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Sample records for chemotherapy managing side

  1. Managing Chemotherapy Side Effects: Constipation

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Constipation Take these steps: Eat high-fiber foods such as: ● ● Whole-grain breads and cereals ● ● Fruits and vegetables ● ● Nuts and seeds ...

  2. Managing Chemotherapy Side Effects: Diarrhea

    Science.gov (United States)

    ... such as Pedialyte ® ••Tea (without caffeine) ••Water ••Applesauce ••Bananas ••Crackers ••Cream of wheat or rice cereal ••Eggs •• ... has a series of 18 Chemotherapy Side Effects Sheets at: www.cancer.gov/chemo-side-effects

  3. Managing Chemotherapy Side Effects: Nausea and Vomiting

    Science.gov (United States)

    ... boiled, without the skin ••White rice ••White toast ••Bananas ••Canned fruit such as applesauce, peaches, and pears •• ... has a series of 18 Chemotherapy Side Effects Sheets at: www.cancer.gov/chemo-side-effects

  4. 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 ...

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

    Science.gov (United States)

    ... nurse about other exercises that can help. Stretching, yoga, or Tai Chi help some people. Questions to ... NCI has a series of 18 Chemotherapy Side Effects Sheets at: www.cancer.gov/chemo-side-effects

  6. Side Effects of Chemotherapy

    Science.gov (United States)

    ... Jacket Fashion Show Contact Us Side Effects of Chemotherapy Each of the chemotherapy drugs available today works in a slightly different ... few rules of thumb when it comes to chemotherapy that should always be kept in mind. Ignore ...

  7. 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

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

    Directory of Open Access Journals (Sweden)

    Roe H

    2014-08-01

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

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

    Science.gov (United States)

    ... 1- to 2-Year-Old Side Effects of Chemotherapy and Radiation KidsHealth > For Parents > Side Effects of Chemotherapy and Radiation Print A A A What's in ... and can no longer do their jobs efficiently. Chemotherapy (or "chemo") and radiation , the two most common ...

  10. 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 ...

  11. Managing Chemotherapy Side Effects: Infection

    Science.gov (United States)

    ... with soap and water. Have people around you wash their hands well, too. ● ● Check with your doctor or nurse about when to use hand sanitizer. Stay extra clean. ● ● Brush your teeth after meals and before you go ...

  12. Side effects of chemotherapy in musculoskeletal oncology.

    Science.gov (United States)

    Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Romantini, Matteo; Angelini, Andrea; Ruggieri, Pietro

    2010-01-01

    With recent advances in medical and orthopedic oncology, radiation therapy and single- or multiple-agent perioperative chemotherapy are currently applied as an essential part of the multidisciplinary treatment to improve disease-free and overall survival of patients with primary and metastatic bone and soft tissue tumors. However, these treatments have led to unwanted complications. A better understanding of the effects of various antineoplastic agents on bone, soft tissue, and organs may provide the basis for the more efficacious use of antiproliferative drugs when fracture healing or allograft incorporation is required. This knowledge may also provide a rationale for concurrent treatment with drugs that protect against or compensate for adverse effects in osseous repair resulting from chemotherapy.

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

    Science.gov (United States)

    Lee, Hye-Ok; Lee, Jung-Joo

    2015-01-01

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

  14. 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.

  15. The Dark Side of Management

    DEFF Research Database (Denmark)

    Hanlon, Gerard; Dunne, Stephen; Johnsen, Christian Garmann

    2017-01-01

    Towards the end of 2015, the ephemera collective organised, chaired and participated within two separate Q+A panels celebrating the launch of Gerard Hanlon’s The dark side of management: A secret history of management theory. The events took place in The University of Leicester’s School...... of Management and Copenhagen Business School’s Management, Politics and Philosophy Department. Each of the events were recorded, transcribed, edited and amalgamated into the following feature....

  16. Overview, prevention and management of chemotherapy extravasation.

    Science.gov (United States)

    Kreidieh, Firas Y; Moukadem, Hiba A; El Saghir, Nagi S

    2016-02-10

    Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracyclines extravasation. We highlight the importance of education and training of the oncology team for prevention and prompt pharmacological and non-pharmacological management and stress the availability of new antidotes like dexrazoxane wherever anthracyclines are being infused.

  17. Chemotherapy | Smokefree.gov

    Science.gov (United States)

    Chemotherapy works by killing cancer cells, but healthy cells get attacked too. Damage to healthy cells can cause uncomfortable side effects. Use this action deck to get information on common chemotherapy side effects and learn how to manage them.

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    2012-01-01

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

  1. 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.

  2. [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.

  3. Dietetic management in gastrointestinal complications from antimalignant chemotherapy.

    Science.gov (United States)

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

    2012-01-01

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

  4. 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

  5. Demand Side Management for Multiple Devices

    NARCIS (Netherlands)

    Molderink, Albert; Bakker, Vincent; Smit, Gerard J.M.

    2013-01-01

    Steering a heterogeneous set of devices in a Smart Grid using cost functions: Demand Side Management (DSM) is an important element in smart grids. DSM is already in operation for large consumers, but thorough research is required into DSM on a building level within the distribution grid.

  6. 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  

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

    Institute of Scientific and Technical Information of China (English)

    Yu Zhang; Jing Wan; Yuebo Yang; Xiaomao Li

    2013-01-01

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

  8. Demand side management of electric car charging

    DEFF Research Database (Denmark)

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

    2012-01-01

    in terms of distributed energy storage and flexible load. This paper examines how optimising the charging cycles of an electriccar using DSM (DemandSideManagement) based on a number of criteria could be used to achieve financial savings, increased demand on renewable energy, reduce demand on thermal...... generation plant, and reduce peak load demand. The results demonstrate that significant gains can be achieved using currently available market data which highlights the point that DSM can be implemented without any further technological advents....

  9. Industrial demand side management status report - synopsis

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-05-01

    Industrial demand side management (DSM) programs, though not as developed or widely implemented as residential and commercial programs, hold the promise of significant energy savings-savings that will benefit industrial firms, utilities and the environment. This paper is a synopsis of a larger research report, Industrial Demand Side Management: A Status Report, prepared for the U.S. Department of Energy. The report provides an overview of and rationale for DSM programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential electricity savings from industrial energy efficiency measures. Overcoming difficulties to effective program implementation is worthwhile, since rough estimates indicate a substantial potential for electricity savings. The report categorizes types of DSM programs, presents several examples of each type, and explores elements of successful programs. Two in-depth case studies (of Boise Cascade and of 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. Finally, the research report also includes a comprehensive bibliography, a description of technical assistance programs, and an example of a methodology for evaluating potential or actual savings from projects.

  10. Industrial demand side management status report: Synopsis

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, M.E.F.; Conger, R.L.; Foley, T.J.; Parker, J.W.; Placet, M.; Sandahl, L.J.; Spanner, G.E.; Woodruff, M.G.; Norland, D.

    1995-08-01

    Industrial demand side management (DSM) programs, though not as developed or widely implemented as residential and commercial programs, hold the promise of significant energy savings-savings that will benefit industrial firms, utilities and the environment. This paper is a synopsis of a larger research report, Industrial Demand Side Management. A Status Report, prepared for the US Department of Energy. The report provides an overview of and rationale for DSM programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential electricity savings from industrial energy efficiency measures. Overcoming difficulties to effective program implementation is worthwhile, since rough estimates indicate a substantial potential for electricity savings. The report categorizes types of DSM programs, presents several examples of each type, and explores elements of successful programs. Two in-depth case studies (of Boise Cascade and of 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. Finally, the research report also includes a comprehensive bibliography, a description of technical assistance programs, and an example of a methodology for evaluating potential or actual savings from projects.

  11. 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

  12. 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.

  13. [Side effects of chemotherapy in patients with pulmonary tuberculosis and concomitant diseases].

    Science.gov (United States)

    Nikolaeva, O D

    2003-01-01

    As many as 395 patients with pulmonary tuberculosis concurrent with other illnesses were examined. It has been ascertained that in 57.8 percent of cases there occurs a side effect in the wake of the antituberculous drug administration. The following were recognized as ill effects of the drugs employed--allergic reactions, candidiasis, disbacteriosis, toxic reactions,--in 25.44%, 3.07%, 7.02%, and 64.47% of cases respectively. Revealed in the above series was a marked side effect on the digestive organs, neurotoxic reactions, toxic effect on the cardiovascular system in 28.08%, 15.35%, 10.53% of cases respectively. The most frequently seen side effect was due to rifampicin (23.25%), streptomycin (18.42%), isoniazid (17.08%). The least number of complications was with taking etambutol--3.94%. In 43.42% of cases, the identified side effect necessitates withdrawal of the drug, in 56.58% of cases, the management of the concomitant medical problems, a change in routes of administration of medicines, and combined employment of antihistaminic drugs and hyposensitizing methodological approaches to the management of the condition permitted carrying on with the therapy instituted.

  14. Side Effects during Treatment of Advanced Gastric Carcinoma by Chemotherapy Combined with CIK-cell Transfusion in Elderly People

    Institute of Scientific and Technical Information of China (English)

    Jingting Jiang; Changping Wu; Liangrong Shi; Ning Xu; Haifeng Deng; Mingyang Lu; Mei Ji; Yibei Zhu; Xueguang Zhang

    2008-01-01

    OBJECTIVE To study the side effects and therapeutic results of autologous cytokine-induced killer (CIK) cell treatment in elderly patients with advanced gastric cancer.METHODS CIK cells were induced and cultured using biotechnics in vitro, and then the ceils were infused back into the patients. Sixty elderly gastric cancer patients treated by chemotherapy (FOLFOX4 protocol) were followed-up. Among them, 29 patients were treated with CIK cells during application of chemotherapy. Short-term curative effects and adverse events from the CIK transfusion and chemotherapy were observed.RESULTS Eight cases developed partial remission (PR), 9 cases moderate remission (MR), 7 cases stable disease(SD) and 5 cases progressive disease (PD). Out of a total of 29 patients who received chemotherapy combined with autologous CIK therapy,the total remission rate (PR + MR) was 58.6%. The total remission rate following chemotherapy alone was 45.2%, including 5 PR cases, 9 MR cases, 7 SD cases, and 10 PD cases. There was a relatively lower rate of severe chemotherapic toxicities in the CIK-cell transfusion group. Side effects of autologous CIK transfusion included chilis (13 cases), fever (9 cases), nausea and vomiting(1 case) and general malaise (3 cases). Side effects were treated with conventional therapy resulting in their amelioration. No patients developed shock, blood capillary leakage syndrome, or abnormalities in routine blood, urine, liver and renal function tests.CONCLUSION Adoptive immunotherapy with autologous CIK cells may decrease the clinical signs and symptoms of elderly patients who suffer from advanced gastric cancer. Adverse reactions of patients can be alleviated by conventional therapy.Autologous CIK-cell transfusion may improve endurance to chemotherapy.

  15. Incentives for demand-side management

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

  16. Incentives for demand-side management

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

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

    DEFF Research Database (Denmark)

    Andersen, Christina; Adamsen, Lis; Møller, Tom

    2006-01-01

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

  18. Metallic taste in cancer patients treated with chemotherapy

    NARCIS (Netherlands)

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

    2015-01-01

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

  19. 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

  20. The social side of river management

    NARCIS (Netherlands)

    Groot, de W.T.; Warner, J.F.

    2011-01-01

    River management faces many challenges world-wide including climate change, flood risks and the demand for more adaptive and 'ecosystem-based' systems. Instead of raising the dikes even higher, the new adage for river managers is to give the rivers more space to drain their waters. This in turn impl

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    2011-04-01

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

  4. Demand Side Management Performance Evaluation for Commercial Enterprises

    Directory of Open Access Journals (Sweden)

    Jun Dong

    2016-10-01

    Full Text Available Demand Side Management in power systems plays an important role in ensuring a reliable power supply and protecting the environment. Demand Side Management in the commercial sector is vital for sustainable development during China’s industrial restructuring. A hybrid multi-criteria decision making framework for evaluating Demand Side Management performance of commercial enterprises is proposed from a sustainability perspective. A fuzzy Analytic Hierarchy Process is employed to determine the weights of the criteria and a fuzzy technique for order preference by similarity to an ideal solution is applied to rank Demand Side Management performance. An evaluation index system is built, containing economic, social, environmental and technical criteria associated with 15 sub-criteria. Four groups of expert panels from government departments, research institutions, electricity utilities and commercial enterprises gave judgments on criteria weights and criteria performances for alternatives. The effectiveness of the proposed hybrid framework was demonstrated through a case study in Beijing, in which Demand Side Management performances of four alternatives were ranked. Sensitivity analysis results indicate that the hybrid framework is robust.

  5. Age-related differences in renal side-effects of radiation and chemotherapy in the rat

    NARCIS (Netherlands)

    M.H.T.M. Jongejan (Mieke)

    1988-01-01

    textabstractThe improved life-expectancy of cancer patient has brought to light late sequelae of oncology therapy. This is especially true for pediatric patients. Renal damage is one of the adverse side-effects of anti-tumor therapy that may occur. Studies conceming damaging effects of radiotherapy

  6. Chemotherapy-Related Side Effects in Childhood Acute Lymphoblastic Leukemia in Indonesia: Parental Perceptions

    NARCIS (Netherlands)

    Sitaresmi, M.N.; Mostert, S.; Purwanto, I.; Gundy, C.; Sutaryo, N.N.; Veerman, A.J.P.

    2009-01-01

    Noncompliance with prescribed medication has been associated with increased chance of relapse and poor outcome. Side effects may be an important cause of noncompliance. Fifty-one parents of children with acute lymphoblastic leukemia in a tertiary care hospital in Indonesia were interviewed about the

  7. 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.

  8. 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.

  9. US electric utility demand-side management, 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-26

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

  10. 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

  11. 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....

  12. 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.

  13. Treatment of Nausea and Vomiting During Chemotherapy.

    Science.gov (United States)

    Mustian, Karen M; Devine, Katie; Ryan, Julie L; Janelsins, Michelle C; Sprod, Lisa K; Peppone, Luke J; Candelario, Grace D; Mohile, Supriya G; Morrow, Gary R

    2011-01-01

    Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.

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

    Science.gov (United States)

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

    2016-05-29

    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.

  15. 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.

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

    Science.gov (United States)

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

    1988-03-01

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

  17. 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.

  18. Impact of Demand Side Management in Active Distribution Networks

    DEFF Research Database (Denmark)

    Ponnaganti, Pavani; Bak-Jensen, Birgitte; Pillai, Jayakrishnan Radhakrishna

    2017-01-01

    Demand Side Management (DSM) is an efficient flexible program which helps distribution network operators to meet the future critical peak demand. It is executed in cases of not only technical issues like voltage sag or swell, transformer burdening, cable congestions, but also to increase the degree...... of visibility in the electricity markets. The aim of this paper is to find the optimal flexible demands that can be shifted to another time in order to operate the active distribution system within secure operating limits. A simple mechanism is proposed for finding the flexibility of the loads where electric...

  19. 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...

  20. New Insights into Potential Prevention and Management Options for Chemotherapy-Induced Peripheral Neuropathy

    Directory of Open Access Journals (Sweden)

    Janet Schloss

    2016-01-01

    Full Text Available Objective: Neurological complications such as chemotherapy-induced peripheral neuropathy (CIPN and neuropathic pain are frequent side effects of neurotoxic chemotherapy agents. An increasing survival rate and frequent administration of adjuvant chemotherapy treatments involving neurotoxic agents makes it imperative that accurate diagnosis, prevention, and treatment of these neurological complications be implemented. Methods: A consideration was undertaken of the current options regarding protective and treatment interventions for patients undergoing chemotherapy with neurotoxic chemotherapy agent or experience with CIPN. Current knowledge on the mechanism of action has also been identified. The following databases PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, CINAHL, CNKI, and Google Scholar were searched for relevant article retrieval. Results: A range of pharmaceutical, nutraceutical, and herbal medicine treatments were identified that either showed efficacy or had some evidence of efficacy. Duloxetine was the most effective pharmaceutical agent for the treatment of CIPN. Vitamin E demonstrated potential for the prevention of cisplatin-IPN. Intravenous glutathione for oxaliplatin, Vitamin B6 for both oxaliplatin and cisplatin, and omega 3 fatty acids for paclitaxel have shown protection for CIPN. Acetyl-L-carnitine may provide some relief as a treatment option. Acupuncture may be of benefit for some patients and Gosha-jinki-gan may be of benefit for protection from adverse effects of oxaliplatin induced peripheral neuropathy. Conclusions: Clinicians and researchers acknowledge that there are numerous challenges involved in understanding, preventing, and treating peripheral neuropathy caused by chemotherapeutic agents. New insights into mechanisms of action from chemotherapy agents may facilitate the development of novel preventative and treatment options, thereby enabling medical staff to better support patients by

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

    Directory of Open Access Journals (Sweden)

    Talita Garcia do Nascimento

    2014-04-01

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

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

    Science.gov (United States)

    Vigants, Haralds; Blumberga, Dagnija; Veidenbergs, Ivars

    2014-12-01

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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Nutritional and Pharmacological Management during Chemotherapy in a Patient with Propionic Acidaemia and Rhabdomyosarcoma Botryoides.

    Science.gov (United States)

    Martín-Hernández, E; Quijada-Fraile, P; Oliveros-Leal, L; García-Silva, Mt; Pérez-Cerdá, C; Baro-Fernández, M; Pérez-Alonso, V; Vivanco, Jl

    2012-01-01

    We present the nutritional and pharmacological management of a 2-year-old girl with a severe form of propionic acidaemia and a genitourinary embryonal rhabdomyosarcoma. This association has not been described before, nor the utilization of chemotherapy in patients with propionic acidaemia.The patient is a girl with neonatal onset of propionic acidaemia, homozygous for the c.2041-2924del3889 mutation in PCCA gene. At 23 months of age she was diagnosed with genitourinary embryonal rhabdomyosarcoma. Conservative surgery, brachytherapy and nine cycles of chemotherapy with iphosphamide, vincristine and actinomycin were recommended by oncologists. Due to the possibility that the child could present decompensations, we elaborated three different courses of treatment: when the patient was stable (treatment 1), intermittent bolus feeding through gastrostomy, containing 70 kcal/kg/day and 1.4 g/kg/day of total protein (0.6 g/kg/day of natural protein and 0.8 g/kg/day of amino acid-based formula) was prescribed; on the chemotherapy-days (treatment 2), diet consisted on continuous feeding, with the same energy and amino acid-based formula but half of natural protein intake; in case of decompensation (treatment 3), we increased by 10% the energy intake, and completely stopped natural protein in the diet but maintaining the amino acid-based formula. On chemotherapy- days carnitine was increased from 100 mg/kg/day to 150 mg/kg/day, and N-carbamylglutamate was added.Through the 7 months with chemotherapy the patient did not suffer decompensations, while she maintained good nutritional status.Enteral continuous feeding by gastrostomy, amino acid-based formula, and preventive use of N-carbamylglutamate during chemotherapy-days are the principal measures we propose in these situations.

  8. Induction of a Tumor-Metastasis-Receptive Microenvironment as an Unwanted Side Effect After Radio/Chemotherapy and In Vitro and In Vivo Assays to Study this Phenomenon.

    Science.gov (United States)

    Schneider, Gabriela; Sellers, Zachariah Payne; Ratajczak, Mariusz Z

    2016-01-01

    Besides surgical removal of tumor tissue, chemotherapy and radiotherapy are the most important and efficient treatment modalities employed to treat therapy-susceptible malignancies. The main aim of this treatment-to destroy tumor cells-is unfortunately usually associated with toxicity to nontumor cells and different degrees of tissue and organ damage. In damaged tissues several chemoattractants are upregulated and released that may attract tumor cells. Moreover, highly migratory radio/chemotherapy treatment may endow cells with several properties of cancer stem cells which survive and respond to these chemoattractants upregulated in collateral tissues. Based on this, one of the unwanted and underappreciated side effects of chemotherapy or radiotherapy is the creation of a metastasis-receptive microenvironment in bones as well as in other organs of the body. Herein we describe methods and assays that can be employed to study migratory properties of cancer cells in in vitro (chemotaxis) and in vivo (seeding efficiency assay) conditions in response to the induction of pro-metastatic microenvironments in various organs and tissues.

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Jo Lynne W. Robins

    2013-01-01

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

  12. Chemotherapy-Induced Peripheral Neuropathy: Current Status and Progress

    OpenAIRE

    Brewer, Jamie R; Morrison, Gladys; Dolan, M Eileen; Gini F Fleming

    2015-01-01

    As there are increasing numbers of cancer survivors, more attention is being paid to the long term unwanted effects patients may experience as a result of their treatment and the impact these side effects can have on their quality of life. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common long-term toxicities from chemotherapy. In this review we will briefly review the clinical presentation, evaluation and management of chemotherapy-induced peripheral neuropathy, wit...

  13. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Thais de Oliveira Gozzo

    Full Text Available The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

  14. 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...

  15. 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.

  16. [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.

  17. 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

  18. Combined side-to-end anastomosis with temporary end colostomy for the management of selected left-sided colonic emergencies.

    Science.gov (United States)

    Safioleas, Michael; Stamatakos, Michael; Safioleas, Panayoitis; Safioleas, Konstantinos; Sakorafas, George H

    2011-04-01

    Management of surgical emergencies of the left colon commonly requires excision of the colonic segment bearing the lesion, creation of an end colostomy, and closure of the rectosigmoid stump. Closure of the end stoma may be technically challenging. During this study, we used a new surgical technique involving the creation of an end-to-side anastomosis of the rectosigmoid stump to the base of the proximal colonic segment in association with an end colostomy. During a 15-year period, 23 patients were offered this type of surgery. Mortality was zero. Complications were observed in seven patients (morbidity, 7/23). Mean hospitalization time was 12.3 days. Closure of the colostomy was performed approximately 1 month after initial surgery and was easily performed using a mechanical stapler, either intraperitoneally or even extraperitoneally. No complications were observed after closure of the colostomy. The described technique is a useful alternative for the management of selected patients with left-sided colonic surgical emergencies. Its main advantage is that it greatly facilitates colostomy closure, which is performed earlier compared with the colostomy closure after a typical Hartmann's procedure.

  19. Neoadjuvant chemotherapy versus cystectomy in management of stages II, and III urinary bladder cancer

    Directory of Open Access Journals (Sweden)

    Mohammed A. Osman

    2014-12-01

    Full Text Available Purpose: This phase III trial was de - signed to compare the survival benefit, surgical respectability, and toxicities among patients treated by neoadjuvant chemotherapy followed by radical cystectomy (arm A, with those treated by radical cystectomy (arm B in the management of stage II, III urinary bladder cancer. Patients and Methods: For inclusion, patients should have pathologically proven urothelial carcinoma in urinary bladder, clinical stages from T2N0M0 to T4aN0M0, patient age less than 65 years, and performance state ≤ 2. Additionally, patients should have adequate hematological, renal, and liver functions. Arm A patients underwent 3 cycles of neoadjuvant cisplatin and gemcitabine followed by radical cystectomy, while arm B patients underwent radical cystectomy directly. Results: Thirty patients had been enrolled in each arm between September 2009 and April 2014 in 3 educational institutes in Egypt. The 3 year OS (overall survival for arm A, and B were 60% and 50% respectively. The median OS for arm A was 36+ months and that for arm B was 32.5 months. The 3 year progression-free survival (PFS for arm A, and B were 57% and 43% respectively. The median PFS for arm A was 36+ months and for arm B was 28 months. A subgroup analysis was performed to correlate between 3 year OS and predetermined prognostic factors including age, tumor size, pathological stage, and the response to neoadjuvant chemotherapy. The later was performed only in arm A. Both treatment arms were tolerated well with mild toxicities profiles. Conclusion: Neoadjuvant chemotherapy achieved better survival, surgical respectability, with nearly equivalent toxicities when compared with radical cystectomy.

  20. 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.

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

    Science.gov (United States)

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

    2016-01-27

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

  2. Induction of a tumor-metastasis-receptive microenvironment as an unwanted and underestimated side effect of treatment by chemotherapy or radiotherapy.

    Science.gov (United States)

    Ratajczak, Mariusz Z; Jadczyk, Tomasz; Schneider, Gabriela; Kakar, Sham S; Kucia, Magda

    2013-12-27

    There are well-known side effects of chemotherapy and radiotherapy that are mainly related to the toxicity and impaired function of vital organs; however, the induction by these therapies of expression of several pro-metastatic factors in various tissues and organs that in toto create a pro-metastatic microenvironment is still, surprisingly, not widely acknowledged. In this review, we support the novel concept that toxic damage in various organs leads to upregulation in "bystander" tissues of several factors such as chemokines, growth factors, alarmines, and bioactive phosphosphingolipids, which attract circulating normal stem cells for regeneration but unfortunately also provide chemotactic signals to cancer cells that survived the initial treatment. We propose that this mechanism plays an important role in the metastasis of cancer cells to organs such as bones, lungs, and liver, which are highly susceptible to chemotherapeutic agents as well as ionizing irradiation. This problem indicates the need to develop efficient anti-metastatic drugs that will work in combination with, or follow, standard therapies in order to prevent the possibility of therapy-induced spread of tumor cells.

  3. Bevacizumab chemotherapy for management of pulmonary and laryngotracheal papillomatosis in a child.

    Science.gov (United States)

    Zur, Karen B; Fox, Elizabeth

    2016-12-20

    Recurrent laryngeal papillomatosis (RRP) can be a devastating condition for a child to endure, and pulmonary involvement may have terminal consequences. Adjuvant therapies have been trialed and reported over the years; however, these chemotherapy options have not been successful. Bevacizumab (Avastin, Genetech Inc., South San Francisco, CA) is a vascular endothelial factor (VEGF) inhibitor that has shown promise in the management of papillomatosis. Most research has focused on intralesional injections of this antiangiogenic drug. The systemic use of bevacizumab is not as well described. This is a case report of a 12-year-old female diagnosed with severe laryngotracheal papillomatosis near birth who underwent a tracheostomy tube placement at 1 year of age. She required weekly debridements to prevent tracheal obstruction. When lung involvement was diagnosed at 1 year of age, cidofovir was started intravenously. Over the course of the past 10 years, the patient was managed with celecoxib (Celebrex, Pfizer, New York, NY), anti-reflux medications, zithromycin, propranolol, Gardasil (Merck and Co., Kenilworth, NJ), and a 7-year course of interferon-alpha. Intravenous bevacizumab was started when the patient's pulmonary status deteriorated. There was remarkable improvement in her laryngotracheal disease within 6 weeks of therapy. Following 3 months of bevacizumab, the patient's disease was completely resolved at the laryngeal level and nearly gone in the trachea, and she was decannulated. A computed scan was performed following 5 months of intravenous bevacizumab, and the pulmonary RRP nodules completely resolved. The patient had no major or minor complication from the chemotherapy to date. Systemic Bevacizumab is a promising modality of adjuvant therapy for significant papillomatosis. Laryngoscope, 2016.

  4. Use of allogeneic platelet gel in the management of chemotherapy extravasation injuries: a case report

    Directory of Open Access Journals (Sweden)

    Di Costanzo G

    2015-02-01

    Full Text Available Gaetano Di Costanzo,1 Giovanna Loquercio,1 Gianpaolo Marcacci,2 Vincenzo Iervolino,1 Stefano Mori,3 Arnolfo Petruzziello,1 Pasquale Barra,1 Carmela Cacciapuoti1 1Transfusion Service, Department of Haematology, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy; 2Hematology-Oncology and Stem Cell Transplantation Unit, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy; 3Department of Surgery, Melanoma – Soft Tissues – Head and Neck – Skin Cancers, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy Abstract: The allogeneic platelet (PLT gel offers to be a valid supportive measure in the management of chemotherapy extravasation injuries. We report a case of a 58-year-old patient with multiple myeloma enrolled for high-dose chemotherapy and autologous stem cell transplantation. As pretransplant therapy, the patient received induction therapy with bortezomib, adriblastina, and desametazone. A port was inserted in the vein on the back of the hand. After three cycles, the patient reported rapid development of redness, pain, and necrotic tissue in the left hand, and a diagnosis of extravasation was addressed. The patient presented a raw area on the back of the hand caused by cytotoxic/chemotherapeutic drug leakage because of the malposition of venous access devices. Skin ulcer was debrided, and the wound was reconstructed with a combination of local random rotational flap and abdomen skin graft. Two weeks later, a 20% skin flap necrosis was observed. In the context of wound healing, topical plasma-rich PLT gel is able to accelerate the regeneration and repair of tissue, so it was set out to assess PLT gel efficacy in this case. The PLT gel was applied topically once every 5 days, for a duration of 60 days on average. There were no adverse reactions observed during the topical therapy. Complete wound healing was observed after 12 PLT-rich plasma applications. No ulcer

  5. Biosimilar epoetin for the management of chemotherapy-induced anemia in elderly patients

    Directory of Open Access Journals (Sweden)

    Kurtz JE

    2016-10-01

    only 17.6% and 16.4% of younger and elderly patients, respectively. A greater number of thromboembolic events and a lesser rate of infections were reported in the elderly, but were still lower than reported in clinical registration trials. No treatment fatalities occurred in either group. Conclusion: Biosimilar epoetin was an effective and well-tolerated treatment for managing CIA in elderly cancer patients. Keywords: biosimilar, elderly, epoetin, ESA, chemotherapy-induced anemia, anemia

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

    Directory of Open Access Journals (Sweden)

    Guariglia R

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  8. 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....

  9. 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.

  10. 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.

  11. Optimal Privacy-Cost Trade-off in Demand-Side Management with Storage

    OpenAIRE

    Tan, Onur; Gündüz, Deniz; Gómez-Vilardebó, Jesús

    2015-01-01

    Demand-side energy storage management is studied from a joint privacy-energy cost optimization perspective. Assuming that the user's power demand profile as well as the electricity prices are known non-causally, the optimal energy management (EM) policy that jointly increases the privacy of the user and reduces his energy cost is characterized. The backward water-filling interpretation is provided for the optimal EM policy. While the energy cost is reduced by requesting more energy when the p...

  12. 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

    of the power sector in mind and thus can differ significantly in their architecture, their integration into the various markets, their integration into distribution network operation and several other aspects. This paper proposes a classification of load control policies for demand side management in smart...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  14. 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.

  15. 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…

  16. Experimental determination of demand side management potential of wet appliances in the Netherlands

    NARCIS (Netherlands)

    Staats, M. R.; de Boer-Meulman, P. D M; van Sark, W. G J H M

    2017-01-01

    The potential of demand side management (DSM) of wet appliances (washing machine, dishwasher and tumble dryer) in households with photovoltaic (PV) systems is studied experimentally focusing on evening peak demand reduction and increase in PV self-consumption. In a sample of 100 Dutch households the

  17. Modeling and Analysis of Commercial Building Electrical Loads for Demand Side Management

    Science.gov (United States)

    Berardino, Jonathan

    In recent years there has been a push in the electric power industry for more customer involvement in the electricity markets. Traditionally the end user has played a passive role in the planning and operation of the power grid. However, many energy markets have begun opening up opportunities to consumers who wish to commit a certain amount of their electrical load under various demand side management programs. The potential benefits of more demand participation include reduced operating costs and new revenue opportunities for the consumer, as well as more reliable and secure operations for the utilities. The management of these load resources creates challenges and opportunities to the end user that were not present in previous market structures. This work examines the behavior of commercial-type building electrical loads and their capacity for supporting demand side management actions. This work is motivated by the need for accurate and dynamic tools to aid in the advancement of demand side operations. A dynamic load model is proposed for capturing the response of controllable building loads. Building-specific load forecasting techniques are developed, with particular focus paid to the integration of building management system (BMS) information. These approaches are tested using Drexel University building data. The application of building-specific load forecasts and dynamic load modeling to the optimal scheduling of multi-building systems in the energy market is proposed. Sources of potential load uncertainty are introduced in the proposed energy management problem formulation in order to investigate the impact on the resulting load schedule.

  18. 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.

  19. Managing patients with side effects and adverse events to immunoglobulin therapy.

    Science.gov (United States)

    Azizi, Gholamreza; Abolhassani, Hassan; Asgardoon, Mohammad Hossein; Shaghaghi, Shiva; Negahdari, Babak; Mohammadi, Javad; Rezaei, Nima; Aghamohammadi, Asghar

    2016-01-01

    Immunoglobulin therapy has not only served as a lifesaving approach for the prevention and treatment of infections in primary and secondary immunodeficiency diseases, but has also been used as an immunomodulatory agent for autoimmune and inflammatory disorders and to provide passive immunity for some infectious diseases. Most of the adverse effects associated with immunoglobulin therapy are mild, transient and self-limiting. However, serious side effects also occur. Therefore, to minimize the adverse events of immunoglobulin therapy, specialist review of patient clinical status and immunoglobulin products, in addition to selection of appropriate treatment strategy for the management of patients with associated side effects and adverse events, are crucial.

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

    Directory of Open Access Journals (Sweden)

    Pankaj G. Vashi

    2012-07-01

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

  1. A multicenter study of recombinant human erythropoietin (epoetin alpha) in the management of anemia in cancer patients receiving chemotherapy.

    Science.gov (United States)

    Pawlicki, M; Jassem, J; Bösze, P; Lotan, C; Kurteva, G P; Siddiqui, M; Kosmidis, P A; Rigatos, G A; Kansu, E; Durkovic, P; Aziz, Z; Al Idrissi, H; Roth, A; Cozma, G

    1997-11-01

    Current evidence suggests that epoetin alpha administration is well tolerated and effective in the management of anemia of cancer and cancer chemotherapy. An open-label, multinational, non-comparative study was conducted in 215 cancer patients with anemia secondary to chemotherapy with platinum- or non-platinum-based combinations. Epoetin alpha was administered s.c. (150 IU/kg three times/week) for a planned period of 16 weeks. The response rate of epoetin alpha, defined as an increase in hemoglobin level of 2 g/dl or more from baseline, was 67%. The rate of response was not related to the chemotherapy regimen administered (platinum or non-platinum based). The percentage of patients transfused and the transfusion rate during epoetin alpha treatment were reduced. Transfusional need was eliminated in 64 (75%) of the 85 patients transfused before the study start, after 1 month of therapy. Quality of life, assessed using a visual analog scale, improved markedly in patients who experienced a hematological response. These patients also experienced a statistically significant (p performance score. These findings indicate that epoetin alpha is a well tolerated and effective agent which increases hemoglobin concentration and reduces transfusion requirements in anemic cancer patients receiving chemotherapy.

  2. Chemotherapy-induced peripheral neuropathy: Current status and progress.

    Science.gov (United States)

    Brewer, Jamie R; Morrison, Gladys; Dolan, M Eileen; Fleming, Gini F

    2016-01-01

    As there are increasing numbers of cancer survivors, more attention is being paid to the long term unwanted effects patients may experience as a result of their treatment and the impact these side effects can have on their quality of life. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common long-term toxicities from chemotherapy. In this review we will briefly review the clinical presentation, evaluation and management of chemotherapy-induced peripheral neuropathy, with a focus on CIPN related to platinum and taxane agents. We will then discuss current clinical models of peripheral neuropathy and ongoing research to better understand CIPN and develop potential treatment options.

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

    DEFF Research Database (Denmark)

    Hawkes, Eliza A; Ladas, George; Cunningham, David

    2012-01-01

    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...

  4. 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...

  5. 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.

  6. 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.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    S. Sofana Reka

    2016-09-01

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

  9. 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 ...

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

    DEFF Research Database (Denmark)

    Zong, Yi; You, Shi; Hu, Junjie

    2015-01-01

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

  11. 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.

