Síndrome post-aborto. Reacciones psicológicas post-aborto

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Ximena Fuentes Martínez

2009-06-01

Las distintas investigaciones y la experiencia clínica describen desde reacciones ansiosas, depresivas, sentimientos de vacío y dolor, hasta un síndrome específico, el síndrome post-aborto, el cual presentaría casi las mismas características del estrés pos-traumático

Reacciones adversas a medicamentos notificadas por pacientes del policlínico Gustavo Aldereguía

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Adbel Abad Hechavarría Espinosa

2014-12-01

Full Text Available Las reacciones adversas a medicamentos son el resultado de una interacción entre el medicamento administrado y algunas características inherentes o adquiridas del paciente y que determinan el patrón individual de respuesta. Se realizó un estudio, donde se describen los principales resultados obtenidos en el sistema de la farmacovigilancia del policlínico “Dr. Gustavo Aldereguía Lima”, en el período comprendido entre enero y diciembre de 2012. Los casos se reportaron a través del modelo 33-36-1, para el reporte de sospecha de reacciones adversas a medicamentos. La muestra estuvo constituida por 242 pacientes notificados con reacciones adversas a medicamentos (RAM, obteniéndose como resultados más relevantes que el 67,3 % eran pacientes del sexo femenino; los meses de abril y mayo fueron los de mayor cantidad de reportes; el 90,9 % fueron reportados por médicos; los grupos farmacológicos que mayor incidencia tuvieron, en el orden siguiente, fueron los antibacterianos, los antihipertensivos y las vacunas; las reacciones más frecuentes fueron el eritema, la fiebre y el prurito, siendo la piel el órgano más reportado; el 30,1 % fueron importantes (según criterios para determinar RAM importantes, descritos en las normas y procedimientos de trabajo del sistema cubano de farmacovigilancia. Según la causalidad, el 95,4 % fueron probables y el 63,2 % frecuentes. El 19,0 % requirió atención de urgencia

Adverse effects to iodinated contrast media in interleukin-2 treated patients; Reacciones adversas a los medio de contraste yodados en pacientes tratados con interleuquina 2

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Vias, I.; Nicolas, A. I.; Lopez Picazo, J. M.; Elduayen, B.; Delgado, C.; Ano, M.; Fernande-villa, T.; Garcia del Barrio, L.; Velazquez, P.; Bilbao, J. I. [Universidad de Navarra. Pamplona (Spain)

2000-07-01

Interleukin-2 (IL-2) is a potent modulator of immune response that provokes tumor regression in cancer patients. IL-2 may induce sensitization to radiological iodinated contrast media (ICM) and this phenomenon has been rarely reported in literature. We report the increased incidence of adverse reactions to ICM patients treated with systemic IL-2, discuss the possible mechanisms of action, and propose patient management strategies. Retrospective study was conducted in 168 patients treated with subcutaneous IL-2 and 544 patients who did not.CT scans were performed with intravenous administration of 80-160 ml of nonionic ICM with a power injector. The incidence of adverse reactions to ICM among our patients was 7.14%. It differs significantly (p<0.001) from that in the control group (1.28%). Thus, patients treated with IL-2 have a relative risk of 5,6 times (CI 95%; 2.2-13.9). The adverse reactions in IL-2 patients were mild and resolved promptly without treatment in 11 patients. In one patient hypotension required intravenous forced hydration. Patients on IL-2 treatment may be at risk of experiencing contrast induced adverse reactions. Potent of the immune system by IL-2 may increase the potential risk for hypersensitivity or other adverse reactions to ICM. Knowledge of this fact may be valuable in clinical decision making and patient follow-up strategies. (Author) 18 refs.

Reacciones del consumidor mexiquense hacia las faltantes en anaquel. ¿Qué factores intensifican las reacciones negativas hacia el detallista?

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Victoria Eugenia Erosa Martín; María del Pilar Ester Arroyo López

2011-01-01

Este estudio analiza las reacciones de los consumidores ante faltantes de anaquel en una empresa local del sector del comercio al menudeo con el propósito de apoyar en el diseño de estrategias para incrementar la satisfacción y retención de su clientela. Se tomaron como referencias teóricas la satisfacción y el comportamiento del consumidor; para ello, se realizó una encuesta en tiendas detallistas con distintos perfiles donde se recopilaron datos sobre el perfil demográfico y de compra de lo...

Las pruebas VDRL falsas reactivas en el manejo de la sífilis Reacciones Falsas positivas en el embarazo

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Miguel Guzmán

1981-09-01

Full Text Available Se presenta un estudio sobre reacciones VDRL falsas reactivas en el embarazo. Se analizan los resultados de las pruebas practicadas a los sueros sanguíneos obtenidos de 4.344 gestantes tomadas al azar sobre un universo restringido de 13.477; 64 muestras fueron VDRL reactivas y FTA-ABS no reactivas, lo cual da 1.5% de falsas reactivas; 25 reacciones fueron VDRL reactivas y FTA-ABS reactivas, para 0.6% de Sífilis. Las reacciones falsas reactivas están más asociadas con el primer embarazo. Las reacciones falsas reactivas lo son a títulos muy bajos de O a dos diluciones. Se encontró una marcada relación entre la ocurrencia de falsas reactivas y el grupo sanguíneo A, Rh(-. No existe relación entre la falsa reactividad y los antecedentes patológicos generales u obstétricos. Igualmente se encontró que no existe una distribución específica por grupos de edad. La falsa reactividad no está asociada con un período especial del embarazo y aparece desde los primeros meses. En el seguimiento durante el post-parto se demostró que las pruebas falsas reactivas se negativizan hasta seis meses después.

Reacciones adversas a medicamentos en una población colombiana, 2007-2013: análisis de bases de datos

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Jorge Enrique Machado-Alba

2016-03-01

Conclusiones. Se encontró un incremento de reportes de reacciones adversas a medicamentos en los últimos años, lo que concuerda con la tendencia mundial. Se evidenciaron diferencias entre los reportes hospitalarios y de consulta ambulatoria. La información sobre los reportes de reacciones adversas a medicamentos, sobre todo la recopilada por el Instituto Nacional de Vigilancia de Medicamentos y Alimentos (Invima, debería ser pública para su uso académico e institucional.

Reacciones transfusionales mediadas inmunológicamente immunologically mediated transfusional reactions

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Elkín Ferdinand Cardona Duque

2001-01-01

Full Text Available Son muchas las complicaciones potenciales de la terapia transfusional, pero la mayoría se presentan en pacientes que requieren múltiples transfusiones. Los riesgos asociados con la transfusión de una unidad sanguínea son realmente bajos pero deben considerarse contra los beneficios que se buscan al ordenarla. Las reacciones transfusionales se pueden clasificar como inmunológicas y no inmunológicas. Muchas de las primeras son causadas por estimulación de los anticuerpos por parte de los antígenos presentes en la transfusión de glóbulos rojos, leucocitos, plaquetas o proteínas del plasma. Esa isoinmunización puede llevar a una reacción futura cuando dichos antígenos sean transfundidos nuevamente al paciente. Entre las posibilidades se incluyen la hemólisis por incompatibilidad; las reacciones febriles o pulmonares causadas por antígenos en las plaquetas o los leucocitos; los fenómenos alérgicos o anafilácticos debidos a anticuerpos que reaccionan con antígenos solubles, generalmente del tipo de proteínas plasmáticas, y otras de menor importancia. The potential complications of blood transfusion therapy are multiple but most of them occur only in patients requiring repeated transfusions. Risks associated with transfusion of a single unit of blood are low; however, they must be weighted against the benefits at the time each transfusion is ordered. Transfusion reactions can be classified as either immunologic or non-immunologic. Many immune reactions are caused by stimulation of antibody production by foreign alloantigens present on transfused red cells, leukocytes, platelets, or plasma proteins. Such alloimmunization may lead to future immunologically mediated reactions when transfusions carrying these antigens are administered. These include hemolytic reactions caused by red blood cell incompatibility; febrile or pulmonary reactions caused by leukocytes and platelet antigens; allergic or anaphylactic reactions caused by

Reacciones adversas a medicamentos como causa de abandono del tratamiento farmacológico en hipertensos Adverse reactions to drugs as leaving drug therapy cause in hypertensive persons

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Ana Julia García Milián

2009-03-01

Full Text Available INTRODUCCIÓN: los fallos al seguir las prescripciones médicas exacerban los problemas de salud y la progresión de las enfermedades, e imposibilitan estimar los efectos y el valor de un determinado tratamiento. OBJETIVO: caracterizar las causas que generan la no adherencia al tratamiento farmacológico en hipertensos. MÉTODOS: estudio observacional descriptivo de corte transversal, constituido por 241 hipertensos inscriptos por algún fármaco antihipertensivo en farmacias comunitarias seleccionadas de Guantánamo, Las Tunas, Camagüey, Cienfuegos, Villa Clara, Granma, Santiago de Cuba y Ciego de Ávila. El método de recogida de la información fue la encuesta. RESULTADOS: los antihipertensivos más consumidos fueron el captopril, la hidroclorotiacida y el atenolol, y fue el primero, con el 31,9 %, el medicamento que tuvo un mayor porcentaje de incumplidores y productor de evento adverso. El cumplimiento fue mayor en los pacientes menores de 30 años. Dentro de los motivos las reacciones adversas ocuparon el 2do. lugar, con el 16,9 %. Las reacciones que causaron abandono terapéutico fueron la tos, las reacciones cutáneas y el decaimiento. CONCLUSIONES: las reacciones adversas se ubican dentro de las causas más frecuentes de abandono de tratamiento antihipertensivo, y fueron el captopril y la hidroclorotiacida los que con mayor frecuencia la provocaron. Las reacciones adversas referidas, en su mayoría, son consideradas como leves.INTRODUCTION: failures to follow medical prescriptions increase health problems and diseases progression, and make it impossible for to estimate effects and value of a specific treatment. AIM: to characterize causes generating the non-adherence to pharmacologic treatment in hypertensive patients. METHODS: cross-sectional descriptive and observational study including 241 hypertensive patients registered by some anti-hypertensive drug in selected community drugstore In Guantánamo, Las Tunas, Camaguey, Villa Clara

Estudio de las reacciones medicamentosas por hipersensibilidad retardada mediante la proliferación linfoblástica Study of drug reactions due to delayed hypersensitivity by lymphoblastic proliferation

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Yulién Alpízar Olivares

1999-12-01

Full Text Available Se estudiaron 6 enfermos con el posible diagnóstico de reacciones medicamentosas por hipersensibilidad retardada (HR mediante la prueba de transformación linfoblástica con criterio de incorporación de timidina tritiada. Se demostró que en 2 pacientes existían reacciones de HR a la carbamazepina, en uno al ácido acetil salicílico, en uno a la cloroquina y el sulfaprim y el otro paciente al ácido acetil salicílico en tabletas y a la materia prima. Se comprobó que la introducción de este método para la evaluación de la reacción de HR tipo IV en el estudio de las reacciones adversas a medicamentos es de gran utilidad en nuestro medio. Se modificó la conducta terapéutica en cada enfermo de acuerdo con los resultados obtenidos, lo que favoreció el pronóstico, la estadía hospitalaria y la curación6 patients with the possible diagnosis of drugs reactions due to delayed hypersensitivity (DH were studied by using the test of lymphoblastic transformation with criterion of incorporation of tritiated thymidine. It was proved that in 2 patients there DH reactions to carbamazepine, in one to aspirin, in one to chloroquine and sulfaprim, and the other patient to aspirin in tablets and to the raw material. It was proved that the introduction of this method for evaluating the reaction of type IV DH in the study of adverse reactions to drugs is very useful in our environment. The therapeutic conduct was modified in each patient according to the results obtained, which favored the prognosis, hospital stay and healing

La metoclopramida y sus reacciones adversas sobre el sistema nervioso central The metoclopramide and its adverse reactions on the nervous central system

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Ismary Alfonso Orta

2011-06-01

ser clasificadas como tempranas o agudas, y las reacciones adversas que predominaron fueron las leves y probables.Introduction: metoclopramide from 2000 to 2006 years became the drug with higher frequency of association with late dyskinesia seen. In a analysis carried out by Food and Drug Administration (FDA it is noticed that the 20 % of patients with a prescription of metoclopramide use it drug for more than 3 months. Objective: to characterize the adverse reactions reported of metoclopramide and its relation to the notification of a late dyskinesia in our country. Methods: a cross-sectional, descriptive, observational study related to pharmacosurveillance using the method of spontaneous notification of reports on drug adverse reactions and the database of the National Coordination Unit of Pharmacosurveillance. Authors analyzed all reports of drug adverse react ions from 2003 to 2008 from all country. Results: a total of 1 119 notifications of drug adverse reactions. The organic system more involved were the central nervous system (43,2 % followed by the cardiovascular one (14,2 %. There was predominance of probable drug adverse reactions (73,6 % and slights (51,7 %, a 0,4 % accounted for severe adverse reactions, whereas the more frequent were: extrapyramidal syndrome (29,0 %, dizziness (18,2 % and shaking (9,9 %. The predominant temporary sequence between the occurrence of adverse reaction and drug ingestion was in hours (53,8 %. Conclusions: it was evidenced that children and elderly populations show a great relation with the predominance of drug adverse reactions of central nervous system, however, the adult population must not to be excluded, since more than a half of above mentioned reported reactions were in this age group. That system was the more involved even though there was not a link with high doses. The reported dyskinesias may be classified as early or acute and the adverse reactions predominant were the slight and probable ones.

DESARROLLO DE REACCIONES DE CONDENSACIÓN ALDÓLICA SOBRE SOPORTE DE CELULOSA

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Liliana E. Luna

2011-01-01

Full Text Available En este trabajo se desarrollan algunas reacciones sobre soporte sólido de celulosa para alumnos de Química Orgánica del segundo año de las carreras de Bioquímica, Farmacia, Lic. en Química y Lic. en Biotecnología. Las reacciones analizadas fueron la de Claisen-Schmidt entre ciclohexanona y benzaldehído en medio básico para la síntesis de 2,6-dibenciliden-ciclohexanona y la reacción aldólica de acetona con benzaldehído en medio básico para preparar la 4-fenil-4-hidroxi-butanona. Los productos se aíslan permitiendo su identificación por cromatografía en capa delgada, espectroscopía de RMN de protones y se comparan con los productos obtenidos por el método tradicional en solución. Esta metodología simple y eficiente que se experimentó en grupos de alumnos de segundo año de esta Facultad permite la integración de los temas aldehídos, cetonas y enolatos aprendidos anteriormente, en consonancia con espectroscopía IR y RMN-1H en una dada transformación química.

Anatomía Humana: estudio de las reacciones de los estudiantes de primero de medicina ante la sala de disección

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Maribel Miguel Pérez

Full Text Available Introducción: El objetivo de este estudio es reflejar las reacciones físicas y emocionales de los estudiantes de primer curso de Medicina de la Universidad de Barcelona (Campus de Bellvitge ante la sala de disección. Material y métodos: Los estudiantes responden a tres cuestionarios que valoran la intensidad del miedo, las reacciones físicas y psicológicas frente la sala de disección y los métodos de afrontamiento, en dos momentos del curso: al inicio y al final del curso académico. Resultados: Las reacciones más frecuentes fueron la sensación de disgusto, la pérdida del apetito, las imágenes visuales recurrentes de los cadáveres, el insomnio y las pesadillas. Respecto a los métodos de afrontamiento más usados por los estudiantes para contrarrestar las reacciones adversas correspondieron en juntarse y hacer broma con los amigos, estudiar anatomía y pedir consejo a compañeros y profesores. Conclusiones: La sala de disección representa, para los estudiantes del primer curso de medicina, el primer encuentro relacionado con la muerte y ésta, a la vez, implica el desarrollo de mecanismos de adaptación en su futuro profesional. Los profesores de anatomía no solo tienen una mera función docente como transmisores de contenidos, sino que también deberían dar apoyo a la adaptación progresiva de los alumnos a la sala de disección.

Costos directos y aspectos clínicos de las reacciones adversas a medicamentos en pacientes hospitalizados en el servicio de medicina interna de una institución de tercer nivel de Bogotá.

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Gabriel Tribiño

2006-03-01

Full Text Available Introducción. Las reacciones adversas a medicamentos constituyen un problema clínico frecuente en el ámbito hospitalario y aumentan los costos de la atención en salud. En Colombia son pocos los estudios realizados para evaluarlas desde el punto de vista clínico y económico. Objetivo. Determinar los costos generados por las reacciones adversas a medicamentos en pacientes hospitalizados en el servicio de medicina interna de una institución de tercer nivel e identificar sus principales características clínicas. Materiales y métodos. Se hizo seguimiento intensivo de los pacientes del servicio de medicina interna durante un período de cinco meses para detectar reacciones adversas. La información se recolectó mediante un formulario basado en el formato de reporte del INVIMA. La probabilidad de causalidad se generó mediante el algoritmo de Naranjo. Se calcularon los costos directos desde la perspectiva del pagador teniendo en cuenta la estancia adicional, los medicamentos, los exámenes paraclínicos, los procedimientos, los traslados a la unidad de cuidado intermedio o intensivo y los insumos. Resultados. Se detectaron 268 reacciones adversas en 208 de los 836 pacientes que ingresaron en el servicio (proporción de incidencia, 25,1%; razón de presencia, 0,32. El 74,3% se clasificó como probable; el 92,5% fue tipo A; el 81,3% correspondió a reacciones moderadas. El sistema más frecuentemente afectado fue el hematológico (33,9%. Los medicamentos que actúan en sangre fueron los más frecuentemente relacionados (37,6%. El costo generado por la atención de las reacciones adversas fluctuó entre $93'633.422 y $122'155.406. Conclusiones. Dado el impacto negativo de las reacciones adversas en el bienestar de los pacientes, los recursos que se emplean en su atención y la proporción importante de reacciones adversas prevenibles, se requieren programas operativos de farmacovigilancia institucional.

Reacciones adversas medicamentosas y errores de prescripción: morbi-mortalidad

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Sebastián Chaio

2013-04-01

Full Text Available La farmacovigilancia tiene por objeto la detección, evaluación, comprensión y prevención de cualquier problema relacionado a las drogas. La recolección de información relacionada a reacciones adversas medicamentosas (RAM posterior a la aprobación y el manejo del riesgo basados en los datos observacionales son críticos para la salud pública.El objetivo primario fue evaluar la morbimortalidad de las reacciones adversas medicamentosas y describir los errores médicos de prescripción en un hospital público de la Ciudad de Buenos Aires. Se llevó a cabo un estudio prospectivo observacional. Se definió RAM como cualquier manifestación nociva, clínica y/o biológica imputable a un medicamento, que ocurra a las dosis habitualmente utilizadas en humanos para la profilaxis, diagnóstico o tratamiento de una enfermedad. La mortalidad global fue del 7% (21/310 y la atribuible a RAM observada fue del 1% (3/310. Se identificaron 149 RAMs en el 36% de los pacientes (111/310 y las RAM constituyeron el 11% (35/310 de los motivos de internación. Las RAM causan un número significativo de internaciones y son responsables de morbilidad evitable durante la internación. Ningún fármaco aislado causó más del 6% de las RAM, por lo que las estrategias para disminuirlas deben estar dirigidas a múltiples grupos farmacológicos.

Decisiones en reacciones adversas a medicamentos, intoxicaciones y respuestas inesperadas de productos naturales como problema de salud pública

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Pedro P. Álvarez-Falconí

2007-10-01

Full Text Available En esta revisión se evalúa la información relevante sobre diversas reacciones adversas severas atribuidas a medicamentos de relativa reciente introducción en el mercado mundial, intoxicaciones por medicamentos contaminados, así como respuestas inesperadas adversas de productos naturales, todo lo cual contribuyó a la toma y adopción de decisiones en el pasado y en el presente, por organismos reguladores en medicamentos en diversos países. Se exploran a grandes perfiles las acciones relacionadas con los pilares de las políticas de medicamentos, los sucesos históricos y actuales calificados como desastres o tragedias en salud pública en el uso de medicamentos en el siglo pasado y presente, a fin de ofrecer un panorama básico en este manejo. Se incluyeron efectos que afectaron la salud por el empleo de algunos productos naturales para prestar atención a su implicancia en la práctica médica. Se comentan y discuten las decisiones de los organismos reguladores internacionales, los enormes gastos en salud pública por reacciones adversas, las estrategias que han contribuido a evitar perjuicios en la sociedad por reacciones adversas de medicamentos innovadores y antiguos. Se contribuye en afianzar los conceptos de responsabilidad empresarial y gubernamental, estándares científicos, éticos y seguridad de los medicamentos, la importancia del control de calidad, bioética, buenas prácticas clínicas en la investigación científica en medicamentos, buenas prácticas de manufactura y evitar prácticas corruptas. Se reafirma que el éxito de la medicina moderna se debe en magnitud importante a los medicamentos y dentro de ellos a los innovadores. Las decisiones oportunas de los expertos se orientan a evitar tragedias, sufrimientos y gastos innecesarios por reacciones adversas a medicamentos y consecuentemente eludir problemas en salud pública.

Reacciones adversas inmediatas a la donación: frecuencia y caracterización, Banco de Sangre de la Clínica Cardiovascular Santa María, Medellín, 1999

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María I. Múnera

2001-09-01

Full Text Available Disponer de un flujo suficiente de donantes altruistas que permita la obtención de componentes sanguíneos de buena calidad es el problema más importante en los bancos de sangre en nuestro medio. La presencia de reacciones adversas a la donación puede influir en forma negativa en la disposición del donante para regresar al banco de sangre. Con el objetivo de establecer la frecuencia y explorar los factores de riesgo involucrados en la aparición de reacciones adversas a la donación, se realizó un estudio de corte, basado en los registros de donantes del Banco de Sangre de la Clínica Cardiovascular Santa María de Medellin durante 1999. La edad promedio de los donantes estudiados fue de 33 años en mujeres y 34 en hombres; se encontró una frecuencia de reacciones adversas de 2,7% y la predominante fue la reacción vasovagal con el 1,2%. Los posibles factores de riesgo relacionados con las reacciones adversas, en general, fueron donación por primera vez, edad menor de 25 años y sexo femenino.

Caracterización de las reacciones adversas medicamentosas en ancianos: Cuba, 2003-2005 Characterization of the adverse reactions to drugs in the elderly: Cuba, 2003-2005

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Raisa Rodriguez Duque

2007-12-01

Full Text Available El seguimiento de las reacciones adversas en poblaciones de riesgo como los ancianos es prioridad del sistema cubano de farmacovigilancia. Por lo que se realizó una investigación descriptiva y prospectiva, para caracterizar las notificaciones de sospechas de reacciones adversas medicamentosas en ancianos mayores de 60 años de edad, recibidas en la Unidad Coordinadora Nacional de Farmacovigilancia desde el 1ro de enero de 2003 al 31 de diciembre de 2005. Constituyeron objetivos del trabajo la identificación de los grupos farmacológicos que produjeron las reacciones adversas medicamentosas así como los fármacos más comprometidos, la clasificación de las reacciones adversas según la severidad, el mecanismo de producción, el sistema de órgano afectado y el grado de imputabilidad. De igual manera, se analizó si la presencia de factores como la polifarmacia y los antecedentes patológicos personales predisponen la aparición de la reacción adversa medicamentosa y su posible prevención. Los resultados más importantes muestran que los grupos farmacológicos con mayor representatividad resultaron los antibacterianos, los antihipertensivos y los antiinflamatorios y analgésicos no opioides; los fármacos más frecuentes fueron el captopril, la penicilina procaínica y la nifedipina; las reacciones leves ocuparon el mayor porcentaje así como las reacciones probables. Predominó el mecanismo de producción tipo A; el sistema de órgano más afectado fue la piel y anejos, y la presencia de antecedentes patológicos personales propició en gran medida la aparición de las reacciones adversas medicamentosas, lo que no ocurrió con la polifarmacia. Se pudieron haber evitado el 82,3 % del total de reacciones adversas medicamentosas estudiadasThe follow-up of adverse reactions in risk populations as the elderly is a priority of the Cuban drug surveillance system. A descriptive and prospective research was conducted to characterize the

Comportamiento de las reacciones adversas a los analgésicos y antiinflamatorios no esteroideos notificadas por el Sistema Cubano de Farmacovigilancia en el 2001

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Giset Jiménez López

2003-12-01

Full Text Available Los fármacos analgésicos y antiinflamatorios no esteroideos comparten algunas actividades terapéuticas y efectos colaterales, su mecanismo de acción está mediado por la inhibición de la ciclooxigenasa (COX 1 y 2, enzima encargada de la biosíntesis de prostaglandinas y otros autacoides similares. En la Unidad Coordinadora de Farmacovigilancia se hace un análisis periódico de las sospechas de reacciones adversas notificadas, y en el 2001 se observó que de los 10 fármacos sospechosos de producir mayor número de reacciones adversas el 50 % corresponde al grupo de los analgésicos y antiinflamatorios no esteroideos, que es a su vez uno de los grupos de mayor consumo en el país. Se realiza una descripción del comportamiento de las sospechas de reacciones adversas relacionadas con aspirina, dipirona, indometacina, ibuprofeno, naproxeno, paracetamol y piroxicam, incluyendo severidad, características demográficas y mecanismo fisiopatológico de estas. En el 2001 se recibieron en la Unidad Coordinadora de Farmacovigilancia 16 195 notificaciones que contenían un total de 33 601 reacciones adversas medicamentosas, de las cuales el 21,5 % correspondió a los analgésicos y antiinflamatorios no esteroideos, grupo este más notificado después de los antimicrobianos. Se encontró que las reacciones de mayor gravedad afectaron a los sistemas hematológico, gastrointestinal y cuerpo como un todo; el sexo femenino y el adulto joven fueron los más afectados. Debido a las reacciones notificadas y a la severidad de estas es necesario mantener vigilancia activa sobre dicho grupo farmacológico y realizar una prescripción adecuada por los médicos con el fin de minimizar el riesgo de sufrir reacciones adversas.The analgesics and nonsteroideal antiinflammatory drugs share some therapeutic activities and side effects. Their action mechanism is mediated by the inhibition of cyclooxygenase (COX 1 and 2, an enzime incharge of the biosynthesis of

Ivermectin-related adverse clinical events in patients treated for Mansonella ozzardi infections Efectos clínicos adversos relacionados con ivermectina en pacientes tratados por infecciones con Mansonella ozzarddi

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Alejandro J. Krolewiecki

2011-03-01

Full Text Available We report the occurrence of serious reactions after treatment with oral ivermectin in two patients with Mansonella ozzardi infections. Both had systemic and respiratory symptoms and recovered without sequelae. Follow-up revealed clearance of microfilaremia in both cases, with relapse in one of them. These reactions are well described in the treatment of other filarial infections, but have not yet been reported in the treatment of M. ozzardi. We are now reporting the first such known reactions with this helminthiasis.Se informa la aparición de reacciones adversas graves con el tratamiento con ivermectina oral en dos pacientes con infección por Mansonella ozzardi. Ambos presentaron síntomas respiratorios y sistémicos y se recuperaron sin secuelas. El seguimiento mostró ausencia de microfilaremia en ambos casos, con recidiva en uno de ellos. Estas reacciones, bien conocidas durante el tratamiento de otras filariosis, se describen por primera vez con esta helmintiasis.

Algunas consideraciones sobre las reacciones adversas por alimentos Some considerations on the adverse ractions to food

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Mirta Álvarez Castelló

2004-12-01

Full Text Available Las reacciones adversas por alimentos son motivo de consulta frecuente en el servicio de alergia del Hospital "Calixto García". En ocasiones su diagnóstico es complejo, y pueden requerir estudios más específicos, sobre todo, cuando los síntomas son respiratorios, como es el caso de la rinitis y el asma, o cuando existe sensibilidad a más de un alimento. Muchas veces estas reacciones adversas, luego de la ingestión de un determinado alimento nada tienen que ver con la alergia y adonde acuden inicialmente es a los médicos de atención primaria, por lo que se revisa en este artículo determinados aspectos de interés en su diagnóstico y atención, con el objetivo de mejorar el tratamiento y control de todo paciente con estas características. Finalmente se hace énfasis en la importancia de un buen interrogatorio, en las pruebas de eliminación y provocación, así como en la aparición de tolerancia a muchos alimentos en la etapa de la infancia, en la que es frecuente este comportamiento. Con este estudio se pretende difundir asimismo, el trabajo y control que debe aplicarse con dichos pacientes, al tiempo que se fomentan mejores hábitos alimentarios en la población.The adverse reactions to food are a reason for the frequent visit to the allergy service at "Calixto García" Hospital. Sometimes, its diagnosis is complex and it may require more specific studies, mainly when the symptoms are respiratory, as in the case of rhinitis and asthma, or when there is sensitivity to more than one food. Many times, these adverse reactions after the ingestion of a certain food have nothing to do with allergy and the patients initially go to see doctors at the the primary health care level, so some aspects of interest in its diagnosis and care are reviewed aimed at improving the treatment and control of every patient with these characteristics. Finally, emphasis is made on the importance of a good interview, on the tests of elimination and provocation

Second malignancy in patients treated for Hodgkin's disease

International Nuclear Information System (INIS)

Baccarani, M; Bosi, A.; Papa, G.

1980-01-01

Six hundred and thirteen consecutive patients with Hodgkin's disease (HD), with a follow-up of two to ten years, were reviewed with the aim of establishing the type and frequency of second malignancies. Acute non-lymphoid leukemia developed in 2 of 152 patients treated by chemotherapy (CHT), and in 5 of 344 patients treated by CHT and radiotherapy (RT). Leukemia developed 12 to 83 months after diagnosis of HD, was always preceded by a preleukemic phase (3 to 25 months), and was always fatal (after 1 to 12 months). The karyotype of leukemic cells was studied in 4 of 7 patients and was always abnormal. Solid tumors developed in 1 of 152 patients treated by CHT, and in 4 of 344 patients treated by CHT and RT. The tumors appeared 10 to 63 months after diagnosis of HD and killed all 5 patients after 10 to 16 months. For patients treated by CHT, the actuarial frequency of leukemia and other tumors seven years after diagnosis of HD was 2.0% and 1.26%, respectively. For patients treated by CHT and RT, the figures were 2.04% and 2.26%, respectively. Second malignancies were not recorded among 117 patients treated by RT alone. These data are consistent with a relationship of acute leukemia to therapy for HD

Reacciones adversas al tratamiento antirretroviral de gran actividad inicial en el hospital Santa Rosa – Piura.

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Jiovany Jahn Carlos Saldaña-Gastulo

2011-01-01

Full Text Available Objetivo: Determinar la incidencia y factores asociados a reacciones adversas medicamentosas (RAM al TARGA inicial durante el periodo enero 2006 – diciembre 2007 en el Hospital de Apoyo Santa Rosa-Piura. Diseño: Se realizó un estudio analítico de cohorte retrospectiva. Lugar: Hospital de Apoyo Santa Rosa-Piura. Participantes: 107 historias clínicas de pacientes VIH positivos mayores de 18 años que recibieron TARGA y fueron atendidos durante este periodo en el consultorio de infectología. Intervenciones: Se analizaron retrospectivamente las historias clínicas que fueron pertinentes para la recolección de datos. Principales medidas de resultado: Analisis Univariado, Bivariado (t de Student, y Riesgo Relativo, multivariado (Regresión logística con 95% de confianza (p<0.05. Resultados: En 107 pacientes se encontró una incidencia acumulada de 66,35% de RAM al TARGA inicial. Las RAM experimentadas con mayor frecuencia fueron anemia (35,2%, rash (16,9% y vómitos (9,9%. Se encontró diferencias significativas entre la media de edad y la presencia de RAM con la prueba de t de student (p < 0.05 Conclusiones: Existe una alta incidenica de RAM en pacientes incluidos en TARGA, siendo la más frecuente la anemia en 25 pacientes (35,2%. La media de edad es mayor en pacientes con RAM. Palabras Claves: VIH/SIDA, Terapia de alta actividad antirretroviral, Reacciones adversas a medicamentos.

Heart failure in patients treated with bisphosphonates

DEFF Research Database (Denmark)

Grove, E L; Abrahamsen, B; Vestergaard, P

2013-01-01

The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates.......The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates....

Experiencias de Discriminación Social de Inmigrantes Nicaragüenses en Costa Rica: Reacciones Afectivas y Atribuciones Causales

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Vanessa Smith-Castro

2010-01-01

Full Text Available En dos estudios, 190 inmigrantes nicaragüenses fueron encuestados mediante un cuestionario sobre: (a sus experiencias de discriminación en Costa Rica, (b sus reacciones afectivas ante la discriminación, y (c sus representaciones sobre las causas de los eventos discriminatorios. El Estudio 1 (N = 102, 50% mujeres muestra que las reacciones ante la discriminación forman dos dimensiones básicas, a saber, ira y depresión. Estas dimensiones se encontraron diferencialmente relacionadas con marcadores de salud mental, específicamente autoestima personal y colectiva. El Estudio 2 (N = 88, 51% mujeres replica esta estructura bidimensional y muestra que las atribuciones sobre las causas de la discriminación moderan la relación entre discriminación, depresión e ira. Específicamente, las experiencias de discriminación se encontraron asociadas a la depresión, cuando la atribución causal de la discriminación eran las actitudes de los otros (el prejuicio de los costarricenses, pero cuando la explicación causal de la discriminación recayó en la pertenencia al colectivo discriminado (ser nicaragüense, las experiencias discriminación se encontraron asociadas a la ira.

Do Surgeons Treat Their Patients Like They Would Treat Themselves?

NARCIS (Netherlands)

Janssen, Stein J.; Teunis, Teun; Guitton, Thierry G.; Ring, David; Spoor, Andy B.; Chauhan, Aakash; Shafritz, Adam B.; Wasterlain, Amy; Terrono, Andrew L.; Neviaser, Andrew S.; Schmidt, Andrew; Nelson, Andy; Miller, Anna N.; Kristan, Anze; Apard, Thomas; Berner, Arne; Ilyas, Asif; Jubel, Axel; Jost, Bernhard; Babis, George; Watkins, Barry; Kreis, Barbara; Nolan, Betsy M.; Crist, Brett D.; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo Jose Romero; Ekholm, Carl; Swigart, Carrie; Spath, Catherine; Zalavras, Charalampos; Cassidy, Charles; Garnavos, Christos; Moreno-Serrano, Constanza L.; Rodner, Craig; Klostermann, Cyrus; Osei, Daniel A.; Rikli, Daniel A.; Haverkamp, Daniel; Polatsch, Daniel; Drosdowech, Darren; Edelstein, David M.; Eygendaal, Denise; Verbeek, Diederik O. F.; Doornberg, Job N.; van den Bekerom, Michel P. J.; Schep, Niels; Kloen, Peter; Haverlag, Robert; Schepers, Tim

2015-01-01

There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. (1) Are surgeons more likely to recommend surgery when choosing for

Anxiety in Patients Treated with Hemodialysis.

Science.gov (United States)

Cohen, Scott D; Cukor, Daniel; Kimmel, Paul L

2016-12-07

Anxiety is a common yet frequently overlooked psychiatric symptom in patients with ESRD treated with hemodialysis (HD). Anxiety is characterized by disruptive feelings of uncertainty, dread, and fearfulness. A variety of common medical complaints may be manifestations of an anxiety disorder, including palpitations, tremors, indigestion, numbness/tingling, nervousness, shortness of breath, diaphoresis, and fear. It is essential for the clinician to rule out specific medical conditions, including cardiovascular, pulmonary, and neurologic diseases, before ascribing these symptoms to an anxiety disorder. In addition, there is considerable overlap between the symptoms of anxiety and those of depression and uremia. This psychiatric condition has a significant adverse impact on patients' perception of quality of life. Little is known regarding the prevalence and impact of anxiety disorders in patients with ESRD treated with HD; however, many of the seemingly irrational behaviors of patients, or behaviors which place them in conflict with staff and physicians, such as behavioral noncompliance, may be the expression of an underlying anxiety disorder. In this review, we present three clinical vignettes, highlighting the impact of anxiety disorders in patients with ESRD treated with HD. Copyright © 2016 by the American Society of Nephrology.

Seguridad de la ivermectina: toxicidad y reacciones adversas en diversas especies de mamíferos

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Aránzazu González Canga

2010-08-01

Full Text Available La ivermectina es un fármaco antiparasitario muy utilizado en Medicina Veterinaria, dado su espectro de actividad que abarca tanto endo como ectoparásitos, elevada eficacia y amplio margen de seguridad. No obstante, su administración puede dar lugar a efectos tóxicos. La mayoría de ellos derivan de la sobredosificación del compuesto, aunque también se han descrito, a dosis terapéuticas, casos de susceptibilidad extrema a los efectos neurotóxicos del fármaco en determinadas razas o subpoblaciones de animales, así como reacciones anafilácticas por la destrucción masiva de parásitos.

Metodologies d’anulació en substrats heterocíclics: Reaccions de RCM i ciclacions de Heck

OpenAIRE

Alonso Serrano, Sandra

2010-01-01

[cat] La present Tesi Doctoral es situa en el context de l’estudi d’estratègies sintètiques per a la formació d’anells en l’àrea heterocíclica. En particular, s’han avaluat les possibilitats sintètiques de la combinació de dues reaccions d’eficàcia prou reconeguda per a la formació d’enllaços carboni-carboni, la reacció de RCM i la reacció intramolecular de Heck d’halurs vinílics, per a la construcció de les estructures policíliques amb pont característiques dels alcaloides ervitsina i apari...

Fertility in patients treated for testicular cancer.

Science.gov (United States)

Matos, Erika; Skrbinc, Breda; Zakotnik, Branko

2010-09-01

Testicular cancer affects men mostly in their reproductive age with a cure rate over 90% and fertility is one of the main concerns of survivors. To further elucidate the question of fertility after treatment for testicular cancer, we performed a survey in patients treated in our institution. We sent a questionnaire to patients treated for testicular cancer at our institute from 1976 to 2002 (n = 490) of whom 297 (60.6%) responded. We considered the patients to have conserved fertility if they had children after treatment without assisted reproductive technologies. Before treatment 119/297 (40.1%) of patients and after treatment 150/297 (50.5%) of patients tried to have children (p = 0.019). Of 119 patients who tried to have children before treatment for testicular cancer 98 (82.4%) succeeded and 74/150 (49.3%) were successful after treatment (p years. The post-treatment fatherhood in patients treated with surgery only (orchidectomy +/- retroperitoneal lymphnode dissection-RPLND) was 59%, in those with additional radiotherapy 68%, and chemotherapy 50% (p = 0.233). Fertility rate in patients where a non nerve sparing RPLND was performed was only 37%, 62% in patients with nerve sapring RPLND, and 77% in patients where RPLND was not performed (p Fertility rate after treatment for testicular cancer is reduced. From our data, the most important treatment modality that influences fertility is non nerve sparing RPLND that should be avoided whenever possible in order improve the quality of life our patients.

Silicatos y alúminosilicatos mesoporosos funcionalizados como catalizadores en reacciones de interés en Química Fina

OpenAIRE

Pineda, A.

2013-01-01

En la presente Memoria de Tesis Doctoral se muestra el gran potencial que los materiales mesoporosos tienen en el campo de la catálisis heterogénea, permitiendo ser funcionalizados por síntesis directa o mediante procedimientos post-síntesis. La funcionalización de los materiales mesoporosos permite el empleo de estos como catalizadores en una gran variedad de reacciones: catalizadas por centros ácidos, por centros básicos y por centros redox, como se demuestra en esta Memoria ...

Metallic taste in cancer patients treated with chemotherapy.

Science.gov (United States)

IJpma, I; Renken, R J; Ter Horst, G J; Reyners, A K L

2015-02-01

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 taste in chemotherapy treated cancer patients. Literature search for metallic taste and chemotherapy was performed in PubMed up to September 2014, resulting in 184 articles of which 13 articles fulfilled the inclusion criteria: English publications addressing metallic taste in cancer patients treated with FDA-approved chemotherapy. An additional search in Google Scholar, in related articles of both search engines, and subsequent in the reference lists, resulted in 13 additional articles included in this review. Cancer patient forums were visited to explore management strategies. Prevalence of metallic taste ranged from 9.7% to 78% among patients with various cancers, chemotherapy treatments, and treatment phases. No studies have been performed to investigate the influence of metallic taste on dietary intake, body weight, and quality of life. Several management strategies can be recommended for cancer patients: using plastic utensils, eating cold or frozen foods, adding strong herbs, spices, sweetener or acid to foods, eating sweet and sour foods, using 'miracle fruit' supplements, and rinsing with chelating agents. Although metallic taste is a frequent side effect of chemotherapy and a much discussed topic on cancer patient forums, literature regarding metallic taste among chemotherapy treated cancer patients is scarce. More awareness for this side effect can improve the support for these patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Predictores Selectivos en el Sector Público: Validez Predictiva y Reacciones de los Candidatos

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Alexander Rodríguez

2018-02-01

Full Text Available Esta investigación ha tenido como objetivo profundizar en el conocimiento sobre el funcionamiento de los procedimientos selectivos en el sector público. Para ello, a partir de los datos del concurso-oposición de 2010 para la selección de auxiliares administrativos en el Gobierno Vasco se estudiaron dos cuestiones: a la validez predictiva de los predictores empleados y b la justicia percibida por parte de los auxiliares con respecto al proceso selectivo y a las pruebas empleadas y su relación con el resultado en las mismas y el desempeño laboral. Los resultados muestran que la prueba de conocimientos es el mejor predictor del desempeño y que las reacciones de los candidatos presentan una correlación positiva con el desempeño laboral y con el resultado en el test de juicio situacional. Se comentan las limitaciones de la investigación así como las implicaciones prácticas de los resultados.

Reacciones de profesoras y profesores de la universidad de Costa Rica ante la flexibilización del currículum para estudiantes con necesidades educativas especiales

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Irma Arguedas Negrini

2004-01-01

Full Text Available La Universidad de Costa Rica ha asumido el compromiso de garantizar la accesibilidad a los procesos de aprendizaje cuando esto sea requerido por estudiantes con necesidades educativas especiales. El presente trabajo se realizó con el propósito de recolectar información que favorezca que los procesos de igualdad de oportunidades se cumplan de la forma que aporte mayores beneficios para todos los involucrados y de proporcionar un espacio para que el personal docente manifestara sus reacciones ante sus experiencias con la flexibilización del currículum. Se analizan elementos que contribuyen a hacer la accesibilidad una realidad y se reportan las reacciones de diez profesoras y profesores de la Sede Rodrigo Facio quienes han impartido cursos a estudiantes que han solicitado la aplicación del Artículo 37 del Reglamento de Régimen Académico Estudiantil. Se concluye que la aplicación de adecuaciones curriculares o de acceso y la aceptación de la diversidad en el medio universitario pueden ser una fuente de aprendizaje y enriquecimiento.

High mortality among heart failure patients treated with antidepressants

DEFF Research Database (Denmark)

Veien, Karsten Tang; Videbæk, Lars; Schou, Morten

2011-01-01

This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients.......This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients....

Pulmonary cryptococcosis in a ruxolitinib-treated patient with primary myelofibrosis

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Anna Hirano

2017-01-01

Full Text Available We present the case of a 79-year-old man who showed multiple pulmonary nodules on chest computed tomography (CT after being treated for 6 months with ruxolitinib, an inhibitor of Janus kinase (JAK 1 and 2, to treat primary myelofibrosis. We examined the lesions by bronchoscopy, and the biopsy specimen revealed fungus bodies of Cryptococcus with granulomatous inflammation. As a result, the patient was diagnosed with pulmonary cryptococcosis. The patient was treated with fluconazole (200 mg daily for 2 weeks with concomitant ruxolitinib administration, but the pulmonary lesions progressed. Subsequently, the patient was treated with voriconazole (300 mg daily for 3 weeks, but the lesions worsened further. The administration of ruxolitinib was therefore discontinued, and the dosage of voriconazole was increased to 400 mg daily. Three months later, the pulmonary lesions diminished in size. The present case of pulmonary cryptococcosis occurred in a patient treated with ruxolitinib. Treatment of pulmonary cryptococcosis with concomitant JAK inhibitor administration may result in poor treatment efficacy. It might be better to stop administration of JAK inhibitors, if possible, in patients being treated for pulmonary cryptococcosis.

SUSTANCIAS Y REACCIONES QUÍMICAS. TEMAS DEL CURSO DE INGRESO UNIVERSITARIO TRATADOS CON DIFERENTES RECURSOS

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René O. Güemes

2011-01-01

Full Text Available En esta investigación se buscó detectar y comparar dificultades presentadas en la comprensión de los temas “Sustancias” y “Reacciones Químicas” en alumnos ingresantes a la Universidad Nacional del Litoral (Santa Fe, Argentina implementando dos estrategias didácticas diferentes durante el dictado del “Curso de Ingreso de Química”. Se trabajó con dos grupos de alumnos; uno de los grupos utilizó un libro de texto, mientras que el otro trabajó con material multimedia en un aula de informática. Ambos grupos fueron evaluados al inicio y final del curso con la misma evaluación de opciones múltiples. Pudo comprobarse que el grupo que trabajó con el material multimedia alcanzó una mayor comprensión de los conceptos abstractos.

Craniofacial morphology in Turner syndrome patients treated with growth hormone

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Jovana Julsoki

2015-05-01

Full Text Available ABSTRACT Introduction: In addition to well-established physical characteristics, Turner syndrome patients have distinct craniofacial morphology. Since short stature is the most typical characteristic, Turner syndrome patients are commonly treated with growth hormone in order to increase final height. At the same time, growth hormone treatment was found to influence craniofacial growth and morphology in various groups of treated patients. Whereas craniofacial characteristics of Turner syndrome patients are well documented, comparatively little is known of craniofacial morphology of those who are treated with growth hormone. Aim: The aim of this study was to investigate craniofacial morphology in Turner syndrome patients treated with growth hormone in comparison to healthy females. Materials and methods: The cephalometric evaluation was conducted on twenty lateral cephalograms of Turner syndrome patients (13.53 ± 4.04 years treated with growth hormone for at least one year (4.94 ± 1.92 years in average. As a control group, forty lateral cephalograms of healthy female controls, who matched Turner syndrome patients by chronological (11.80 ± 2.37 years and skeletal age, were used. Eleven angular, seven linear measurements and six dimensional ratios were measured to describe craniofacial morphology. Results: The results obtained for angular measurements, in cephalometric analyses for Turner syndrome patients treated with growth hormone, revealed bimaxillary retrognathism. The linear measurements indicated longer mandibular ramus, anterior cranial base and both anterior and posterior facial heights. However, posterior cranial base and maxilla were in proportion to the anterior cranial base, when comparing dimensional ratios. Anterior cranial base, maxilla and mandibular ramus were larger in proportion to mandibular body; as well as posterior facial height was when compared to anterior facial height. Turner syndrome patients treated with growth

Avascular osteonecrosis in patients treated for Hodgkin's disease

International Nuclear Information System (INIS)

Enrici, R.M.; Donato, V.; Santoro, M.; Tombolini, V.; Anselmo, A.P.

1998-01-01

The aim of this study is to assess the risk of avascular osteonecrosis (AVN) of the femoral head in patients treated for Hodgkin's disease (HD), in relation to the type of treatment they have received. For this purpose, a cohort of 1391 patients treated for HD at University of Rome between 1972 and 1996 was divided into 2 groups according to their initial treatment. The first group contained 784 patients treated, at the onset of HD, either with chemotherapy (CT) containing steroids, combined in some cases with subdiaphragmatic radiotherapy (RT), or with subdiaphragmatic RT combined with CT without steroids. The second group was made up of 607 patients who had received, initially, supradiaphragmatic RT alone or supradiaphragmatic RT combined with CT without steroids. For the purpose of this study, only the 784 patients belonging to the first group were observed for the appearance of AVN, which occurred in 9 cases. The period of time which elapsed between the end of treatment and the radiological evidence of AVN ranged from 23 to 97 months, with an average of 35 months. Because the number of cases of AVN was so small, the pathogenesis of this complication could not be identified. (au)

Reduction in Clostridium difficile environmental contamination by hospitalized patients treated with fidaxomicin.

