...... 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...

  12. 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.

  13. 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.

  14. 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...

  15. 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

  16. 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。

  17. 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

  18. 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.

  19. Chemotherapy-induced cognitive changes

    OpenAIRE

    Lindner, Oana

    2015-01-01

    The present thesis, entitled Chemotherapy-induced cognitive changes, is being submitted in the alternative format, by Oana Calina Lindner to The University of Manchester for the degree of Doctor of Philosophy in the Faculty of Medical and Human Sciences, School of Psychological Sciences. The thesis consists of five empirical studies, written in article formats and three connecting chapters. The General introduction in Chapter 1, places the thesis in the context of late effects research in can...

  20. Polymer conjugates for combination chemotherapy

    Czech Academy of Sciences Publication Activity Database

    Etrych, Tomáš; Kostková, Hana; Šírová, Milada; Říhová, Blanka; Ulbrich, Karel

    Salt Lake City : University of Utah, 2010. s. 57-58. [Symposium on Biomedical Polymers for Drug Delivery. 26.03.2010-27.03.2010, Salt Lake City] R&D Projects: GA MŠk 1M0505; GA AV ČR IAA400500806 Institutional research plan: CEZ:AV0Z40500505 Keywords : polymer * combination chemotherapy * doxorubicin Subject RIV: EI - Biotechnology ; Bionics

  1. 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.

  2. 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

  3. 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...

  4. 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...

  5. 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...

  6. Simulations: The dark side

    Science.gov (United States)

    Frenkel, D.

    2013-01-01

    This paper discusses the Monte Carlo and Molecular Dynamics methods. Both methods are, in principle, simple. However, simple does not mean risk-free. In the literature, many of the pitfalls in the field are mentioned, but usually as a footnote --and these footnotes are scattered over many papers. The present paper focuses on the "dark side" of simulation: it is one big footnote. I should stress that "dark", in this context, has no negative moral implication. It just means: under-exposed.

  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. 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

  9. Internet chemotherapy information: impact on patients and health professionals

    Science.gov (United States)

    Davies, E; Yeoh, K-W

    2012-01-01

    Background: Reliable information can improve patients' knowledge of chemotherapy. As internet chemotherapy information (ICI) is increasingly viewed as a valuable patient education tool, we investigated the impact of ICI on patient care and analysed health professionals' (HPs') attitudes towards ICI. Methods: The following questionnaires were distributed: (1) self-administered questionnaire randomly given to 261 patients receiving chemotherapy (80% returned); and (2) separate questionnaire given to 58 HPs at the same UK Oncology Centre (83% returned). Results: Just over half of the patient respondents accessed the internet regularly. They were younger, with higher incomes and qualifications. Key search topics included chemotherapy modes of action, symptom management and treatment success, and most considered ICI useful. More than half wanted to discuss ICI with HPs but most did not get the opportunity. Although the majority of HP respondents supported the need for patients to retrieve ICI, most questioned the accuracy of ICI and did not routinely recommend its use. Conclusion: This study has shown that ICI is generally perceived by patients to be a valuable information resource. Given the potential impact of ICI, the following should be addressed in future studies: (1) inequalities in accessing ICI; (2) maintaining the quality of ICI (with clear guidance on recommended websites); (3) bridging the gap between the perception of ICI by patients and HPs; (4) integration of ICI with traditional consultation models. PMID:22262319

  10. Treatment side effects and follow-up of malignant melanoma

    International Nuclear Information System (INIS)

    Side effects in the therapy of malignant melanoma are primarily of importance for radiologists in advanced tumor stages. The available treatment options and their respective side effect profiles have undergone a profound change in recent years after the introduction of modern oncological therapies (e.g. immunotherapy and targeted therapy) with an increasing focus on individual tumor biology and differ significantly from those of classical chemotherapy. The immunotherapeutic agents, in particular ipilimumab, take on a special position because of their specific immune-mediated mechanisms of action and the associated side effects, so-called immune-related adverse events (irAE). The majority of the treatment effects are manifested on the skin (> 50 %) and are generally not detectable by diagnostic radiology. Only a comparatively small proportion of treatment side effects is detectable with diagnostic imaging (15-20 %) but as in the example of therapy-induced colitis with ipilimumab, may be rapidly fatal. In addition to colitis (10-20 %) further therapy side effects apparent in diagnostic imaging are hypophysitis (1.8-17 %), thyroiditis (0.8 %), myositis (1.7 %), fasciitis and sarcoid-like lymph node alterations (6.8 %). To detect radiologically detectable side effects early on and to delineate them especially from tumor progression and (opportunistic) infections, detailed knowledge of the therapeutic methods for melanoma, the mechanisms of action and in particular the sometimes very specific side effects is imperative for radiologists. (orig.)

  11. 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

  12. 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...

  13. Demand side management of electric car charging

    DEFF Research Database (Denmark)

    Finn, P.; Fitzpatrick, C.; Connolly, David

    2012-01-01

    Ireland is currently striving to source 10% of the energy required for its transport fleet from renewable energy sources by 2020. As part of the measures being implemented in order to help realise this ambitious target a number of Government schemes have been introduced to financially subsidise t...