  12. 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

  13. 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

  14. Management of Invasive Fungal Infections in Pediatric Acute Leukemia and the Appropriate Time for Restarting Chemotherapy

    Directory of Open Access Journals (Sweden)

    Özlem Tüfekçi

    2015-12-01

    Full Text Available INTRODUCTION: Rapid and effective treatment of invasive fungal infection (IFI in patients with leukemia is important for survival. In this study, we aimed to describe variations regarding clinical features, treatment modalities, time of restarting chemotherapy, and outcome in children with IFI and acute leukemia (AL. METHODS: The charts of all pediatric AL patients in our clinic between the years of 2001 and 2013 were retrospectively reviewed. All patients received prophylactic fluconazole during the chemotherapy period. RESULTS: IFI was identified in 25 (14% of 174 AL patients. Most of them were in the consolidation phase of chemotherapy and the patients had severe neutropenia. The median time between leukemia diagnosis and definition of IFI was 122 days. Twenty-four patients had pulmonary IFI. The most frequent finding on computed tomography was typical parenchymal nodules. The episodes were defined as proven in 4 (16% patients, probable in 7 (28% patients, and possible in 14 (56% patients. The median time for discontinuation of chemotherapy was 27 days. IFI was treated successfully in all patients with voriconazole, amphotericin B, caspofungin, or posaconazole alone or in combination. Chemotherapy was restarted in 50% of the patients safely within 4 weeks and none of those patients experienced reactivation of IFI. All of them were given secondary prophylaxis. The median time for antifungal treatment and for secondary prophylaxis was 26 and 90 days, respectively. None of the patients died due to IFI. DISCUSSION AND CONCLUSION: Our data show that rapid and effective antifungal therapy with rational treatment modalities may decrease the incidence of death and that restarting chemotherapy within several weeks may be safe in children with AL and IFI.

  15. 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

  16. 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.

  17. Side effects of aesthetic therapy by lasers and IPL source: a dark side of the correct management of the patients

    Science.gov (United States)

    Oskarbski, George V.

    2004-09-01

    A medical practice by laser or IPL device means professional experience, reputation, strong economical investment, while a patient needs results for the bill he pays. In front of a publicity of non-invasive solutions for a broad base of clinical applications, the everyday practice offers embarrassing side effects about which it is better to prepare the users. Inefficiency, hypo-hyper-pigmentations, scars show that we need to have clear instructions and experienced studies, before emphasizing good results.

  18. Management of chemotherapy-induced adverse effects in the treatment of colorectal cancer

    NARCIS (Netherlands)

    Jansman, FGA; Sleijfer, DT; de Graaf, JC; Coenen, JLLM; Brouwers, JRBJ

    2001-01-01

    The anticancer agents fluorouracil, raltitrexed, irinotecan and oxaliplatin show limited efficacy in the treatment of colorectal cancer and may be associated with substantial toxicity. Therefore, the prevention and reduction of chemotherapy-induced adverse effects is of major significance, in accord

  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. [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.

  1. 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.)

  2. Load curve classification for the evaluation of demand side management programs

    Science.gov (United States)

    Yumak, K.; Tosun, G.; Varlik, B.; Bağriyanık, M.

    2016-11-01

    The demand side management of electrical power systems is an issue of growing concern. In this study, annual load curves those have been obtained by field measurements on MV (31.5kV) feeders in an electricity distribution company in Turkey have been studied. Feeders supplying different type of customers (Agricultural irrigation, Commercial & Industrial and Residential) are classified through Peak and Night Ratio for the assessment of convenient incentive or price based methods. Statistical parameters, such as peak-to-average ratio, load factor and standard deviation are calculated. Active power deviations on annual and daily load curves are discussed.

  3. 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.

  4. 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.

  5. Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Schweitzer, M.

    1991-01-01

    Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mix of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.

  6. 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.

  7. Demand Side Management for Stand-Alone Hybrid Power Systems Based on Load Identification

    Directory of Open Access Journals (Sweden)

    Friederich Kupzog

    2012-11-01

    Full Text Available Within the field of Distributed Generation (DG, stand-alone Hybrid Power Systems (HPS are a suitable solution to provide energy to isolated facilities where the connection to a centralized grid is not affordable. The logical evolution of such systems involves the optimization of power resources and related control strategies, but also enhancements concerning the management of energy loads. This paper introduces Demand Side Management (DSM strategies specially designed for HPS. They are applied on a real and patented HPS that consists of PV panels, a diesel generator, an inverter and a set of batteries. DSM strategies are built up on a framework of distributed endpointdevices connected to a central control application where loads are identified according to their behavior. System network components, load definitions, the control application and DSM strategies are depicted. Finally, simulations show illustrative savings achieved by the application of some of the proposed strategies.

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

    Directory of Open Access Journals (Sweden)

    Annekathrin Haberland

    2013-02-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Rodríguez Américo David

    2006-01-01

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

  10. 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 ...

  11. Advances in management of adjuvant chemotherapy in rectal cancer: Consequences for clinical practice.

    Science.gov (United States)

    Netter, Jeanne; Douard, Richard; Durdux, Catherine; Landi, Bruno; Berger, Anne; Taieb, Julien

    2016-11-01

    More than half the patients with rectal cancer present with locally advanced rectal disease at diagnosis with a high risk of recurrence. Preoperative chemoradiotherapy and standardized radical surgery with total mesorectal excision have been established as the 'gold standard' for treating these patients. Pathological staging using the ypTNM classification system to decide on adjuvant chemotherapy (ACT) is widely used in clinical practice, but the delivery of ACT is still controversial, as many discrepancies persist in the conclusions of different trials, due to heterogeneity of the inclusion criteria between studies, lack of statistical power, and variations in preoperative and adjuvant regimens. In 2014, a meta-analysis of four randomized phase-III trials (EORTC 22921, I-CNR-RT, PROCTOR-SCRIPT, CHRONICLE) failed to demonstrate any statistical efficacy of fluorouracil (5FU)-based ACT. Three recent randomized trials aimed to compare 5FU with 5FU plus oxaliplatin-based chemotherapy. Two of them (ADORE, CAO/ARO/AIO-04) appeared to find a disease-free survival benefit for patients treated with the combination therapy. Thus, while awaiting new data, it can be said that, as of 2015, patients with yp stage I tumors or histological complete response derived no benefit from adjuvant therapy. On the other hand, the FOLFOX chemotherapy regimen should be proposed for yp stage III patients, and may be considered for yp stage II tumors in fit patients with high-risk factors. Nevertheless, well-designed and sufficiently powered clinical trials dedicated to adjuvant treatments for rectal cancer remain justified in future to achieve a high level of proof in keeping with evidence-based medical standards.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Sohail Razzaq

    2016-10-01

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

  14. 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.

  15. Small Cell Neuroendocrine Carcinoma of the Urinary Tract Successfully Managed with Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Mustapha Ahsaini

    2013-01-01

    Full Text Available Introduction. Small cell neuroendocrine carcinomas of the urinary tract is an extremely rare entity and very few cases have been reported in the literature. Small cell neuroendocrine carcinoma of the urinary tract (SCC-UT is the association between bladder and urinary upper tract-small cell carcinoma (UUT-SCC. It characterized by an aggressive clinical course. The prognosis is poor due to local or distant metastases, and usually the muscle of the bladder is invaded. Case Presentation. We report a rare case of a 54-year-old Arab male native of moroccan; he is a smoker and was referred to our institution for intermittent hematuria. Following a diagnosis of small cell neuroendocrine carcinomas of the ureter and the bladder, thoracoabdominal-pelvic CT was done, and the staging of the tumor was done in the bladder (T2N0M0 and (T1N0M0 in the ureter. Neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin was realized, and nephroureterectomy associated to a cystoprostatectomy was carried out. After 24 months of followup, no local or distant metastasis was detected. Conclusion. The purpose of this review is to present a rare case of pure small cell neuroendocrine carcinoma of the urinary tract and review the literature about the place of neoadjuvant chemotherapy in this rare tumors.

  16. 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.

  17. 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)

  18. A novel domestic electric water heater model for a multi-objective demand side management program

    Energy Technology Data Exchange (ETDEWEB)

    Paull, Liam; Li, Howard; Chang, Liuchen [University of New Brunswick, Department of Electrical Engineering, Fredericton, NB (Canada)

    2010-12-15

    This paper presents a novel domestic hot water heater model to be used in a multi-objective demand side management program. The model incorporates both the thermal losses and the water usage to determine the temperature of the water in the tank. Water heater loads are extracted from household load data and then used to determine the household water usage patterns. The benefits of the model are: (1) the on/off state of the water heater and temperature of the water in the tank can be accurately predicted, and (2) it enables the development of water usage profiles so that users can be classified based on usage behaviour. As a result, the amount of ancillary services and peak shaving that can be achieved are accurately predictable and can be maximized without adversely affecting users. (author)

  19. 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

  20. 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.

  1. 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.

  2. Distributed Demand Side Management with Battery Storage for Smart Home Energy Scheduling

    Directory of Open Access Journals (Sweden)

    Omowunmi Mary Longe

    2017-01-01

    Full Text Available The role of Demand Side Management (DSM with Distributed Energy Storage (DES has been gaining attention in recent studies due to the impact of the latter on energy management in the smart grid. In this work, an Energy Scheduling and Distributed Storage (ESDS algorithm is proposed to be installed into the smart meters of Time-of-Use (TOU pricing consumers possessing in-home energy storage devices. Source of energy supply to the smart home appliances was optimized between the utility grid and the DES device depending on energy tariff and consumer demand satisfaction information. This is to minimize consumer energy expenditure and maximize demand satisfaction simultaneously. The ESDS algorithm was found to offer consumer-friendly and utility-friendly enhancements to the DSM program such as energy, financial, and investment savings, reduced/eliminated consumer dissatisfaction even at peak periods, Peak-to-Average-Ratio (PAR demand reduction, grid energy sustainability, socio-economic benefits, and other associated benefits such as environmental-friendliness.

  3. 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

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

    Institute of Scientific and Technical Information of China (English)

    周婉; 许勤; 言克莉; 任驹茗; 严凤

    2015-01-01

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

  5. Managing Radiation Therapy Side Effects: What to Do When You Have Loose Stools (Diarrhea)

    Science.gov (United States)

    ... rice • White toast Fruits and other foods • Applesauce • Bananas • Canned fruit, such as peaches and pears • Gelatin ( ... series of 9 Radiation Therapy Side Effects Fact Sheets at: www. cancer. gov/ radiation- side- effects

  6. Managing Sustainable Demand-side Infrastructure for Power System Ancillary Services

    Science.gov (United States)

    Parkinson, Simon Christopher

    Widespread access to renewable electricity is seen as a viable method to mitigate carbon emissions, although problematic are the issues associated with the integration of the generation systems within current power system configurations. Wind power plants are the primary large-scale renewable generation technology applied globally, but display considerable short-term supply variability that is difficult to predict. Power systems are currently not designed to operate under these conditions, and results in the need to increase operating reserve in order to guarantee stability. Often, operating conventional generation as reserve is both technically and economically inefficient, which can overshadow positive benefits associated with renewable energy exploitation. The purpose of this thesis is to introduce and assess an alternative method of enhancing power system operations through the control of electric loads. In particular, this thesis focuses on managing highly-distributed sustainable demand-side infrastructure, in the form of heat pumps, electric vehicles, and electrolyzers, as dispatchable short-term energy balancing resources. The main contribution of the thesis is an optimal control strategy capable of simultaneously balancing grid- and demand-side objectives. The viability of the load control strategy is assessed through model-based simulations that explicitly track end-use functionality of responsive devices within a power systems analysis typically implemented to observe the effects of integrated wind energy systems. Results indicate that there is great potential for the proposed method to displace the need for increased reserve capacity in systems considering a high penetration of wind energy, thereby allowing conventional generation to operate more efficiently and avoid the need for possible capacity expansions.

  7. 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

  8. Inoperable esophageal carcinoma managed by combined chemotherapy (CBDCA, 5FU and VDS) and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Morishima, Yuichi; Tashiro, Tsuguhiko; Yamamori, Hideo [Chiba Univ. (Japan). School of Medicine] [and others

    1997-06-01

    Eleven inoperable patients with advanced esophageal carcinoma were treated with chemotherapy (carboplatin, 5-FU, vindesine) and concomitant radiotherapy. Two patients (T2) received this treatment due to their poor general condition and refusal of operation, and 9 patients for infiltration of tumor into the adjacent organs (T4). Administration of carboplatin (30 mg/body) and 5-FU (250 mg/body) together with radiotherapy (1.8 Gy/d) for 5 days a week was performed. This chemoradiation therapy was carried out for 5 consecutive weeks. In addition, vindesine (1-3 mg/body) was administered in the 1st and 4th week. After evaluation, endoscopic balloon dilatation was performed in 6 patients with stenosis of the esophagus. The general response rate was 80%. CR was noted in 2 patients of T2 but 1 patient of T4 developed severe leucopenia and immunosuppression, and died of septic MOF. All but the MOF case could take enough food orally following the endoscopic dilatation. The 1-year survival rate in the T4 group (45%) was significantly better than the non-treatment group (0%). In conclusion, this treatment is beneficial for patients with inoperable esophageal carcinoma to obtain a satisfactory QOL and survival rate. (author)

  9. Successful management of refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis by vincristine adriamycin dexamethasone chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Mima Akira

    2010-10-01

    Full Text Available Abstract Introduction Refractory pleural effusion in systemic immunoglobulin light chain amyloidosis without cardiac decompensation is rarely reported and has a poor prognosis in general (a median survival of 1.6 months. Moreover, the optimum treatment for this condition is still undecided. This is the first report on the successful use of vincristine, adriamycin and dexamethasone chemotherapy for refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis without cardiac decompensation. Case presentation We report the case of a 68-year old Japanese male with systemic immunoglobulin light chain amyloidosis presenting with bilateral pleural effusion (more severe on the right side in the absence of cardiac decompensation that was refractory to diuretic therapy. The patient was admitted for fatigue, exertional dyspnea, and bilateral lower extremity edema. He had been receiving intermittent melphalan and prednisone chemotherapy for seven years. One month before admission, his dyspnea had got worse, and his chest radiograph showed bilateral pleural effusion; the pleural effusion was ascertained to be a transudate. The conventionally used therapeutic measures, including diuretics and thoracocentesis, failed to control pleural effusion. Administration of vincristine, adriamycin, and dexamethasone chemotherapy led to successful resolution of the effusion. Conclusion Treatment with vincristine, adriamycin, and dexamethasone chemotherapy was effective for the refractory pleural effusion in systemic immunoglobulin light chain amyloidosis without cardiac decompensation and appears to be associated with improvement in our patient's prognosis.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

  14. 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.

  15. Exploring Community-Oriented Approaches in Demand Side Management Projects in Europe

    Directory of Open Access Journals (Sweden)

    Anna Mengolini

    2016-12-01

    Full Text Available This paper seeks to investigate if the theoretical and political trends towards a more collective dimension of energy use are reflected in the design and development of demand side management (DSM pilot projects in Europe. Specifically, the paper analyses DSM projects in the database of the Joint Research Centre (JRC of the European Commission to capture signs of a new attention towards the wider context in which consumers live and towards the social dimension associated with energy consumption. To this end, the paper investigates the projects’ scope (in terms of project’s partners, end-use sectors and targeted services as well as the consumer engagement strategies that projects use. These elements reflect the projects’ consideration for the socio-economic dimension of the community where the pilots take place and their inclination to build on community dynamics. The analysis shows that DSM projects in the EU are increasingly being designed and developed with a collegial approach to energy consumption in mind, although an integrated approach is still missing. In addition, research is still needed to link the use of this innovative approach to project results. A closer look at the developments and results of these projects can help to identify what works and what doesn’t in real life experiences, thus supporting effective policy making at the EU and national level.

  16. 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.

  17. 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.

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

    OpenAIRE

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

    2012-01-01

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

  19. 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

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

    Science.gov (United States)

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

    2016-04-01

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

  1. 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...

  2. Hepatitis C treatment in patients with drug addiction: clinical management of interferon-alpha-associated psychiatric side effects.

    Science.gov (United States)

    Schaefer, Martin; Mauss, Stefan

    2008-06-01

    60-90% of patients with intravenous drug abuse are chronically infected with the hepatitis C virus (HCV). Antiviral treatment with pegylated interferon-alfa (IFN-alpha) plus ribavirin is often complicated by psychiatric adverse events, significantly affecting patients adherence. Depression, anxiety, fatigue and irritability as typical IFN-alpha associated side effects occur in 30-80% during antiviral treatment of hepatitis C. Patients with drug addiction were shown to have an increased risk to discontinue HCV-treatment early in the first three treatment months, where most neuropsychiatric side effects appear. Especially vegetative side effects in the first few weeks ("flu-like syndrome") can be misunderstood as withdrawal symptoms, followed by a relapse in drug or alcohol abuse. As a consequence methadone substitution treatment was found to be the best therapeutic setting. In addition side effect management should be intensified during first three months of HCV-treatment. Most data for the management of specific IFN-alpha associated side effects are available for depressive syndromes. Antidepressants (especially serotonin-reuptake-inhibitors) such as citalopram were shown to significantly reduce IFN-alpha associated depressive symptoms. A pre-emptive treatment with antidepressants should be considered at least for patients with additional psychiatric risk factors before interferon-based therapy is started. Because data from prospective controlled trials are lacking, management of other side effects such as sleep disturbances, irritability, psychotic syndromes, mania, suicidal thoughts and delirious syndromes should follow general psychiatric treatment recommendations. Overall, the psychiatric adverse event profile of interferon-based therapy for HCV-infected patients with drug addiction is considerable and requires active management and knowledge about psychiatric medical therapy.

  3. 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

    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...... with the use of Medline; additional cited works not detected on the initial search regarding neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and chemotherapy for patients with metastatic urothelial cancer were reviewed. Evidence-based recommendations for diagnosis and management...... trials have yet compared survival with transurethral resection of bladder tumor alone versus cystectomy for the management of patients with muscle-invasive disease. Collaborative international adjuvant chemotherapy trials are needed to assist researchers in assessing the true value of adjuvant...

  4. Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management.

    Science.gov (United States)

    Miller, Kristen K; Gorcey, Loren; McLellan, Beth N

    2014-10-01

    Chemotherapy-induced hand-foot syndrome and nail changes are common complications of many classic chemotherapeutic agents and the newer molecular targeted therapies. They significantly impact patient quality of life, and frequently necessitate chemotherapy dose intensity modification or reduction. We aim to describe the epidemiology, pathogenesis, clinical presentation, and current evidence-based treatment options for these entities.

  5. Lifestyle related factors in the self management of chemotherapy induced peripheral neuropathy in colorectal cancer: : A systematic review

    NARCIS (Netherlands)

    Derksen, T.; Bours, M.J.; Mols, F.; Weijenberg, M.P.

    2017-01-01

    Background. Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of chemotherapy treatment in colorectal cancer (CRC), negatively affecting the daily functioning and quality of life of CRC patients. Currently, there are no established treatments to prevent or reduce CIPN. The

  6. Application of nursing risk management in nursing care of patients with gynecologic malignancies undergoing pacli-taxel chemotherapy%护理风险管理在妇科恶性肿瘤病人紫杉醇化疗护理中的应用

    Institute of Scientific and Technical Information of China (English)

    刘荣华

    2016-01-01

    Objective:To observe the application effect of nursing risk management in nursing care of patients with gynecologic malignancies undergoing paclitaxel chemotherapy.Methods:A total of 124 patients with gyne-cologic malignancies after paclitaxel chemotherapy were randomly divided into observation group and control group,62 cases in each.The patients in control group received the chemotherapy routine nursing,while the pa-tients in observation group received nursing risk management,that is to establish risk management process ac-cording to chemotherapy plans and to identify,analyze and prevent the nursing risk,then to compare the nursing effect and patients’satisfaction between both groups.Results:The chemotherapy knowledge awareness rate, chemotherapy compliance rate,the total effective rate of chemotherapy,satisfaction rate of patients in observa-tion group were higher than those in control group (P<0.05).Whereas incidence of bloodstream infection,inci-dence of the local skin necrosis and incidence of phlebitis after peripheral venous insertion of central venous catheter (PICC)were lower than those in control group(P<0.05).The degree of side effects including nausea and vomiting,bone marrow suppression,mucositis,thrombocytopenia in observation group was lower than that in control group (P<0.05).Conclusion:The nursing risk management could improve chemotherapy compliance and knowledge awareness rate of chemotherapy for patients with gynecologic malignancies,reduce risk events and side effects of chemotherapy,and it was helpful to improve the effect of paclitaxel chemotherapy and im-prove patients’satisfaction.%[目的]观察护理风险管理在妇科恶性肿瘤病人紫杉醇化疗护理中的应用效果。[方法]将124例妇科恶性肿瘤行紫杉醇化疗病人根据随机数字表法分为观察组和对照组各62例,对照组化疗期间实施常规护理,观察组实施护理风险管理,即根据化疗方案建立风险管理流程,并对护

  7. Chemotherapy for Melanoma.

    Science.gov (United States)

    Wilson, Melissa A; Schuchter, Lynn M

    2016-01-01

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

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

    CERN Document Server

    So, Seulgi; Peschel, Ulf; Schmuki, Patrik

    2016-01-01

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

  9. Chemotherapy of Leishmaniasis.

    Science.gov (United States)

    1978-12-01

    NOTES 1S. KEY WORDS (Continue on reverse side linscoeawy and identiIIy by block number) LEISHMANIA LEISHMANIASIS CHEMOTHERAPY ANTILEISHMANIAL PENTOSTAM...number of compounds was supplied by WRAIR for testing on four strains of Leishmania in December 1977. Preliminary data were supplied to WRAIR by the...j_ = L. tropica major (Strain LV39 from USSR) and the New World cutaneous leishmaniasis by L. mexicana amazonensis (Strain LV78 from Brazil). The test

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Damiano Patrono

    2014-01-01

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

  12. The changeable nature of patients' fears regarding chemotherapy: implications for palliative care.

    Science.gov (United States)

    Passik, S D; Kirsh, K L; Rosenfeld, B; McDonald, M V; Theobald, D E

    2001-02-01

    The side effects of chemotherapy are feared by cancer patients as they begin their treatment. In this study, we investigated patients' anticipatory fears about chemotherapy. We then re-assessed these fears three to six months after the initial interview for patients who received chemotherapy during that time. We also examined symptom distress at these intervals. Hair loss, vomiting, infection, nausea, and weight loss were ranked as the most feared side effects of cancer treatment for the group as they began treatment. Patients beginning chemotherapy endorsed frequent or intense levels of fatigue, worrying about the future, pain, and sleep problems. No differences were found in the reporting of symptoms based on gender, age, or educational level. While changes in symptom distress over the study period were unremarkable, changes in fears about chemotherapy were of interest. The most feared symptoms were re-ordered following the treatment experience. The endorsement of nausea and vomiting, alopecia, and loss of appetite decreased significantly. Thirty-five percent fewer chemotherapy patients reported vomiting as one of their most feared side effects; 45% fewer patients who received anti-emetics reported vomiting as one of their most feared side effects. Effective treatments, such as those that have been developed to treat acute chemotherapy-related emesis, can relieve the fears of patients on treatment. We conclude that patients' fears about treatment are fluid and malleable. Patients' fears of suffering related to chemotherapy treatment change in response to the provision of adequate management. We discuss the implications of these findings for palliative care education.

  13. 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

  14. 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

  15. One-sided time constraints routing problem in supply chain management- An Ant colony optimization based heuristic

    OpenAIRE

    2013-01-01

    Transportation costs constitute a significant fraction of total logistics cost in Supply Chain Management (SCM). To reduce transportation costs, improve customer service and to achieve maximum customer satisfaction, the optimal selection of the vehicle route is a frequent decision problem and this is commonly known as vehicle routing problem. Vehicle routing problem with one-sided time constraint, where the delivery of products from depots to distribution centers has to take place within the ...

  16. 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.

  17. Neoadjuvant chemotherapy first, followed by chemoradiation and then surgery, in the management of locally advanced rectal cancer.

    Science.gov (United States)

    Cercek, Andrea; Goodman, Karyn A; Hajj, Carla; Weisberger, Emily; Segal, Neil H; Reidy-Lagunes, Diane L; Stadler, Zsofia K; Wu, Abraham J; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Temple, Larissa K; Garcia-Aguilar, Julio; Saltz, Leonard B

    2014-04-01

    Standard therapy for locally advanced rectal cancer (LARC) is preoperative chemoradiotherapy and postoperative chemotherapy. At Memorial Sloan-Kettering Cancer Center (MSKCC) the authors began offering FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) as initial treatment for patients with high-risk LARC to target micrometastases while treating the primary tumor. The purpose of this study is to report the safety and efficacy of initial FOLFOX given before chemoradiotherapy on tumor downsizing and pathologic complete response (pathCR) in LARC. The records of patients with stage II/III rectal cancer treated at MSKCC between 2007 and 2012 were reviewed. Of approximately 300 patients with LARC treated at MSKCC, 61 received FOLFOX as initial therapy. Of these 61 patients, 57 received induction FOLFOX (median 7 cycles) followed by chemoradiation, and 4 experienced an excellent response, declined chemoradiation, and underwent total mesorectal excision (TME). Twelve of the 61 patients did not undergo TME: 9 had a complete clinical response (CCR), 1 declined despite persistent tumor, 1 declined because of comorbidities, and 1 developed metastatic disease. Among the 61 patients receiving initial FOLFOX, 22 (36%) had either a pathCR (n=13) or a CCR (n=9). Of the 49 patients who underwent TME, all had R0 resections and 23 (47%) had tumor response greater than 90%, including 13 (27%) who experienced a pathCR. Of the 28 patients who received all 8 cycles of FOLFOX, 8 experienced a pathCR (29%) and 3 a CCR (11%). No serious adverse events occurred that required a delay in treatment during FOLFOX or chemoradiation. FOLFOX and chemoradiation before planned TME results in tumor regression, a high rate of delivery of planned therapy, and a substantial rate of pathCRs, and offers a good platform for nonoperative management in select patients.

  18. 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.

  19. Demand-side Management, Supply-side Management and Current Macro-policy Choic%需求管理、供给管理及当前宏观政策选择

    Institute of Scientific and Technical Information of China (English)

    李义平

    2016-01-01

    纵观市场经济国家从需求管理到供给管理的发展过程,并从需求管理及供给管理理论的特点及旨在解决问题出发,可以看出,我国当前经济面临的主要问题是结构调整和创新问题。选择供给管理的宏观经济政策是必要的。然而,供给管理必须要有适合的制度安排,这个制度的安排实质上是一个制度的变革问题。它包括加大真正的企业的供给、与市场经济相适应的政府职能转变、创新的制度安排等等。%This article explores how the country who uses a market economy walks from the supply side to the demand side on the way of macroeconomic manage-ment based on the problems these two arts or sciences are designed to deal with and an analysis of their characteristics. As the primary issues facing Chi-na’s current state of economy, innovation and structural adjustment, it argues, lead to urgent requirements for reforms on supply - side management and new institutional arrangements relevant to it.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  2. 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...

  3. Chemotherapy (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old 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 ...

  4. Metronomic chemotherapy regimens in oncology

    Directory of Open Access Journals (Sweden)

    M. Yu. Fedyanin

    2016-01-01

    Full Text Available Metronomic chemotherapy implies the regular use of cytotoxic agents in doses much smaller than the maximum tolerable doses for a long time. Preclinical experiments show that this treatment option has a many-sided (antiangiogenic, immunostimulating, and direct cytotoxic effect on tumor. Moreover, this approach has gained the widest acceptance in treating patients with metastatic breast cancer in clinical practice. By taking into account the high activity of angiogenesis in colon cancer progression, it is interesting to study the impact of metronomic chemotherapy regimens for this nosological entity as well. This literature review considers not only the history of metronomic chemotherapy, the mechanisms of action, and a range of drugs having an antitumor effect in the metronomic regimens, but also analyzes clinical trials of metronomic chemotherapy regimens in patients with metastatic colon cancer.

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

    Science.gov (United States)

    Clancy, Thomas R

    2009-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Saini, S.

    2004-06-01

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

  7. 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.

  8. 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

    The last fifteen years many European countries have integrated large percentage of renewable energy on their electricity generation mix. In Denmark the 21.3% of the electricity consumed nowadays is produced by the wind, and it has planned to be the 50% by 2025. In order to front future challenges...... 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...

  9. Guidelines for the management of bacterial and fungal infections during chemotherapy for pediatric acute leukemia or solid tumors: what is available in 2010?

    Directory of Open Access Journals (Sweden)

    Elio Castagnola

    2011-02-01

    Full Text Available Optimizing the therapeutic strategies based on the results of randomized studies comparing different regimens led to a better prognosis of nearly all pediatric malignancies during the past four decades. Fever and neutropenia (FN is a common complication in patients undergoing chemotherapy to treat cancer. There is no consensus on when standard therapy can be safely reduced; this lack of consensus leads to important variations in management of FN between different institutions, usually conducted according to local attitudes. To address this issue, the Infection working group of the Italian association for pediatric hematology oncology (AIEOP organized a consensus meeting. This paper reports the agreement derived from this meeting.

  10. 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.

  11. Introducing the Human Side of Total Quality Management into Educational Institutions.

    Science.gov (United States)

    Thor, Linda M.

    1994-01-01

    Drawing from the experiences of Rio Salado Community College (Arizona) in implementing Total Quality Management, discusses common barriers to change (e.g., time, aversion to change, and pitfalls of change); leadership failure as a cause of failure in TQM implementation; and the importance of constancy of purpose, employee empowerment, and…

  12. Stress Management and Health Promotion: Two Sides of the same Coin,

    Science.gov (United States)

    recognize that the health promotion effort should involve interventions that members of the community can focus on themselves. But will anyone out their...link the two concepts, stress management, and health promotion into a cohesive fabric of organizational-personal intervention to insure a healthy military population.

  13. 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

  14. An inexact double-sided chance-constrained model for air quality management in Nanshan District, Shengzhen, China

    Science.gov (United States)

    Shao, Liguo; Xu, Ye; Huang, Guohe

    2014-12-01

    In this study, an inexact double-sided fuzzy-random-chance-constrained programming (IDSFRCCP) model was developed for supporting air quality management of the Nanshan District of Shenzhen, China, under uncertainty. IDSFRCCP is an integrated model incorporating interval linear programming and double-sided fuzzy-random-chance-constrained programming models. It can express uncertain information as both fuzzy random variables and discrete intervals. The proposed model was solved based on the stochastic and fuzzy chance-constrained programming techniques and an interactive two-step algorithm. The air quality management system of Nanshan District, including one pollutant, six emission sources, six treatment technologies and four receptor sites, was used to demonstrate the applicability of the proposed method. The results indicated that the IDSFRCCP was capable of helping decision makers to analyse trade-offs between system cost and risk of constraint violation. The mid-range solutions tending to lower bounds with moderate αh and qi values were recommended as decision alternatives owing to their robust characteristics.

  15. 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

  16. 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.

  17. Analyses the hospital side staff labor contract management%浅析医院编外人员劳动合同管理

    Institute of Scientific and Technical Information of China (English)

    蒋杏茂

    2015-01-01

    Side personnel is an important structure in hospital on-the-job personnel, how to strengthen the hospital side personnel management become an important topic in the research of the hospital. From the hospital side personnel employment status, nature of work type, and improve the personnel management measures to explore the side personnel management methods, aims to provide a reference for relevant departments.%编外人员是医院在职人员中的重要结构,如何加强医院编外人员的管理成为医院研究的重要内容。本文将从医院编外人员聘任现状,工作性质类型,以及改进人员管理措施等方面探究编外人员管理方法,旨在为相关部门提供参考意见。

  18. Review of Strategies and Technologies for Demand-Side Management on Isolated Mini-Grids

    Energy Technology Data Exchange (ETDEWEB)

    Harper, Meg [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-03-01

    This review provides an overview of strategies and currently available technologies used for demandside management (DSM) on mini-grids throughout the world. For the purposes of this review, mini-grids are defined as village-scale electricity distribution systems powered by small local generation sources and not connected to a main grid.1 Mini-grids range in size from less than 1 kW to several hundred kW of installed generation capacity and may utilize different generation technologies, such as micro-hydro, biomass gasification, solar, wind, diesel generators, or a hybrid combination of any of these. This review will primarily refer to AC mini-grids, though much of the discussion could apply to DC grids as well. Many mini-grids include energy storage, though some rely solely on real-time generation.

  19. Progress in systemic chemotherapy of primary breast cancer: an overview.

    Science.gov (United States)

    Hortobagyi, G N

    2001-01-01

    Substantial progress has been made in the multidisciplinary management of primary breast cancer during the last 30 years. Adjuvant chemotherapy has been shown to significantly reduce the annual risk of cancer recurrence and mortality, and these effects persist even 15 years after diagnosis. Combination chemotherapy is superior to single-agent therapy and anthracycline-containing regimens. Those that combine an anthracycline with 5-fluorouracil and cyclophosphamide are more effective than regimens without an anthracycline. Six cycles of a single regimen appear to provide optimal benefit. Dose reductions below the standard range are associated with inferior results. Dose increases that require growth factor or hematopoietic stem cell support are under investigation; at this time, the existing results provide no compelling reason to use this strategy outside a clinical trial. Regimens using fixed crossover designs with two non-cross-resistant regimens are being evaluated. The addition of a taxane to anthracycline-containing regimens is currently under intense scrutiny, and preliminary analysis of the first three clinical trials has shown encouraging, albeit not compelling, results. For patients with estrogen receptor-positive breast cancer, the sequential administration of chemotherapy and 5 years of tamoxifen therapy provides additive benefits. No compelling evidence exists to combine ovarian ablation with chemotherapy. Most side effects and toxic effects are self-limited, although premature menopause requires monitoring and preventive interventions to preserve bone mineral density. The small risk of acute leukemia is of concern, and additional research to develop safer regimens is clearly indicated. The overall effect of optimal local/regional treatment combined with an anthracycline-containing adjuvant chemotherapy and a taxane (and, for patients with estrogen receptor-positive tumors, 5 years of tamoxifen therapy) is a greater than 50% reduction in annual risks of

  20. Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial.

    Directory of Open Access Journals (Sweden)

    Andreas Charalambous

    Full Text Available Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI and Progressive Muscle Relaxation (PMR on a cluster of symptoms experienced by patients undergoing chemotherapy.This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks. Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients' self-reported health related quality of life-HRQoL. Chi-square tests (X2, independent T-tests and Linear Mixed Models were calculated.Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225, and Pain (p = 0.0003 compared to those in the control group and experienced better HRQoL (p<0.0001 [PRE-POST:Pain 4.2(2.5 - 2.5(1.6, Fatigue 27.6(4.1 - 19.3(4.1, HRQoL 54.9(22.7 - 64.5(23, CONTROL: Pain 3.5(1.7 - 4.8(1.5, Fatigue 28.7(4.1 - 32.5(3.8, HRQoL 51.9(22.3- 41.2(24.1]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9- 20.6(5.6 compared to the control group (17.8(6.5- 22.7(5.3 (F = 58.50 p<0.0001. More patients in the control group (pre:n = 33-post:n = 47 were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15 (X2 = 5.93; p = 0.02.This study provided evidence that the combination of GI and PMR can be effective in the management

  1. 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

  2. Inoperable nonmetastatic squamous cell carcinoma of the esophagus managed by concomitant chemotherapy (5-fluorouracil and cisplatin) and radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, J.F.; Giovannini, M.; Padaut-Cesana, J.; Fuentes, P.; Giudicelli, R.; Gauthier, A.P.; Carcassonne, Y. (Institut J. Paoli-I. Calmettes, Marseilles (France))

    1990-07-15

    Thirty-five patients with nonmetastatic squamous cell carcinoma of the esophagus were treated with chemotherapy (5-fluorouracil, cisplatin) and concomitant split-course radiation therapy. All of the patients presented with dysphagia. Treatment consisted of two courses of chemotherapy with 5-FU (1 g/m2/day in continuous infusion for 5 days (days 1 to 5 and days 29 to 33) ) and cisplatin (70 mg/m2 intravenous bolus at days 2 and 30). Radiation therapy was concomitant in two courses delivering 20 Gy in 5 days (days 1 to 5 and days 29 to 33). On the first day of treatment, endoscopic peroral dilation or Nd-YAG laser therapy was usually carried out. At the end of the treatment, all of the patients were capable of oral nutrition. Histoendoscopic confirmation was made 8 weeks after the beginning of the therapy. Twenty-five of the 35 patients had a complete response with negative biopsy findings. There was only one serious complication (fatal myelosuppression) in the only patient who received more than two courses of chemotherapy. Sixteen patients died and 19 were still alive at 3 to 42 months after the beginning of treatment. Overall median survival for the 35 patients is 17 months. Actuarial survival was 55 +/- 18% at 1 year and 41 +/- 21% at 2 years. The median survival of the Stage I and II patients is 28 months. These results confirm that concomitant chemoradiotherapy is capable of producing a very high histoendoscopic complete response rate and improved 1-year and 2-year survival. The use of concentrated split-course radiotherapy enabled the authors to reduce the total length of the treatment to two periods of 5 days, with results that are similar to previous studies using classic radiotherapy for a 5-week to 7-week period.