Science.gov (United States)

Biswas, J S; Patel, A; Otter, J A; Wade, P; Newsholme, W; van Kleef, E; Goldenberg, S D

2015-07-01

Fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with Clostridium difficile infection (CDI). This study investigated whether fidaxomicin for treatment of all patients with CDI reduced C. difficile environmental contamination. Surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. Patients treated with fidaxomicin were less likely to contaminate their environment (25/68, 36.8%) than patients treated with metronidazole and/or vancomycin (38/66 57.6%) (P = 0.02). Treatment with fidaxomicin was associated with reduced environmental contamination with C. difficile. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Patrón de reacciones adversas a medicamentos referidas por la población mayor de 15 años Drugs-adverse reactions pattern provoked mentioned by population aged older than 15

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Liuba Alonso Carbonell

2009-03-01

Full Text Available INTRODUCCIÓN: la población puede constituir una de las fuentes de notificación de reacciones adversas producidas por los medicamentos. OBJETIVO: describir, desde la perspectiva del consumidor, las reacciones adversas producidas por medicamentos. MÉTODOS: investigación descriptiva de corte transversal, en la población mayor de 15 años de Cuba, distribuidos proporcionalmente según edad y sexo, procedentes de cada municipio cabecera del país, con excepción de Ciudad de La Habana donde fueron incluidos todos. RESULTADOS: el 22,6 % de los encuestados refirió haber tenido en algún momento una reacción adversa a medicamentos, siendo más evidente en personas mayores de 40 años (56,7 % y en las mujeres (60 %. Los fármacos reportados con mayor frecuencia como productores de reacciones adversas fueron los antimicrobianos (42,3 % y los antiinflamatorios no esteroideos (18,1 %. Los principales eventos adversos reportados se ubican en la piel (35,6 % y en el sistema nervioso central (17,8. Las reacciones adversas más reportadas fueron las leves (91,2 %. De las severas (9,8 %, las más frecuentes fueron el edema angioneurótico y la pérdida del conocimiento con 10 y 8 casos respectivamente. CONCLUSIÓN: el patrón de reacciones adversas a medicamentos referido por la población encuestada es similar al que muestra la Unidad Coordinadora Nacional de Farmacovigilancia de Cuba, que se nutre de las notificaciones espontáneas de los profesionales del sistema nacional de salud.INTRODUCTION: persons may be one of the notification sources of adverse reactions provoked by drugs. AIM: to describe, from consumer perspective, adverse reactions provoked by drugs. METHODS: a cross-sectional descriptive research in Cuban people aged older than 15, proportionally distributed by age and sex, from each capital municipality of country, except Havana City, where all were included. RESULTS: the 22,6 % of interviewed refers had in some moment a drug's adverse

Hair cortisol measurement in mitotane-treated adrenocortical cancer patients.

Science.gov (United States)

Manenschijn, L; Quinkler, M; van Rossum, E F C

2014-04-01

The only approved drug for the treatment of adrenocortical cancer (ACC) is mitotane. Mitotane is adrenolytic and therefore, hydrocortisone replacement therapy is necessary. Since mitotane increases cortisol binding globulin (CBG) and induces CYP3A4 activity, high doses of hydrocortisone are thought to be required. Evaluation of hydrocortisone therapy in mitotane-treated patients has been difficult since there is no good marker to evaluate hydrocortisone therapy. Measurement of cortisol in scalp hair is a novel method that offers the opportunity to measure long-term cortisol levels. Our aim was to evaluate whether hair cortisol measurements could be useful in evaluating recent hydrocortisone treatment in mitotane-treated ACC patients. Hair cortisol levels were measured in 15 mitotane-treated ACC patients on hydrocortisone substitution and 96 healthy individuals. Cortisol levels were measured in 3 cm hair segments, corresponding to a period of 3 months. Hair cortisol levels were higher in ACC patients compared to healthy individuals (pcortisol levels above the reference range. None of the patients had hair cortisol levels below normal. In contrast to hydrocortisone doses (β=0.03, p=0.93), hair cortisol levels were associated with BMI (β=0.53, p=0.042). There was no correlation between hair cortisol levels and hydrocortisone doses (β=0.41, p=0.13). Almost half of the ACC patients had high hair cortisol levels, suggesting long-term over-substitution of hydrocortisone in some of the patients, whereas none of the patients was under-substituted. Hair cortisol measurements might be useful in long-term monitoring hydrocortisone treatment in mitotane-treated ACC patients. © Georg Thieme Verlag KG Stuttgart · New York.

Unexpected cutaneous reactions in diabetic and pre diabetic patients treated with salsalate

International Nuclear Information System (INIS)

Adibi, N.; Faghihimani, E.; Mirbagher, L.; Sohrabi, H.; Toghiani, A.

2012-01-01

Objective: The most commonly reported side effects of salsalate are gastrointestinal events, and few reports are available on its cutaneous side effects. We therefore assessed cutaneous side effects among diabetic/pre-diabetic patients treated with salsalate. Methodology: In a randomized placebo-controlled trial, we evaluated cutaneous side effects in 52 diabetic and 124 pre-diabetic patients, 90 of whom received 3 g/day salsalate and 86 of whom receive a placebo for four weeks. The evaluation was carried out every week using a checklist completed by a single general practitioner. Results: The difference between the salsalate- and placebo-treated groups in overall prevalence of cutaneous reactions was not significant (26.7% versus 17.4%; P < 0.05). Side effects included urticaria (nine (10.1%) salsalate-treated versus six (6.9%) placebo-treated), rashes (five (5.5%) salsalate-treated versus three (3.4%) placebo-treated), pruritus (six (6.7%) salsalate-treated versus three (3.4%) placebo-treated), and edema (two (2.2%) salsalate-treated versus one (1.2%) placebo-treated); in addition, one (1.1%) case of erythema nodosum and one (1.1%) of vasculitis were observed in the salsalate-treated group. In the salsalate group, therapy was discontinued by the physician for three (3.3%) patients because of acute and severe vasculitis, erythema nodosum and urticaria and two (2.2%) patients stopped the treatment themselves because of mild urticaria compared with two patients who stopped using the placebo. Conclusions: Salsalate can cause several and, in some cases, severe cutaneous side effects in patients with diabetes/pre-diabetes. Because these cutaneous eruptions can raise various concerns, including patient non-compliance, greater attention should be paid to dermatological problems in patients under salsalate treatment. (author)

N-methyl-3-pyrrolidines preparation by means of [3+2] dipoles cycloaddition reactions; Preparacion de N-metil-3-arilpirrolidinas mediante reacciones de cicloadicion dipolares [3+2

Energy Technology Data Exchange (ETDEWEB)

Negron, Guillermo [Universidad Autonoma Metropolitana-Azcapotzalco, Mexico, D.F. (Mexico); Fuentes, Aydee; Romero, Moises [Universidad Autonoma del Estado de Mexico, Toluca, Estado de Mexico (Mexico); Madrid, Gustavo; Cruz, Raymundo [Universidad Nacional Autonoma de Mexico, Mexico, D.F. (Mexico)

1999-08-01

The [3+2] cycloaddition reaction between azomethine ylide generated by deprotonation of trimethylamine N-oxide with LDA and various {alpha}-asarone derivatives to afford the corresponding pyrrolidines is described. [Spanish] Las reacciones de cicloadicion [3+2] entre iluros de azometino generados por accion del LDA sobre el N-oxido de trimetilamina y varios derivados de la {alpha}-asarona, permite la obtencion de las pirrolidinas correspondientes.

Cardiotoxicity in cancer patients treated with 5-fluorouracil or capecitabine

DEFF Research Database (Denmark)

Polk, Anne; Vaage-Nilsen, Merete Bech; Vistisen, Kirsten

2013-01-01

To systematically review the incidence, manifestations and predisposing factors for cardiovascular toxicity in cancer patients treated with systemic 5-fluorouracil or capecitabine.......To systematically review the incidence, manifestations and predisposing factors for cardiovascular toxicity in cancer patients treated with systemic 5-fluorouracil or capecitabine....

Cognitive behavioral program in treating insomnia among elderly patients

OpenAIRE

Richter, Kneginja; Miloseva, Lence; Niklewski, Günter; Piehl, Anja

2015-01-01

Introduction: Insomnia is a most common in elderly patients. World wide experience showed that Cognitive behavioral program in treating insomnia is one of the best effective model. Objectives: The present study aim to present clinical experience from University Clinic Nuremberg, Centre for Sleeping Medicine with application of Cognitive behavioral program in treating insomnia among elderly. Material and Methods: The sample consists of 22 patients with chronic insomnia (10 primary insom...

Guidelines on the management of patients treated with iodine-131

International Nuclear Information System (INIS)

1993-03-01

The purpose of these guidelines is to assist health care institutions establish protocols for the management of patients treated with iodine-131. These guidelines are written primarily for the use of Na 131 I in the treatment of benign and malignant thyroid disease. The principles have some application for the use of complex 131 I-labelled radiopharmaceuticals in that the treated patient will become a temporary radiation source and since contamination with body fluids of treated patients must be guarded against. The document outlines radiation protection and logistical concerns associated with the management of 131 I patients before, during and after therapy. These concerns include the safety of health care personnel, visitors, and any other persons who are at risk; and protection of the environment. (L.L.) 23 refs., 2 tabs

Secondary acute non lymphoid leukemia in patients treated for non Hodgkin's lymphoma

International Nuclear Information System (INIS)

Cimino, G.; Anselma, A.; Cartoni, C.

1987-01-01

The present study was undertaken to evaluate the frequency, characteristics and actual risk of secondary acute non lymphoid leukemia (s-ANLL) in 141 patients treated for non Hodgkin's lymphoma with different modalities. One hundred and twenty-four patients received chemotherapy according to PROVECIP protocol (9). Of these, 15 also received as induction treatment a local nodal irradiation and 33 an extended field radiotherapy. Seventeen out of 141 were treated by total body irradiation. Of these, 15 relapsed and received salvage chemotherapy. Sixteen of the 124 patients trated with PROVECIP also underwent different chemotherapeutic programs as salvage treatment. Of the entire population studied, 2 patients significantly affected the occurrence of s-ANLL, since both leukemias occurred in patients treated with total body irradiation, given alone or followed by chemotherapy. The actuarial risk at 8 years was 5.24% in the whole group, whereas it greatly increased in the group of patients treated with total body irradiation (24%). Conversely, no risk was found in the group treated with PROVECIP, alone, with additional chemotherapy, or with associated local or extended field radiotherapy

Comparison of long-term prognosis of patients with AIDS treated and not treated with zidovudine. AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Phillips, A N; Pedersen, C

1994-01-01

zidovudine, the death rate was approximately constant for the first 5 years after AIDS diagnosis. For patients treated with zidovudine, the death rate within the first year since starting zidovudine was markedly lower than for untreated patients who had developed AIDS at the same time (relative rate, 0......OBJECTIVE--To determine the association between elapsed time since starting zidovudine and survival in patients with acquired immunodeficiency syndrome (AIDS). DESIGN--Inception cohort and observational study of patients treated and not treated with zidovudine. SETTING--Fifty-one centers in 17...... European countries. PATIENTS--A total of 4484 patients diagnosed as having AIDS from 1979 to 1989 who survived their initial AIDS-defining event and who had not started zidovudine before AIDS diagnosis. MAIN OUTCOME MEASURES--Use of zidovudine and mortality. RESULTS--Among patients who did not receive...

Avascular osteonecrosis in patients treated for Hodgkin`s disease

Energy Technology Data Exchange (ETDEWEB)

Enrici, R.M.; Donato, V.; Santoro, M. [La Sapienza Univ. of Rome, Inst. of Radiology, Chair of Radiation Oncology, Rome (Italy); Tombolini, V. [Univ of L`Aquila, Hospital S. Maria di Collemaggio, Dept. of Radiation Oncology, L`Aquila (Italy); Anselmo, A.P. [La Sapienza Univ. of Rome, Dept. of Human Biopathology, Haematology Section, Rome (Italy)

1998-09-01

The aim of this study is to assess the risk of avascular osteonecrosis (AVN) of the femoral head in patients treated for Hodgkin`s disease (HD), in relation to the type of treatment they have received. For this purpose, a cohort of 1391 patients treated for HD at University of Rome between 1972 and 1996 was divided into 2 groups according to their initial treatment. The first group contained 784 patients treated, at the onset of HD, either with chemotherapy (CT) containing steroids, combined in some cases with subdiaphragmatic radiotherapy (RT), or with subdiaphragmatic RT combined with CT without steroids. The second group was made up of 607 patients who had received, initially, supradiaphragmatic RT alone or supradiaphragmatic RT combined with CT without steroids. For the purpose of this study, only the 784 patients belonging to the first group were observed for the appearance of AVN, which occurred in 9 cases. The period of time which elapsed between the end of treatment and the radiological evidence of AVN ranged from 23 to 97 months, with an average of 35 months. Because the number of cases of AVN was so small, the pathogenesis of this complication could not be identified. (au) 55 refs.

Reacciones de formación de enlaces C-C catalizadas por metales de transición y factores que les afectan

OpenAIRE

Noverges Pedro, Bárbara

2015-01-01

La síntesis y funcionalización de compuestos carbonílicos ha atraído la atención de los químicos a lo largo del tiempo ya que el grupo carbonilo es una función muy versátil en química orgánica y está presente en numerosos compuestos con actividad biológica. Por su parte, las reacciones de acoplamiento cruzado de dos y tres componentes son metodologías que actualmente se aplican a nivel tanto académico como industrial debido a que requieren condiciones suaves de reacción, la extracción de los ...

Muscle mitochondrial metabolism and calcium signaling impairment in patients treated with statins

Energy Technology Data Exchange (ETDEWEB)

Sirvent, P., E-mail: pascal.sirvent@univ-bpclermont.fr [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France); Clermont Université, Université Blaise Pascal, EA 3533, Laboratoire des Adaptations Métaboliques à l' Exercice en conditions Physiologiques et Pathologiques (AME2P), BP 80026, F-63171 Aubière cedex (France); Fabre, O.; Bordenave, S. [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France); Hillaire-Buys, D. [CHRU Montpellier, 34295 Montpellier (France); Raynaud De Mauverger, E.; Lacampagne, A.; Mercier, J. [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France)

2012-03-01

The most common and problematic side effect of statins is myopathy. To date, the patho-physiological mechanisms of statin myotoxicity are still not clearly understood. In previous studies, we showed that acute application in vitro of simvastatin caused impairment of mitochondrial function and dysfunction of calcium homeostasis in human and rat healthy muscle samples. We thus evaluated in the present study, mitochondrial function and calcium signaling in muscles of patients treated with statins, who present or not muscle symptoms, by oxygraphy and recording of calcium sparks, respectively. Patients treated with statins showed impairment of mitochondrial respiration that involved mainly the complex I of the respiratory chain and altered frequency and amplitude of calcium sparks. The muscle problems observed in statin-treated patients appear thus to be related to impairment of mitochondrial function and muscle calcium homeostasis, confirming the results we previously reported in vitro. -- Highlights: ► The most common and problematic side effect of statins is myopathy. ► Patients treated with statins showed impairment of mitochondrial respiration. ► Statins-treated patients showed altered frequency and amplitude of calcium sparks.

Muscle mitochondrial metabolism and calcium signaling impairment in patients treated with statins

International Nuclear Information System (INIS)

Sirvent, P.; Fabre, O.; Bordenave, S.; Hillaire-Buys, D.; Raynaud De Mauverger, E.; Lacampagne, A.; Mercier, J.

2012-01-01

The most common and problematic side effect of statins is myopathy. To date, the patho-physiological mechanisms of statin myotoxicity are still not clearly understood. In previous studies, we showed that acute application in vitro of simvastatin caused impairment of mitochondrial function and dysfunction of calcium homeostasis in human and rat healthy muscle samples. We thus evaluated in the present study, mitochondrial function and calcium signaling in muscles of patients treated with statins, who present or not muscle symptoms, by oxygraphy and recording of calcium sparks, respectively. Patients treated with statins showed impairment of mitochondrial respiration that involved mainly the complex I of the respiratory chain and altered frequency and amplitude of calcium sparks. The muscle problems observed in statin-treated patients appear thus to be related to impairment of mitochondrial function and muscle calcium homeostasis, confirming the results we previously reported in vitro. -- Highlights: ► The most common and problematic side effect of statins is myopathy. ► Patients treated with statins showed impairment of mitochondrial respiration. ► Statins-treated patients showed altered frequency and amplitude of calcium sparks.

Production of hydrogen using the combination of water-gas shift and carbonatation reaction of a CO{sub 2} absorbent; Produccion de hidrogeno mediante la combinacion de las reacciones de desplazamiento de agua y carbonatacion de un absorbente de CO{sub 2}

Energy Technology Data Exchange (ETDEWEB)

Escobedo-Bretado, M. A.; Ponce-Pena, P. [Facultad de Ciencias Quimicas, UJED, Durango, Durango (Mexico)]. E-mail: miguel.escobedo@ujed.mx; Delgado-Vigil, M. D.; Salinas-Gutierrez, J. M.; Lopez Ortiz, A.; Collins-Martinez, V.H. [Centro de Investigacion en Materiales Avanzados, S.C., Chihuahua, Chihuahua (Mexico)

2009-09-15

The production of hydrogen by the water-gas shift (WGS) normally requires multiple catalytic reactions followed by the separation of CO{sub 2} to obtain highly pure H{sub 2}. Nevertheless, using the combination of the WGS reaction and the solid-gas reaction between CO{sub 2} and an absorbent, the production of H{sub 2} and the separation of CO{sub 2} can be accomplished in a single step AEWGS (Absorption Enhanced Water Gas Shift). This combination of reactions was studied at the laboratory scale using a quartz fixed-bed reactor. The absorbents tested were calcined dolomite (CaO*MgO) and sodium zirconate (Na{sub 2}ZrO{sub 3}) in catalyst/absorbent mixtures (cat/abs) with weight ratios of 1/1, 1/2 and 2/1, using a high-temperature catalyst from the WGS reaction, synthesized in the laboratory (Fe-Cr). All the tests used 3cm{sup 3} of cat/abs, composed of 5% CO, 15% H{sub 2}O, 10.5% He and 69.5% N{sub 2}, with a spatial velocity (SV) of 1500h-1, 600 degrees Celsius and atmospheric pressure. The catalyst presented 100% conversion of CO to CO{sub 2}, maintaining its surface area after the reaction (12 m{sup 2}/g). The results with a dry base using the cat/abs mixture of 1/2 and CaO*MgO generated 95% H{sub 2} with 5% CO-free CO{sub 2}, while with Na{sub 2}ZrO{sub 3}, the maximum concentration of H{sub 2} was 70%, with 29% CO{sub 2} and 1% of CO without reacting. The results using only CaO*MgO (as a bifunctional material) presented a maximum H{sub 2} concentration of 96% and a minimum of 4% CO{sub 2}, as well as 7% CO without reaction, which was attributed to kinetic effects. [Spanish] La produccion de hidrogeno mediante la reaccion de desplazamiento de agua WGS (Water Gas Shift), normalmente requiere de multiples reacciones cataliticas seguidas por la separacion de CO{sub 2} para obtener H{sub 2} de alta pureza. Sin embargo mediante la combinacion de la reaccion WGS con la reaccion solido-gas entre el CO{sub 2} y un absorbente provee la oportunidad de producir H2 y

Life Expectancy in Patients Treated for Osteoporosis

DEFF Research Database (Denmark)

Abrahamsen, Bo; Osmond, Clive; Cooper, Cyrus

2015-01-01

Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity, and death. Long-term treatment may be required, but the long-term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may...... not be rational if the risk of death is reduced by treatment. It is difficult to devise goal-directed long-term strategies for managing osteoporosis without firm information about residual life expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions...... for osteoporosis drugs, comorbid conditions, and deaths. We included 58,637 patients and 225,084 age- and sex-matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10 to 17 years. In men younger than 80 years and women younger than 60 years...

A clinical assessment of antiretroviral-treated patients Referred from ...

African Journals Online (AJOL)

HAART) on the immunological, virological and clinical status of two groups of patients in the South African government antiretroviral (ARV) programme in KwaZulu-Natal, viz. patients previously treated with ARVs in the private sector and then ...

Pioglitazone metabolic effect in metformin-intolerant obese patients treated with sibutramine.

Science.gov (United States)

Derosa, Giuseppe; Mereu, Roberto; Salvadeo, Sibilla A T; D'Angelo, Angela; Ciccarelli, Leonardina; Piccinni, Mario N; Ferrari, Ilaria; Gravina, Alessia; Maffioli, Pamela; Cicero, Arrigo F G

2009-01-01

Metformin is the drug of choice to treat obese type 2 diabetes patients because it reduces either insulin-resistance and body weight. We aimed to comparatively test the efficacy and tolerability of pioglitazone and sibutramine in metformin-intolerant obese type 2 diabetic patients treated with sibutramine. Five hundred and seventy-six consecutive Caucasian obese type 2 diabetic patients were evaluated during a 12-months period and fifty-two patients were resulted intolerant to metformin at maximum dosage (3,000 mg/day). All intolerant patients to metformin received a treatment with pioglitazone (45 mg/day) and sibutramine (10 mg/day) and they were compared with fifty-three patients treated with metformin (3,000 mg/day) and sibutramine (10 mg/day) for 6 months in a single-blind controlled trial. We assessed body mass index, waist circumference, glycated hemoglobin, Fasting Plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin, lipid profile, systolic blood pressure, diastolic blood pressure and heart rate at baseline and after 3, and 6 months. No body mass index change was observed at 3, and 6 months in pioglitazone + sibutramine group, while a significant reduction of body mass index and waist circumference was observed after 6 months in metformin + sibutramine group (psibutramine combination appears to be a short-term equally efficacious and well-tolerated therapeutic alternative respect to metformin-intolerant obese type 2 diabetic patients treated with sibutramine.

Cranial base pathology in pediatric osteogenesis imperfecta patients treated with bisphosphonates.

Science.gov (United States)

Arponen, Heidi; Vuorimies, Ilkka; Haukka, Jari; Valta, Helena; Waltimo-Sirén, Janna; Mäkitie, Outi

2015-03-01

Cranial base pathology is a serious complication of osteogenesis imperfecta (OI). Our aim was to analyze whether bisphosphonate treatment, used to improve bone strength, could also prevent the development of craniocervical junction pathology (basilar impression, basilar invagination, or platybasia) in children with OI. In this single-center retrospective study the authors analyzed the skull base morphology from lateral skull radiographs and midsagittal MR images (total of 94 images), obtained between the ages of 0 and 25 years in 39 bisphosphonate-treated OI patients. The results were compared with age-matched normative values and with findings in 70 OI patients who were not treated with bisphosphonates. In addition to cross-sectional data, longitudinal data were available from 22 patients with an average follow-up period of 7.6 years. The patients, who had OI types I, III, IV, VI, and VII, had been treated with zoledronic acid, pamidronate, or risedronate for 3.2 years on average. Altogether 33% of the 39 bisphosphonate-treated patients had at least 1 cranial base anomaly, platybasia being the most prevalent diagnosis (28%). Logistic regression analysis suggested a higher risk of basilar impression or invagination in patients with severe OI (OR 22.04) and/or older age at initiation of bisphosphonate treatment (OR 1.45), whereas a decreased risk was associated with longer duration of treatment (OR 0.28). No significant associations between age, height, or cumulative bisphosphonate dose and the risk for cranial base anomaly were detected. In longitudinal evaluation, Kaplan-Meier curves suggested delayed development of cranial base pathology in patients treated with bisphosphonates but the differences from the untreated group were not statistically significant. These findings indicate that cranial base pathology may develop despite bisphosphonate treatment. Early initiation of bisphosphonate treatment may delay development of craniocervical junction pathology

[Ocular Surface Evaluation in Patients Treated with Prostaglandin Analogues Considering Preservative Agent].

Science.gov (United States)

Mlčáková, E; Mlčák, P; Karhanová, M; Langová, K; Marešová, K

The aim of this study was to evaluate the ocular surface in patients treated with prostaglandin analogues considering contained preservative agent. 60 patients with glaucoma or ocular hypertension treated with prostaglandin analogue monotherapy were enrolled in this observational study. 20 patients with glaucoma suspect or ocular hypertension without local or systemic glaucoma medication formed the control group. Demographic data and medical history were recorded for each participant. Patients filled in the Ocular surface disease index© (OSDI) questionnaire and underwent an ophthalmological examination including assessment of conjunctival hyperaemia according to Efron, tear film break up time (BUT) and fluorescein staining according to the Oxford grading scheme. Treated participants were divided into 3 groups according to the preservative contained in the currently used prostaglandin analogue: the preservative-free group (18 patients), the polyquaternium group (17 patients) and the benzalkonium chloride (BAK) group (25 patients). The control group had significantly lower fluorescein staining than the preservative-free group (p=0.001), the polyquaternium group (p=0.007) and the BAK group (p=0.002). The conjunctival hyperaemia was significantly lower in the preservative-free group compared to the polyquaternium group (p=0.011). There was no significant difference among the other groups. The difference neither in the OSDI score nor in the BUT was statistically important. This study confirmed that the ocular surface is worse in patients treated with prostaglandin analogue monotherapy than in people without glaucoma medication. A significant difference among treated patients depending on a preservative agent was not proved.Key words: benzalkonium chloride, glaucoma, ocular surface disease, preservatives, prostaglandin analogues.

Health status in patients treated with cardiac resynchronization therapy

DEFF Research Database (Denmark)

Schiffer, Angélique A; Denollet, Johan; Pedersen, Susanne S.

2008-01-01

Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated...

Radiological Risk for Patients Treated with 131I

International Nuclear Information System (INIS)

Chas, J.; Janiak, M.K.; Kowalczyk, A.; Siekierzynski, M.; Dziuk, E.

2001-01-01

Full text: Dose equivalents were measured during the three-day therapy with 131 I in patients treated at the Clinic of Endocrinology and Radioisotope Therapy, Central Clinical Hospital, Military University School of Medicine, Warsaw, Poland, for thyroid cancer (supplementary treatment; 21 cases), hyperthyroidism in the Graves-Basedov's disease (18 cases), and toxic nodular goiter (19 cases). The absorbed doses were measured with thermoluminescent dosimeters placed above the jugular incisure and above the pubic symphysis; the readings were used for calculation of the dose equivalent over the thyroid and in the ovaries. Following the radical treatment of thyroid cancer iodine uptake in the thyroid gland was very low and most of the applied 131 I was excreted within one to three days. In our 21 patients who were given on average 2.8 GBq (76 mCi) 131 I and stimulated with TSH (approx. 60 μIU/mL) the mean dose equivalents over the thyroid and in the ovaries were 115±123 mSv and 56±19 mSv, respectively. In comparison, the calculated dose equivalents in the Graves-Basedov's disease patients (424 MBq mean activity of the applied 131 I) and the goiter patients (544 MBq mean activity of the applied 131 I) were approx. 3.5 times higher over the thyroid and approx. 2.5 times lower in the ovaries. No disfunctions of the ovaries were detected in the treated young women. Based on these results it is recommended to stimulate diuresis during the first two-three days after the injection of 131 I. The results also indicate that exposure to ionising radiation of patients treated for various thyroid disorders with 131 I does not lead to the development of clinically detectable non-stochastic effects. (author)

Radiation therapy for endometrial cancer in patients treated for postoperative recurrence

International Nuclear Information System (INIS)

Hart, Kimberly B.; Han, Ihn; Shamsa, Falah; Court, Wayne S.; Chuba, Paul; Deppe, Gunter; Malone, John; Christensen, Carl; Porter, Arthur T.

1998-01-01

Purpose: To retrospectively evaluate the outcome and risk factors in patients treated with radiation for endometrial cancer at time of recurrence. Materials and Methods: Three hundred ninety-nine women were treated with radiation therapy for endometrial cancer at KCI/WSU from January 1980 to December 1994. Of these, 26 patients treated primarily with surgery received radiation therapy at the time of recurrence. Median time to recurrence after surgery was 8 months, with all recurrences occurring within 24 months. Twenty-four patients had recurrences in the vaginal cuff, vagina, or pelvis. These patients received external-beam radiation to the pelvis (45.00-50.40 Gy) and periaortic lymph nodes (45.00-50.00 Gy), along with a boost given by external-beam radiation or brachytherapy (16.00-30.00 Gy). Mean follow-up was 15 months (range 1-85 months). Results: The 2-year survival was 50% and median survival was 16 months (survival range 1-85 months). Of 26 patients, 54% (14) failed locally following radiation therapy. Factors indicative of poor survival included histology (sarcoma, poorly differentiated adenocarcinoma), grade, and lymph node positivity. Histological differentiation influenced local control; lymphovascular space invasion was of borderline significance with regard to local control. Conclusion: Local control and survival for surgically treated endometrial cancer patients who receive radiation at the time of recurrence are poor, with the exception of those patients with recurrent disease limited to the vagina. Early detection of recurrence may improve outcome. Pathologic risk factors may identify those patients at risk for extrapelvic recurrence. Alternative treatment modalities need to be developed for this high-risk group of patients

[Circulating endothelial progenitor cell levels in treated hypertensive patients].

Science.gov (United States)

Maroun-Eid, C; Ortega-Hernández, A; Abad, M; García-Donaire, J A; Barbero, A; Reinares, L; Martell-Claros, N; Gómez-Garre, D

2015-01-01

Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP<140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

Reacciones políticas a la economía

Directory of Open Access Journals (Sweden)

JOSÉ Mª MARAVALL

1999-01-01

Full Text Available ¿Influyen las condiciones de la economía en las decisiones de voto de los individuos? El presente estudio se basa en datos individuales procedentes de 63 encuestas a lo largo de dieciséis años, abarcando 158.412 entrevistados. Analizando series temporales de la relación entre las valoraciones agregadas de la economía y las condiciones objetivas de ésta, el trabajo muestra que las valoraciones se ajustaron con precisión a tales condiciones. Pero sin embargo, las expectativas acerca del futuro no se fundamentaron ni en las valoraciones del pasado ni en las condiciones objetivas de la economía. Muestra también, a partir de estimaciones logit multinominales, que tanto los juicios económicos retrospectivos como los prospectivos ejercieron influencia en el voto individual, con independencia de la ideología o de las condiciones sociales personales. Sin embargo, al combinar las valoraciones acerca del pasado con las expectativas acerca del futuro, los resultados son más complejos. Mediante mecanismos "intertemporales", "exonerativos" o "de oposición", los votantes con frecuencia premiaron a los gobiernos cuando sus juicios sobre la economía fueron negativos, o los castigaron cuando tales juicios fueron buenos. En tales casos, preferencias políticas, asociadas a la ideología, las condiciones sociales o al voto previo, alteraron la relación causal entre las valoraciones económicas y el apoyo electoral. Es decir, un votante decidía primero a quién votar y luego, según las condiciones objetivas de la economía y la edad del gobierno, decidía sus juicios económicos y qué responsabilidad atribuir al gobierno. De esta forma, la lógica del voto económico resulta mucho más compleja de lo que se ha supuesto: las reacciones políticas individuales a la economía distaron de ser mecánicas.

Effective doses to family members of patients treated with radioiodine-131

International Nuclear Information System (INIS)

Kocovska, M Zdraveska; Vaskova, O; Majstorov, V; Kuzmanovska, S; Gjorceva, D Pop; Jokic, V Spasic

2011-01-01

The purpose of this study was to evaluate the effective dose to family members of thyroid cancer and hyperthyroid patients treated with radioiodine-131, and also to compare the results with dose constraints proposed by the International Commission of Radiological Protection (ICRP) and the Basic Safety Standards (BSS) of the International Atomic Energy Agency (IAEA). For the estimation of the effective doses, sixty family members of sixty patients, treated with radioiodine-131, and thermoluminiscent dosimeters (Model TLD 100) were used. Thyroid cancer patients were hospitalized for three days, while hyperthyroid patients were treated on out-patient basis. The family members wore TLD in front of the torso for seven days. The radiation doses to family members of thyroid cancer patients were well below the recommended dose constraint of 1 mSv. The mean value of effective dose was 0.21 mSv (min 0.02 - max 0.51 mSv). Effective doses, higher than 1 mSv, were detected for 11 family members of hyperthyroid patients. The mean value of effective dose of family members of hyperthyroid patients was 0.87 mSv (min 0.12 - max 6.79). The estimated effective doses to family members of hyperthyroid patients were higher than the effective doses to family members of thyroid carcinoma patients. These findings may be considered when establishing new national guidelines concerning radiation protection and release of patients after a treatment with radioiodine therapy.

Serum Leptin Levels in Epileptic Patients Treated with Topiramate and Valproic Acid

Directory of Open Access Journals (Sweden)

İrem Fatma Uludağ

2011-03-01

Full Text Available OBJECTIVE: Leptin is considered to be a signal factor that regulates body weight and energy expenditure, and there is a strong correlation between serum leptin concentrations, body mass index, and body fat mass in humans. Our aim in this study was to evaluate the role of leptin in valproic acid (VPA and topiramate (TPM related weight changes in epileptic patients. METHODS: Body mass index is calculated and serum leptin and insulin levels are measured in 56 patients with epilepsy (40 patients taking VPA and 16 patients taking VPA and TPM and in 40 healty control subjects. RESULTS: Obesity was seen in 21 patients (52.5% in VPA treated group, in 15 patients (37.5% in the control group and in only one male (6.3% in VPA and TPM treated group. Body mass index was lower in the group treated with VPA and TPM (p<0.001. Serum leptin concentrations were correlated with the body mass index (r=0.49, p<0.001 and were significantly higher in obese subjects (p<0.001 and in women (p<0.001. Serum leptin levels were significantly lower in patients treated with VPA and TPM (p<0.05. CONCLUSION: High levels of serum leptin in patients taking VPA and significantly low levels of serum leptin in patients taking VPA and TPM in our study are in agreement with the hypotheses that weight changes induced with VPA and TPM are related with the alterations in serum leptin levels

Serum Leptin Levels in Epileptic Patients Treated with Topiramate and Valproic Acid

Directory of Open Access Journals (Sweden)

İrem Fatma Uludağ

2011-03-01

Full Text Available OBJECTIVE: Leptin is considered to be a signal factor that regulates body weight and energy expenditure, and there is a strong correlation between serum leptin concentrations, body mass index, and body fat mass in humans. Our aim in this study was to evaluate the role of leptin in valproic acid (VPA and topiramate (TPM related weight changes in epileptic patients. METHODS: Body mass index is calculated and serum leptin and insulin levels are measured in 56 patients with epilepsy (40 patients taking VPA and 16 patients taking VPA and TPM and in 40 healty control subjects. RESULTS: Obesity was seen in 21 patients (52.5% in VPA treated group, in 15 patients (37.5% in the control group and in only one male (6.3% in VPA and TPM treated group. Body mass index was lower in the group treated with VPA and TPM (p<0.001. Serum leptin concentrations were correlated with the body mass index (r=0.49, p<0.001 and were significantly higher in obese subjects (p<0.001 and in women (p<0.001. Serum leptin levels were significantly lower in patients treated with VPA and TPM (p<0.05. CONCLUSION: High levels of serum leptin in patients taking VPA and significantly low levels of serum leptin in patients taking VPA and TPM in our study are in agreement with the hypotheses that weight changes induced with VPA and TPM are related with the alterations in serum leptin levels.

Fatal hemoptysis in patients with advanced esophageal cancer treated with apatinib

Directory of Open Access Journals (Sweden)

Wang W

2018-05-01

Full Text Available Wei Wang, Lin Zhang, Yan Xie, Tianchang Zhen, Gongzhang Su, Qi Zang Department of Thoracic Surgery, The Affiliated Qianfoshan Hospital of Shandong University, Jinan, China Abstract: Targeted therapy is commonly used for treating advanced malignant tumors. Compared with cytotoxic drugs, targeted drugs have the characteristics of good curative results, less adverse effects, and convenient oral administration. Hence, they are especially suitable for patients with cancer who are not able to tolerate chemotherapy. Anti-angiogenic therapy can achieve the objective by inhibiting the formation of new blood vessels in tumors. Apatinib is a novel tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor-2. It has been proven to be effective and safe in treating patients with gastric carcinoma and gastroesophageal junction carcinoma. So far, no reports are available on the treatment of esophageal cancer with apatinib. Two patients with advanced esophageal cancer were treated with oral apatinib because of their poor physical condition. After treatment, the dyspnea symptoms disappeared and quality of life significantly improved. Chest computed tomography showed massive necrosis of tumor tissues in each patient. The tumors significantly reduced and a cavity was formed locally in each patient. However, both patients died of massive hemoptysis, probably due to the rupture of the bronchial artery eroded by tumors. The results indicated that apatinib was effective in treating some patients with advanced esophageal cancer, and adverse effects were controllable. However, doctors should choose appropriate candidates according to apatinib’s indications. In addition, the use of apatinib should be carefully controlled for patients with esophageal cancer, especially in those with large vessels and trachea or bronchus eroded by tumor, so as to avoid or reduce the occurrence of fatal hemorrhage. Keywords: angiogenesis

VARIABILIDAD EN LA NOTIFICACIÓN DE REACCIONES ADVERSAS A LAS VACUNAS DE LA GRIPE PANDÉMICA Y ESTACIONAL. TEMPORADAS 2009-2010 Y 2010-2011, COMUNITAT VALENCIANA

OpenAIRE

Ana María Alguacil Ramos; José Antonio Lluch Rodrigo; Antonio Portero Alonso; Rosa Martín Ivorra; Eliseo Pastor Villalba

2012-01-01

Fundamentos: La pérdida de confianza en la seguridad de las vacunas derivada de situaciones de alarma, como en el caso de la gripe pandémica, puede afectar tanto a las coberturas vacunales como a la sensibilidad frente a la notificación de las sospechas de reacciones adversas asociadas a vacunas (SRAAV). El objetivo del trabajo es describir los efectos adversos a la vacuna frente a la gripe pandémica notificados en la temporada 2009-2010 y comparar si existen diferencias con los descritos con...

Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

DEFF Research Database (Denmark)

Dragsted, Casper; Aagaard, Theis; Ohrt-Nissen, Søren

2017-01-01

center. Indications for surgery, pre- and postoperative neurological impairment, comorbidities, and mortality were recorded. A survey was conducted on all eligible patients with the EuroQol 5-dimension (EQ-5D) questionnaire and Oswestry Disability Index (ODI). RESULTS: Sixty-five patients were diagnosed...... neurological impairment. CONCLUSIONS: Several years after surgery, patients surgically treated for spondylodiscitis have significantly lower HRQL and more disability than the background population. Neurological impairment prior to index surgery predicts adverse outcome in terms of disability and lower HRQL.......PURPOSE: To assess mortality, disability, and health-related quality of life (HRQL) in patients surgically treated for spondylodiscitis. METHODS: A retrospective longitudinal study was conducted on all patients surgically treated for spondylodiscitis over a 6-year period at a single tertiary spine...

Swallowing assessment in early laryngeal cancer patients treated either with surgery or radiotherapy

International Nuclear Information System (INIS)

Celedon L, Carlos; Gambi A, Galo; Royer F, Michel; Esquivel C, Patricia; Arteaga J, Patricia; Valdes P, Constanza

2008-01-01

Swallowing is a complex neuromuscular process that requires anatomical indemnity and an adequate coordination of several organs. Laryngeal cancer treatment may cause swallowing disorders. Traditionally, a high frequency of this type of disorder after surgery has been reported, but no actual data concerning its incidence in patients undergoing radiotherapy for early laryngeal cancer has been published. Aim. To compare swallowing disorders frequency posterior to treatment in early laryngeal cancer patients. Material and Method. Two groups of early laryngeal cancer patients were transversally studied, one treated with vertical partial surgery (CP), and the other treated exclusively with radiotherapy. Each patient had otorhinolaryngological, nasofibroscopic and video fluoroscopic evaluations after treatment. Differences between groups were compared using the - square test. Results. Twenty patients per group were entered in this study, predominantly males of similar age. Both groups presented a high incidence of aspiration symptoms (55% in RT and 35% in CP). There were no significant differences between both groups. Discussion and Conclusion. A high incidence of swallowing disorders in patients treated for early laryngeal cancer was found. It should then be considered as a frequent alteration in this group of patients, either treated with RT or CP

Diagnostic Accuracy of Tests for Polyuria in Lithium-Treated Patients.

Science.gov (United States)

Kinahan, James Conor; NiChorcorain, Aoife; Cunningham, Sean; Freyne, Aideen; Cooney, Colm; Barry, Siobhan; Kelly, Brendan D

2015-08-01

In lithium-treated patients, polyuria increases the risk of dehydration and lithium toxicity. If detected early, it is reversible. Despite its prevalence and associated morbidity in clinical practice, it remains underrecognized and therefore undertreated. The 24-hour urine collection is limited by its convenience and practicality. This study explores the diagnostic accuracy of alternative tests such as questionnaires on subjective polyuria, polydipsia, nocturia (dichotomous and ordinal responses), early morning urine sample osmolality (EMUO), and fluid intake record (FIR). This is a cross-sectional study of 179 lithium-treated patients attending a general adult and an old age psychiatry service. Participants completed the tests after completing an accurate 24-hour urine collection. The diagnostic accuracy of the individual tests was explored using the appropriate statistical techniques. Seventy-nine participants completed all of the tests. Polydipsia severity, EMUO, and FIR significantly differentiated the participants with polyuria (area under the receiver operating characteristic curve of 0.646, 0.760, and 0.846, respectively). Of the tests investigated, the FIR made the largest significant change in the probability that a patient experiences polyuria (3500 mL/24 hours; interval likelihood ratio, 14). Symptomatic questioning, EMUO, and an FIR could be used in clinical practice to inform the prescriber of the probability that a lithium-treated patient is experiencing polyuria.

Effective doses to family members of patients treated with radioiodine 131

International Nuclear Information System (INIS)

Kocovska, Marina Zdravevska; Ristevska, Svetlana Micevska; Nikolovski, Sasho; Jokic, Vesna Spasic

2010-01-01

The purpose of this study was to evaluate the effective dose to family members of thyroid cancer and hyperthyroid patients treated with radioiodine 131; also to compare the results with dose constraints proposed by International Commission of Radiological Protection (ICRP) and Basic Safety Standards (BSS) of the International Atomic Energy Agency (IAEA). Material and methods: for estimation of effective doses at sixty family members of thirty thyroid cancer and thirty hyperthyroid patients treated with radioiodine 131, the thermoluminescent dosimeters, Model TLD 100, were used. Thyroid cancer patients were hospitalized for three days, while hyperthyroid patients were treated on out-patient basis. The family members wore thermoluminescent dosimeter in front of the torso for seven days. Results: The radiation doses to family members of thyroid cancer patients were well below recommended dose constraint of 1 mSv. The mean value of effective dose was 0.21 mSv (min 0.02 - max 0.51 mSv). Effective doses, higher than 1 mSv, were detected at 11 family members of hyperthyroid patients.. The mean value of effective dose at family members of hyperthyroid patients was 0.87 mSv (min 0.12 - max 6.79) Conclusion: After three days of hospitalization and detailed given oral and written instruction, thyroid carcinoma patients maintain not to exceed the proposed dose limits. Hyperthyroid patients present a greater radiation hazard than thyroid carcinoma patients. The estimated effective doses were higher than the effective doses at family members of thyroid carcinoma patients. These findings may be considered when establishing new national guidelines concerning radiation protection and release of patients after a treatment with radioiodine therapy.(Author)

Addison disease in patients treated with glucocorticoid therapy.

LENUS (Irish Health Repository)

Cronin, C C

2012-02-03

Acute adrenal crisis in patients with unrecognized chronic adrenocortical failure is difficult to diagnose and potentially fatal. We describe 2 patients with acute adrenal crisis whose diagnoses were hindered because of concomitant glucocorticoid treatment. Acute adrenal insufficiency is primarily a state of mineralocorticoid deficiency. Prednisolone and prednisone, the most frequently prescribed anti-inflammatory corticosteroid agents, have minimal mineralocorticoid activity. Several conditions that may be treated with pharmacological glucocorticoids are associated with an increased risk of Addison disease. An acute adrenal crisis, against which concurrent glucocorticoid therapy does not confer adequate protection, may develop in such patients.

Cognitive function in patients with chronic pain treated with opioids

DEFF Research Database (Denmark)

Kurita, G P; de Mattos Pimenta, C A; Braga, P E

2012-01-01

The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...

Radiation exposure estimation from patient treated by I-131

International Nuclear Information System (INIS)

Lahfi, Y.; Anjak, O.

2012-09-01

Radioactive iodine is the main radiopharmaceutical substance in the nuclear medicine field which used in diagnosis and treatment of patients suffering from thyroid cancer; thus it can be considered as the main source of the public and patient relative exposure. In this study, 192 patients were selected randomly and their radiation dose rate was measured at different levels of the patient's body (thyroid, knee, bladder) after one, twenty four and forty eight hours from availing the prescript quantity of the I-131. The collected data may serve in estimating the worker and public exposure related to the patient treated by I-131. (authors)

Long-Term Survivorship of Esophageal Cancer Patients Treated with Radical Intent

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Alex Agranovich

2008-01-01

Full Text Available To investigate the recent trends in definitive management of esophageal cancer, the records of 138 consecutive patients treated with radical intent in a single institution between 1995 and 2003 were reviewed and analyzed. The median follow-up period was 5.7 years (range 1.1 to 10.4 years. Seventy-seven patients were treated with radiation therapy (RT only and 61 with combined regimens (CRT, in which RT was combined with either radical surgery or chemotherapy, or both. The overall survival of the entire cohort was 32% over two years and 20% over five years. The survivorship in the RT group was 17% over two years and 5% over five years. In the CRT group, 51% and 35% survived over two and five years, respectively. From all the potential prognostic factors examined by univariate and multivariate analyses, only male sex and use of CRT were strongly associated with better survivorship. There was no significant difference in the outcomes among the different regimens of CRT. Survivorship was not affected by the location or histology of the tumour, clinical stage, dose of RT or use of endoluminal brachytherapy in addition to external beam RT. There was a greater tendency to use RT only more often in older patients, but patient age did not affect survivorship. The proportion of patients treated with CRT did not change significantly over the last versus the first four years of the observed period. Combined regimens are undoubtedly superior to RT as a single modality. The long-term survivorship of patients in a subgroup of our patients treated with combined modality protocols compared favourably with the previously reported results in the literature and specifically in prospective randomized trials. However, the optimal combined modality regimen is yet to be defined.

Gemcitabine and capecitabine for heavily pre-treated metastatic colorectal cancer patients

DEFF Research Database (Denmark)

Spindler, Karen-Lise G; Pallisgaard, Niels; Andersen, Rikke F

2014-01-01

AIM: We investigated the efficacy and safety of capecitabine and gemcitabin (GemCap) in heavily pre-treated, therapy-resistant metastatic colorectal cancer (mCRC) patients and the clinical importance of cell-free DNA (cfDNA) measurement. PATIENTS AND METHODS: Patients' inclusion criteria included...

Evaluation of QOL in cancer patients treated with radiation therapy

International Nuclear Information System (INIS)

Takahashi, Takeo; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Murata, Osamu; Osada, Hisato; Omichi, Masahide

2002-01-01

Evaluation of quality of life (QOL) in cancer patients is an important theme. However, we do not have an established method to assess QOL in cancer patients during radiotherapy in Japan. We evaluated both the changes of QOL and the factors affecting QOL in radiotherapy patients. Three hundred fifty-five cancer patients, who filled in a questionnaire at the beginning, middle, and end of radiotherapy between 1998 and 2001, were studied. We used The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)'' devised by Kurihara et al, the Ministry of Health and Welfare. The QOL Questionnaire had five categories: physical activity, physical condition, mental state, social interaction, and face scale. The total score, sum of the score of five categories, were established synthetically (maximum score is 110). The mean of total QOL scores were 75.8, 77.6, and 78.2 at the beginning, middle, and end of radiotherapy respectively. Patients with symptoms related to cancer had apparent improvement of QOL score. Patients receiving chemotherapy had a decreased QOL score at the end of radiotherapy. The score of physical condition was reduced improvement. It was suggested that radiotherapy could be performed without losing QOL of cancer patients, including older patients. However, patients receiving chemotherapy and those with head and neck cancer may lose their QOL, therefore, we should treat such patients carefully. (author)

The observation and nursing for advanced hepatocellular carcinoma patients treated with Sorafenib

International Nuclear Information System (INIS)

Chen Yu; Xu Jing; Lin Fuqun

2011-01-01

Objective: To summarize the author's experience which was obtained in observing and nursing the adverse reactions of advanced hepatocellular carcinoma patients who were treated with Sorafenib. Methods: The adverse reactions and their severity observed in 34 patients with advanced hepatocellular carcinoma who were treated with Sorafenib were retrospectively analyzed. Results: Side effects or toxic reaction were observed in all the patients, which included neutropenia, foot-hand syndrome (FHS), fatigue, diarrhea, hypertention, rash, etc. Five patients had to cut down the dose of Sorafenib in order to relieve the symptom, among them one patient had grade 4 FHS, 3 patients had grade 3 FHS and one patient had grade 3 neutropenia. Conclusion: Being familiar with sorafenib's adverse reaction, closely observing the patients condition and affording appropriate nursing measures, all the above items can definitely improve the therapeutic results and patient's living quality. (authors)

Severe hyponatraemia in an amiloride/hydrochlorothiazide-treated patient

NARCIS (Netherlands)

Van Assen, S.; Mudde, A.H.

1999-01-01

A 85-year-old woman treated with, among other drugs, a thiazide diuretic presented with a severe hyponatraemia. She met several of the criteria for SIADH and, besides drugs, no cause for SIADH was found. After stopping the thiazide diuretic and restricting fluid intake the patient recovered fully.