  14. 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

  15. Maintenance chemotherapy after chemoradiation improves survival of patients with locally advanced pancreatic carcinoma. A retrospective analysis of prospectively recruited patients

    International Nuclear Information System (INIS)

    Background and purpose: currently, there is no treatment standard for patients with locally advanced pancreatic cancer (PaCa) after chemoradiation. The aim of the present study was to retrospectively assess overall survival and toxicity of chemotherapy in addition to chemoradiation in this patient group. Patients and methods: three-dimensional conformal irradiation to the primary tumor (55.8 Gy) and the lymphatics (50.4 Gy) was combined with 5-fluorouracil- or gemcitabine-based chemotherapy followed by additional chemotherapy with gemcitabine until progression or no further treatment. Decision for chemotherapy was taken at the discretion of the attending physician considering the patient's desire. Results: a total of 172 patients were addressed to the local tumor board. Patients with (neo)adjuvant treatment or metastatic disease were excluded (n = 90). 82 patients were treated with chemoradiation and had additional chemotherapy (n = 40) or no further treatment (n = 42). Characteristics of the two groups were equally distributed. Patients with chemotherapy had significantly longer overall survival as compared to patients without (13 months vs. 8 months; p < 0.0001; median survival = 10.7 months for all patients). Acute toxicity of maintenance chemotherapy was relatively mild. Conclusion: maintenance chemotherapy after chemoradiation for patients with locally advanced PaCa may significantly increase survival rates without severe side effects and is therefore recommended as standard treatment following chemoradiation. (orig.)

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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 ...

  3. 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...... in April 2004. The following issues will be addressed: dose and schedule of antiemetics, different groups of antiemetics such as corticosteroids, serotonin(3) receptor antagonists, dopamine(2) receptor antagonists, and neurokinin(1) receptor antagonists. Furthermore, antiemetic prophylaxis in...

  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 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

  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. Left-sided omental torsion: CT appearance

    International Nuclear Information System (INIS)

    A 34-year-old male presented with exquisite left flank pain. Computed tomography showed a hyperdense vascular structure surrounded by whirling linear streaks situated in the greater omentum under the splenic flexure of the colon. Omental stranding extended caudally into the pelvis where part of the inflamed omentum entered a left inguinal hernia sac. Surgery revealed left-sided torsion of the greater omentum. Left-sided omental torsion is infrequent and pre-operative diagnosis is rarely established. The CT findings of an omental fatty mass with a whirling pattern is characteristic of omental torsion. Preoperative diagnosis is important because conservative management has been suggested. (orig.)

  8. 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.

  9. 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)

  10. 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.

  11. West-Side Story

    Science.gov (United States)

    Marochnik, L. S.

    2005-12-01

    This paper deals with the history of Density-Wave Spiral Theories in the 1960s. The motivation to write the paper was the publication of two papers on the history of these theories (Pasha 2004a, b). Pasha's papers tell only a part of the story that took place on the Western side of the Iron Curtain in the 1960s. But giving only a part of the full story is a distortion of historical truth. Important work done on the Eastern side of the Iron Curtain is still little known in the West. In this paper, I fill the gaps and correct chronological inaccuracies in Pasha's story and mention facts that are still unknown (or little known) to the astronomical community in the West. I also give my recollection of the development of Density-Wave Spiral Theories in the 1960s. The paper gives examples of important results in the theory of density waves in galaxies that are mistakenly attributed to C. C. Lin, F. H. Shu, Y.Y. Lau, C. Yuan and others, meanwhile they were obtained earlier by L. Marochnik, A. Suchkov and others. Below is another example. Both "famous" paper of Lin, Yuan and Shu (1969) and Marochnik and Suchkov (1969a) have appeared simultaneously in March of 1969. Both papers dealt, in particular, with the comparison of theory with observations. However, in the frame of their WKB approximation, Lin, Yuan and Shu (1969) employed an incorrect approach. It was a direct consequence of Marochnik and Suchkov (1969a) analysis and led to the far-going consequences. The paper has been published at the http://arxiv.org/abs/astro-ph/0501170 web site.

  12. 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 ...

  13. The Importance of Non Struck Side Occupants in Side Collisions

    OpenAIRE

    Frampton, R. J.; Brown, R.; Thomas, P; P. Fay

    1998-01-01

    In a representative sample of tow-away side collisions from the UK Midlands, one third of front seat occupants were alone, on the struck side of the car. The other two thirds were either a non struck side occupant alone or two occupants sitting together. Occupant restraint, especially in perpendicular side impacts, was a notable factor in determining injury outcome for belted non struck side occupants. With both front seats occupied, there was a reduction in AIS 2+ injury to belted non struck...

  14. 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 ...

  15. 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.

  16. 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)

  17. [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

  18. 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)

  19. 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...

  20. Neoadjuvant chemotherapy in locally advanced colon cancer

    DEFF Research Database (Denmark)

    Jakobsen, Anders; Andersen, Fahimeh; Fischer, Anders;

    2015-01-01

    BACKGROUND: Neoadjuvant chemotherapy has proven valuable in several tumors, but it has not been elucidated in colon cancer. The present phase II trial addressed the issue in high-risk patients selected by computed tomography (CT) scan. MATERIAL AND METHODS: Patients with resectable colon cancer...... mutational status received three cycles of capecitabine 2000 mg/m(2) days 1-14 q3w and oxaliplatin 130 mg iv day 1 q3w. Wild-type patients received the same chemotherapy supplemented with panitumumab 9 mg/kg iv q3w. After the operation, patients fulfilling the international criteria for adjuvant chemotherapy......, i.e. high-risk stage II and III patients, received five cycles of the same chemotherapy without panitumumab. Patients not fulfilling the criteria were offered follow-up only. The primary endpoint was the fraction of patients not fulfilling the criteria for adjuvant chemotherapy (converted patients...