  3. 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.

  4. 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:

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

    Directory of Open Access Journals (Sweden)

    Samuel J. G. Cooper

    2013-06-01

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

  6. Types of chemotherapy

    Science.gov (United States)

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

  7. Chemotherapy for Thyroid Cancer

    Science.gov (United States)

    ... Type and Stage Thyroid Cancer Treating Thyroid Cancer Chemotherapy for Thyroid Cancer Chemotherapy (chemo) uses anti-cancer drugs that are injected ... vein or muscle, or are taken by mouth. Chemotherapy is systemic therapy, which means that the drug ...

  8. Chemotherapy for Testicular Cancer

    Science.gov (United States)

    ... Type and Stage Testicular Cancer Treating Testicular Cancer Chemotherapy for Testicular Cancer Chemotherapy (chemo) is the use of drugs to treat ... that is only in the testicle. Doctors give chemotherapy in cycles, with each period of treatment followed ...

  9. Chemotherapy and Your Mouth

    Science.gov (United States)

    ... Treatment and Oral Health > Chemotherapy and Your Mouth Chemotherapy and Your Mouth Main Content Are You Being ... Problems Too? Remember Are You Being Treated With Chemotherapy for Cancer? If so, this booklet can help ...

  10. The management of cytotoxic drug wastes in Shiraz, Iran: an overview of all government and private chemotherapy settings, and comparison with national and international guidelines.

    Science.gov (United States)

    Askarian, Mehrdad; Momeni, Mohsen; Danaei, Mina

    2013-06-01

    Excessive use of cytotoxic drugs owing to a dramatic increase in malignancy incidence leads to the production of high amounts of cytotoxic wastes. In Iran, management of hazardous wastes has been neglected in recent decades. The aim of this study was to determine the amount of intravenous cytotoxic drug wastes, their collection and disposal status in chemotherapy wards, and to compare the current status with standard guidelines in Shiraz, Iran. This cross-sectional study was performed using data collected during 2 consecutive months, from 22 June to 22 August 2011, in all 13 chemotherapy wards in Shiraz. The amount of prescribed drugs, drugs waste, collection and disposal status of cytotoxic drugs were recorded. We then compared the current status of waste collection and disposal in our samples with our national guideline. The prescription of cytotoxic drugs and the amount of total drugs waste reached approximately 6 and 0.2 kilograms respectively. Total vials volume was calculated to be approximately 1000 l in order to estimate the volume of containers required for the encapsulation method. The results demonstrated that the current status of cytotoxic waste collection and disposal is inappropriate, and none of the facilities under study followed our guidelines perfectly. The adherence to all recommendations and guidelines was poorer in private wards than in government-run ones. The management of cytotoxic wastes is inappropriate and our existing national guidelines are lacking. Suggestions for the best management of cytotoxic waste are revising the existing guidelines, allocating a sufficient budget, training healthcare workers, providing multiple administration options of cytotoxic drugs and accomplishing a surveillance system.

  11. Fighting Cancer Together: Development and Implementation of Shared Medical Appointments to Standardize and Improve Chemotherapy Education

    Science.gov (United States)

    Prescott, Lauren S.; Dickens, Andrea S.; Guerra, Sandra L.; Tanha, Jila M.; Phillips, Desiree G.; Patel, Katherine T.; Umberson, Katie M.; Lozano, Miguel A.; Lowe, Kathryn B.; Brown, Alaina J.; Taylor, Jolyn S.; Soliman, Pamela T.; Garcia, Elizabeth A.; Levenback, Charles F.; Bodurka, Diane C.

    2015-01-01

    Objective Shared medical appointments offer a novel approach to improve efficiency and quality of care consistent with the goals of the Institute of Medicine. Our objective was to develop and implement a shared medical appointment for gynecologic cancer patients initiating chemotherapy. Methods We first assessed the level of interest in shared medical appointments among our patients and providers through qualitative interviews. Both patients and providers identified pre-chemotherapy as an optimal area to pilot shared medical appointments. We subsequently created a multidisciplinary team comprised of physicians, advanced practice providers, nurses, pharmacists, administrators, health education specialists and members of the Quality Improvement Department to establish a Shared Medical Appointment and Readiness Teaching (SMART) program for all gynecologic oncology patients initiating chemotherapy with platinum- and/or taxane-based regimens. We developed a standardized chemotherapy education presentation and provided patients with a tool kit that consisted of chemotherapy drug education, a guide to managing side effects, advance directives, and center contact information. Results From May 9, 2014 to June 26, 2015, 144 patients participated in 51 SMART visits. The majority of patients had ovarian cancer and were treated with carboplatin/paclitaxel. Surveyed patients reported being highly satisfied with the group visit and would recommend shared medical appointments to other patients. Conclusions This model of care provides patient education within a framework of social support that empowers patients. Shared medical appointments for oncology patients initiating chemotherapy are both feasible and well accepted. PMID:26549108

  12. 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.

  13. 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.

  14. 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)

  15. 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

  16. 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.

  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. [Oral complications of chemotherapy of malignant neoplasms].

    Science.gov (United States)

    Obralić, N; Tahmiscija, H; Kobaslija, S; Beslija, S

    1999-01-01

    Function and integrity disorders of the oral cavity fall into the most frequent complication of the chemotherapy of leucemias, malignant lymphomas and solid tumors. Complications associated with cancer chemotherapy can be direct ones, resulting from the toxic action of antineoplastic agents on the proliferative lining of the mouth, or indirect, as a result of myelosuppression and immunosuppression. The most frequent oral complications associated with cancer chemotherapy are mucositis, infection and bleeding. The principles of prevention and management of oral complications during cancer chemotherapy are considered in this paper.

  19. Protocols for management of oral complications of chemotherapy and/or radiotherapy for oral cancer: Systematic review and meta-analysis current

    Science.gov (United States)

    de-Menezes, Juliana-Dreyer-da-Silva; Moura, Lucas-Borin; Massucato, Elaine-Maria-Sgavioli; de-Andrade, Cleverton-Roberto

    2017-01-01

    Background and Objectives Considering the high possibility of dentist consult a patient with oral complications of chemotherapy and/or radiotherapy for oral cancer because of the advances in this area, this study aims to systematically review the literature to identify and suggest effective and safe protocols for the managements of oral complications in oncology patients. Material and Methods TThe systematic review was designed by PICO and PRISMA including eligibility and exclusion criteria; the source of information and search strategy in PubMed according MeSH: “Mouth Neoplasms and Radiotherapy” and “Mouth Neoplasms and Drug Therapy” the period from 2010 to 2015; selection and data collection of study was carried form blind and independently by two researchers; risk of bias and methodological quality: ensured by the PEDro scale; synthesis of data: of oral complications were evaluated by adapted version of associative direction classification proposed by Costigan and collaborators; and data analysis was performed by the meta-analysis of BioEstat program (5.0) in the included studies. Results 2,700 articles found, 2,371 were selected after removal of duplicate and elected 40 full-text articles. Of these, only 06 articles were included in the systematic review with exclusion of others, per obtain punctuation ≥ 7 with high methodological quality for synthesis of the managements of oral complications. Since 05 articles were associated with low risk of bias composing the protocols suggestive for managements and the meta-analysis in odds ratio (0.916) to cure and relative risk (1.049) for the development of oral mucositis and pain. Conclusions The protocols suggestive for managements of oral mucositis and pain with MuGard - mucoadhesive hydrogel; PerioAid Tratamiento® antiseptic mouthrinse with chlorhexidine and cetylpyridinium chloride; Episil® plus benzydamine - bioadhesive oromucosal gel; 0,03% of Triclosan mouthwash Colgate Plax; and Diode Laser Therapy

  20. Pulmonary blastoma: remission with chemotherapy

    DEFF Research Database (Denmark)

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

    1984-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  2. [Combined radio- and chemotherapy of anal cancer].

    Science.gov (United States)

    Dobrowsky, W

    1986-05-30

    The treatment regime in anal carcinoma is changing from being a mainly surgical problem. Combined radio-chemotherapy is of increasing interest as treatment of choice. The new treatment modality, including chemotherapy with Mitomycin C and 5-fluorouracil combined with percutaneous and interstitial radiotherapy is presented. The treatment regimes performed at the University Department for Radiotherapy and Radiobiology Vienna is discussed with regard to tolerance, side effects and local control.

  3. Chemotherapy-Induced Nausea and Vomiting.

    Science.gov (United States)

    Mustian, Karen M; Darling, Tom V; Janelsins, Michelle C; Jean-Pierre, Pascal; Roscoe, Joseph A; Morrow, Gary R

    2008-01-01

    Despite treatment advances, nausea and vomiting, especially anticipatory nausea and vomiting, delayed nausea and vomiting and nausea alone, are still the most common, expected and feared side effects among patients receiving chemotherapy. Of the 70 to 80% of cancer patients who experience chemotherapy-induced nausea and vomiting many will delay or refuse future chemotherapy treatments and contemplate stopping all treatments because of fear of further nausea and vomiting. The purpose of this chapter is to provide an overview of the patho-psychophysiology of CINV, the recommended guidelines for standard treatment, and highlight newer targeted treatment approaches.

  4. 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.

  5. 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.

  6. Evaluating the Role of Interdigitated Neoadjuvant Chemotherapy and Radiation in the Management of High-Grade Soft-Tissue Sarcoma

    Science.gov (United States)

    Raval, Raju R.; Frassica, Deborah; Thornton, Katherine; Meyer, Christian; Ettinger, David S.; Frassica, Frank; Weber, Kristin; Terezakis, Stephanie A.

    2016-01-01

    Objectives High-grade soft-tissue sarcoma (STS) has a poor prognosis. The goal of this study was to review treatment outcomes of patients with high-grade STS treated with interdigitated neoadjuvant chemotherapy (CT) and radiation at our institution. Materials and Methods Patients with high-grade STS (1997 to 2010) were planned for treatment with 3 cycles of neoadjuvant CT, interdigitated preoperative radiation therapy (44 Gy administered in split courses with a potential 16 Gy postoperative boost), and 3 cycles of postoperative CT. Cancer control outcomes at 3 years were analyzed. Results Sixteen patients with high-grade STS were evaluated. Median age was 53 years, the median longest tumor diameter was 14.6 cm, and median follow-up was 33 months. All 16 patients received 2 or 3 cycles of neoadjuvant CT and all patients completed neoadjuvant RT. The estimated 3-year rate for local control was 100%, disease-free survival 62.5%, and overall survival 73.4%. Conclusions Patients with high-grade STS treated with interdigitated neoadjuvant CT and radiation before surgical resection had excellent rates of local control, along with disease-free survival and overall survival similar to previously published reports. This combined-modality approach continues to have a role in the treatment of patients with high-grade STS. PMID:25268069

  7. 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

  8. Application effect of meticulous management in nursing management of tumor patient with chemotherapy%精细化管理在肿瘤患者化疗护理管理中的应用效果

    Institute of Scientific and Technical Information of China (English)

    李菁华

    2015-01-01

    目的:探讨精细化管理在肿瘤患者化疗护理管理中的应用效果。方法本院肿瘤科于2012年6月~2014年6月实施精细化管理,在进行精细化管理前后分别对本院肿瘤科患者及其家属进行满意度问卷调查,评估管理前后的护理满意度及护理质量。结果管理后的护理满意度为99.15%,显著高于管理前的91.76%,差异有统计学意义(字2=76.71,P<0.05)。管理后的护理质量评分显著高于管理前,差异有统计学意义(P<0.05)。结论精细化管理在肿瘤患者化疗护理管理中的应用效果显著,能够提高护理满意度及护理质量。%Objective To explore the application effect of meticulous management in nursing management of tumor pa-tient with chemotherapy. Methods Meticulous management was executed in the department of oncology from June 2012 to June 2014.Satisfaction questionnaire survey was conducted among patients in the oncology department in our hospital and their families before and after meticulous management respectively,and the nursing qualities and the degree of nursing satisfaction was evaluated before and after meticulous management. Results The degree of nursing satisfaction after management was 99.15%,which was higher than 91.76% before management,with significant difference (P<0.05). The score of nursing quality after management was higher than that before management,with significant difference (P<0.05). Conclusion The application effect of meticulous management in nursing management of tumor patient with chemotherapy is significant,which can improve the degree of nursing satisfaction and nursing quality.

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

    Science.gov (United States)

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

  10. 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

  11. 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.

  12. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice.

    Science.gov (United States)

    Harrold, K; Gould, D; Drey, N

    2015-11-01

    Management of cytotoxic drug extravasation remains contentious, with differing views on the most effective management strategy. With the increasing drive to provide effective, evidence-based healthcare, while ensuring the patient experience of the treatment provided plays a significant part in the development of clinical practice guidelines, the purpose of this literature review was to both critically analyse the quality of evidence that underpins contemporary practice and to determine if the patient experience is taken into account. A literature search was undertaken sourcing publications from the 1960s to July 2014 identifying all studies detailing strategies aimed at preventing the need for surgical debridement and all studies evaluating extravasation management from the patient's perspective. No conclusive evidence was found to suggest one clinical strategy as more effective than the other. No studies were identified that evaluated outcome from the patient's perspective. It is therefore suggested that outcomes-based research should underpin contemporary extravasation management guidelines to determine what the final outcome or 'end result' is and how this impacts on the patient and that the current lack of research into the patient experience of extravasation management is an area that needs to be addressed.

  13. Application of the Six Sigma Management in nursing management of the daily chemotherapy ward%六西格玛管理法在日间化疗病房护理管理中的应用

    Institute of Scientific and Technical Information of China (English)

    陆海晴; 程洁; 应美芳

    2013-01-01

    Objective To explore the effects of the Six Sigma Management applied in nursing management of daily chemotherapy ward. Methods A Six Sigma project team was set up and trained, the influencing factors of quality management were analyzed, hospitalization process and intravenous infusion procedure were optimized, nursing human resources were adjusted and the infusion security measures were strengthened. Results The intravenous infusion waiting time was shortened and the chemotherapy extravasation incidence decreased ( P < 0. 05 ). The nurses'job satisfaction and patients' satisfaction increased (P <0.01 ). Conclusion The application of the Six Sigma Management can optimize intravenous infusion procedure, hospitalization process and improve the patients satisfaction.%目的 探讨六西格玛管理模式对日间化疗病房进行管理的效果.方法 组建六西格玛项目管理团队并进行培训,分析影响质量管理的因素,优化住院流程、输液流程,对护理人力资源进行调整,加强输液安全保障措施.结果 患者输液等待时间缩短,化疗药物外渗发生率降低,护士工作满意度、患者满意度提高(P<0.01或P<0.05).结论 应用六西格玛管理模式能优化输液流程和住院流程,提高患者满意度.

  14. Uterine/Endometrial Cancer: Chemotherapy

    Science.gov (United States)

    ... Types of Gynecologic Cancers Uterine/Endometrial Cancer Chemotherapy Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for endometrial cancer is usually given intravenously (injected ...

  15. [Chemotherapy-induced stomatitis and diarrhea].

    Science.gov (United States)

    Kadowaki, Shigenori; Yamaguchi, Kensei

    2011-11-01

    Chemotherapy-induced mucositis is a clinically important and sometimes dose-limiting toxicity of cancer treatment, including standard-dose chemotherapy, high-dose chemotherapy and chemoradiotherapy. Consequently, dose reductions or treatment delays resulting from mucositis may impair treatment effectiveness. Symptoms are oral mucositis, dysphagia, abdominal pain and diarrhea, depending on the affected site. Although the underlying pathobiology of oral mucositis has been considerably elucidated over the past decade, there are few interventions for the prevention or treatment validated by randomized trials. The most commonly accepted intervention is basic oral care. Diarrhea is most common in patients treated with irinotecan and in some cases, life-threatening. No definitive interventions for the prevention of diarrhea exist, but there is evidence that loperamide and octreotide are effective for chemotherapy-induced diarrhea. In future, there is a need for well designed trials, preferably including a placebo or no treatment control, validating more effective interventions for managing chemotherapy- induced mucositis.

  16. Mechanisms of chemotherapy-induced behavioral toxicities

    OpenAIRE

    Vichaya, Elisabeth G.; Chiu, Gabriel S.; Karen eKrukowski; Lacourt, Tamara E.; Annemieke eKavelaars; Robert eDantzer; Cobi J Heijnen; Adam K. Walker

    2015-01-01

    While chemotherapeutic agents have yielded relative success in the treatment of cancer, patients are often plagued with unwanted and even debilitating side-effects from the treatment which can lead to dose reduction or even cessation of treatment. Common side effects (symptoms) of chemotherapy include (i) cognitive deficiencies such as problems with attention, memory and executive functioning; (ii) fatigue and motivational deficit; and (iii) neuropathy. These symptoms often develop during tre...

  17. Mechanisms of chemotherapy-induced behavioral toxicities

    Directory of Open Access Journals (Sweden)

    Elisabeth G Vichaya

    2015-04-01

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

  18. Mechanisms of chemotherapy-induced behavioral toxicities.

    Science.gov (United States)

    Vichaya, Elisabeth G; Chiu, Gabriel S; Krukowski, Karen; Lacourt, Tamara E; Kavelaars, Annemieke; Dantzer, Robert; Heijnen, Cobi J; Walker, Adam K

    2015-01-01

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

  19. 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

  20. Chemotherapy and Dietary Phytochemical Agents

    Directory of Open Access Journals (Sweden)

    Katrin Sak

    2012-01-01

    Full Text Available Chemotherapy has been used for cancer treatment already for almost 70 years by targeting the proliferation potential and metastasising ability of tumour cells. Despite the progress made in the development of potent chemotherapy drugs, their toxicity to normal tissues and adverse side effects in multiple organ systems as well as drug resistance have remained the major obstacles for the successful clinical use. Cytotoxic agents decrease considerably the quality of life of cancer patients manifesting as acute complaints and impacting the life of survivors also for years after the treatment. Toxicity often limits the usefulness of anticancer agents being also the reason why many patients discontinue the treatment. The nutritional approach may be the means of helping to raise cancer therapy to a new level of success as supplementing or supporting the body with natural phytochemicals cannot only reduce adverse side effects but improve also the effectiveness of chemotherapeutics. Various plant-derived compounds improve the efficiency of cytotoxic agents, decrease their resistance, lower and alleviate toxic side effects, reduce the risk of tumour lysis syndrome, and detoxify the body of chemotherapeutics. The personalised approach using various phytochemicals provides thus a new dimension to the standard cancer therapy for improving its outcome in a complex and complementary way.

  1. 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.

  2. 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

  3. Safe chemotherapy in the home environment.

    Science.gov (United States)

    Chavis-Parker, Paula

    2015-05-01

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

  4. Fasting and differential chemotherapy protection in patients.

    Science.gov (United States)

    Raffaghello, Lizzia; Safdie, Fernando; Bianchi, Giovanna; Dorff, Tanya; Fontana, Luigi; Longo, Valter D

    2010-11-15

    Chronic calorie restriction has been known for decades to prevent or retard cancer growth, but its weight-loss effect and the potential problems associated with combining it with chemotherapy have prevented its clinical application. Based on the discovery in model organisms that short term starvation (STS or fasting) causes a rapid switch of cells to a protected mode, we described a fasting-based intervention that causes remarkable changes in the levels of glucose, IGF-I and many other proteins and molecules and is capable of protecting mammalian cells and mice from various toxins, including chemotherapy. Because oncogenes prevent the cellular switch to this stress resistance mode, starvation for 48 hours or longer protects normal yeast and mammalian cells and mice but not cancer cells from chemotherapy, an effect we termed Differential Stress Resistance (DSR). In a recent article, 10 patients who fasted in combination with chemotherapy, reported that fasting was not only feasible and safe but caused a reduction in a wide range of side effects accompanied by an apparently normal and possibly augmented chemotherapy efficacy. Together with the remarkable results observed in animals, these data provide preliminary evidence in support of the human application of this fundamental biogerontology finding, particularly for terminal patients receiving chemotherapy. Here we briefly discuss the basic, pre-clinical, and clinical studies on fasting and cancer therapy.

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

    Institute of Scientific and Technical Information of China (English)

    曹京津; 秦立军

    2014-01-01

    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.%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。

  6. Discussion on Railway Side Slope Condition Information Management System%铁路边坡状态信息管理系统的探讨

    Institute of Scientific and Technical Information of China (English)

    吴敏敏; 吕宾林; 陈汇远; 李中国; 蔡德钩; 张千里

    2012-01-01

    基于铁路边坡和计算机数据库的特点,研究了铁路边坡状态监测信息管理系统的功能、架构和实现方案,提出了采用数据库和面向对象可视化编程等技术的二次开发模式,为构建铁路边坡状态信息数据动态、高效、完备的信息化管理系统奠定基础。信息管理系统的实现,将为铁路系统养护维修和运营管理提供技术支持,同时,对提高铁路系统的安全预警能力和降低系统运行的安全风险具有重要的现实意义。%Based on the characteristics of railway side slope and computer database, the functionality, architecture and implementation scheme of the railway side slope condition monitoring information management system are studied. Database and object-oriented visual programming technology as the secondary development mode are put forward, to lay the foundation for building the railway side slope condition dynamic, efficient and comprehensive information management system, hnplementation of the information management system will provide technical support for railway maintenance and operational management. At the same time, it has important practical significance to improve the safety of the railway system with early warning capabilities and reduce risks to system safety.

  7. Intrathecal chemotherapy. Selection of cytostatic agents.

    Science.gov (United States)

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

    1970-09-01

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

  8. 从需求侧管理谈高校节能减排%Demand Side Management on Reducing Greenhouse Gas Emissions and Energy Saving in University

    Institute of Scientific and Technical Information of China (English)

    刘纯江; 韩俊; 安丽娜

    2011-01-01

    随着高校办学规模日益扩大,能源紧缺现象经常发生.运用需求侧管理高校节能减排,是缓解高校供能紧张的有效方法.建设节约型校园,推动社会和谐发展.%As with the development of university, the energy shortage often occurs.Demand side management is an effective method of reducing greenhouse gas emission and energy saving in university.Constructing conserving campus helps promote social harmony.

  9. Deliverable 5 of Changing Behaviour. Interaction Schemes for Successful Energy Demand Side Management. Building blocks for a practicable and conceptual framework

    Energy Technology Data Exchange (ETDEWEB)

    Mourik, R.M.; Feenstra, C.F.J. [ECN Policy Studies, Petten (Netherlands); Heiskanen, E.; Rask, M.; Saastamoinen, M.; Johnson, M. [National Consumer Research Centre NCRC, Helsinki (Finland); Barabanova, Y.; Pariag, J. [Central European University CEU, Budapest (Hungary); Bauknecht, D.; Brohmann, B.; Buerger, V. [Institute for Applied Ecology OEKO, Freiburg (Germany); Hodson, M.; Marvin, S. [The SURF Centre, University of Salford, Manchester (United Kingdom); Jalas, M.; Rinne, S.; Salminnen, J. [Enespa Ltd. (Finland); Maier, P.; Meinel, H. [Verbraucherzentrale Nordrhein-Westfalen e.V. VZ NRW, Duesseldorf (Germany); Robinson, S. [Manchester Knowledge Capital MKC, Manchester Enterprises ME, Manchester (United Kingdom); Valuntiene, I. [Cowi Baltic, Vilnius (Lithuania); Vadovics, E. [GreenDependent Sustainable Solutions Association, Magyarorszag (Hungary)

    2009-10-15

    Changing Behaviour is a project that aims to support change in energy use and energy services by applying social research on technological change to practical use. The focus is on the interaction between energy experts and energy users: How can these different groups learn to understand each other better. D5 presents the comprehensive body of knowledge from theoretical inquiry into relevant social scientific literature; an in depth meta- analysis of 27 energy demand-side management case studies and workshops with external practitioners from various European countries. Particular attention is awarded to the importance of interactions between intermediary practitioners and end users.

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

    Institute of Scientific and Technical Information of China (English)

    周宇晨; 李斯丹; 周翾

    2015-01-01

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

  11. Chemotherapy for Soft Tissue Sarcomas

    Science.gov (United States)

    ... Stage Soft Tissue Sarcoma Treating Soft Tissue Sarcomas 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 ...

  12. 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...

  13. 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

    estimation (MLE), validated through the model residuals analysis and cross-validated to detect model over-fitting. A nonlinear model based on the reversed Carnot cycle is also presented and included in the modeling performance analysis. As an application of the models, we apply model predictive control (MPC......) 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).......This paper describes the application of stochastic grey-box modeling to identify electrical power consumption-to-temperature models of a domestic freezer using experimental measurements. The models are formulated using stochastic differential equations (SDEs), estimated by maximum likelihood...

  14. 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)

  15. 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.

  16. Impacts of Western Area Power Administration`s power marketing alternatives on utility demand-side management and conservation and renewable energy programs

    Energy Technology Data Exchange (ETDEWEB)

    Cavallo, J.D.; Germer, M.F.; Tompkins, M.M.

    1995-03-01

    The Western Area Power Administration (Western) requires all of its long-term firm power customers to implement programs that promote the conservation of electric energy or facilitate the use of renewable energy resources. Western has also proposed that all customers develop integrated resource plans that include cost-effective demand-side management programs. As part of the preparation of Western`s Electric Power Marketing Environmental Impact Statement, Argonne National Laboratory (ANL) developed estimates of the reductions in energy demand resulting from Western`s conservation and renewable energy activities in its Salt Lake City Area Office. ANL has also estimated the energy-demand reductions from cost-effective, demand-side management programs that could be included in the integrated resource plans of the customers served by Western`s Salt Lake City Area Office. The results of this study have been used to adjust the expected hourly demand for Western`s major systems in the Salt Lake City Area. The expected hourly demand served as the basis for capacity expansion plans develops with ANL`s Production and Capacity Expansion (PACE) model.

  17. 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)

  18. Ayurveda for chemo-radiotherapy induced side effects in cancer patients.

    Science.gov (United States)

    Metri, Kashinath; Bhargav, Hemant; Chowdhury, Praerna; Koka, Prasad S

    2013-01-01

    Chemotherapy drugs and radiotherapy are highly toxic and both damage adjacent healthy cells. Side effects may be acute (occurring within few weeks after therapy), intermediate or late (occurring months or years after the therapy). Some important side effects of chemotherapy are: nausea, vomiting, diarrhea, mucositis, alopecia, constipation etc; whereas radiation therapy though administered locally, can produce systemic side effects such as fatigue, anorexia, nausea, vomiting, alteration in the taste, sleep disturbance, headache, anemia, dry skin, constipation etc. Late complications of these therapies also include pharyngitis, esophagitis, laryngitis, persistent dysphagia, fatigue, hepatotoxicity, infertility and cognitive deficits. These arrays of side effects have a devastating effect on the quality of life of cancer survivors. Due to the inadequacy of most of the radio-protectors and chemo-protectors in controlling the side effects of conventional cancer therapy the complementary and alternative medicines have attracted the view of researchers and medical practitioners more recently. This review aims at providing a comprehensive management protocol of above mentioned chemo-radiotherapy induced side effects based on Ayurveda, which is an ancient system of traditional medicine practiced in Indian peninsula since 5000 BC. When the major side effects of chemo-radiotherapy are looked through an ayurvedic perspective, it appears that they are the manifestations of aggravated pitta dosha, especially under the group of disorders called Raktapitta (haemorrhage) or Raktadushti (vascular inflammation). Based on comprehensive review of ancient vedic literature and modern scientific evidences, ayurveda based interventions are put forth. This manuscript should help clinicians and people suffering from cancer to combat serious chemo-radiotherapy related side effects through simple but effective home-based ayurveda remedies. The remedies described are commonly available and

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

    DEFF Research Database (Denmark)

    Xydis, George A.; Nanaki, Evanthia A.; Koroneos, Christopher J.

    2013-01-01

    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 t...... 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....

  20. 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

  1. Evaluating the impact of demand-side management on water resources under changing climatic conditions and increasing population.

    Science.gov (United States)

    Dawadi, Srijana; Ahmad, Sajjad

    2013-01-15

    This study investigated the effect of increasing population and changing climatic conditions on the water resources of a semi-arid region, the Las Vegas Valley (LVV) in southern Nevada. A system dynamics model was developed for the LVV from 1989 to 2035. The impact of climate change on water demand and the water supply from the Colorado River was modeled, using projections from 16 global climate models for 3 emission scenarios. Variability in water demand and supply under different scenarios of population growth and demand management, including water conservation and water pricing, was evaluated. With the population growth that was projected, if no further demand management policies were implemented, the LVV would not be able to meet the water demand in the near future. However, by combining water conservation and pricing policies, the available supply could last well into the future. The reduction in water demand in 2035 was predicted to be 327 million cubic meters (MCM) for 'status quo' population growth, or 30.6%; 408 MCM for 50% of the projected growth, or 38%; and 511 MCM for no population growth, or 47.8%. Water supply reliability decreased significantly with changing climatic conditions. Therefore, major challenges to water sustainability in the LVV would be due to rapid population growth as well as to climate variability. However, with the combination of reduced population growth rate and water conservation policies, the Colorado River supply could meet the future demand of the LVV most of the time.

  2. Effective Management of Advanced Angiosarcoma by the Synergistic Combination of Propranolol and Vinblastine-based Metronomic Chemotherapy: A Bench to Bedside Study

    Science.gov (United States)

    Pasquier, Eddy; André, Nicolas; Street, Janine; Chougule, Anuradha; Rekhi, Bharat; Ghosh, Jaya; Philip, Deepa S.J.; Meurer, Marie; MacKenzie, Karen L.; Kavallaris, Maria; Banavali, Shripad D.

    2016-01-01

    Background Angiosarcomas are rare malignant tumors of vascular origin that represent a genuine therapeutic challenge. Recently, the combination of metronomic chemotherapy and drug repositioning has been proposed as an attractive alternative for cancer patients living in developing countries. Methods In vitro experiments with transformed endothelial cells were used to identify synergistic interactions between anti-hypertensive drug propranolol and chemotherapeutics. This led to the design of a pilot treatment protocol combining oral propranolol and metronomic chemotherapy. Seven consecutive patients with advanced/metastatic/recurrent angiosarcoma were treated with this combination for up to 12 months, followed by propranolol-containing maintenance therapy. Findings Gene expression analysis showed expression of ADRB1 and ADRB2 adrenergic receptor genes in transformed endothelial cells and in angiosarcoma tumors. Propranolol strongly synergized with the microtubule-targeting agent vinblastine in vitro, but only displayed additivity or slight antagonism with paclitaxel and doxorubicin. A combination treatment using bi-daily propranolol (40 mg) and weekly metronomic vinblastine (6 mg/m2) and methotrexate (35 mg/m2) was designed and used in 7 patients with advanced angiosarcoma. Treatment was well tolerated and resulted in 100% response rate, including 1 complete response and 3 very good partial responses, based on RECIST criteria. Median progression-free and overall survival was 11 months (range 5–24) and 16 months (range 10–30), respectively. Interpretation Our results provide a strong rationale for the combination of β-blockers and vinblastine-based metronomic chemotherapy for the treatment of advanced angiosarcoma. Furthermore, our study highlights the potential of drug repositioning in combination with metronomic chemotherapy in low- and middle-income country setting. Funding This study was funded by institutional and philanthropic grants. PMID:27211551

  3. [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.

  4. 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

  5. Incidence of Chemotherapy-Induced Amenorrhea After Adjuvant Chemotherapy With Taxane and Anthracyclines in Young Patients With Breast Cancer

    OpenAIRE

    2013-01-01

    Background Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. Methods In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departmen...

  6. 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.

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

    Science.gov (United States)

    ... high-acid foods and juices (like oranges or tomatoes) should be avoided. Regular dental checkups are important ... back — though it might be a slightly different color or texture. In the meantime, many kids choose ...

  8. Chemotherapy-induced alopecia: advice and support for hair loss.

    Science.gov (United States)

    Roe, Helen

    This article provides insight into the growth cycle of a hair follicle and the potential impact chemotherapy agents can have on this process, which often results in hair loss (alopecia). It explores the psychological consequences of chemotherapy-induced alopecia for an individual as a result of the perceptions of others as well as an individual's perception of his or her self-image. Despite the development of various forms of scalp cooling, chemotherapy-induced alopecia remains a major side effect for patients receiving chemotherapy; however, there have been improvements in wig provision and changing public opinion relating to baldness. Although chemotherapy-induced alopecia affects both males and females and all age groups, this article focuses on the potential impact for patients receiving chemotherapy as a form of treatment for breast cancer. As professionals we need to understand the social significance of hair in relation to a person's outward presentation and social interactions, along with the possible psychological implications of a person losing his or her bodily hair, and not just the head hair. We must aim to minimize the distress alopecia can cause by: ensuring we provide patients with up-to-date verbal and written information to enable them to prepare for losing their hair; helping them to preserve their self-image and minimize the psychological consequences of hair loss while receiving chemotherapy; and preparing them for their hair re-growth following completion of chemotherapy.

  9. 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.

  10. 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.

  11. Vesicant chemotherapy extravasation antidotes and treatments.

    Science.gov (United States)

    Schulmeister, Lisa

    2009-08-01

    Oncology nurses and pharmacists often are given the responsibility of developing or updating institutional policies to manage vesicant chemotherapy extravasations. Antidote and treatment recommendations of vesicant chemotherapy manufacturers, antidotes and treatments approved by the U.S. Food and Drug Administration (FDA), and guidelines and recommendations made by professional oncology organizations are useful resources in this process. This article describes manufacturers' recommendations, lists antidotes and treatments approved by the FDA, and reviews published guidelines and recommendations. Available antidote and treatment formulations and their preparation and administration also are discussed.

  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. Use of an alpha lipoic, methylsulfonylmethane and bromelain dietary supplement (Opera(®)) for chemotherapy-induced peripheral neuropathy management, a prospective study.

    Science.gov (United States)

    Desideri, Isacco; Francolini, Giulio; Becherini, Carlotta; Terziani, Francesca; Delli Paoli, Camilla; Olmetto, Emanuela; Loi, Mauro; Perna, Marco; Meattini, Icro; Scotti, Vieri; Greto, Daniela; Bonomo, Pierluigi; Sulprizio, Susanna; Livi, Lorenzo

    2017-03-01

    Chemotherapy-induced peripheral neuropathy (CIPN) is a major clinical problem associated with a number of cytotoxic agents. OPERA(®) (GAMFARMA srl, Milan, Italy) is a new dietary supplement where α-lipoic acid, Boswellia Serrata, methylsulfonylmethane and bromelain are combined in a single capsule. The aim of this prospective study was to determine the efficacy and safety of OPERA(®) supplementation in a series of patients affected by CIPN. We selected 25 subjects with CIPN evolving during or after chemotherapy with potentially neurotoxic agents. Patients were enrolled at the first clinical manifestation of neuropathy. CIPN was assessed at the enrollment visit and subsequently repeated every 3 weeks until 12 weeks. Primary endpoint was the evaluation of changes of measured scores after 12 weeks of therapy compared to baseline evaluation. Secondary endpoints were the evaluation of neuropathy reduction at 12 weeks after beginning of therapy with OPERA(®). Analysis of VAS data showed reduction in pain perceived by patients. According to NCI-CTC sensor and motor score, mISS scale and TNSc scale, both pain and both sensor and motor neuropathic impairment decreased after 12 weeks of treatments. Treatment with OPERA supplement was well tolerated; no increase in the toxicity profile of any of the therapeutic regimen that the patients were undergoing was reported. OPERA(®) was able to improve CIPN symptoms in a prospective series of patients treated with neurotoxic chemotherapy, with no significant toxicity or interaction. Prospective RCT in a selected patients' population is warranted to confirm its promising activity.