Risk stratification for progressive multifocal leukoencephalopathy in patients treated with natalizumab

DEFF Research Database (Denmark)

Sørensen, Per Soelberg; Bertolotto, Antonio; Edan, Gilles

2012-01-01

using or considering natalizumab therapy. Recommendations for clinical management of patients with MS and use of natalizumab are provided based on the presence of these three risk factors. The identification of risk factors that increase the likelihood of PML in natalizumab-treated patients can......Natalizumab is a highly effective immunomodulator in the treatment of multiple sclerosis (MS). Treatment with natalizumab has been associated with progressive multifocal leukoencephalopathy (PML), an infection of the central nervous system (CNS) caused by a pathogenic form of the normally benign JC......-treated patients. With the development of a reliable and validated assay for detection of antibodies in patients with MS directed against JCV, it is now possible to identify persons who are carriers of JCV. The availability of this assay provides an additional option for risk stratification of PML in patients...

Análisis de la incidencia, características e implicaciones clínicas de las reacciones adversas a medicamentos de uso humano en el medio hospitalario

OpenAIRE

Esteban Jiménez, Óscar; Pérez Calvo, Juan Ignacio; Lanuza Giménez, Francisco Javier

2014-01-01

JUSTIFICACIÓN Todos los medicamentos existentes en el mercado, aparte de sus acciones terapéuticas, también pueden desarrollar efectos nocivos para el organismo, los que son conocidos como reacciones adversas a medicamentos (R.A.M.). Según la Organización Mundial de la Salud (OMS), las RAM se definen como cualquier efecto nocivo no intencionado y no deseado que se presenta después de la administración de un medicamento en las dosis normalmente utilizadas en el hombre, con fines de profilaxis,...

Bone mineral density in adult patients treated with various antiepileptic drugs

DEFF Research Database (Denmark)

Beniczky, Simona Alexandra; Viken, Janina; Jensen, Lars Thorbjørn

2012-01-01

adult consecutive outpatients treated with AEDs for more than 2 years, and who underwent measurement of the BMD. We compared the incidence of decreased BMD among the patients treated with 6 different AEDs: carbamazepine (CBZ), oxcarbazepine (OXC), valproic acid (VPA), lamotrigine (LTG), topiramate (TPM...

Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

DEFF Research Database (Denmark)

Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach

2016-01-01

, is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.......PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence....... RESULTS: From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total...

Follow-up of conservatively treated sleep apnoea patients

African Journals Online (AJOL)

Health of School Children: Treatment of /ntestinal. Helminths and Schistosomiasis (WHO/GDS/IPI/GTD 92.1). Geneva: WHO, 1992. Accepted 17 June 1994. Follow-up of conservatively treated sleep apnoea patients. P. R. Bartel, J. Verster, P. J. Becker. Polysomnograms have been recorded at our laboratory since 1985 for ...

Profile of Hospitalized Elderly Patients Treated for Falling

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Yu-Ling Hsiao

2012-03-01

Conclusion: This study utilized actual nationwide data to provide a profile of elderly patients treated for falling in Taiwan. Based on the results of this study, fall prevention should especially target the female elderly, and should be given more emphasis during the winter season, in terms of clinical and policy applications.

Infusion of Hematopoietic Stem Cells: Types, Characteristics, Adverse and Transfusion Reactions and the Implications for Nursing Infusión de células madre hematopoyéticas: tipos, características, reacciones adversas y de transfusión y sus implicaciones para la enfermería Infusão de células-tronco hematopoéticas: tipos, características, reações adversas e transfusionais e implicações para a enfermagem

Directory of Open Access Journals (Sweden)

Ana Carolina de Jesus Vieira Curcioli

2010-08-01

Full Text Available Hematopoietic stem cell infusion is an important procedure in Hematopoietic Stem Cell Transplantation (HSCT. This study identifies transfusion and other adverse reactions that can occur during infusion and the nursing care related to the procedure. This epidemiologic study used transplantations performed between 2006 and 2008. A total of 166 transplantations were performed: 114 were autologous, 47 allogeneic and five haploidentical. Three transfusion reactions and 96 adverse reactions were observed. Adverse reactions were related to the presence of cryoprotectant, though the infusion rate and quantity of infused cryoprotectant were not related to the occurrence of reactions. The products were fresh and infused within the recommended time when transfusion reactions occurred. In regard to cell source, lower engraftment time was found in peripheral blood. Nursing documentation is relevant for patients' safety as well to planning an infusion in order to minimize the occurrence of reactions.La infusión de las células madre hematopoyéticas es un importante procedimiento en el trasplante de células madre hematopoyéticas. Este estudio se propuso identificar las reacciones adversas y de transfusión que pueden ocurrir durante la infusión y los cuidados de enfermería inherentes al procedimiento. Se trata de un estudio epidemiológico en trasplantes ocurridos en los años de 2006 a 2008. En ese período ocurrieron 166 trasplantes, siendo 114 autólogos, 47 alogénicos y 5 haploidénticos. Se observaron tres reacciones de transfusión y 96 reacciones adversas. Las reacciones adversas están ligadas a presencia del crioprotector. Sin embargo, la velocidad de infusión y la cantidad del crioprotector infundido, no tuvieron relación con la ocurrencia de las reacciones. En las reacciones de transfusión, los productos eran frescos e infundidos con la velocidad preconizada. En cuanto a las fuentes de células, hubo menor tiempo de injerto en la sangre

Metabolic control of type 2 diabetic patients commonly treated with ...

African Journals Online (AJOL)

Fasting insulin and glucose concentrations were used to assess insulin resistance and sensitivity (%S) using Homeostasis model assessment (HOMA) method. Results: Of the 179 patients studied, 87% of male and 92% of female patients were treated with sulphonylurea drugs whereas 13% and 9% of male and female ...

CHANGES OF INTERCELLULAR COOPERATION IN PERIPHERAL BLOOD IN TREATED PATIENTS WITH CARDIOLOGIC DISEASES

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L. N. Korichkina

2009-01-01

Full Text Available Aim. To study changes of intercellular cooperation in peripheral blood induced by treatment in patients with arterial hypertension (HT, ischemic heart disease (IHD and chronic heart failure (CHF.Material and methods. 610 patients were involved into the study, including 250 patients with HT of stages I-III (50 untreated patients, 150 patients with IHD and 210 patients with CHF of stages I-III. All patients were treated except 50 hypertensive ones. 80 healthy patients (40 men, 40 women were included into control group. Blood smears of patients were evaluated (Romanovsky's stain. A number of leukocyte, autorosettes and autorosettes with erythrocyte lysis was calculated. The cellular association consisting of a neutrophil, monocyte or eosinocyte with 3 or more erythrocytes skintight to their surface defined as autorosettes. Erythrocytes number and hemoglobin level determined in peripheral blood.Results. Single autorosettes in peripheral blood were observed in patients of control group and in untreated patients with HT. Treated patients with HT, IHD and CHF had increased number of autorossets and autorosettes with erythrocytes lysis. This phenomenon resulted in reduction of erythrocytes number and hemoglobin level in peripheral blood.Conclusion. Treated patients with cardiologic diseases had changes in intercellular cooperation. It should be considered at intensive and long term therapy.

Sexual function in prostatic cancer patients treated with radiotherapy, orchiectomy or oestrogens

International Nuclear Information System (INIS)

Bergman, B.; Damber, J.-E.; Littbrand, B.; Sjoegren, K.; Tomic, R.

1984-01-01

Sexual function in prostatic carcinoma patients was studied in 12 patients from each of three treatment groups: radiotherapy, orchiectomy and oestrogen treatment. Significant deterioration occurred in all groups. Although erectile potency was preserved in 9 of 12 patients treated with radiotherapy, 7 of these had a marked reduction in the frequency of sexual activity. Men subjected to orchiectomy or oestrogen treatment were seldom capable of having intercourse or of experiencing orgasm. However, oestrogen-treated men continued sexual activity with their partner more often than orchiectomised subjects. Patients receiving oestrogen treatment scored significantly higher for mental depression than those in the other two treatment groups. (author)

Sexual function in prostatic cancer patients treated with radiotherapy, orchiectomy or oestrogens

Energy Technology Data Exchange (ETDEWEB)

Bergman, B.; Damber, J.E.; Littbrand, B.; Sjoegren, K.; Tomic, R. (Umeaa Univ. (Sweden))

1984-02-01

Sexual function in prostatic carcinoma patients was studied in 12 patients from each of three treatment groups: radiotherapy, orchiectomy and oestrogen treatment. Significant deterioration occurred in all groups. Although erectile potency was preserved in 9 of 12 patients treated with radiotherapy, 7 of these had a marked reduction in the frequency of sexual activity. Men subjected to orchiectomy or oestrogen treatment were seldom capable of having intercourse or of experiencing orgasm. However, oestrogen-treated men continued sexual activity with their partner more often than orchiectomised subjects. Patients receiving oestrogen treatment scored significantly higher for mental depression than those in the other two treatment groups.

Suicide risk in patients treated with lithium

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Søndergård, Lars; Kvist, Kajsa

2005-01-01

CONTEXT: Prior observational studies suggest that treatment with lithium may be associated with reduced risk of suicide in bipolar disorder. However, these studies are biased toward patients with the most severe disorders, and the relation to sex and age has seldom been investigated. OBJECTIVE......: To investigate whether treatment with lithium reduces the risk of suicide in a nationwide study. DESIGN: An observational cohort study with linkage of registers of all prescribed lithium and recorded suicides in Denmark during a period from January 1, 1995, to December 31, 1999. SETTING: All patients treated...... with lithium in Denmark, ie, within community psychiatry, private specialist practice settings, and general practice. PARTICIPANTS: A total of 13 186 patients who purchased at least 1 prescription of lithium and 1.2 million subjects from the general population. MAIN OUTCOME MEASURE: All suicides identified...

Reactivation of Herpesvirus in Patients With Hepatitis C Treated With Direct-Acting Antiviral Agents.

Science.gov (United States)

Perelló M, Christie; Fernández-Carrillo, Carlos; Londoño, María-Carlota; Arias-Loste, Teresa; Hernández-Conde, Marta; Llerena, Susana; Crespo, Javier; Forns, Xavier; Calleja, José Luis

2016-11-01

We performed a case-series analysis of reactivation of herpesvirus in patients with hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents. We collected data from 576 patients with HCV infection treated with DAA combinations at 3 hospitals in Spain, from November 2014 through November 2015. We also collected data from a control population (230 HCV-infected patients, matched for sex and age; 23 untreated and 213 treated with interferon-based regimens). Herpesvirus was reactivated in 10 patients who received DAA therapy (7 patients had cirrhosis and 3 patients had received liver transplants), a median of 8 weeks after the therapy was initiated. None of the controls had herpesvirus reactivation. Patients with herpesvirus reactivation were receiving the DAA agents sofosbuvir with ledipasvir (with or without ribavirin, 7/10), ombitasvir with paritaprevir and ritonavir plus dasabuvir (with or without ribavirin, 2/10), or sofosbuvir with simeprevir plus ribavirin (1/10). Two of the 10 patients developed postherpetic neuralgia and 1 patient developed kerato-uveitis. All 10 patients with herpesvirus reactivation achieved a sustained virologic response. Immune changes that follow clearance of HCV might lead to reactivation of other viruses, such as herpesvirus. Patients with HCV infection suspected of having herpesvirus infection should be treated immediately. Some groups also might be screened for herpesvirus infection. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy

Science.gov (United States)

2017-10-01

AWARD NUMBER: W81XWH-15-1-0681 TITLE: Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy PRINCIPAL...TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0681Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated...effects, urinary morbidity, rectal injury, sexual dysfunction 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF

Materiales basados en heteropoliácidos tipo Keggin y su aplicación en reacciones de esterificación para la valorización de derivados de biomasa

OpenAIRE

Escobar Caicedo, Angélica María

2017-01-01

Objetivos: - Sintetizar y caracterizar catalizadores basados en heteropoliácidos con estructura tipo Keggin inmovilizados sobre óxido de zirconio (ZrO2), óxido de titanio (TiO2) y materiales magnéticos (Fe3O4) encapsulados en óxido de silicio (SiO2), y evaluarlos en reacciones de esterificación de los ácidos 2-furoico y levulínico (los cuales pueden obtenerse a partir de biomasa vegetal) con diferentes alcoholes, para la obtención de compuestos de alto valor agregado. - Desarrollo de u...

Treatment Beyond Progression in Patients with Advanced Renal Cell Carcinoma Treated with Nivolumab in CheckMate 025

DEFF Research Database (Denmark)

Escudier, Bernard; Motzer, Robert J; Sharma, Padmanee

2017-01-01

BACKGROUND: Response patterns to nivolumab differ from those seen with other approved targeted therapies. OBJECTIVE: To investigate the efficacy of nivolumab in previously treated patients with advanced renal cell carcinoma who were treated beyond (Response Evaluation Criteria In Solid Tumors......) RECIST progression. DESIGN, SETTING, AND PARTICIPANTS: This was a subgroup analysis of patients treated with nivolumab in the phase 3 CheckMate 025 study. Patients continuing to tolerate therapy and exhibiting investigator-assessed clinical benefit were eligible to be treated beyond RECIST progression...... (TBP) and received therapy for ≥4 wk after first progression; patients not treated beyond RECIST progression (NTBP) received 0 wk to Nivolumab 3mg/kg intravenously every 2 wk. RESULTS AND LIMITATIONS: Of 406 nivolumab-treated patients, 316 (78...

Clinical study of Atopic Dermatitis patient treated with Poison Extraction Method

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Park Chi-young

2007-06-01

Full Text Available Objectives : This study is desinged in order to evaluate the Poison extraction method for the Atopic dermatitis. Methods : The authors observed the two cases of Atopic dermatitis patients who previously used steroid-based ointment. for treating the Poison Extraction Method. Conclusions : 1. In case 1, the patient with mild case of Atopic dermatitis in face is treated with the Poison extraction method. Rash symptoms intensed for first few days. As sweating appeared in the local area from the seventh day, all the symptoms was disappeared rapidly. No recurrence was found. 2. In case 2, the patient with severe case of Atopic dermatitis in whole body is treated with the Poison extraction method. The symptoms intensed after two months and all the symptoms of itchiness, rash, scaly letter dissapeared in the third and fourth months. No recurrence was found. 3. In both cases of mild and severe cases of Atopic dermatitis. all the symptoms were disappeared and no recurrence was found with the Poison Extraction Method.

Reacciones adversas a la vacuna contra influenza A (H1N1 en trabajadores de salud de una institución pública peruana

Directory of Open Access Journals (Sweden)

Pedro P. Álvarez-Falconí

2011-07-01

Full Text Available Introducción: En abril de 2009 se produjo un brote de influenza en la frontera de México y EE UU por el nuevo virus A(H1N1 2009. La pandemia no fue severa y la vacuna aplicada en diversos países produjo diversas reacciones adversas a medicamentos (RAM. Objetivos: Evaluar la posible relación entre las RAM notificadas espontáneamente y la vacunación en trabajadores de salud de un instituto. Así mismo, identificar tópicos afines a las RAM por dicha vacuna. Diseño: Estudio prospectivo y descriptivo basado en la notificación espontánea. Institución: Local central del Instituto Nacional de Salud en Lima. Participantes: Trabajadores de salud. Metodología: Las RAM notificadas espontáneamente fueron registradas en Hojas RAM. Se aplicó un algoritmo para buscar una relación causa-efecto. Principales medidas de resultados: Reacciones adversas a la vacuna influenza A(H1N1. Resultados: Hubo tres notificaciones espontáneas entre 148 trabajadores de salud vacunados (2% contra la influenza A(H1N1 2009. La relación causa-efecto fue ‘cierta’ para fiebre y fatiga y ‘posible’ para afecciones respiratorias en tres mujeres (faringitis aguda, catarro nasal agudo, bronquitis catarral. Conclusiones: Entre los pocos trabajadores de salud que presentaron RAM, las afecciones respiratorias con una relación considerada ‘posible’ podría interpretarse que las mujeres serían más sensibles para esa RAM comparadas con los varones. Las RAM fiebre y fatiga alcanzaron una relación considerada ‘cierta’. La menor cantidad de infectados en personas de tercera edad en el país y en otros podría explicarse por la presencia de ‘anticuerpos protectores’ en ellos.

[Outcome of eating disorder patients treated in tertiary care].

Science.gov (United States)

Suokas, Jaana; Gissler, Mika; Haukka, Jari; Linna, Milla; Raevuori, Anu; Suvisaari, Jaana

2015-01-01

We assessed the outcome of eating disorder patients treated in a specialized treatment setting. Register-based follow-up study of adults (n = 2 450, 95% women, age range 18-62 years). For each patient four background-matched controls were selected. The hazard ratio for all-cause mortality was 6.51 in anorexia, 2.97 in bulimia and 1.77 in BED. Autoimmune diseases were more common in patients than in controls. Bulimia and BED were associated with increased type 2 diabetes risk. Pregnancy and childbirth rates were lower among patients than among controls. Eating disorders are associated with multiple health problems and increased mortality risk.

Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

National Research Council Canada - National Science Library

Marks, Lawrence B

2006-01-01

Purpose: To determine the incidence dose/time-dependence and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

Three-year followup of patients treated with lower energy microwave thermotherapy

NARCIS (Netherlands)

de Wildt, M. J.; D'Ancona, F. C.; Hubregtse, M.; Carter, S. S.; Debruyne, F. M.; de la Rosette, J. J.

1996-01-01

A retrospective study was done to investigate the long-term outcome of patients treated with lower energy transurethral microwave thermotherapy. A total of 305 patients with lower urinary tract symptoms and benign prostatic hypertrophy underwent transurethral microwave thermotherapy according to a

Sexual functioning in testosterone-supplemented patients treated for bilateral testicular cancer

NARCIS (Netherlands)

van Basten, Johannes; vanDriel, MF; Jonker, G; Sleijfer, DT; Schraffordt Koops, Heimen; van de Wiel, HBM; Hoekstra, HJ

Objective To determine the effects of intramuscular injections with testosterone (Sustanon(R)) on sex-hormone levels, sexual functioning and general wellbeing in patients treated with orchidectomy for bilateral testicular cancer. Patients and methods The study comprised seven men (median age 38

Incidence of Second Malignancies Among Patients Treated With Proton Versus Photon Radiation

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Chung, Christine S., E-mail: chungc1@sutterhealth.org [Department of Radiation Oncology, Alta Bates Summit Medical Center, Berkeley, California (United States); Yock, Torunn I. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Nelson, Kerrie [Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts (United States); Xu, Yang [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Keating, Nancy L. [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Department of General Internal Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Tarbell, Nancy J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Office of the Executive Dean, Harvard Medical School, Boston, Massachusetts (United States)

2013-09-01

Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study

Incidence of Second Malignancies Among Patients Treated With Proton Versus Photon Radiation

International Nuclear Information System (INIS)

Chung, Christine S.; Yock, Torunn I.; Nelson, Kerrie; Xu, Yang; Keating, Nancy L.; Tarbell, Nancy J.

2013-01-01

Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study

Anatomía Humana: estudio de las reacciones de los estudiantes de primero de medicina ante la sala de disección Human Anatomy: reactions of first year medical students to the dissection room

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Maribel Miguel Pérez

2007-06-01

Full Text Available Introducción: El objetivo de este estudio es reflejar las reacciones físicas y emocionales de los estudiantes de primer curso de Medicina de la Universidad de Barcelona (Campus de Bellvitge ante la sala de disección. Material y métodos: Los estudiantes responden a tres cuestionarios que valoran la intensidad del miedo, las reacciones físicas y psicológicas frente la sala de disección y los métodos de afrontamiento, en dos momentos del curso: al inicio y al final del curso académico. Resultados: Las reacciones más frecuentes fueron la sensación de disgusto, la pérdida del apetito, las imágenes visuales recurrentes de los cadáveres, el insomnio y las pesadillas. Respecto a los métodos de afrontamiento más usados por los estudiantes para contrarrestar las reacciones adversas correspondieron en juntarse y hacer broma con los amigos, estudiar anatomía y pedir consejo a compañeros y profesores. Conclusiones: La sala de disección representa, para los estudiantes del primer curso de medicina, el primer encuentro relacionado con la muerte y ésta, a la vez, implica el desarrollo de mecanismos de adaptación en su futuro profesional. Los profesores de anatomía no solo tienen una mera función docente como transmisores de contenidos, sino que también deberían dar apoyo a la adaptación progresiva de los alumnos a la sala de disección.Introduction: The aim of this study is to record the physical and emotional reactions of the first-year medical students at the University of Barcelona (Campus de Bellvitge to the dissection room. Material and methods: Three questionnaires focusing on degree of fear and psychological and physical reactions were prepared and administered to students before the first dissection session, after the first dissection, and at the end of the course. Results: The most frequent reactions were sensation of disgust, loss of appetite, recurring visual images of cadavers, insomnia and nightmares. To cope with these

Tumor-stroma ratio predicts recurrence in patients with colon cancer treated with neoadjuvant chemotherapy

DEFF Research Database (Denmark)

Hansen, Torben Frøstrup; Kjær-Frifeldt, Sanne; Lindebjerg, Jan

2017-01-01

BACKGROUND: Neoadjuvant chemotherapy represents a new treatment approach to locally advanced colon cancer. The aim of this study was to analyze the ability of tumor-stroma ratio (TSR) to predict disease recurrence in patients with locally advanced colon cancer treated with neoadjuvant chemotherapy....... MATERIAL AND METHODS: This study included 65 patients with colon cancer treated with neoadjuvant chemotherapy in a phase II trial. All patients were planned for three cycles of capecitabine and oxaliplatin before surgery. Hematoxylin and eosin stained tissue sections from surgically resected primary tumors...... was 55%, compared to 94% in the group of patients with a high TSR. CONCLUSIONS: TSR assessed in the surgically resected primary tumor from patients with locally advanced colon cancer treated with neoadjuvant chemotherapy provides prognostic value and may serve as a relevant parameter in selecting...

Which Factors Affect Dental Esthetics and Smile Attractiveness in Orthodontically Treated Patients?

Science.gov (United States)

Heravi, Farzin; Rashed, Roozbeh; Zarrabi, Mohammad Javad; Setayesh, Yasin

2015-01-01

Objectives: This study aimed to find the factors that affect dental esthetics and smile attractiveness in orthodontically treated patients according to laypeople’s judgment, and to determine whether there is any relationship between dental and smile esthetics. Materials and Methods: Using the Q-sort technique, 60 laypersons (30 males, 30 females) rated dental and smile photographs of 48 orthodontically treated patients based on their degree of attractiveness. Dental and smile parameters of each rated image were measured by Smile Analyzer software. The Student’s t-test and chi-square test were used to compare dental and smile parameters between attractive and unattractive images. The logistic regression was used to assess which variables predicted dental and smile esthetics in treated individuals. Results: The philtral to commissural height ratio and gingival display were significantly different in attractive and unattractive smiles (P=0.003 and P=0.02, respectively). None of the dental variables were found to be a determinant of dental esthetics at the end of the orthodontic treatment (P>0.05). According to the judgment of all raters (female and male) and the male raters’ judgment, smile attractiveness could be predicted by philtral to commissural height ratio and buccal corridor ratio (Pesthetics and smile attractiveness in orthodontically treated patients (P>0.05). Conclusion: The philtral to commissural height ratio and buccal corridor ratio can be considered as predictors of smile attractiveness in orthodontically treated patients. Achieving dental esthetics at the end of orthodontic treatment does not guarantee smile attractiveness. PMID:26877739

Increased daytime somnolence despite normal sleep patterns in patients treated for nonfunctioning pituitary macroadenoma

NARCIS (Netherlands)

van der Klaauw, Agatha A.; Dekkers, Olaf M.; Pereira, Alberto M.; van Kralingen, Klaas W.; Romijn, Johannes A.

2007-01-01

In patients treated for nonfunctioning pituitary macroadenoma (NFMA), increased fatigue scores on quality of life (QoL) have been reported. Because this may be related to altered sleep patterns, we evaluated daytime sleepiness and sleep patterns in patients successfully treated for NFMA in our

Exercise training improves glycemic control in long-standing insulin-treated type 2 diabetic patients

NARCIS (Netherlands)

Feyter, de H.M.M.L.; Praet, S.F.E.; Broek, van den N.M.A.; Kuipers, H.; Stehouwer, C.D.; Nicolay, K.; Prompers, J.J.; Loon, van L.J.C.

2007-01-01

Regular exercise represents an effective strategy to prevent and/or treat type 2 diabetes ( 1 , 2 ). However, the clinical benefits of exercise intervention in a vastly expanding group of long-standing insulin-treated type 2 diabetic patients with comorbidities are less evident. As these patients

MGMT inactivation and clinical response in newly diagnosed GBM patients treated with Gliadel.

Science.gov (United States)

Grossman, Rachel; Burger, Peter; Soudry, Ethan; Tyler, Betty; Chaichana, Kaisorn L; Weingart, Jon; Olivi, Alessandro; Gallia, Gary L; Sidransky, David; Quiñones-Hinojosa, Alfredo; Ye, Xiaobu; Brem, Henry

2015-12-01

We examined the relationship between the O(6)-methylguanine-methyltransferase (MGMT) methylation status and clinical outcomes in newly diagnosed glioblastoma multiforme (GBM) patients who were treated with Gliadel wafers (Eisai, Tokyo, Japan). MGMT promoter methylation has been associated with increased survival among patients with GBM who are treated with various alkylating agents. MGMT promoter methylation, in DNA from 122 of 160 newly diagnosed GBM patients treated with Gliadel, was determined by a quantitative methylation-specific polymerase chain reaction, and was correlated with overall survival (OS) and recurrence-free survival (RFS). The MGMT promoter was methylated in 40 (32.7%) of 122 patients. The median OS was 13.5 months (95% confidence interval [CI] 11.0-14.5) and RFS was 9.4 months (95% CI 7.8-10.2). After adjusting for age, Karnofsky performance score, extent of resection, temozolomide (TMZ) and radiation therapy (RT), the newly diagnosed GBM patients with MGMT methylation had a 15% reduced mortality risk, compared to patients with unmethylated MGMT (hazard ratio 0.85; 95% CI 0.56-1.31; p=0.46). The patients aged over 70 years with MGMT methylation had a significantly longer median OS of 13.5 months, compared to 7.6 months in patients with unmethylated MGMT (p=0.027). A significant difference was also found in older patients, with a median RFS of 13.1 versus 7.6 months for methylated and unmethylated MGMT groups, respectively (p=0.01). Methylation of the MGMT promoter in newly diagnosed GBM patients treated with Gliadel, RT and TMZ, was associated with significantly improved OS compared to the unmethylated population. In elderly patients, methylation of the MGMT promoter was associated with significantly better OS and RFS. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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

2012-04-01

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

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

International Nuclear Information System (INIS)

Samuelian, Jason M.; Callister, Matthew D.; Ashman, Jonathan B.; Young-Fadok, Tonia M.; Borad, Mitesh J.; Gunderson, Leonard L.

2012-01-01

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

Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

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Albano, Domenico; La Grutta, Ludovico; Grassedonio, Emanuele; Brancatelli, Giuseppe; Lagalla, Roberto; Midiri, Massimo; Galia, Massimo [University of Palermo, Department of Radiology, DIBIMED, Palermo (Italy); Patti, Caterina; Mule, Antonino [Azienda Ospedali Riuniti Villa Sofia-Cervello, Department of Hematology I, Palermo (Italy)

2017-05-15

The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %). The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. (orig.)

Personality Disorders in Substance Abusers: A Comparison of Patients Treated in a Prison Unit and Patients Treated in Inpatient Treatment

DEFF Research Database (Denmark)

Hesse, Morten; Stefánsson, Ragnar

2008-01-01

-III. Baserate scores indicated a prevalence of 95% of personality disorders. A logistic regression analysis correctly identified 95% of the sample, and showed that antisocial personality disorder traits were characteristic of the prison sample, and masochistic personality disorder traits were characteristic......Abstract  A large body of literature has shown a high prevalence of personality disorders in substance abusers. We compared a sample of substance abusers treated in a prison setting with substance abusers treated in a non-prison inpatient setting rated with the Millon Clinical Multiaxial Inventory...... of the inpatient sample. The findings indicate that treatment models used in prison settings should be adjusted to meet the needs of antisocial patients....

EBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients

Directory of Open Access Journals (Sweden)

Juliana Guarize

2017-10-01

Full Text Available Mediastinal lymph node enlargement is common in the follow-up of patients with previously treated malignancies. The aim of this study is to assess the role of endobronchial ultrasound (EBUS transbronchial needle aspiration (TBNA for cyto-histological evaluation of positron emission tomography with 18fluorodeoxyglucose (PET positive mediastinal and hilar lymph nodes developed in patients with previous malignancies. All EBUS-TBNA cases performed from January 2012 to May 2016 were retrospective reviewed. Results of EBUS-TBNA in patients with mediastinal and/or hilar lymphadenopathies were analysed. Non-malignant cytopathologies were confirmed with surgical procedures or clinical and radiological follow-up. Among 1780 patients, 176 were included in the analysis. 103 of these (58.5% had a diagnosis of tumour recurrence whereas 73 (41.5% had a different diagnosis: 63 (35.8% had a non-neoplastic diagnosis and 8 patients (4.6% had a different cell type malignancy. Samples were false-negative in 5 (2.8% out of 176 patients. The overall sensitivity, specificity, negative predicted value and diagnostic accuracy were 95.7% (95% CI 90.2–98.6%, 100% (95% CI 94.0–100%, 92.3% (95% CI 83.2–96.7% and 97.2% (95% CI 93.5–98.8%, respectively. EBUS-TBNA demonstrated a pathological diagnosis different from the previous tumour in a large percentage of patients, confirming its strategic role in the management of patients with previously treated malignancies.

The definition of biochemical failure in patients treated with definitive radiotherapy

International Nuclear Information System (INIS)

Kattan, Michael W.; Fearn, Paul A.; Leibel, Steven; Potters, Louis

2000-01-01

Purpose: The American Society for Therapeutic Radiology and Oncology (ASTRO) published a definition for biochemical failure following treatment of prostate cancer. Others have noted difficulties with interpreting this definition and recommended modifications to accommodate special recurrence patterns. We have compared various modifications to the original ASTRO definition on our series of 1213 patients treated with transperineal permanent prostate brachytherapy. Methods and Materials: The ASTRO modifications we considered adjusted for (1) early censoring of nonrecurrent patients with rising prostate-specific antigen levels (PSA), (2) cumulative rather than consecutive rises (without a decrease) as evidence of recurrence, (3) both of the above, and (4) waiting 2 years before data analysis. The Kaplan-Meier method was used to compute the effects on recurrence rate for patients treated with and without neoadjuvant hormones. Results: With the original ASTRO definition, freedom from recurrence in our series of men who did not receive neoadjuvant hormones was 83% at 4 years. All of the modifications considered had statistically insignificant effects on freedom from recurrence rates, varying from 80% to 83% at 4 years. Patients treated with neoadjuvant hormones also showed very little sensitivity to the recurrence definition employed. Conclusion: Early censoring of equivocal patients and counting cumulative rather than consecutive rises in PSA (without a decrease) had little empiric effect on the ASTRO recurrence rates. However, we favor the addition of both these modifications to the ASTRO definition on conceptual grounds for evaluating patients following any modality (radiation or surgery), whereby a trend over multiple PSA values is used to judge failure.

Glucoregulation in normal weight schizophrenia patients treated by first generation antipsychotics

Directory of Open Access Journals (Sweden)

Marić Nađa

2008-01-01

Full Text Available Introduction Schizophrenia patients are at greater risk of obesity, diabetes mellitus (DM, lipid abnormalities and cardiovascular disorders. The metabolic complications in patients are associated with several risk factors: family history of DM, lifestyle, smoking, dietary habits, physical inactivity, but also with antipsychotic medication. In literature, most publications have been focused on the effects of the second generation antipsychotics (SGA on glucose metabolism. However, less attention has been paid to abnormality in glucoregulation, patients with schizophrenia treated with the first generation antipsychotics (FGA. Objective The present study evaluated glucose metabolism in normal weight schizophrenia patients treated with FGA. METHOD The cross-sectional study included 18 patients (FGA treated and 20 healthy controls with neither group differences in sex distribution, age, nor in BMI. Inclusion criteria were normal BMI (20-25 kg/m2. The glucose levels, insulin levels and growth hormone levels during oral glucose tolerance test (OGTT were measured. Results Fasting glucose and insulin levels did not differ significantly between groups. Groups differed in OGTT glucose and insulin peak and area under curve (AUC, level of significance p<0.05 (patients vs. controls: glucose peak 8.3±0.4 vs.6.9±0.5 mmol/l, glucose AUC 758±28 vs. 640±36 mU/l/120 min; insulin peak in patients 92.7±15.6 mU/l; insulin AUC 6060±1016 mU/l/120 min, insulin peak in controls 47.9±6.5 mU/l; insulin AUC 2597±256 mU/l/120 min. Conclusion Patients with schizophrenia, although with normal body mass index, are at high risk of abnormal glucose regulation. Not only SGA increase the risk of impaired glucoregulation and metabolic syndrome, but this may also be due to FGA or schizophrenia per se. .

Acute exercise in treated phenylketonuria patients: Physical activity and biochemical response

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Priscila Nicolao Mazzola

2015-12-01

Conclusions: Acute aerobic exercise followed by a Phe-restricted breakfast did not change Phe concentrations in treated phenylketonuria patients, but it was associated with decreased Phe/Tyr only in controls. Further studies are necessary to confirm our results in a higher number of patients.

QualiCOP: real-world effectiveness, tolerability, and quality of life in patients with relapsing-remitting multiple sclerosis treated with glatiramer acetate, treatment-naïve patients, and previously treated patients.

Science.gov (United States)

Ziemssen, Tjalf; Calabrese, Pasquale; Penner, Iris-Katharina; Apfel, Rainer

2016-04-01

Treatment of symptoms and signs beyond the expanded disability status scale remains a major target in multiple sclerosis. QualiCOP was an observational, non-interventional, open-label study conducted at 170 sites in Germany. Of the 754 enrolled patients, 96 % had relapsing-remitting multiple sclerosis (MS) and were either disease-modifying therapy naïve (de novo, n = 481) or previously treated (n = 237) with once-daily, subcutaneous 20-mg/mL glatiramer acetate (GA). Assessments of relapse rate, disease progression, overall functioning, quality of life (QoL), cognition, fatigue, and depression were performed over 24 months. GA treatment over 24 months was associated with reduced annual relapse rate for previously treated (from 0.98 to 0.54 relapses) and de novo (from 0.81 to 0.48 relapses) patients. Multiple Sclerosis Functional Composite scores showed slight improvement in both cohorts (all p Multiple Sclerosis Inventory Cognition scale scores showed robust improvement in cognition among previously treated and de novo cohorts (all p treatment in important QoL parameters beyond standard measures of relapse and disease severity.

Producción de la lipasa LIP2 de Candida rugosa en el sistema Pichia pastoris: caracterización y aplicación en reacciones de síntesis

OpenAIRE

Alarcón Vivero, Manuel Rubén

2008-01-01

Consultable des del TDX Títol obtingut de la portada digitalitzada Las lipasas son enzima con numerosas aplicaciones en biocatálisis debido a su reacción natural, hidrólisis de enlaces éster, como a su utilización en reacciones de transesterificación y síntesis orgánica. Se destaca como productor de lipasas la levadura Candida rugosa. Existen lipasas comerciales de este microorganismo, pero tienen el inconveniente de ser una mezcla de isoenzimas que hace inviable el proceso de purificac...

Imipenem, meropenem, or doripenem to treat patients with Pseudomonas aeruginosa ventilator-associated pneumonia.

Science.gov (United States)

Luyt, Charles-Edouard; Aubry, Alexandra; Lu, Qin; Micaelo, Maïté; Bréchot, Nicolas; Brossier, Florence; Brisson, Hélène; Rouby, Jean-Jacques; Trouillet, Jean-Louis; Combes, Alain; Jarlier, Vincent; Chastre, Jean

2014-01-01

Only limited data exist on Pseudomonas aeruginosa ventilator-associated pneumonia (VAP) treated with imipenem, meropenem, or doripenem. Therefore, we conducted a prospective observational study in 169 patients who developed Pseudomonas aeruginosa VAP. Imipenem, meropenem, and doripenem MICs for Pseudomonas aeruginosa isolates were determined using Etests and compared according to the carbapenem received. Among the 169 isolates responsible for the first VAP episode, doripenem MICs were lower (Pimipenem and meropenem (MIC50s, 0.25, 2, and 0.38, respectively); 61%, 64%, and 70% were susceptible to imipenem, meropenem, and doripenem, respectively (P was not statistically significant). Factors independently associated with carbapenem resistance were previous carbapenem use (within 15 days) and mechanical ventilation duration before VAP onset. Fifty-six (33%) patients had at least one VAP recurrence, and 56 (33%) died. Factors independently associated with an unfavorable outcome (recurrence or death) were a high day 7 sequential organ failure assessment score and mechanical ventilation dependency on day 7. Physicians freely prescribed a carbapenem to 88 patients: imipenem for 32, meropenem for 24, and doripenem for 32. The remaining 81 patients were treated with various antibiotics. Imipenem-, meropenem-, and doripenem-treated patients had similar VAP recurrence rates (41%, 25%, and 22%, respectively; P=0.15) and mortality rates (47%, 25%, and 22%, respectively; P=0.07). Carbapenem resistance emerged similarly among patients treated with any carbapenem. No carbapenem was superior to another for preventing carbapenem resistance emergence.

Quality of life in Chinese patients with schizophrenia treated in primary care.

Science.gov (United States)

Li, Yan; Hou, Cai-Lan; Ma, Xin-Rong; Zhong, Bao-Liang; Zang, Yu; Jia, Fu-Jun; Lin, Yong-Qiang; Lai, Kelly Y C; Chiu, Helen F K; Ungvari, Gabor S; Hall, Brian J; Cai, Mei-Ying; Ng, Chee H; Xiang, Yu-Tao

2017-08-01

In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Attitudes and beliefs among patients treated with mood stabilizers

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Hansen, Hanne Vibe; Bech, Per

2006-01-01

that they previously had been or currently were in treatment with a mood stabilizer. A large proportion of the patients (40 to 80 %) had non-correct views on the effect of mood stabilizers. Older patients consistently had a more negative view on the doctor-patient relationship, more non-correct views on the effect...... psychiatrist, community psychiatry doctor, hospital doctor, other doctor). CONCLUSION: There is a need of improving knowledge and attitudes toward diagnosis and treatment especially among elder patients as this may add to improve the prognosis of depressive and bipolar disorders....... Compliance Questionnaire (MSQC) was mailed to a large population of patients with depressive or bipolar disorder representative of patients treated at their first contacts to hospital settings in Denmark. RESULTS: Of the 1005 recipients, 49.9 % responded to the letter and among these 256 indicated...

Pain management of opioid-treated cancer patients in hospital settings in Denmark

DEFF Research Database (Denmark)

Lundorff, L.; Peuckmann, V.; Sjøgren, Per

2008-01-01

AIM: To evaluate the performance and quality of cancer pain management in hospital settings. METHODS: Anaesthesiologists specialised in pain and palliative medicine studied pain management in departments of oncology and surgery. Study days were randomly chosen and patients treated with oral opioids......-treated patients in hospital settings: however, focussing on average pain intensity, the outcome seems favourable compared with other countries. Pain mechanisms were seldom examined and adjuvant drugs were not specifically used for neuropathic pain. Opioid dosing intervals and supplemental opioid doses were most...

Central D2-dopamine receptor occupancy in schizophrenic patients treated with antipsychotic drugs

International Nuclear Information System (INIS)

Farde, L.; Wiesel, F.A.; Halldin, C.; Sedvall, G.

1988-01-01

Using positron emission tomography and the carbon 11-labeled ligand raclopride, central D2-dopamine receptor occupancy in the putamen was determined in psychiatric patients treated with clinical doses of psychoactive drugs. Receptor occupancy in drug-treated patients was defined as the percent reduction of specific carbon 11-raclopride binding in relation to the expected binding in the absence of drug treatment. Clinical treatment of schizophrenic patients with 11 chemically distinct antipsychotic drugs (including both classic and atypical neuroleptics such as clozapine) resulted in a 65% to 85% occupancy of D2-dopamine receptors. In a depressed patient treated with the tricyclic antidepressant nortriptyline, no occupancy was found. The time course for receptor occupancy and drug levels was followed after withdrawal of sulpiride or haloperidol. D2-dopamine receptor occupancy remained above 65% for many hours despite a substantial reduction of serum drug concentrations. In a sulpiride-treated patient, the dosage was reduced in four steps over a nine-week period and a curvilinear relationship was demonstrated between central D2-dopamine receptor occupancy and serum drug concentrations. The results demonstrate that clinical doses of all the currently used classes of antipsychotic drugs cause a substantial blockade of central D2-dopamine receptors in humans. This effect appears to be selective for the antipsychotics, since it was not induced by the antidepressant nortriptyline

Reacciones de las profesoras y profesores de la Universidad de Costa Rica ante la flexibilización del curriculum para estudiantes con necesidades educativas especiales

Directory of Open Access Journals (Sweden)

Arguedas Negrini, Irma

2004-12-01

Full Text Available La Universidad de Costa Rica ha asumido el compromiso de garantizar la accesibilidad a los procesos de aprendizaje cuando esto sea requerido por estudiantes con necesidades educativas especiales. El presente trabajo se realizó con el propósito de recolectar información que favorezca que los procesos de igualdad de oportunidades se cumplan de la forma que aporte mayores beneficios para todos los involucrados y de proporcionar un espacio para que el personal docente manifestara sus reacciones ante sus experiencias con la flexibilización del currículum. Se analizan elementos que contribuyen a hacer la accesibilidad una realidad y se reportan las reacciones de diez profesoras y profesores de la Sede Rodrigo Facio quienes han impartido cursos a estudiantes que han solicitado la aplicación del Artículo 37 del Reglamento de Régimen Académico Estudiantil. Se concluye que la aplicación de adecuaciones curriculares o de acceso y la aceptación de la diversidad en el medio universitario pueden ser una fuente de aprendizaje y enriquecimiento. At Universidad de Costa Rica efforts have been made to provide access to the curriculum to students with special needs. This work was done with the purpose of obtaining information that could help to make the provision of equal opportunities a process that benefits all who are involved, as well as to listen to the reactions of faculty who have applied accommodations for students that require them. Elements that contribute to make equal access a reality are analyzed, and the reactions to the experiences of ten educators from different areas of the university are reported. It is concluded that the provision of accommodations and the acceptance of student diversity at university settings could enhance the quality of teaching.

Polyneuropathy in levodopa-treated Parkinson's patients.

Science.gov (United States)

Szadejko, Karol; Dziewiatowski, Krzysztof; Szabat, Krzysztof; Robowski, Piotr; Schinwelski, Michał; Sitek, Emilia; Sławek, Jarosław

2016-12-15

Recently published studies show that the prevalence of polyneuropathy (PNP) is higher in patients with Parkinson's disease (PD) than in age-matched controls. Its pathogenesis, however is a matter of controversy. The major hypothesis is the toxicity of high concentrations of homocysteine (Hcy) possibly related to levodopa (LD) therapy. The aim of the present study was to determine the prevalence of PNP, independent of other etiologies, and to determine the relationship to demographic and clinical factors in LD-treated Parkinson's patients. A total of 102 patients (51 patients with PD and 51 sex- and age-matched healthy controls) were enrolled in the study. The presence of any risk factors for PNP, ascertained from the history and laboratory tests, was an exclusion criterion. The Toronto Clinical Scoring System (TCSS) was used for clinical assessment of PNP. The objective assessment was based on electroneurography (ENG) studies in which motor nerves (peroneal and tibial nerves) as well as sensory nerves (sural and superficial peroneal nerves) were bilaterally examined. The severity of the disease was determined using the UPDRS scale (Unified Parkinson's Disease Rating Scale) and the Hoehn-Yahr (H-Y) scale. In the PD group, the clinical and neurophysiological indicators of PNP, manifested as a symmetrical and predominantly sensory axonal neuropathy, were more frequent then in the control group and observed in 43.1% vs. 13.7% and 15.7% vs. 2% of subjects respectively. The presence of PNP correlated with age and the severity of PD. Patients with PD and PNP had a higher level of Hcy as compared to PD patients without PNP, however the difference was not statistically significant. The frequency of PNP in PD patients is higher than in controls. The characteristics and discrepancy between the number of patients with clinical and ENG detected PNP may suggest the small fiber neuropathy (SFN) as the dominant form of neuropathy in PD patients. Copyright © 2016 Elsevier B.V. All

The natural history of cystic echinococcosis in untreated and albendazole-treated patients.

Science.gov (United States)

Solomon, N; Kachani, M; Zeyhle, E; Macpherson, C N L

2017-07-01

The World Health Organization (WHO) treatment protocols for cystic echinococcosis (CE) are based on the standardized ultrasound (US) classification. This study examined whether the classification reflected the natural history of CE in untreated and albendazole-treated patients. Data were collected during mass US screenings in CE endemic regions among transhumant populations, the Turkana and Berber peoples of Kenya and Morocco. Cysts were classified using the WHO classification. Patient records occurring prior to treatment, and after albendazole administration, were selected. 852 paired before/after observations of 360 cysts from 257 patients were analyzed. A McNemar-Bowker χ 2 test for symmetry was significant (palbendazole-treated patients was significant (palbendazole-induced changes. Regressions may reflect the stability of CE3B cysts. Copyright © 2017. Published by Elsevier B.V.

Prognostic value of anemia for patients with cervical cancer treated with irradiation

International Nuclear Information System (INIS)

Grigiene, R.; Aleknavicius, E.; Kurtinaitis, J.

2005-01-01

The objective of this study was to evaluate the prognostic value of anemia in uterine cervical carcinoma patients treated with irradiation. A total of 162 patients diagnosed with stage IIA-IIIB cervical carcinoma by the criteria of International Federation of Gynecology and Obstetrics and treated with irradiation were analyzed. Univariate and multivariate analyses using the Cox regression model were performed to determine statistical significance of some tumor-related factors. Patients were divided into two groups according to the hemoglobin level before treatment: 10 mm) assessed by computed tomography had impact on overall survival (p=0.008), disease-free survival (p=0.023) and relapse-free survival (p=0.028). Using multivariate analysis, the hemoglobin level before treatment was found to be an independent prognostic factor for overall survival (p=0.001), disease-free survival (p=0.040) and local relapse-free survival (p=0.013); Iymph node status assessed by computed tomography had impact on overall survival (p=0.030) and local relapse-free survival (p=0.038). Hemoglobin level before treatment is a significant prognostic factor for patients with uterine cervical carcinoma treated with irradiation. (author)

Cancer Incidence and Mortality in Patients Treated Either With RAI or Thyroidectomy for Hyperthyroidism.

Science.gov (United States)

Ryödi, Essi; Metso, Saara; Jaatinen, Pia; Huhtala, Heini; Saaristo, Rauni; Välimäki, Matti; Auvinen, Anssi

2015-10-01

Some previous studies have suggested increased cancer risk in hyperthyroid patients treated with radioactive iodine (RAI). It is unclear whether the excess cancer risk is attributable to hyperthyroidism, its treatment, or the shared risk factors of the two diseases. The objective was to assess cancer morbidity and mortality in hyperthyroid patients treated with either RAI or surgery. We identified 4334 patients treated surgically for hyperthyroidism in Finland during 1986-2007 from the Hospital Discharge Registry and 1814 patients treated with RAI for hyperthyroidism at Tampere University Hospital. For each patient, three age- and gender-matched controls were chosen. Information on cancer diagnoses was obtained from the Cancer Registry. The follow-up began 3 months after the treatment and ended at cancer diagnosis, death, emigration, or the common closing date (December 31, 2009). The overall cancer incidence was not increased among the hyperthyroid patients compared to their controls (rate ratio [RR], 1.05; 95% confidence interval [CI], 0.96-1.15). However, the risk of cancers of the respiratory tract (RR, 1.46; 95% CI, 1.05-2.02) and the stomach (RR, 1.64; 95% CI, 1.01-2.68) was increased among the patients. The overall cancer mortality did not differ between the patients and the controls (RR, 1.08; 95% CI, 0.94-1.25). The type of treatment did not affect the overall risk of cancer (hazard ratio for RAI vs thyroidectomy, 1.03; 95% CI, 0.86-1.23) or cancer mortality (hazard ratio, 1.04; 95% CI, 0.91-1.21). In this cohort of Finnish patients with hyperthyroidism treated with thyroidectomy or RAI, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients. Based on this large-scale, long-term follow-up study, the increased cancer risk in hyperthyroid patients is attributable to hyperthyroidism and shared risk factors, not the treatment modality.

Should vestibular schwannoma in patients with useful hearing be treated with radiation? A comparison of patients treated with stereotactic radiotherapy (SRT) and those not treated with SRT

International Nuclear Information System (INIS)

Shirato, H.; Sakamoto, T.; Kagei, K.; Satoh, N.; Hashimotok, S.; Aoyama, H.; Kitahara, H.; Inuyama, Y.; Miyasaka, K.