  14. Role of chemotherapy in Hodgkin's lymphoma.

    Science.gov (United States)

    Seam, Pamela; Janik, John E; Longo, Dan L; Devita, Vincent T

    2009-01-01

    The development of curative chemotherapy regimens for the treatment of Hodgkin's lymphoma (HL) is one of the true success stories in oncology. Most patients diagnosed with HL today can be cured. The major task remaining before us is curing as many patients as possible with their initial therapeutic approach while minimizing the acute toxicities and limiting the lifetime risks of important secondary events such as cardiovascular complications and secondary malignancies. In the 40 years since DeVita et al. developed the mechlorethamine, vincristine, procarbazine, and prednisone chemotherapy regimen, we have learned a great deal about risk stratification to minimize treatment-related toxicity. Positron emission tomography may further assist us in reducing radiation treatment without compromising cures. This review will discuss the development of the chemotherapy regimens used in the management of early and advanced stage HL and the advantages and disadvantages of their use in combination with radiation therapy.

  15. Reducing psychological distress in patients undergoing chemotherapy.

    Science.gov (United States)

    Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

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

  16. 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)

  17. 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.

  18. Induction chemotherapy with cisplatin, epirubicin, and paclitaxel (CEP), followed by concomitant radiotherapy and weekly paclitaxel for the management of locally advanced nasopharyngeal carcinoma. A hellenic cooperative oncology group phase II study

    Energy Technology Data Exchange (ETDEWEB)

    Fountzilas, G.; Kalogera-Fountzila, A.; Karanikiotis, C.; Nicolaou, A.; Plataniotis, G.; Daniilidis, J. [AHEPA Hospital, Aristotle Univ. of Thessaloniki, Thessaloniki (Greece); Tolis, C.; Bai, M.; Tsekeris, P. [Univ. of Ioannina Medical School, Ioannina (Greece); Misailidou, D. [' ' Papageorgiou' ' Hospital, Thessaloniki (Greece); Samantas, E.; Athanassiou, E. [' ' Agii Anargiri' ' Cancer Hospital, Athens (Greece); Papamichael, D.; Catodritis, N. [Bank of Cyprus Oncology Center, Nicosia (Cyprus); Makatsoris, T. [' ' Rio' ' Hospital, Univ. of Patras Medical School, Rio, Patras (Greece); Papakostas, P. [' ' Ippokration' ' Hospital, Athens (Greece); Zamboglou, N. [Dept. of Radiotherapy, Klinikum Offenbach, Offenbach (Germany)

    2005-04-01

    Background: clinical research on the treatment of nasopharyngeal cancer (NPC) has been focused primarily on the reduction of incidence of the development of distant metastases as well as the improvement of locoregional control. Patients and methods: untreated patients with stage IIB-IVB nonmetastatic NPC were treated with three cycles of induction chemotherapy (IC) consisting of epirubicin 75 mg/m{sup 2} followed by paclitaxel 175 mg/m{sup 2} as 3-h infusion on day 1 and cisplatin 75 mg/m{sup 2} on day 2 every 3 weeks, followed by concomitant radiation therapy (70 Gy), and chemotherapy (CCRT) with weekly paclitaxel 60 mg/m{sup 2}. Results: from November 1999 until April 2003, 47 patients entered the study. Complete response rate post IC therapy was 15%, which was raised to 66% after the completion of CCRT. The most frequent side effect from IC was myelotoxicity (55%), whereas stomatitis and xerostomia were the most pronounced (grade 3, 4) toxicities during CCRT. The presence of Epstein-Barr virus (EBV) was detected either by in situ hybridization in tumor tissue sections or by polymerase chain reaction in the peripheral blood in 37 out of 46 patients tested (80%). All three histological types were associated with the presence of EBV. After a median follow-up of 23.5 months, median time to treatment failure was 17.9 months, whilst median survival has not been reached yet. Conclusion: IC followed by CCRT is feasible and produces durable complete responses in the majority of patients with NPC. The case detection rate of EBV in this study appears to be similar to that reported from endemically infected regions. (orig.)

  19. 基于电力需求侧管理平台的电力管理信息化%Power Management Platform Informatization Based on Power Electricity Demand Side

    Institute of Scientific and Technical Information of China (English)

    董春泉; 段飞; 匡晔; 宋哲

    2015-01-01

    从用户和开发者的角度介绍电力需求侧管理平台建设对于企业和电力部门产生的价值,以指导企业有效使用平台;并从实际使用的层面体现电力需求侧管理平台的实际应用效益,进一步推广电力需求侧管理平台建设。%The article introduces power electricity demand side management platform construction’s value to enterprises and power departments from the perspectives of customers and developers, which instructs enterprises to use platform effectively and reflects power electricity demand side management platform practical application effect from actual usage perspective to further promote power electricity demand side management platform construction.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    O’Connell Kathryn A

    2012-10-01

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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. Fall-related injuries in elderly cancer patients treated with neurotoxic chemotherapy: A retrospective cohort study

    OpenAIRE

    Ward, PR; Wong, MD; Moore, R.; Naeim, A

    2014-01-01

    Background: Fall-related injuries are a well-described cause of morbidity and mortality in the community-dwelling elderly population, but have not been well described in patients with cancer. Cancer treatment with chemotherapy can result in many unwanted side effects, including peripheral neuropathy if the drugs are potentially neurotoxic. Peripheral neuropathy and other side effects of chemotherapy may lead to an increased risk of fall-related injuries. Methods: We conducted a retrospective ...

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

    Directory of Open Access Journals (Sweden)

    Braulio Alexander Martinez MD

    2015-06-01

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

  10. 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

  11. The Relationship of Psychological Resilience with Side Effects and Quality of Life in Patients with Radiotherapy and Chemotherapy for Cancer%肿瘤放化疗患者心理弹性与治疗副反应和生存质量的关系研究

    Institute of Scientific and Technical Information of China (English)

    水会锋

    2016-01-01

    Objective:To analyze the relationship of psychological resilience with the side effects and the quality of life.Method:102 tumor patients in our hospital for diagnosis and treatment were selected from January 2014 to May 2015 as the research objects, the different psychological resilience in patients with adverse reactions incidence,the relationship between the occurrence of tumor patients with resilience and side effect of the treatment of existing were observed and compared; at the same time the different resilience in patients with the quality of life index were compared.The relationship of tumor patients mental flexibility and quality of life were analyzed. Result:In the treatment of 102 cases with tumor had 59 cases of adverse reactions, the incidence rate was 57.8%, including 16 cases of head and neck, 12 cases of lung, 18 cases of digestive tract, 8 cases of gynecological, 5 cases of other cases.Different parts of the tumor patients with low psychological resilience in the treatment the incidence of side effects was significantly higher than that in the center psychological resilience,the center psychological resilience of those were higher than high psychological resilience,the differences were statistically significant (P<0.05).Different parts of the tumor patients with low resilience physiological function,health status, social function and emotional intelligence score significantly lower than the center psychological resilience, the center psychological resilience of those were significantly lower than that of high psychological resilience,the differences were statistically significant(P<0.05).Conclusion:There is a certain relationship of the psychological resilience with the treatment side effects and the quality of life in radiotherapy and chemotherapy.The higher resilience, the lower incidence of side effects,and the higher quality of life.%目的:分析心理弹性与治疗副反应和生存质量的关系。方法:选取2014年1月-2015年5月

  12. 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.

  13. 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.

  14. 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.

  15. Chemotherapy-induced nausea and vomiting. Easing patients' fear and discomfort with effective antiemetic regimens.

    Science.gov (United States)

    Bilgrami, S; Fallon, B G

    1993-10-01

    Patients receiving chemotherapy should be given optimal antiemetic therapy to maximize their comfort initially and to prevent development of delayed and anticipatory nausea and vomiting. Understanding the mechanisms of chemotherapy-induced nausea and vomiting allows the healthcare team to design drug regimens capable of avoiding these side effects. Prevention is important, because side effects can be debilitating and sometimes dose-limiting, and up to 10% of patients refuse chemotherapy altogether to avoid them. In general, combination antiemetic therapy is preferred over single-agent therapy for chemotherapeutic regimens that produce moderate to severe adverse effects.

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

    Institute of Scientific and Technical Information of China (English)

    蔡文智; 盛小燕; 周瑾; 周小平; 曹文静; 王丽; 缪景霞

    2013-01-01

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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Marr Brian

    2010-01-01

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

  2. Improving chemotherapy for patients with advanced non-small cell lung cancer

    DEFF Research Database (Denmark)

    von Plessen, Christian

    2011-01-01

    treatment option is palliative chemotherapy. Given the palliative intention of the chemotherapy, it is clinically highly relevant to establish the optimal treatment duration. While chemotherapy prolongs survival and improves quality of life (QoL), it also has side effects and only a minority of patients...... achieve an objective treatment response. Clinicians need guidance on treatment duration from controlled trials to balance these aspects. Improvements of the conditions under which chemotherapy is given can increase patient and staff satisfaction and increase system performance. This is especially relevant...... of care. Clinicians, health care administrators and the public need knowledge about the outcomes of palliative chemotherapy in unselected patient populations. The efficacy of palliative chemotherapy for advanced NSCLC has been amply documented in controlled clinical trials. Meanwhile, the elderly...

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

    Institute of Scientific and Technical Information of China (English)

    黄中; 邵汛帆; 郑乃莹

    2014-01-01

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

  4. Ginger as a miracle against chemotherapy-induced vomiting

    Science.gov (United States)

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

    2012-01-01

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

  5. 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.

  6. Application of Continuous Nursing Care in Home Management of Breast Cancer Patients with Chemotherapy%乳腺癌化疗患者居家管理中延续护理的应用

    Institute of Scientific and Technical Information of China (English)

    宋玲玲

    2016-01-01

    Objective To explore the application effect of continuous nursing care in the treatment of breast cancer pa-tients with chemotherapy. Methods Select our hospital from March 2012 to July 2014 breast cancer chemotherapy pa-tients with 88 cases, randomly divided as control group(44 cases) and observation group(44 cases) and the control group patients were discharged after given regular education, the observation group patients in home management in the im-plementation of extended care. Compared with the two groups of patients after nursing cognitive score, status score, be-havior score, nursing satisfaction and depression status. Results The observation group of patients with cognitive scores and status scores and scores were (4.03±0.67) points,(4.08±0.54) and(4.13±0.64), were significantly better than the con-trol group, and the observation group, patients satisfaction more high, depression of mild, moderate and severe patients with lower proportion of (P< 0.05). Conclusion In home management, the continuation of the application and nursing can improve the cognition of disease in breast cancer patients receiving chemotherapy, strengthen self-management of the disease, to improve nursing satisfaction, improve the psychological status, and is suitable for popularization.%目的:探讨乳腺癌化疗患者居家管理中延续护理的应用效果。方法选取该院2012年3月—2014年7月乳腺癌化疗患者88例,将其随机分为对照组(44例)和观察组(44例),其中对照组患者出院后给予常规教育,观察组患者在居家管理中实施延续护理。比较两组患者护理后的认知评分、现状评分、行为评分、护理满意度和抑郁状况。结果观察组患者的认知评分、现状评分和行为评分分别为(4.03±0.67)分、(4.08±0.54)分和(4.13±0.64)分,均显著优于对照组患者,且观察组患者护理满意度更高,心理抑郁轻度、中度和重度患者的比例更低(P<0.05)。结论在居

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

    Science.gov (United States)

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

    2016-02-01

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

  8. Alternative Methods to Treat Nausea and Vomiting from Cancer Chemotherapy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Sheikhi

    2015-01-01

    Full Text Available Chemotherapy Induced Nausea and Vomiting (CINV is among the most intensive side effects and critical concerns for patients with cancer. Most of these patients experience nausea and vomiting after chemotherapy. Sometimes, this is so annoying that it may prevent them from continuing the therapy. With the recent advances, a variety of therapeutic methods are innovated and applied to control CINV. Among them, the main methods include medicinal therapy, relaxation, and herbal therapy. Yet, using dexamethasone together with massage therapy and ginger is identified as the most effective method.

  9. Anaphylaxis to chemotherapy and monoclonal antibodies.

    Science.gov (United States)

    Castells, Mariana C

    2015-05-01

    Hypersensitivity reactions are increasingly prevalent, although underrecognized and underreported. Platins induce immunoglobulin E-mediated sensitization; taxenes and some monoclonal antibodies can induce reactions at first exposure. Severe hypersensitivity can preclude first-line therapy. Tryptase level at the time of a reaction is a useful diagnostic tool. Skin testing provides a specific diagnosis. Newer tests are promising diagnostic tools to help identify patients at risk before first exposure. Safe management includes rapid drug desensitization. This review provides information regarding the scope of hypersensitivity and anaphylactic reactions induced by chemotherapy and biological drugs, as well as diagnosis, management, and treatment options.

  10. 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...

  11. Role of myeloid growth factors in chemotherapy induced neutropenia

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    Ravinutala Srinath Bharadwaj

    2016-10-01

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

  12. Why chemotherapy can fail?

    Science.gov (United States)

    Król, M; Pawłowski, K M; Majchrzak, K; Szyszko, K; Motyl, T

    2010-01-01

    There are many reasons that lead to failure of cancer chemotherapy. Cancer has the ability to become resistant to many different types of drugs. Increased efflux of drug, enhanced repair/increased tolerance to DNA damage, high antiapoptotic potential, decreased permeability and enzymatic deactivation allow cancer cell survive the chemotherapy. Treatment can lead to the death of most tumor cells (drug-sensitive), but some of them (drug-resistant) survive and grow again. These tumor cells may arise from stem cells. There are many studies describing human experiments with multidrug resistance, especially in breast cancer. Unfortunately, studies of canine or feline ABC super family members are not as extensive as in human or mice and they are limited to several papers describing PGP in mammary cancer, cutaneous mast cell tumors and lymphoma. Multidrug resistance is one of the most significant problems in oncology today. The involvement of many different, not fully recognized, mechanisms in multidrug resistance of cancer cells makes the development of effective methods of therapy very difficult. Understanding the mechanisms of drug resistance in cancer cells may improve the results of treatment. This review article provides a synopsis of all aspects that refer to cancer cell resistance to antitumor drugs.

  13. Chemotherapy for children with medulloblastoma

    NARCIS (Netherlands)

    Michiels, E.M.; Schouten-van Meeteren, A.Y.; Doz, F.; Janssens, G.O.R.J.; Dalen, E.C. van

    2015-01-01

    BACKGROUND: Post-surgical radiotherapy (RT) in combination with chemotherapy is considered as standard of care for medulloblastoma in children. Chemotherapy has been introduced to improve survival and to reduce RT-induced adverse effects. Reduction of RT-induced adverse effects was achieved by delet

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

    Science.gov (United States)

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

    2013-12-01

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

  15. 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)

  16. A history of cancer chemotherapy.

    Science.gov (United States)

    DeVita, Vincent T; Chu, Edward

    2008-11-01

    The use of chemotherapy to treat cancer began at the start of the 20th century with attempts to narrow the universe of chemicals that might affect the disease by developing methods to screen chemicals using transplantable tumors in rodents. It was, however, four World War II-related programs, and the effects of drugs that evolved from them, that provided the impetus to establish in 1955 the national drug development effort known as the Cancer Chemotherapy National Service Center. The ability of combination chemotherapy to cure acute childhood leukemia and advanced Hodgkin's disease in the 1960s and early 1970s overcame the prevailing pessimism about the ability of drugs to cure advanced cancers, facilitated the study of adjuvant chemotherapy, and helped foster the national cancer program. Today, chemotherapy has changed as important molecular abnormalities are being used to screen for potential new drugs as well as for targeted treatments.

  17. Interstitial pneumonitis following intrapleural chemotherapy

    Directory of Open Access Journals (Sweden)

    Humphries Gary N

    2009-02-01

    Full Text Available Abstract Background Mucinous neoplasms within the abdomen may disseminate by direct extension through the diaphragm to involve the pleural space. Treatment of this condition is by parietal and visceral pleurectomy followed by hyperthermic intrapleural chemotherapy. Case presentation In this case report a patient developed persistent right upper lobe interstitial pneumonitis and progressive parenchymal fibrosis following intrapleural chemotherapy treatment with mitomycin C and doxrubicin. The condition persisted until death 28 months later. Death was from progressive intraabdominal disease with intestinal obstruction and sepsis associated with progressive pulmonary parenchymal disease. The right pleural space disease did not recur. Conclusion This manuscript is the first case report describing interstitial pneumonitis and lung fibrosis following intrapleural chemotherapy. Since pulmonary toxicity from chemotherapy is a dose-dependent phenomenon, dose reduction of intrapleural as compared to intraperitoneal hyperthermic chemotherapy may be necessary.

  18. Intravenous chemotherapy combined with intravesical chemotherapy to treat T1G3 bladder urothelial carcinoma after transurethral resection of bladder tumor: results of a retrospective study

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2016-01-01

    Full Text Available Yu Zhang,1,* Linguo Xie,1,* Tao Chen,1,* Wanqin Xie,2 Zhouliang Wu,1 Hao Xu,1 Chen Xing,1 Nan Sha,1 Zhonghua Shen,1 Yunkai Qie,1 Xiaoteng Liu,1 Hailong Hu,1 Changli Wu1 1Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, 2Key Laboratory of Genetics and Birth Health of Hunan Province, The Family Planning Research Institute of Hunan Province, Changsha, People’s Republic of China *These authors contributed equally to this work Objective: The management of stage 1 and grade 3 (T1G3 bladder cancer continues to be controversial. Although the transurethral resection of bladder tumor (TURBT followed by intravesical chemotherapy is a conservative strategy for treatment of T1G3 bladder cancer, a relatively high risk of tumor recurrence and progression remains regarding the therapy. This study aimed to compare the efficacy of intravenous chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone for T1G3 bladder cancer after TURBT surgery. Methods: We retrospectively reviewed the cases of 457 patients who were newly diagnosed with T1G3 bladder urothelial carcinoma between January 2009 and March 2014. After TURBT, 281 patients received intravesical chemotherapy alone, whereas 176 patients underwent intravesical chemotherapy in combination with intravenous chemotherapy. Tumor recurrence and progression were monitored periodically by urine cytology and cystoscopy in follow-up. Recurrence-free survival and progression-free survival of the two chemotherapy strategies following TURBT were analyzed. Univariable and multivariable Cox hazards analyses were performed to predict the prognostic factors for tumor recurrence and progression. Results: The tumor recurrence rate was 36.7% for patients who received intravesical chemotherapy alone after TURBT, compared with 19.9% for patients who received intravenous chemotherapy combined with intravesical chemotherapy after

  19. 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

  20. Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

    Science.gov (United States)

    Williams, Jane; Phillips, Catherine; Byrd, Hollie Marie

    2017-01-01

    Simple Summary Cancer is as common amongst pets as it in humans. Chemotherapy can be integrated into treatment regimes for terminally ill pets to attempt to shrink tumours to extend life expectancy, but it does not cure cancer and it can have negative side effects including vomiting, depression and behavioral changes. To date, little research has been undertaken to explore owners’ decisions whether or not to treat their animals with chemotherapy. Seventy-eight dog and cat owners completed an online questionnaire to determine if they would opt for chemotherapy if their pet was diagnosed with cancer, and asked how they thought their pet’s quality of life would be affected. Fifty-eight percent of respondents would not use chemotherapy largely due to their previous experience of it. Seventy-two percent over estimated pet survival time post chemotherapy, with most people believing it would lead to remission or a cure. Owners expected their pets to be less active, sleep more and play less, reducing their quality of life. Common side effects associated with chemotherapy were not rated as acceptable. The results suggest pet owners would benefit from an increased understanding of the positive and negative impacts of chemotherapy when initially discussing treatment options with the veterinary team. Abstract Chemotherapy is a commonly integrated treatment option within human and animal oncology regimes. Limited research has investigated pet owners’ treatment decision-making in animals diagnosed with malignant neoplasia. Dog and cat owners were asked to complete an online questionnaire to elucidate factors which are key to the decision making process. Seventy-eight respondents completed the questionnaire in full. Fifty-eight percent of pet owners would not elect to treat pets with chemotherapy due to the negative impact of the associated side effects. Seventy-two percent of respondents over estimated pet survival time post chemotherapy, indicating a general perception

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

    Directory of Open Access Journals (Sweden)

    Lejla Mutapcic Vajzovic

    2011-02-01

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

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

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    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.

  3. 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.

  4. Worsening of rest-activity circadian rhythm and quality of life in female breast cancer patients along progression of chemotherapy cycles.

    Science.gov (United States)

    Sultan, Armiya; Choudhary, Vivek; Parganiha, Arti

    2017-02-16

    Chemotherapy and its associated side effects can induce the disruption of circadian rest-activity rhythm and may have negative consequences on health-related quality of life (HRQoL) of cancer patients. In the current study, repeated-measures cross-sectional design was implemented to determine the status of circadian rest-activity rhythm and to assess the HRQoL of newly diagnosed female breast cancer patients those were planned to receive six cycles of chemotherapy. Rest activity and HRQoL were assessed in twenty-five patients during chemotherapy cycles 1st (C1), 3rd (C3), and 6th (C6) immediately after they reported to the outdoor ward of the Regional Cancer Center, Pt. J.N.M. Medical College, Dr. B.R. Ambedkar Memorial Hospital, Raipur, India. Wrist actigraphs for consecutive spans of 3-4 days were used to record the rest-activity rhythm, and its parameters were computed with the help of Cosinor Rhythmometry. Quality of life (QoL) parameters were assessed using EORTC QLQ-C30 and QLQ-BR23. Results revealed that average scores of all rhythm parameters, such as MESOR, amplitude, acrophase, rhythm quotient, circadian quotient, peak activity, dichotomy index, and autocorrelation coefficient; and all functional scales of QLQ-C30, such as physical, role, emotional, cognitive, and social, and global quality of life statistically significantly decreased with the increasing number of chemotherapy cycles (C1 to C3 and C6). Scores of symptom scales of QLQ-C30, such as fatigue, pain, dyspnoea, insomnia, appetite loss, and diarrhea increased significantly from C1 to C6. Among the QLQ-BR23 scales, scores of sexual functioning, sexual enjoyment, breast symptoms, and arm symptoms significantly decreased, whereas scores of systemic therapy side effects, and upset by hair loss significantly increased across the chemotherapy cycles. We conclude that rest-activity rhythm disrupted and HRQoL of breast cancer patients worsened along the increasing number of chemotherapy cycles. We

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

    Science.gov (United States)

    Addington, James; Freimer, Miriam

    2016-01-01

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

  6. Chemotherapy-induced peripheral neuropathy: an update on the current understanding [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    James Addington

    2016-06-01

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

  7. Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Aziz, Fahad

    2012-07-01

    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. The discovery of several NK1 receptor antagonists is a big revolution to dealt this problem. NK1 receptor antagonists prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). These agents act centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, these agents help improve patients' daily living and their ability to complete multiple cycles of chemotherapy. They are effective for both moderately and highly emetogenic chemotherapy regimens. Their use might be associated with increased infection rates; however, additional appraisal of specific data from RCTs is needed.

  8. Phase III Double-Blind, Placebo-Controlled Study of Gabapentin for the Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy, NCCTG N08C3 (Alliance)

    Science.gov (United States)

    Barton, Debra L.; Thanarajasingam, Gita; Sloan, Jeff A.; Diekmann, Brent; Fuloria, Jyotsna; Kottschade, Lisa A.; Lyss, Alan P.; Jaslowski, Anthony J.; Mazurczak, Miroslaw A.; Blair, Scott C.; Terstriep, Shelby; Loprinzi, Charles L.

    2014-01-01

    BACKGROUND Despite targeted antiemetics, data support an unmet need related to the management of delayed nausea and vomiting (NV). Promising pilot data informed this phase III trial evaluating gabapentin for delayed NV from highly emetogenic chemotherapy (HEC). METHODS Participants were randomized to receive prophylactic treatment with 20 mg of dexamethasone and a 5HT3 receptor antagonist (RA) on the day of chemotherapy, followed by gabapentin 300 mg twice a day and dexamethasone (dex) or placebo and dex after HEC. Gabapentin/placebo was started the day of chemotherapy and continued through day 5 for the first chemotherapy cycle, whereas dex was titrated down on days 2–4. The primary end point was complete response (CR), defined as no emesis and no use of rescue medications on days 2–6, using an NV diary. The percentages of those in each group with a CR were compared by Fisher’s exact test. RESULTS Four hundred thirty patients were enrolled in this study. Forty-seven percent of patients in the gabapentin arm and 41% in the placebo arm had a CR (P = .23). Mean number of emesis episodes was <0.5 daily, and mean nausea severity was <2 (mild). In both arms, patient satisfaction with NV control was greater than 8 (with 10 being perfectly satisfied). There were no significant differences in unwanted side effects. CONCLUSIONS In this study, gabapentin did not significantly improve delayed NV. Patients were satisfied with the control of their nausea and vomiting irrespective of arm. The use of a 5HT3 RA and dexamethasone provided good control of nausea and vomiting for most patients. PMID:25043153

  9. 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.

  10. [Loco-regional chemotherapy at the outpatient clinic for gastric cancer patients with home enteral nutrition].

    Science.gov (United States)

    Maruyama, Michio; Nagahama, Takeshi; Sugano, Norihide; Satoh, Eigo; Maruyama, Shouji; Tanami, Hideo; Chiba, Tetsuma; Murakata, Ayano; Mitsuhashi, Yosuke; Uehira, Daisuke; Akazawa, Naoya; Suzuki, Keiichirou

    2011-11-01

    In over the 10 years from 2000-2010, 21 gastric cancer patients received loco-regional chemotherapy with home enteral nutrition (HEN) at an outpatient clinic because of insufficient oral intake. These loco-regional chemotherapy regimens consisted of 5 intra-aortic chemotherapies, 4 hepato-arterial infusions and 12 intra-peritoneal chemotherapies. Five out of 8 cases that had measurable lesions showed PR, and 3 cases revealed PD. The patients received HEN with peptide central formula, 400-1,200 kcal/day in night time. The average duration of HEN was 12.9 months. The post-operative nutritional management was needed for continuation and securing of outpatient chemotherapy. The author reported an experience of the outpatient loco-regional chemotherapy with HEN for the gastric cancer patients who could not eat a sufficient volume of food.

  11. Starvation Based Differential Chemotherapy: A Novel Approach for Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Sidra Naveed

    2014-11-01

    Full Text Available Cancer patients undergoing chemotherapy treatment are advised to increase food intake to overcome the therapy-induced side effects, and weight loss. Dietary restriction is known to slow down the aging process and hence reduce age-related diseases such as cancer. Fasting or short-term starvation is more effective than dietary restriction to prevent cancer growth since starved cells switch off signals for growth and reproduction and enter a protective mode, while cancer cells, being mutated, are not sensitized by any external growth signals and are not protected against any stress. This phenomenon is known as differential stress resistance (DSR. Nutrient signaling pathways involving growth hormone/insulin-like growth factor-1 axis and its downstream effectors, play a key role in DSR in response to starvation controlling the other cell maintenance systems, such as autophagy and apoptosis, that are related to the tumorigenesis. Yeast cells lacking these effectors are better protected against oxidative stress compared to normal cells. In the same way, starvation protects many cell lines and mice against high-dose chemotherapeutic drugs. According to a series of studies, fasting results in overall reduction in chemotherapy side effects in cancer patients. Data shows that starvation-dependent differential chemotherapy is safe, feasible and effective in cancer treatment, but the possible side effects of starvation limit its efficacy. However, further studies and clinical trials may result in its implementation in cancer treatment.

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

    Institute of Scientific and Technical Information of China (English)

    闫华光; 陈宋宋; 钟鸣; 蒋利民

    2015-01-01

    为引导需求侧优化用能管理水平、参与电网高峰负荷削减,实现能源利用效率的整体提升,简述了电力需求侧能效管理与需求响应系统建设的背景、意义;概述了系统在监测用户能源消耗数据、控制用户关键用能系统或设备的运行状态、响应电网侧需求响应事件方面功能;提出了系统的层次结构并描述了各层之间的关系;详细设计了系统的物理架构、功能架构,并分析了系统关键技术。本设计方案已应用于国家电力需求侧管理平台、国家电网公司电能服务管理平台的研发建设,为国家电力需求侧管理工作提供了技术支撑。未来,将对为能效管理与需求响应业务在国内的推广实施奠定技术基础。%To guide the optimization of demand side energy utilization management level and to participate the peak load shaving of power grid to overall improve the energy utilization efficiency, both the background and the meaning of constructing the demand side energy efficiency management and demand response system are briefly explained; the functions of the demand side energy efficiency management and demand response system in following aspects such as monitoring user energy consumption data, controlling operating states of user’s key energy utilization system or devices, responding grid-side demand response event are summarized; the hierarchical structure of this system is proposed and the relationship among hierarchies are described; both physical architecture and functional structure of this system are designed in detail and key technologies of this system are analyzed. The design scheme presented in this paper has been applied in the development and construction of national power demand side management platform and electric energy service management platform of China State Power Grid Corp. to provide technical support for national electric power demand side management. In future, the

  13. 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.

  14. Induction of cancer cell stemness by chemotherapy.

    Science.gov (United States)

    Hu, Xingwang; Ghisolfi, Laura; Keates, Andrew C; Zhang, Jian; Xiang, Shuanglin; Lee, Dong-ki; Li, Chiang J

    2012-07-15

    Recent studies indicate that cancer stem cells (CSCs) exist in most hematological and solid tumors. CSCs are characterized by their ability to self-renew and their capacity to differentiate into the multitude of cells that comprise the tumor mass. Moreover, these cells have been shown to be intrinsically resistant to conventional anticancer therapies. Despite their fundamental role in cancer pathogenesis, the cellular origin of CSCs remains highly controversial. The aim of this study was to examine whether heterogeneous cancer cells can acquire stem cell-like properties in response to chemotherapy. We demonstrate that carboplatin can induce the self-renewal (spherogenesis) and pluripotency (Sox2 and Oct3/4 expression) of hepatocellular carcinoma (HCC) cells grown under stem cell culture conditions. Moreover, we show that non-CSC cells, obtained by side population flow cytometric sorting using Hoechst 33342, can acquire stem-like properties after exposure to carboplatin. Finally, we show that knockdown of Sox2 and Oct3/4 gene expression in HCC cells can reduce carboplatin-mediated increases in sphere formation and increase cellular sensitivity to chemotherapy. Taken together, our data indicate that bulk cancer cells may be an important source of CSCs during tumor development, and that targeting Sox2 and/or Oct3/4 may be a promising approach for targeting CSCs in clinical cancer treatment.

  15. 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...... receiving multiple cycles of moderately emetogenic chemotherapy will be reviewed. Consensus statements are given, including optimal dose and schedule of serotonin(3) receptor antagonists, dexamethasone, and neurokinin(1) receptor antagonists. The most significant recommendations (and changes since the 2004...... version of the guidelines) are as follows: the best prophylaxis in patients receiving moderately emetogenic chemotherapy (not including a combination of an anthracycline plus cyclophosphamide) is the combination of palonosetron and dexamethasone on the day of chemotherapy, followed by dexamethasone...

  16. 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)

  17. Etravirine: a good option for concomitant use with chemotherapy for Hodgkin's lymphoma.

    Science.gov (United States)

    Kurz, Mario; Stoeckle, Marcel; Krasniqi, Fatime; Battegay, Manuel; Marzolini, Catia

    2015-03-01

    The treatment of malignancies in HIV patients is challenged by the issue of drug-drug interactions between antiretroviral therapy and antineoplastic agents. While protease inhibitors have been shown to increase the incidence and severity of cancer therapy-related side effects, the impact of other antiretroviral agents on the tolerability and response to chemotherapy is less well documented. We report the successful use of an etravirine-based regimen in a patient treated with BEACOPP chemotherapy for advanced Hodgkin's lymphoma. Etravirine constitutes a valuable option for concomitant use with chemotherapy due to its moderate inducing effect on drug metabolising enzymes.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    OpenAIRE

    Olfa Kassar; Feten Kallel; Manel Ghorbel; Hatem. Bellaaj; Zeineb Mnif; Moez Elloumi

    2015-01-01

    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 patie...

  3. 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.

  4. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2 : proposed applications and treatment protocols

    NARCIS (Netherlands)

    Zecha, J.A.E.M.; Raber-Durlacher, J.E.; Nair, R.G.; Epstein, J.B.; Elad, S.; Hamblin, M.R.; Barasch, A.; Migliorati, C.A.; Milstein, D.M.J.; Genot, M.T.; Lansaat, L.; van der Brink, R.; Arnabat-Dominguez, J.; van der Molen, L.; Jacobi, I.; van Diessen, J.; de Lange, J.; Smeele, L.E.; Schubert, M.M.; Bensadoun, R.J.

    2016-01-01

    Purpose There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together

  5. Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy.

    Science.gov (United States)

    Hashiguchi, Yasunori; Kasai, Mari; Fukuda, Takeshi; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki

    2015-11-01

    Chemotherapy-induced neutropenia is a common complication in cancer treatment. In this study, we investigated chemotherapy-induced neutropenia that was recently detected in all patients with gynecologic malignancy. Between January 2009 and December 2011, we examined cases of chemotherapy-induced neutropenia reported in our hospital. We analyzed the incidence and clinical features of chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. During the study period, we administered over 1614 infusions (29 regimens) to 291 patients. The median age of the patients was 60 years (range 24-84 years). Chemotherapy-induced neutropenia occurred in 147 (50.5%) patients over 378 (23.4%) chemotherapy cycles. Febrile neutropenia occurred in 20 (6.9%) patients over 25 (1.5%) cycles. The mean duration of neutropenia and fever was 3.6 days (range 1-12 days) and 3.4 days (range 1-9 days), respectively. The source of fever was unexplained by examination or cultures in 14 (56.0%) cycles. There were two cases of neutropenia-related death. Chemotherapy-induced neutropenia was associated with older age (over 70 years) (PFebrile neutropenia was associated with poor performance status (Pneutropenia nor febrile neutropenia was associated with bone marrow metastases or previous radiotherapy. By identifying risk factors for febrile neutropenia, such as performance status, no previous chemotherapy, disseminated disease, and distant metastatic disease, the safe management of chemotherapy-induced neutropenia may be possible in patients with gynecologic malignancy.

  6. 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.

  7. Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy.

    Science.gov (United States)

    Ansari, Mansour; Porouhan, Pezhman; Mohammadianpanah, Mohammad; Omidvari, Shapour; Mosalaei, Ahmad; Ahmadloo, Niloofar; Nasrollahi, Hamid; Hamedi, Seyed Hasan

    2016-01-01

    Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the frst 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (±1.31) and 1.46 (±1.28) with no statistically significant difference. After the 2nd chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After 3rd chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (±1.14), versus 1.42 (±1.30)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (±0.96) and in control arm it was 1.40 (±0.92). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (±1.03), 0.68 (±1.00) and 0.77 (±1.18). In control arm, mean vomiting was 0.983 (±1.23), 1.03 (±1.22) and 1.15 (±1.27). In all sessions, ginger decreased vomiting severity from 1.4 (±1.04) to 0.71 (±0.86). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe (0.64±0.87) compared to those who received placebo (1.13±1.12), which was statistically significant (p-value <0.05). Further and larger studies are needed to draw conclusions.

  8. Special forest products: An east-side perspective. Interior Columbia Basin ecosystem management project: Scientific assessment. Forest Service general technical report

    Energy Technology Data Exchange (ETDEWEB)

    Schlosser, W.E.; Blatner, K.

    1997-02-01

    The special forest products industry has gained increasing attention, as timber harvest levels in the Pacific Northwest have declined, and has been heralded, at least by some, as a partial solution to the employment problems common throughout the rural areas of Washington, Oregon, Idaho, and Montana. To date, relatively little work has been published on those portions of the industry located east of the Cascade Range. Yet the east side produced about 48 percent of the total wild edible mushroom harvest (about 1.9 million pounds worth $11.8 million) during 1992. The region also accounts for all of the baby`s breath harvested in the Pacific Northwest and has the potential to produce large quantities of other foral products. It also seems to have the potential to become an important producer of other edibles and medicinal products; however, relatively little is known about this segment of the industry. The following report provides overview of the special forest products industry east of the Cascade Range and evaluates its potential for expansion.

  9. 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

  10. The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study

    NARCIS (Netherlands)

    Groot, S. de; Vreeswijk, M.P.; Welters, M.J.; Gravesteijn, G.; Boei, J.J.; Jochems, A.; Houtsma, D.; Putter, H.; Hoeven, J.J.M. van der; Nortier, J.W.; Pijl, H.; Kroep, J.R.

    2015-01-01

    BACKGROUND: Preclinical evidence shows that short-term fasting (STF) protects healthy cells against side effects of chemotherapy and makes cancer cells more vulnerable to it. This pilot study examines the feasibility of STF and its effects on tolerance of chemotherapy in a homogeneous patient group

  11. 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.

  12. Fertility preservation after chemotherapy for Hodgkin lymphoma

    NARCIS (Netherlands)

    van der Kaaij, Marleen A. E.; van Echten-Arends, Jannie; Simons, Arnold H. M.; Kluin-Nelemans, Hanneke C.

    2010-01-01

    Treatment for Hodgkin lymphoma can negatively affect fertility. This review summarizes data on fertility after chemotherapy in adult patients. Alkylating chemotherapy, especially if containing procarbazine and/or cyclophosphamide, is most harmful to gonadal functioning. Alkylating regimens cause pro

  13. Breast Cancer Chemotherapy and Your Heart

    Science.gov (United States)

    ... American Heart Association Cardiology Patient Page Breast Cancer Chemotherapy and Your Heart Christine Unitt , Kamaneh Montazeri , Sara ... cancer treatments. Breast cancer treatments include the following: Chemotherapy involves drugs that are intended to kill the ...

  14. Neoadjuvant chemotherapy as ovarian cancer treatment

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Ottesen, Bent; Kehlet, Henrik

    2012-01-01

    INTRODUCTION: The traditional first-line treatment for patients with advanced ovarian cancer with primary debulking surgery (PDS) and adjuvant chemotherapy is controversial as some authors report a potential benefit from the alternative treatment with neoadjuvant chemotherapy (NACT) and interval...

  15. Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

    Directory of Open Access Journals (Sweden)

    Jane Williams

    2017-03-01

    Full Text Available Chemotherapy is a commonly integrated treatment option within human and animal oncology regimes. Limited research has investigated pet owners’ treatment decision-making in animals diagnosed with malignant neoplasia. Dog and cat owners were asked to complete an online questionnaire to elucidate factors which are key to the decision making process. Seventy-eight respondents completed the questionnaire in full. Fifty-eight percent of pet owners would not elect to treat pets with chemotherapy due to the negative impact of the associated side effects. Seventytwo percent of respondents over estimated pet survival time post chemotherapy, indicating a general perception that it would lead to remission or a cure. Vomiting was considered an acceptable side effect but inappetence, weight loss and depression were considered unacceptable. Owners did expect animals’ to be less active, sleep more and play less, but common side effects were not rated as acceptable despite the potential benefits of chemotherapy. Based on the results, veterinary teams involved with oncology consultations should establish if clients have prior experience of cancer treatments and their expectations of survival time. Quality of life assessments should also be implemented during initial oncology consultations and conducted regularly during chemotherapy courses to inform client decision making and to safe guard animal welfare.

  16. 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 ...

  17. 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.

  18. 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.)

  19. 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.

  20. [Research progress of nutrition support for patients with lung cancer during chemotherapy].

    Science.gov (United States)

    Luo, Yiqiao; Zhu, Jiang

    2014-12-01

    Primary lung cancer is one of the most common malignancies. Nowadays, both its morbidity and mortality rank first, patients with lung cancer are often goes with some affiliating symptoms such as malnutrition and weight loss. The side effects of cytotoxicity during chemotherapy may lead to further deteriorate of the nutritional status and worsen the anti-tumor therapy's efficacy and the patients' quality of life. With the development of palliative treatment and the higher request of patients 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.

  1. Changes in the gastric potential difference during chemotherapy in patients with metastatic breast cancer

    DEFF Research Database (Denmark)

    Fabrin, B; Højgaard, L; Mouridsen, H T

    1991-01-01

    Nausea and vomiting are frequent side-effects of intravenous cancer chemotherapy. How these complications were related to the gastric mucosal function was investigated by measuring the gastric mucosal potential difference (PD). Eight patients with metastatic breast cancer receiving chemotherapy...... were investigated. The liquid junction-corrected gastric PD and pH were measured with a newly developed microelectrode. The measurements started half an hour before chemotherapy and continued for 4-5 hours. Nausea, vomiting, psychological stress and sleeping episodes were registered. The initial PD...... values were -34 mV +/- 8 mV (mean +/- SD). During the observation period 6 of 8 patients had one or more episodes of nausea and vomiting. All episodes were preceded by a significant decline in PD. The magnitude of the decline in PD was unrelated to the time-lag between administration of chemotherapy...

  2. 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.

  3. Congenital sacrococcygeal PNET and chemotherapy

    Directory of Open Access Journals (Sweden)

    Colin Patrick Hawkes

    2012-01-01

    Full Text Available We present the case of a congenital localised sacrococcygeal primitive neuroectodermal tumor treated aggressively with surgical resection and modified age-appropriate adjuvant chemotherapy. The conventional combination chemotherapy of vincristine, adriamycin, cyclophosphamide, ifosfamide and etoposide was modified to a regimen including vincristine, adriamicin, cyclophosphamide and actinomycin in order to minimise the predicted toxicity in this age group. Adjuvant "induction" chemotherapy commenced at 4 weeks of age and consisted of four cycles of vincristine, adriamycin and cyclophosphamide at 50%, 75%, 75% and 100% of recommended doses (vincristine 0.05 mg/kg, adriamycin 0.83 mg/kg daily × 2, cyclophosphamide 40 mg/kg at 3-weekly intervals. This was followed by four cycles of "maintenance" chemotherapy with vincristine (0.025 mg/kg, actinomycin (0.025 mg/kg and cyclophosphamide (36 mg/kg at full recommended doses. Cardioxane at a dose of 16.6 mg/kg was infused immediately prior to the adriamycin. Our patient is thriving at 19 months out from end of treatment.

  4. Chemotherapy of Human African Trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Cyrus J. Bacchi

    2009-01-01

    Full Text Available Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  5. Chemotherapy of human african trypanosomiasis.

    Science.gov (United States)

    Bacchi, Cyrus J

    2009-01-01

    Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  6. 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...... boundaries and came to define what it meant to “work” the “dark side.”...

  7. Arterial occlusion precipitated by cisplatinbased chemotherapy

    OpenAIRE

    2010-01-01

    Cisplatin-based therapy is curative in testicular cancer. Adverse effects of cisplatin-based chemotherapy include dose-dependent myelosuppression, nephrotoxicity, neurotoxicity, and ototoxicity. By contrast, chemotherapy-associated vascular complications are unpredictable. Few incidents of digital gangrene with cisplatin have been reported. Here, we present a patient who developed arterial occlusion leading to gangrene of the toe after cisplatinbased chemotherapy.

  8. Successful adjuvant bi-weekly gemcitabine chemotherapy for pancreatic cancer without impairing patients’ quality of life

    Directory of Open Access Journals (Sweden)

    Toyama Yoichi

    2013-01-01

    Full Text Available Abstract Background Although adjuvant gemcitabine (GEM chemotherapy for pancreatic cancer is standard, the quality of life (QOL in those patients is still impaired by the standard regimen of GEM. Therefore, we studied whether mild dose-intensity adjuvant chemotherapy with bi-weekly GEM administration could provide a survival benefit with acceptable QOL to the patients with pancreatic cancer. Methods After a phase I trial, an adjuvant bi-weekly 1,000 mg/m2 of GEM chemotherapy was performed in 58 patients with pancreatic cancer for at least 12 courses (Group A. In contrast, 36 patients who declined the adjuvant bi-weekly GEM chemotherapy underwent traditional adjuvant 5FU-based chemotherapy (Group B. Careful periodical follow-ups for side effects of GEM and disease recurrence, and assessment of patients’ QOL using the EORTC QOL questionnaire (QLQ-C30 and pancreatic cancer-specific supplemental module (QLQ-PAN26 were performed. Retrospectively, the degree of side effects, patients’ QOL, compliance rate, disease-free survival (DFS, and overall survival (OS in Group A were compared with those in Group B. Results No severe side effects (higher than Grade 2 according to the common toxicity criteria of ECOG were observed, except for patients in Group B, who were switched to the standard GEM chemotherapy. Patients’ QOL was better in Group A than B (fatigue: 48.9 ± 32.1 versus 68.1 ± 36.3, nausea and vomiting: 26.8 ± 20.4 versus 53.7 ± 32.6, diarrhea: 21.0 ± 22.6 versus 53.9 ± 38.5, difficulty gaining weight: 49.5 ± 34.4 versus 67.7 ± 40.5, P P P Conclusions Adjuvant chemotherapy with bi-weekly GEM offered not only the advantage of survival benefits but the excellent compliance with acceptable QOL for postoperative pancreatic cancer patients.

  9. 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.

  10. Partial splenic embolization to permit continuation of systemic chemotherapy.

    Science.gov (United States)

    Luz, Jose Hugo M; Luz, Paula M; Marchiori, Edson; Rodrigues, Leonardo A; Gouveia, Hugo R; Martin, Henrique S; Faria, Igor M; Souza, Roberto R; Gil, Roberto de Almeida; Palladino, Alexandre de M; Pimenta, Karina B; de Souza, Henrique S

    2016-10-01

    Systemic chemotherapy treatments, commonly those that comprise oxaliplatin, have been linked to the appearance of distinctive liver lesions that evolves to portal hypertension, spleen enlargement, platelets sequestration, and thrombocytopenia. This outcome can interrupt treatment or force dosage reduction, decreasing efficiency of cancer therapy. We conducted a prospective phase II study for the evaluation of partial splenic embolization in patients with thrombocytopenia that impeded systemic chemotherapy continuation. From August 2014 through July 2015, 33 patients underwent partial splenic embolization to increase platelets count and allow their return to treatment. Primary endpoint was the accomplishment of a thrombocyte level superior to 130 × 10(9) /L and the secondary endpoints were the return to chemotherapy and toxicity. Partial splenic embolization was done 36 times in 33 patients. All patients presented gastrointestinal cancer and colorectal malignancy was the commonest primary site. An average of 6.4 cycles of chemotherapy was done before splenic embolization and the most common regimen was Folfox. Mean platelet count prior to embolization was 69 × 10(9) /L. A total of 94% of patients achieved primary endpoint. All patients in need reinitiated treatment and median time to chemotherapy return was 14 days. No grade 3 or above adverse events were identified. Aiming for a 50% to 70% infarction area may be sufficient to achieve success without the complications associated with more extensive infarction. Combined with the better safety profile, partial splenic embolization is an excellent option in the management of thrombocytopenia, enabling the resumption of systemic chemotherapy with minimal procedure-related morbidity.

  11. Chemotherapy e-prescribing: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Elsaid KA

    2015-05-01

    Full Text Available Khaled A Elsaid,1,2 Steven Garguilo,1 Christine M Collins2 1Department of Pharmaceutical Sciences, School of Pharmacy, MCPHS University, Boston, MA, 2Pharmacy Services, Rhode Island Hospital, Providence, RI, USA Abstract: Chemotherapy drugs are characterized by low therapeutic indices and significant toxicities at clinically prescribed doses, raising serious issues of drug safety. The safety of the chemotherapy medication use process is further challenged by regimen complexity and need to tailor treatment to patient status. Errors that occur during chemotherapy prescribing are associated with serious and life-threatening outcomes. Computerized provider order entry (CPOE systems were shown to reduce overall medication errors in ambulatory and inpatient settings. The adoption of chemotherapy CPOE is lagging due to financial cost and cultural and technological challenges. Institutions that adopted infusional or oral chemotherapy electronic prescribing modified existing CPOE systems to allow chemotherapy prescribing, implemented chemotherapy-specific CPOE systems, or developed home-grown chemotherapy electronic prescribing programs. Implementation of chemotherapy electronic prescribing was associated with a significant reduction in the risk of prescribing errors, most significantly dose calculation and adjustment errors. In certain cases, implementation of chemotherapy CPOE was shown to improve the chemotherapy use process. The implementation of chemotherapy CPOE may increase the risk of new types of errors, especially if processes are not redesigned and adapted to CPOE. Organizations aiming to implement chemotherapy CPOE should pursue a multidisciplinary approach engaging all stakeholders to guide system selection and implementation. Following implementation, organizations should develop and use a risk assessment process to identify and evaluate unanticipated consequences and CPOE-generated errors. The results of these analyses should serve to

  12. Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management

    OpenAIRE

    SMITH, J. JOSHUA; Chow, Oliver S; Gollub, Marc J.; Nash, Garrett M.; Temple, Larissa K.; Weiser, Martin R.; Guillem, José G.; Paty, Philip B.; Avila, Karin; Garcia-Aguilar, Julio; ,

    2015-01-01

    Background Treatment of patients with non-metastatic, locally advanced rectal cancer (LARC) includes pre-operative chemoradiation, total mesorectal excision (TME) and post-operative adjuvant chemotherapy. This trimodality treatment provides local tumor control in most patients; but almost one-third ultimately die from distant metastasis. Most survivors experience significant impairment in quality of life (QoL), due primarily to removal of the rectum. A current challenge lies in identifying pa...

  13. [Psychoanalysis and Side Effect].

    Science.gov (United States)

    Shirahase, Joichiro

    2015-01-01

    A study of psychoanalysis from the perspective of side effects reveals that its history was a succession of measures to deal with its own side effects. This, however, does not merely suggest that, as a treatment method, psychoanalysis is incomplete and weak: rather, its history is a record of the growth and development of psychoanalysis that discovered therapeutic significance from phenomena that were initially regarded as side effects, made use of these discoveries, and elaborated them as a treatment method. The approach of research seen during the course of these developments is linked to the basic therapeutic approach of psychoanalysis. A therapist therefore does not draw conclusions about a patient's words and behaviors from a single aspect, but continues to make efforts to actively discover a variety of meanings and values from them, and to make the patient's life richer and more productive. This therapeutic approach is undoubtedly one of the unique aspects of psychoanalysis. I discuss the issue of psychoanalysis and side effects with the aim of clarifying this unique characteristic of psychoanalysis. The phenomenon called resistance inevitably emerges during the process of psychoanalytic treatment. Resistance can not only obstruct the progress of therapy; it also carries the risk of causing a variety of disadvantages to the patient. It can therefore be seen as an adverse effect. However, if we re-examine this phenomenon from the perspective of transference, we find that resistance is in fact a crucial tool in psychoanalysis, and included in its main effect, rather than a side effect. From the perspective of minimizing the character of resistance as a side effect and maximizing its character as a main effect, I have reviewed logical organization, dynamic evaluation, the structuring of treatment, the therapist's attitudes, and the training of therapists. I conclude by stating that psychoanalysis has aspects that do not match the perspective known as a side

  14. Prevention of chemotherapy-induced peripheral neuropathy by the small-molecule inhibitor pifithrin-mu

    NARCIS (Netherlands)

    Krukowski, Karen; Nijboer, Cora H.; Huo, XiaoJiao; Kavelaars, Annemieke; Heijnen, Gobi J.

    2015-01-01

    Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment. It is the most frequent cause of dose reduction or treatment discontinuation in patients treated for cancer with commonly used drugs including taxanes and platinum-based compounds. No FDA-approved treatmen

  15. Synthesis of prodrugs of anthracyclines and evaluation of their use in selective chemotherapy

    NARCIS (Netherlands)

    Leenders, R.G.G.

    1998-01-01

    This thesis is devoted to the synthesis and biological evaluation of prodrugs of anthracycline anti-tumor antibiotics designed for use in selective chemotherapy. The severe side effects caused by conventional cancer chemotherapeutic agents arises from the lack of distinction between tumor and normal

  16. 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,

  17. Modulation of Circulating Angiogenic Factors and Tumor Biology by Aerobic Training in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

    OpenAIRE

    Jones, Lee W.; Fels, Diane R.; West, Miranda; Allen, Jason D.; Broadwater, Gloria; Barry, William T; Wilke, Lee G.; Masko, Elisabeth; Douglas, Pamela S.; Dash, Rajesh C.; Povsic, Thomas J.; Peppercorn, Jeffrey; Marcom, P. Kelly; Kimberly L Blackwell; Kimmick, Gretchen

    2013-01-01

    Aerobic exercise training (AET) is an effective adjunct therapy to attenuate the adverse side-effects of adjuvant chemotherapy in women with early breast cancer. Whether AET interacts with the antitumor efficacy of chemotherapy has received scant attention. We carried out a pilot study to explore the effects of AET in combination with neoadjuvant doxorubicin–cyclophosphamide (AC+AET), relative to AC alone, on: (i) host physiology [exercise capacity (VO2 peak), brachial artery flow-mediated di...

  18. Clinical roundtable monograph. Treatment of chemotherapy-induced nausea and vomiting: a post-MASCC 2010 discussion.

    Science.gov (United States)

    Kris, Mark G; Urba, Susan G; Schwartzberg, Lee S

    2011-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and troubling side effects of treatment, and the side effect cancer patients tend to fear most. An improved understanding of the pathophysiology underlying CINV, together with a clear definition of the risk for nausea and vomiting associated with specific chemotherapeutic agents, has for allowed the development of specific and effective antiemetic regimens. Anti­emesis is most effective when used prophylactically, a principle shared among CINV management guidelines. Several antiemetic drug classes are available; among the most effective of these are serotonin (5HT₃) receptor antagonists, neurokinin 1 (NK₁) receptor antagonists, and steroids (primarily dexamethasone), although others are commonly used as well. When choosing an appropriate antiemetic regimen, clinicians should consider patient-specific factors such as sex and prior history of CINV, as well as treatment-specific factors such as the emetogenic potential of each chemotherapeutic agent. Using these factors, clinicians can follow the available algorithms included in guidelines from groups such as the National Comprehensive Cancer Network, the American Society of Clinical Oncology, and the Multinational Association for Supportive Care in Cancer. Ongoing and future clinical trials will be pivotal in helping to further delineate the optimal strategies to prevent and manage CINV in cancer patients.

  19. Induction Chemotherapy in Locally Advanced Pharyngolaryngeal Cancers with Stridor: Is It Feasible and Safe?

    Directory of Open Access Journals (Sweden)

    Vijay Maruti Patil

    2012-01-01

    Full Text Available Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.

  20. Working the Dark Side

    DEFF Research Database (Denmark)

    Bjering, Jens Christian Borrebye

    half—dark side—documents the making and nature of the dark side by analyzing a series of legal memos from the Department of Justice's Office of Legal Council and from the White House and concludes by relating its findings to traditional ideas about emergency action, national security, and torture....... By analyzing official reports and testimonies from soldiers partaking in the War On Terror, the dissertation's second part—dark arts—focuses on the transformation of the dark side into a productive space in which “information” and the hunt for said information overshadowed all legal, ethical, or political...

  1. 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.

  2. Symptoms in Children After Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sevcan Atay Turan

    2016-08-01

    Full Text Available Introduction: Identification of symptoms resulted from chemotherapy in children. Materials and Methods: In this study 46 children and adolescents who had chemotherapy in a pediatric oncology clinic of an oncology hospital were included. Sociodemographic questionnaire and Memorial Symptom Assessment Scale (10-18 years were used as data collection tool. Results: In this survey the mean age of children with cancer was 13.47±2.14 years and the majority of them (41.3% were monitored with non-Hodgkin’s lymphoma diagnosis. The most common symptoms in children who had chemotherapy in hospital were fatigue (76.1%, feeling nervous (69.6%, alopecia (65.2%, nausea (60.9% and feeling sad (60.9%, while the least common symptoms were swelling in the arms/legs (8.7% and problems in urination (6.5%. The most troublesome symptoms were dizziness (66.6%, difficulty in swallowing (64.3%, pain (47.8% and hair loss (43.4%. Conclusions: It was seen that the children still experience high prevalence of post-treatment symptoms, they had more intense psychological symptoms and physical symptoms caused more discomfort.

  3. Combination therapy for scalp angiosarcoma using bevacizumab and chemotherapy: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Ping Yang; Qi Zhu; Fuqiang Jiang

    2013-01-01

    Bevacizumab,an angiogenesis inhibitor,is a recombined humanized monoclonal antibody against vascular endothelial growth factor and a promising therapeutic option for angiosarcoma management.This is a case report and review of the literature using bevacizumab and combination chemotherapy for angiosarcoma.The understanding of the effectiveness of combined therapy of bevacizumab and chemotherapy agents is still limited.The benefits of bevacizumab treatment for angiosarcoma will need to be weighed against the risks of venous thromboembolism in this population.

  4. 遗传算法的阶梯电价用电需求管理方案%Demand side management strategy on multistep electricity price using Genetic Algo-rithm

    Institute of Scientific and Technical Information of China (English)

    杨曦华; 胡晓敏

    2014-01-01

    用电需求管理是智能电网中的重要部分,能让消费者根据自己的用电量做出合适的决策,帮助供电者减少峰值负载,让负载的时空分布更为均衡,从而增加智能电网的可持续性,并减少运营成本和碳排放量。一种基于负载转移技术的用电需求管理方案可以满足对大量、多种设备的调节需求。用电需求管理的解决方案使用改进的遗传算法,并引入了一个新的算子,模拟测试的结果显示通过改进的算法获得的方案节省了可观的成本,并且在使用阶梯式电价的情况下,减少了智能电网的峰值负载。%Demand side management plays an important role in smart grid business, which allows consumers to choose a suitable electricity consuming strategy according to their demand, lowers the peak load in smart grid, and makes the load curve even. These characteristics lead to a more sustainable, economical smart grid, and a reduction on carbon emission. A demand side management strategy based on a load-shifting technique is proposed, which will be able to manage the demand that comes from large quantities and types of devices. The strategy is carried out with an improved genetic algorithm which imports a new operator. Simulation shows that the resulting strategy generated by the proposed algorithm saves appreciable cost, and reduces the peak load of the smart grid when involving a multistep electricity price.

  5. 护理风险管理能有效提高糖尿病合并恶性肿瘤患者的化疗疗效%Risk management of nursing improves chemotherapy efficiency for diabetic patients with malignant tumor

    Institute of Scientific and Technical Information of China (English)

    徐灵莉; 邓本敏; 唐玲; 刘玲; 李真华

    2013-01-01

    Objective To evaluate the impact of risk management of nursing on the clinical therapeutic efficiency and nursing quality in patients undergoing chemotherapy with malignant tumor and diabetes mellitus (DM). Methods Eighty-seven diabetic patients with malignant tumor hospitalized in our institute from February 2010 to January 2011 were enrolled as control group, and received routine nursing risk management, including education of diabetes knowledge and treatment. One hundred and nine patients with DM and malignant tumor recruited from February 2011 to February 2012 were test group, and received the risk management of nursing, with PDCA ( Plan Do Check Action) cycling risk management, including individualized risk control, risk prevention program of chemotherapy, and nursing risk management during chemotherapy. The incidences of acute complications of diabetes or extravasation of chemotherapeutic drugs and patients satisfaction were recorded and analyzed. Results The incidence of acute complications of diabetes or ( 1. 83% vs 9. 19% ) , hypertonic ketoacidosis (0.91% vs 6. 89% ), non-ketoic acidosis (0. 91% vs 5. 74% ) of extravasation of chemotherapeutic drugs (0 vs 3. 45%) were significantly decreased, and patients satisfaction (98. 16% vs 91. 96% ) was increased after implementation of nursing risk management. Conclusion Nursing risk management can implement the efficiency in patients undergoing chemotherapy with malignant tumor and DM.%目的 在糖尿病合并恶性肿瘤化疗患者中,评价护理风险管理干预对临床治疗效果及护理质量的影响.方法 筛选2010年2月至2011年1月收治糖尿病合并恶性肿瘤化疗患者87例(对照组);2011年2月至2012年2月收治糖尿病合并恶性肿瘤化疗患者109例,实施护理风险管理(观察组).对照组按常规实施方法进行护理风险管理,主要包括:糖尿病知识宣教及对症处理;观察组采用PDCA(计划Plan,执行Do、检查Check、处理Action)循环式风险

  6. 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

  7. Colorectal cancers choosing sides

    NARCIS (Netherlands)

    Albuquerque, Cristina; Bakker, Elvira R. M.; van Veelen, Wendy; Smits, Ron

    2011-01-01

    In contrast to the majority of sporadic colorectal cancer which predominantly occur in the distal colon, most mismatch repair deficient tumours arise at the proximal side. At present, these regional preferences have not been explained properly. Recently, we have screened colorectal tumours for mutat

  8. Dysregulation of cytokine mediated chemotherapy induced cognitive impairment.

    Science.gov (United States)

    Ren, Xiaojia; St Clair, Daret K; Butterfield, D Allan

    2017-03-01

    One of the major complaints patients who survive cancer often make is chemotherapy induced cognitive impairment (CICI), which survivors often call "chemo brain." CICI is a side effect of chemotherapy due to the cytotoxicity and neurotoxicity of anti-cancer drugs causing structural and functional changes in brain, even when drugs that do not cross the blood brain barrier (BBB) are used. Diminished cognitive functions including diminution of learning and memory, concentration and attention, processing speed and executive functions that reduce quality of life and ability to work are common signs and symptoms of CICI. There still is not a clarified and complete mechanism for CICI, but researchers have pointed to several biochemical candidates. Chemotherapy-induced, cytokine-mediated involvement in CICI will be mainly discussed in this review paper with emphasis on different types of cytokines, correlated with BBB and epigenetic changes. Mechanisms of ROS-generating, anti-cancer drugs and their relation to cytokine-mediated CICI will be emphasized.

  9. Optimal Intermittent Dose Schedules for Chemotherapy Using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Nadia ALAM

    2013-08-01

    Full Text Available In this paper, a design method for optimal cancer chemotherapy schedules via genetic algorithm (GA is presented. The design targets the key objective of chemotherapy to minimize the size of cancer tumor after a predefined time with keeping toxic side effects in limit. This is a difficult target to achieve using conventional clinical methods due to poor therapeutic indices of existing anti-cancer drugs. Moreover, there are clinical limitations in treatment administration to maintain continuous treatment. Besides, carefully decided rest periods are recommended to for patient’s comfort. Three intermittent drug scheduling schemes are presented in this paper where GA is used to optimize the dose quantities and timings by satisfying several treatment constraints. All three schemes are found to be effective in total elimination of cancer tumor after an agreed treatment length. The number of cancer cells is found zero at the end of the treatment for all three cases with tolerable toxicity. Finally, two of the schemes, “Fixed interval variable dose (FIVD and “Periodic dose” that are periodic in characteristic have been emphasized due to their additional simplicity in administration along with friendliness to patients. responses to the designed treatment schedules. Therefore the proposed design method is capable of planning effective, simple, patient friendly and acceptable chemotherapy schedules.

  10. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy 
in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer

    Directory of Open Access Journals (Sweden)

    Pengfei LUO

    2011-07-01

    Full Text Available Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg, when patients’ general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times. Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 oC-41.5 oC for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m2 and vinorelbine (50 mg/m2. Results The complete remission rate (CR of malignant pericardial effusion was 54.3% and the response rate (RR was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05. After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05. The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosup-pression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia

  11. Influence of Orem support-education system on breast cancer patients′ self-management during chemotherapy%Orem支持教育系统对化疗期乳腺癌患者自我管理效能感的影响

    Institute of Scientific and Technical Information of China (English)

    赵勇; 孙惠杰; 王海燕; 尚丽华

    2015-01-01

    目的:探讨Orem支持教育系统对化疗期乳腺癌患者自我管理效能感的影响。方法将75例乳腺癌术后化疗患者,采用随机数字表法随机分为观察组39例和对照组36例。对照组给予常规护理,观察组根据自我管理能力和自我需求,运用Orem支持教育系统给予人性化心理支持和情感支持。干预前后应用中文版自我管理效能感量表( C-SUPPH )评估两组患者自我管理效能感的水平。结果干预前,75例化疗期乳腺癌患者中12%的患者自我管理效能感水平处于高等水平,82.7%的患者处于中等水平。干预后观察组自我管理效能感水平总分为(103.4±18.9)分,对照组为(50.94±8.31)分,两组比较差异有统计学意义(t=-15.74,P<0.01)。结论 Orem支持教育系统能提高化疗期乳腺癌患者自我管理能力和应对能力。%Objective To explore the Orem support-education system′s influence on the breast cancer patients′self-management during chemotherapy. Methods A total of 75 cases of patients with breast cancer receiving postoperative chemotherapy were divided into observation group with 39 cases and control group with 36 cases, according to random alphabet. The Chinese Strategies Used by People to Promote Health ( C-SUPPH) was used to assess the patients′ level of self-management sense. The control group was given routine care, and according to self-management and self-requirement, the observation group was supported with Orem support-education system which could offer humanistic psychological and emotional support. Results The self-management sense level assessment of breast cancer patients during chemotherapy showed that 12% of the 75 patients were in high level and 82. 7% patients were in the medium level. After the intervention, the patients′ total score of self-management sense level was ( 103. 4 ± 18. 9 ) in the observation group, which was significantly higher than (50.94±8.31) in the control group (t= -15.74,P

  12. 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.

  13. 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

  14. [Neoadjuvant chemotherapy of invasive cancer of the urinary bladder].

    Science.gov (United States)

    Selivanov, S P; Isaeva, S N; Kovalik, T A; Chén', M N; Aleksandrovich, I N; Kaliev, E A

    2007-01-01

    We studied efficacy of a combination of intraosseous and systemic administration of drugs in patients with invasive cancer of the urinary bladder (UB). A total of 20 patients aged 54-79 years with verified had recurrence, 2 had tumors with continuous growth. T2N0M0 UB carcinoma was diagnosed in 7 patients, T3N0M0--in 12, T6N0M0--in 1 patient. All the patients received systemic chemotherapy with gemzar in a single daily dose 800-1000 mg/m2 on day 1, 7 and 14. On day 2 a single intraosseous 100 mg eloxatin was given. A total of three courses of combined chemotherapy with 4-week interval was used. Intravenous gemzar administration was accompanied with mild leukopenia in 4 patients, moderate leukopenia--in 1, allergic reaction--in 2 patients. This required gemzar discontinuation. No side effects were seen in response to intraosseous administration of eloxatin. The combined chemotherapy produced complete regression of UB cancer in 3 of 18 patients, partial regression--in 12, stabilization--in 3 patients. Neither local nor long-term tumor progression was found. Short-term therapeutic efficacy of combined therapy was 70%. Fifteen patients with partial regression or stabilization have undergone transurethral resection. Duration of a recurrence-free period reached 5 to 72 months (mean 17 months). The neoadjuvant chemotherapy proposed by us allows achievement of a high percentage of regression in patients with invasive UB cancer located in UB cervix and provides concervative surgery including patients over 70 years of age.

  15. The Application of Self Management Program of Chronic Disease in Patients With Gynecological Malignant Tumor PICC Chemotherapy%妇科恶性肿瘤PICC化疗患者中慢性病自我管理项目的应用

    Institute of Scientific and Technical Information of China (English)

    熊彩云

    2016-01-01

    目的分析妇科恶性肿瘤PICC化疗患者实施慢性病自我管理项目的效果。方法本次200例恶性肿瘤PICC化疗患者从我院妇科2013年1月~2015年12月抽选,按照患者的入院编号分成不同组:对照组行基础化的护理措施,研究组实施慢性病自我管理项目,评定预后效果。结果研究组的护理满意率为98.0%,高于对照组的82.0%,P<0.05,差异有统计学意义;研究组的自我效能、自我监测、治疗依从性、健康状态等评分高于对照组,P<0.05,差异有统计学意义。结论临床针对妇科恶性肿瘤PICC化疗患者实施慢性病自我管理项目作用显著,可提高自我管理能力、治疗依从性,预防并发症。%Objective To analyze the effect of PICC chemotherapy on patients with gynecological malignant tumor.Methods 200 cases of chemotherapy in patients with malignant PICC, from January 2013 to December 2015 in our hospital, according to the patient's admission number, which were divided into different groups, the control group foundation of care measures, the implementation of the study group of patients of chronic diseases self-management program, assess prognosis.Results The study group care satisfaction rate 98.0%, 82.0% higher than the control group,P<0.05, was difference had statistically significance, self-efficacy study groups, self-monitoring, treatment compliance, health status score was higher than the control group,P<0.05, was difference had statistically signiifcance.Conclusion The clinical treatment of gynecological malignant tumor PICC chemotherapy patients with chronic disease self management project effect signiifcantly, can improve self-management ability, treatment compliance, prevention of complications.

  16. 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.

  17. Pharmacogenomics in lung cancer chemotherapy: a review of what the oncologist should know.

    Science.gov (United States)

    D'Antonio, Chiara; Milano, Annalisa; Righini, Riccardo; Onesti, Concetta Elisa; Bassanelli, Maria; Falcone, Rosa; Paris, Ida; Lauro, Salvatore; Marchetti, Paolo

    2014-10-01

    Lung cancer is the leading cause of cancer-related death around the world; the addition of chemotherapy to treatment of this disease has been shown to significantly increase progression-free survival and overall survival. Despite newer chemotherapies, it is important to personalize the care (treatment and dose) upon each single patient's susceptibility for controlling and reducing adverse side-effects, at best. The present review describes the current status of pharmacogenomics studies regarding germline DNA variants that may alter response and tolerability to chemotherapeutic agents used to treat lung cancer, including perspective studies.

  18. Effects of Combined Chinese Drugs and Chemotherapy in Treating Advanced Non-small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    陈衍智; 李占东; 高非; 张莹; 孙红; 李萍萍

    2009-01-01

    Objective:To evaluate the efficacy and side effects of combined Chinese drugs and chemotherapy in treating advanced non-small cell lung cancer(NSCLC).Methods:Sixty-three patients with stageⅢB andⅣNSCLC hospitalized from October 2001 to October 2008 were enrolled and assigned to two groups using a randomizing digital table,with 33 patients in the treatment group and 30 in the control group. They were all treated with the Navelbine and Cisplatin(NP) chemotherapy,but to the treatment group the Chinese drugs...

  19. 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...

  20. How Do I Manage Side Effects?

    Science.gov (United States)

    ... occurred while processing XML file."); } }); $.ajax({ type: "GET", url: "http://www.lung.org/related-content.xml?related_ ... eventdate = ''; } var title = $(this).find('title').text(); var url = $(this).find('link').text(); var html = ' Event: ' + title + ...

  1. Demand side management for smart district heating

    DEFF Research Database (Denmark)

    Big, Oovidiu; Li, Hongwei; Svendsen, Svend

    2015-01-01

    constant. The results show that by the extensive renovation the energy consumption and the peak load could be reduced with more than 55% for two heating systems: radiant floor heating and radiators convective heating. Light renovation case has the peak load and energy consumption decreased with values...... between 25% and 35%. By making the light renovation, the heating system needs a minimum supply water temperature of 58ºC in order to cover the thermal comfort. Through extensive renovation, the supply water temperature could be reduced to 50ºC which makes it possible to transform the District Heating...

  2. 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.