1997-01-01

Purpose/Objective: Prognostic factors for hearing preservation after SRT in patients with vestibular schwannoma are investigated, and hearing change is compared to that of the matched control group of patients whose hearing was observed historically. Material and Methods: Of 41 patients with vestibular schwannoma treated from 1991 through 1997 by SRT, 24 with measurable hearing, given 36 Gy in 20 fractions to 48 Gy in 23 fractions were investigated. Tumor sizes ranged from 5 mm to 30 mm with a median of 15 mm. Nine patients had episodes of sudden hearing loss and 12 suffered from progressive hearing loss. Follow-up time after SRT ranged from 4 to 70 months, resulting in a median follow-up time of 21 months. Twelve patients with vestibular schwannoma who were followed without any treatment were selected as a matched control. Results: Eighty-three percent showed a less than 20dB change in pure tone average (PTA), and 43.5% showed a less than 10dB change after SRT. Tumor size was not related to the change in PTA. A higher preservation rate was suggested in subjects younger than 50 years of age. Good pre-treatment PTA (less than 42dB) was related in hearing preservation after RT (p< 0.05). A change in PTA of less than 10 dB was observed in 67.5% of those patients who experienced a sudden onset of hearing loss and in 25.0% of those patients with progressive hearing loss (p< 0.05). Worsening in PTA more than 10dB was observed in no patients with normal type of audiogram before SRT, 33.3% of valley type impairment (drop in 1-2kHz), 63.6% of a high-tone impariment type and 66.7% of horizontal impairment type. No change in PTA between 14 and 32 months after the treatment was observed in 3 patients who were given 36 Gy in 20 fractions. Tumor size did not increase in 97.6% of patients by SRT and in 66.7% by follow-up policy. In patients who received SRT, PTA hearing loss recorded from their first visit was a little worse at 1 year, but at 2 and 3 years became the same as

Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

DEFF Research Database (Denmark)

Nguyen, Mai; Pødenphant, Jan; Ravn, Pernille

2013-01-01

-intensive diagnostic work-up and early treatment should be performed. Systematic postmarketing studies are needed to clarify if there is a true increased risk of disseminated S aureus infections. We suggest caution when prescribing tocilizumab to patients with prosthetic joints and/or prior invasive S aureus......We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part...... of their 'current medical treatment', and the physician may not be aware that the patient is severely immunosuppressed. Severe infections in RA patients treated with tocilizumab may present with mild symptoms despite severe and disseminated infection and, as these patients are severely immunodeficient...

Assessment of Effectiveness of Fluconazole and Clotrimazole in Treating Oral Candidiasis Patients: A Comparative Study.

Science.gov (United States)

Reddy, R C Jagat; Jeelani, S; Duraiselvi, P; Kandasamy, M; Kumar, G Suresh; Pandian, R Azhal Vel

2017-01-01

One of the most common fungal infections infecting humans is Candidiasis. Belonging to the group of opportunistic infections, it often affects individuals with various debilitating diseases. Fluconazole and clotrimazole are two of the commonly used anti-fungal agents for the treatment of oral candidiasis. Hence, we planned this study to evaluate the effectiveness of fluconazole and clotrimazole in the treatment of patients suffering from candidiasis. A total of 180 participants were enrolled in the present study. All the patients of candidiasis were divided broadly into two study groups. Group I included patients who were treated with fluconazole mouthrinse whereas group II included patients who were treated with clotrimazole mouth paint. Grading of patient discomfort was done as noted from readings given by the patients. Specimen was collection by a swab from the lesional area of the oral cavity from the patients and were incubated in Sabouraud's dextrose agar medium and assessed. All the patients were treated with medication as give to their respective groups. Patients were recalled as assessed. All the readings were recorded and analyzed. For group I patients, the fungal eradication was 89.5%, whereas for group II patients, the fungal eradication was 86.7%. No significant results were obtained while comparing the mycological eradiation in patients of the two study groups. Approximately similar effectiveness in terms of treatment was noted with fluconazole and clotrimazole in treating patients with candidiasis.

Asymmetric dimethylarginine in somatically healthy schizophrenia patients treated with atypical antipsychotics

DEFF Research Database (Denmark)

Jørgensen, Anders; Knorr, Ulla Benedichte Søsted; Soendergaard, Mia Greisen

2015-01-01

ratio are positively correlated to measures of oxidative stress. METHODS: We included 40 schizophrenia patients treated with AAP, but without somatic disease or drug abuse, and 40 healthy controls. Plasma concentrations of ADMA and L-arginine were determined by high-performance liquid chromatography...... in a range of cardiovascular disorders. Increased ADMA levels may also lead to increased oxidative stress. We hypothesized that ADMA and the L-arginine:ADMA ratio are increased in somatically healthy schizophrenia patients treated with atypical antipsychotics (AAP), and that the ADMA and the L-arginine: ADMA....... Data were related to markers of systemic oxidative stress on DNA, RNA and lipids, as well as measures of medication load, duration of disease and current symptomatology. RESULTS: Plasma ADMA and the L-arginine:ADMA ratio did not differ between schizophrenia patients and controls. Furthermore, ADMA...

Las reacciones adversas a medicamentos: una aproximación desde el punto de vista económico.

Directory of Open Access Journals (Sweden)

Omar Segura

2003-12-01

Full Text Available La farmacovigilancia, en cuanto disciplina y actividad de las ciencias de salud dedicada a la recolección de información, análisis y ayuda a la toma de decisiones sobre reacciones adversas a medicamentos (RAM, ha tenido expansión conceptual y práctica desde la década de 1960. No obstante, muy pocos estudios han analizado en profundidad cuánto puede costarle este problema a un sistema de salud. El presente artículo pretende ofrecer un análisis de la literatura disponible, orientado hacia el costo generado por la atención de eventos adversos frente a medicamentos en la práctica médica - basado en datos de la literatura internacional - y ofrece un ejercicio hipotético de extrapolación sobre futuros costos de las RAM en Colombia. La finalidad última del presente artículo es sensibilizar y llamar a la reflexión a los diferentes actores del sector salud sobre el impacto económico y la necesidad de apoyar la implementación y desarrollo de un sistema nacional de farmacovigilancia.

Longitudinal Changes in Active Bone Marrow for Cervical Cancer Patients Treated With Concurrent Chemoradiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Noticewala, Sonal S.; Li, Nan; Williamson, Casey W. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Hoh, Carl K. [Division of Nuclear Medicine, Department of Radiology, University of California San Diego, La Jolla, California (United States); Shen, Hanjie [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T.; Saenz, Cheryl C. [Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, La Jolla, California (United States); Einck, John [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Plaxe, Steven [Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, La Jolla, California (United States); Vaida, Florin [Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

2017-03-15

Purpose: To quantify longitudinal changes in active bone marrow (ABM) distributions within unirradiated (extrapelvic) and irradiated (pelvic) bone marrow (BM) in cervical cancer patients treated with concurrent chemoradiation therapy (CRT). Methods and Materials: We sampled 39 cervical cancer patients treated with CRT, of whom 25 were treated with concurrent cisplatin (40 mg/m{sup 2}) and 14 were treated with cisplatin (40 mg/m{sup 2}) plus gemcitabine (50-125 mg/m{sup 2}) (C/G). Patients underwent {sup 18}F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and 1.5 to 6.0 months after treatment. ABM was defined as the subvolume of bone with standardized uptake value (SUV) above the mean SUV of the total bone. The primary aim was to measure the compensatory response, defined as the change in the log of the ratio of extrapelvic versus pelvic ABM percentage from baseline to after treatment. We also quantified the change in the proportion of ABM and mean SUV in pelvic and extrapelvic BM using a 2-sided paired t test. Results: We observed a significant increase in the overall extrapelvic compensatory response after CRT (0.381; 95% confidence interval [CI]: 0.312, 0.449) and separately in patients treated with cisplatin (0.429; 95% CI: 0.340, 0.517) and C/G (0.294; 95% CI: 0.186, 0.402). We observed a trend toward higher compensatory response in patients treated with cisplatin compared with C/G (P=.057). Pelvic ABM percentage was reduced after CRT both in patients receiving cisplatin (P<.001) and in those receiving C/G (P<.001), whereas extrapelvic ABM percentage was increased in patients receiving cisplatin (P<.001) and C/G (P<.001). The mean SUV in pelvic structures was lower after CRT with both cisplatin (P<.001) and C/G (P<.001). The mean SUV appeared lower in extrapelvic structures after CRT in patients treated with C/G (P=.076) but not with cisplatin (P=.942). We also observed that older age and more intense chemotherapy

Longitudinal Changes in Active Bone Marrow for Cervical Cancer Patients Treated With Concurrent Chemoradiation Therapy

International Nuclear Information System (INIS)

Noticewala, Sonal S.; Li, Nan; Williamson, Casey W.; Hoh, Carl K.; Shen, Hanjie; McHale, Michael T.; Saenz, Cheryl C.; Einck, John; Plaxe, Steven; Vaida, Florin; Yashar, Catheryn M.; Mell, Loren K.

2017-01-01

Purpose: To quantify longitudinal changes in active bone marrow (ABM) distributions within unirradiated (extrapelvic) and irradiated (pelvic) bone marrow (BM) in cervical cancer patients treated with concurrent chemoradiation therapy (CRT). Methods and Materials: We sampled 39 cervical cancer patients treated with CRT, of whom 25 were treated with concurrent cisplatin (40 mg/m"2) and 14 were treated with cisplatin (40 mg/m"2) plus gemcitabine (50-125 mg/m"2) (C/G). Patients underwent "1"8F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and 1.5 to 6.0 months after treatment. ABM was defined as the subvolume of bone with standardized uptake value (SUV) above the mean SUV of the total bone. The primary aim was to measure the compensatory response, defined as the change in the log of the ratio of extrapelvic versus pelvic ABM percentage from baseline to after treatment. We also quantified the change in the proportion of ABM and mean SUV in pelvic and extrapelvic BM using a 2-sided paired t test. Results: We observed a significant increase in the overall extrapelvic compensatory response after CRT (0.381; 95% confidence interval [CI]: 0.312, 0.449) and separately in patients treated with cisplatin (0.429; 95% CI: 0.340, 0.517) and C/G (0.294; 95% CI: 0.186, 0.402). We observed a trend toward higher compensatory response in patients treated with cisplatin compared with C/G (P=.057). Pelvic ABM percentage was reduced after CRT both in patients receiving cisplatin (P<.001) and in those receiving C/G (P<.001), whereas extrapelvic ABM percentage was increased in patients receiving cisplatin (P<.001) and C/G (P<.001). The mean SUV in pelvic structures was lower after CRT with both cisplatin (P<.001) and C/G (P<.001). The mean SUV appeared lower in extrapelvic structures after CRT in patients treated with C/G (P=.076) but not with cisplatin (P=.942). We also observed that older age and more intense chemotherapy regimens were

Renal function and symptoms/adverse effects in opioid-treated patients with cancer

DEFF Research Database (Denmark)

Kurita, G P; Lundström, S; Sjøgren, P

2015-01-01

BACKGROUND: Renal impairment and the risk of toxicity caused by accumulation of opioids and/or active metabolites is an under-investigated issue. This study aimed at analysing if symptoms/adverse effects in opioid-treated patients with cancer were associated with renal function. METHODS: Cross...... loss of appetite (P = 0.04). No other significant associations were found. CONCLUSION: Only severe constipation and loss of appetite were associated with low GFR in patients treated with morphine. Oxycodone and fentanyl, in relation to the symptoms studied, seem to be safe as used and titrated...

Long-Term Survival of AIDS Patients Treated with Only Traditional Chinese Medicine

OpenAIRE

Wang, Yifei; Jin, Fujun; Wang, Qiaoli; Suo, Zucai

2017-01-01

Abstract Traditional Chinese herbal medicine (TCM) has been used in Chinese society for more than 5,000 years to treat diseases from inflammation to cancer. Here, we report the case of nine living AIDS patients in the age range of 51 to 67 who were treated with either a unique formula of TCM alone from 2001 to 2009 or the TCM from 2001 to 2006 and then switched to occasional antiretroviral therapy. Surprisingly, the viral loads of eight patients were at undetectable levels on June 28, 2016, w...

Quantitative analysis of the erythrocyte membrane proteins in polycythemia vera patients treated with hydroxycarbamide

Directory of Open Access Journals (Sweden)

Darshana Kottahachchi

2015-06-01

Full Text Available More than 90% of polycythemia vera (PV patients have a mutation in the protein JAK2, which is closely associated with the erythrocyte membrane. With the comparison of 1-D gels of erythrocyte membranes obtained from PV patients treated with hydroxycarbamide and those of untreated controls we observed significant differences in the region of 40–55 kDa. On the basis of the LC–MS/MS analysis of this region we report up-regulation of four protein disulfide isomerases, which was subsequently confirmed by targeted mass spectrometric analysis. In further studies it will be prudent to compare this in patients both treated and not treated with hydroxycarbamide.

Is Androgen Deprivation Therapy Necessary in All Intermediate-Risk Prostate Cancer Patients Treated in the Dose Escalation Era?

International Nuclear Information System (INIS)

Castle, Katherine O.; Hoffman, Karen E.; Levy, Lawrence B.; Lee, Andrew K.; Choi, Seungtaek; Nguyen, Quynh N.; Frank, Steven J.; Pugh, Thomas J.; McGuire, Sean E.; Kuban, Deborah A.

2013-01-01

Purpose: The benefit of adding androgen deprivation therapy (ADT) to dose-escalated radiation therapy (RT) for men with intermediate-risk prostate cancer is unclear; therefore, we assessed the impact of adding ADT to dose-escalated RT on freedom from failure (FFF). Methods: Three groups of men treated with intensity modulated RT or 3-dimensional conformal RT (75.6-78 Gy) from 1993-2008 for prostate cancer were categorized as (1) 326 intermediate-risk patients treated with RT alone, (2) 218 intermediate-risk patients treated with RT and ≤6 months of ADT, and (3) 274 low-risk patients treated with definitive RT. Median follow-up was 58 months. Recursive partitioning analysis based on FFF using Gleason score (GS), T stage, and pretreatment PSA concentration was applied to the intermediate-risk patients treated with RT alone. The Kaplan-Meier method was used to estimate 5-year FFF. Results: Based on recursive partitioning analysis, intermediate-risk patients treated with RT alone were divided into 3 prognostic groups: (1) 188 favorable patients: GS 6, ≤T2b or GS 3+4, ≤T1c; (2) 71 marginal patients: GS 3+4, T2a-b; and (3) 68 unfavorable patients: GS 4+3 or T2c disease. Hazard ratios (HR) for recurrence in each group were 1.0, 2.1, and 4.6, respectively. When intermediate-risk patients treated with RT alone were compared to intermediate-risk patients treated with RT and ADT, the greatest benefit from ADT was seen for the unfavorable intermediate-risk patients (FFF, 74% vs 94%, respectively; P=.005). Favorable intermediate-risk patients had no significant benefit from the addition of ADT to RT (FFF, 94% vs 95%, respectively; P=.85), and FFF for favorable intermediate-risk patients treated with RT alone approached that of low-risk patients treated with RT alone (98%). Conclusions: Patients with favorable intermediate-risk prostate cancer did not benefit from the addition of ADT to dose-escalated RT, and their FFF was nearly as good as patients with low-risk disease

Reacciones Adversas al Tratamiento Antirretroviral de Gran Actividad Inicial en el Hospital Santa Rosa - Piura.

Directory of Open Access Journals (Sweden)

Jiovany Jhan Carlos Saldaña-Gastulo

2009-01-01

Full Text Available Objetivo, Determinar la incidencia y factores asociados a reacciones adversas medicamentosas (RAM al TARGA inicial durante el periodo enero 2006 - diciembre 2007 en el Hospital de Apoyo Santa Rosa-Piura. Diseño, Se realizó un estudio analítico de cohorte retrospectiva. Lugar, Hospital de Apoyo Santa Rosa-Piura. Participantes, 107 historias clínicas de pacientes VIH positivos mayores de 18 años que recibieron TARGA y fueron atendidos durante este periodo en el consultorio de infectología. Intervenciones, Se analizaron retrospectivamente las historias clínicas que fueron pertinentes para la recolección de datos. Principales medidas de resultado, Analisis Univariado, Bivariado (t de Student, y Riesgo Relativo, multivariado (Regresión logística con 95% de confianza (p<0.05. Resultados, En 107 pacientes se encontró una incidencia acumulada de 66,35% de RAM al TARGA inicial. Las RAM experimentadas con mayor frecuencia fueron anemia (35,2%, rash (16,9% y vómitos (9,9%. Se encontró diferencias significativas entre la media de edad y la presencia de RAM con la prueba de t de student (p < 0.05 Conclusiones, Existe una alta incidenica de RAM en pacientes incluidos en TARGA, siendo la más frecuente la anemia en 25 pacientes (35,2%. La media de edad es mayor en pacientes con RAM.

Non-dipper treated hypertensive patients do not have increased cardiac structural alterations

Directory of Open Access Journals (Sweden)

Magrini Fabio

2003-02-01

Full Text Available Abstract Background Non-dipping pattern in hypertensive patients has been shown to be associated with an excess of target organ damage and with an adverse outcome. The aim of our study was to assess whether a reduced nocturnal fall in blood pressure (BP, established on the basis of a single 24-h BP monitoring, in treated essential hypertensives is related to more prominent cardiac alterations. Methods We enrrolled 229 treated hypertensive patients attending the out-patient clinic of our hypertension centre; each patient was subjected to the following procedures : 1 clinic BP measurement; 2 blood and urine sampling for routine blood chemistry and urine examination; 3 standard 12-lead electrocardiogram; 4 echocardiography; 5 ambulatory BP monitoring (ABPM. For the purpose of this study ABPM was carried-out in three subgroups with different clinic BP profile : 1 patients with satisfactory BP control (BP 2 in men and 110 g/m2 in women, ≥51/gm2.7 in men and 47/g/m2.7 in women. Results Of the 229 study participants 119 (51.9% showed a fall in SBP/DBP Conclusions In treated essential hypertensives with or without BP control the extent of nocturnal BP decrease is not associated with an increase in LV mass or LVH prevalence; therefore, the non-dipping profile, diagnosed on the basis of a single ABPM, does not identify hypertensive patients with greater cardiac damage.

Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

Science.gov (United States)

Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

2015-01-01

Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

Reacciones de adición a 1,1-BIS (Difenilfosfino) eteno activada por coordinación en compuestos ciclometalados de Pd(II) : complejos de metales de transición con disfosfinas funcionalizadas

OpenAIRE

Mosteiro Taboada, Roberto

2016-01-01

[Resumen] El trabajo consta de dos partes. La primera estudia la reactividad del doble enlace vinílico de la difosfina 1,1 bis (difenilfosfino)eteno (vdpp) frente a diferentes nucleófilos cuando ésta se encuentra coordinada actuando como ligando bidentado quelato en compuestos ciclometalados. Si bien el doble enlace del grupo vinílico de las fosfina libre presenta una reactividad muy limitada, la coordinación al metal produce su activación permitiendo llevar a cabo reaccion...

Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy

International Nuclear Information System (INIS)

Takahashi, Takeo; Hondo, Mikito; Nishimura, Keiichiro; Kitani, Akira; Yamano, Takafumi; Yanagita, Hisami; Osada, Hisato; Shinbo, Munefumi; Honda, Norinari

2008-01-01

The importance of the quality of life (QOL) and mental condition of patients being treated for cancer is now recognized. In this study, we evaluated QOL and mental condition in patients with cancer before and after radiotherapy. The subjects were 170 patients who had undergone radiotherapy. The examination of QOL was performed using the quality of life questionnaire for cancer patients treated with anticancer drugs (QOL-ACD), and mental condition (anxiety and depression) was examined using the hospital anxiety and depression scale (HADS). These examinations were performed at the start of radiotherapy and immediately after radiotherapy. The QOL score was slightly higher in all patients after the completion of radiotherapy than before the start of radiotherapy. In the palliative radiotherapy group, QOL score was significantly improved by treatment. Anxiety and depression were improved after radiotherapy. There was a correlation between the degrees of improvement of the HADS and QOL score. We could treat cancer patients by radiotherapy without reducing their QOL, and improvement in QOL was significant in the palliative radiotherapy group. Mental condition was also improved after radiotherapy. (author)

Glucometabolic hormones and cardiovascular risk markers in antipsychotic-treated patients

DEFF Research Database (Denmark)

Ebdrup, Bjørn Hylsebeck; Knop, Filip Krag; Madsen, Anna

2014-01-01

levels, non-diabetic antipsychotic-treated patients display emerging signs of dysmetabolism and a compromised cardiovascular risk profile. The appetite regulating hormones, GLP-1 and ghrelin appear not to be influenced by antipsychotic treatment. Our findings provide new clinical insight...

Ethical issues in treating gay and lesbian patients.

Science.gov (United States)

Drescher, Jack

2002-09-01

Since the 1973 decision to remove homosexuality from the list of mental disorders, most mental health practitioners have shifted their clinical focus from "the cure" of homosexuality to treating the concerns of gay and lesbian patients. Some clinicians, however, reject the mental health mainstream's view and continue to conceptualize homosexuality as a mental disorder. Their clinical theories have been incorporated into wider societal debates regarding the status of gay and lesbian people. The sexual conversion or reparative therapies they practice, however, may include routine ethical violations in the realm of improper pressure, confidentiality, informed consent, and fiduciary responsibility to the patient's best interest. On the other hand, a normal/identity approach to treatment, particularly in its most reductionistic forms, may involve ethical lapses in the areas of informed consent and fiduciary responsibility to the patient's best interests as well.

Clinical research of comprehensive rehabilitation in treating brachial plexus injury patients.

Science.gov (United States)

Zhou, Jun-Ming; Gu, Yu-Dong; Xu, Xiao-Jun; Zhang, Shen-Yu; Zhao, Xin

2012-07-01

Brachial plexus injury is one of the difficult medical problems in the world. The aim of this study was to observe the clinical therapeutic effect of comprehensive rehabilitation in treating dysfunction after brachial plexus injury. Forty-three cases of dysfunction after brachial plexus injury were divided into two groups randomly. The treatment group, which totaled 21 patients (including 14 cases of total brachial plexus injury and seven cases of branch brachial plexus injury), was treated with comprehensive rehabilitation including transcutaneous electrical nerve stimulation, mid-frequency electrotherapy, Tuina therapy, and occupational therapy. The control group, which totaled 22 patients (including 16 cases of total brachial plexus injury and six cases of branch brachial plexus injury), was treated with home-based electrical nerve stimulation and occupational therapy. Each course was of 30 days duration and the patients received four courses totally. After four courses, the rehabilitation effect was evaluated according to the brachial plexus function evaluation standard and electromyogram (EMG) assessment. In the treatment group, there was significant difference in the scores of brachial plexus function pre- and post-treatment (P injury. The scores of two "total injury" groups had statistical differences (P injury" groups had statistical differences (P brachial plexus injury than nonintegrated rehabilitation.

Cytologic follow-up of patients with invasive cervical carcinoma treated by radiotherapy

International Nuclear Information System (INIS)

Muram, D.; Curry, R.H.; Drouin, P.

1982-01-01

In an 11-year study done at the Ottawa Civic Hospital, cytologic assessment of 323 patients treated by radiotherapy for invasive cervical carcinoma was reviewed. The value and limitations of gynecologic cytology in the follow-up of these patients are discussed

Treating iron overload in patients with non-transfusion-dependent thalassemia

Science.gov (United States)

Taher, Ali T; Viprakasit, Vip; Musallam, Khaled M; Cappellini, M Domenica

2013-01-01

Despite receiving no or only occasional blood transfusions, patients with non-transfusion-dependent thalassemia (NTDT) have increased intestinal iron absorption and can accumulate iron to levels comparable with transfusion-dependent patients. This iron accumulation occurs more slowly in NTDT patients compared to transfusion-dependent thalassemia patients, and complications do not arise until later in life. It remains crucial for these patients' health to monitor and appropriately treat their iron burden. Based on recent data, including a randomized clinical trial on iron chelation in NTDT, a simple iron chelation treatment algorithm is presented to assist physicians with monitoring iron burden and initiating chelation therapy in this group of patients. Am. J. Hematol. 88:409–415, 2013. © 2013 Wiley Periodicals, Inc. PMID:23475638

Clinical outcome of patients treated with spinal cord stimulation for therapeutically refractory angina pectoris

OpenAIRE

TenVaarwerk, I; Jessurun, G; DeJongste, M; Andersen, C; Mannheimer, C; Eliasson, T; Tadema, W; Staal, M

1999-01-01

OBJECTIVE—To determine morbidity and mortality characteristics in patients treated with electrical neuromodulation for refractory angina pectoris.
DESIGN—A retrospective multicentre study of patients treated with spinal cord stimulation between 1987 and 1997; 21 centres were contacted and 14 responded.
SETTING—Specialist centres worldwide.
PATIENTS—Questionnaires were returned on 517 patients, of whom 71% were male. One was lost to follow up. Mean (SD) age was 63.9 (10.1) years. Duration of a...

Vertebral fractures in patients with rheumatoid arthritis treated with corticosteroids

NARCIS (Netherlands)

Lems, W. F.; Jahangier, Z. N.; Jacobs, J. W.; Bijlsma, J. W.

1995-01-01

To examine the relationship between roentgenological deformities of the vertebral column and clinical manifestations of vertebral fractures in patients with RA, treated with glucocorticosteroids (Cs). In all outpatients of Utrecht University Hospital with RA, who were currently using Cs (n = 52),

Ophthalmological evolution in hyperthyroid patients treated with radioactive iodine

International Nuclear Information System (INIS)

Marrero Rodriguez, Maria Teresa; Rodriguez Gonzalez, Julio Cesar; Alavez Martin, Ernesto

2005-01-01

This study was aimed at analyzing the ophthalmological evolution in hyperthyroid patients treated with radioactive iodine. 100 patients (88 females and 12 males) from the thyroid department of the National Institute of Endocrinology with clinical and biochemical diagnosis of hyperthyroidism and with a mean age of 40 + - 10 years old, were studied. These patients underwent a treatment with radioactive iodine at a dose of 80 m Ci/g of thyroid tissue. A bilateral ophthalmometry was performed to each patient before the treatment and 12 months after it. Mean ophthalmometry of the right eye was 14.51 + - 2.86 mm before the treatment and 13.92 + - 2.83 mm after the treatment, whereas for the left eye it was 14.98 + - 2.91 mm and 14.27 + - 2.83 mm , respectively. Taking into account the results of the ophthalmometry, we concluded that the use of radioactive iodine in the treatment of hyperthyroid patients had no negative results on the ophthalmological evolution of the studied patients

Localized Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma Treated With Radiation Therapy: A Long-Term Outcome in 86 Patients With 104 Treated Eyes

Energy Technology Data Exchange (ETDEWEB)

Harada, Ken, E-mail: keharada@ncc.go.jp [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Murakami, Naoya; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Yoshio, Kotaro; Inaba, Koji; Morota, Madoka; Ito, Yoshinori; Sumi, Minako [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Suzuki, Shigenobu [Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo (Japan); Tobinai, Kensei [Department of Hematologic Oncology, National Cancer Center Hospital, Tokyo (Japan); Uno, Takashi [Department of Radiology, Chiba University School of Medicine, Chiba (Japan); Itami, Jun [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)

2014-03-01

Purpose: To evaluate the natural history, behavior of progression, prognostic factors, and treatment-related adverse effects of primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML). Methods and Materials: Eighty-six patients with histologically proven stage I POAML treated with radiation therapy at National Cancer Center Hospital, Tokyo between 1990 and 2010 were retrospectively reviewed. The median age was 56 years (range, 18-85 years). The median dose administered was 30 Gy (range, 30-46 Gy). Seventy-seven patients (90%) were treated by radiation therapy alone. Results: The median follow-up duration was 9 years (range, 0.9-22 years). The 5- and 10-year overall survival (OS) rates were 97.6% and 93.5%, respectively, and no patients died of lymphoma. Patients with tumor sizes ≥4 cm showed a greater risk of contralateral relapse (P=.012). Six patients with contralateral relapse were seen and treated by radiation therapy alone, and all the lesions were controlled well, with follow-up times of 3 to 12 years. There was 1 case of local relapse after radiation therapy alone, and 3 cases of relapse occurred in a distant site. Cataracts developed in 36 of the 65 eyes treated without lens shielding and in 12 of the 39 patients with lens shielding (P=.037). Conclusions: The majority of patients with POAML showed behavior consistent with that of localized, indolent diseases. Thirty gray of local irradiation seems to be quite effective. The initial bilateral involvement and contralateral orbital relapses can be also controlled with radiation therapy alone. Lens shielding reduces the risk of cataract.

Localized Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma Treated With Radiation Therapy: A Long-Term Outcome in 86 Patients With 104 Treated Eyes

International Nuclear Information System (INIS)

Harada, Ken; Murakami, Naoya; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Yoshio, Kotaro; Inaba, Koji; Morota, Madoka; Ito, Yoshinori; Sumi, Minako; Suzuki, Shigenobu; Tobinai, Kensei; Uno, Takashi; Itami, Jun

2014-01-01

Purpose: To evaluate the natural history, behavior of progression, prognostic factors, and treatment-related adverse effects of primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML). Methods and Materials: Eighty-six patients with histologically proven stage I POAML treated with radiation therapy at National Cancer Center Hospital, Tokyo between 1990 and 2010 were retrospectively reviewed. The median age was 56 years (range, 18-85 years). The median dose administered was 30 Gy (range, 30-46 Gy). Seventy-seven patients (90%) were treated by radiation therapy alone. Results: The median follow-up duration was 9 years (range, 0.9-22 years). The 5- and 10-year overall survival (OS) rates were 97.6% and 93.5%, respectively, and no patients died of lymphoma. Patients with tumor sizes ≥4 cm showed a greater risk of contralateral relapse (P=.012). Six patients with contralateral relapse were seen and treated by radiation therapy alone, and all the lesions were controlled well, with follow-up times of 3 to 12 years. There was 1 case of local relapse after radiation therapy alone, and 3 cases of relapse occurred in a distant site. Cataracts developed in 36 of the 65 eyes treated without lens shielding and in 12 of the 39 patients with lens shielding (P=.037). Conclusions: The majority of patients with POAML showed behavior consistent with that of localized, indolent diseases. Thirty gray of local irradiation seems to be quite effective. The initial bilateral involvement and contralateral orbital relapses can be also controlled with radiation therapy alone. Lens shielding reduces the risk of cataract

Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

Directory of Open Access Journals (Sweden)

E. Filippucci

2011-06-01

Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

Are Nigerian dentists willing to treat patients with HIV infection ? | Uti ...

African Journals Online (AJOL)

Objective: HIV/AIDS is a modern day plague, which is a challenge to dentistry. The willingness of dentists to treat HIV positive patients is crucial in the provision of oral health care to this increasing population of patients. The purpose of this study was to assess the willingness of dentists and factors that influence willingness ...

Erectile dysfunction in patients with chronic pain treated with opioids.

Science.gov (United States)

Ajo, Raquel; Segura, Ana; Inda, María-Del-Mar; Margarit, César; Ballester, Pura; Martínez, Emi; Ferrández, Guillermina; Sánchez-Barbie, Ángel; Peiró, Ana M

2017-07-21

Chronic pain is associated with comorbidities that have an impact on the quality of life of patients and, among others, affect their sexual functioning. One of the most relevant side effects of opioid analgesics is erectile dysfunction (ED), due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels. To evaluate ED and effectiveness of treatment in men with chronic pain treated with long-term opioids. Prospective observational study lasting 3 years, where the intensity of pain (visual analogue scale, 0-10cm), erectile function (IIEF-EF, range 1-30 points), quality of life (EQ-VAS, 0-100mm), quality of sexual life (MSLQ-QOL, 0-100 points), anxiety/depression (HAD, 0-21 points) and testosterone levels, was assessed in patients who reported sexual dysfunction (ED or libido modification). A 6-month follow-up was applied to each patient after administering the usual treatment in the Andrology Unit. The study was approved by the Clinical Research Ethics Committee and data were statistically analyzed with the GraphPad Prism 5 software. ED was observed in 27.6% of patients (n=105, 57±12.2 years, mean dose of morphine equivalent=107.1±107.9mg/day, 84.3% adjuvant analgesics). After 6 months, 42% of patients showed a significant improvement after being treated with iPDE5 (48.5%) and/or testosterone gel (81.8%), with a resolution rate of 31% (p=0.000). A positive correlation was observed between the improvement of IIEF and quality of sexual life (55.5±25.7 points, p=0.000), as well as anxiety (7.4±4.3 points, p=0.048). No significant changes were observed in the levels of testosterone, in the levels of pain nor in the quality of life, which remained moderate. Erectile function and quality of sexual life, as well as anxiety, improved in patients treated chronically with opioids after administering andrological treatment. The management of patients with pain should include a review of their sexual health history given the

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

Science.gov (United States)

Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

2013-10-01

The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

International Nuclear Information System (INIS)

Li, Richard; Polishchuk, Alexei; DuBois, Steven; Hawkins, Randall; Lee, Stephanie W.; Bagatell, Rochelle; Shusterman, Suzanne; Hill-Kayser, Christine; Al-Sayegh, Hasan; Diller, Lisa; Haas-Kogan, Daphne A.; Matthay, Katherine K.; London, Wendy B.

2017-01-01

Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

Energy Technology Data Exchange (ETDEWEB)

Li, Richard [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Polishchuk, Alexei [School of Medicine, University of California San Francisco, San Francisco, California (United States); DuBois, Steven [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hawkins, Randall [School of Medicine, University of California San Francisco, San Francisco, California (United States); Lee, Stephanie W. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bagatell, Rochelle [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Shusterman, Suzanne [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hill-Kayser, Christine [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Al-Sayegh, Hasan [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Diller, Lisa [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Haas-Kogan, Daphne A. [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Matthay, Katherine K. [School of Medicine, University of California San Francisco, San Francisco, California (United States); London, Wendy B. [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); and others

2017-02-01

Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

Metastatic melanoma patients treated with dendritic cell vaccination, Interleukin-2 and metronomic cyclophosphamide

DEFF Research Database (Denmark)

Ellebaek, Eva; Engell-Noerregaard, Lotte; Iversen, Trine Zeeberg

2012-01-01

Dendritic cells (DC) are the most potent antigen presenting cells and have proven effective in stimulation of specific immune responses in vivo. Competing immune inhibition could limit the clinical efficacy of DC vaccination. In this phase II trial, metronomic Cyclophosphamide and a Cox-2 inhibitor...... have been added to a DC vaccine with the intend to dampen immunosuppressive mechanisms. Twenty-eight patients with progressive metastatic melanoma were treated with autologous DCs pulsed with survivin, hTERT, and p53-derived peptides (HLA-A2(+)) or tumor lysate (HLA-A2(-)). Concomitantly the patients...... were treated with IL-2, Cyclophosphamide, and Celecoxib. The treatment was safe and tolerable. Sixteen patients (57 %) achieved stable disease (SD) at 1st evaluation and 8 patients had prolonged SD (7-13.7 months). The median OS was 9.4 months. Patients with SD had an OS of 10.5 months while patients...

External validation of three dimensional conformal radiotherapy based NTCP models for patient-rated xerostomia and sticky saliva among patients treated with intensity modulated radiotherapy

International Nuclear Information System (INIS)

Beetz, Ivo; Schilstra, Cornelis; Luijk, Peter van; Christianen, Miranda E.M.C.; Doornaert, Patricia; Bijl, Henk P.; Chouvalova, Olga; Heuvel, Edwin R. van den; Steenbakkers, Roel J.H.M.; Langendijk, Johannes A.

2012-01-01

Purpose: The purpose of this study was to investigate the ability of predictive models for patient-rated xerostomia (XER 6M ) and sticky saliva (STIC 6M ) at 6 months after completion of primary (chemo)radiation developed in head and neck cancer patients treated with 3D-conformal radiotherapy (3D-CRT) to predict outcome in patients treated with intensity modulated radiotherapy (IMRT). Methods and materials: Recently, we published the results of a prospective study on predictive models for patient-rated xerostomia and sticky saliva in head and neck cancer patients treated with 3D-CRT (3D-CRT based NTCP models). The 3D-CRT based model for XER 6M consisted of three factors, including the mean parotid dose, age, and baseline xerostomia (none versus a bit). The 3D-CRT based model for STIC 6M consisted of the mean submandibular dose, age, the mean sublingual dose, and baseline sticky saliva (none versus a bit). In the current study, a population consisting of 162 patients treated with IMRT was used to test the external validity of these 3D-CRT based models. External validity was described by the explained variation (R 2 Nagelkerke) and the Brier score. The discriminative abilities of the models were calculated using the area under the receiver operating curve (AUC) and calibration (i.e. the agreement between predicted and observed outcome) was assessed with the Hosmer–Lemeshow “goodness-of-fit” test. Results: Overall model performance of the 3D-CRT based predictive models for XER 6M and STIC 6M was significantly worse in terms of the Brier score and R 2 Nagelkerke among patients treated with IMRT. Moreover the AUC for both 3D-CRT based models in the IMRT treated patients were markedly lower. The Hosmer–Lemeshow test showed a significant disagreement for both models between predicted risk and observed outcome. Conclusion: 3D-CRT based models for patient-rated xerostomia and sticky saliva among head and neck cancer patients treated with primary radiotherapy or

Effect of vitamin E on protein bound carbohydrate complexes in radiation treated oral squamous cell carcinoma patients

International Nuclear Information System (INIS)

Chitra, S.; Shyamala Devi, C.S.

2008-01-01

Serum glycoproteins were evaluated in oral squamous cell carcinoma patients treated with radiotherapy and also the effect of vitamin E was studied. Cell surface glycoconjugates are important parameters in the detection of malignancy. Thus, the objective of the present study is to evaluate the efficacy of vitamin E on glycoproteins in oral cavity cancer patients treated with radiotherapy. The study includes 26 age and sex matched normal healthy individuals and 26 patients with squamous cell carcinoma of oral cavity. These patients were divided into two groups, one for radiotherapy alone (at a dosage of 6000 cGy in five fractions per week for a period of six weeks) and the other for radiotherapy plus vitamin E supplementation (at a dosage of 400 IU/day of vitamin E) for the entire period of radiotherapy. Levels of hexose, hexosamine, fucose and sialic acid were increased in oral squamous cell carcinoma patients and a significant decrease was observed in radiation treated patients when compared to control. The levels of glycoconjugates were significantly decreased in radiation treated patients supplemented with vitamin E. This measurement may be useful in assessing disease progression and identifying patients resistant to therapy and a possible role of vitamin E on reduction in glycoconjugate levels of radiation treated oral squamous cell carcinoma patients. (author)

Prevalence and persistence of masked hypertension in treated hypertensive patients.

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Verberk, Willem J; Thien, Theo; Kroon, Abraham A; Lenders, Jacques W M; van Montfrans, Gert A; Smit, Andries J; de Leeuw, Peter W

2007-12-01

Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the thresholds for normal BP. We investigated the prevalence and persistence of MH and MHE in patients who were being treated for high BP and who had been followed for a period of 1 year. One hundred and sixty-one treated hypertensive patients underwent office blood-pressure measurements (OBPMs) at seven visits and self-performed blood-pressure measurements (SBPMs) for 1 week before each visit over a period of 1 year. All measurements were performed with the same type of automatic device. At each visit, MH was determined according to the European Society of Hypertension definition (OBPM, /=135 mm Hg or 85 mm Hg). In addition, we determined prevalences of MHE at 5/3 mm Hg (SBPM exceeds OBPM by 5 mm Hg systolic and 3 mm Hg diastolic), and MHE at 10/6 mm Hg (SBPM exceeds OBPM by 10 mm Hg systolic and 6 mm Hg diastolic), respectively. During the entire study, 50% of the patients had MH, and 40% had MHE at 5/3 mm Hg at least once. At four sequential OBPM visits, 2% consistently had MH, and 3% had MHE at 5/3 mm Hg or MHE at 10/6 mm Hg. The prevalence of MH increased with lower OBPM levels but remained rather constant for MHE at 5/3 mm Hg and MHE at 10/6 mm Hg. The persistence of MH and the MHE over time in individual patients was low. We conclude that MH and MHE at 5/3 mm Hg and MHE at 10/6 mm Hg commonly occur in treated patients, but are not persistent phenomena and probably result from an accidentally low OBPM value on one particular occasion.

Erectile dysfunction in patients taking psychotropic drugs and treated with phosphodiesterase-5 inhibitors

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Rossella Mazzilli

2018-03-01

Full Text Available Objectives: The aim of this study was to assess the prevalence of patients with Erectile Dysfunction (ED receiving psychotropic drugs, the impact of these drugs on hormonal profile, and the efficacy of PDE5-i in these patients. Materials and methods: We recruited 1872 patients referring for ED to our Andrology Unit. Assessment included serum testosterone, gonadotropins, TSH, prolactin, and PSA, and the IIEF-5 questionnaire for ED diagnosis. Inclusion criteria were age 21-75 years and IIEF-5 total score ≤ 21; exclusion criteria included hypogonadism, diabetes mellitus, previous prostatectomy, other medication intake, and ED diagnosis prior to psychotropic drug treatment. Efficacy was rated with the IIEF-5 (remission: total score ≥ 22. Results: The prevalence of ED patients treated with psychotropic drugs since ≥ 3 months was 9.5% (178/1872, subdivided according to the drugs used into: Group A, 16 patients treated with atypical antipsychotics (9.0%; Group B, 55 patients with benzodiazepines (30.9%; Group C, 33 patients with antidepressant drugs (18.5%; and Group D, 74 patients with multiple psychotropic drugs (41.6%. Patients in Group A were significantly younger than other groups (p < 0.05. The hormonal profile presented only higher prolactin level in patients treated with antipsychotics, alone or in combination (p < 0.05. Overall, 146 patients received PDE5-i. Remission rate, after three months of treatment, was significantly higher in Group B compared to C and D groups (p < 0.05. Conclusions: A substantial portion of patients receiving psychotropic drugs show ED. Sexual performance in these patients benefits from PDE5-i. Age, effects of psychiatric disorders, psychotropic drugs, and PDE5-i treatment modality accounted for variability of response in this sample.

The value of vacuum-assisted closure in septic patients treated with laparostomy.

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Pliakos, Ioannis; Papavramidis, Theodossis S; Michalopoulos, Nick; Deligiannidis, Nickolaos; Kesisoglou, Isaak; Sapalidis, Konstantinos; Papavramidis, Spiros

2012-09-01

The ideal method of temporary abdominal closure (TAC) should allow rapid closure, easy maintenance, and wound repair with minimal tissue damage. The aim of this retrospective study is to compare open abdomen outcomes between patients managed with vacuum-assisted closure (VAC), and patients managed with other methods of TAC, when septic abdomen is present. Two groups of patients with septic open abdomen: 27 treated with VAC versus 31 treated with other techniques of TAC. We studied open abdomen duration, number of dressing changes, re-exploration rate, successful abdominal closure rate, overall mortality, and development of enteroatmospheric fistulas. The VAC device demonstrated its superiority concerning open abdomen duration (P advantages concerning clinical feasibility. The high rates of direct fascia closure with an acceptable rate of ventral hernias are further benefits of this technique.

Prognostic value of exercise capacity among patients with treated depression: The Henry Ford Exercise Testing (FIT) Project.

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Ahmed, Amjad M; Qureshi, Waqas T; Sakr, Sherif; Blaha, Michael J; Brawner, Clinton A; Ehrman, Jonathan K; Keteyian, Steven J; Al-Mallah, Mouaz H

2018-04-01

Exercise capacity is associated with survival in the general population. Whether this applies to patients with treated depression is not clear. High exercise capacity remains associated with lower risk of all-cause mortality (ACM) and nonfatal myocardial infraction (MI) among patients with treated depression. We included 5128 patients on antidepressant medications who completed a clinically indicated exercise stress test between 1991 and 2009. Patients were followed for a median duration of 9.4 years for ACM and 4.5 years for MI. Exercise capacity was estimated in metabolic equivalents of tasks (METs). Cox proportional hazards regression models were used. Patients with treated depression who achieved ≥12 METs (vs those achieving model, exercise capacity was associated with a lower ACM (HR per 1-MET increase in exercise capacity: 0.82, 95% CI: 0.79-0.85, P capacity had an inverse association with both ACM and nonfatal MI in patients with treated depression, independent of cardiovascular risk factors. These results highlight the potential impact of assessing exercise capacity to identify risk, as well as promoting an active lifestyle among treated depression patients. © 2018 Wiley Periodicals, Inc.

Measurement of radiation exposure in attendants of thyroid cancer patients treated with 131I

International Nuclear Information System (INIS)

Ramirez G, Y. T.

2012-01-01

Patients treated with 131 I for differentiated thyroid cancer present radiological risk to relatives, occupational exposed workers and general public. Recently, the IAEA issued document K-9010241, 2010, which recommends that patient discharge from hospital must be based on the particular status of each patient, unlike the current criteria applied in Mexico based on the exposure rate at a 1 m distance. In this work thermoluminescent dosimeters were used during a 15 day period to measure the effective dose received by 40 family caregivers of patients treated with 131 I, after their release from hospital 'Instituto Nacional de Cancerologia', Mexico. Relatives were classified in two groups, ambulatory (outpatients) and hospitalized (inpatients), according to the release mode of the patient. Measurements were performed for 20 family caregivers in each group. The effective dose received by all family members of outpatient and inpatient groups was found to be smaller that 5 mSv. In addition, 70 and 90% of inpatient and outpatient groups, respectively, received doses lower than 1 mSv. These data provide information which allow to give recommendations of possible modifications to current regulations in Mexico regarding discharge from hospital of patients treated with radiopharmaceuticals. (Author)

Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab

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Qin, Rosie [School of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Olson, Adam [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Singh, Bhavana [Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Thomas, Samantha; Wolf, Steven [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States); Bhavsar, Nrupen A. [Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Hanks, Brent A. [Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina (United States); Salama, Joseph K. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Salama, April K.S., E-mail: april.salama@duke.edu [Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina (United States)

2016-09-01

Purpose: Ipilimumab and radiation therapy (RT) are standard treatments for advanced melanoma; preclinical models suggest the potential for synergy. However, limited clinical information exists regarding safety and optimal timing of the combination. Methods and Materials: We reviewed the records of consecutive patients with unresectable stage 3 or 4 melanoma treated with ipilimumab. Patients were categorized as having received RT or not. Differences were estimated between these 2 cohorts. Results: We identified 88 patients treated with ipilimumab. At baseline, the ipilimumab-plus-RT group (n=44) had more unfavorable characteristics. Despite this, overall survival, progression-free survival, and both immune-related and non–immune-related toxicity were not statistically different (P=.67). Patients who received ipilimumab before RT had an increased duration of irradiated tumor response compared with patients receiving ipilimumab after RT (74.7% vs 44.8% at 12 months; P=.01, log-rank test). In addition, patients receiving ablative RT had non–statistically significantly improved median overall survival (19.6 vs 10.2 months), as well as 6-month (95.1% vs 72.7%) and 12-month (79.7% vs 48.5%) survival rates, compared with those treated with conventionally fractionated RT. Conclusions: We found that both ablative and conventionally fractionated RT can be safely administered with ipilimumab without a clinically apparent increase in toxicity. Patients who received ipilimumab before RT had an increased duration of irradiated tumor response.

Reporting Late Rectal Toxicity in Prostate Cancer Patients Treated With Curative Radiation Treatment

International Nuclear Information System (INIS)

Faria, Sergio L.; Souhami, Luis; Joshua, Bosede; Vuong, Te; Freeman, Carolyn R.