  3. The European Medicines Agency Review of Abiraterone for the Treatment of Metastatic Castration-Resistant Prostate Cancer in Adult Men After Docetaxel Chemotherapy and in Chemotherapy-Naïve Disease: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use

    Science.gov (United States)

    Lopez, Arantxa Sancho; Hemmings, Robert James; Jiménez, Jorge Camarero; Garcia-Carbonero, Rocio; Gallego, Isabel García; Giménez, Elena Valencia; O'Connor, Daniel; Giuliani, Rosa; Salmonson, Tomas; Pignatti, Francesco

    2013-01-01

    On September 5, 2011, abiraterone was approved in the European Union in combination with prednisone or prednisolone for the treatment of metastatic castration-resistant prostate cancer (CRPC) in adult men whose disease has progressed on or after a docetaxel-based chemotherapy regimen. On December 18, 2012, the therapeutic indication was extended to include the use of abiraterone in combination with prednisone or prednisolone for the treatment of metastatic CRPC in adult men who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated. Abiraterone is a selective, irreversible inhibitor of cytochrome P450 17α, an enzyme that is key in the production of androgens. Inhibition of androgen biosynthesis deprives prostate cancer cells from important signals for growth, even in cases of resistance to castration. At the time of European Union approval and in a phase III trial in CRPC patients who had failed at least one docetaxel-based chemotherapy regimen, median overall survival for patients treated with abiraterone was 14.8 months versus 10.9 months for those receiving placebo (hazard ratio, 0.65; 95% confidence interval 0.54–0.77; p < .0001). In a subsequent phase III trial in a similar but chemotherapy-naïve patient population, median radiographic progression-free survival was 16.5 months for patients in the abiraterone treatment arm versus 8.3 months for patients in the placebo arm (hazard ratio, 0.53; 95% confidence interval, 0.45–0.62; p < .0001). Abiraterone was most commonly associated with adverse reactions resulting from increased or excessive mineralocorticoid activity. These were generally manageable with basic medical interventions. The most common side effects (affecting more than 10% of patients) were urinary tract infection, hypokalemia, hypertension, and peripheral edema. PMID:23966222

  4. Interventional Analgesic Management of Lung Cancer Pain

    Science.gov (United States)

    Hochberg, Uri; Elgueta, Maria Francisca; Perez, Jordi

    2017-01-01

    Lung cancer is one of the four most prevalent cancers worldwide. Comprehensive patient care includes not only adherence to clinical guidelines to control and when possible cure the disease but also appropriate symptom control. Pain is one of the most prevalent symptoms in patients diagnosed with lung cancer; it can arise from local invasion of chest structures or metastatic disease invading bones, nerves, or other anatomical structures potentially painful. Pain can also be a consequence of therapeutic approaches like surgery, chemotherapy, or radiotherapy. Conventional medical management of cancer pain includes prescription of opioids and coadjuvants at doses sufficient to control the symptoms without causing severe drug effects. When an adequate pharmacological medical management fails to provide satisfactory analgesia or when it causes limiting side effects, interventional cancer pain techniques may be considered. Interventional pain management is devoted to the use of invasive techniques such as joint injections, nerve blocks and/or neurolysis, neuromodulation, and cement augmentation techniques to provide diagnosis and treatment of pain syndromes resistant to conventional medical management. Advantages of interventional approaches include better analgesic outcomes without experiencing drug-related side effects and potential for opioid reduction thus avoiding central side effects. This review will describe various pain syndromes frequently described in lung cancer patients and those interventional techniques potentially indicated for those cases. PMID:28261561

  5. 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.

  6. Immunological aspects of cancer chemotherapy.

    Science.gov (United States)

    Zitvogel, Laurence; Apetoh, Lionel; Ghiringhelli, François; Kroemer, Guido

    2008-01-01

    Accumulating evidence indicates that the innate and adaptive immune systems make a crucial contribution to the antitumour effects of conventional chemotherapy-based and radiotherapy-based cancer treatments. Moreover, the molecular and cellular bases of the immunogenicity of cell death that is induced by cytotoxic agents are being progressively unravelled, challenging the guidelines that currently govern the development of anticancer drugs. Here, we review the immunological aspects of conventional cancer treatments and propose that future successes in the fight against cancer will rely on the development and clinical application of combined chemo- and immunotherapies.

  7. Chemotherapy

    Science.gov (United States)

    ... tumor cells. Mitotic inhibitors—These agents are usually plant-based, natural substances that interfere with the production ... drugs Infertility Seizures Weakness Balance or coordination problems Memory or cognitive problems Brain swelling Damage to internal ...

  8. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects.

    Science.gov (United States)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthoj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

    2013-02-01

    Abstract These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful. They are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F) and five levels of recommendation (1-5) ( Bandelow et al. 2008a ,b, World J Biol Psychiatry 9:242, see Table 1 ). This second part of the updated guidelines covers long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of adults suffering from schizophrenia.

  9. Clinical evaluation on cardiac enlargement in patients with esophageal cancer treated by radiotherapy with or without chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine

    2002-09-01

    Recent literature on chemoradiotherapy for esophageal cancer report the comparable survival results as surgery, and suggest the importance of management for the late adverse effect of chemoradiotherapy. The aim of this study is to investigate the incidence and risk factors of cardiomegaly after chemoradiotherapy using low dose continuous infusion of 5FU/CDDP+5FU for esophageal cancer. Fifty-one patients with stage I-IVA esophageal cancer who were treated by radiotherapy with more than 50 Gy with or without chemotherapy and followed up for more than 6 months were analyzed. Sixteen patients were treated by radiation alone and 35 patients were treated by chemoradiotherapy. A change of CTR (cardio-thoracic ratio) was defined as the difference between CTR in the pre-treatment X-ray film and CTR in the post-treatment X-ray film with maximum cardiac silhouette. A change of CTR by more than 10% was defined as ''significant cardiomegaly''. In this study cardiac area-dose'', which is the sum of the products of cardiac area within every radiation field and its target dose, was calculated in each patient as a radiation parameter. Significant cardiomegaly was noted in 1 patient (6%) in the radiation alone group, in 8 patients (23%) in the chemoradiotherapy group and in 9 patients (18%) in the total population. In cases with more than 0.4 m{sup 2}{center_dot}Gy in cardiac area-dose, CTR elevation was significantly higher than in cases with less than 0.4m{sup 2}{center_dot}Gy. More than moderate pleural effusion was noted in 5 patients (10%). Chronic pericardial effusion and subsequent cardiac tamponade was considered to be one of the contributing factors for pleural effusion, because increases of pleural effusion coincided with CTR elevations in 3 cases. In addition, the fact that no case had right-sided unilateral pleural effusion suggested the direct effect of radiation to the pleura. Significant cardiomegaly was seen in 18% of 51 patients with

  10. Antiangiogenic drugs used with chemotherapy for patients with recurrent ovarian cancer: a meta-analysis

    Science.gov (United States)

    Yi, SuYi; Zeng, LongJia; Kuang, Yan; Cao, ZhiJuan; Zheng, ChengJun; Zhang, Yue; Liao, Meng; Yang, Lu

    2017-01-01

    Objective The value of antiangiogenic inhibitors for patients with recurrent ovarian cancer has not been completely affirmed. Therefore, we aimed to assess the effectiveness and toxicities of various antiangiogenic drugs for the treatment of recurrent ovarian cancer. Methods In this meta-analysis, we searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases for complete randomized controlled trials. The searches were extended to May 15, 2016. The risk of bias of the included studies was evaluated via a Cochrane systematic evaluation, and the statistical analyses were performed using RevMan 5.2 software. Results In total, we included 8 randomized controlled trials involving 3,211 patients and divided them into 3 groups, vascular endothelial growth factor receptor inhibitors (VEGFRIs), vascular endothelial growth factor (VEGF) inhibitors (bevacizumab), and angiopoietin inhibitors (trebananib). The progression-free survival improved significantly in all the groups being given antiangiogenic drugs (hazard ratio [HR]: 0.55, 95% confidence interval [CI]: 0.45–0.67, I2=0%, Phypokalemia. Conclusion This meta-analysis showed that antiangiogenic drugs improved the progression-free survival. The VEGFRI, bevacizumab, and trebananib groups showed increased overall survival. Adding antiangiogenic drugs to chemotherapy treatment resulted in a higher incidence of grade 3/4 side effects, but these were manageable. PMID:28255243

  11. Chemotherapy and Hair Loss: What to Expect during Treatment

    Science.gov (United States)

    Tests and Procedures Chemotherapy Find out what to expect when it comes to chemotherapy and hair loss. Plan to use your energy staying ... you have cancer and are about to undergo chemotherapy, the chance of hair loss is very real. ...

  12. Chemotherapy and Sex: Is Sexual Activity OK during Treatment?

    Science.gov (United States)

    ... and Procedures Chemotherapy Is it safe to have sex with my husband while undergoing chemotherapy? Answers from ... best to discuss any concerns about chemotherapy and sex with your doctor, who's familiar with your individual ...

  13. Left-sided omental torsion: CT appearance

    Energy Technology Data Exchange (ETDEWEB)

    Aoun, N.; Haddad-Zebouni, S.; Slaba, S.; Ghossain, M. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of Radiology; Noun, R. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of General Surgery

    2001-01-01

    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.)

  14. The effect of acupuncture on chemotherapy-associated gastrointestinal symptoms in gastric cancer

    Science.gov (United States)

    Zhou, J.; Fang, L.; Wu, W.Y.; He, F.; Zhang, X.L.; Zhou, X.; Xiong, Z.J.

    2017-01-01

    Background Gastrointestinal (gi) symptoms are the most notable side effects of chemotherapeutic drugs; such symptoms are currently treated with drugs. In the present study, we investigated the effect of acupuncture on gi symptoms induced by chemotherapy in patients with advanced gastric cancer. Methods A cohort of 56 patients was randomly divided into an experimental group and a control group. All patients received combination chemotherapy with oxaliplatin–paclitaxel. Patients in the experimental group received 30 minutes of acupuncture therapy daily for 2 weeks. The frequency and duration of nausea, vomiting, abdominal pain, and diarrhea, the average days and costs of hospitalization, and quality-of-life scores were compared between the groups. Results Nausea was sustained for 32 ± 5 minutes and 11 ± 3 minutes daily in the control and experimental groups respectively (p acupuncture. Conclusions Acupuncture, a safe technique, could significantly reduce gi symptoms induced by chemotherapy and enhance quality of life in patients with advanced gastric cancer. PMID:28270726

  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. 电力需求侧管理城市综合试点给电网企业带来的机遇和挑战%Power demand side management opportunities and challenges of integrated and pilot city brought to power grid enterprises

    Institute of Scientific and Technical Information of China (English)

    何湛邦

    2013-01-01

    佛山市全国成为开展电力需求侧管理综合试点工作的首批四个试点城市之一。作为为实施电力需求侧管理工作的主体单位,佛山供电局面临巨大的机遇和挑战。本文通过分析电力需求侧管理优势和现状存在的不足,为电力需求侧管理健康发展提出了具体建议措施。%Foshan City,China has become one of the developing power demand side management pilot work of the first four pilot city.As for the management of the implementation of power demand side body unit,Foshan Power Supply Bureau is facing great opportunities and challenges.By analyzing the deficiency of power de-mand side management advantages and status of existence,the concrete measures for the healthy development of power demand side management put forward.

  17. Chemotherapy-induced nausea, vomiting, and fatigue--the role of individual differences related to sensory perception and autonomic reactivity

    DEFF Research Database (Denmark)

    Zachariae, R; Paulsen, K; Mehlsen, M;

    2007-01-01

    about the role of other factors. The aim of our study was to investigate the role of individual differences related to sensory perception for posttreatment side effects. METHODS: Hundred and twenty-five women receiving adjuvant chemotherapy for breast cancer completed measures of absorption, autonomic...... autonomic nervous system activity, and absorption has been associated with increased autonomic nervous system reactivity to stress. The results suggest that individuals with high absorption may be at greater risk for developing side effects. Improved precision in identifying patients at risk of experiencing...... more severe side effects after cancer treatment will increase the ability to target treatments aimed at reducing these side effects....

  18. 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...

  19. Pre-operative chemotherapy and radiotherapy in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Goldhirsch, A. [Division of Medical Oncology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Viale, G. [Division of Pathology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Zurrida, S.; Veronesi, P. [Division of Senology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Orecchia, A. [Service of Radiology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Luini, A. [Division of Senology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Noberasco, C.; Minchella, I.; Nole' , F.; Colleoni, M. [Division of Medical Oncology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy)

    1998-04-01

    Primary systemic treatment of breast cancer with cytotoxics yields a high response rate and allows conservative surgical procedures in bulky tumours. In order to maximise local control of disease, two innovations were introduced in a pilot study. The first was to identify the good responders after three cycles of chemotherapy and to treat them with three additional cycles. The second was to also give this group of patients a full dose of radiotherapy before surgery with the aim of verifying the rate of pathological complete remissions in view of a possible treatment of breast primary with chemoradiotherapy only. Patients were treated with doxorubicin 60 mg/m{sup 2} and cyclophosphamide, 600 mg/m{sup 2} both intravenously on day 1, every 21 days for three courses. Partial or complete responders received three more courses followed by radiotherapy (50 Gy plus a 10 Gy boost). The others underwent immediate surgery. A total of 32 patients (median age, 50 years; range 28-69 years); performance status, 0-1; T{sub 2} 22, T{sub 3} 8, T{sub 4} 2) were enrolled and were evaluable for response and side-effects. 9 patients had only three cycles of chemotherapy due to absence of response and 23 patients had six cycles of chemotherapy. Overall, 7 patients had a complete remission, 16 a partial remission and 9 had stable disease, for an overall response rate of 72% (95% confidence interval 53-86%). In the group of patients that completed the programme, two complete pathological remissions were observed and 5 patients had only microfoci of tumour. No toxic death or grade III-IV toxicities were observed. Mild or moderate side-effects included mucositis, nausea/vomiting and leucopenia. In conclusion, our results indicate that the addition of radiotherapy to pre-operative chemotherapy did not significantly enhance the incidence of pathological complete remissions. New primary treatment approaches should be explored in this subset of patients in order to improve outcome. (Copyright (c

  20. [A CASE OF UROTHELIAL CARCINOMA OF THE URINARY BLADDER WITH SQUAMOUS DIFFERENTIATION RESPONDING TO PACLITAXEL AND CARBOPLATIN NEOADJUVANT CHEMOTHERAPY].

    Science.gov (United States)

    Banno, Eri; Nishino, Aki; Nagai, Yasuharu; Yasuda, Muneo; Tahara, Hideo; Kino, Shigeo; Kanno, Norihumi

    2015-07-01

    A 42-year-old man was referred to our hospital for macrohematuria. Computer tomography and magnetic resonance imaging revealed right hydronephrosis and a retroperitoneal mass, located next to right side of the bladder. Cystoscopy showed a protruded lesion covered with normal mucosa at the right lateral wall. The patient underwent transurethral resection of the bladder tumor and biopsies of the bladder wall. Histological examination showed squamous cell carcinoma. Neoadjuvant chemotherapy using paclitaxel and carboplatin (TC) was performed. A total cystectomy, right nephroureterectomy and construction of the ileal conduit were performed after one course of systemic chemotherapy. Histological examination showed urothelial carcinoma with squamous cell differentiation. Unexpectedly, a small amount of CIS was detected only in the vicinity of the TUR scar. The patient received 2 cycles of TC chemotherapy as adjuvant chemotherapy. Unfortunately, 11 months later, local recurrence and liver metastasis were detected. He died 17 months after the surgery.

  1. Development of aprepitant, the first neurokinin-1 receptor antagonist for the prevention of chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Hargreaves, Richard; Ferreira, Juan Camilo Arjona; Hughes, David; Brands, Jos; Hale, Jeff; Mattson, Britta; Mills, Sandy

    2011-03-01

    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. EMEND (aprepitant) is the first and only neurokinin-1 (NK-1) receptor antagonist available on the market for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Aprepitant acts centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, EMEND helps improve patients' daily living and their ability to complete multiple cycles of chemotherapy. The development of aprepitant included a novel nanoparticle formulation to optimize oral absorption and innovative chemistry to discover a prodrug form suitable for intravenous administration to improve compliance and convenience for healthcare professionals and cancer patients.

  2. Toxicity during l-LV/5FU adjuvant chemotherapy as a modified RPMI regimen for patients with colorectal cancer.

    Science.gov (United States)

    Hotta, Tsukasa; Takifuji, Katsunari; Arii, Kazuo; Yokoyama, Shozo; Matsuda, Kenji; Higashiguchi, Takashi; Tominaga, Toshiji; Oku, Yoshimasa; Yamaue, Hiroki

    2005-08-01

    l-leucovorin (LV)/5-fluorouracil (5FU) may play an important role, as an adjuvant chemotherapy, in improving the survival of patients with stage III colorectal cancer. However, severe toxicity of the chemotherapeutic agent could be fatal. Adverse effects, including bone marrow suppression, liver damage, renal damage, and glucose tolerance, were evaluated daily during 3 courses of l-LV/5FU-modified RPMI regimen adjuvant chemotherapy for 22 patients with stage III colorectal cancer. Decrease in the serum levels of neutrophils and platelets occurred in the 1st course, which became more obvious after three or four administrations of l-LV/5FU in the 1st course. Furthermore, serum levels of leukocytes, neutrophils, and platelets on the re-start day of this chemotherapy after 2-week intervals were lower than those on the start day of this chemotherapy. In the evaluation of liver damage, renal damage, and glucose tolerance; serum alanine aminotransferase level in the 2nd course, serum total bilirubin (T.Bil) level in the 1st course, and serum creatinine level in the 1st course deteriorated during the course. T.Bil levels on the re-start day of this chemotherapy after 2-week intervals were especially high compared to that on the start day. The more courses of this chemotherapy we perform, the more attention we must pay to bone marrow suppression and hyperbilirubinemia. Thus, we clarified the attentive point of side effect of l-LV/5FU adjuvant chemotherapy for colorectal cancer.

  3. History of chemotherapy of leprosy.

    Science.gov (United States)

    Noordeen, Shaik K

    2016-01-01

    Chemotherapy of leprosy over the past 70 years has passed through several phases, from sulfones, to clofazimine, and to highly bactericidal drugs like rifampicin. The use particularly of the more potent drugs in effective combinations and the development of standard multidrug therapy regimens have made a huge difference in the successful treatment of leprosy as well as in reducing tremendously the prevalence of leprosy globally. A major contributing factor to development of better drugs and drug combinations has been the introduction of the mouse footpad model to evaluate the in vivo activity of drugs against Mycobacterium leprae. The World Health Organization has recommended multidrug therapy, which has been used to treat more than 15 million patients in the last 30 years and has set an excellent record with regard to its very high rate of cure, very low occurrence of relapse, and very rare occurrence of drug resistance.

  4. Chemotherapy of metastatic colon cancer

    Directory of Open Access Journals (Sweden)

    M. Yu. Fedyanin

    2012-01-01

    Full Text Available Colorectal cancer is one of the leading causes of cancer incidence and mortality. In 2008 inRussian Federation55 719 new cases of colorectal cancer were diagnosed and 37 911 patients died of this disease. A significant progress was achieved in metastatic colorectal cancer treatment during the last decades. A lot of treatment options became available: from 5-fluoruracil monotherapy to combined treatment treatment schemes including surgery. A group of patients with isolated liver metastases was distinguished, who can achieve 5-year survival rate of 40 % after systemic treatment and surgery. Today, based on clinical data and molecular analysis, we come close to individualized treatment of this patient group. In this literature review results of metastatic colorectal cancer chemotherapy are being analyzed and rational treatment tactic is proposed based on therapy goals. 

  5. 惰性淋巴瘤非化疗药物的治疗现状及进展%Advances and the current status in chemotherapy-free management for indolent lym-phomas

    Institute of Scientific and Technical Information of China (English)

    宋腾(综述); 王华庆(审校)

    2016-01-01

    Indolent B-cell lymphomas constitute a slow growing cancer of the lymphatic system. These lymphomas mainly include fol-licular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenstom macroglobulinemia, marginal zone lym-phoma, and low malignant mantle cell lymphoma. These lymphomas are sensitive to chemotherapy and/or immunochemotherapy, but they cannot be cured. Furthermore, patient age at diagnosis, patient age at time of first onset or subsequent relapses, and compli-cations often influence the chemotherapy curative effect. At present, recent progress has been achieved in our understanding of dys-regulated pathways and immunologic anti-tumor responses in indolent lymphoma. In particular, the breakthrough of non-cytotoxic drugs renders"chemo-free"treatment a near-future reality. In this review, we highlight these promising approaches, such as the com-bination of anti-CD20 antibodies with immunomodulatory drugs, mAbs directed against other surface antigens, and programmed cell death 1 (PD-1) receptor inhibitor or B-cell receptor signaling pathway inhibitors. Future phase III studies will evaluate the efficacy of these drugs in the context of non-chemotherapy and further clarify treatment status.%惰性B细胞淋巴瘤是一类生长缓慢的淋巴系统肿瘤,主要包括滤泡性淋巴瘤(follicular lymphoma,FL)、慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)/小淋巴细胞淋巴瘤(small lymphocytic lymphoma,SLL)、华氏巨球蛋白血症(waldenstom mac⁃roglobulinemia,WM)、边缘区淋巴瘤(marginal zone lymphoma,MZL)以及低度恶性的套细胞淋巴瘤(low malignant mantle cell lym⁃phoma,MCL)等,对化疗及免疫治疗敏感,但无法治愈。患者发病年龄、首次发病及再次复发时间、并发症等均可影响化疗疗效。当前,在惰性淋巴瘤信号转导通路及抗肿瘤免疫反应等方面,尤其是非细胞毒药物研究的突破,支持了

  6. The potential usage of caffeic acid phenethyl ester (CAPE) against chemotherapy-induced and radiotherapy-induced toxicity.

    Science.gov (United States)

    Akyol, Sumeyya; Ginis, Zeynep; Armutcu, Ferah; Ozturk, Gulfer; Yigitoglu, M Ramazan; Akyol, Omer

    2012-07-01

    Protection of the patients against the side effects of chemotherapy and radiotherapy regimens has attracted increasing interest of clinicians and practitioners. Caffeic acid phenethyl ester (CAPE), which is extracted from the propolis of honeybee hives as an active component, specifically inhibits nuclear factor κB at micromolar concentrations and show ability to stop 5-lipoxygenase-catalysed oxygenation of linoleic acid and arachidonic acid. CAPE has antiinflammatory, antiproliferative, antioxidant, cytostatic, antiviral, antibacterial, antifungal and antineoplastic properties. The purpose of this review is to summarize in vivo and in vitro usage of CAPE to prevent the chemotherapy-induced and radiotherapy-induced damages and side effects in experimental animals and to develop a new approach for the potential usage of CAPE in clinical trial as a protective agent during chemotherapy and radiotherapy regimens.

  7. HIV Medicines and Side Effects

    Science.gov (United States)

    Side Effects of HIV Medicines HIV Medicines and Side Effects (Last updated 1/17/2017; last reviewed 1/17/2017) 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 ...

  8. Therapeutic effect analysis of different neoadjuvant chemotherapy on the locally cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Li

    2015-01-01

    Objective:To explore the therapeutic effect of different neoadjuvant chemotherapy on the locally cervical cancer.Methods:A total of 85 patients with cervical cancer for the initial treatment who were admitted in our hospital from January, 2011 to January, 2013 were included in the study and divided into the observation group and the control group according to different chemotherapy regimens. The way of drug administration is by transcatheter arterial chemoembolization (TACE). The patients in the observation group were given Taxol in combined with carboplatin for neoadjuvant chemotherapy, while the patients in the control group were given irinotecan in combined with carboplatin. The remission degree of clinical symptoms, chemotherapeutic effect, toxic and side effect, and operation evaluation 14 and 20 days after chemotherapy were evaluated.Results:The comparison of clinical symptom remission between the two groups was not statistically significant. The occurrence rate of myelosuppression in III-IV degree in the observation was significantly higher than that in the control group, but the occurrence rate of diarrhea was significantly lower than that in the control group. The comparisons of operation time and intraoperative amount of bleeding after chemotherapy between the two groups were not statistically significant. The comparisons of the occurrence rates of parametrial infiltration and lymphatic metastasis and the muscular layer invasion depth were not statistically significant.Conclusions:Arterial embolism neoadjuvant chemotherapy can obviously shorten the tumor volume in patients with local cervical cancer, relieve the clinical symptoms, and enhance the living qualities, but in the clinical application, appropriate chemotherapy regimen should be chosen according to the specific condition.

  9. Development of self-management behavior assessment scale for chemotherapy patients with PICC%经外周静脉置入中心静脉导管化疗患者自我管理行为测评量表的开发

    Institute of Scientific and Technical Information of China (English)

    邢冬婕; 李莲静; 单丽霞

    2014-01-01

    目的 开发PICC化疗患者自我管理行为测评量表,并进行效度和信度检验.方法 参考美国斯坦福大学患者教育研究中心创建的《慢性病自我管理研究测量表》及其评分标准,结合PICC患者自我管理内容,经参考文献、专家评定,修订成《PICC化疗患者自我管理行为测评量表》.量表包括5个维度,19项量化指标,共78个条目.2010年2月至2011年11月192例乳腺癌PICC化疗患者参加了调查.结果 有效问卷178份,量表的CVI为0.906,总体Cronbachα系数为0.892.采用因子分析法,提取出特征根>1的公因子4个,解释总方差的41.180%,每个条目在相应因子上的负荷均在03以上.结论 此测评量表具有较好的效度和信度,为研究者提供了PICC化疗患者自我管理行为评价和干预的工具.%Objective To develop self-management behavior assessment scale for chemotherapy patients with peripherally inserted central catheter (PICC),and test the validity and reliability of it.Methods In reference to "Chronic Disease Self Management Study Measure" and its scoring standard by patient education and study center of American Stanford University,in combination with PICC patient self-management content,with reference to the literature,expert assessment,the self-management behavior assessment scale was established.The scale included five dimensions,19 quantitative indicators,a total of 78 entries.From February 2010 to November 2011 192 cases of breast cancer chemotherapy patients with PICC participated in the survey.Results Effective questionnaire was 178 copies,scale of content validity index (CVI) was 0.906,the overall Cronbach alpha coefficient was 0.892.Using factor analysis method,4 common factors were extracted whose characteristic root was greater than 1,and could explain 41.180% of the total variance,each item on the corresponding factor of load was above 0.3.Conclusions The evaluation scale has good validity and reliability,which can

  10. Carbamazepine for prevention of chemotherapy-induced nausea and vomiting: a pilot study

    Directory of Open Access Journals (Sweden)

    Thaiana Aragão Santana

    Full Text Available CONTEXT AND OBJECTIVE: Nausea and vomiting are major inconveniences for patients undergoing chemotherapy. Despite standard preventive treatment, chemotherapy-induced nausea and vomiting (CINV still occurs in approximately 50% of these patients. In an attempt to optimize this treatment, we evaluated the possible effects of carbamazepine for prevention of CINV.DESIGN AND LOCATION: Prospective nonrandomized open-label phase II study carried out at a Brazilian public oncology service. METHODS: Patients allocated for their first cycle of highly emetogenic chemotherapy were continuously recruited. In addition to standard antiemetic protocol that was made available, they received carbamazepine orally, with staggered doses, from the third day before until the fifth day after chemotherapy. Considering the sparseness of evidence about the efficacy of anticonvulsants for CINV prevention, we used Simon's two-stage design, in which 43 patients should be included unless overall complete prevention was not achieved in 9 out of the first 15 entries. The Functional Living Index-Emesis questionnaire was used to measure the impact on quality of life.RESULTS:None of the ten patients (0% presented overall complete prevention. In three cases, carbamazepine therapy was withdrawn because of somnolence and vomiting before chemotherapy. Seven were able to take the medication for the entire period and none were responsive, so the study was closed. There was no impact on the patients' quality of life.CONCLUSION: Carbamazepine was not effective for prevention of CINV and also had a deleterious side-effect profile in this population.

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

    Directory of Open Access Journals (Sweden)

    Paulo Sergio da Silva Santos

    2013-04-01

    Full Text Available The side effects of chemotherapy on the lips may cause esthetic and functional impact and increase the risk of infection. HPA Lanolin® is an option for supportive therapy because it has anti-inflammatory, antimicrobial and moisturizing properties. Objective: To evaluate the efficacy of this product in the prevention of lip alterations in a population of patients undergoing chemotherapy. Material and Methods: Patients undergoing chemotherapy (n = 57 were examined and distributed into two groups: study (used HPA Lanolin® and control (without supportive therapy on the lips. We evaluated the patients two weeks after chemotherapy, registering oral alterations, symptoms of pain, discomfort, limitation of mouth opening and dehydration, classified according to a visual analogue scale. Results: Patients who used HPA Lanolin® had lower dehydration and experienced improvement of lip dryness (p<0.001. The main symptoms were dehydration, discomfort, limitation of mouth opening, pain. The main clinical signs were dry lips, mucositis, cheilitis, hematoma, swelling and cracking. We found no difference concerning the variables of pain, discomfort, and limitation of mouth opening between the study and control group. Conclusions: We suggest that HPA Lanolin® is effective in reducing the symptoms of dehydration and the signs of lip dryness resulting from toxicity of chemotherapy, proving to be an interesting alternative supportive therapy for cancer patients.

  12. Practical use of perioperative chemotherapy for muscle-invasive bladder cancer: summary of session at the Society of Urologic Oncology annual meeting.

    Science.gov (United States)

    Apolo, Andrea B; Grossman, Herbert Barton; Bajorin, Dean; Steinberg, Gary; Kamat, Ashish M

    2012-01-01

    At the 11th annual meeting of the Society of Urologic Oncology, an expert panel was convened to discuss the practical use of perioperative chemotherapy for muscle-invasive bladder cancer. The discussion was structured as a case-based debate among the panelists. The topics included: neoadjuvant chemotherapy with a focus on T2 disease, pros and cons, survival data, tolerability of cisplatin-based therapy, can we avoid radical cystectomy in complete responders, limitations and alternatives to cisplatin-based therapy, management of 'suboptimal' chemotherapy, residual disease after neoadjuvant chemotherapy, adjuvant chemotherapy, and key aspects of radical cystectomy and lymph-node dissection in multimodal therapy. The presentations were derived from published literature. The panelists agreed that patients with muscle-invasive bladder cancer should be managed with a multidisciplinary team, including urologist and medical oncologist. Cisplatin-based neoadjuvant chemotherapy has demonstrated improved survival and should be incorporated into the management of all eligible patients with muscle-invasive bladder cancer. However, in some centers, neoadjuvant chemotherapy is reserved for patients with >T2 disease or high-risk features. There are no data for the administration of non-cisplatin-based neoadjuvant chemotherapy, such as carboplatin-combinations. Cisplatin-ineligible patients should proceed directly to surgical extirpation with adjuvant cisplatin-based chemotherapy considered based on pathologic findings. However, the data for adjuvant chemotherapy is less compelling. As our refinement of the selection process continues, we may be able to better identify subsets of patients who may be spared chemotherapy, but much work remains to be done in this arena. The current standard for muscle-invasive bladder cancer patients is cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy and pelvic lymph-node dissection.

  13. Surgical technology and pharmacology of hyperthermic perioperative chemotherapy

    Science.gov (United States)

    Van der Speeten, Kurt

    2016-01-01

    Although cytoreductive surgery (CRS) and hyperthermic perioperative chemotherapy (HIPEC) have not been shown to be effective by themselves, as a combined treatment they are now standard of care for peritoneal metastases from appendiceal cancer and from colorectal cancer as well as peritoneal mesothelioma. The timing of the HIPEC in relation to the CRS is crucial in that the HIPEC is to destroy minimal residual disease that remains following the CRS and prevent microscopic tumor emboli within the abdomen and pelvis from implanting within the resection site, within fibrinous clot, or within blood clot. Proper selection of chemotherapy agents is crucial to the long-term benefit of CRS and HIPEC. One must consider the response expected with the cancer chemotherapy agent, its area under the curve (AUC) ratio indicating the amount of dose intensity within the peritoneal space, and the drug retention within the peritoneal space for a prolonged exposure. Hyperthermia will augment the cytotoxicity of the cancer chemotherapy agents and improve drug penetration. Irrigation techniques should not be overlooked as an important means of reducing the cancer cell burden within the abdomen and pelvis. Multiple technologies for HIPEC exist and these have advantages and disadvantages. The techniques vary from a totally open technique with a vapor barrier over the open abdominal space to a totally closed technique whereby the HIPEC is administered at the completion of the surgical procedure. The open techniques depend on a table-mounted retractor for suspension of the skin edges allowing a reservoir to occur within the abdomen and pelvis. There are nearly a dozen commercially available hyperthermia pumps, all of which seem to perform adequately for HIPEC although there is a variable degree of convenience and documentation of the HIPEC procedure. As the management of peritoneal metastases has progressed over three decades, early cases are now seen in which a laparoscopic CRS and HIPEC

  14. Bone Mineral Density, Growth, and Thyroid Function in Long-Term Survivors of Pediatric Hodgkin's Lymphoma Treated with Chemotherapy Only

    NARCIS (Netherlands)

    R.D. van Beek; M.M. van den Heuvel-Eibrink; F.G. Hakvoort-Cammel; C. van den Bos; H.J.H. van der Pal; E.P. Krenning; Y.B. de Rijke; R. Pieters; S.M.P.F. de Muinck Keizer-Schrama

    2009-01-01

    Background: The aim of this study was to investigate the long-term side effects of treatment for childhood Hodgkin's lymphoma with chemotherapy only on growth, bone mineral density (BMD), body composition, and thyroid function. Procedure: A total of 88 patients (56 male, 32 female; 17.6-42.6 yr), tr

  15. CD8+ T Cells and Endogenous IL-10 Are Required for Resolution of Chemotherapy-Induced Neuropathic Pain

    NARCIS (Netherlands)

    Krukowski, Karen; Eijkelkamp, Niels; Laumet, Geoffroy; Hack, C Erik; Li, Yan; Dougherty, Patrick M; Heijnen, Cobi J; Kavelaars, Annemieke

    2016-01-01

    Chemotherapy-induced peripheral neuropathy (CIPN), characterized by pain and numbness in hands and feet, is a common side effect of cancer treatment. In most patients, symptoms of CIPN subside after treatment completion. However, in a substantial subgroup, CIPN persists long into survivorship. Impai

  16. Intestinal response to myeloablative chemotherapy in piglets

    DEFF Research Database (Denmark)

    Pontoppidan, Peter Erik Lotko; Shen, René Liang; Petersen, Bodil L

    2014-01-01

    Chemotherapy-induced myeloablation prior to allogeneic hematopoietic stem cell transplantation (HSCT) may be associated with severe toxicity. The current understanding of the pathophysiology of oral and gastrointestinal (GI) toxicity is largely derived from studies in rodents and very little...... is known from humans, especially children. We hypothesized that milk-fed piglets can be used as a clinically relevant model of GI-toxicity related to a standard conditioning chemotherapy (intravenous busulfan, Bu plus cyclophosphamide, Cy) used prior to HSCT. In study 1, dose-response relationships were...... for investigating chemotherapy-induced toxicity and dietary and medical interventions....

  17. Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice.

    OpenAIRE

    Vasquez, S.; Guidon, Marie; McHugh, E; Lennon, Olive; Grogan, L.; Breathnach, O S

    2013-01-01

    BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, potentially reversible side effect of some chemotherapeutic agents. CIPN is associated with decreased balance, function and quality of life (QoL). This association has to date been under-investigated. AIMS: To profile patients presenting with CIPN using the modified Total Neuropathy Score (mTNS) in this cross-sectional study and to examine the relationship between CIPN (measured by mTNS) and indices of balance, qual...