2008-01-01

Purpose: Long-term rectal toxicity is a concern for patients with prostate cancer treated with curative radiation. However, comparing results of late toxicity may not be straightforward. This article reviews the complexity of reporting long-term side effects by using data for patients treated in our institution with hypofractionated irradiation. Methods and Materials: Seventy-two patients with localized prostate cancer treated with hypofractionated radiotherapy alone to a dose of 66 Gy in 22 fractions were prospectively assessed for late rectal toxicity according to the Common Toxicity Criteria, Version 3, scoring system. Ninety percent of patients had more than 24 months of follow-up. Results are compared with data published in the literature. Results: We found an actuarial incidence of Grade 2 or higher late rectal toxicity of 27% at 30 months and a crude incidence of Grade 2 or higher late rectal toxicity of 18%. This was mostly severe toxicity documented during follow-up. The incidence of Grade 3 rectal toxicity at the last visit was 3% compared with 13% documented at any time during follow-up. Conclusion: Comparison of late toxicity after radiotherapy in patients with prostate cancer must be undertaken with caution because many factors need to be taken into consideration. Because accurate assessment of late toxicity in the evaluation of long-term outcome after radiotherapy in patients with localized prostate cancer is essential, there is a need to develop by consensus guidelines for assessing and reporting late toxicity in this group of patients

Results in patients treated with high-dose-rate interstitial brachytherapy for oral tongue cancer

International Nuclear Information System (INIS)

Yamamoto, Michinori; Shirane, Makoto; Ueda, Tsutomu; Miyahara, Nobuyuki

2006-01-01

Eight patients were treated with high-dose-rate interstitial brachytherapy for oral tongue cancer between September 2000 and August 2004. The patient distribution was 1 T1, 5 T2, 1 T3, and 1 T4a. Patients received 50-60 Gy in 10 fractions over seven days with high-dose-rate brachytherapy. Six of the eight patients were treated with a combination of external beam radiotherapy (20-30 Gy) and interstitial brachytherapy. The two-year primary local control rate was 83% for initial case. High-dose-rate brachytherapy was performed safely even for an aged person, and was a useful treatment modality for oral tongue cancer. (author)

Risk stratification of patients with advanced squamous cell carcinoma of cervix treated by radiotherapy alone

International Nuclear Information System (INIS)

Hong, J.-H.; Tsai, C.-S.; Lai, C.-H.; Chang, T.-C.; Wang, C.-C.; Chou, H.-H.; Lee, Steve P.; Lee, C.-C.; Tang, Simon G.; Hsueh Swei

2005-01-01

Purpose: To identify prognostic factors for local and distant relapse and perform risk stratification for patients with advanced cervical cancer treated with radiotherapy (RT) alone. Methods and Materials: A total of 1031 patients with Stage IB-IVA squamous cell carcinoma of the cervix treated with full-course RT but without any chemotherapy were included for analysis. Of these, 311 patients with nonbulky Stage IB-IIA disease were designated the reference group and the other 720 patients were the study group. The associations of stage, squamous cell carcinoma antigen (SCC-ag) level, hemoglobin level, age, cell differentiation, and pelvic lymph node status with treatment failure were evaluated. The independent prognostic factors were identified by multivariate analysis. The study group was further stratified into subgroups using combinations of these risk factors. Results: In the study group, independent risk factors for local relapse were advanced stage and age 2, and positive pelvic lymph nodes. The 5-year distant relapse-free survival rate was 83% for patients with bulky Stage IB-IIA and IIB disease, SCC-ag level 2, and positive lymph nodes. Conclusion: The risk of treatment failure in advanced-stage cervical cancer patients treated by RT alone can be more precisely predicted by risk stratification. A certain subgroup of patients had better control than the others. The benefit of treating these relatively low-risk patients with additional treatment such as concurrent chemotherapy should be further evaluated in prospective studies or meta-analyses

Factors associated with collagen deposition in lymphoid tissue in long-term treated HIV-infected patients.

Science.gov (United States)

Diaz, Alba; Alós, Llúcia; León, Agathe; Mozos, Anna; Caballero, Miguel; Martinez, Antonio; Plana, Montserrat; Gallart, Teresa; Gil, Cristina; Leal, Manuel; Gatell, Jose M; García, Felipe

2010-08-24

The factors associated with fibrosis in lymphoid tissue in long-term treated HIV-infected patients and their correlation with immune reconstitution were assessed. Tonsillar biopsies were performed in seven antiretroviral-naive patients and 29 successfully treated patients (median time on treatment, 61 months). Twenty patients received protease inhibitors-sparing regimens and nine protease inhibitor-containing regimens. Five tonsillar resections of HIV-negative individuals were used as controls. Lymphoid tissue architecture, collagen deposition (fibrosis) and the mean interfollicular CD4(+) cell count per mum were assessed. Naive and long-term treated HIV-infected patients had a higher proportion of fibrosis than did HIV-uninfected persons (P lymphoid tissue (P = 0.03) and smaller increase in peripheral CD4(+) T cells (r = -0.40, P = 0.05). The factors independently associated with fibrosis in lymphoid tissue were age (P lymphoid tissue viral load when compared with patients with undetectable lymphoid tissue viral load (median 5 vs. 12%, respectively, P = 0.017) and patients receiving a protease inhibitor-sparing vs. a protease inhibitor-containing regimen (median 8 vs. 2.5%, respectively, P = 0.04). Fibrosis in lymphoid tissue was associated with a poor reconstitution of CD4(+) T cells and long-term antiretroviral therapy did not reverse this abnormality. HIV infection, older age, a detectable level of lymphoid tissue viral load in treated patients and protease inhibitor-sparing regimens seem to favour fibrosis in lymphoid tissue.

Medical marijuana use in head and neck squamous cell carcinoma patients treated with radiotherapy.

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Elliott, David A; Nabavizadeh, Nima; Romer, Jeanna L; Chen, Yiyi; Holland, John M

2016-08-01

The purpose of the study was to better understand why patients with history of head and neck cancer (HNC) treated with radiotherapy are using medical marijuana (MM). Established HNC quality of life questionnaires and our own MM quality of life questionnaire were sent to 15 HNC patients treated at our institution who reported using MM. Patients are clinically disease free and currently using MM to manage long-term side effects after curative HNC treatment. There was a 100 % response rate. Median time from treatment was 45 months (21-136 months). Most patients smoked marijuana (12 patients), while others reported ingestion (4 patients), vaporizing (3 patients), and use of homemade concentrated oil (1 patient). Six patients reported prior recreational marijuana use before diagnosis. MM provided benefit in altered sense, weight maintenance, depression, pain, appetite, dysphagia, xerostomia, muscle spasm, and sticky saliva. HNC patients report MM use to help with long-term side effects of radiotherapy.

[Granulomatous mastitis in a patient treated with prednisone].

Science.gov (United States)

Fetveit, T; Uggerud, R

1993-09-30

A 36 year old woman, mother of a two year old child developed, in the course of one night, a tender mass in the upper medial quadrant of the left mamma. Treatment with antibiotics had no effect, and after a week the patient was admitted to hospital for drainage of the abscess and further examination. She had then developed reactive arthritis. Histological examination of a specimen from the mamma revealed lobular granulomatous mastitis. This connection has not been described before in the literature. Further examination showed no signs of infectious disease or sarcoidosis. Surgical drainage had only a minor effect on the breast-mass. The patient was treated with prednisone for six months, and after one year of observation the mass has disappeared, but the arthralgias persists.

Incidence of tumours of the skeleton in 224Ra-treated ankylosing spondylitis patients

International Nuclear Information System (INIS)

Wick, R.R.; Goessner, W.

1983-01-01

We are following 1426 ankylosing spondylitis (a.sp.) patients treated with 224 Ra and 1556 control patients with a.sp. not treated with any form of ionizing radiation. The average follow-up time of the exposure group is 16 years and the average α-dose to the skeleton is 65 rad, resulting from intravenous injection of 4.8μCi/kg 224 Ra on average within a medium injection span of 12 weeks. Injections normally have been performed once a week, and in some cases also half-weekly with a correspondingly shorter injection span. Since 1970 three cases of malignant tumours in the skeleton have been observed in the exposure group in patients with skeletal α-doses below 90 rad compared with 0.6 expected. (No bone tumour has occurred in the control group.) Two of the three cases observed were tumours of the bone marrow. The incidence of leukaemias in both exposure and control groups is discussed with respect to phenylbutazone treatment and α-radiation from 224 Ra. An effect of 224 Ra on the bone marrow not yet detected in the Spiess series of patients treated with higher amounts of 224 Ra cannot be excluded. (author)

Immediate adverse reactions to intravenous iodinated contrast media in computed tomography Reacciones adversas inmediatas al contraste yodado intravenoso en tomografía computarizada Reações adversas imediatas ao contraste iodado intravenoso em tomografia computadorizada

Directory of Open Access Journals (Sweden)

Beatriz Cavalcanti Juchem

2007-02-01

Full Text Available This exploratory-descriptive, non-experimental quantitative research aimed to learn about immediate adverse reactions to intravenous iodinated contrast media in hospitalized patients submitted to computed tomography at a teaching hospital in the South of Brazil. During the study period, all adverse reactions showed mild intensity, at a frequency of 12.5% with ionic iodinated contrast media, and 1% with non-ionic contrast agent. The extravasation of contrast occurred in 2.2% of the injections in a peripheral vein without complications in any of the cases. The results are within the limits cited in international literature and suggest that tomography service professionals should know their own rates of adverse reactions to iodinated contrast agent, as well as the conditions in which they occur, in order to obtain evidence to evaluate the respective care delivery processes.Investigación cuantitativa del tipo exploratorio-descriptivo, de carácter no experimental. El objetivo consistía en conocer las reacciones adversas inmediatas al contraste yodado intravenoso en pacientes internados, sometidos a tomografía computarizada en un hospital escuela del sur de Brasil. Durante el período del estudio, todas las reacciones adversas tuvieron intensidad leve y una frecuencia del 12,5% con la utilización del contraste yodado iónico, y 1% con contraste no iónico. La extravasación del contraste ocurrió en un 2,2% de las inyecciones en vena periférica, no ocasionando complicaciones en ninguno de los casos. Los índices evidenciados en el presente estudio se mantuvieron dentro de los límites que constan en la revisión de literatura y, entre las recomendaciones, se sugiere que los servicios de tomografía conozcan los propios índices de reacciones adversas al contraste yodado y las condiciones en que ocurren, con la finalidad de obtener evidencias para evaluación de los respectivos procesos asistenciales.Pesquisa quantitativa, explorat

Patient characteristics do not predict poor glycaemic control in type 2 diabetes patients treated in primary care

NARCIS (Netherlands)

Goudswaard, AN; Stolk, RP; Zuithoff, P; Rutten, GEHM

Many diabetic patients in general practice do not achieve good glycaemic control. The aim of this study was to assess which characteristics of type 2 diabetes patients treated in primary care predict poor glycaemic control (HbA(1c) greater than or equal to7%). Data were collected from the medical

Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

International Nuclear Information System (INIS)

Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo; Lee, Heui Kwan; Kim, Soo Geon

2008-01-01

We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

Effects of bestatin on the host immunity in patients treated for urogenital cancer

International Nuclear Information System (INIS)

Ozono, S.; Iwai, A.; Babaya, K.; Hiramatsu, T.; Yoshida, K.; Yamada, K.; Hirao, Y.; Aoyama, H.; Ohara, S.; Okajima, E.

1990-01-01

To examine effects of bestatin on the host immunity of patients with urogenital cancer, 54 patients were randomized into 2 groups: bestatin treated and controls. In each group, the patients were divided into 2 subgroups: one which received basic treatment expected to greatly affect host immunity ('invasive treatment') while the other one received other types of basic treatment ('non-invasive treatment'). Peripheral lymphocyte, OKT 4/8 ratio and purified protein derivative (PPD) skin reaction were used as immunological markers. There were significant differences in the 'invasive' treatment group between bestatin treated patients and controls concerning lymphocyte counts and PPD skin reactions and in the 'non-invasive' group concerning lymphocyte counts and OKT 4/8 ratios. These results suggest that bestatin may potentiate host immunity in patients with urogenital cancer. Further studies on larger materials are, however, needed before more definite conclusions can be drawn. (orig.)

Brain abnormalities on MRI in non-functioning pituitary adenoma patients treated with or without postoperative radiotherapy

NARCIS (Netherlands)

Sattler, Margriet G. A.; Meiners, Linda C.; Sluiter, Wim J.; van den Berg, Gerrit; Langendijk, Johannes A.; Wolffenbuttel, Bruce H. R.; van den Bergh, Alphons C. M.; van Beek, Andre P.

Background and purpose: To assess and compare brain abnormalities on Magnetic Resonance Imaging (MRI) in non-functioning pituitary macro-adenoma (NFA) patients treated with or without postoperative radiotherapy (RT). Material and methods: In 86 NFA patients, treated between 1987 and 2008 at the

Treat the whole patient and be aware of drug interactions.

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Breivik, Harald

2015-03-01

The case of an elderly male with bilateral shoulder pain is presented. The pain had been successfully treated years earlier with surgery, but a repeat rotator cuff procedure when the pain recurred was not effective. The patient's physician asked about impact of systemic analgesics on the elderly patient and interactions with his blood pressure medications. Cardiovascular and renal risks of NSAOIDs are discussed as are potential toxicities of tramadol and too rapid withdrawal from it. Drug interactions of medications used are described.

Myeloproliferative disorders in patients with rheumatoid arthritis treated with total body irradiation

International Nuclear Information System (INIS)

Urowitz, M.B.; Rider, W.D.

1985-01-01

Four patients with refractory rheumatoid arthritis were treated with total body irradiation administered in two sittings, 300 to 400 rads to each half of the body. All four patients had taken antimetabolites prior to receiving total body irradiation, and two continued to use them after total body irradiation. Two patients had taken alkylating agents before, and one had used them after total body irradiation. All patients showed clinical improvement. However, in two patients myeloproliferative disorders developed: a myelodysplastic preleukemia at 40 months after total body irradiation in one and acute myelogenous leukemia at 25 months in the other. Total body irradiation differs from total nodal irradiation in the total dose of irradiation (300 to 400 rads versus 2,000 to 3,000), and in the duration of the therapy (two sittings versus treatment over several weeks to months). Furthermore, the patients in the total body irradiation study frequently used cytotoxic drugs before and/or after irradiation, whereas in one total nodal irradiation study, azathioprine (2 mg/kg per day or less) was permitted, but no other cytotoxic agents were allowed. Rheumatologists may therefore face a binding decision when deciding to treat a patient with rheumatoid arthritis with either a cytotoxic drug or irradiation

Final adult height in long-term growth hormone-treated achondroplasia patients.

Science.gov (United States)

Harada, Daisuke; Namba, Noriyuki; Hanioka, Yuki; Ueyama, Kaoru; Sakamoto, Natsuko; Nakano, Yukako; Izui, Masafumi; Nagamatsu, Yuiko; Kashiwagi, Hiroko; Yamamuro, Miho; Ishiura, Yoshihito; Ogitani, Ayako; Seino, Yoshiki

2017-07-01

The objective of this study was to evaluate the gain in final height of achondroplasia (ACH) patients with long-term growth hormone (GH) treatment. We analyzed medical data of 22 adult patients (8 males and 14 females) treated with GH at a dose of 0.05 mg/kg/day. Optionally, tibial lengthening (TL) was performed with the Ilizalov method in 15 patients and TL as well as femoral lengthening (FL) in 6 patients. Concomitant gonadal suppression therapy with buserelin acetate was applied in 13 patients. The mean treatment periods with GH were 10.7 ± 4.0 and 9.3 ± 2.5 years for males and females, respectively. GH treatment augmented the final height +0.60 ± 0.52 SD (+3.5 cm) and +0.51 ± 1.29 SD (+2.8 cm) in males and females compared to non-treated ACH patients, respectively. Final height of ACH patients that underwent GH and TL increased +1.72 ± 0.72 SD (+10.0 cm) and +1.95 ± 1.34 SD (+9.8 cm) in males and females, respectively. GH, TL, and FL increased their final height +2.97 SD (+17.2 cm) and +3.41 ± 1.63 SD (+17.3 cm) in males and females, respectively. Gonadal suppression therapy had no impact on final height. Long-term GH treatment contributes to 2.6 and 2.1% of final adult height in male and female ACH patients, respectively.

Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

International Nuclear Information System (INIS)

Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

1984-01-01

Of 1203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. The authors conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

Caracterización y fotoestabilidad de compuestos fluorescentes y pardos generados en reacciones enzimáticas y no enzimáticas. Implicancias en la conservación de materiales orgánicos

OpenAIRE

Matiacevich, Silvia Beatriz

2008-01-01

Las reacciones de pardeamiento no enzimático (reacción de Maillard) y enzimático (polimerización de polifenoles oxidados) generan productos fluorescentes y pigmentos pardos que contribuyen a las características físico-químicas de materiales orgánicos (biomoléculas, alimentos, fármacos). El objetivo de esta tesis fue analizar las características cromáticas y de fluorescencia y la fotoestabilidad de los compuestos generados por la reacción de Maillard y de pigmentos polifenólicos, para dilucida...

Measurement of radiation exposure in relatives of thyroid cancer patients treated with (131)I.

Science.gov (United States)

Ramírez-Garzón, Y T; Ávila, O; Medina, L A; Gamboa-deBuen, I; Rodríguez-Laguna, A; Buenfil, A E; Ruíz-Trejo, C; Estrada, E; Brandan, M E

2014-11-01

This work evaluates the radiological risk that patients treated with I for differentiated thyroid cancer could present to relatives and occupationally exposed workers. Recently, the International Atomic Energy Agency issued document K9010241, which recommends that patient discharge from the hospital must be based on the particular status of each patient. This work measures effective dose received by caregivers of patients treated with I at the Instituto Nacional de Cancerología, Mexico City. Thermoluminescent dosimeters were carried during a 15-d period by 40 family caregivers after patient release from hospital. Relatives were classified into two groups, ambulatory and hospitalized, according to the release mode of the patient, and three categories according to the individual patient home and transport facilities. Categories A, B, and C were defined going from most to least adequate concerning public exposure risk. Measurements were performed for 20 family caregivers in each group. The effective dose received by all caregivers participating in this study was found to be less than 5 mSv, the recommended limit per event for caregivers suggested by ICRP 103. In addition, 70 and 90% of ambulatory and hospitalized groups, respectively, received doses lower than 1 mSv. Caregivers belonging to category C, with home situations that are not appropriate for immediate release, received the highest average doses; i.e., 2.2 ± 1.3 and 3.1 ± 1.0 mSv for hospitalized and ambulatory patients, respectively. Results of this work have shown that the proper implementation of radiation protection instructions for relatives and patients can reduce significantly the risk that differentiated thyroid cancer patients treated with I can represent for surrounding individuals. The results also stress the relevance of the patient's particular lifestyle and transport conditions as the prevailing factors related to the dose received by the caregiver. Therefore, the patient's status should be

Evaluation of temporomandibular disorders in Class III patients treated with mandibular cervical headgear and fixed appliances.

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Rey, Diego; Oberti, Giovanni; Baccetti, Tiziano

2008-03-01

Our aim in this study was to evaluate the prevalence of temporomandibular disorders (TMD) in Class III patients treated with mandibular cervical headgear (MCH) and fixed appliances. The sample of 75 patients included 25 patients with no previous orthodontic treatment, 25 Class I patients who had undergone orthodontic treatment with fixed appliances and without extractions, and 25 patients with dentoskeletal Class III disharmonies treated with MCH and fixed appliances. The Helkimo index was used to test the prevalence of TMD symptoms in the 3 groups. The prevalence rates of the Helkimo index in the 3 groups were compared with the z score on proportions. No statistically significant differences in the prevalence rates of the Helkimo index scores in the 3 groups were found (P = .367). Most subjects in the 3 groups had an Helkimo index of zero (66.7%). Subjects with Class III malocclusions treated with MCH and fixed appliances do not have greater prevalence of TMD symptoms than do Class I subjects treated with fixed appliances or untreated subjects.

Experience and needs of family members of patients treated with extracorporeal membrane oxygenation.

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Tramm, Ralph; Ilic, Dragan; Murphy, Kerry; Sheldrake, Jayne; Pellegrino, Vincent; Hodgson, Carol

2017-06-01

To explore the experiences of family members of patients treated with extracorporeal membrane oxygenation. Sudden onset of an unexpected and severe illness is associated with an increased stress experience of family members. Only one study to date has explored the experience of family members of patients who are at high risk of dying and treated with extracorporeal membrane oxygenation. A qualitative descriptive research design was used. A total of 10 family members of patients treated with extracorporeal membrane oxygenation were recruited through a convenient sampling approach. Data were collected using open-ended semi-structured interviews. A six-step process was applied to analyse the data thematically. Four criteria were employed to evaluate methodological rigour. Family members of extracorporeal membrane oxygenation patients experienced psychological distress and strain during and after admission. Five main themes (Going Downhill, Intensive Care Unit Stress and Stressors, Carousel of Roles, Today and Advice) were identified. These themes were explored from the four roles of the Carousel of Roles theme (decision-maker, carer, manager and recorder) that participants experienced. Nurses and other staff involved in the care of extracorporeal membrane oxygenation patients must pay attention to individual needs of the family and activate all available support systems to help them cope with stress and strain. An information and recommendation guide for families and staff caring for extracorporeal membrane oxygenation patients was developed and needs to be applied cautiously to the individual clinical setting. © 2016 John Wiley & Sons Ltd.

Evaluation of Serum IgA level in nontreated and treated oral squamous cell carcinoma patients

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Richa Mishra

2018-01-01

Full Text Available Introduction: Research in early cancer detection has led to discovery of many immunological tumor markers that contribute considerably to supplement the method of diagnosis. High serum immunoglobulin A (IgA values in patients with cancer have been used as tumor markers. Aims and Objectives: To evaluate and compare the serum IgA levels in nontreated, treated oral squamous cell carcinoma (SCC patients, and control group. Materials and Methods: A total of 60 patients were included in the study. 20 biopsy confirmed oral SCC patients, who have received no medical treatment, 20 oral SCC patients treated with surgery and/or radiotherapy and 20 normal healthy individuals. Venous blood samples were collected from anterior cubital vein and were delivered to the biochemistry laboratory for the estimation of serum IgA level by nephelometry method. Statistical Analysis Used: Statistical method employed were the Pearson's Chi-square test and One-way analysis of variance (Welch followed by Games-Howell post-hoc test. Results: We observed significant difference for serum IgA between study subjects in control, nontreated and treated oral SCC patients (P < 0.001. Serum IgA level in nontreated group was significantly higher than treated group and there was an approximately two-fold increase in serum IgA level in nontreated oral SCC patients when compared to that of the normal healthy individuals. Conclusion: Serum level of IgA might be employed as diagnostic and prognostic indicators in oral cancer.

Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

International Nuclear Information System (INIS)

Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

1984-01-01

Of 1,203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 patients were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. We conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

Cancer patients treated with sunitinib or sorafenib have sufficient antibody and cellular immune responses to warrant influenza vaccination.

Science.gov (United States)

Mulder, Sasja F; Jacobs, Joannes F M; Olde Nordkamp, Michel A M; Galama, Joep M D; Desar, Ingrid M E; Torensma, Ruurd; Teerenstra, Steven; Mulders, Peter F A; Vissers, Kris C P; Punt, Cornelis J A; de Vries, I Jolanda M; van Herpen, Carla M L

2011-07-01

The tyrosine kinase inhibitors sorafenib and sunitinib have efficacy in several types of cancer. Recent studies indicate that these agents affect the immune system. The way it affects the immune response to influenza vaccination is unknown. The aim of this study was to elucidate the specific immune response to seasonal flu vaccination in cancer patients treated with sunitinib or sorafenib. Sunitinib- or sorafenib-treated cancer patients were vaccinated against seasonal influenza with an inactivated vaccine. Healthy controls and patients with metastatic renal cell cancer (mRCC) without systemic treatment (nontreated mRCC controls) were included for comparison. Antibody responses were measured at baseline, day 8, and day 22 by a standard hemagglutination inhibition assay and cellular T-cell responses at baseline and day 8 by proliferation assay and secretion of cytokines. Forty subjects were enrolled: 16 patients treated with sunitinib, 6 patients with sorafenib, 7 nontreated mRCC controls, and 11 healthy controls. All patients treated with sunitinib and sorafenib developed seroprotection rates comparable with controls. Functional T-cell reactivity was observed in all groups, except for patients treated with sorafenib who showed a decreased proliferation rate and IFN-γ/IL-2 production and increased IL-10 compared with healthy controls. We conclude that influenza vaccination should be recommended to cancer patients treated with sunitinib or sorafenib.

Missing Teeth and Prosthetic Treatment in Patients Treated at College of Dentistry, University of Dammam

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Shaimaa M. Fouda

2017-01-01

Full Text Available The percentage of completely and partially edentulous patients and their prosthetic treatment at the Department of Substitutive Dental Sciences (SDS, College of Dentistry, University of Dammam, were investigated. Panoramic radiographs and medical records of adult patients (n=479, mean age 45.9 years, and range 25–96 years treated in 2011–2014 were examined. 6% of the patients were completely edentulous, 8% had single jaw edentulousness, and 74% were partially edentulous. Edentulousness was significantly correlated with age and the number of missing teeth was significantly higher among males (p<0.026. Diabetes was significantly associated with complete edentulousness, single edentulous jaw (p value 0.015, and partial edentulousness (p value 0.023. Kennedy class III was the most frequent class of partial edentulousness in single and/or both jaws (p=0.000. Patients having class I and/or class II were treated most often with removable partial dentures (RPD (p=0.000, while patients having class III were treated with fixed partial dentures (FPD. It was found that complete edentulousness increases in older age and the number of missing teeth was significantly higher among males. Kennedy class III was most common in both upper and lower jaw and was treated more often with FPD than with RPD.

Survival Benefit for Pediatric Patients With Recurrent Ependymoma Treated With Reirradiation

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Bouffet, Eric, E-mail: eric.bouffet@sickkids.ca [Department of Hematology/Oncology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Hawkins, Cynthia E. [Department of Pathology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Ballourah, Walid [Department of Hematology/Oncology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Taylor, Michael D. [Division of Neurosurgery, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Bartels, Ute K. [Department of Hematology/Oncology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Schoenhoff, Nicholas [Department of Psychology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Tsangaris, Elena; Huang, Annie [Department of Hematology/Oncology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Kulkarni, Abhaya [Division of Neurosurgery, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Mabbot, Donald J. [Department of Psychology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada); Laperriere, Normand [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario (Canada); Tabori, Uri [Department of Hematology/Oncology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario (Canada)

2012-08-01

Purpose: The outcome of recurrent ependymoma in children is dismal. Reirradiation has been proposed as an effective modality for ependymoma at relapse. However, the toxicity and outcome benefits of this approach have not been well established. Methods and Materials: We conducted a retrospective population-based study of all patients with recurrent ependymoma treated between 1986 and 2010 in our institution. Demographic, treatment, and outcome data were analyzed for the entire cohort. Results: Of 113 patients with intracranial ependymoma, 47 patients relapsed. At the time of relapse, 29 patients were treated with surgical resection and/or chemotherapy, and 18 patients received full-dose ({>=}54 Gy focal and/or craniospinal) reirradiation with or without surgery at recurrence. Reirradiation was tolerated well with no severe acute complications noticed. Three-year overall survival was 7% {+-} 6% and 81% {+-} 12% for nonreirradiated and reirradiated patients, respectively (p < 0.0001). Time to second progression after reirradiation was significantly longer than time to first progression. This surprising phenomenon was associated with improved progression-free survival for tumors with evidence of DNA damage (n = 15; p = 0.002). At a mean follow-up of 3.73 years, only 2/18 patients had endocrine dysfunction, and 1 patient required special education support. However, a decline in intellectual function from pre- to postreirradiation assessment was observed. Conclusions: Reirradiation is an effective treatment that may change the natural history of recurrent ependymoma in children. However, this change may be associated with increased neurocognitive toxicity. Additional follow-up is needed to determine the risk of late recurrence, secondary radiation-induced tumors, and long-term functional outcome of these patients.

Survival Benefit for Pediatric Patients With Recurrent Ependymoma Treated With Reirradiation

International Nuclear Information System (INIS)

Bouffet, Eric; Hawkins, Cynthia E.; Ballourah, Walid; Taylor, Michael D.; Bartels, Ute K.; Schoenhoff, Nicholas; Tsangaris, Elena; Huang, Annie; Kulkarni, Abhaya; Mabbot, Donald J.; Laperriere, Normand; Tabori, Uri

2012-01-01

Purpose: The outcome of recurrent ependymoma in children is dismal. Reirradiation has been proposed as an effective modality for ependymoma at relapse. However, the toxicity and outcome benefits of this approach have not been well established. Methods and Materials: We conducted a retrospective population-based study of all patients with recurrent ependymoma treated between 1986 and 2010 in our institution. Demographic, treatment, and outcome data were analyzed for the entire cohort. Results: Of 113 patients with intracranial ependymoma, 47 patients relapsed. At the time of relapse, 29 patients were treated with surgical resection and/or chemotherapy, and 18 patients received full-dose (≥54 Gy focal and/or craniospinal) reirradiation with or without surgery at recurrence. Reirradiation was tolerated well with no severe acute complications noticed. Three-year overall survival was 7% ± 6% and 81% ± 12% for nonreirradiated and reirradiated patients, respectively (p < 0.0001). Time to second progression after reirradiation was significantly longer than time to first progression. This surprising phenomenon was associated with improved progression-free survival for tumors with evidence of DNA damage (n = 15; p = 0.002). At a mean follow-up of 3.73 years, only 2/18 patients had endocrine dysfunction, and 1 patient required special education support. However, a decline in intellectual function from pre- to postreirradiation assessment was observed. Conclusions: Reirradiation is an effective treatment that may change the natural history of recurrent ependymoma in children. However, this change may be associated with increased neurocognitive toxicity. Additional follow-up is needed to determine the risk of late recurrence, secondary radiation-induced tumors, and long-term functional outcome of these patients.

How are patients with heart failure treated in primary care?
.

Science.gov (United States)

Vaillant-Roussel, Hélène; Pereira, Bruno; Gibot-Boeuf, Sylvaine; Eschalier, Romain; Dubray, Claude; Boussageon, Rémy; Vorilhon, Philippe

2018-05-24

The aim of this study was to assess the adherence of general practitioners (GPs) to guidelines in patients with heart failure with reduced ejection fraction (HFrEF) and to describe GPs' prescribing behavior regarding patients with heart failure with preserved ejection fraction (HFpEF). Cross-sectional study as part of the ETIC trial. Five classes of drugs were described: angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs); β-blockers (BBs); mineralocorticoid receptor antagonists (MRAs); diuretics (thiazide or loop diuretics); and digoxin. 178 patients were studied: their mean age was 73.5 years (± 10.6). Of the 128 patients with HFpEF, 81.3% received ACEIs or ARBs, 63.3% received BBs, 13.3% received MRAs, 75.8% received diuretics, and 12.5% received digoxin. Of the 50 patients with HFrEF, 84% received ACEIs or ARBs, 74% received BBs, 20% received MRAs, 76% received diuretics, and 2% received digoxin. 25% of the patients were given a drug in accordance with the recommendations for drug class but not a drug authorized for the HFrEF indication. Among the patients with HFrEF who were treated in accordance with the recommendations, target doses were achieved in 1/3 given ACEIs/ARBs, 1/4 given BBs, and 1/2 given MRAs. Only 6% of the patients had a perfect Global Adherence Indicator-3 (GAI-3) with all target doses achieved. Several drugs were prescribed even though they were not recommended, and few patients were treated optimally. It seems to be necessary to develop a pragmatic tool to help GPs and cardiologists in optimizing treatment.
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Characteristics of female patients with primary lung cancer treated with radiotherapy

International Nuclear Information System (INIS)

Shiojima, Kazumi; Hayakawa, Kazushige; Nakayama, Yuko; Saito, Yoshihiro; Mitomo, Osamu; Katano, Susumu; Mitsuhashi, Norio; Niibe, Hideo

1993-01-01

From 1976 to 1985, 402 patients with primary lung cancer were treated with radiotherapy at our hospital. There were 75 female patients who formed the basis of our analysis. Comparing the characteristics of female and male patients, the predominant characteristics of the female patients were as follows; 1) larger proportion of the patients with adenocarcinoma, 2) higher percentage of stage 4 patients, 3) lower average age, 4) better performance status (PS), 5) lower frequency of lethal complications, and 6) higher frequency of more than two admissions. The prognosis of female patients was better than that of males. The favorable characteristics of female patients for prognosis, were lower average age, better PS, and lower frequency of lethal complications. A higher frequency of admission to hospital might be a favorable characteristics for female patients to extend survival in patients with recurrence disease. (author)

Risk of dementia in German patients treated with antidepressants in general or psychiatric practices
.

Science.gov (United States)

Jacob, Louis; Bohlken, Jens; Kostev, Karel

2017-04-01

To study the impact of the use of antidepressants on dementia in German patients with depression treated in general (GPs) or psychiatric practices (PPs). Patients with a first-time documentation of depression with known severity level between 2010 and 2013 (index date) were identified by 1,126 general practitioners and 176 psychiatrists in the IMS Disease Analyzer database. We included patients between the ages of 60 and 80 years who had not previously received prescriptions for antidepressant drugs and had not been diagnosed with all-cause dementia prior to or on the index date. The main outcome of the study was the risk of dementia depending on antidepressant therapy. Cox proportional hazards models (dependent variable: incident dementia) were used to adjust for confounders and to estimate the effect of antidepressant therapy. A total of 22,838 patients treated in GPs and 33,112 patients treated in PPs were included in this study. Of those, 9,570, 30,321, and 16,059 individuals suffered from mild, moderate, and severe depression, respectively. Antidepressant drug use was associated with a decreased risk of dementia in patients affected by moderate (HR = 0.86, 95% CI: 0.77 - 0.95) or severe depression (HR = 0.83, 95% CI: 0.73 - 0.94). The use of antidepressants decreased dementia risk in patients with moderate or severe depression.
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[Sensitization to chymopapain in patients treated with chemonucleolysis].

Science.gov (United States)

García-Ortega, P; Ramírez Ferreiras, W; Sancho, A; Urías, S; Cisteró, A

1991-03-23

Chemonucleolysis (intradisk administration of chymopapain) is a procedure to treat intervertebral disk hernia. Recently, its use has been questioned due to the development of anaphylactic reactions in patients sensitized to chymopapain. The prevalence of sensitization to chymopapain has been evaluated before and after chemonucleolysis, and the possibility to establish risk groups through the allergy history has been assessed. 104 consecutive patients who were candidates to chemonucleolysis were evaluated with an allergy questionnaire, cutaneous tests to aeroallergens and to chymopapain, and chymopapain-specific IgE. The two latter tests were repeated one month after chemonucleolysis. Only 2 patients (1.9%) showed evidence of chymopapain sensitization before the procedure. Sixteen patients (16%) were sensitized after chemonucleolysis. None of the possible risk factors evaluated in the allergy questionnaire (atopy, drug allergy, papaya occupational exposure or use of additives, cosmetics or drugs containing papaine) were significantly related with the risk of sensitization to chymopapain. The prevalence of chymopapain sensitization in the study group was low. The allergy questionnaire (atopy, drug allergy, use of papaya, occupational history did not identify sensitized patients. Cutaneous tests and specific IgE are the best method to detect chymopapain sensitization. The remarkable rate of sensitization after chemonucleolysis may partially limit the usefulness of the procedure.

Derangement of lipid profile in antiepileptic drugs treated patients in local population

International Nuclear Information System (INIS)

Zuberi, N.A.; Perveen, T.

2012-01-01

Epilepsy is the third most common neurological disorder. It is not a single entity. The abnormal electrical activity may result in a variety of events, including loss of consciousness, abnormal movements, a typical or odd behavior or distorted perceptions falls seizers. Epilepsy is a chronic disorder and often requiring years of treatment. A large number of drugs are used for the treatment of epilepsy. The choice among the antiepileptic drugs depends on its effectiveness and side effects. Our retrospective study investigated the effect of anti epileptic drugs on lipid profile. Serum lipid profile was measured in 160 patients in which 40 patients were not started any antiepileptic drug .The remaining 120 patients were receiving antiepileptic drugs (AEDs). 40 control subjects were taken from general population for comparison. The height, weight and body mass index (BMI) and lipid profile of antiepileptic drugs treated patients were compared with control and untreated group. The weight and body mass index of antiepileptic drugs treated group was significantly increased when compared to the control group. Total Cholesterol (TC), Triglyceride (TO), High density lipoprotein (HDL-C), low density lipoprotein (LDL-C), ratio TC/HDL-C and ratio LDL-C/HDL-C were investigated for each group of drugs and controls. TC, TO, LDL-C, ratio TC/HDL-C and ratio LDL-C/HDL-C were significantly increased in patients who were on AEDs when compared with control but HDL-C of all drug treated groups showed significantly decreased when compared with control group. There was significant change in lipid profile was seen in AEDs treated group when compared with control group. Ratio TC/HDL-C and ratio LDUHDL-C alteration showed the risk of atherosclerosis and cardiovascular diseases. Anti-epileptic drugs also alter the BMI and so it could potentially facilitate the development of diabetes mellitus. Our results additionally suggest that there is a need for careful monitoring of lipid profile in

Leuconostoc sp. Meningitis in a Patient Treated with Rituximab for Mantle Cell Lymphoma

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Hrvoje Holik

2015-09-01

Full Text Available We present a 64-year-old man who was treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone chemoimmunotherapy for mantle cell lymphoma and developed purulent meningitis, probably caused by Leuconostoc sp. The patient had severe hypogammaglobulinemia, which is a possible complication of rituximab therapy. To our knowledge and after reviewing the available medical literature, this is the first described case of purulent meningitis caused by Leuconostoc sp. in a patient with mantle cell lymphoma that appeared after treatment with the R-CHOP protocol. The diagnosis of purulent meningitis was based on clinical, laboratory and cytological cerebrospinal fluid findings, in addition to blood culture results in which we isolated Leuconostoc sp. The patient was treated with meropenem with full recovery.

Low vascularity predicts favourable outcomes in leiomyoma patients treated with uterine artery embolization.

Science.gov (United States)

Tang, Yixin; Chen, Chunlin; Duan, Hui; Ma, Ben; Liu, Ping

2016-10-01

To investigate the clinical factors predicting outcomes of leiomyoma treated with uterine artery embolization (UAE). A total of 183 uterine leiomyoma patients undergoing UAE were retrospectively analyzed. Patient age, characteristics of vascular supply in magnetic resonance imaging (MRI)/digital subtraction angiography (DSA), number, size and location of leiomyoma were recorded. Leiomyoma regrowth, new leiomyoma appearance and recurrence of any previously reported symptoms were carefully monitored over a mean follow-up of 30 months (median 32 months, range 12-80). Potential recurrence risk factors were analyzed by univariate and multivariate cox regression analysis. Twenty-three recurrences were recorded. The difference in the vascularity classification systems between MRI and DSA was not statistically significant (P = 0.059). High vascularity in MRI, high vascularity in DSA and multiple leiomyoma showed a significant risk of recurrence using univariate and multivariate analysis (P = 0.004, P leiomyoma recurrence (P > 0.05). Low vascularity and solitary leiomyoma indicated favourable outcomes in patients treated with UAE. • Low vascularity and solitary mass predicted favourable outcomes in UAE-treated patients. • MRI might provide information on vascularity in leiomyoma before UAE. • Variations in vascular supply, age, size, location were not associated with recurrence.

Neutron dose to patients treated with high-energy medical accelerators

International Nuclear Information System (INIS)

McGinley, P.H.

2001-01-01

The neutron dose equivalent received by patients treated with high energy x-ray beams was measured in this research. A total of 13 different medical accelerators were evaluated in terms of the neutron dose equivalent in the patient plane and at the beam center. The neutron dose equivalent at the beam center was found to ranged from 0.02 to 9.4 mSv per Sv of x-ray dose and values from 0.029 to 2.58 mSv per Sv of x-ray were measured in the patient plane. It was concluded that the neutron levels meet the International Electrotechnical Commission standard for the patient plane. It was also concluded that when intensity modulated radiation treatment is conducted the neutron dose equivalent received by the patient will increase by a factor of 2 to 10. (author)

Acoplamiento de modelos de transporte de solutos y de modelos de reacciones químicas

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Samper, J.

1993-08-01

ímicos asociados a reacciones de diversa naturaleza. La mayoría de los modelos de transporte de solutos tienen en cuenta de forma rigurosa los procesos hidrodinámicos, pero sólo consideran las interacciones de tipo químico de forma muy simplificada. Por otro lado, los modelos de especiación química contemplan una gran variedad de procesos químicos en condiciones de equilibrio químico, aunque sólo son aplicables a sistemas acuáticos estáticos sin flujo. En la última década se han desarrollado un número considerable de modelos acoplados que contemplan, con grados muy variables de sofisticación, tanto los procesos hidrodinámicos como los químicos. Estos modelos contienen por un lado las ecuaciones diferenciales en derivadas parciales (EDP correspondientes al transporte de solutos y las correspondientes a los. procesos químicos, que en la hipótesis de equilibrio químico, son ecuaciones algebraicas no lineales. Un aspecto importante en la solución del problema es la adecuada selección de las variables primarias dependientes, las cuales satisfacen las ecuaciones de transporte. La inadecuada elección de las variables primarias limita la aplicabilidad del método de solución a sistemas químicos mixtos que contienen reacciones lentas (cinética y rápidas (equilibrio. Una característica común de la mayoría de los modelos existentes es la extraordinaria exigencia de tiempos de cálculo que motiva que con determinados enfoques sólo sea viable la solución de problemas unidimensionales.

Prognostic role of patient gender in limited-disease small-cell lung cancer treated with chemoradiotherapy

International Nuclear Information System (INIS)

Roengvoraphoj, Olarn; Eze, Chukwuka; Niyazi, Maximilian; Li, Minglun; Belka, Claus; Manapov, Farkhad; Hildebrandt, Guido; Fietkau, Rainer

2017-01-01

Previous studies have demonstrated that female gender could be a prognostic factor in limited-disease (LD) small-cell lung cancer (SCLC), but the correlation between patient gender and survival parameters remains unclear. Data from 179 LD SCLC patients treated with definitive chemoradiotherapy (CRT) were reviewed. Influence of patient gender on time to progression (TTP), local control (LC), brain metastasis-free (BMFS), distant metastasis-free (DMFS) and overall survival (OS) was analysed. Definitive CRT was completed by 179 (110 men/69 women) patients. Of these, 68 (38%; 34 men/34 women) patients were treated in concurrent and 111 (62%; 76 men/35 women) in sequential mode. Prophylactic cranial irradiation (PCI) was subsequently applied in 70 (39%; 36 men/34 women) patients with partial or complete response after CRT. Median OS was 20 (95% confidence interval [CI] 10-22) and 14 (95% CI 10-18) months in female and male patients, respectively (p = 0.021). In subgroups defined by remission status (complete and partial response) after CRT, an OS benefit for females compared to males was also detected. There was no correlation between patient gender and TTP, LC or DMFS, and no difference in OS in the female and male subgroups treated with PCI. The incidence of metachronous brain metastases (BMs) in the male and female subgroups differed significantly (40/110 men vs. 18/69 women, p = 0.03). Also, mean BMFS was significantly longer in women (p = 0.023). Patient gender also significantly correlated with OS on multivariate analysis after adjustment for other prognostic factors (p = 0.04, HR 1.38, 95% CI 1.08-1.92). In this heterogeneous LD SCLC patient cohort treated with definitive CRT, female gender was significantly associated with longer BMFS and OS, as well as with a lower incidence of metachronous brain failure. (orig.) [de

Longitudinal follow-up to evaluate speech disorders in early-treated patients with infantile-onset Pompe disease.

Science.gov (United States)

Zeng, Yin-Ting; Hwu, Wuh-Liang; Torng, Pao-Chuan; Lee, Ni-Chung; Shieh, Jeng-Yi; Lu, Lu; Chien, Yin-Hsiu

2017-05-01

Patients with infantile-onset Pompe disease (IOPD) can be treated by recombinant human acid alpha glucosidase (rhGAA) replacement beginning at birth with excellent survival rates, but they still commonly present with speech disorders. This study investigated the progress of speech disorders in these early-treated patients and ascertained the relationship with treatments. Speech disorders, including hypernasal resonance, articulation disorders, and speech intelligibility, were scored by speech-language pathologists using auditory perception in seven early-treated patients over a period of 6 years. Statistical analysis of the first and last evaluations of the patients was performed with the Wilcoxon signed-rank test. A total of 29 speech samples were analyzed. All the patients suffered from hypernasality, articulation disorder, and impairment in speech intelligibility at the age of 3 years. The conditions were stable, and 2 patients developed normal or near normal speech during follow-up. Speech therapy and a high dose of rhGAA appeared to improve articulation in 6 of the 7 patients (86%, p = 0.028) by decreasing the omission of consonants, which consequently increased speech intelligibility (p = 0.041). Severity of hypernasality greatly reduced only in 2 patients (29%, p = 0.131). Speech disorders were common even in early and successfully treated patients with IOPD; however, aggressive speech therapy and high-dose rhGAA could improve their speech disorders. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Classical prognostic factors in patients with non-advanced endometrial cancer treated with postoperative radiotherapy

International Nuclear Information System (INIS)

Karolewski, K.; Kojs, Z.; Jakubowicz, J.; Urbanski, K.; Michalak, A.

2006-01-01

Aim: Analysis of classical prognostic factors in patients with non-advanced endometrial cancer treated with postoperative radiotherapy. Materials/Methods: In the years 1985 - 1999, 705 patients underwent postoperative radiotherapy due to endometrial cancer: 529 patients with FIGO stage I and 176 with FIGO stage II cancer. Mean age was 58 years. In 96% of patients endometrioid adenocarcinoma was found. In 49.9% the cancer had a high, in 27.9% a medium, and in 22.2% a low degree of differentiation. Results: 82% of patients had 5-year disease-free survival. In univariate analysis a significantly higher rate of disease-free survival was observed in: patients younger than 60, with moderately and well differentiated cancers, with stage I endometrioid adenocarcinoma with less than 50% myometrial invasion. In multivariate analysis degree of cancer differentiation was the only independent prognostic factor. Conclusions: In a group of patients with non-advanced endometrial cancer treated with postoperative radiotherapy, degree of cancer differentiation is the primary prognostic factor. (authors)

Pulmonary Function in Patients With Germ Cell Cancer Treated With Bleomycin, Etoposide, and Cisplatin

DEFF Research Database (Denmark)

Lauritsen, Jakob; Kier, Maria Gry Gundgaard; Bandak, Mikkel

2016-01-01

PURPOSE: For patients with germ cell cancer, various pulmonary toxicity risk factors have been hypothesized for treatment with bleomycin, etoposide, and cisplatin (BEP). Because existing studies have shortcomings, we present a large, unselected cohort of patients who have undergone close monitoring...... expiratory volume in 1 second and forced vital capacity remained unchanged after BEP but increased significantly to levels above pretreatment during follow-up. International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic group, mediastinal primary, pulmonary metastases, and smoking all...... PFT. CONCLUSION: After 5 years of follow-up, pulmonary impairment in patients with germ cell cancer who were treated with BEP was limited. Exceptions were patients treated with pulmonary surgery, those who suffered pulmonary embolism, and those in the IGCCCG poor prognostic group....

Survival in patients with amyotrophic lateral sclerosis, treated with an array of antioxidants

NARCIS (Netherlands)

Vyth, A.; Timmer, J. G.; Bossuyt, P. M.; Louwerse, E. S.; de Jong, J. M.

1996-01-01

Between 1983 and 1988 we treated 36 patients with sporadic amyotrophic lateral sclerosis (ALS) by an array of antioxidants and added other drugs to the regimen whenever a patient reported deterioration. Our customary prescription sequence was N-acetylcysteine (NAC); vitamins C and E;

Evaluating deviations in prostatectomy patients treated with IMRT.

Science.gov (United States)

Sá, Ana Cravo; Peres, Ana; Pereira, Mónica; Coelho, Carina Marques; Monsanto, Fátima; Macedo, Ana; Lamas, Adrian

2016-01-01

To evaluate the deviations in prostatectomy patients treated with IMRT in order to calculate appropriate margins to create the PTV. Defining inappropriate margins can lead to underdosing in target volumes and also overdosing in healthy tissues, increasing morbidity. 223 CBCT images used for alignment with the CT planning scan based on bony anatomy were analyzed in 12 patients treated with IMRT following prostatectomy. Shifts of CBCT images were recorded in three directions to calculate the required margin to create PTV. The mean and standard deviation (SD) values in millimetres were -0.05 ± 1.35 in the LR direction, -0.03 ± 0.65 in the SI direction and -0.02 ± 2.05 the AP direction. The systematic error measured in the LR, SI and AP direction were 1.35 mm, 0.65 mm, and 2.05 mm with a random error of 2.07 mm; 1.45 mm and 3.16 mm, resulting in a PTV margin of 4.82 mm; 2.64 mm, and 7.33 mm, respectively. With IGRT we suggest a margin of 5 mm, 3 mm and 8 mm in the LR, SI and AP direction, respectively, to PTV1 and PTV2. Therefore, this study supports an anisotropic margin expansion to the PTV being the largest expansion in the AP direction and lower in SI.

Ultrasound elastography in patients with rectal cancer treated with chemoradiation

DEFF Research Database (Denmark)

Rafaelsen, S R; Vagn-Hansen, C; Sørensen, T

2013-01-01

OBJECTIVE: The current literature has described several predictive markers in rectal cancer patients treated with chemoradiation, but so far none of them have been validated for clinical use. The purpose of the present study was to compare quantitative elastography based on ultrasound measurements...... in the course of chemoradiation with tumor response based on T stage classification and the Mandard tumor regression grading (TRG). MATERIALS AND METHODS: We prospectively examined 31 patients with rectal cancer planned for high dose radiochemotherapy. The tumor and the mesorectal fat elasticity were measured...