  18. Nongenotoxic p53 activation protects cells against S-phase-specific chemotherapy

    DEFF Research Database (Denmark)

    Kranz, Dominique; Dobbelstein, Matthias

    2006-01-01

    Mutations in the tumor suppressor gene TP53 represent the most frequent genetic difference between tumor cells and normal cells. Here, we have attempted to turn this difference into an advantage for normal cells during therapy. Using the Mdm2 antagonist nutlin-3, we first activated p53 in U2OS an...... a killer to a protector of cells, with the potential to reduce unwanted side effects of chemotherapy....

  19. Amelioration of Chemotherapy-Induced Intestinal Mucositis by Orally Administered Probiotics in a Mouse Model

    OpenAIRE

    Chun-Yan Yeung; Wai-Tao Chan; Chun-Bin Jiang; Mei-Lien Cheng; Chia-Yuan Liu; Szu-Wen Chang; Jen-Shiu Chiang Chiau; Hung-Chang Lee

    2015-01-01

    Background and Aims Intestinal mucositis is a frequently encountered side effect in oncology patients undergoing chemotherapy. No well-established or up to date therapeutic strategies are available. To study a novel way to alleviate mucositis, we investigate the effects and safety of probiotic supplementation in ameliorating 5-FU-induced intestinal mucositis in a mouse model. Methods Seventy-two mice were injected saline or 5-Fluorouracil (5-FU) intraperitoneally daily. Mice were either orall...

  20. Ice massage on chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Mehdi Sadeghi Shermeh

    2012-05-01

    Full Text Available Background and Aim: Nausea and vomiting are the most common side effects of chemotherapy. The aim of the current study was to assess the effect of ice massage applied to the pericardium 6 (P6 or Neigaun acupuncture point on nausea– vomiting due to chemotherapy in cancer patient. Materials and Methods: In a randomized clinical trial one- blind, 114 patients were randomly divided into three groups. Ice massage group were massaged gently on the skin around P6 point of the hand with ice cube into a wet gauze pad for 7 minutes twice a day with 12-hours interval for 24 hours by the patient. Placebo group were massaged with wooden cube and the control group received no interventions. Nausea and vomiting in three groups rated by Morrow Assessment of Nausea and Emesis (MANE Questionnaire in 4 periods of time in 24 hours was used for the assessment of nausea and vomiting. Results: There were significant decreases in the frequency of nausea (P<0.01 and vomiting (P<0.03 and a decrease in the intensity of nausea (P=0.63 and vomiting (P=0.34 in the case group. Frequency of nausea was significantly lower among placebo group than the control group (P<0.02. Conclusion: Ice massage on Neigaun point is effective on reducing the frequency of chemotherapy induced nausea and vomiting in cancer patients. Placebos, patient-practitioner relationship, suggestion, and the patient's view on nausea and vomiting and the role of interaction between the therapist and the patient is effective to some extent.

  1. Chemotherapy drug shortages in pediatric oncology: a consensus statement.

    Science.gov (United States)

    Decamp, Matthew; Joffe, Steven; Fernandez, Conrad V; Faden, Ruth R; Unguru, Yoram

    2014-03-01

    Shortages of essential drugs, including critical chemotherapy drugs, have become commonplace. Drug shortages cost significant time and financial resources, lead to adverse patient outcomes, delay clinical trials, and pose significant ethical challenges. Pediatric oncology is particularly susceptible to drug shortages, presenting an opportunity to examine these ethical issues and provide recommendations for preventing and alleviating shortages. We convened the Working Group on Chemotherapy Drug Shortages in Pediatric Oncology (WG) and developed consensus on the core ethical values and practical actions necessary for a coordinated response to the problem of shortages by institutions, agencies, and other stakeholders. The interdisciplinary and multiinstitutional WG included practicing pediatric hematologist-oncologists, nurses, hospital pharmacists, bioethicists, experts in emergency management and public policy, legal scholars, patient/family advocates, and leaders of relevant professional societies and organizations. The WG endorsed 2 core ethical values: maximizing the potential benefits of effective drugs and ensuring equitable access. From these, we developed 6 recommendations: (1) supporting national polices to prevent shortages, (2) optimizing use of drug supplies, (3) giving equal priority to evidence-based uses of drugs whether they occur within or outside clinical trials, (4) developing an improved clearinghouse for sharing drug shortage information, (5) exploring the sharing of drug supplies among institutions, and (6) developing proactive stakeholder engagement strategies to facilitate prevention and management of shortages. Each recommendation includes an ethical rationale, action items, and barriers that must be overcome. Implemented together, they provide a blueprint for effective and ethical management of drug shortages in pediatric oncology and beyond.

  2. Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies Aceptabilidad y efectos secundarios percibidos del rociado residual intradomiciliario de insecticidas bajo diferentes esquemas de manejo de resistencia

    Directory of Open Access Journals (Sweden)

    Américo David Rodríguez

    2006-08-01

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

  3. Effect of a Nausea Expectancy Manipulation on Chemotherapy-Induced Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study

    OpenAIRE

    Shelke, Abhay R.; Roscoe, Joseph A.; Morrow, Gary R.; Colman, Lauren K; Banerjee, Tarit K.; Kirshner, Jeffrey J.

    2008-01-01

    Several studies have shown that patients’ expectancy for the development of nausea following chemotherapy are robust predictors of that treatment-related side effect and some studies have shown that interventions designed to influence expectancies can affect patients’ reports of symptoms. In this randomized multicenter Community Clinical Oncology Program (CCOP) trial, we investigated the effect of an expectancy manipulation designed to reduce nausea expectancy on chemotherapy-induced nausea i...

  4. 乳腺癌FE100C类方案新辅助化疗后粒细胞减少和肝功能损害的发生及对策%Neoadjuvant chemotherapy using epirubicin, cyclophosphamide and fluorouracil:neutropenia and elevation of transaminase, and their management

    Institute of Scientific and Technical Information of China (English)

    王歆光; 范铁; 范照青; 王天峰; 解云涛; 李金锋; 欧阳涛

    2015-01-01

    consecutive breast cancer patients with complete treatment data treated in our department were included in this analysis. All patients received neoadjuvant chemotherapy with equal dose of EPI (100 mg/m2 ) administered every 3 weeksfor4cyclesbeforesurgery.Results 200patients(66.0%)experiencedatleastoneepisodeof grade 3/4 neutropenia/leukopenia, among them 176 patients experienced their first episode after the first cycle.Febrile neutropenia ( FN) occurred in 13 patients for 14 episodes.Elevation of transaminase occurred in a total of 46 patients ( 15.2%) , among them, grade 2 or higher elevation occurred in 15 patients (5.0%).Three blood test plans were adopted to monitor the patients during chemotherapy:(1) Routine blood count repeated every week; ( 2 ) Routine blood count before and on day 10 of each chemotherapy episode;(3) Routine blood count before and on day 7, 10 and 14 of each chemotherapy episode.The number of patients whose chemotherapy was delayed due to 3/4 neutropenia/leucopenia in each blood test plan was 3 (5.0%), 7 (3.9%) and 2 (3.2%), respectively.The number of patients with febrile neutropenia (FN) in each blood test plan was 2 (3.3%), 8 (4.4%) and 3 (4.8%), respectively.No statistically significant difference in treatment delay or the incidence of FN was observed among different blood test plans.No statistically significant difference in the incidence of grade 3/4 neutropenia/leukopenia or grade 2 or higher transaminase elevation was observed among different 5-Fu regimens.Conclusions During neoadjuvant chemotherapy using FE100 C, Fci E100 C or E100 C for breast cancer patients without routine prophylactic G-CSF, the incidence of grade 3/4 neutropenia/leukopenia is 66.0%.With the patient management plan we adopted, 4.3%of patients developed febrile neutropenia.Prophylactic medication may not be necessary for patients without evident liver dysfunction.

  5. [The quality of life after chemotherapy in advanced non-small cell lung cancer patients].

    Science.gov (United States)

    Słowik-Gabryelska, A; Szczepanik, A; Kalicka, A

    1999-01-01

    The intensity of complains, short survival and great number of patients makes many oncologists to apply chemotherapy in advanced non-small cell lung cancer/NSCLC/. The achieved median duration of life after chemotherapy was 6 to 12 month. From the other hand non small cell lung cancer chemotherapy is a big burden even to healthy persons. It can worsen the quality of life. That was the reason we evaluated the quality of life after chemotherapy in advanced non small cell lung cancer patients. Taking into account, that the evaluation of quality of life, used in most diseases is useless in advanced NSCLC patients, for appreciation the quality of life in these cases the lung cancer symptoms scale/LCSS/was adopted. In 110 non small cell lung cancer patients in stage IIIB and IV, who received combined chemotherapy by Le Chevalier/Vindesine, Cisplatin, Cyclophosphamide, Lomustin/or by Rosell/Mitomycin, Cyclophosphamide, Cisplatin/the quality of life was evaluated. In 20-persons control group all patients received the symptomatic treatment. In observed group of 110 patients, tumor regressions after 4 courses of chemotherapy allowed to resect cancer in 14 cases, to apply radiotherapy in 42 and to continue chemiotherapy in 23 persons. In every person from above mentioned group the quality of life was evaluated on the basis of intensity of cancer symptoms, accordingly to LCSS. The intensity of cancer symptoms was compared before and after treatment. There were compared; the innensity of complains, weakness, appetite, malnutrition, and hematological, neurological, performans state as well as respiratory sufficiency, infections, cardiac disorders and pain. Apart it, the side effects of applied therapy were assessed in 5 degree scale. The level of hemoglobin, the number of leucocytes, thrombocytes, bilirubine and transaminases in peripheral blood, hematurie, proteinurie, bleedings, appetite, nausea, vomitings, diarrhea, mucosal lesions, infections, skin lesions, cardiac lesions

  6. Pulmonary Fibrosis Secondary to FOLFOX Chemotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Wai Cheong Soon

    2014-09-01

    Full Text Available A 54-year-old female presented with a 2-week history of increasing shortness of breath and fever. She had a history of a poorly differentiated sigmoid adenocarcinoma for which she underwent an anterior resection 6 months prior to admission, followed by 12 cycles of adjuvant FOLFOX chemotherapy. The patient was treated for a severe community-acquired pneumonia; however, she remained hypoxic. A chest CT revealed extensive right-sided fibrotic changes, tractional dilatation of the airways and ground glass density, which had developed since a staging CT scan performed 2 months previously. Although her symptoms improved with steroid therapy, repeat imaging revealed that right hydropneumothorax had developed, and this required the insertion of a chest drain. Following its successful removal, the patient continues to improve clinically and radiographically. The rapid onset and nature of these changes is consistent with a drug-induced fibrotic lung disease secondary to FOLFOX chemotherapy. The phenomenon is underreported and yet, it is relatively common: it occurs in approximately 10% of patients who are treated with antineoplastic agents, although information specifically relating to FOLFOX-induced pulmonary toxicity is limited. It is associated with significant morbidity and mortality, but is often hard to differentiate from other lung conditions, making the diagnosis a challenge. Pulmonary toxicity is an important complication associated with antineoplastic agents. It should be considered in any patient on a chemotherapeutic regimen who presents with dyspnoea and hypoxia in order to try to reduce the associated morbidity and mortality.

  7. Therapy operating characteristic curves: tools for precision chemotherapy.

    Science.gov (United States)

    Barrett, Harrison H; Alberts, David S; Woolfenden, James M; Caucci, Luca; Hoppin, John W

    2016-04-01

    The therapy operating characteristic (TOC) curve, developed in the context of radiation therapy, is a plot of the probability of tumor control versus the probability of normal-tissue complications as the overall radiation dose level is varied, e.g., by varying the beam current in external-beam radiotherapy or the total injected activity in radionuclide therapy. This paper shows how TOC can be applied to chemotherapy with the administered drug dosage as the variable. The area under a TOC curve (AUTOC) can be used as a figure of merit for therapeutic efficacy, analogous to the area under an ROC curve (AUROC), which is a figure of merit for diagnostic efficacy. In radiation therapy, AUTOC can be computed for a single patient by using image data along with radiobiological models for tumor response and adverse side effects. The mathematical analogy between response of observers to images and the response of tumors to distributions of a chemotherapy drug is exploited to obtain linear discriminant functions from which AUTOC can be calculated. Methods for using mathematical models of drug delivery and tumor response with imaging data to estimate patient-specific parameters that are needed for calculation of AUTOC are outlined. The implications of this viewpoint for clinical trials are discussed.

  8. Beyond Photodynamic Therapy: Light-Activated Cancer Chemotherapy.

    Science.gov (United States)

    Szymanski, Wiktor; Reeßing, Friederike

    2016-09-06

    Light-activatable cytotoxic agents present a novel approach in targeted cancer therapy. The selectivity in addressing cancer cells is a crucial aspect in minimizing unwanted side effects that stem from unspecific cytotoxic activity of cancer chemotherapeutics. Photoactivated chemotherapy is based on the use of inactive prodrugs whose biological activity is significantly increased upon exposure to light. As light can be delivered with a very high spatiotemporal resolution, this technique is a promising approach to selectively activate cytotoxic drugs at their site of action and thus to improve the tolerability and safety of chemotherapy. This innovative strategy can be applied to both cytotoxic metal complexes and organic compounds. In the first case, the photoresponsive element can either be part of the ligand backbone or be the metal center itself. In the second case, the activity of a known organic, cytotoxic compound is caged with a photocleavable protecting group, providing the release of the active compound upon irradiation. Besides these approaches, also the use of photoswitchable (photopharmacological) chemotherapeutics, which allow an "on" and "off" switching of biological activity, is being developed. The aim of this review is to present the current state of photoactivated cancer therapy and to identify its challenges and opportunities.

  9. Pain management in cancer cervix

    Directory of Open Access Journals (Sweden)

    Palat Gayatri

    2005-01-01

    Full Text Available Cancer of the cervix uteri is a common cause of pain among women. On the physical realm, the cancer may cause somatic [soft tissue and bone], visceral and neuropathic pain [lumbosacral plexopathy]. Radiotherapy and chemotherapy may cause neuropathy too. Psychological, social and cultural factors modify the pain. Evaluation of the individual type of pain and a patient-centred approach are fundamental requirements for rational management. Disease modifying treatment like radiotherapy and chemotherapy must be considered when applicable. Pain control is usually achieved by the use of WHO three-step ladder, remembering that possible association of renal dysfunction would necessitate caution in the use of NSAIDs and opioids. Side effects must be anticipated, prevented when possible, and aggressively treated; nausea and vomiting may already be present, and constipation can worsen pain when there is a pelvic mass. Pain emergencies can be treated by quick titration with intravenous morphine bolus doses. Neuropathic pain may warrant the use of usual adjuvants, with particular reference to cortico-steroids and the NMDA antagonist, ketamine. In intractable pain, many neurolytic procedures are tried, but a solid evidence base to justify their use is lacking. Continuous epidural analgesia with local anaesthetic and opioid may be needed when drug therapy fails, and desperate situations may warrant interventions such as neurolysis. Such physical measures for pain relief must be combined with psychosocial support and adequate explanations to the patient and the family.

  10. Novel Combination Chemotherapy for Localized Ewing Sarcoma

    Science.gov (United States)

    In this clinical trial, researchers will test whether the addition of the drug combination vincristine, topotecan, and cyclophosphamide to a standard chemotherapy regimen improves overall survival in patients with extracranial Ewing

  11. Adjuvant chemotherapy in early breast cancer

    DEFF Research Database (Denmark)

    Ejlertsen, Bent

    2016-01-01

    % of patients aged 40 or younger in 77B had regular menses throughout chemotherapy, the corresponding percentage was 37 in 82B and 47 in 89B. The DBCG in collaboration with a Swedish and a Dutch centre participating in the DBCG trial 89B compared CMF with ovarian ablation in premenopausal high-risk breast...... are not clinically useful by themselves as other chemotherapy regimens have been more efficacious, and knowledge is still lacking regarding the benefits from adding ovarian suppression to chemotherapy plus tamoxifen. The results from the DBCG 77B and 82C are in accordance with other large adjuvant trials...... adjuvant trials demonstrated that patients with either TOP2A or centromere 17 aberrations, but not with HER2 amplification, benefit from anthracycline-containing adjuvant chemotherapy. Anthracyclins have additional distinct biological mechanisms; and results from the DBCG 89D suggested that tumours...

  12. Adverse Effects of Radiation and Chemotherapy

    OpenAIRE

    1991-01-01

    The long-term consequences of radiation and chemotherapy on intellectual and endocrine function in children with brain tumors is reviewed from the Departments of Neurology and Pediatrics, State University of New York, Buffalo, NY.

  13. Patient expectancy and post-chemotherapy nausea

    DEFF Research Database (Denmark)

    Colagiuri, Ben; Zachariae, Robert

    2010-01-01

    , specifically controlling for a history of nausea, and involving breast cancer patients, none of the moderators assessed were statistically significant. CONCLUSIONS: These findings suggest that patient expectancies may contribute to post-chemotherapy nausea and that expectancy-based manipulations may provide......BACKGROUND: Post-chemotherapy nausea remains a significant burden to cancer patients. While some studies indicate that expecting nausea is predictive of experiencing nausea, there are a number of conflicting findings. PURPOSE: The purpose of this study was to conduct a meta-analytic review......, there was a robust positive association between expectancy and post-chemotherapy nausea (ESr = 0.18, equivalent to Cohen's d = 0.35), suggesting that patients with stronger expectancies experience more chemotherapy-induced nausea. Although weaker associations were found in studies employing multivariate analysis...

  14. Comparison between Parodontax® and carbonated water to prevent chemotherapy-induced mucositis in children with cancer who attend the Centro Javeriano de Oncología

    OpenAIRE

    Erazo Cerón, Ivania Paola; Pontificia Universidad Javeriana; Romero Barrera, Erika María; Pontificia Universidad Javeriana; Bayona, Aura Lucía; Pontificia Universidad Javeriana

    2009-01-01

    BACKGROUND: During chemotherapy for cancer treatment side effects in oral cavity are frequent, of which mucositis is the most common. PURPOSE: Compare the efficacy of Parodontaxâ and carbonated water used to treat chemotherapy-induced mucositis in children with cancer. METHODS: This was a double-blinded randomized clinical trial. The sample consisted of 30 children between the ages of 0 and 14 years who attended the Centro Javeriano de Oncología for chemotherapy. 3 dental plaque scores and di...

  15. [Effectiveness of Leukostim, a Russian preparation of granulocyte colony-stimulating factor, in the treatment of chemotherapy-induced neutropenia in patients with malignant tumors].

    Science.gov (United States)

    Korman, D B; Boronovskaia, L E; Maslova, I A; Andreeva, E V; Seregina, G V

    2008-01-01

    Recombinant preparation of human G-CSF-Leukostim (Russia)--(filgrastim; analog of Neupogen)--was administered in 31 patients (breast cancer--28; ovarian carcinoma--3) to treat or prevent chemotherapy-induced neutropenia. The latter was aborted after 2-6 injections. Due to use of Leukostim, another course of chemotherapy (10 cycles) was successfully used in 5 breast cancer patients: no inhibition of hemopoiesis followed although the patients had suffered acute and persistent neutropenia from previous chemotherapy. No adverse side-effects of Leukostim administration were reported.

  16. Combined chemotherapy including platinum derivatives for medulloblastoma. The usefulness as maintenance chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Hikaru; Otani, Mitsuhiro; Yoshida, Kazunari; Kagami, Hiroshi; Shimazaki, Kenji; Toya, Shigeo; Kawase, Takeshi [Keio Univ., Tokyo (Japan). School of Medicine

    1997-02-01

    The authors reviewed 24 cerebellar medulloblastoma patients treated at Keio University to determine usefulness of combined chemotherapy including platinum derivatives (cisplatin, carboplatin) as the induction and maintenance treatment. All patients underwent radical surgery and craniospinal irradiation. Ten received adjuvant chemotherapy other than platinum derivatives (mainly with nitrosourea compounds), five were treated by induction and maintenance chemotherapy including platinum derivatives, and nine patients did not undergo chemotherapy. The progression-free survival rate of patients treated with platinum derivatives was better than that of patients treated with other modes of chemotherapy and also that of patients who did not receive chemotherapy. The results were especially good in the case of four patients treated with maintenance chemotherapy consisting of carboplatin and etoposide, two of whom had been free from relapse beyond the risk period of Collins. The occurrences of toxicity in maintenance chemotherapy with carboplatin and etoposide were limited to transient leucopenia. The present study indicates combined chemotherapy including platinum derivatives benefits patients with medulloblastoma, and could be useful, especially as maintenance treatment. (author)

  17. Chemotherapy-induced sclerosing cholangitis

    Energy Technology Data Exchange (ETDEWEB)

    Sandrasegaran, K.; Alazmi, W.M.; Tann, M.; Fogel, E.L.; McHenry, L.; Lehman, G.A

    2006-08-15

    Aim: To review the computed tomography (CT), magnetic resonance imaging (MRI) and cholangiographic findings of chemotherapy-induced sclerosing cholangitis (CISC). Methods: Between January 1995 and December 2004, 11 patients in the endoscopic retrograde cholangiography database were identified with CISC. Twelve CT, four MRI, 69 endoscopic and nine antegrade cholangiographic studies in these patients were reviewed. Serial change in appearance and response to endoscopic treatment were recorded. Results: CISC showed segmental irregular biliary dilatation with strictures of proximal extrahepatic bile ducts. The distal 5 cm of common bile duct was not affected in any patient. CT and MRI findings included altered vascular perfusion of one or more liver segments, liver metastases or peritoneal carcinomatosis. Biliary strictures needed repeated stenting in 10 patients (mean: every 4.7 months). Cirrhosis (n = 1) or confluent fibrosis (n = 0) were uncommon findings. Conclusion: CISC shares similar cholangiographic appearances to primary sclerosing cholangitis (PSC). Unlike PSC, biliary disease primarily involved ducts at the hepatic porta rather than intrahepatic ducts. Multiphasic contrast-enhanced CT or MRI may show evidence of perfusion abnormalities, cavitary liver lesions, or metastatic disease.

  18. Potential Benefits of Oral Cryotherapy for Chemotherapy-Induced Mucositis.

    Science.gov (United States)

    Wodzinski, Amelia

    2016-10-01

    Mucositis is a common side effect of cancer therapies that causes painful, erythematous lesions to develop in the gastrointestinal tract. These lesions can lead to malnutrition, increased risk for serious infection, prolonged hospital stays, and reduced quality of life. Oral cryotherapy, or the use of ice chips to cool the mucous membranes during bolus chemotherapy infusions (e.g., 5-fluorouracil [Adrucil®] and melphalan [Alkeran®]), is the most readily accessible and cost-effective intervention available. Although many factors may contribute to the development of mucositis during cancer treatment, studies have found a reduction in the incidence and the severity of mucositis with the use of oral cryotherapy.


  19. Individual differences in chemotherapy-induced anticipatory nausea

    Directory of Open Access Journals (Sweden)

    Marcial eRodríguez

    2013-08-01

    Full Text Available Anticipatory Nausea (AN is a severe side effect of chemotherapy that can lead cancer patients to discontinue their treatment. This kind of nausea is usually elicited by the re-exposure of the patients to the clinical context they need to attend to be treated. There has been considerable agreement that AN represents a paradigmatic example of Pavlovian conditioning, and within this framework, several behavioral interventions have been proposed in order to prevent this psychopathology. However, some studies have questioned the validity of the Pavlovian approach, suggesting that CS-US associations are neither necessary nor sufficient for AN to occur. The data and the alternative theories behind such criticisms are discussed. Additionally, it is suggested that animal models of AN could be enriched by taking into account rats’ individual differences.

  20. Efficacy and Toxicity of Low-Dose versus Conventional-Dose Chemotherapy for Malignant Tumors: a Meta-Analysis of 6 Randomized Controlled Trials

    Science.gov (United States)

    Xie, Xianhe; Wu, Yupeng; Luo, Shuimei; Yang, Haitao; Li, Lina; Zhou, Sijing; Shen, Ruifen; Lin, Heng

    2017-02-01

    Low-dose chemotherapy has emerged as a new strategy for control of cancer. However, there is a controversy as to whether low-dose chemotherapy is an effective way to manage many human malignancies. To shed light on this controversy, we performed a meta-analysis of relative merits between low-dose and conventional-dose chemotherapy in different carcinomas. Studies published before February 29, 2016 were reviewed for the meta-analysis and selected according to defined criteria. The effect levels of low-dose chemotherapy regarding overall survival (OS), progression-free survival (PFS) and severe adverse events (SAEs) (Grade≥3) were calculated as risk ratios (ORs) or adjusted hazard ratios (HRs). Six randomized controlled studies (RCTs) have provided data for low-dose chemotherapy versus conventional-dose chemotherapy for 838 cases and 833 cases, respectively. Interestingly, low-dose chemotherapy achieved the same desired potency as conventional-dose chemotherapy, with no differences in pooled ORR (RR=1.00, 95%CI [0.89, 1.13]; (P=0.97), OS (HR=1.07, 95%CI [0.90, 1.26]; P=0.44) and PFS (HR=1.02, 95%CI [0.84, 1.23]; P=0.87) values. Furthermore, pooled data for common SAEs showed that, compared with conventional-dose chemotherapy regimen, low-dose chemotherapy regimen resulted in significant less mucositis (Plow-dose chemotherapy may play an important role in achieving the same desired potency as conventional-dose chemotherapy in managing malignant tumors. Moreover, low-dose regimen seems to possess positive advantages of lower toxicity which is a particular concern for most patients.

  1. Application and evaluation of clinical nursing path in patients with solid tumors and chemotherapy PICC Management%临床护理路径在实体肿瘤化疗患者 PICC管理中的应用与评价

    Institute of Scientific and Technical Information of China (English)

    黄秀春

    2016-01-01

    目的:评价实体肿瘤化疗患者外周静脉置入中心静脉导管( PICC)管理中应用临床护理路径的效果。方法:选取实体肿瘤化疗患者60例作为研究对象,随机均分为两组,各30例。对照组实施常规PICC治疗,而研究组在对照组基础上加用临床护理路径管理,观察记录两组患者置管成功率、置管时间、并发症发生率及患者依从率,并对比分析。结果:研究组置管成功率、患者依从率均明显高于对照组,差异有统计学意义( P﹤0.05),而并发症发生率则明显低于对照组,差异有统计学意义( P﹤0.05),同时研究组置管时间要明显长于对照组,差异有统计学意义( P﹤0.05)。结论:实体肿瘤化疗患者PICC管理中实施临床护理路径,可明显提高置管成功率、患者依从性,同时降低并发症发生,值得借鉴。%Objective To evaluate patients with chemotherapy entity peripherally inserted central catheter( PICC)manage-ment application results in clinical nursing path. Method 60 patients with solid tumor chemotherapy were selected as the re-search object,they were randomly divided into 2 groups,30 cases in each group. The control group implementation of convention-al PICC treatment,and the research group on the basis of the control group was given clinical nursing pathway management,the success rate of two groups of patients with catheter time,complication rates,and patients compliance rate,and comparative analy-sis were observed and recorded. Results The team success rate of catheter,patients compliance rate were significantly higher than that of control group,the difference was statistically significant( P﹤0. 05 ),while the complication rate was significantly lower than the control group,the difference was statistically significant( P﹤0. 05 ),and at the same time the team catheter time was significantly longer than control group,the difference was statistically

  2. Neurosurgical management of L-asparaginase induced haemorrhagic stroke.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

    The authors describe a case of L-asparaginase induced intracranial thrombosis and subsequent haemorrhage in a newly diagnosed 30-year-old man with acute lymphoblastic leukaemia who was successfully managed by surgical intervention. At presentation, he had a Glasgow Coma Score of 7\\/15, was aphasic and had dense right hemiplegia. Neuroimaging revealed an acute anterior left middle cerebral artery infarct with parenchymal haemorrhagic conversion, mass effect and subfalcine herniation. He subsequently underwent left frontal craniotomy and evacuation of large frontal haematoma and decompressive craniectomy for cerebral oedema. Six months postoperatively he underwent titanium cranioplasty. He had made good clinical recovery and is currently mobilising independently with mild occasional episodes of expressive dysphasia, difficulty with fine motor movement on the right side, and has remained seizure free. This is the first documented case of L-asparaginase induced haemorrhagic stroke managed by neurosurgical intervention. The authors emphasise the possible role of surgery in managing chemotherapy induced intracranial complications.

  3. A new combinational electrical load analysis method for demand side management%一种面向需求侧管理的用户负荷形态组合分析方法

    Institute of Scientific and Technical Information of China (English)

    黄宇腾; 侯芳; 周勤; 付博; 郭创新

    2013-01-01

    Traditional electrical load analysis methods have disadvantages on gaining the representative load profile of a single customer as well as evaluating similarity between the different load patterns. This paper proposes a new combinational load analysis method by using the density based clustering to gain the representative load profile of a single customer and clustering different customers into different clusters according to the cosine similarity function. After applying this method to a real power system’s data set, the result is compared with the one using traditional analysis method and the applications in demand side management (DSM) are discussed. The results show that this new method could effectively find the representative load profiles and recognize the different load profiles, and thus confirm the value of this method in DSM applications.%  提出了一种面向需求侧管理的用户负荷形态组合分析方法,改善了传统方法在单一用户典型负荷形态提取以及不同负荷形态相似性度量上的不足。该方法以密度聚类算法剔除单一用户异常日用电形态的影响,提取其典型负荷形态,再以余弦相似度度量不同用户典型负荷形态的相似波动特性,对用户进行分类。将该方法应用于实际电力负荷数据,将获得的用户分类结果与传统方法进行了比较,并以此为基础对负荷聚类在需求侧管理中的应用做了探讨。结果表明该方法能够有效地提取单一用户的典型负荷形态,并能够较好地度量不同负荷形态之间的相似波动特性,在需求侧管理中具有实用价值。

  4. The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Marks, L.B.; Anscher, M.S. [Duke Univ. Medical Center, Durham, NC (United States); Carroll, P.R. [Univ. of California, San Francisco, CA (United States)] [and others

    1995-03-30

    A comprehensive review of the physiological and clinical response of the urinary bladder, ureter, and urethra to radiation and chemotherapy is presented. The clinical syndromes that follow therapy for cancer of the bladder, prostate, and cervix are reviewed in detail. Methods of assessing, scoring, and managing toxicity are discussed. 165 refs., 8 figs., 14 tabs.

  5. The Effects of Acupressure on Meridian Energy as well as Nausea and Vomiting in Lung Cancer Patients Receiving Chemotherapy.

    Science.gov (United States)

    Shen, Chi-Hsiang; Yang, Li-Yu

    2017-03-01

    Nausea and vomiting are the most common side effects of antineoplastic chemotherapy. However, only a small number of studies have been conducted in Taiwan to determine the efficacy of acupressure in treating these side effects in cancer patients receiving chemotherapy. In this quasi-experimental study, we aimed to explore the effects of acupressure on meridian energy as well as nausea and vomiting in 70 lung cancer patients receiving chemotherapy. Patients were assigned to the experimental or control group based on order of hospital admission. The experimental group received acupressure on "Neiguan (PC6)" and "Gongsun (SP4)" points, and the control group received sham acupoint patches on "Houxi (SI3)" point. The results showed that the mean meridian energy in the experimental group after acupressure was significantly higher than in the control group ( F = 28.71, p energy and effectively decreased the severity of nausea and vomiting in lung cancer patients undergoing chemotherapy. We recommend that clinical nurses provide acupressure as an intervention to relieve nausea and vomiting in patients receiving chemotherapy.

  6. STOMATOLOGIC STATUS IN PATIENTS WITH MALIGNANT NEOPLASMS OF MAXILLOFACIAL REGION UNDERGOING CHEMOTHERAPY AND RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Olga Shpulina

    2013-06-01

    Full Text Available The aim of this study was to evaluate the early acute side effects following radiation and chemotherapy in patients with head and neck cancer (HNC, namely: to ascertain main patient complaints; to investigate saliva properties and to determine the microecology of the oral cavity in patient with HNC before and after radiation and chemotherapy. Eighteen patients with HNC which were prescribed gamma therapy on two buccal submandibular fields combined with close-focus roentgenotherapy and methotrexate as a cytostatic were examined. It was established that 3 weeks after the radio- and chemotherapy 100 % of patients pointed at xerostomia, dysgeusia, disturbances during speech, burning, pricking and itching in oral cavity. After cancer treatment the speed of salivation decreased two times and pH was 15 % lower than before radio and chemotherapy. Anti-cancer treatment caused significant decrease of lysozyme level (34 % lower and secretory immunoglobulin A (1,5 times lower in patients with HNC. After radio and chemotherapy different fungi of Candida genus from oral cavity were inoculated in high concentrations (from 4,0 ± 0.07 to 6,9 ± 0.07 lg CFU/ml, such as С. Аlbicans, C. Kruzei, С. Tropicalis, C. Stellatoidea.Thus significant negative changes from the side of speed and character of salivation, decrease of saliva pH, depression of both non-specific and specific components of immune defense and high contamination of oral mucosa with fungi of Candida genus considerably worsenpost-cancer rehabilitation.

  7. The facilitating role of chemotherapy in the palliative phase of cancer: qualitative interviews with advanced cancer patients.

    Directory of Open Access Journals (Sweden)

    Hilde M Buiting

    Full Text Available OBJECTIVE: To explore the extent to which patients have a directing role in decisions about chemotherapy in the palliative phase of cancer and (want to anticipate on the last stage of life. DESIGN: Qualitative interview study. METHODS: In depth-interviews with 15 patients with advanced colorectal or breast cancer at the medical oncology department in a Dutch teaching hospital; interviews were analysed following the principles of thematic content-analysis. RESULTS: All patients reported to know that the chemotherapy they received was with palliative intent. Most of them did not express the wish for information about (other treatment options and put great trust in their physicians' treatment advice. The more patients were aware of the severity of their disease, the more they seemed to 'live their life' in the present and enjoy things besides having cancer. Such living in the present seemed to be facilitated by the use of chemotherapy. Patients often considered the 'chemotherapy-free period' more stressful than periods when receiving chemotherapy despite their generally improved physical condition. Chemotherapy (regardless of side-effects seemed to shift patients' attention away from the approaching last stage of life. Interestingly, although patients often discussed advance care planning, they were reluctant to bring on end-of-life issues that bothered them at that specific moment. Expressing real interest in people 'as a person' was considered an important element of appropriate care. CONCLUSIONS: Fearing their approaching death, patients deliberately focus on living in the present. Active (chemotherapy treatment facilitates this focus, regardless of the perceived side-effects. However, if anxiety for what lies ahead is the underlying reason for treatment, efforts should be made in assisting patients to find other ways to cope with this fear. Simultaneously, such an approach may reduce the use of burdensome and sometimes costly treatment in the

  8. Antioxidant activity of ginger extract as a daily supplement in cancer patients receiving adjuvant chemotherapy: a pilot study

    Science.gov (United States)

    Danwilai, Kwanjit; Konmun, Jitprapa; Sripanidkulchai, Bung-orn; Subongkot, Suphat

    2017-01-01

    Purpose The aim of this study was to examine the antioxidant activity of ginger extract oral supplement in newly diagnosed cancer patients receiving adjuvant chemotherapy compared to placebo. Patients and methods Newly diagnosed cancer patients receiving moderate-to-high emetogenic potential adjuvant chemotherapy were randomized to receive either a ginger extract (standardized 6-gingerol 20 mg/day) or a placebo 3 days prior to chemotherapy, which they continued daily. Oxidant/antioxidant parameters, including the activities of superoxide dismutase (SOD) and catalase (CAT) and levels of glutathione peroxidase (GPx), total glutathione (GSH/GSSG), lipid peroxidation products detected as malondialdehyde (MDA) and NO2−/NO3−, were measured at baseline and at days 1, 22, 43 and 64 after undergoing chemotherapy. Two-sided statistical analysis, with P ginger group and placebo group, respectively. Antioxidant activity parameters, including SOD, CAT, GPx and GSH/GSSG, were significantly increased at day 64 in the ginger group compared to those in the placebo group, while MDA and NO2−/NO3− levels were significantly decreased (P ginger extract started 3 days prior to chemotherapy has been shown to significantly elevate antioxidant activity and reduce oxidative marker levels in patients who received moderate-to-high emetogenic potential chemotherapy compared to placebo. PMID:28203106

  9. Radiation induced chemotherapy sensitization in trimodality therapy of stage 3 non small cell lung cancer. A preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Takita, H. [Millard Fillmore Hospital, Buffalo (United States); Shin, K. H. [CCS Oncology Center, Kenmore, NY, (United States)

    2000-12-01

    The overall cure rate of locally advanced non-small cell lung carcinoma (NSCLC) remains poor. Although there have been encouraging reports of preoperative use of chemotherapy, more recent trend is the trimodal approach of radiation, chemo, and surgical-therapies. With the trimodal therapy, increased tumor response and resectability are reported, however, there are increased treatment related side effects. It was observed that a relatively small dose of radiation given prior to induction chemotherapy greatly enhanced the tumor response to the chemotherapy without increased toxicity. A total of 18 patients (8 3. A and 10 3.B) were initially given 20 Gy of radiation therapy in 10 fractions and then received 2 courses of Taxol combination chemotherapy. The overall response rate was 83% (15/18) and 13 out of 18 patients underwent surgery. There was one postoperative death (not therapy related). It is speculated that the small dose of radiation therapy may have sensitized the tumor to subsequent chemotherapy, and it was suggested a new hypothesis of radiation therapy induced chemotherapy sensitization.