Pharmacogenetic Risk Stratification in Angiotensin-Converting Enzyme Inhibitor-Treated Patients with Congestive Heart Failure

DEFF Research Database (Denmark)

Nelveg-Kristensen, Karl Emil; Busk Madsen, Majbritt; Torp-Pedersen, Christian

2015-01-01

BACKGROUND: Evidence for pharmacogenetic risk stratification of angiotensin-converting enzyme inhibitor (ACEI) treatment is limited. Therefore, in a cohort of ACEI-treated patients with congestive heart failure (CHF), we investigated the predictive value of two pharmacogenetic scores...... SNPs of the angiotensin-converting enzyme gene (rs4343) and ABO blood group genes (rs495828 and rs8176746). METHODS: Danish patients with CHF enrolled in the previously reported Echocardiography and Heart Outcome Study were included. Subjects were genotyped and categorized according to pharmacogenetic.......05 [95% CI 0.79-1.40]), respectively. CONCLUSIONS: We found no association between either of the analyzed pharmacogenetic scores and fatal outcomes in ACEI-treated patients with CHF....

Quality of Life and Gastrointestinal Symptoms in Long-Term Treated Dermatitis Herpetiformis Patients: A Cross-Sectional Study in Finland.

Science.gov (United States)

Pasternack, Camilla; Kaukinen, Katri; Kurppa, Kalle; Mäki, Markku; Collin, Pekka; Reunala, Timo; Huhtala, Heini; Salmi, Teea

2015-12-01

Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking. The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life. Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls. The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life. We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.

Mortality in patients treated for hyperthyroidism with iodine-131

Energy Technology Data Exchange (ETDEWEB)

Hall, P.; Lundell, G.; Holm, L.E. (Karolinska Hospital, Stockholm (Sweden))

1993-03-01

Causes of death were studied in 10552 Swedish hyperthyroid patients treated with [sup 131]I diagnosed between 1950 and 1975. The patients were followed for an average of 15 years and were matched with the Swedish cause of death register. A total of 5400 deaths were observed and the overall standardized mortality ratio was 1.47. The standardized mortality ratio for females was 1.50 compared to 1.31 in males. The most common cause of death was from cardiovascular diseases. Significantly elevated risks were also seen for tumours, diseases of the endocrine system, respiratory system, gastro-intenstinal system, and congenital malformations. In all causes of death, except tumours and trauma, decreasing standardized mortality ratios over time were seen. Patients followed for more than 10 years had significantly elevated risks for tumours, diseases of the endocrine, respiratory, and cardiovascular systems. Patients given higher [sup 131]I activity and younger patients had higher standardized mortality ratios than those given lower activity and older patients. The hyperthyroidism per se, rather than the [sup 131]I treatment, appeared to be the major explanation for the elevated mortality. 20 refs., 3 tabs.

Mortality in patients treated for hyperthyroidism with iodine-131

International Nuclear Information System (INIS)

Hall, P.; Lundell, G.; Holm, L.E.

1993-01-01

Causes of death were studied in 10552 Swedish hyperthyroid patients treated with 131 I diagnosed between 1950 and 1975. The patients were followed for an average of 15 years and were matched with the Swedish cause of death register. A total of 5400 deaths were observed and the overall standardized mortality ratio was 1.47. The standardized mortality ratio for females was 1.50 compared to 1.31 in males. The most common cause of death was from cardiovascular diseases. Significantly elevated risks were also seen for tumours, diseases of the endocrine system, respiratory system, gastro-intenstinal system, and congenital malformations. In all causes of death, except tumours and trauma, decreasing standardized mortality ratios over time were seen. Patients followed for more than 10 years had significantly elevated risks for tumours, diseases of the endocrine, respiratory, and cardiovascular systems. Patients given higher 131 I activity and younger patients had higher standardized mortality ratios than those given lower activity and older patients. The hyperthyroidism per se, rather than the 131 I treatment, appeared to be the major explanation for the elevated mortality. 20 refs., 3 tabs

Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

Science.gov (United States)

Merkac, Maja Ivartnik; Tomazic, Janez; Strle, Franc

2015-12-01

A 57-year-old woman, receiving TNF-alpha inhibitor adalimumab for psoriasis, presented with early Lyme neuroborreliosis (Bannwarth's syndrome). Discontinuation of adalimumab and 14-day therapy with ceftriaxone resulted in a smooth course and favorable outcome of Lyme borreliosis. This is the first report on Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

Blood pressure reduction in patients with irreversible pulpitis teeth treated by non-surgical root canal treatment

Directory of Open Access Journals (Sweden)

James I-Sheng Huang

2017-12-01

Full Text Available Background/purpose: The hypotension in patients during non-surgical root canal treatment (NSRCT has not yet investigated. This study aimed to assess the mean systolic blood pressure (MSBP, mean diastolic blood pressure (MDBP, and mean arterial blood pressure (MABP reduction percentages in patients with irreversible pulpitis teeth treated by NSRCT. Materials and methods: We prospectively recruited 111 patients with a total of 138 irreversible pulpitis teeth. All patients underwent two NSRCT sessions. The first NSRCT session involved mainly the removal of vital pulp tissue with the direct stimulation of the dental branches of the trigeminal nerve, and the second NSRCT session included the root canal debridement and enlargement with minimal disturbance to the dental nerves. The blood pressure of each patient was recorded before and during both NSRCT sessions. Results: There were significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients (all the P-values < 0.001. If the patients were divided into 2 or more groups according to the clinical variables including the patients' gender, age, tooth type, and anesthesia type, we also found significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients except for patients below 40 years of age and for patients with lower anterior teeth treated (all the P-values < 0.05. Conclusion: The decrease in blood pressure in patients receiving vital pulpal extirpation is a relatively common phenomenon. Keywords: hypotension, irreversible pulpitis teeth, non-surgical root canal treatment, blood pressure, parasympathetic effect, vital pulpal extirpation

Chromosome inversions in lymphocytes of prostate cancer patients treated with X-rays and carbon ions

International Nuclear Information System (INIS)

Pignalosa, Diana; Lee, Ryonfa; Hartel, Carola; Sommer, Sylvester; Nikoghosyan, Anna; Debus, Jürgen; Ritter, Sylvia; Durante, Marco

2013-01-01

Background and purpose: To investigate the cytogenetic damage of the intrachange type in peripheral blood lymphocytes of patients treated for prostate cancer with different radiation qualities. Material and methods: Prostate cancer patients were enrolled in a clinical trial based at the Heidelberg University Hospital and at the GSI Helmholtz Centre for Heavy Ion Research in 2006. Patients were treated either with intensity-modulated radiation therapy (IMRT) alone or with a carbon-ion boost followed by IMRT. Blood samples were collected at the end of the therapy and the mBAND technique was used to investigate the cytogenetic damage of the inter and intrachange types. Moreover, the mBAND analysis was performed on healthy donor cells irradiated in vitro with X-rays or C-ions. Results: Our results show no statistically significant differences in the yield and the spectrum of chromosome aberrations among patients treated only with IMRT and patients receiving the combined treatment when similar target volumes and doses to the target are compared. Conclusion: The study suggests that the risks of normal tissue late effects and second malignancies in prostate cancer patients are comparable when heavy ions or IMRT radiotherapy are applied

[Prevalence of Dental Caries in Type 1 Diabetic Patients Treated with Insulin Pump].

Science.gov (United States)

Garcia, Rosana; Coelho, Ana; Paula, Anabela; Marques Ferreira, Manuel; Caramelo, Francisco; Barros, Luísa; Batista, Carla; Melo, Miguel; Silva, Mário Jorge; Carrilho, Eunice

2016-08-01

Type 1 diabetes mellitus and oral health are strictly related on a reciprocal basis, and an increased susceptibility to a wide variety of oral diseases is recognised in these patients. The aim of the present study was to establish a relationship between the prevalence of dental caries in Type 1 diabetic patients treated with insulin pump and that of non-diabetic patients. An observational clinical study of analytical and cross-sectional nature was conducted. The sample consisted of 30 adults with diabetes mellitus treated with insulin pump (selected from the Coimbra Hospital and Universitary Centre) and 30 nondiabetic adults (selected from the ones accompanying the diabetic patients). One dentist evaluated all of the patients between January and May of 2015 in the Faculty of Medicine of the University of Coimbra. During the clinical evaluation a case report form adapted to the objectives of the investigation was completed. Data analysis was performed and the significance level was set at 5%. Diabetic patients showed similar levels on the caries and plaque index to non-diabetic patients. There were no statistically significant differences between the two groups as regards oral hygiene habits and frequency of visits to the dentist. Discussão: Although diabetics' diet is less abundant in carbohydrates, which provides a smaller exposure to cariogenic food, the regularity of meals can increase the risk of caries since the critical pH for demineralization is reached frequently throughout the day. However, the existence of a chronic condition may determine a high concern for general preventive care, resulting in an overall improvement of their oral health, which could justify the results. Type 1 diabetic patients treated with insulin pump don't have a higher prevalence of dental caries.

Survival Outcomes of Patients Treated with Hypofractionated Stereotactic Body Radiation Therapy for Parotid Gland Tumors: a Retrospective Analysis

International Nuclear Information System (INIS)

Karam, Sana D.; Snider, James W.; Wang, Hongkun; Wooster, Margaux; Lominska, Christopher; Deeken, John; Newkirk, Kenneth; Davidson, Bruce; Harter, K. William

2012-01-01

Background: to review a single-institution experience with the management of parotid malignancies treated by fractionated stereotactic body radiosurgery (SBRT). Findings: Between 2003 and 2011, 13 patients diagnosed with parotid malignancies were treated with adjuvant or definitive SBRT to a median dose of 33 Gy (range 25–40 Gy). There were 11 male and two female patients with a median age of 80. Ten patients declined conventional radiation treatment and three patients had received prior unrelated radiation therapy to neighboring structures with unavailable radiation records. Six patients were treated with definitive intent while seven patients were treated adjuvantly for adverse surgical or pathologic features. Five patients had clinical or pathologic evidence of lymph node disease. Conclusion: at a median follow-up of 14 months only one patient failed locally, and four failed distantly. The actuarial 2-year overall survival, progression-free survival, and local-regional control rates were 46, 84, and 47%, respectively. Statistical analysis revealed surgery as a positive predictor of overall survival while presence of gross disease was a negatively correlated factor (p < 0.05).

VIRUS DEL PAPILOMA HUMANO REACCIONES ADVERSAS DE LOS MEDICAMENTOS Y EL PAPEL DE LOS MEDIOS MASIVOS DE COMUNICACIÓN.

Directory of Open Access Journals (Sweden)

Martalucía Tamayo Fernández

2014-10-01

Full Text Available A raíz del reciente fenómeno sucedido en Carmen de Bolívar, mucho se ha especulado sobre lo que allí pueda estar pasando y se ha puesto sobre el tapete un tema tan delicado e importante para la salud pública de nuestro país, como es el uso masivo de vacunas y más aún, de la vacuna del papiloma humano (VPH. Estos hechos y las noticias ciertas o verdaderas que la prensa y la televisión han mostrado, nos llevan a preguntarnos una vez más por la responsabilidad y el papel de los medios masivos de comunicación en estas situaciones de reacciones adversas a medicamentos o a biológicos. Este artículo analiza los aspectos históricos de la noticia, su impacto en la persona que la recibe, la ética del periodismo y la inconveniencia de la presión sobre el comunicador, quien debe responder por el impacto que genere entre la gente que sigue a un determinado medio, lo que influye en sus ganancias.

Addition of sunitinib to cetuximab and irinotecan in patients with heavily pre-treated advanced colorectal cancer

DEFF Research Database (Denmark)

Qvortrup, Camilla; Jensen, Benny Vittrup; Jørgensen, Trine Lembrecht

2010-01-01

Results of continuous sunitinib, in combination with cetuximab and irinotecan every other week (SIC) for compassionate use in heavily pre-treated patients with mCRC are presented.......Results of continuous sunitinib, in combination with cetuximab and irinotecan every other week (SIC) for compassionate use in heavily pre-treated patients with mCRC are presented....

Usage of S-Adchnon 50 for patients treated with radiotherapy

International Nuclear Information System (INIS)

Yorishima, Shin; Shigemasa, Kazushi; Myoga, Hiroshi; Tanioka, Yoshihide; Hayashitani, Seiji; Egawa, Kenji; Katsube, Yasuhiro; Fujiwara, Atsushi

1986-01-01

S-Adchnon 50 (300 mg/day), divided into three equal daily doses, was orally given as a potential prophylaxic drug for leukopenia to 34 patients with genecological malignancies receiving radiotherapy. The efficacy of the drug was evaluated by WBC count before and during irradiation. Overall, 91 % of the patients responded to the drug. According to disease, the effective rate of S-Adchnon 50 tended to be low in patients with ovarian cancer who were given intensive chemotherapy before irradiation. None of the patients experienced aggravation of liver and renal function. Radiotherapy and conservative chemotherapy are most likely responsible for the tendency toward decreased counts of the platelets. No side effects probably due to the drug were observed. In view of high effective rate and lack of side effects, the usage of S-Adchnon 50 would be of value in patients treated with radiotherapy. (Namekawa, K.)

Surgical Resection of Brain Metastases and the Risk of Leptomeningeal Recurrence in Patients Treated With Stereotactic Radiosurgery

International Nuclear Information System (INIS)

Johnson, Matthew D.; Avkshtol, Vladimir; Baschnagel, Andrew M.; Meyer, Kurt; Ye, Hong; Grills, Inga S.; Chen, Peter Y.; Maitz, Ann; Olson, Rick E.; Pieper, Daniel R.; Krauss, Daniel J.

2016-01-01

Purpose: Recent prospective data have shown that patients with solitary or oligometastatic disease to the brain may be treated with upfront stereotactic radiosurgery (SRS) with deferral of whole-brain radiation therapy (WBRT). This has been extrapolated to the treatment of patients with resected lesions. The aim of this study was to assess the risk of leptomeningeal disease (LMD) in patients treated with SRS to the postsurgical resection cavity for brain metastases compared with patients treated with SRS to intact metastases. Methods and Materials: Four hundred sixty-five patients treated with SRS without upfront WBRT at a single institution were identified; 330 of these with at least 3 months' follow-up were included in this analysis. One hundred twelve patients had undergone surgical resection of at least 1 lesion before SRS compared with 218 treated for intact metastases. Time to LMD and overall survival (OS) time were estimated from date of radiosurgery, and LMD was analyzed by the use of cumulative incidence method with death as a competing risk. Univariate and multivariate analyses were performed with competing risk regression to determine whether various clinical factors predicted for LMD. Results: With a median follow-up time of 9.0 months, 39 patients (12%) experienced LMD at a median of 6.0 months after SRS. At 1 year, the cumulative incidence of LMD, with death as a competing risk, was 5.2% for the patients without surgical resection versus 16.9% for those treated with surgery (Gray test, P<.01). On multivariate analysis, prior surgical resection (P<.01) and breast cancer primary (P=.03) were significant predictors of LMD development. The median OS times for patients undergoing surgery compared with SRS alone were 12.9 and 10.6 months, respectively (log-rank P=.06). Conclusions: In patients undergoing SRS with deferral of upfront WBRT for intracranial metastatic disease, prior surgical resection and breast cancer primary are associated with an

7,528 patients treated with PCI - a Scandinavian real-life scenario

DEFF Research Database (Denmark)

Pedersen, S.; Galatius, S.; Bech, J.

2008-01-01

AIM: Analyze clinical, temporal and procedural characteristics from 7,528 consecutive percutaneous coronary intervention (PCI) patients in one of the largest published contemporary European PCI-database during a 6-year period. METHOD: Retrospective study design. Period: 1998-2004. Temporal...... and referral changes in a Danish PCI-registry were analyzed. Demographic and angiographic variables were compared with data from randomized clinical trials, US-registries and current guidelines. RESULTS: 22,214 patients were examined with coronary angiography and 7,528 patients were treated with PCI....... The annual number of PCI's increased by 15%. Over time, the fraction of patients with risk factors increased, median age increased from 61 to 64 years and the coronary pathology was significantly worsened. ST-elevation myocardial infarction patients primarily admitted to hospitals without facilities...

VARIABILIDAD EN LA NOTIFICACIÓN DE REACCIONES ADVERSAS A LAS VACUNAS DE LA GRIPE PANDÉMICA Y ESTACIONAL. TEMPORADAS 2009-2010 Y 2010-2011, COMUNITAT VALENCIANA

Directory of Open Access Journals (Sweden)

Ana María Alguacil Ramos

2012-01-01

Full Text Available Fundamentos: La pérdida de confianza en la seguridad de las vacunas derivada de situaciones de alarma, como en el caso de la gripe pandémica, puede afectar tanto a las coberturas vacunales como a la sensibilidad frente a la notificación de las sospechas de reacciones adversas asociadas a vacunas (SRAAV. El objetivo del trabajo es describir los efectos adversos a la vacuna frente a la gripe pandémica notificados en la temporada 2009-2010 y comparar si existen diferencias con los descritos con la vacuna de la gripe estacional en las temporadas 2009-2010 y 2010-2011 en la Comunitat Valenciana (CV. Métodos: Se realizó un estudio descriptivo de los individuos vacunados frente a la gripe que presentaron alguna SRAAV a la vacuna antigripal y que fue notificada a través del Sistema de Información Vacunal, durante las temporadas 2009-2010 (incluyendo la vacunación pandémica y 2010-2011 en CV. se calcularon las tasas de notificación de sospechas de reacciones adversas asociadas a vacunas por cada mil dosis de vacunas administradas y sus intervalos de confianza al 95%. Resultados: Durante el periodo 2009-2010 la tasa de notificación de SRAAV para la vacuna de la gripe estacional fue de 0,02 por mil dosis administradas, para la vacuna pandémica de 0,95. En el periodo 2010-2011 la tasa para la vacuna de la gripe estacional fue de 0,04 por mil. Conclusiones: Durante las temporadas analizadas se incrementó el número de notificaciones de SRAAV para las vacunas pandémicas en comparación con el resto de vacunas antigripales. La mayor tasa de notificación de SRAAV correspondió al grupo de profesionales sociosanitarios, tanto para las vacunas frente a la gripe estacional como pandé- mica.

Cephalometric changes in growing patients with increased vertical dimension treated with cervical headgear.

Science.gov (United States)

Sambataro, Sergio; Fastuca, Rosamaria; Oppermann, Nelson J; Lorusso, Paola; Baccetti, Tiziano; Franchi, Lorenzo; Caprioglio, Alberto

2017-07-01

The aim of the present study was to investigate the cephalometric changes in patients with increased vertical dimension after treatment with cervical headgear compared to controls. The sample of the present retrospective study consisted of 20 Class II patients (10 males, 10 females; mean age 8.54 ± 1.15 years) with increased vertical dimension treated with cervical headgear (treatment group) and 21 Class II patients (11 males, 10 females; mean age 8.41 ± 1.15 years) with increased vertical dimension who underwent no treatment (control group). Cephalograms were available for each subject at baseline (T1) and after treatment/observation time (T2) for both groups and cephalometric analysis allowed for evaluation of changes between time points and between groups. Regarding facial axis, N-ANS/ANS-Me, and overbite, there were no negatively significant changes in the treated group showing no significant worsening in the vertical dimension. Regarding facial angle, there was a significant increase in the treated group between the time points and when compared to the control group, showing counterclockwise rotation of the mandible in the treated group. The vertical dimension was not significantly altered after cervical headgear treatment although the anterior facial height was higher at the beginning of treatment. There was significant counterclockwise rotation of the mandible, and clockwise rotation and distal displacement of the maxilla after treatment.

Electrochemical performance in the hydrogen evolution reaction of Ni-TR (TR= La, Ce) materials synthesized using the solid state reaction method; Desempeno electroquimico en la reaccion de evolucion de hidrogeno de materiales de electrodo Ni-TR (TR = La, Ce) sintetizados por el metodo de reaccion de estado solido

Energy Technology Data Exchange (ETDEWEB)

Torres-Huerta, A. M.; Dominguez-Crespo, M. A.; Ramirez-Meneses, E.; Yanez-Zamora, C. [CICATA, IPN, Altamira, Tamaulipas (Mexico); Avila-Garcia, I. [IPN, ESIQIE, UPALM, Mexico, D.F. (Mexico)]. E-mail: mdominguezc@ipn.mx; adcrespo2000@yahoo.com.mx

2009-09-15

relacionados con su operacion. El material de electrodo con mayor electroactividad es el Pt, pero debido a su costo elevado se han tenido que buscar electrocatalizadores alternativos con un balance entre costo y actividad. Uno de los materiales que mas se ha utilizado es el Niquel en conjunto con algunas de sus aleaciones. Este material ha demostrado un buen desempeno utilizando bajos sobrepotenciales en reacciones tradicionales como las reacciones de evolucion de hidrogeno (REH) y oxigeno (REO), asi como una alta resistencia a la corrosion y bajo costo. Particularmente, aleaciones binarias y ternarias han demostrado un incremento importante en la actividad de la REH al compararla con los materiales en su estado puro o masivo. Por esta razon, en la busqueda de nuevas alternativas con una aceptable eficiencia al compararla con los materiales a bajo costo, en este trabajo se obtuvieron materiales Ni-TR (TR = La, Ce) por el metodo de reaccion de estado solido, a partir de: a) acetilacetonatos metalicos y b) polvos metalicos. Estos materiales se sinterizaron durante 3 h a diferentes temperaturas (795 o 920 , 1000 y 1200 grados centigrados) a fin de evaluar su efecto en el desempeno electroquimico de los electrocatalizadores. La caracterizacion estructural y morfologica de materiales se realizo por las tecnicas de DRX y MEB, respectivamente. Asimismo, el desempeno electroquimico de los materiales de electrodo se evaluo en la REH utilizando voltametria ciclica (VC) y curvas potenciodinamicas. Los resultados obtenidos muestran que a bajas temperaturas se obtiene una mezcla de oxidos (NiO, CeO{sub 2} y LaNiO{sub 3}); sin embargo a medida que la temperatura de sinterizado se incrementa, se alcanza la formacion de las aleaciones NiO-CeO{sub 2} y NiO-LaNiO{sub 3}, respectivamente. Al mismo tiempo se observo una clara dependencia de la actividad electrocatalitica con la fuente obtencion de estos materiales (Ni-TR).

Longitudinal follow-up of patients with conservatively treated and arthroscopically repaired peripheral meniscal tears

International Nuclear Information System (INIS)

Deutsch, A.L.; Mink, J.H.; Rothman, B.J.

1989-01-01

Tears involving the peripheral third of the meniscus represent an important subgroup of meniscal injuries due to their unique ability to heal by synovial ingrowth and vascular proliferation. Serial MR images were obtained in 14 patients with arthroscopically proved peripheral meniscal tears to assess changes in MR appearance associated with meniscal healing. Six patients were treated conservatively, and eight underwent arthroscopic repair. All patients were considered clinically stable and presumably healed based on commonly accepted orthopedic criteria. Persistent grade 3 signal was seen in all patients up to 6 months after injury. In two patients more than 14 months after repair, grade 3 signal was present but decreased. In no patient did the signal entirely resolve. The authors concluded that signal from conservatively treated and repaired meniscal tears may persist long after the tear has become asymptomatic and presumable healed. This likely reflects known histologic differences between the native meniscus and reparative fibrocartilage. Persistence of grade 3 signal should not be interpreted as reflective of nonhealing in patients with persistent symptoms or as evidence of another tear in those with recurrent symptoms

Dynamics of body composition and bone in patients with juvenile idiopathic arthritis treated with growth hormone.

Science.gov (United States)

Bechtold, Susanne; Ripperger, Peter; Dalla Pozza, Robert; Roth, Johannes; Häfner, Renate; Michels, Hartmut; Schwarz, Hans Peter

2010-01-01

GH has a positive impact on growth, bone, and muscle development. The objectives of this study were to demonstrate the effects of GH treatment on regional body composition and bone geometry at final height in patients with juvenile idiopathic arthritis (JIA). In this longitudinal study, parameters of bone mineral density and geometry as well as muscle and fat cross-sectional area (CSA) in the nondominant forearm were recorded using peripheral quantitative computed tomography at yearly intervals until final height in 12 patients (seven females) receiving GH treatment. Data at final height were compared with 13 patients (nine females) with JIA not treated with GH. Patients were treated with GH for a mean of 5.35 +/- 0.7 yr. Correcting for height, total bone CSA (+0.89 +/- 0.5 sd) and muscle CSA (+1.14 +/- 0.6 sd) increased significantly and normalized at final height. Compared with JIA patients without GH at final height, there was a significantly higher muscle CSA and a lower fat CSA in GH-treated patients. Additionally, in relation to total bone CSA, there was significantly more cortical and less marrow CSA in boys with GH treatment. During GH treatment, there was a significant increase and normalization of total bone and muscle CSA at final height. In accordance with an anabolic effect of GH, fat mass stabilized at the lower limit of healthy children. At final height, cortical and marrow CSA, relative to total bone CSA, were normalized in GH-treated patients.

Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

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... to Surgery for Many Patients Spotlight on Research Physical Therapy to Treat Torn Meniscus Comparable to Surgery ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded ...

A Study of Patients with Primary Mediastinal Germ Cell Tumors Treated Using Multimodal Therapy

Directory of Open Access Journals (Sweden)

Yutaro Tanaka

2017-01-01

Full Text Available Objectives. Primary mediastinal germ cell tumors (PMGCTs are rare, which often makes them difficult to treat. Herein, we examined patients with PMGCTs who underwent multimodal treatment. Methods. We examined 6 patients (median age: 25 years, range: 19–27 years with PMGCTs who underwent multimodal treatment between April 2001 and March 2015. Three patients had seminomas, 2 patients had yolk sac tumors, and 1 patient had choriocarcinoma. The median observation period was 32.5 months (range: 8–84 months. Results. Three of the 6 patients received initial operation followed by 3-4 courses of chemotherapy (bleomycin, etoposide, and cisplatin (BEP or etoposide and cisplatin (EP. One patient developed multiple lung metastases 17 months after surgery; received salvage chemotherapy with vinblastine, ifosfamide, and cisplatin; and achieved complete remission. The remaining 3 patients received initial BEP and EP chemotherapy. Multiple lung metastases and supraclavicular lymph node metastases were detected in 2 of these patients at the initial diagnosis. The patients underwent resections to remove residual tumor after treatment, and no viable tumor cells were found. Conclusions. Reliable diagnosis and immediate multimodal treatments are necessary for patients with PMGCTs. The 6 patients treated in our hospital have never experienced recurrence after the multimodal treatment.

Secukinumab shows significant efficacy in two patients with difficult-to-treat areas of psoriasis: a Greek experience.

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Platsidaki, Eftychia; Kostopoulos, Nikolaos; Marnelakis, Ioannis; Panagakis, Pantelis

2018-03-15

Psoriasis is one of the most frequently occurring chronic inflammatory skin diseases. There are some specialized regions of the body that are considered difficult to treat. Secukinumab is a human monoclonal immunoglobulin G antibody that blocks the interleukin 17A ligand and has been shown to be highly efficacious in treating moderate-to-severe psoriasis. We studied two Greek patients, one with scalp psoriasis and the other with palmoplantar psoriasis, both resistant to treatment. Patients were treated with secukinumab and efficacy and safety were recorded. The patient with severe, refractory palmoplantar psoriasis achieved complete clearance at the end of the 4-week treatment period with secukinumab. The patient with moderate to severe, chronic scalp psoriasis was successfully treated with secukinumab, obtaining complete clearance of symptoms and remission of disease after approximately 16 weeks. In both cases clinical response was maintained through week 52. Secukinumab has been shown to be highly efficacious in the treatment of psoriasis of specific anatomical sites with an acceptable safety profile.

Prognosis was not deteriorated by multiple primary cancers in esophageal cancer patients treated by radiotherapy

International Nuclear Information System (INIS)

Shirai, Katsuyuki; Tamaki, Yoshio; Kitamoto, Yoshizumi

2013-01-01

Esophageal cancer patients are often associated with multiple primary cancers (MPC). The aim of this study is to evaluate the effect of MPC on prognosis in esophageal cancer patients treated by radiotherapy. Between 2001 and 2008, esophageal cancer patients treated by definitive radiotherapy at Gunma Cancer Center were retrospectively reviewed. Exclusion criteria were preoperative or postoperative radiotherapy, palliative radiotherapy, follow-up of <6 months, radiation dose of <50 Gy and no information on MPC. We analyzed 167 esophageal cancer patients and 56 (33.5%) were associated with MPC. Gastric cancer was the most frequent tumor (38.2%), followed by head and neck cancer (26.5%). Median follow-up time was 31.5 months (range 6.1-87.3 months). Patients with MPC included more stage I/II esophageal cancer than those without MPC (66.1% vs. 36.9%, P<0.01). The 5-year overall survival rate for esophageal cancer with MPC was relatively better than those without MPC (46.1% vs. 26.7%), although the difference did not reach statistical significance in univariate analysis (P=0.09). Stage I/II esophageal cancer patients had a significantly better overall survival than stage III/IV patients (P<0.01). Among esophageal cancer patients with MPC, there was no difference in overall survival between antecedent and synchronous cancer (P=0.59). Our study indicated that the prognosis of esophageal cancer patients treated by radiotherapy was primarily determined by the clinical stage itself, but not the presence of MPC. (author)

Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries.

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Dowling, Sean Taylor; Lin, Brian Wai

2017-10-01

A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. Emergency department of Kaiser Permanente Medical Center, San Francisco, California. Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury. All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications. This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

Does "smoker's paradox" exist in clopidogrel-treated Turkish patients with acute coronary syndrome.

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Edem, Efe; Kirdök, Ali Hikmet; Kınay, Ahmet Ozan; Tekin, Ümit İlker; Taş, Sedat; Alpaslan, Erkan; Pabuccu, Mustafa Türker; Akdeniz, Bahri

2016-01-01

Previously conducted studies revealed that smoking enhanced the efficacy of clopidogrel by increasing formation of the active metabolite (AM) from the prodrug through induction of the cytochrome CYP1A2. The expression of cytochrome enzymes depends on genotype and no data exists in literature conducted in Turkish patients comparing the clopidogrel responsiveness between active smokers and non-active smokers treated with clopidogrel. In this study, our aim was to investigate the clopidogrel responsiveness in clopidogrel-treated Turkish acute coronary syndrome (ACS) patients according to their smoking status. We retrospectively enrolled 258 patients who were hospitalized due to ACS. Clinical variables of the patients, especially smoking status were recorded. Clopidogrel resistance was evaluated by using adenosine diphosphate (ADP) induced platelet aggregometry. Clopidogrel resistance was detected as a change in maximal aggregation ≤20% from baseline. A total of 139 patients were active smokers while 12 were former smokers. 107 patients did not have a history of smoking. Ten of the smokers were hyporesponsive to clopidogrel, whereas 36 of non-smokers were hyporesponsive to clopidogrel (p value >612.5 predicted the clopidogrel resistance with a sensitivity of 60% (OR: 100.65, %95 CI = 19.996-506.615 p paradox" probably exists in Turkish ACS patients.

Development of Age-Related Macular Degeneration (AMD) in the Fellow Eye of Patients with AMD Treated by Treat-and-Extend Intravitreal Therapy with Aflibercept.

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Mimura, Kensuke; Matsumoto, Hidetaka; Morimoto, Masahiro; Akiyama, Hideo

2018-01-01

To evaluate the development of neovascular age-related macular degeneration (nAMD) in the fellow eye in patients with unilateral nAMD treated by a treat-and-extend (TAE) regimen with intravitreal aflibercept injections. We retrospectively studied 104 patients with treatment-naïve unilateral nAMD. We assessed best-corrected visual acuity (BCVA) and exudative changes in the treated eyes and development of nAMD in the fellow eye for 2 years. The subjects included 46 patients with typical AMD (tAMD), 44 with polypoidal choroidal vasculopathy (PCV), and 14 with retinal angiomatous proliferation (RAP). BCVA was significantly improved after the loading phase in all subtypes. Forty-six patients (44.2%) had no recurrence within 2 years after the loading phase, including 12 (26.1%) with tAMD, 23 (52.2%) with PCV, and 11 (78.6%) with RAP (p < 0.01). Eleven patients (10.6%) developed nAMD in the fellow eye within 2 years, including 4 (8.7%) with tAMD, 0 (0%) with PCV, and 7 (50.0%) with RAP (p < 0.001). Patients with RAP had significantly more frequent development of nAMD in the fellow eye compared to other subtypes, while they showed significantly less recurrence during the TAE regimen with intravitreal aflibercept injections. Development of nAMD in the fellow eye should be monitored in RAP when the injection interval is extended. © 2017 S. Karger AG, Basel.

Analysis of toxicity in a group of patients treated for pancreatic cancer with combined modality 3D radiation therapy

International Nuclear Information System (INIS)

Fine, Robert M.; Fernandez-Vicioso, Eduardo; Higgins, Patrick; Schell, Michael; Sohn, Jason; Pelley, Robert; Walsh, R. M.; Vogt, David; Hermann, Robert

1995-01-01

Purpose: To evaluate the acute toxicity of a group of 37 pancreatic cancer patients treated with noncoplanar, nonopposed, conformal radiation therapy with concurrent chemotherapy (5-FU). Materials and Methods: We retrospectively evaluated a group of initially nonadvanced 37 pancreatic cancer patients treated with combined concurrent chemotherapy and 3D radiation therapy treated between 1992 until 1995. During this period we began treating the initially unresectable patients with preoperative chemo-RT (50.4 Gy) after treating an initial group of unresectable patients to a higher dose of 66.6 Gy. We also include a group of patients who received postop chemo-RT after Whipple resection (59.4 Gy). All radiation was delivered at a 1.8 Gy per fraction dose rate. The total group was made up of 37 patients of whom 21 were male (57%) and 16 female (43%). There were 22 (59%) head of pancreas lesions, 10 (27%) body of pancreas lesions, and 5 (14%) head and body of pancreas cancers. Of these 37 patients 7 (19%) were treated with chemo-RT as their only treatment, 10 patients (29%) were treated post Whipple resection, and 20 patients (54%) were treated with preoperative intent. Results: Three patients (8%) required a treatment break, one with a body and 2 with head lesions. Two of these patients stopped RT short of planned dose (32.56 and 46.8 Gy) both suffering from nausea, vomiting, and anorexia with the third, who finished a planned 66.6 Gy dose, after a 4 day rest for leukopenia. One of 20 patients (5%) preop patients underwent the planned post chemo-RT Whipple resection, while 4 of the 20 patients (20%), remained unresectable, but without disease progression and had Iodine 125 interstitial implants at exploration delivering a minimal tumor dose of 120 Gy on top or the 50.4 Gy delivered preoperatively. Four patients (11%) maintained a minimal Karnofsky score of 100, 23 patients (62%) maintained a minimal KPS of 90, 6 patients (16%) maintained a minimal KPS of 80, and 4

Outcome analysis of 300 prostate cancer patients treated with neoadjuvant androgen deprivation and hypofractionated radiotherapy

International Nuclear Information System (INIS)

Higgins, Geoffrey S.; McLaren, Duncan B.; Kerr, Gillian R.; Elliott, Tony; Howard, Grahame

2006-01-01

Purpose: Neoadjuvant androgen deprivation and radical radiotherapy is an established treatment for localized prostate carcinoma. This study sought to analyze the outcomes of patients treated with relatively low-dose hypofractionated radiotherapy. Methods and Materials: Three hundred patients with T1-T3 prostate cancer were treated between 1996 and 2001. Patients were prescribed 3 months of neoadjuvant androgen deprivation before receiving 5250 cGy in 20 fractions. Patients' case notes and the oncology database were used to retrospectively assess outcomes. Median follow-up was 58 months. Results: Patients presented with prostate cancer with poorer prognostic indicators than that reported in other series. At 5 years, the actuarial cause-specific survival rate was 83.2% and the prostate-specific antigen (PSA) relapse rate was 57.3%. Metastatic disease had developed in 23.4% of patients. PSA relapse continued to occur 5 years from treatment in all prognostic groups. Independent prognostic factors for relapse included treatment near the start of the study period, neoadjuvant oral anti-androgen monotherapy rather than neoadjuvant luteinizing hormone releasing hormone therapy, and diagnosis through transurethral resection of the prostate rather than transrectal ultrasound. Conclusion: This is the largest reported series of patients treated with neoadjuvant androgen deprivation and hypofractionated radiotherapy in the United Kingdom. Neoadjuvant hormonal therapy did not appear to adequately compensate for the relatively low effective radiation dose used

Development and validation of a prognostic model for recurrent glioblastoma patients treated with bevacizumab and irinotecan

DEFF Research Database (Denmark)

Urup, Thomas; Dahlrot, Rikke Hedegaard; Grunnet, Kirsten

2016-01-01

Background Predictive markers and prognostic models are required in order to individualize treatment of recurrent glioblastoma (GBM) patients. Here, we sought to identify clinical factors able to predict response and survival in recurrent GBM patients treated with bevacizumab (BEV) and irinotecan....... Material and methods A total of 219 recurrent GBM patients treated with BEV plus irinotecan according to a previously published treatment protocol were included in the initial population. Prognostic models were generated by means of multivariate logistic and Cox regression analysis. Results In multivariate...

Long-Term Outcome in Levothyroxine Treated Patients With Subclinical Hypothyroidism and Concomitant Heart Disease.

Science.gov (United States)

Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager; Kristensen, Søren Lund; Faber, Jens; Torp-Pedersen, Christian; Gislason, Gunnar H; Selmer, Christian

2016-11-01

Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. This was a register-based historical cohort study. The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011. Patients were stratified according to whether they claimed a subsequent prescription of levothyroxine. Event rates and incidence rate ratios (IRR) were calculated by use of time-dependent multivariable Poisson regression models. Measures included all-cause mortality and major adverse cardiac events (MACEs), defined as cardiovascular death, fatal or nonfatal myocardial infaction and stroke, and all-cause hospital admissions. Of 61 611 patients with a diagnosis of cardiac disease having their first time thyroid function testing, 1192 patients with subclinical hypothyroidism (mean age 73.6 [SD ± 13.3] y, 63.8% female) were included, of whom 136 (11.4%) were treated with levothyroxine. During a median follow-up time of 5.6 y (interquartile range, 6.5 y), 694 (58.2%) patients died. Patients treated with levothyroxine displayed no significantly increased risk of all-cause mortality (adjusted IRR, 1.17; 95% confidence interval [CI], 0.90-1.52), MACE (adjusted IRR, 1.08; 95% CI, 0.80-1.45), or hospital admission (adjusted IRR, 0.94; 95% CI, 0.71-1.24), when compared with patients not treated with levothyroxine. Levothyroxine treatment in patients with subclinical hypothyroidism and heart disease was not associated with a significant benefit nor risk of all-cause mortality, MACE, or hospital admission in this large real-world cohort study.

Salivary gland function of nasopharyngeal cancer patients treated by simultaneous modulated accelerated radiation therapy

International Nuclear Information System (INIS)

Zhang Qi; Li Huanbin; Wang Ling

2007-01-01

The work was to study protective effect of simultaneous modulated accelerated radiation therapy (SMART) on salivary function of nasopharyngeal cancer patients. Forty-six patients were treated by SMART with 2.5Gy/fraction at gross tumor volume to a total does of 70 Gy, and 2.0 Gy/fraction at the clinical treatment volume to a total does of 56 Gy. The SMART was practiced in step-and-shoot mode, one time a day, and five times each week. Fourteen patients were treated by conventional radiation therapy. All the patients received salivary gland function imaging for their uptake index, excretive index and excretive speed, so as to evaluate their degree of salivary function injury. Meanwhile, the dry discomfort in mouth of the patients was recorded and classified. The results showed that the functional indexes of the SMART group were significantly higher than those of the conventional radiation therapy group (P 2 =23.52, P<0.005). Therefore, SMART can play a key role in protecting salivary gland function of naso- pharyngeal cancer patients. (authors)

Artificial neural network analysis to assess hypernasality in patients treated for oral or oropharyngeal cancer

NARCIS (Netherlands)

de Bruijn, Marieke; ten Bosch, Louis; Kuik, Dirk J.; Langendijk, Johannes A.; Leemans, C. Rene; Verdonck-de Leeuw, Irma

2011-01-01

Objective. Investigation of applicability of neural network feature analysis of nasalance in speech to assess hypernasality in speech of patients treated for oral or oropharyngeal cancer. Patients and methods. Speech recordings of 51 patients and of 18 control speakers were evaluated regarding

Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

International Nuclear Information System (INIS)

Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

2011-01-01

Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

Science.gov (United States)

Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

2011-11-01

Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

Handwriting Movement Analyses for Monitoring Drug-Induced Motor Side Effects in Schizophrenia Patients Treated with Risperidone

Science.gov (United States)

Caligiuri, Michael P.; Teulings, Hans-Leo; Dean, Charles E.; Niculescu, Alexander B.; Lohr, James

2009-01-01

Epidemiologic studies indicate that nearly 60% of schizophrenia (SZ) patients treated with conventional antipsychotic drugs develop extrapyramidal side effects (EPS) such as parkinsonism and tardive dyskinesia. Although the prevalence of EPS has decreased due to the newer antipsychotics, EPS continue to limit the effectiveness of these medicines. Ongoing monitoring of EPS is likely to improve treatment outcome or compliance and reduce the frequency of re-hospitalization. A quantitative analysis of handwriting kinematics was used to evaluate effects of antipsychotic medication type and dose in schizophrenia patients. Twenty-seven schizophrenia patients treated with risperidone, six schizophrenia patients who received no antipsychotic medication and 46 healthy comparison participants were enrolled. Participants performed a 20-minute handwriting task consisting of loops of various sizes and a sentence. Data were captured and analyzed using MovAlyzeR software. Results indicated that risperidone-treated participants exhibited significantly more dysfluent handwriting movements than either healthy or untreated SZ participants. Risperidone-treated participants exhibited lower movement velocities during production of simple loops compared to unmedicated patients. Handwriting dysfluency during sentence writing increased with dose. A 3-factor model consisting of kinematic variables derived from sentence writing accounted for 83% (r = .91) of the variability in medication dose. In contrast, we found no association between observer-based EPS severity ratings and medication dose. These findings support the importance of handwriting-based measures to monitor EPS in medicated schizophrenia patients. PMID:19692133

Quality of life of patients treated with radiotherapy

Directory of Open Access Journals (Sweden)

Adrianna Rożniecka-Hełmińska

2018-03-01

Full Text Available Abstract: Radiotherapy is one of the most commonly used anticancer treatments. Despite continuous technological development it may cause adverse symptoms, and as a result reduce the quality of life in patients undergoing radiation therapy. Objective of the work: Analysis of the quality of life of patients treated with radiation therapy and the effect determination of selected factors and their clinical complications on the quality of life of oncological patients. Material and methods: The study included 100 patients diagnosed with cancer, including 47 (47% women and 53 (53% men, with an average age of 62.1 (± 9.47 years. The study used a standardized questionnaire EORTC QLQ-C30, in assessing the quality of life of cancer patients and a questionnaire of our own design containing sociodemographic and clinical data. The collected empirical data were analyzed statistically. The level of significance was p <0.05. Results: In the group of patients tested the average rate the overall quality of life was 50.5 (± 16.28 with a median of 50. The highest quality of life in the test reported in the field of cognitive functioning, and the lowest in the area of social functioning. In 72% of patients experienced complications of radiotherapy. During the analysis, it was found that the overall quality of life and functioning in all domains is lower comparing to the results of patients with no side effects of treatment. The analysis also found that in patients with head and neck cancer, which are irradiated at the same area, the level of cognitive functioning is significantly lower than the level of functioning in the same domain patients irradiated in the chest area (p <0.008 and in the area of reproductive organs (p <0.007. Conclusions: There is a diversity of quality of life of patients with and without complications of treatment with ionizing radiation, which have a significant impact on the quality of life of cancer patients. Location area irradiated

Obesity predicts for arm edema in conservatively treated breast cancer patients

International Nuclear Information System (INIS)

Werner, R.S.; McCormick, B.; Gray, J.R.; Cox, L.; Cirrincione, C.; Petrek, J.A.; Yahalom, J.

1990-01-01

This paper identifies risk factors for arm edema (AE) following breast-conserving surgery and radiation therapy. Upper and lower arm circumferences were measured at interval follow-up visits in 284 patients. A different of 2.5 cm or more in either measurement (treated vs untreated arms) defined AE. Possible predictors for AE examined by univariate and multivariate analysis included level of dissection; number of nodes removed; number involved; tumor size and location; use of supraclavicular fields; patient age, weight, and size (tangent separation measurement); and systemic therapy

Monocytic myeloid-derived suppressor cells as prognostic factor in chronic myeloid leukaemia patients treated with dasatinib.

Science.gov (United States)

Giallongo, Cesarina; Parrinello, Nunziatina L; La Cava, Piera; Camiolo, Giuseppina; Romano, Alessandra; Scalia, Marina; Stagno, Fabio; Palumbo, Giuseppe A; Avola, Roberto; Li Volti, Giovanni; Tibullo, Daniele; Di Raimondo, Francesco

2018-02-01

Myeloid suppressor cells are a heterogeneous group of myeloid cells that are increased in patients with chronic myeloid leukaemia (CML) inducing T cell tolerance. In this study, we found that therapy with tyrosine kinase inhibitors (TKI) decreased the percentage of granulocytic MDSC, but only patients treated with dasatinib showed a significant reduction in the monocytic subset (M-MDSC). Moreover, a positive correlation was observed between number of persistent M-MDSC and the value of major molecular response in dasatinib-treated patients. Serum and exosomes from patients with CML induced conversion of monocytes from healthy volunteers into immunosuppressive M-MDSC, suggesting a bidirectional crosstalk between CML cells and MDSC. Overall, we identified M-MDSC as prognostic factors in patients treated with dasatinib. It might be of interest to understand whether MDSC may be a candidate predictive markers of relapse risk following TKI discontinuation, suggesting their potential significance as practice of precision medicine. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Systemic mastocytosis in a patient with polycythemia vera treated with radioactive phosphorus

International Nuclear Information System (INIS)

Eagan, J.W. Jr.; Baughman, K.L.; Miller, S.; Conley, C.L.; Eggleston, J.C.

1977-01-01

Systemic mastocytosis occurred as a fatal event in a patient with long-standing polycythemia vera. The patient had been treated over the course of 21 yr with radioactive phosphorus. Possible relationships between mastocytosis and polycythemia vera, and also between mastocytosis and treatment with ionizing radiation, are discussed. Histopathologic and electron microscopic findings are illustrated. Difficulties in establishing the diagnosis of mast cell disease in this setting are also described

The prognostic importance of heart failure and age in patients treated with primary angioplasty

NARCIS (Netherlands)

Henriques, Jose P. S.; Zijlstra, Felix; de Boer, Menko-Jan; van 't Hof, Arnoud W. J.; Gosselink, A. T. Marcel; Dambrink, Jan-Henk E.; Suryapranata, Harry; Hoorntje, Jan C. A.

2003-01-01

Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction. The prognostic value of heart failure defined by Killip

Early prognostication markers in cardiac arrest patients treated with hypothermia.

Science.gov (United States)

Karapetkova, M; Koenig, M A; Jia, X

2016-03-01

Established prognostication markers, such as clinical findings, electroencephalography (EEG) and biochemical markers, used by clinicians to predict neurological outcome after cardiac arrest (CA) are altered under therapeutic hypothermia (TH) conditions and their validity remains uncertain. MEDLINE and Embase were searched for evidence on the current standards for neurological outcome prediction for out-of-hospital CA patients treated with TH and the validity of a wide range of prognostication markers. Relevant studies that suggested one or several established biomarkers and multimodal approaches for prognostication are included and reviewed. Whilst the prognostic accuracy of various tests after TH has been questioned, pupillary light reflexes and somatosensory evoked potentials are still strongly associated with negative outcome for early prognostication. Increasingly, EEG background activity has also been identified as a valid predictor for outcome after 72 h after CA and a preferred prognostic method in clinical settings. Neuroimaging techniques, such as magnetic resonance imaging and computed tomography, can identify functional and structural brain injury but are not readily available at the patient's bedside because of limited availability and high costs. A multimodal algorithm composed of neurological examination, EEG-based quantitative testing and somatosensory evoked potentials, in conjunction with newer magnetic resonance imaging sequences, if available, holds promise for accurate prognostication in CA patients treated with TH. In order to avoid premature withdrawal of care, prognostication should be performed more than 72 h after CA. © 2015 EAN.

Prediabetes in patients treated with antipsychotic drugs.

Science.gov (United States)

Manu, Peter; Correll, Christoph U; van Winkel, Ruud; Wampers, Martien; De Hert, Marc

2012-04-01

In 2010, the American Diabetes Association (ADA) proposed that individuals with fasting glucose level of 100-125 mg/dL (5.6-6.9 mmol/L) or glucose level of 140-199 mg/dL (7.8-11.0 mmol/L) 2 hours after a 75-g oral glucose tolerance test or hemoglobin A(1c) 5.7%-6.4% be classified as prediabetic, indicating increased risk for the emergence of diabetes mellitus. At the same time, the ADA formulated guidelines for the use of metformin for the treatment of prediabetes. To determine the prevalence of prediabetes in a cohort of psychiatrically ill adults receiving antipsychotics and to compare the clinical and metabolic features of prediabetic patients with those of patients with normal glucose tolerance and those with diabetes mellitus. The 2010 ADA criteria were applied to a large, consecutive, single-site European cohort of 783 adult psychiatric inpatients (mean age: 37.6 years) without a history of diabetes who were receiving antipsychotics. All patients in this cross-sectional study underwent measurement of body mass index (BMI), waist circumference, oral glucose tolerance test, and fasting insulin and lipids from November 2003 through July 2007. 413 patients (52.8%) had normal glucose tolerance, 290 (37.0%) had prediabetes, and 80 (10.2%) had diabetes mellitus. The fasting glucose and/or hemoglobin A(1c) criteria were met by 89.7% of prediabetic patients. A statistically significant intergroup gradient from normal glucose tolerance to prediabetes and from prediabetes to diabetes mellitus was observed for waist circumference, triglycerides, fasting insulin levels, and frequency of metabolic syndrome (P = .02 to P prediabetic patients (6.6%) met the 2010 ADA criteria for treatment with metformin. Prediabetes is highly prevalent in adults treated with antipsychotic drugs and correlates with markers of increased intraabdominal adiposity, enhanced lipolysis, and insulin resistance. Criteria for using metformin to prevent the emergence of diabetes mellitus may need to be

Influence of race on outcome in patients treated with breast conserving therapy

International Nuclear Information System (INIS)

Campbell, T.; Heimann, R.; Powers, C.; Vijayakumar, S.; Ewing, C.; Halpern, H.; Michel, A.; Rubin, S.; Weichselbaum, R.

1995-01-01

PURPOSE: Race is reported to correlate with outcome in breast cancer with African Americans (AA) having worse outcome compared to whites. However, little data is available from large standardized series of patients with early stage breast cancer. We report here the influence of race on local control (LC), disease free survival (DFS), cause specific survival (CSS) and overall survival (OS) for patients treated at our center with breast conserving therapy (BCT). MATERIALS AND METHODS: From a database of 925 patients treated between 1977 and 1993 with BCT for early stage invasive breast cancer, a total of 892 patients were available for study after excluding non-AA/non-white patients. Median age of patients was 56 years. Median follow-up was 35 months (range, 2 to 166). All patients underwent lumpectomy and radiation therapy(RT). Seven hundred eighty-six (88%) patients had axillary dissection. Median RT dose was 6000cGy with 90% of patients receiving 6000cGy or more. Two hundred fifty (28%) had chemotherapy, 327(37%) had tamoxifen and 64(7%) had both. T stage distribution was as follows: 632 T1 (71%), 244 T2 (27%), 12 T3 (1%) and 4 unknown ( 4cm (5 vs 1%)(p=0.001) or were unknown size (10 vs 6%)(p=.001). Comparing AA and whites yielded 5 yr actuarial LC (94 vs 94%)(p=0.380), DFS (83 vs 85%)(p=0.120), CSS (84 vs 85%)(p=0.201) and OS (77 vs 80%)(p=0.112). Multivariate analysis demonstrated that the number of positive nodes was the strongest predictor of OS (p<.001) and although race did not reach statistical significance as an independent prognostic factor, a trend was demonstrated (p=.106). Sub-group analysis of 186 patients with ER/PR negative tumors showed significantly worse DFS (75 vs 93%)(p=0.005), CSS (79 vs 91%)(p=0.021) and OS (76 vs 89%)(p=0.011) for AA patients. Race was demonstrated to be an independent prognostic factor by multivariate analysis in this sub-group (p=.024). No significant differences by race were apparent in patients grouped by tumor size

Study on Blood Cortisol in Patients treated with Oral Corticosteroid Drugs

International Nuclear Information System (INIS)

Park, J. H.; Kim, K. W.; Yoo, H. S.; Lee, J. T.; Park, C. Y.; Ryu, K. J.

1980-01-01

This is an analysis of 32 patients who received long continuous corticosteroid drug due to some diseases. Patients were collected from June 1976 to March 1980. Blood cortisol level, variation of diurnal rhythm and side effects were studied. The Result as follows: 1) Side effects were observed in 24 patients (75%) and most common complaint was obesity. 2) Diurnal rhythm analysed by Doe's method shows abnormal diurnal rhythm is 21 out 32 (66%) 3) Mean durations of therapy of abnormal diurnal rhythm were 55.7±4.4 months and 43.9±7.0 months respectively which shows statistically significant difference. 4) Mean cortisol value of steroid treated patients were lower than normal. 5) Reverse diurnal rhythm was 4 out of 21 patients. 6) 8 A.M. cortisol value is lower than 2 times of 8 P.M. in all patients who showed abnormal diurnal rhythm except one.

Predictive value of bcl-2 immunoreactivity in prostate cancer patients treated with radiotherapy

International Nuclear Information System (INIS)

Bylund, A.; Widmark, A.; Stattin, P.; Bergh, A.

1998-01-01

Background and purpose: Recent experimental evidence suggests that overexpression of bcl-2, a protein functioning by blocking apoptosis, may influence the treatment outcome in human tumours, including prostate cancer. To test the clinical implications of this hypothesis, tumours from patients with prostate cancer treated with external beam radiotherapy were investigated for bcl-2 immunoreactivity (IR) and correlated with prognosis and treatment outcome. Materials and methods: Bcl-2 IR was evaluated in archival tumour specimens obtained through transurethral resection from 42 patients with localized prostate cancer (T0-T4, N0 and M0). Bcl-2 IR expression was related to stage, grade and cancer-specific survival. Specimens were obtained prior to administrating routine radiotherapy for all patients. Results: Bcl-2 IR was present in 19/42 (45%) tumours. The bcl-2-positive patients had a significantly longer cancer-specific survival than the bcl-2-negative patients (10.3 versus 3.4 years, P<0.04). At follow-up (7-19 years), nine patients were still alive, 26 patients had died of prostate cancer and seven patients had died of other causes. Conclusions: This study indicates that pre-treatment bcl-2 overexpression is related to a favourable outcome in prostate cancer treated with radiotherapy. Low bcl-2 along with a high stage may be a predictor of poor prognosis and these patients might benefit from additional treatment. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

Patterns of Radiation Therapy Practice for Patients Treated for Intact Cervical Cancer in 2005 to 2007: A Quality Research in Radiation Oncology Study

Energy Technology Data Exchange (ETDEWEB)

Eifel, Patricia J., E-mail: peifel@mdanderson.org [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ho, Alex; Khalid, Najma [American College of Radiology Clinical Research Center, Philadelphia, Pennsylvania (United States); Erickson, Beth [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Owen, Jean [American College of Radiology Clinical Research Center, Philadelphia, Pennsylvania (United States)

2014-06-01

Purpose: To assess practice patterns and compliance with clinical performance measures for radiation therapy (RT) for patients with intact carcinoma of the cervix. Methods and Materials: Trained research associates reviewed the records of 261 randomly selected patients who received RT for cervix carcinoma between 2005 and 2007 from 45 facilities randomly selected after stratification by practice type. National estimates of patient and treatment characteristics were calculated from survey data using SUDAAN statistical software. Results: From the survey data, we estimated that only 8% of US facilities treated on average more than 3 eligible patients per year. No small or medium nonacademic facilities in the survey treated more than 3 eligible patients per year. Approximately 65.5% of patients began treatment in a facility that treated 3 or fewer eligible patients per year. Although 87.5% of patients had brachytherapy as part of their treatment, the proportion treated with external beam RT only was about double that estimated from the 1996 to 1999 survey. The use of high-dose-rate brachytherapy sharply increased, particularly in small nonacademic facilities. Overall, patients treated in nonacademic facilities were more likely to have incomplete or protracted treatment; 43% of patients treated in small nonacademic facilities did not have treatment completed within 10 weeks. Also, patients treated in facilities that treated 3 or fewer eligible patients per year were significantly less likely to receive concurrent chemotherapy than were patients treated in other facilities. Conclusion: Survey results indicate a disturbingly high rate of noncompliance with established criteria for high-quality care of patients with cervical cancer. Noncompliance rates are particularly high in nonacademic facilities, especially those that treat relatively few patients with intact cervical cancer.

Bone densitometry in pediatric patients treated with pamidronate

Energy Technology Data Exchange (ETDEWEB)

Grissom, Leslie E.; Kecskemethy, Heidi H.; Harcke, H.Theodore [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Department of Medical Imaging, P.O. Box 269, Wilmington, DE (United States); Bachrach, Steven J. [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Division of General Pediatrics, P.O. Box 269, Wilmington, DE (United States); McKay, Charles [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Division of Nephrology, P.O. Box 269, Wilmington, DE (United States)

2005-05-01

To determine the effect of intravenous pamidronate on the bone mineral density of children with osteogenesis imperfecta and spastic quadriplegic cerebral palsy. Charts of 38 children with osteogenesis imperfecta (n=20) and spastic quadriplegic cerebral palsy (n=18) treated with pamidronate were retrospectively reviewed. Patients were selected for treatment because of prior fracture and/or abnormally low bone mineral density. All received intravenous pamidronate at two-month to eight-month intervals and were periodically examined using dual energy X-ray absorptiometry. All patients had abnormally low bone mineral density prior to treatment. Lumbar spine bone mineral density and z-scores showed serial improvement in 31 of 32 patients. Spine bone mineral density increased 78{+-}38.1% in OI and 47.4{+-}39.0% in children with cerebral palsy. The area of greatest lateral distal femur bone mineral density improvement was in the metaphysis adjacent to the growth plate, with a 96{+-}87.8% improvement in the osteogenesis imperfecta group and 65.7{+-}55.2% improvement in the cerebral palsy group. Increases in bone mineral density exceeded that expected for age-specific growth. This was demonstrated by improvement in both spine and femur z-scores for both groups. No children with spastic quadriplegic cerebral palsy experienced fractures after the first week of treatment, whereas patients with osteogenesis imperfecta continued to have fractures but at a decreased rate. (orig.)

Bone densitometry in pediatric patients treated with pamidronate

International Nuclear Information System (INIS)

Grissom, Leslie E.; Kecskemethy, Heidi H.; Harcke, H.Theodore; Bachrach, Steven J.; McKay, Charles

2005-01-01

To determine the effect of intravenous pamidronate on the bone mineral density of children with osteogenesis imperfecta and spastic quadriplegic cerebral palsy. Charts of 38 children with osteogenesis imperfecta (n=20) and spastic quadriplegic cerebral palsy (n=18) treated with pamidronate were retrospectively reviewed. Patients were selected for treatment because of prior fracture and/or abnormally low bone mineral density. All received intravenous pamidronate at two-month to eight-month intervals and were periodically examined using dual energy X-ray absorptiometry. All patients had abnormally low bone mineral density prior to treatment. Lumbar spine bone mineral density and z-scores showed serial improvement in 31 of 32 patients. Spine bone mineral density increased 78±38.1% in OI and 47.4±39.0% in children with cerebral palsy. The area of greatest lateral distal femur bone mineral density improvement was in the metaphysis adjacent to the growth plate, with a 96±87.8% improvement in the osteogenesis imperfecta group and 65.7±55.2% improvement in the cerebral palsy group. Increases in bone mineral density exceeded that expected for age-specific growth. This was demonstrated by improvement in both spine and femur z-scores for both groups. No children with spastic quadriplegic cerebral palsy experienced fractures after the first week of treatment, whereas patients with osteogenesis imperfecta continued to have fractures but at a decreased rate. (orig.)

Outcome of Patients Treated With a Single-Fraction Dose of Palliative Radiation for Cutaneous T-Cell Lymphoma

International Nuclear Information System (INIS)

Thomas, Tarita O.; Agrawal, Priya; Guitart, Joan; Rosen, Steven T.; Rademaker, Alfred W.; Querfeld, Christiane; Hayes, John P.; Kuzel, Timothy M.; Mittal, Bharat B.

2013-01-01

Purpose: Cutaneous T-cell lymphoma (CTCL) is a radiosensitive tumor. Presently, treatment with radiation is given in multiple fractions. The current literature lacks data that support single-fraction treatment for CTCL. This retrospective review assesses the clinical response in patients treated with a single fraction of radiation. Methods and Materials: This study reviewed the records of 58 patients with CTCL, primarily mycosis fungoides, treated with a single fraction of palliative radiation therapy (RT) between October 1991 and January 2011. Patient and tumor characteristics were reviewed. Response rates were compared using Fisher's exact test and multiple logistic regressions. Survival rates were determined using the Kaplan-Meier method. Cost-effectiveness analysis was performed to assess the cost of a single vs a multifractionated treatment regimen. Results: Two hundred seventy individual lesions were treated, with the majority (97%) treated with ≥700 cGy; mean follow-up was 41.3 months (range, 3-180 months). Response rate by lesion was assessed, with a complete response (CR) in 255 (94.4%) lesions, a partial response in 10 (3.7%) lesions, a partial response converted to a CR after a second treatment in 4 (1.5%) lesions, and no response in 1 (0.4%) lesion. The CR in lower extremity lesions was lower than in other sites (P=.0016). Lesions treated with photons had lower CR than those treated with electrons (P=.017). Patients with lesions exhibiting large cell transformation and tumor morphology had lower CR (P=.04 and P=.035, respectively). Immunophenotype did not impact response rate (P=.23). Overall survival was significantly lower for patients with Sézary syndrome (P=.0003) and erythroderma (P 200% higher than that for single-fraction radiation. Conclusions: A single fraction of 700 cGy-800 cGy provides excellent palliation for CTCL lesions and is cost effective and convenient for the patient

Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum

International Nuclear Information System (INIS)

Melichar, Bohuslav; Hyšpler, Radomír; Dragounová, Emanuela; Dvořák, Josef; Kalábová, Hana; Tichá, Alena

2007-01-01

Combination of platinum derivatives with paclitaxel is currently the standard front line regimen for patients with epithelial ovarian carcinoma, and represents also an active regimen in patients with metastatic breast or unknown primary carcinomas. Measurement of intestinal permeability represents one of the potential methods of noninvasive laboratory assessment of gastrointestinal mucositis induced by chemotherapy, but little is known about intestinal permeability in patients treated with paclitaxel or platinum. Intestinal permeability was assessed in 36 breast and ovarian cancer patients treated with paclitaxel/platinum combination by measuring, using capillary gas chromatography, urinary sucrose, lactulose, xylose and mannitol after oral challenge. The significance of differences during the therapy compared to pre-treatment values was studied by Wilcoxon paired test. The differences between groups of patient were studied by Mann-Whitney U test. Fisher exact test was used to compare the frequency in different subgroups. After administration of the first dose, a significant (p < 0.05) decrease in xylose absorption and increased lactulose/mannitol, sucrose/mannitol, lactulose/xylose and sucrose/xylose ratios were observed, but these parameters returned subsequently to pre-treatment levels. Patients who experienced serious (grade 3 or 4) toxicity had at baseline significantly lower percentages of xylose, mannitol and sucrose, and higher lactulose/mannitol ratio. Nine of 13 (69%) patients with baseline lactulose/mannitol ratio 0.070 or above experienced serious toxicity compared to 4 out of 23 patients (17%) with the ratio below 0.070 (p = 0.002). Post-treatment lactulose, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were significantly increased in patients with serious toxicity. A transient significant increase in lactulose/monosaccharide and sucrose/monosaccharide ratios was observed in ovarian and breast cancer patients treated with paclitaxel

Clobazam-Treated Patients with Lennox Gastaut Syndrome Experienced Fewer Seizure-Related Injuries than Placebo Patients During Trail OV-1012

Science.gov (United States)

2016-08-19

severe seizure- related AEs occurred in the placebo group, with three patients experiencing one severe AE each (fall, contusion, or jaw fracture ). In all...only one non–seizure- related injury, and therefore no evidence to suggest that the drug was associated with injuries. The analysis also helps to...Clobazam-treated patients with Lennox-Gastaut syndrome experienced fewer seizure- related injuries than placebo patients during trial OV-1012 *Jouko

Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin

Science.gov (United States)

Lolis, Nikolaos; Veldekis, Dimitrios; Moraitou, Hellen; Kanavaki, Sofia; Velegraki, Aristea; Triandafyllidis, Charis; Tasioudis, Chronis; Pefanis, Angellos; Pneumatikos, Ioannis

2008-01-01

We describe a case of Saccharomyces boulardii fugaemia in a critically ill patient with septic shock treated with a probiotic agent containing this yeast. We attributed this fugaemia to gut translocation. Our use of caspofugin yielded excellent results. PMID:18423057

Circulating Tumor Cells in Breast Cancer Patients Treated by Neoadjuvant Chemotherapy: A Meta-analysis.

Science.gov (United States)

Bidard, François-Clément; Michiels, Stefan; Riethdorf, Sabine; Mueller, Volkmar; Esserman, Laura J; Lucci, Anthony; Naume, Bjørn; Horiguchi, Jun; Gisbert-Criado, Rafael; Sleijfer, Stefan; Toi, Masakazu; Garcia-Saenz, Jose A; Hartkopf, Andreas; Generali, Daniele; Rothé, Françoise; Smerage, Jeffrey; Muinelo-Romay, Laura; Stebbing, Justin; Viens, Patrice; Magbanua, Mark Jesus M; Hall, Carolyn S; Engebraaten, Olav; Takata, Daisuke; Vidal-Martínez, José; Onstenk, Wendy; Fujisawa, Noriyoshi; Diaz-Rubio, Eduardo; Taran, Florin-Andrei; Cappelletti, Maria Rosa; Ignatiadis, Michail; Proudhon, Charlotte; Wolf, Denise M; Bauldry, Jessica B; Borgen, Elin; Nagaoka, Rin; Carañana, Vicente; Kraan, Jaco; Maestro, Marisa; Brucker, Sara Yvonne; Weber, Karsten; Reyal, Fabien; Amara, Dominic; Karhade, Mandar G; Mathiesen, Randi R; Tokiniwa, Hideaki; Llombart-Cussac, Antonio; Meddis, Alessandra; Blanche, Paul; d'Hollander, Koenraad; Cottu, Paul; Park, John W; Loibl, Sibylle; Latouche, Aurélien; Pierga, Jean-Yves; Pantel, Klaus

2018-04-12

We conducted a meta-analysis in nonmetastatic breast cancer patients treated by neoadjuvant chemotherapy (NCT) to assess the clinical validity of circulating tumor cell (CTC) detection as a prognostic marker. We collected individual patient data from 21 studies in which CTC detection by CellSearch was performed in early breast cancer patients treated with NCT. The primary end point was overall survival, analyzed according to CTC detection, using Cox regression models stratified by study. Secondary end points included distant disease-free survival, locoregional relapse-free interval, and pathological complete response. All statistical tests were two-sided. Data from patients were collected before NCT (n = 1574) and before surgery (n = 1200). CTC detection revealed one or more CTCs in 25.2% of patients before NCT; this was associated with tumor size (P < .001). The number of CTCs detected had a detrimental and decremental impact on overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P < .001), but not on pathological complete response. Patients with one, two, three to four, and five or more CTCs before NCT displayed hazard ratios of death of 1.09 (95% confidence interval [CI] = 0.65 to 1.69), 2.63 (95% CI = 1.42 to 4.54), 3.83 (95% CI = 2.08 to 6.66), and 6.25 (95% CI = 4.34 to 9.09), respectively. In 861 patients with full data available, adding CTC detection before NCT increased the prognostic ability of multivariable prognostic models for overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P = .008). CTC count is an independent and quantitative prognostic factor in early breast cancer patients treated by NCT. It complements current prognostic models based on tumor characteristics and response to therapy.

Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas

DEFF Research Database (Denmark)

Kristensen, Diana; Bauer, Jeanett; Pedersen, Ida Hageman

2011-01-01

To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). We examined charts from 79 patients diagnosed with schizophrenia (n = 55), persistent delusional disorders (n = 7), and schizoaffective disorders (n = 17) between 2003...

Outcomes in 24 selected patients with stage IVB cervical cancer and excellent performance status treated with radiotherapy and chemotherapy

International Nuclear Information System (INIS)

Zighelboim, Israel; Taylor, Nicholas P.; Powell, Matthew A.; Gibb, Randall K.; Rader, Janet S.; Mutch, David G.; Grigsby, Perry W.

2006-01-01

We sought to review outcomes in patients with stage IVB carcinoma of the cervix treated with irradiation in combination with chemotherapy. We report outcomes of 24 consecutive patients with good performance status treated from 1998 to 2005. Most of these patients underwent concurrent irradiation with platinum-based chemotherapy. Some patients received subsequent systemic chemotherapy. All patients underwent external beam radiotherapy; 7 patients (29%) had additional high-dose-rate and 12 (50%) low-dose-rate brachytherapy. Two patients (8%) received an intensity modulated radiation therapy (IMRT) boost instead of brachytherapy. The mean dose to point A was variable (73.9±19.2 Gy). Twenty patients (83%) received radio-sensitizing platinum-based chemotherapy, and the remaining had radiotherapy alone. Seven patients (29%) had further combination chemotherapy. Therapy was well tolerated. The overall survival was 44% at 36 months and 22% at 5 years. Patients with stage IVB cervical cancer have mostly been treated with palliative intent. With the advent of concurrent chemoradiation, we have treated many of these cases with aggressive combination therapy. In this series, the use of radiotherapy and multiagent chemotherapy in patients with stage IVB cervical carcinoma and good performance status was well tolerated and resulted in higher survival rates than previously reported. (author)

123I-IBZM SPECT in schizophrenic patients treated with quetiapine

International Nuclear Information System (INIS)

Pavics, L.; Szekeres, G.; Janka, Z.

2002-01-01

Full text: Quetiapine is a novel antipsychotic substance with relative short half-life and low affinity for D2 dopamine receptors. PET and SPECT studies demonstrated individually different D2 receptor occupancy during quetiapine monotherapy. In the present study D2 receptor occupancy was investigated in quetiapine treated schizophrenic patients for the detection of the relationship between the scintigraphic pattern and clinical sign and symptoms. In 10 schizophrenic patients (7 woman, 3 man, age ±SD: 34 ±7 PANSS: 72 ±20) IBZM SPECT (185 MBq, acquisition was started 90 min p.i.) were performed during introduction of quetiapine therapy (600-800 mg/day) and during a lower preservation dose (200-400 mg/day). All the patients were under quetiapine monotherapy. Simultaneously to the SPECT investigations visual contrast standardized rating scales determined sensitivity, clinical symptoms and extrapyramidal signs. For the evaluation of SPECT images visual interpretation and striatum/occipital lobe (S/O) activity ratio was calculated. The striatum/occipital lobe ratio at the first investigation was 1.7 ± 0.23 at the second 1.68 ± 0.12. The receptor occupancy was individually different but no significant difference was observed in relation to the quetiapine dose used. There was no significant difference in PANNSS and no patients had extrapyramidal signs. In 5 patients in clinical steady state decreasing the dose of quetiapine the S/O ratio increased by 1-35 % without long term relapse but in 5 with decreasing S/O ratio (9-29 %) clinical relapse of the disease were observed. The IBZM uptake changes correlated with the time interval until the relapse, but not with the PANNS changes. The initial striatum/occipital ratio was also significantly higher in the group of patients with relapse (over 1.8) compared to the other group. There were no relationship between the initial D2 receptor occupancy and the PANNS changes and the interval until the relapse. Endogen dopamin

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

Science.gov (United States)

Karaduman, Mert

2007-01-01

Cierny-Mader (C-M) Type III osteomyelitis is defined as a localised lesion with both medullary and cortical involvement that is stable mechanically after debridement. The treatment of C-M Type III osteomyelitisis is difficult and requires a precise protocol to achieve a disease-free long-term follow-up. We report here the results of our study on 26 patients (19 men and 7 women; average age: 34.7 years) with C-M Type III osteomylelitis who were treated with radical debridement, irrigation, vancomycin-impregnated custom-made beads and culture-specific systemic antibiotics. Those patients with metaphyseal involvement were treated with deroofing of the cortex and debridement by means of a “trough” (16 patients); those with diaphyseal involvement were treated with both intramedullary reaming and debridement from a trough (ten patients). Antibiotic cement rods were used as an additional therapy in five patients with diaphyseal involvement. Recurrence developed in three patients and was attributed to inadequate debridement; all three patients were treated again in the same manner with success. The mean follow-up is currently 3.6 years (range: 2–6 years). All of the patients have normal clinical, radiographic and laboratory parameters, and all are ambulatory and have returned to their pretreatment level of activity or better. We conclude that C-M Type III chronic osteomyelitis can be safely treated with this protocol. PMID:17375299

PCSK9 Inhibitors: Treating the Right Patients in Daily Practice.

Science.gov (United States)

King, Peta; Nicholls, Stephen J

2017-08-01

Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a novel approach to low-density lipoprotein cholesterol (LDL-C) lowering. The potential role of PCSK9 inhibitors in clinical practice will be reviewed. Clinical trials have demonstrated that PCSK9 inhibitors produce robust LDL-C lowering when administered either as monotherapy or in combination with statins. This provides the opportunity to achieve effective lipid lowering in familial hypercholesterolemia, patients with either established atherosclerotic cardiovascular disease or high risk primary prevention and an important opportunity to treat patients with statin intolerance. The findings from plaque imaging and patients with established atherosclerotic cardiovascular disease suggest that PCSK9 inhibition has favorable outcomes beyond improving lipid profiles, which has the opportunity to expand their use. PCSK9 inhibitors represent a new approach to achieving effective cardiovascular risk reduction in a broader number of patients. How these agents will be taken up in clinical practice remains to be determined.

Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

DEFF Research Database (Denmark)

Schenkeveld, Lisanne; Pedersen, Susanne S.; van Nierop, Josephine W I

2010-01-01

Health status has become increasingly important as an outcome measure in patients with cardiovascular disease. Poor patient-rated health status has been shown to predict mortality in patients with coronary artery disease and heart failure. In patients treated with percutaneous coronary interventi...

Visceral leishmaniasis in a patient with rheumatoid arthritis treated with methotrexate.

Science.gov (United States)

Loarce-Martos, Jesús; Garrote-Corral, Sandra; Gioia, Francesca; Bachiller-Corral, Javier

2017-09-25

A large number of complications have been associated with rheumatoid arthritis (RA), those of infectious etiology being of special relevance. Their high incidence is closely linked to the use of immunosuppressive medication. The spectrum of agents causing opportunistic infections in patients with RA is very broad; however, there are relatively few cases of Leishmania infection, especially in patients not being treated with biological drugs. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Longitudinal PET evaluation of cerebral glucose metabolism in rivastigmine treated patients with mild Alzheimer's disease

International Nuclear Information System (INIS)

Stefanova, E.; Forsberg, A.; Wall, A.; Nilsson, A.; Langstroem, B.; Almkvist, O.; Nordberg, A.

2006-01-01

In this study 11 patients with mild Alzheimer's disease (AD) were treated with the cholinesterase inhibitor rivastigmine (mean dose 8.6 ± 1.3 mg) for 12 months and underwent positron emission tomography (PET) studies of cerebral glucose metabolism (CMRglc) and neuropsychological testing at baseline and after 12 months. An untreated group of 10 AD patients served as control group. While the untreated AD patients showed a significant decline of CMRglc in the temporo-parietal and frontal cortical regions after 12 months follow-up the rivastigmine-treated patients showed no decline in CMRglc in corresponding cortical brain regions. Furthermore, a significant dose-related increase in CMRglc was recorded in the right frontal association region after 12 months rivastigmine treatment. A positive correlation was observed between changes in CMRglc and several cognitive tests in patients receiving higher doses (10.5-12 mg) of rivastigmine. These results suggest a stabilization effect of rivastigmine on CMRglc in mild AD patients receiving long-term rivastigmine treatment. (author)

Preliminary result in patients with primary hepatoma treated by stereotactic radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Kang, Ki Mun; Choi, Ihl Bohng; Kim, In Ah; Choi, Byung Ock; Kang, Young Nam; Han, Sung Tae; Chung, Gyu Won [College of Medicine, Catholic Univ., Seoul (Korea, Republic of); Chai, Gyu Young [College of Medicine, Gyeongsang National Univ., Chinju (Korea, Republic of)

2001-03-01

It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of 44-66 year old (median: 59) and the tumor size of 10-825 cc (median: 185 cc). SRT was given to them 3-5 fractions a week (5 Gy/fraction, 90% isodose line) for 2-3 weeks. Median dose of SRT was 50 Gy and the range was 30-50 Gy. Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT: they are classified by 1 complete regression (7.7%), 7 partial regression (53.8%), 4 minimal regression (30.8%), 1 stable disease (7.7%). The positive responses more than partial remission were 8 patients (61.5%) after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been 92.3% decreased. There was no severe complication except dyspepsia 84.6%, mild nausea 69.2%, transient decreased of hepatic function 15.4% and fever 7.7%. SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

Psychological distress and intervention in cancer patients treated with radiotherapy

International Nuclear Information System (INIS)

Sostaric, M.; Sprah, L.

2004-01-01

Background. Common side effects of treatment with radiation therapy (RT) often cause psychophysical distress in cancer patients. Anxiety, adjustment disorders and depression (which are according to many studies experienced in about half of the oncological population) might originate some serious psychiatric forms of mood disorders and can even culminate in suicide, if not treated appropriately. There are some groups of cancer patients who are especially vulnerable and among them are cancer patients undergoing RT - they should receive special attention from medical staff. The purpose of this review is to present a variety of psychosocial interventions and illustrate some methods that are (or could be) used in psycho-oncology practice. Conclusions. A large body of literature suggests that the first intervention step should be effective screening for patients in distress. In regard to these proposals the development of (computerized) screening programmes is the first measure that ought to be taken. Moreover, further systematical research of traditional, non-traditional and complementary intervention strategies in cancer patients in distress would be necessary in order to provide reliable empirical results about the effectiveness of different approaches. (author)

The effect of the second dose 131I in patients with Grave's disease, treated with 185 MBq low-fixed dose regimen

International Nuclear Information System (INIS)

Bochev, P.; Klissarova, A.; Hristozov, H.; Chaushev, B.; Cvetanova, B.

2006-01-01

Full text: The aim of the study was to evaluate the success rate after application of a second dose 131 I in patients with Grave's disease, treated with a fixed dose 185 MBq 131 I and still hyperthyroid. 27 patients with Grave's disease, treated with 185 MBq 131 I. Each patient was followed up by physical exam, ultrasonography and hormone levels for a period of at least one year. On the sixth month after the initial treatment 14 patients (52%) were still hyperthyroid. Based on hormone levels and reduction of gland size a decision for applying a second dose 131 I was taken for 8 patients. The remaining six patients with persistent hyperthyroidism were treated with antithyroid drugs till the end of the first year. By the time of the study 12.5% of the patients being treated with a second dose are still hyperthyroid, 37.5% - euthyroid and 50% -hypothyroid with total success rate (hypo+euthyroid) of 87%. In comparison 16 % of the patients treated with antithyroid drugs are euthyroid. The use of a second dose 131 I in patients with Graves disease being treated with low-fixed dose regimen and still hyperthyroid by the sixth month after the initial treatment leads to a high overall success rate in one year

Inadvertent yellow fever vaccination of a patient with Crohn's disease treated with infliximab and methotrexate

DEFF Research Database (Denmark)

Ekenberg, C.; Friis-Møller, N.; Ulstrup, Thomas

2016-01-01

We present a case of a 56-year-old woman with Crohn's disease, treated with methotrexate and infliximab, who inadvertently received yellow fever vaccination (YFV) prior to a journey to Tanzania. She was not previously vaccinated against YF. YFV contains live-attenuated virus, and is contraindicated...... in patients treated with immunosuppressive drugs. Following vaccination, the patient fell ill with influenza-like illness. Elevated transaminase levels and YF viremia were detected. Despite being immunocompromised, the patient did not develop more severe adverse effects. Neutralising antibodies to YF virus...... were detected on day 14 following vaccination and remained protective at least 10 months after vaccination. Limited data is available on outcomes of YFV in patients receiving immunosuppressive therapy, including biologics, and we report this case as a reminder of vigilance of vaccine recommendations...

A Survival Analysis of Patients with Malignant Biliary Strictures Treated by Percutaneous Metallic Stenting

International Nuclear Information System (INIS)

Brountzos, Elias N.; Ptochis, Nikolaos; Panagiotou, Irene; Malagari, Katerina; Tzavara, Chara; Kelekis, Dimitrios

2007-01-01

Background. Percutaneous metal stenting is an accepted palliative treatment for malignant biliary obstruction. Nevertheless, factors predicting survival are not known. Methods. Seventy-six patients with inoperable malignant biliary obstruction were treated with percutaneous placement of metallic stents. Twenty patients had non-hilar lesions. Fifty-six patients had hilar lesions classified as Bismuth type I (n = 15 patients), type II (n = 26), type III (n = 12), or type IV (n = 3 patients). Technical and clinical success rates, complications, and long-term outcome were recorded. Clinical success rates, patency, and survival rates were compared in patients treated with complete (n = 41) versus partial (n = 35) liver parenchyma drainage. Survival was calculated and analyzed for potential predictors such as the tumor type, the extent of the disease, the level of obstruction, and the post-intervention bilirubin levels. Results. Stenting was technically successful in all patients (unilateral drainage in 70 patients, bilateral drainage in 6 patients) with an overall significant reduction of the post-intervention bilirubin levels (p < 0.001), resulting in a clinical success rate of 97.3%. Clinical success rates were similar in patients treated with whole-liver drainage versus partial liver drainage. Minor and major complications occurred in 8% and 15% of patients, respectively. Mean overall primary stent patency was 120 days, while the restenosis rate was 12%. Mean overall secondary stent patency was 242.2 days. Patency rates were similar in patients with complete versus partial liver drainage. Mean overall survival was 142.3 days. Survival was similar in the complete and partial drainage groups. The post-intervention serum bilirubin level was an independent predictor of survival (p < 0.001). A cut-off point in post-stenting bilirubin levels of 4 mg/dl dichotomized patients with good versus poor prognosis. Patient age and Bismuth IV lesions were also independent predictors

Treating hepatic encephalopathy in cirrhotic patients admitted to ICU with sodium phenylbutyrate: a preliminary study.

Science.gov (United States)

Weiss, Nicolas; Tripon, Simona; Lodey, Marion; Guiller, Elsa; Junot, Helga; Monneret, Denis; Mayaux, Julien; Brisson, Hélène; Mallet, Maxime; Rudler, Marika; Imbert-Bismut, Françoise; Thabut, Dominique

2018-04-01

Hepatic encephalopathy (HE) influences short-term and long-term prognoses. Recently, glycerol phenylbutyrate (PB), that lowers ammonia by providing an alternate pathway to urea for waste nitrogen excretion, has shown that it was effective in preventing the occurrence of HE in RCT. The aim was to assess the benefits of sodium PB in cirrhotic patients admitted to ICU for overt HE, in terms of ammonia levels decrease, neurological improvement, and survival. Cirrhotic patients who presented with overt HE, ammonia levels >100 μmol/L, and did not display any contra-indication were included. Sodium PB was administered at 200 mg/kg/day. Control group included historical controls treated by standard therapy, matched for age, sex, MELD score, and severity of HE. Eighteen patients were included and treated with sodium PB (age: 59 [45-68], male gender: 15 [83%], Child-Pugh B: 8 [44%], Child-Pugh C: 10 [56%], and MELD score: 16 [13-23]). Ammonia levels significantly decreased in the PB as compared to the control group from inclusion to 12 h and from inclusion to 48 h (P = 0.0201 and P = 0.0230, respectively). The proportion of patients displaying neurological improvement was only higher in the PB-treated group as compared to controls at ICU discharge (15 [83%] vs. 9 [50%], P = 0.0339). ICU discharge survival was significantly higher in patients treated with PB (17 [94%] vs. 9 [50%], P = 0.0017). In cirrhotic patients with overt HE, sodium PB could be effective in reducing ammonia levels and might be effective in improving neurological status and ICU discharge survival. More extensive data, especially a RCT, are mandatory. © 2017 Société Française de Pharmacologie et de Thérapeutique.

Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

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Schmitt, E [Universitatsklinik Friedrichsheim, Frankfurt, West Germany; Ruckbeil, C; Wick, R R

1983-01-01

Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

Case Report of Pes Anserine Bursitis patient treated with Bee Venom Acua-Acupuncture Therapy by Using DITI

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Moon Ja-Young

2004-02-01

Full Text Available Objective : The purpose of this study is to report the effect of Bee Venom Acua-Acupuncture Therapy to the patient of Pes Anserine Bursitis by using DITI. Patient & Methods : The patient was 60-year-old woman who complained severe knee pain. She was treated by bee venom acuaacupuncture therapy. To estimate the efficacy of tratment, we used DITI, visual analog scale, knee joint check(ROM. Results : In this case, we treated patient of Pes Anserine Bursitis for 28 days. bee venom acua-acupuncture therapy efficiently relieved patient's pain and improved ROM. DITI and Visual analog scale also showed significantly valuable changes.

Does Targeted Education of Emergency Physicians Improve Their Comfort Level in Treating Psychiatric Patients?

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Brenda J Walker

2012-12-01

Full Text Available Introduction: We determined if targeted education of emergency physicians (EPsregarding the treatment of mental illness will improve their comfort level in treatingpsychiatric patients boarding in the emergency department (ED awaiting admission.Methods: We performed a pilot study examining whether an educational interventionwould change an EP’s comfort level in treating psychiatric boarder patients (PBPs. Weidentified a set of psychiatric emergencies that typically require admission or treatmentbeyond the scope of practice of emergency medicine. Diagnoses included majordepression, schizophrenia, schizoaffective disorder, bipolar affective disorder, generalanxiety disorder, suicidal ideation, and criminal behavior. We designed equivalentsurveys to be used before and after an educational intervention. Each survey consistedof 10 scenarios of typical psychiatric patients. EPs were asked to rate their comfort levelsin treating the described patients on a visual analogue scale. We calculated summaryscores for the non intervention survey group (NINT and intervention survey group (INTand compared them using Student’s t-test.Results: Seventy-nine percent (33/42 of eligible participants completed the preinterventionsurvey (21 attendings, 12 residents and comprised the NINT group. Fiftyfivepercent (23/42 completed the post-intervention survey (16 attendings, 7 residentscomprising the INT group. A comparison of summary scores between ‘NINT’ and ‘INT’groups showed a highly significant improvement in comfort levels with treating thepatients described in the scenarios (P = 0.003. Improvements were noted on separateanalysis for faculty (P = 0.039 and for residents (P = 0.012. Results of a sensitivityanalysis excluding one highly significant scenario showed decreased, but still importantdifferences between the NINT and INT groups for all participants and for residents, butnot for faculty (all: P = 0.05; faculty: P = 0.25; residents: P = 0

The Prognostic Impact of K-RAS Mutations in Adult Acute Myeloid Leukemia Patients Treated with High Dose Cytarabine

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Ahmad, E.I.; Gawish, H.H.; Al-Azizi, N.M.A.; El-Hefni, A.M.

2009-01-01

Activating point mutation of the RAS gene has been generally accepted as an oncogenic event in a variety of malignancies. It represents one of the most common genetic alterations in acute myeloid leukemia (AML). However there is still controversy about its clinical relevance on the treatment outcome of this leukemia. Objective: This study aimed to clarify the biologic and prognostic impact of K-RAS mutations in relation to the dose of cytarabine (ara-C) used in post induction consolidation chemotherapy in adult AML patients. Patients and Methods: The study comprised 71de novo AML patients with a male: Female ratio of 1.4: 1; their ages ranged from 21-59 years with a median of 37 years. They were subjected to full clinical evaluation, routine laboratory investigations, cytogenetic studies by G banding and K-RAS mutation detection using realtime PCR. The patients were randomized into 2 groups (gps) according to the ara-C dose used in consolidation treatment, HDAC gp receiving 400 mg ara-C and LDAC gp receiving 100 mg ara-C. They were followed over a period of 5 years. Results: Mutations in the K-RAS gene (mutRAS) were detected in 23 patients (32%) with the remaining 48 patients (68%) having wild type RAS (wtRAS). Blast cell percentage was significantly lower in mutRAS compared to wtRAS patients (p=<0.001). The M4 subtype of AML and cases with Inv 16 showed significantly higher frequencies in mutRAS compared to wtRAS patients, (p=0.015, 0.003, respectively). The patients were followed up for a median of 43 months (range 11-57 months). There was no significant difference in overall survival (OS) between mutRAS and wtRAS patients (p=0.326). Within the mutRAS patients treated with HDAC, cumulative OS was significantly higher than those treated with LDAC (p=0.001). This was not the case in the wtRAS group (p=0.285). There was no significant difference in disease The Prognostic Impact of K-RAS Mutations in Adult Acute Myeloid Leukemia Patients Treated with High Dose

Experiences of 23 patients ≥ 90 years of age treated with radiation therapy

International Nuclear Information System (INIS)

Oguchi, Masahiko; Ikeda, Hiroshi; Watanabe, Toshikazu; Shikama, Naoto; Ohata, Takeo; Okazaki, Youichi; Kiyono, Kunihiro; Sone, Shusuke

1998-01-01

Purpose: To present 23 patients ≥ 90 years old treated with radiotherapy, and to retrospectively evaluate the results of radiotherapy and tolerance in these patients. Methods and Materials: The clinical records of 27 patients over 90 years of age who were treated with radiotherapy at the Department of Radiology, Shinshu University Hospital, and eight affiliated general hospitals from 1990 until 1995 were reviewed. The strategy of radiotherapy was individually planned depending on the stage of the disease and performance status (PS) of the patient; however, it was not modified, based solely on chronologic age. The overall survival rate and disease-free survival rate were determined using the Kaplan-Meier method. The Radiation Therapy Oncology Group scoring criteria of acute and late reactions of radiation therapy were used. Results: This group of patients accounted for 0.37% of all patients treated with radiotherapy in these hospitals. Of these, 23 patients in whom cancer was pathologically confirmed and whose follow-up data were available for retrospective analysis were included in the final evaluation of data. The age of the 23 patients ranged from 90 to 96 years (median 93). Tumor was untreated and in the early stage in five patients, locoregionally advanced in 13, recurrent in four, and systemic in one. Definitive radiation therapy was administered in 12 patients (13 sites), preoperative intent in one, and palliative intent in 10. The period of observation ranged from 2.5 to 6 years (median 18 months). Seven patients were alive for 15-67 months. Fourteen patients died because of intercurrent diseases or senility associated with active cancer, and two because of senility without evidence of cancer. The overall and relapse-free survival rates were 65% and 30% at 1 year and 30% and 21% at 2 years, respectively. Definitive radiation therapy was completed in 13 of 13 patients (100%), and local control was attained in 9 of 13 patients at 6 months (62%). Palliative

Incidencia y factores asociados con las reacciones adversas del tratamiento antirretroviral inicial en pacientes con VIH

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Juan Astuvilca

2007-07-01

Full Text Available La alta incidencia de reacciones adversas medicamentosas (RAMA al tratamiento antirretroviral de gran actividad (TARGA en pacientes con VIH/SIDA puede afectar la calidad de vida y adherencia al tratamiento. Objetivos: Determinar la incidencia de RAMA del TARGA inicial e identificar los factores asociados con la ocurrencia de RAMA al recibir dicha terapia. Materiales y métodos: Se realizó un estudio de cohorte histórica con todos los pacientes VIH (+ mayores de 18 años que recibieron TARGA por primera vez en el Hospital Nacional Arzobispo Loayza, con un seguimiento de 360 días desde la primera prescripción. Se recabó las RAMA de las historias clínicas y tarjetas de control. Resultados: Se incluyeron 353 pacientes, se encontró una incidencia acumulada de 66,7% de efectos adversos al TARGA inicial y una densidad de incidencia de 9,1 eventos de RAMA por 10 personas año de seguimiento (IC95%: 8,1-10,1. Anemia (23,4%, náuseas (20,6% y rash (17,2% fueron las RAMA más frecuentes. El uso de drogas (OR 2,40; IC95% 1,01-5,67; consumo de alcohol (OR 0.32; IC95%: 0,19-0,55 y estadio SIDA (OR 0,20; IC95%: 0,04-0,95 estuvieron asociadas con la presencia de RAMA. Conclusiones: Existe un alta incidencia de RAMA, siendo la anemia la más frecuente. El uso de drogas es un factor de riesgo para presentar RAMA.

A 4-Year Longitudinal Study of 555 Patients Treated with Ranibizumab for Neovascular Age-related Macular Degeneration

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Rasmussen, Annette; Bloch, Sara B; Fuchs, Josefine

2013-01-01

To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years.......To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years....

Poor adherence to P2Y12 antagonists increased cardiovascular risks in Chinese PCI-treated patients.

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Sun, Yang; Li, Chenze; Zhang, Lina; Hu, Dong; Zhang, Xudong; Yu, Ting; Tao, Min; Wang, Dao Wen; Shen, Xiaoqing

2017-03-01

Low adherence to secondary prevention medications (ATM) of patients after acute coronary syndrome (ACS) is associated with poor clinical outcomes. However, literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS. In the current work, ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5, 2013 to December 31, 2014. A total of 2126 patients were classified under low adherence (proportion of days covered (PDC) C50%) groups based on their performance after discharge. All patients were followed up at the 1st, 6th, and 12th month of discharge while recording ATM and major adverse cardiac events (MACE). Bivariate logistic regression was used to identify the factors associated with ATM. Cox regression was used to analyze the association between ATM and MACE within one year after discharge. Results showed that coronary artery bypass grafting (CABG) alone had significantly lower proportion of high adherence to P2Y12 antagonists (83.0% vs. 90.7%, P < 0.01) than patients treated with percutaneous coronary intervention (PCI) only. Moreover, in patients undergoing PCI, high adherence to P2Y12 antagonists decreased the risk of MACE (hazard ratio = 0.172, 95% confidence interval: 0.039-0.763; P = 0.021). In conclusion, PCI-treated patients are more prone to remaining adherent to medications than CABG-treated patients. High adherence to P2Y12 antagonists was associated with lower risk of MACE.

Intensity-Modulated Radiotherapy Triggers Onset of Bullous Pemphigoid in a Patient with Advanced Melanoma Treated with Nivolumab

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Kayo Tanita

2018-02-01

Full Text Available Since the efficacy of ipilimumab on nivolumab-resistant advanced melanoma is extremely low, additional supportive therapy for anti-PD-1 antibody therapy-resistant advanced melanoma is needed. Although several supportive therapies that enhance the antitumor immune response of anti-PD-1 antibodies have already been reported, unexpected immune-related adverse events were detected at the same time. In this report, we describe a patient with advanced melanoma treated with nivolumab followed by intensity-modulated radiotherapy, which might have triggered bullous pemphigoid (BP. Although several cases of BP developing in anti-PD-1 antibody-treated patients have already been reported, in this report, we shed light on the possible pathogenesis of BP developing in a patient treated with nivolumab through M2 macrophages.

Primary CNS lymphoma in a patient treated with azathioprine

DEFF Research Database (Denmark)

Glesner, Matilde Kanstrup; Ocias, Lukas Frans; Larsen, Thomas Stauffer

2014-01-01

with surrounding oedema. There was cerebrospinal fluid pleocytosis, and Epstein-Barr virus (EBV) DNA was detected in the spinal fluid by PCR. A brain biopsy confirmed the suspicion of primary brain lymphoma. EBV-associated primary brain lymphoma is a relevant differential diagnosis in patients with long......A 33-year-old man treated with azathioprine for 12 years for Crohn's disease presented with headache, nausea and vomiting accompanied by difficulty in putting words together and slight mental confusion. Prednisolone and antibiotics were without effect. MRI of the brain showed multiple focal lesions...

The Potential Impact of Maintaining a 3-Hour IV Thrombolysis Window: How Many More Patients can we Safely Treat?

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Lyerly, Michael J; Albright, Karen C; Boehme, Amelia K; Shahripour, Reza Bavarsad; Houston, James T; Rawal, Pawan V; Kapoor, Niren; Alvi, Muhammad; Sisson, April; Alexandrov, Anne W; Alexandrov, Andrei V

2013-09-13

In 2008, the European Cooperative Acute Stroke Study-3 (ECASS-3) demonstrated that intravenous-tissue plasminogen activator could be safely administered for acute stroke patients presenting between 3 and 4.5 hours from symptom onset. Recently, the Food and Drug Administration rejected expansion of this time window in the United States. We sought to determine how many fewer patients would be treated by maintaining this restricted time window. We reviewed charts from patients who received intravenous thrombolysis at the University of Alabama at Birmingham between January 2009 and December 2011. Patients were divided into two groups (treated within 3 hours of onset, treated between 3 and 4.5 hours from onset). Demographics, stroke severity and protocol deviations according to the ECASS-3 trial were collected. Our safety measures were any hemorrhagic transformation, symptomatic intracerebral hemorrhage and systemic hemorrhage. Two hundred and twelve patients were identified, of whom 192 were included in our analysis. A total of 36 patients (19%) were treated between 3 and 4.5 hours. No statistical differences were seen between age (p=0.633), gender (p=0.677), race (p=0.207) or admission stroke severity (p=0.737). Protocol deviations from the ECASS-3 criteria were found in 20 patients (56%). These were primarily age > 80 and aggressive blood pressure management. Despite these deviations, we did not see significant increases in the rates of adverse events in patients treated in the extended time window. Our data are consistent with previously reported international data that IV thrombolysis can safely be used up to 4.5 hours from symptom onset. Restricting the time window to 3 hours would have resulted in almost one-fifth fewer patients treated at our center.