  10. [Clinical availability of the herbal medicine, SYOUSAIKOTOU, as a gargling agent for prevention and treatment of chemotherapy-induced stomatitis].

    Science.gov (United States)

    Matsuoka, Hitoshi; Mizushima, Yuki; Kawano, Masako; Tachibana, Naoko; Sawada, Yoshiko; Kato, Sachiko; Nagakura, Hiromi; Tanaka, Miyuki; Suzuki, Keiko; Tadanobu, Kuribayashi

    2004-11-01

    The stomatitis accompanying chemotherapy reduces a patient's QOL. Many reports have suggested that some kinds of gargling agents for oral mucositis shorten the duration and severity of symptoms. This study tested the prevention and efficacy against stomatitis of a herbal medicine (Syousaikotou) as a gargling agent for patients receiving chemotherapy. Compared to gargling with providone-iodine and amphotericin B, the Syousaikotou gargle showed a significantly decreased incidence of stomatitis, and a painkilling effect. Stomatitis occurred in about 17.4% among 23 chemotherapy cycles with the Syousaikotou gargle, against about 40.8% among 71 chemotherapy cycles without the Syousaikotou gargle. Among the patients suffering stomatitis pain after 22 chemotherapy cycles, the painkilling effect was seen to be 76.2%, and continues for about 2 hours. Critical side effects were not seen, but in 4 cases there were complaints about foul smells, such as oil and grass smells. Syousaikotou gargle was considered to be one of the useful methods against the stomatitis prevention and sharp pain mitigation from the chemotherapy.

  11. Chemotherapy, cognitive impairment and hippocampal toxicity.

    Science.gov (United States)

    Dietrich, J; Prust, M; Kaiser, J

    2015-11-19

    Cancer therapies can be associated with significant central nervous system (CNS) toxicity. While radiation-induced brain damage has been long recognized both in pediatric and adult cancer patients, CNS toxicity from chemotherapy has only recently been acknowledged. Clinical studies suggest that the most frequent neurotoxic adverse effects associated with chemotherapy include memory and learning deficits, alterations of attention, concentration, processing speed and executive function. Preclinical studies have started to shed light on how chemotherapy targets the CNS both on cellular and molecular levels to disrupt neural function and brain plasticity. Potential mechanisms include direct cellular toxicity, alterations in cellular metabolism, oxidative stress, and induction of pro-inflammatory processes with subsequent disruption of normal cellular and neurological function. Damage to neural progenitor cell populations within germinal zones of the adult CNS has been identified as one of the key mechanisms by which chemotherapy might exert long-lasting and progressive neurotoxic effects. Based on the important role of the hippocampus for maintenance of brain plasticity throughout life, several experimental studies have focused on the study of chemotherapy effects on hippocampal neurogenesis and associated learning and memory. An increasing body of literature from both animal studies and neuroimaging studies in cancer patients suggests a possible relationship between chemotherapy induced hippocampal damage and the spectrum of neurocognitive deficits and mood alterations observed in cancer patients. This review aims to briefly summarize current preclinical and neuroimaging studies that are providing a potential link between the neurotoxic effects of chemotherapy and hippocampal dysfunction, highlighting challenges and future directions in this field of investigation.

  12. The Dark Side of Creativity

    Science.gov (United States)

    Cropley, David H., Ed.; Cropley, Arthur J., Ed.; Kaufman, James C., Ed.; Runco, Mark A., Ed.

    2010-01-01

    With few exceptions, scholarship on creativity has focused on its positive aspects while largely ignoring its dark side. This includes not only creativity deliberately aimed at hurting others, such as crime or terrorism, or at gaining unfair advantages, but also the accidental negative side effects of well-intentioned acts. This book brings…

  13. Pre-exenterative chemotherapy, a novel therapeutic approach for patients with persistent or recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Uribe Jesus

    2005-09-01

    Full Text Available Abstract Background Most cervical cancer patients with pelvic recurrent or persistent disease are not candidates for exenteration, therefore, they only receive palliative chemotherapy. Here we report the results of a novel treatment modality for these patients pre-exenterative chemotherapy- under the rational that the shrinking of the pelvic tumor would allow its resection. Methods Patients with recurrent or persistent disease and no evidence of systemic disease, considered not be candidates for pelvic exenteration because of the extent of pelvic tumor, received 3-courses of platinum-based chemotherapy. Response was evaluated by CT scan and bimanual pelvic examination; however the decision to perform exenteration relied on the physical findings. Toxicity to chemotherapy was evaluated with standard criteria. Survival was analyzed with the Kaplan-Meier method. Results Seventeen patients were studied. The median number of chemotherapy courses was 4. There were 9 patients who responded to chemotherapy, evaluated by bimanual examination and underwent pelvic exenteration. Four of them had pathological complete response. Eight patients did not respond and were not subjected to surgery. One patient died due to exenteration complications. At a median follow-up of 11 months, the median survival for the whole group was 11 months, 3 months in the non-operated and 32 months in those subjected to exenteration. Conclusion Pre-exenterative chemotherapy is an alternative for cervical cancer patients that are no candidates for exenteration because of the extent of the pelvic disease. Its place in the management of recurrent disease needs to be investigated in randomized studies, however, its value for offering long-term survival in some of these patients with no other option than palliative care must be stressed.

  14. Second-line Chemotherapy and Its Survival Analysis of 181 Patients with
Extensive-stage Small Cell Lung Cancer in a Single Institute

    Directory of Open Access Journals (Sweden)

    Manjiao MA

    2013-11-01

    Full Text Available Background and objective Small cell lung cancer (SCLC is the most malignant neuroendocrine tumor and sensitive to chemotherapy and radiotherapy. However, most patients who receive first-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. Currently, the standard first-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen while the standard second-line chemotherapy regimen is open to debate. The aim of this study is to analysis the prognostic factors of second-line chemotherapy in extensive-stage SCLC and to compare the differences of objective response rate, side effects and survival among different second-line chemotherapy regimens. Methods 181 patients who were diagnosed as extensive-stage SCLC and received second-line chemotherapy were collected. χ2 test was used to analysis the differences of enumeration data and between different groups. Kaplan-Meier method was used to calculate the overall survival (OS and progression-free survival (PFS. Univariate analysis and Cox regression analysis were used to detect the prognostic factors. Objective response rate was evaluated by RECIST criteria and side effects were evaluated by WHO criteria. Results The patients who received second-line chemotherapy can be divided into 6 groups, namly group A (CE/EP regimen 27 cases, group B (regimens containing TPT 44 cases, group C (regimens containing CPT-11 33 cases, group D (regimens containing TAX/DXL 20 cases, group E (regimens containing IFO 28 cases and group F (other regimens 29 cases. The median OS in second-line chemotherapy as 7.0 months and was relevant with smoking history (P=0.004, ECOG PS (P<0.001, liver metastasis (P=0.019 and bone metastasis (P=0.028 independently. The median PFS in second-line chemotherapy as 3.0 months and was relevant with smoking history (P=0.034, ECOG PS (P=0.011 and bone metastasis (P=0.005. The response rate among six regimens was

  15. Outpatient chemotherapy, family-centered care, electronic information, and education in adolescents and young adults with osteosarcoma

    Directory of Open Access Journals (Sweden)

    Anderson P

    2013-01-01

    Full Text Available Pete Anderson, Patricia Wells, Theresa Lazarte, Laura Gore, Laura Salvador, Maritza Salazar-AbshireMD Anderson Cancer Center, Pediatrics, Houston TX, USAAbstract: Current osteosarcoma chemotherapy is “standard” (doxorubicin, cisplatin, high-dose methotrexate ± ifosfamide-mesna, and etoposide ± mifamurtide, but current regimens have many short-term, medium-term, and long-term side effects. Generally 12–15 cycles of chemotherapy are given in the hospital over 7–10 months. Even in the absence of new research protocols, improvement in quality of life is now possible, with all osteosarcoma chemotherapy agents now being able to be administered in the outpatient setting. Outpatient chemotherapy is not only less expensive, but in the adolescent and young adult population can result in better quality of life for some. In this paper, we share information to help reduce the frequency of hospitalization and review some tools and strategies to facilitate communication when providing outpatient chemotherapy, family-centered care, and information/education. These include antiemetics with both longer-acting 5HT antagonists and aprepitant, outpatient chemotherapy guidelines, and a 5-week editable calendar that is part of our electronic medical record. Sharing information on absolute lymphocyte count recovery is another means of maintaining hope and increasing understanding of the prognosis of osteosarcoma. Finally, this paper shares an advanced directive/palliative care “checklist” of issues for patients and caregivers to consider at end of life, ie, when “cure of cancer is not the answer”. In summary, better communication at all stages of osteosarcoma care can help reduce hospitalization, improve quality of life, and maintain hope in the adolescent and young adult population with osteosarcoma.Keywords: family-centered care, adolescent and young adult, flash drives, chemotherapy calendars, outpatient, osteosarcoma, chemotherapy

  16. Protection against chemotherapy-induced alopecia: targeting ATP-binding cassette transporters in the hair follicle?

    Science.gov (United States)

    Haslam, Iain S; Pitre, Aaron; Schuetz, John D; Paus, Ralf

    2013-11-01

    Currently, efficacious treatments for chemotherapy-induced alopecia (hair loss) are lacking, and incidences of permanent hair loss following high-dose chemotherapy are on the increase. In this article, we describe mechanisms by which the pharmacological defense status of the hair follicle might be enhanced, thereby reducing the accumulation of cytotoxic cancer drugs and preventing or reducing hair loss and damage. We believe this could be achieved via the selective increase in ATP-binding cassette (ABC) transporter expression within the hair follicle epithelium, following application of topical agonists for regulatory nuclear receptors. Clinical application would require the development of hair follicle-targeted formulations, potentially utilizing nanoparticle technology. This novel approach has the potential to yield entirely new therapeutic options for the treatment and management of chemotherapy-induced alopecia, providing significant psychological and physical benefit to cancer patients.

  17. Liver transplantation for acute hepatic failure due to chemotherapy-induced HBV reactivation in lymphoma patients

    Institute of Scientific and Technical Information of China (English)

    Timothée Noterdaeme; Luc Longrée; Christian Bataille; Arnaud Deroover; Anne Lamproye; Jean Delwaide; Yves Beguin; Pierre Honoré; Olivier Detry

    2011-01-01

    Hepatitis B (HBV) reactivation induced by chemotherapy is problem encountered recently in the management of malignant diseases. Chemotherapy-induced HBV reactivation may ultimately lead to terminal acute liver failure. Liver transplantation (LT) currently remains the only definitive treatment option for such cases, but is generally denied to patients suffering from malignancy. Here, the authors describe 2 cases of cancer-free and HBV graft re-infection-free survival after LT performed for terminal liver failure arising from HBV reactivation induced by chemotherapy for advanced stage lymphoma. These 2 cases, and some other reports in the literature, may suggest that patients suffering from hematologic malignancies and terminal liver disease can be considered for LT if the prognosis of their hematologic malignancy is good.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Valerie A. Allen

    2016-01-01

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

  20. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  1. [Chemotherapy of chiasmal gliomas in children].

    Science.gov (United States)

    Helcl, F

    1995-04-01

    Chiasmal gliomas are rare tumors occurring predominantly in childhood. Their optimal treatment is still controversial. In the past only neurosurgeons (performing partial or subtotal removal of the tumor, biopsy or shunting procedure in hydrocephalus) and radiotherapeutists participated in their treatment. In the middle of the eighties there was only a single article dealing with chemotherapy of these tumors (Rosenstock, 1985). Since that time there was an increased number of articles about harmful effects of radiotherapy on the developing child's brain. Neurosurgeons are aware that they will not solve this problem alone. During the past 7 years we have observed gradual retreat from radiotherapy and an inclination to combined chemotherapy of the chiasmal gliomas in children. The author has been engaged in the research of this clinical entity for more than 10 years and he offers to readers a summary of the contemporary knowledge about chemotherapy of chiasmal gliomas in children. Despite the fact that there is lacking experience with long-term survivors after chemotherapy, which is extremely important especially in this disease, the preliminary short-term results of combined chemotherapy of chiasmal gliomas in children are promising. Rapid development of chemistry and pharmacology in the last few years is promising for the discovery of further, more effective anti-tumor drugs. Their new combinations could improve present non-satisfactory results of treatment of chiasmal gliomas in children. (Ref. 25.)

  2. Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

    Directory of Open Access Journals (Sweden)

    MILA TREMENTOSA GARCIA

    Full Text Available SUMMARY Introduction The successful development of chemotherapy enabled a fertilitysparing treatment for patients with trophoblastic neoplasia. After disease remission, the outcome of a subsequent pregnancy becomes a great concern for these women. Objective To analyze existing studies in the literature that describe the reproductive outcomes of patients with trophoblastic neoplasia treated with chemotherapy. Method Systematic review was performed searching for articles on Medline/ Pubmed, Lilacs and Cochrane Library databases, using the terms “gestational trophoblastic disease” and “pregnancy outcome”. Results A total of 18 articles were included. No evidence of decreased fertility after chemotherapy for trophoblastic neoplasia was observed. The abortion rates in patients who conceived within 6 months after chemotherapy was higher compared to those who waited longer. Some studies showed increased rates of stillbirth and repeat hydatidiform moles. Only one work showed increased congenital abnormalities. Conclusion The pregnancies conceived after chemotherapy for trophoblastic neoplasia should be followed with clinical surveillance due to higher rates of some pregnancy complications. However, studies in the literature provide reassuring data about reproductive outcomes of these patients.

  3. Blind loop perforation after side-to-side ileocolonic anastomosis

    Institute of Scientific and Technical Information of China (English)

    Raffaele; Dalla; Valle; Roberto; Zinicola; Maurizio; Iaria

    2014-01-01

    Blind loop syndrome after side-to-side ileocolonic anas-tomosis is a well-recognized entity even though its in-cidence and complication rates are not clearly defined. The inevitable dilation of the ileal cul-de-sac leads to stasis and bacterial overgrowth which eventually leads to mucosal ulceration and even full-thickness perfora-tion. Blind loop syndrome may be an underestimated complication in the setting of digestive surgery. It should always be taken into account in cases of acute abdomen in patients who previously underwent right hemicolectomy. We herein report 3 patients who were diagnosed with perforative blind loop syndrome a few years after standard right hemicolectomy followed by a side-to-side ileocolonic anastomosis.

  4. Blind loop perforation after side-to-side ileocolonic anastomosis.

    Science.gov (United States)

    Valle, Raffaele Dalla; Zinicola, Roberto; Iaria, Maurizio

    2014-08-27

    Blind loop syndrome after side-to-side ileocolonic anastomosis is a well-recognized entity even though its incidence and complication rates are not clearly defined. The inevitable dilation of the ileal cul-de-sac leads to stasis and bacterial overgrowth which eventually leads to mucosal ulceration and even full-thickness perforation. Blind loop syndrome may be an underestimated complication in the setting of digestive surgery. It should always be taken into account in cases of acute abdomen in patients who previously underwent right hemicolectomy. We herein report 3 patients who were diagnosed with perforative blind loop syndrome a few years after standard right hemicolectomy followed by a side-to-side ileocolonic anastomosis.

  5. The management of parotid tumors

    Institute of Scientific and Technical Information of China (English)

    Guang Yan Yu

    2008-01-01

    @@ The majority of salivary gland tumors are of epithelial origin. Parotid gland is the most common location of the tumors. Surgery is the main modality for the management of parotid tumors. Radiotherapy, chemotherapy etc are the auxiliary modalities.

  6. A Case of Advanced Gastric Cancer with Poor Performance Status Which Improved by Chemotherapy

    Directory of Open Access Journals (Sweden)

    Kohei Shitara

    2010-07-01

    Full Text Available Introduction: The prognosis of advanced gastric cancer patients, especially those with poor performance status (PS, is generally dismally poor. Patients with PS 3–4 are usually ineligible for participation in clinical studies and are managed with only best supportive care. Case Report: A 63-year-old male with advanced gastric cancer was admitted to our hospital. His PS was markedly impaired (Eastern Cooperative Oncology Group PS 4, with dyspnea secondary to lymphangitis, pleuritis and pericarditis. He also had bilateral leg paralysis due to multiple bone metastases. He was treated with chemotherapy using 5-fluorouracil and leucovorin for 14 days with pericardial drainage followed by intrapericardial infusion of cisplatin. He was also treated with radiotherapy for bone metastasis. The patient required 5 l/min oxygen therapy at the start of chemotherapy, but his dyspnea was improved by day 14 and he no longer required supplemental oxygen therapy. His leg paralysis also improved with the radiation therapy. His PS was significantly improved with this multimodal treatment modality, and he was ultimately discharged with chemotherapy with oral fluoropyrimidine. Conclusion: This case suggests that multimodal therapy including chemotherapy may be beneficial in advanced gastric cancer patients even in the setting of poor PS. Further study might be required to confirm the benefit of chemotherapy in this patient population.

  7. Intraarterial chemotherapy with gemcitabine and cisplatin in locally advanced or recurrent penile squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Jian-Ye Liu; Yong-Hong Li; Zhuo-Wei Liu; Zhi-Ling Zhang; Yun-Lin Ye; Kai Yao; Hui Han; Zi-Ke Qin; Fang-Jian Zhou

    2013-01-01

    The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC) of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on local y advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were analyzed, and survival rates were calculated. After 2 to 6 cycles of intraarterial chemotherapy with gemcitabine and cisplatin, 1 patients with locoregional y advanced disease achieved a complete response, and 4 achieved partial response. Of the 7 patients with recurrent disease, 2 achieved complete response, 3 achieved partial response, 3 had stable disease, and 1 developed progressive disease. An objective tumor response was therefore achieved in 10 of the 12 patients. The median overal survival for the patients was 24 months (range, 10-50 months). Three out of 10 patients who responded were long-term survivors after intraarterial chemotherapy. Intraarterial chemotherapy with gemcitabine and cisplatin may be effective and potential y curative in locoregional y advanced or recurrent penile SCC. The contribution of this therapy in the primary management of advanced or recurrent penile SCC should be prospectively investigated.

  8. Two-Sided Tests and One-Sided Confidence Bounds

    OpenAIRE

    1994-01-01

    Based on the duality between tests and confidence sets we introduce a new method to derive one-sided confidence bounds following the rejection of a null hypothesis with two-sided alternatives. This method imputes that the experimenter is only interested in confidence bounds if the null hypothesis is rejected. Furthermore, we suppose that he is only interested in the direction and a lower confidence bound concerning the distance of the true parameter value to the parameter values in the null h...

  9. Evaluation of role of radical radiotherapy and chemotherapy in cervical cancer patients- A preliminary report

    Directory of Open Access Journals (Sweden)

    Sanjay Singh Chandel

    2016-01-01

    Full Text Available Background: Carcinoma of uterine cervix is the commonest cancer affecting females in developing countries. Concurrent chemoradiation has remained the sole definitive treatment available in the advanced stages. The study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy, when approximately 40% of total tumor dose is applied. Subjects and Methods: Sixty-four patients were enrolled who had locally advanced uterine cervix carcinoma (Federation of Gynecology and Obstetrics Stage IIB–IVA from July 2011 to May 2013 for concurrent chemotherapy and intracavitory brachytherapy after completion of concurrent chemotherapy and external beam radiotherapy followed by three insertion of brachytherapy separated by a week by flexitron brachytherapy unit to Point A, for each application was 6 Gy by high dose rate. Cisplatin was given (35 mg/m2 1 day before brachytherapy in each application. Results: At medium follow-up of 19 months (range 8–30 months clinical complete response rate was found to be 89% at 3 months of follow-up. Acute side effect as nausea and vomiting Grades I and II were recorded as 55% and 28% respectively, no renal dysfunction and no thrombocytopenia were encountered. No patients had Grade IV or life threatening toxicity. Overall survival and disease free survival after 30 months of follow-up is 88% and 75% respectively. Conclusion: Use of concurrent chemotherapy with brachytherapy is effective and feasible with acceptable toxicity for locally advanced carcinoma of the uterine cervix.

  10. A Reactive 1O2 - Responsive Combined Treatment System of Photodynamic and Chemotherapy for Cancer

    Science.gov (United States)

    Wang, Xiaojun; Meng, Guoqing; Zhang, Song; Liu, Xinli

    2016-07-01

    The development of reactive oxygen species (ROS)-responsive drug delivery and drug release has gradually attracted much attention in recent years as a promising therapeutic strategy. Singlet oxygen (1O2) as the major ROS species is widely used in photodynamic therapy (PDT) of cancer. In the present study, we introduce a combined treatment using ROS-sensitive thioketal (TK) linkage as a linker between upconversion nanoparticles (UNs)-based PDT and doxorubicin (DOX)-based chemotherapy. UNs can not only play a role in PDT, but can also be used as a nanocarrier for drug delivery of DOX. Moreover, the products of 1O2 during PDT are able to cleave TK linker inducing the release of DOX which can further achieve the goal of chemotherapy. By using this 1O2-responsive nanocarrier delivery system, DOX can easily reach the tumor site and be accumulated in the nuclei to effectively kill the cancer cells, and therefore decreasing the side effects of chemotherapy on the body. Thus, PDT also has the function of controlling drug release in this combination treatment strategy. Compared with monotherapy, the combination of PDT with chemotherapy also possesses excellent drug loading capability and anticancer efficiency.

  11. FROM HUMANS TO DOGS AND BACK: THE TRANSLATIONAL LESSON OF METRONOMIC CHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    Alessio Pierini

    2012-01-01

    Full Text Available The main priority in veterinary oncology is to maintain patient quality of life. It is important that new chemotherapy strategies aim to minimize side effects, thus making the treatment attractive for owners as well as their pets. Metronomic chemotherapy has been shown to have an important stabilizing effect on human cancer (including chemotherapy-resistant disease resulting in prolonged clinical benefit. In addition, this form of treatment has been shown to have positive effects on the quality of life of patients with various types of cancer. These positive effects are obtained without any indication of high grade toxicity. Moreover, low cost and oral administration (which reduces the need for hospitalization and enables patients to stay at home longer are key characteristics of this schedule, offering important advantages in frail subgroups of patients (e.g., old patients for whom new therapeutic options are greatly needed. From another perspective, use of metronomic chemotherapy in dogs could reveal new and innovative schedules that could be applied to humans. Veterinary oncology cases treated with metronomic schedules represent the unique opportunity to ethically investigate novel drugs or combination treatments that may be highly translatable to the human community. The aim of the present review was to describe how this new form of treatment has evolved in canine patients thus far."

  12. Chemotherapy in non-small cell lung cancer:opportunities for advancement

    Institute of Scientific and Technical Information of China (English)

    Mani Akhtari; Eric H Bernicker; Bin S Teh

    2016-01-01

    Locally advanced non-small cell lung cancer (NSCLC) continues to be a challenging disease to treat. With high rates of both local and distant failures, there is significant interest in finding more biologically active chemotherapy regimens that can contribute to reduce both failures. The phase III PROCLAIM trial, recently published in the Journal of Clinical Oncology entitled“PROCLAIM: randomized phase III trial of pemetrexed–cisplatin or etoposide–cisplatin plus thoracic radiation therapy followed by consolidation chemotherapy in locally advanced nonsquamous non-small-cell lung cancer”, compared two different chemotherapy regimens given concurrently with radiotherapy in patients with stage III non-squamous lung cancer: pemetrexed plus cisplatin versus cisplatin plus etoposide. Both groups received con-solidation chemotherapy. After enrolling 598 of planned 600 patients, the study was stopped early due to futility as no difference was seen in the primary end-point of overall survival. Since PROCLAIM was designed as a superiority trial, these results suggest that pemetrexed regimens do not offer a clinical advantage over standard cisplatin plus etopo-side. There are some subpopulations who might still benefit from pemetrexed, especially if clinicians are concerned about myelosuppression-related adverse events. Future trials are needed to investigate novel biologic agents and irradiation techniques that can result in more durable local and distant disease control in locally advanced NSCLC.

  13. Solid Matrix Based Lipidic Nanoparticles in Oral Cancer Chemotherapy: Applications and Pharmacokinetics.

    Science.gov (United States)

    Ahmad, Javed; Amin, Saima; Rahman, Mahfoozur; Rub, Rehan Abdur; Singhal, Madhur; Ahmad, Mohammad Zaki; Rahman, Ziyaur; Addo, Richard T; Ahmad, Farhan Jalees; Mushtaq, Gohar; Kamal, Mohammad Amjad; Akhter, Sohail

    2015-01-01

    Chemotherapeutic delivery by oral route in cancer patients has the potential to create "hospitalization free chemotherapy" which is a vision of oncologists, formulation scientists and patients. Such a therapeutic approach will improve patients' compliance, ease the burden of the patients' caregivers and significantly reduce the cost of treatment. In current clinical practice, chemotherapy carried out by intravenous injection or infusion leads to undesired side-effects such as plasma concentrations crossing the maximum safe concentration, rapid body clearance and lower bioavailability. Despite the presence of challenges such as poor aqueous solubility and stability of drugs and the presence of biological barriers like multidrug efflux transporter in the GI tract, oral cancer chemotherapy has the potential to surmount those obstacles. Lipid nanoparticles (LNPs) such as solid lipid nanoparticle, nanostructured lipid carriers, nano lipid-drug conjugates, mixed micelles, liposomes and nanoemulsions have shown some promising results for use in oral anticancer drug delivery through nanotechnological approach. LNPs demonstrate enhanced oral bioavailability owing to their ability to inhibit first pass metabolism via lymphatic absorption by chylomicron-linked and/or M-cell uptake. LNPs reduce the inter- and intrasubject pharmacokinetics variability of administrated drugs. Moreover, certain classes of phospholipids and surfactants used in the formulations of LNPs can suppress the P-glycoprotein efflux system. Here, we shall be discussing the biopharmaceutical challenges in oral cancer chemotherapy and how the LNPs may provide solutions to such challenges. The effect of GI tract environment on LNPs and pharmacokinetics shall also be discussed.

  14. 1例胃癌术后患者化学治疗所致恶心呕吐药学服务%Pharmaceutical Care in the Management of Nausea and Vomiting Induced by Adjuvant Chemotherapy for a Postoperative Patient with Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    刘宇; 邱峰; 李欣宇

    2015-01-01

    Objective To provide reference for clinical pharmacist participating in management of nausea and vomiting induced by tumor chemotherapy. Methods The process of pharmaceutical care for a patient with severe vomiting caused by adjuvant chemotherapy after gastric cancer operation was described. Antiemetic application and drug adverse reactions were analyzed. A new treatment plan was given by clinical pharmacist. Results The suggestions were adopted by clinician. The vomiting was controlled and drug adverse reactions were dealt with. Conclusion To reduce the risk and improve the income of antiemetic,clinical pharmacists should pay more attention to clinical practice guideline,drug interaction and adverse reactions, provide the most suitable suggestions for clinicians according to pharmacology and evidence-based medicine.%目的:为临床药师参与化学治疗(化疗)所致恶心呕吐的管理提供参考。方法临床药师参与1例胃癌术后辅助化疗导致严重呕吐病例的监护过程。对化疗所致呕吐的预防和治疗药物应用、止吐药物不良反应识别和处理进行分析,并基于药理学与临床指南提出药物治疗建议。结果医师采纳药师建议,患者呕吐得到有效控制,止吐药物所致不良反应得到缓解。结论临床药师参与化疗所致恶心呕吐的管理,应注意对临床指南的理解和掌握,加强对止吐药物相互作用和不良反应的关注,并基于药理学和循证医学提供最佳的药物治疗建议,以保障患者用药的安全有效。

  15. Is there any advantage to combined trastuzumab and chemotherapy in perioperative setting her 2neu positive localized gastric adenocarcinoma?

    Directory of Open Access Journals (Sweden)

    Albouzidi Abderrahmane

    2011-09-01

    Full Text Available Abstract We report here a 44-year-old Moroccan man with resectable gastric adenocarcinoma with overexpression of human epidermal growth factor receptor 2 (HER2 by immunohistochemistry who was treated with trastuzumab in combination with chemotherapy in perioperative setting. He received 3 cycles of neoadjuvant chemotherapy consisting of trastuzumab, oxaliplatin, and capecitabine. Afterwards, he received total gastrectomy with extended D2 lymphadenectomy without spleno-pancreatectomy. A pathologic complete response was obtained with a combination of trastuzumab and oxaliplatin and capecitabine. He received 3 more cycles of trastuzumab containing regimen postoperatively. We conclude that resectable gastric carcinoma with overexpression of the c-erbB-2 protein should ideally be managed with perioperative combination of trastuzumab with chemotherapy. Further research to evaluate trastuzumab in combination with chemotherapy regimens in the perioperative and adjuvant setting is urgently needed.

  16. Systemic chemotherapy for metastatic breast cancer

    Institute of Scientific and Technical Information of China (English)

    Yannan Zhao; Biyun Wang

    2015-01-01

    Breast cancer is the leading cause of cancer among women worldwide and the most common cancer in China. Many factors influence the treatment strategy for metastatic breast cancer (MBC). Chemotherapy should be administered to patients with hormone receptor-negative tumors, symptomatic visceral metastasis, and a short disease-free interval. Sequential single-agent chemotherapy has similar efficacy as combination agents in terms of overall survival and quality of life. Anthracyclines are the cornerstone of first-line treatment for MBC, and taxanes represent the second treatment option after resistance. When progression or intolerable toxicity occurs after optimal treatment, the alternative treatments include capecitabine, vinorel-bine, and gemcitabine. Ixabepilone and eribulin are relatively new effective single agents. A combination of cytotoxic agents for patients with rapid clinical progression can further improve the overall response rate and time to progression compared to single-agent treatment. For patients with MBC who were pretreated with anthracyclines in the neoadjuvant/adjuvant setting, a taxane-containing regimen such as docetaxel plus capecitabine or gemcitabine plus paclitaxel should be administered. Platinum-based therapies such as cisplatin or carboplatin have a role in the treatment of triple-negative breast cancer. Meanwhile, the efficacy of the addition of targeted drugs such as iniparib, bevacizumab, and cetuximab to chemotherapy remains unproven. Maintenance chemotherapy is routinely recommended in clinical practice at present. Patients who were previously treated with paclitaxel and gemcitabine have better progression-free and overall survival with maintenance chemotherapy according to a Korean phase Ⅲ clinical trial. Sequential maintenance treatment with capecitabine monotherapy after capecitabine-based combination chemotherapy (X-based X) appears favorable based on a series of domestic studies.

  17. Oculomotor Deficits after Chemotherapy in Childhood.

    Directory of Open Access Journals (Sweden)

    Einar-Jón Einarsson

    Full Text Available Advances in the diagnosis and treatment of pediatric malignancies have substantially increased the number of childhood cancer survivors. However, reports suggest that some of the chemotherapy agents used for treatment can cross the blood brain barrier which may lead to a host of neurological symptoms including oculomotor dysfunction. Whether chemotherapy at young age causes oculomotor dysfunction later in life is unknown. Oculomotor performance was assessed with traditional and novel methods in 23 adults (mean age 25.3 years, treatment age 10.2 years treated with chemotherapy for a solid malignant tumor not affecting the central nervous system. Their results were compared to those from 25 healthy, age-matched controls (mean age 25.1 years. Correlation analysis was performed between the subjective symptoms reported by the chemotherapy treated subjects (CTS and oculomotor performance. In CTS, the temporal control of the smooth pursuit velocity (velocity accuracy was markedly poorer (p<0.001 and the saccades had disproportionally shorter amplitude than normal for the associated saccade peak velocity (main sequence (p = 0.004, whereas smooth pursuit and saccade onset times were shorter (p = 0.004 in CTS compared with controls. The CTS treated before 12 years of age manifested more severe oculomotor deficits. CTS frequently reported subjective symptoms of visual disturbances (70%, unsteadiness, light-headedness and that things around them were spinning or moving (87%. Several subjective symptoms were significantly related to deficits in oculomotor performance. To conclude, chemotherapy in childhood or adolescence can result in severe oculomotor dysfunctions in adulthood. The revealed oculomotor dysfunctions were significantly related to the subjects' self-perception of visual disturbances, dizziness, light-headedness and sensing unsteadiness. Assessments of oculomotor function may, thus, offer an objective method to track and rate the level of

  18. Change of SPARC expression after chemotherapy in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yong-Yin Gao; Xin-Yuan Zhang; Yi Ba; Ding-Zhi Huang; Ru-Bing Han; Xia Wang; Shao-Hua Ge; Hong-Li Li; Ting Deng; Rui Liu; Ming Bai; Li-Kun Zhou

    2015-01-01

    Objective:The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine (SPARC) expression changes atfer chemotherapy in gastric cancer (GC) is unclear. hTis study investigated the inlfuence of chemotherapy on SPARC expression in GC. Methods:Immunohistochemistry was used to analyze SPARC expression in 132 GC cases (including 54 cases with preoperative chemotherapy and 78 cases without preoperative chemotherapy). SPARC expression of postoperative specimens with and without preoperative chemotherapy was assessed to analyze the inlfuence of chemotherapy on SPARC expression. Results:SPARC was highly expressed in GC compared with the desmoplastic stroma surrounding tumor cells and noncancerous tissues. High SPARC expression was correlated with invasion depth, lymph node, and TNM stage. After chemotherapy, a lower proportion of high SPARC expression was observed in patients with preoperative chemotherapy than in the controls. For 54 patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node, TNM stage, and SPARC expression were related to overall survival. Further multivariate analysis showed that lymph node, histology, and SPARC expression atfer chemotherapy were independent prognostic factors. Conclusion:SPARC expression may change after chemotherapy in GC. SPARC expression should be reassessed for patients with GC atfer chemotherapy.

  19. Cardiologic side effects of psychotropic drugs

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Marano; Gianandrea Traversi; Enrico Romagnoli; Valeria Catalano; Marzia Lotrionte; Antonio Abbate; Giuseppe Biondi-Zoccai; Marianna Mazza

    2011-01-01

    Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity.The coexistence of a heart disease complicates the management of mental illness,can contribute to a reduced quality of life and a worse illness course.The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity.Moreover,the complex underlying mechanism that links these two conditions remains unclear.This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.

  20. Novel side branch ostial stent.

    Science.gov (United States)

    Chen, Shao-Liang; Lv, Shu-Zheng; Kwan, Tak W

    2009-04-01

    Bifurcation lesions are technically challenging and plagued by a high incidence of restenosis, especially at the side branch orifice, which results in a more frequent need for revascularization during the follow-up period. This report discusses two clinical experiences with a novel side branch ostial stent, the BIGUARD stent, designed for the treatment of bifurcation lesions; procedural success with no in-hospital complications was observed in types IVb and Ia lesions.