Efficacy of the Laparoendoscopic "Rendezvous" to Treat Cholecystocholedocholithiasis in 210 Consecutive Patients: A Single Center Experience.

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La Greca, Gaetano; Pesce, Antonio; Vitale, Marco; Mannino, Maurizio; Di Marco, Federica; Di Blasi, Michele; Lombardo, Rosario; Puleo, Stefano; Russello, Domenico; Latteri, Saverio

2017-08-01

The simultaneous laparoendoscopic "rendezvous" (LERV) represents an alternative to sequential or totally laparoscopic approaches for patients affected by cholecystocholedocholithiasis. The aim of this study was to analyze the results in a large series of 210 consecutive patients. From 2002 to 2016 all patients affected by cholecystocholedocholithiasis were treated with a standardized "tailored" LERV. The relevant technical features of the procedure were recorded. An analysis of feasibility, effectiveness in stone clearance, and safety was performed. Among 214 patients with common bile duct stones, 210 were treated with LERV and 4 with open rendezvous approach. Intraoperative cholangiography confirmed common bile duct stones in 179 patients (85.2%) or sludge in 18 (8.5%) and in 98.9% stone clearance was obtained endoscopically. Endoscopic papilla cannulation was feasible in 161 patients (76.7%), whereas in 49 (23.3%) a transcystic guidewire was needed. The overall LERV feasibility was 96.6%. The conversion rate to open surgery was 3.3%. Minor morbidity was observed in 1.9% of cases, mortality in 0.47%, and the mean hospital stay was 4.3 days. These results confirm the high effectiveness of LERV. This approach to treat cholecystocholedocholithiasis should be preferred and therefore implemented where a strong collaboration between surgeons and endoscopists is possible.

Fibroproliferative activity in patients with immune thrombocytopenia (ITP) treated with thrombopoietic agents

DEFF Research Database (Denmark)

Ghanima, Waleed; Junker, Peter; Hasselbalch, Hans Carl

2011-01-01

This study assessed the grade of bone marrow (BM) fibrosis and its association with a seromarker for collagen-III formation and fibrosis-related cytokines in 25 immune thrombocytopenia (ITP) patients treated with thrombopoietin receptor agonists (Tpo-RA) who had at least one BM biopsy. Assessment...

Radiation exposure to family members of patients with thyrotoxicosis treated with iodine-131

International Nuclear Information System (INIS)

Cappelen, Tone; Amundsen, Anne Lise; Kravdal, Gunnhild; Unhjem, Jan Frede; Foelling, Ivar

2006-01-01

The purpose of this study was twofold: (1) to measure the radiation exposure to family members of out-patients with thyrotoxicosis treated with radioiodine, 131 I, using the recommendations from the European Commission (EC) guidance and age-specific periods for behaviour restrictions; (2) to use the results to identify necessary restrictions to ensure recommended dose constraints. The study population comprised 76 family members (46 adults and 30 children below the age of 18) of 42 patients. The patients were treated with an average activity of 417 MBq (range 260-600 MBq). They received oral and written EC recommendations about behaviour restrictions (translated into Norwegian). On the day of treatment we repeated the oral instructions to the patient and an adult family member. The time periods for restrictions were 14 days for children aged 0-10 years, 7 days for persons aged 11-59 years and 3 days for persons aged 60 years and older. Family members wore a thermoluminescent dosimeter (TLD) on each wrist day and night for 2 weeks. The doses received were adjusted to give an estimate of the expected values if the TLDs had been worn indefinitely. Radiation doses well below the recommended dose constraints were measured for all adult family members and children, except one 2-year-old child; in the latter case the mother probably did not comply with the instructions given. The radiation dose to family members of thyrotoxic patients treated with up to 600 MBq of radioiodine is well below recommended dose constraints if EC instructions are given and compliance is adequate. The duration of restrictions for various age groups used in this study may be considered when establishing guidelines in Norway. (orig.)

Automated radiofrequency-based US measurement of common carotid intima-media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs.

Science.gov (United States)

Naredo, Esperanza; Möller, Ingrid; Corrales, Alfonso; Bong, David A; Cobo-Ibáñez, Tatiana; Corominas, Hector; Garcia-Vivar, Ma Luz; Macarrón, Pilar; Navio, Teresa; Richi, Patricia; Iagnocco, Annamaria; Garrido, Jesús; Martínez-Hernández, David

2013-02-01

To compare the carotid intima-media thickness (IMT) assessed with automated radiofrequency-based US in RA patients treated with synthetic vs synthetic and biologic DMARDs and controls. Ninety-four RA patients and 94 sex- and age-matched controls were prospectively recruited at seven centres. Cardiovascular (CV) risk factors and co-morbidities, RA characteristics and therapy were recorded. Common carotid artery (CCA)-IMT was assessed in RA patients and controls with automated radiofrequency-based US by the same investigator at each centre. Forty-five (47.9%) RA patients had been treated with synthetic DMARDs and 49 (52.1%) with synthetic and biologic DMARDs. There were no significant differences between the RA patients and controls in demographics, CV co-morbidities and CV disease. There were significantly more smokers among RA patients treated with synthetic and biologic DMARDs (P = 0.036). Disease duration and duration of CS and synthetic DMARD therapy was significantly longer in RA patients treated with synthetic and biologic DMARDs (P radiofrequency-based measurement of CCA-IMT can discriminate between RA patients treated with synthetic DMARDs vs RA patients treated with synthetic and biologic DMARDs.

Medical resource utilization in dermatomyositis/polymyositis patients treated with repository corticotropin injection, intravenous immunoglobulin, and/or rituximab

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Knight T

2017-05-01

Full Text Available Tyler Knight,1 T Christopher Bond,1 Breanna Popelar,2 Li Wang,3 John W Niewoehner,4 Kathryn Anastassopoulos,1 Michael Philbin4 1Covance Market Access Services Inc., Gaithersburg, MD, 2Xcenda, LLC, Palm Harbor, FL, 3STATinMED Research, Ann Arbor, MI, 4Mallinckrodt, LLC, Hazelwood, MO, USA Background: Dermatomyositis and polymyositis (DM/PM are rare, incurable inflammatory diseases that cause progressive muscle weakness and can be associated with increased medical resource use (MRU. When corticosteroid treatment is unsuccessful, patients may receive intravenous immunoglobulin (IVIg, rituximab, or repository corticotropin injection (RCI. This study compared real-world, non-medication MRU between patients treated with RCI and those treated with IVIg and/or rituximab for DM/PM.Methods: Claims of DM/PM patients were analyzed from the combination of three commercial health insurance databases in the United States from July 2009 to June 2014. Patients treated with RCI were propensity score matched to those treated with IVIg, rituximab, and both (IVIg+rituximab based on demographics, prior clinical characteristics, and prior MRU. Per-patient per-month (PPPM MRU and costs were compared using Poisson regression and generalized linear modeling, respectively.Results: One-hundred thirty-two RCI, 1,150 IVIg, and 562 rituximab patients had an average age of 52.6, 46.6, and 51.7 years, respectively, and roughly two-thirds were female. After matching, there were no significant differences in demographics or prior clinical characteristics. RCI patients had fewer PPPM hospitalizations (0.09 vs 0.17; P=0.049, shorter length of stay (LOS; 3.24 days vs 4.55 days; P=0.004, PPPM hospital outpatient department (HOPD visits (0.60 vs 1.39; P<0.001, and PPPM physician office visits (2.01 vs 2.33; P=0.035 than IVIg. RCI had fewer PPPM HOPD visits (0.56 vs 0.92; P<0.001 than rituximab. Patients treated with RCI had shorter LOS (2.18 days vs 5.15; P<0.001 and less PPPM HOPD

Fasting triglycerides predict recurrent ischemic events in patients with acute coronary syndrome treated with statins.

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Schwartz, Gregory G; Abt, Markus; Bao, Weihang; DeMicco, David; Kallend, David; Miller, Michael; Mundl, Hardi; Olsson, Anders G

2015-06-02

Most patients with acute coronary syndrome (ACS) are treated with statins, which reduce atherogenic triglyceride-rich lipoproteins. It is uncertain whether triglycerides predict risk after ACS on a background of statin treatment. This study examined the relationship of fasting triglyceride levels to outcomes after ACS in patients treated with statins. Long-term and short-term relationships of triglycerides to risk after ACS were examined in the dal-OUTCOMES trial and atorvastatin arm of the MIRACL (Myocardial Ischemia Reduction with Acute Cholesterol Lowering) trial, respectively. Analysis of dal-OUTCOMES included 15,817 patients (97% statin-treated) randomly assigned 4 to 12 weeks after ACS to treatment with dalcetrapib (a cholesteryl ester transfer protein inhibitor) or placebo and followed for a median 31 months. Analysis of MIRACL included 1,501 patients treated with atorvastatin 80 mg daily beginning 1 to 4 days after ACS and followed for 16 weeks. Fasting triglycerides at initial random assignment were related to risk of coronary heart disease death, nonfatal myocardial infarction, stroke, and unstable angina in models adjusted for age, sex, hypertension, smoking, diabetes, high-density lipoprotein cholesterol, and body mass index. Fasting triglyceride levels were associated with both long-term and short-term risk after ACS. In dal-OUTCOMES, long-term risk increased across quintiles of baseline triglycerides (p175/≤80 mg/dl) was 1.61 (95% confidence interval: 1.34 to 1.94). There was no interaction of triglycerides and treatment assignment on the primary outcome. In the atorvastatin group of MIRACL, short-term risk increased across tertiles of baseline triglycerides (p=0.03), with a hazard ratio of 1.50 [corrected] (95% confidence interval: 1.05 to 2.15) in highest/lowest tertiles (>195/≤135 mg/dl). The relationship of triglycerides to risk was independent of low-density lipoprotein cholesterol in both studies. Among patients with ACS treated effectively

Human papilloma virus and survival of oropharyngeal cancer patients treated with surgery and adjuvant radiotherapy.

Science.gov (United States)

Broglie, Martina A; Soltermann, Alex; Haile, Sarah R; Huber, Gerhard F; Stoeckli, Sandro J

2015-07-01

Impact of p16 protein, a surrogate marker for human papilloma virus induced cancer, p53 and EGFR as well as clinical factors on survival in a patient cohort with oropharyngeal squamous cell carcinoma (OPSCC) treated by surgical resection and adjuvant radiotherapy (RT) ± concomitant chemotherapy (CT). This is a retrospective analysis of patient's charts and tumor tissue. 57 patients were consecutively included and their tumor tissue assembled on a tissue microarray following immunohistochemical analysis. Survival times were estimated by means of Kaplan-Meier analysis. The importance of clinical and immunohistochemical factors for outcome was estimated by cox proportional hazard models. With 88% 5-year overall survival, 91% 5-year disease-specific survival and 91% 5-year disease-free survival, respectively, we found excellent survival rates in this surgically treated patient cohort of mainly advanced OPSCC (93% AJCC stage III or IV). The only factors positively influencing survival were p16 overexpression as well as p53 negativity and even more pronounced the combination of those biomarkers. Survival analysis of patients classified into three risk categories according to an algorithm based on p16, smoking, T- and N-category revealed a low, intermediate and high-risk group with significant survival differences between the low and the high-risk group. Patients with OPSCC can be successfully treated by surgery and adjuvant RT ± CT with a clear survival benefit of p16 positive, p53 negative patients. We recommend considering a combination of immunohistochemical (p16, p53) and clinical factors (smoking, T- and N-category) for risk stratification.

Culture and drug susceptibility testing among previously treated tuberculosis patients in the Dominican Republic, 2014

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Katia J. Romero Mercado

Full Text Available ABSTRACT Multidrug-resistant tuberculosis (MDR-TB is a major public health concern that threatens global progress toward effective TB control. The risk of MDR-TB is increased in patients who have received previous TB treatment. This article describes the performance of culture and drug susceptibility testing (DST in patients registered as previously treated TB patients in the Dominican Republic in 2014, based on operational research that followed a retrospective cohort design and used routine program data. Under the current system of TB culturing and DST, the majority of patients with previously treated TB do not undergo DST, and those who do often experience considerable delay in obtaining their results. The lack of DST and delay in receiving DST results leads to underestimation of the number of MDR-TB cases and hinders the timely initiation of MDR-TB treatment.

Gonadal function in patients treated for Hodgkin′s disease in childhood

International Nuclear Information System (INIS)

Zaletel, Lorna Zadravec; Bratanic, Nevenka; Jereb, Berta

2010-01-01

The long-term survival of patients treated for Hodgkin's disease (HD) in childhood is high and the chief concern is now being directed toward the late effects of the treatment, including the endocrine dysfunction. Testicular and ovarian functions were assessed in 64 long term survivors (24 females, 40 males) treated for HD in childhood in Slovenia between 1972 and 1994. At diagnosis they were 3–16 years old and had gonadal evaluation 4–27 years later at the age of 13–34. Fifty-four (84%) patients received chemotherapy (ChT), 49 in combination with radiation therapy (RT), 10 received RT alone. Gonadal function was assessed by the clinical examination and measurement of serum concentrations of estradiol and testosterone. Serum levels of LH and FSH were determined in the basal state and after the stimulation. Primary hypogonadism (PH) was found in 30 (47%) patients. Twenty-four of 40 (60%) males had PH with evidence of damage of germinal epithelium, 4 of them had evidence of damage of Leydig cells (LC) and 10 had evidence of dysfunction of LC as well. PH was found in 6 of 24 (25%) females. After therapy for HD PH was more frequent in males than in females. Not only RT but also alkylating agents and procarbazine alone caused damage of LC. Age of patient at the time of treatment was not an important risk factor for gonadal toxicity. Pelvic RT in combination with ChT is the most important risk factor of the development PH both, in males and females

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

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Williams Scott

2011-10-01

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

Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

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Elizabeth Pearce

Full Text Available PURPOSE: To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. METHODS: Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40 measured with Early Treatment Diabetic Retinopathy Study (ETDRS charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA, contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. RESULTS: The slow reading group had poorer contrast sensitivity (p = 0.001, reduced retinal sensitivity (p = 0.027 and less stable fixation (p = 0.013. Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033, (nasal to the fovea in the right eye and temporal to the fovea in the left eye. Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001. CONCLUSION: Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

Infectious complications in head and neck cancer patients treated with cetuximab: propensity score and instrumental variable analysis.

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Ching-Chih Lee

Full Text Available BACKGROUND: To compare the infection rates between cetuximab-treated patients with head and neck cancers (HNC and untreated patients. METHODOLOGY: A national cohort of 1083 HNC patients identified in 2010 from the Taiwan National Health Insurance Research Database was established. After patients were followed for one year, propensity score analysis and instrumental variable analysis were performed to assess the association between cetuximab therapy and the infection rates. RESULTS: HNC patients receiving cetuximab (n = 158 were older, had lower SES, and resided more frequently in rural areas as compared to those without cetuximab therapy. 125 patients, 32 (20.3% in the group using cetuximab and 93 (10.1% in the group not using it presented infections. The propensity score analysis revealed a 2.3-fold (adjusted odds ratio [OR] = 2.27; 95% CI, 1.46-3.54; P = 0.001 increased risk for infection in HNC patients treated with cetuximab. However, using IVA, the average treatment effect of cetuximab was not statistically associated with increased risk of infection (OR, 0.87; 95% CI, 0.61-1.14. CONCLUSIONS: Cetuximab therapy was not statistically associated with infection rate in HNC patients. However, older HNC patients using cetuximab may incur up to 33% infection rate during one year. Particular attention should be given to older HNC patients treated with cetuximab.

Early dietary treated patients with phenylketonuria can achieve normal growth and body composition.

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Rocha, Júlio C; van Spronsen, Francjan J; Almeida, Manuela F; Ramos, Elisabete; Guimarães, João T; Borges, Nuno

2013-01-01

In the past, overtreatment may have resulted in growth impairment in patients with phenylketonuria. The paper aims to investigate height and body composition in early treated patients with phenylketonuria who were diagnosed between 1981 and 2008. A cross-sectional study of 89 patients with phenylketonuria and 78 controls aged (mean ± SD, in years) 14.4 ± 6.6 and 15.9 ± 7.1, respectively, was undertaken, including anthropometric and body composition evaluation using bioelectrical impedance. Median Phe concentrations in the last year before study enrollment were used as a measure of metabolic control. Natural protein and amino acid mixture intakes were recorded in patients. No statistically significant differences were found on height z-scores between patients and controls aged less than 19 years (p=0.301), although all patients with classical phenylketonuria revealed negative height z-scores, resulting in a mean ± SD of -0.65 ± 0.41. Among participants aged 19 years or more, median (p25-p75) of height was significantly higher in controls [168.0 cm (159.2-174.8)] than in patients [160.5 cm (151.9-167.5)] (p=0.017). No significant differences were found between patients and controls regarding fat mass, fat free mass, muscular mass, body cell mass index and phase angle. Our results suggest that early and continuously treated patients with phenylketonuria born after 1992 can achieve normal growth and body composition, although the negative height z-score in patients with classical phenylketonuria strengthens the continuous need to optimize the quality of their protein intake. © 2013 Elsevier Inc. All rights reserved.

Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy

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Kinhikar, Rajesh A.; Murthy, Vedang; Goel, Vineeta; Tambe, Chandrashekar M.; Dhote, Dipak S.; Deshpande, Deepak D.

2009-01-01

The purpose of this work was to estimate skin dose for the patients treated with tomotherapy using metal oxide semiconductor field-effect transistors (MOSFETs) and thermoluminescent dosimeters (TLDs). In vivo measurements were performed for two head and neck patients treated with tomotherapy and compared to TLD measurements. The measurements were subsequently carried out for five days to estimate the inter-fraction deviations in MOSFET measurements. The variation between skin dose measured with MOSFET and TLD for first patient was 2.2%. Similarly, the variation of 2.3% was observed between skin dose measured with MOSFET and TLD for second patient. The tomotherapy treatment planning system overestimated the skin dose as much as by 10-12% when compared to both MOSFET and TLD. However, the MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1% to 1.4%. MOSFETs may be used as a viable dosimeter for measuring skin dose in areas where the treatment planning system may not be accurate.

Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy.

Science.gov (United States)

Kinhikar, Rajesh A; Murthy, Vedang; Goel, Vineeta; Tambe, Chandrashekar M; Dhote, Dipak S; Deshpande, Deepak D

2009-09-01

The purpose of this work was to estimate skin dose for the patients treated with tomotherapy using metal oxide semiconductor field-effect transistors (MOSFETs) and thermoluminescent dosimeters (TLDs). In vivo measurements were performed for two head and neck patients treated with tomotherapy and compared to TLD measurements. The measurements were subsequently carried out for five days to estimate the inter-fraction deviations in MOSFET measurements. The variation between skin dose measured with MOSFET and TLD for first patient was 2.2%. Similarly, the variation of 2.3% was observed between skin dose measured with MOSFET and TLD for second patient. The tomotherapy treatment planning system overestimated the skin dose as much as by 10-12% when compared to both MOSFET and TLD. However, the MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1% to 1.4%. MOSFETs may be used as a viable dosimeter for measuring skin dose in areas where the treatment planning system may not be accurate.

Venous damage prevention by defibrotide in vinorelbine-treated patients.

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Mare, M; Maisano, R; Caristi, N; Adamo, V; Altavilla, G; Carboni, R; Munaò, S; La Torre, F

2003-09-01

The aim of our study was to evaluate the incidence of venous toxicity induced by vinorelbine administration in patients who received a preventive therapy with defibrotide. From July 1996 to July 2002 we treated 203 patients with vinorelbine, 51 with vinorelbine alone and 152 with vinorelbine in combination with other drugs via peripheral vein infusion. Of the 203 patients, 123 were male and 80 female with a median age of 67 years (range 18 to 82 years), and 118 were chemotherapy-naive. Defibrotide was delivered i.v. at a dose of 400 mg in 250 ml normal saline. After infusion of 125 ml over about 15 min, vinorelbine mixed with 10 ml normal saline was delivered as quick brief repeated pulses over 5 min through the plastic tube, followed by infusion of the remaining defibrotide. The specific Rittenberg scale was used to assess venous irritation episodes. Among a total of 1336 vinorelbine infusions, with a median of five infusions per patient, the incidence of venous irritation episodes graded according to Rittenberg scale was 1.1% (15), of which 0.6% (8) were grade 2 and 0.5% (7) grade 1. Globally, 15 patients (7.3%) developed venous toxicity after a median of 3 infusions (range 1-14), but no patient had more than one event. Our findings support the use of defibrotide as an effective, safe and low-cost means for preventing vinorelbine-related venous damage.

Behaviour and school achievement in patients with early and continuously treated phenylketonuria

NARCIS (Netherlands)

Stemerdink, B.A.; Kalverboer, A.F.; Meere, J.J. van der; Molen, M.W. van der; Huisman, J.; Jong, L.W.A. de; Slijper, F.M.E.; Verkerk, P.H.; Spronsen, F.J. van

2000-01-01

Thirty patients with early and continuously treated phenylketonuria (PKU) between 8 and 20 years of age were compared with 30 controls, matched individually for age, sex, and educational level of both parents, on behaviour rating scales for parents and teachers as well as a school achievement scale.

Retrospective Analysis of Nonepileptic Patients With Isolated Epileptiform Discharges Treated With Anticonvulsants.

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Swatzyna, Ronald J; Tarnow, Jay D; Proler, Meyer L; Roark, Alexandra J; MacInerney, Erin K; Kozlowski, Gerald P

2017-09-01

Many antiepileptic drugs (AEDs) have been tested on nonepileptic patients with a variety of diagnoses. The Food and Drug Administration has only approved certain AEDs for a small number of psychiatric conditions. There are few studies of nonepileptic patients that recommend an empirical trial of AEDs when isolated epileptiform discharges (IEDs) are identified in the electroencephalogram (EEG). However, no trials have been published. The purpose of this study is to evaluate the outcome of treating nonepileptic patients with AEDs when IEDs are present. Refractory cases were reviewed from a multidisciplinary practice whose EEG readings contained IEDs and were subsequently medicated with anticonvulsants by the clinic's psychiatrist. The psychiatrist's progress notes were assessed to determine the impact of adding anticonvulsants based on parent reports, teacher reports, and clinical observation. The final sample was composed of 76 refractory cases. Of the 76 patients treated with anticonvulsants, the majority were found to be improved in follow-up progress notes: 65 improved (85.53%), 6 unchanged (7.89%), and 5 more severe (6.58%). These observational findings suggest that further studies will be needed to show that IEDs may predict positive treatment outcome to anticonvulsant medication and act as a step toward an evidence-based treatment. Also, EEG screening may prove to be useful for refractory cases regardless of age, gender, or diagnosis.

Clinical presentation of acute coronary syndrome in patients previously treated with nitrates.

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Latour-Pérez, Jaime; Gómez-Tello, Vicente; Fuset-Cabanes, María Paz; Balsa, Eva de Miguel; Sáez, Frutos Del Nogal; Orts, Francisco Javier Coves; Rodríguez, Carmen Martín; Pino-Izquierdo, Karel; Pesquera, María de la Concepción Pavía; Rodríguez, Antonio José Montón

2013-11-01

Several reports have suggested that nitrates limit acute ischaemic damage by a mechanism similar to preconditioning. This study aims to evaluate the effect of chronic oral nitrates on the clinical presentation and short-term outcomes of patients admitted with acute coronary syndrome (ACS). A retrospective cohort study was conducted in patients with ACS admitted to 62 acute care units from 2010 to 2011. A propensity score-matched samples analysis was performed. We analysed 3171 consecutive patients, of whom 298 (9.4%) were chronically treated with nitrates. Patients previously treated with nitrates had higher comorbidity and disease severity at admission, lower prevalence of ACS with ST elevation, lower troponin elevation, higher prevalence of initial Killip class 2-4 and higher hospital mortality. The propensity score-matched analysis confirmed that previous use of nitrates is independently associated with a lower prevalence of ST-elevation ACS [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.36-0.78; P = 0.0014] and a lower troponin elevation (OR 0.61, 95% CI 0.41-0.92) but not with Killip class on admission (OR 1.18, 95% CI 0.83-1.67, P = 0.3697) or mortality (OR 0.71, 95% CI 0.37-1.38, P = 0.3196). The results support the hypothesis that nitrates have a protective effect on acute ischaemic injury.

Conservatively treated perforation of the neovagina in a male to female transsexual patient

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Amirian, Ilda; Gögenur, Ismail; Rosenberg, Jacob

2011-01-01

An unknown number of patients have had male to female gender transformation. Various surgical techniques have been employed to construct the neovagina. The more traditional techniques include inverted penile grafts and vascular pedicle grafts, but also the small bowel and sigmoid colon have been ...... with contrast through the neovagina showed leakage from the neovaginal top. The patient was treated conservatively with antibiotics and discharged after 7 days....

Renal cell carcinoma in patients with a solitary kidney after nephrectomy treated with radiofrequency ablation: Mid term results

International Nuclear Information System (INIS)

Hoffmann, Ralf-Thorsten; Jakobs, Tobias F.; Kubisch, Constanze H.; Trumm, Christoph; Weber, Christof; Siebels, Michael; Helmberger, Thomas K.; Reiser, Maximilian F.

2010-01-01

This retrospective study aimed to evaluate the feasibility and effectiveness of radiofrequency ablation (RFA) in patients with solitary kidney for the treatment of renal cell carcinoma (RCC). Within 2 years 10 patients (seven males, three females; age 65 ± 8 years) were treated. All patients had a history of nephrectomy of the contralateral kidney. The indications for RFA were inoperability or high probability of complete renal failure after surgical enucleation of the tumor. 13 tumors with a size between 1.9 and 4.2 cm (average 2.7 cm) were treated. In patients with a tumor diameter larger than 2.5 cm a transarterial embolization was performed prior to RFA to reduce heat sink effect and risk of bleeding. Therapeutical success was defined as a lack of contrast enhancement in follow up examinations and shrinking of the treated area. Furthermore all patients' renal function was monitored. RFA of renal tumors under CT-fluoroscopy was feasible in all patients. Within the follow up (3 and 24 months) no tumor recurrence or major complication was detected. One patient developed another RCC and was successfully treated with a second RF-ablation. None of the patients developed renal failure with the need of hemodialysis. In one of the patients a hemorrhage into the surrounding tissue was noticed, which stopped spontaneously. RFA is a valuable and effective therapeutical option in patients with solitary kidney suffering from inoperable renal cell carcinoma. The complication rate is small and an excellent tumor control can be achieved without deterioration of the renal function.

Assessing outcomes of adult oncology patients treated with linezolid versus daptomycin for bacteremia due to vancomycin-resistant Enterococcus.

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Patel, Khilna; Kabir, Rubiya; Ahmad, Samrah; Allen, Steven L

2016-04-01

The incidence and severity of vancomycin-resistant Enterococcus blood stream infections continue to rise and is a significant burden in the healthcare setting. Literature thus far is minimal regarding treatment outcomes in patients with malignancy and vancomycin-resistant Enterococcus bacteremia. Appropriate antibiotic selection is vital to treatment success due to high rates of resistance, limited antimicrobials and mortality in this patient population. We conducted this study to determine whether treatment outcomes differed between cancer patients treated with linezolid and those treated with daptomycin for vancomycin-resistant Enterococcus bacteremia. This single-center, retrospective study included adult patients hospitalized on the oncology service with documented vancomycin-resistant Enterococcus faecium or Enterococcus faecalis bacteremia who received at least 48 h of either linezolid or daptomycin as primary treatment. A total of 65 patients were included in the analysis. Thirty-two patients received daptomycin as primary treatment, and 33 patients received linezolid as primary treatment. Twenty-six (76.5%) patients in the linezolid cohort versus 22 (71%) patients in the daptomycin cohort achieved microbiological cure (p = 0.6141). Median length of stay in days (30 vs. 42, p = 0.0714) and mortality (7/32 (20.6%) vs. 8/33 (25.8%), p = 0.6180) were also similar between the linezolid and daptomycin treated patients, respectively. No differences in microbiological cure, length of stay or mortality were identified between the groups. This study suggests that linezolid and daptomycin are each reasonable options for treating vancomycin-resistant Enterococcus bacteremia in oncology patients. Further prospective, randomized controlled trials are needed to assess the optimal treatment for vancomycin-resistant Enterococcus bacteremia in this patient population. © The Author(s) 2014.

Outcome of Patients Treated With a Single-Fraction Dose of Palliative Radiation for Cutaneous T-Cell Lymphoma

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Thomas, Tarita O.; Agrawal, Priya [Department of Radiation Oncology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Guitart, Joan [Department of Dermatology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Rosen, Steven T. [Division of Hematology/Oncology, Department of Medicine, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Rademaker, Alfred W. [Department of Preventive Medicine, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Querfeld, Christiane [Department of Medicine/Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Hayes, John P. [Department of Radiation Oncology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Kuzel, Timothy M. [Division of Hematology/Oncology, Department of Medicine, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States); Mittal, Bharat B., E-mail: bmittal@nmh.org [Department of Radiation Oncology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois (United States)

2013-03-01

Purpose: Cutaneous T-cell lymphoma (CTCL) is a radiosensitive tumor. Presently, treatment with radiation is given in multiple fractions. The current literature lacks data that support single-fraction treatment for CTCL. This retrospective review assesses the clinical response in patients treated with a single fraction of radiation. Methods and Materials: This study reviewed the records of 58 patients with CTCL, primarily mycosis fungoides, treated with a single fraction of palliative radiation therapy (RT) between October 1991 and January 2011. Patient and tumor characteristics were reviewed. Response rates were compared using Fisher's exact test and multiple logistic regressions. Survival rates were determined using the Kaplan-Meier method. Cost-effectiveness analysis was performed to assess the cost of a single vs a multifractionated treatment regimen. Results: Two hundred seventy individual lesions were treated, with the majority (97%) treated with ≥700 cGy; mean follow-up was 41.3 months (range, 3-180 months). Response rate by lesion was assessed, with a complete response (CR) in 255 (94.4%) lesions, a partial response in 10 (3.7%) lesions, a partial response converted to a CR after a second treatment in 4 (1.5%) lesions, and no response in 1 (0.4%) lesion. The CR in lower extremity lesions was lower than in other sites (P=.0016). Lesions treated with photons had lower CR than those treated with electrons (P=.017). Patients with lesions exhibiting large cell transformation and tumor morphology had lower CR (P=.04 and P=.035, respectively). Immunophenotype did not impact response rate (P=.23). Overall survival was significantly lower for patients with Sézary syndrome (P=.0003) and erythroderma (P<.0001). The cost of multifractionated radiation was >200% higher than that for single-fraction radiation. Conclusions: A single fraction of 700 cGy-800 cGy provides excellent palliation for CTCL lesions and is cost effective and convenient for the patient.

Should ribavirin be used to treat hepatitis C in dialysis patients?

Science.gov (United States)

Carrion, Andres F; Fabrizi, Fabrizio; Martin, Paul

2011-01-01

Hepatitis C virus infection adversely affects outcomes in patients with chronic kidney disease undergoing maintenance dialysis. Pegylated interferon and ribavirin, the standard-of-care treatment in patients with intact renal function, is associated with severe side effects, toxicity, and high dropout rates in this population. Ribavirin has an important role in maintaining antiviral response following completion of therapy and increases sustained viral response (SVR) rates. However, the use of ribavirin in dialysis patients has been limited by the high frequency of severe hemolytic anemia and is currently reserved for study protocols and highly selected candidates treated at experienced centers. Encouraging data from small trials have shown a significant increase in SVR rates with the use of different dosing regimens of ribavirin in addition to interferon-based therapy and aggressive erythroid-stimulating agent support in dialysis patients. Use of ribavirin in selected dialysis patients, particularly renal transplant candidates, by experienced clinicians is appropriate. © 2011 Wiley Periodicals, Inc.

Effects of sertindole on cognition in clozapine-treated schizophrenia patients - a double-blinded, randomized, placebo-controlled trial

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Nielsen, R E; Levander, S; Nielsen, Jimmi

Nielsen RE, Levander S, Thode D, Nielsen J. Effects of sertindole on cognition in clozapine-treated schizophrenia patients. Objective:  To assess the cognitive effects of sertindole augmentation in clozapine-treated patients diagnosed with schizophrenia. Cognition is secondary outcome of the trial....... Method:  A 12-week, double-blinded, randomized, placebo-controlled, augmentation study of patients treated with clozapine. Participants were randomized 1:1 to receive 16 mg of sertindole or placebo as adjunctive treatment to clozapine. Results:  Participants displayed substantial cognitive deficits......, ranging from 1.6 standard deviation below norms at baseline to more than three standard deviations on tests of response readiness and focused attention. There were no significant differences between sertindole augmentation and placebo groups at study end. Correlation analysis of Positive and Negative...

Incidence of dermatitis in head and neck cancer patients treated with primary radiotherapy and cetuximab

International Nuclear Information System (INIS)

Selzer, Edgar; Liederer Susanne; Lemaire, Christiane; Radonjic, Dejan; Poetter, Richard; Bachtiary, Barbara; Kren, Gerhard; Knocke, Thomas; Kornek, Gabriela

2011-01-01

To retrospectively assess the incidence of radiation dermatitis in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) who received primary radiotherapy in combination with cetuximab in a curative intent. A total of 112 consecutively treated patients who received cetuximab in combination with radiotherapy at the Departments of Radiotherapy at the Medical University in Vienna and the Hospital Hietzing (Vienna) were analyzed. Radiotherapy was administered either as conventional radiotherapy (70 Gy in 7 weeks) or using a concomitant boost protocol (72 Gy in 6 weeks). The incidence of dermatitis and mucositis within the radiation portals in 103 eligible patients was compared with a historical control group treated at the Medical University of Vienna as well as with published data. The incidence of grade 1/2, 3, and 4 dermatitis was 57%, 29%, and 1% in the radiotherapy plus cetuximab treated collective. The incidence of grade 1/2, 3, and 4 mucositis was 37%, 47%, and 4%, respectively. The incidence of grade 3 dermatitis during concurrent radiotherapy plus cetuximab was 29% in our patient collective. Only one case of grade 4 dermatitis was observed. These results do not statistically differ significantly from the incidence reported in the Bonner trial and indicate that cetuximab in combination with radiotherapy is well tolerated. (orig.)

Incidence of dermatitis in head and neck cancer patients treated with primary radiotherapy and cetuximab

Energy Technology Data Exchange (ETDEWEB)

Selzer, Edgar; Liederer Susanne; Lemaire, Christiane; Radonjic, Dejan; Poetter, Richard; Bachtiary, Barbara [Medical Univ. Vienna (Austria). Dept. of Radiotherapy; Kren, Gerhard; Knocke, Thomas [Hospital Hietzing, Vienna (Austria). Dept. of Radiotherapy; Kornek, Gabriela [Medical Univ. Vienna (Austria). Dept. of Internal Medicine I

2011-06-15

To retrospectively assess the incidence of radiation dermatitis in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) who received primary radiotherapy in combination with cetuximab in a curative intent. A total of 112 consecutively treated patients who received cetuximab in combination with radiotherapy at the Departments of Radiotherapy at the Medical University in Vienna and the Hospital Hietzing (Vienna) were analyzed. Radiotherapy was administered either as conventional radiotherapy (70 Gy in 7 weeks) or using a concomitant boost protocol (72 Gy in 6 weeks). The incidence of dermatitis and mucositis within the radiation portals in 103 eligible patients was compared with a historical control group treated at the Medical University of Vienna as well as with published data. The incidence of grade 1/2, 3, and 4 dermatitis was 57%, 29%, and 1% in the radiotherapy plus cetuximab treated collective. The incidence of grade 1/2, 3, and 4 mucositis was 37%, 47%, and 4%, respectively. The incidence of grade 3 dermatitis during concurrent radiotherapy plus cetuximab was 29% in our patient collective. Only one case of grade 4 dermatitis was observed. These results do not statistically differ significantly from the incidence reported in the Bonner trial and indicate that cetuximab in combination with radiotherapy is well tolerated. (orig.)

Laboratory monitoring of patients treated with antihypertensive drugs and newly exposed to non steroidal anti-inflammatory drugs: a cohort study.

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Jean-Pascal Fournier

Full Text Available BACKGROUND: Drug-Drug Interactions between Non Steroidal Anti-Inflammatory Drugs (NSAIDs and Angiotensin Converting Enzyme Inhibitors (ACEIs, Angiotensin Receptor Blocker (ARBs or diuretics can lead to renal failure and hyperkalemia. Thus, monitoring of serum creatinine and potassium is recommended when a first dispensing of NSAID occur in patients treated with these drugs. METHODS: We conducted a pharmacoepidemiological retrospective cohort study using data from the French Health Insurance Reimbursement Database to evaluate the proportion of serum creatinine and potassium laboratory monitoring in patients treated with ACEI, ARB or diuretic and receiving a first dispensing of NSAID. We described the first dispensing of NSAID among 3,500 patients of a 4-year cohort (6,633 patients treated with antihypertensive drugs and analyzed serum creatinine and potassium laboratory monitoring within the 3 weeks after the first NSAID dispensing. RESULTS: General Practitioners were the most frequent prescribers of NSAIDs (85.5%, 95% CI: 84.3-86.6. The more commonly prescribed NSAIDs were ibuprofen (20%, ketoprofen (15%, diclofenac (15% and piroxicam (12%. Serum creatinine and potassium monitoring was 10.7% (95% CI: 9.5-11.8 in patients treated by ACEIs, ARBs or diuretics. Overall, monitoring was more frequently performed to women aged over 60, treated with digoxin or glucose lowering drugs, but not to patients treated with ACEIs, ARBs or diuretics. Monitoring was more frequent when NSAIDs' prescribers were cardiologists or anesthesiologists. CONCLUSION: Monitoring of serum creatinine and potassium of patients treated with ACEIs, ARBs or diuretics and receiving a first NSAID dispensing is insufficiently performed and needs to be reinforced through specific interventions.

Assessment of quality of life in patients treated with accelerated radiotherapy for laryngeal and hypopharyngeal carcinomas.

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Allal, A S; Dulguerov, P; Bieri, S; Lehmann, W; Kurtz, J M

2000-05-01

This study was conducted to evaluate quality of life (QOL) and functional outcome in patients with carcinomas of the larynx and hypopharynx treated with accelerated radiotherapy (RT). Between January 1991 and September 1996, 21 patients treated with accelerated concomitant boost RT schedule (69.9 Gy in 5. 5 weeks) for laryngeal (n = 10) or hypopharyngeal (n = 11) carcinomas and who remained free of disease at 1-year minimum follow-up were evaluated. The functional outcome was assessed by the subjective Performance Status Scale for Head and Neck cancer (PSSHN) and general QOL by the European Organization for Research and Treatment of Cancer Core QOL questionnaire (EORTC QLQ-C30). The median length of follow-up was 37 months (range, 13 to 75). The PSSHN scores were 89, 84, and 86, respectively, for eating in public, understandability of speech and normalcy of diet (100 = normal function). Significantly lower scores for understandability of speech were observed in patients with advanced and laryngeal carcinomas. Normalcy of diet was affected negatively by the severity of xerostomia. All mean functional scale scores of the EORTC QLQ-C30 module were 20% to 25% below the higher score. Most of these scale scores were significantly affected by the severity of xerostomia. Patients treated with concomitant boost RT for laryngeal and hypopharyngeal carcinomas appear to have similar QOL and functional outcome to those reported for patients treated with conventional or hyperfractionated RT. As expected, many QOL scales were affected by the severity of xero- stomia.

[Acid-base status in patients treated with peritoneal dialysis].

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Katalinić, Lea; Blaslov, Kristina; Pasini, Eva; Kes, Petar; Bašić-Jukić, Nikolina

2014-04-01

When compared to hemodialysis, peritoneal dialysis is very simple yet low cost method of renal replacement therapy. Series of studies have shown its superiority in preserving residual renal function, postponing uremic complications, maintaining the acid-base balance and achieving better post-transplant outcome in patients treated with this method. Despite obvious advantages, its role in the treatment of chronic kidney disease is still not as important as it should be. Metabolic acidosis is an inevitable complication associated with progressive loss of kidney function. Its impact on mineral and muscle metabolism, residual renal function, allograft function and anemia is very complex but can be successfully managed. The aim of our study was to evaluate the efficiency in preserving the acid-base balance in patients undergoing peritoneal dialysis at Zagreb University Hospital Center. Twenty-eight patients were enrolled in the study. The mean time spent on the treatment was 32.39 ± 43.43 months. Only lactate-buffered peritoneal dialysis fluids were used in the treatment. Acid-base balance was completely maintained in 73.07% of patients; 11.54% of patients were found in the state of mild metabolic acidosis, and the same percentage of patients were in the state of mild metabolic alkalosis. In one patient, mixed alkalosis with respiratory and metabolic component was present. The results of this study showed that acid-base balance could be maintained successfully in patients undergoing peritoneal dialysis, even only with lactate-buffered solutions included in the treatment, although they were continuously proclaimed as inferior in comparison with bicarbonate-buffered ones. In well educated and informed patients who carefully use this method, accompanied by the attentive and thorough care of their physicians, this method can provide quality continuous replacement of lost renal function as well as better quality of life.

Vitamin E and essential polyunsaturated fatty acids supplementation in schizophrenia patients treated with haloperidol.

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Bošković, Marija; Vovk, Tomaž; Koprivšek, Jure; Plesničar, Blanka Kores; Grabnar, Iztok

2016-05-01

Previously, oxidative damage has been associated with severity of clinical symptoms and supplementation with antioxidants and essential polyunsaturated fatty acids (EPUFAs) was proposed to have beneficial effects in schizophrenia. We evaluated the effects of supplementation with EPUFAs and vitamin E in patients treated with haloperidol depot injection. This was a double-blind randomized placebo-controlled study with four arms (Placebo, vitamin E, EPUFAs, and vitamin E + EPUFAs). Biomarkers of oxidative stress, neurochemistry, psychopathology, and extrapyramidal symptoms were assessed at baseline and after 4 months. In EPUFAs group of patients, reduced glutathione concentration was increased compared to placebo. Concentration of oxidized glutathione was decreased in patients receiving vitamin E. In addition, compared to placebo a non-significant trend of increased activity of catalase and superoxide dismutase was observed in all three treatment groups. Patients receiving vitamin E experienced less motor retardation. No difference in extrapyramidal symptoms was found. Our study indicates that supplementation with vitamin E and EPUFAs may improve the antioxidative defense, especially glutathione system, while there is no major effect on symptoms severity. Supplemental treatment with EPUFAs and vitamin E in schizophrenia patients treated with haloperidol is potentially beneficial and a larger independent study appears warranted.

Effect of Oral Pilocarpine in Treating Severe Dry Eye in Patients With Sjögren Syndrome.

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Kawakita, Tetsuya; Shimmura, Shigeto; Tsubota, Kazuo

2015-01-01

The aim of this study is to evaluate the efficacy and safety of oral pilocarpine in treating severe dry eye unresponsive to conventional conservative treatment in patients with Sjögren syndrome. A prospective study. Oral doses of pilocarpine were administered for at least 3 months to patients with Sjögren syndrome complicated by established dry eye of great severity unresponsive to conventional conservative treatment. Subjective eye symptoms (dry eye sensation and eye pain), fluorescein staining scores, rose Bengal staining scores, and tear film breakup time measurements improved significantly after 1 month and 3 months of oral treatment with pilocarpine, whereas no significant improvement was noted in Schirmer I testing. Oral administration of pilocarpine was useful in treating severe dry eye unresponsive to conventional conservative treatment in patients with Sjögren syndrome from the standpoint of efficacy and safety. Thus, we conclude that oral pilocarpine is effective as a new option in treating severe dry eye.

Vitiligo in a patient with lung adenocarcinoma treated with nivolumab: A case report.

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Uenami, Takeshi; Hosono, Yuki; Ishijima, Mikako; Kanazu, Masaki; Akazawa, Yuki; Yano, Yukihiro; Mori, Masahide; Yamaguchi, Toshihiko; Yokota, Soichiro

2017-07-01

Nivolumab, an anti-programmed cell death-1 protein monoclonal antibody, is effective for treating patients with late-stage non-small-cell lung cancer. Immune checkpoint inhibitors such as nivolumab induce various kinds of immune-related adverse events, including vitiligo. Vitiligo has been reported in patients with melanoma but not lung cancer. We describe a 75-year-old man with lung adenocarcinoma, stage 4 with pleural and pericardial effusion, that progressed after first-line chemotherapy. Subsequently, he was treated with nivolumab as second-line therapy. After 6days of administering nivolumab, he developed vitiligo suddenly on the trunk of his body. Except for vitiligo, his physical examination was normal, and treatment with nivolumab was well tolerated. Therefore, this treatment was continued without further development or expansion of vitiligo. A computed tomography scan showed a reduction in the size of the lung nodule and stabilization of the pleural and pericardial effusion. This is the first case of vitiligo associated with the use of nivolumab in a patient with lung adenocarcinoma. Copyright © 2017. Published by Elsevier B.V.

Pesquisaje activo de sospechas de reacciones adversas a medicamentos en el Hospital "Dr. Salvador Allende: Primer semestre 2006 Active screening of suspicions of adverse reactions to drugs in "Dr. Salvador Allende" Hospital: First semester 2006

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José de Jesús Rego Hernández

2007-12-01

Full Text Available Se realizó un estudio descriptivo mediante la revisión diaria del movimiento hospitalario, obtenido en el Departamento de Registros Médicos del Hospital "Dr. Salvador Allende" desde enero hasta junio de 2006 a fin de poder identificar los ingresos susceptibles de ser reacciones adversas a medicamentos, con el objetivo de detectar la frecuencia de ingresos por sospechas de reacciones adversas a medicamentos, así como de caracterizar a estos pacientes. Se llenó una planilla de notificación para cada sospecha de reacción adversa y se analizaron los datos contenidos en las historias clínicas respectivas. Se utilizó una base de Excel diseñada al efecto por el Centro para el Desarrollo de la Farmacoepidemiología. Ingresaron 6 201 pacientes, de los cuales 384 eran susceptibles de tener una reacción adversa a medicamentos (6,2 % y finalmente, se consideraron 57 pacientes cuyo motivo de ingreso se relacionó con algún medicamento (0,9 %. El 66,7 % de los casos eran mayores de 60 años de edad, sin diferencias en cuanto al sexo. Los grupos farmacológicos con mayores afectaciones fueron los analgésicos no opiodes (59,7 % y los antibacterianos (19,4 %. El sangramiento digestivo alto resultó la reacción adversa que más se encontró (57,9 %, con predominio en mayores de 60 años de edad (72,7 %; el ácido acetilsalicílico estuvo presente en el 66,7 % de los casos con este diagnóstico. En el75,5 % de los casos la reacción se consideró como graveA descriptive study was conducted by the daily revision of hospital movement obtained in the Department of Medical Registries of "Dr. Salvador Allende" Hospital from January to June, 2006, aimed at identifying the admissions susceptible to adverse reactions to drugs to detect the frequency of admissions due to suspicions of adverse reactions to drugs, as well as to characterize these patients. A notification form was filled in per each suspicion of adverse reaction, and the data contained in the

Linac-based radiosurgery of cerebral melanoma metastases. Analysis of 122 metastases treated in 64 patients

International Nuclear Information System (INIS)

Herfarth, K.K.; Pirzkall, A.; Izwekowa, O.; Wannenmacher, M.; Thilmann, C.; Debus, J.; Delorme, S.; Hofmann, U.; Schadendorf, D.; Zierhut, D.

2003-01-01

Purpose: Stereotactic radiosurgery is an alternative option to neurosurgical excision in the management of patients with brain metastases. We retrospectively analyzed patients with brain metastases of malignant melanoma who were treated at our institution for outcome and prognostic factors. Patients and Methods: 64 patients with 122 cerebral metastases were treated with stereotactic radiosurgery between 1986 and 2000. Twelve patients (19%) showed neurologic symptoms at the time of treatment, and 46 patients (72%) had extracerebral tumor manifestation at that time. The median dose to the 80% isodose line, prescribed to encompass the tumor margin, was 20 Gy (range, 15-22 Gy). Results: Neurologic symptoms improved in five of twelve symptomatic patients. 41 patients remained asymptomatic or unchanged in their neurologic symptoms. Only five patients (8%) temporarily worsened neurologically after therapy despite no signs of tumor progression. With a mean follow-up time of 9.4 months, actuarial local control was 81% after 1 year. There was a statistically significant dose and size dependency of local tumor control. Median actuarial survival after treatment was 10.6 months. Patients without extracerebral tumor manifestation showed a superior survival (p = 0.04). Conclusions: Despite high local tumor control rates, the prognosis of patients with cerebral metastases of malignant melanoma remains poor. Stereotactic radiosurgery has the potential of stabilizing or improving neurologic symptoms in these patients in a palliative setting. (orig.)

Novel silicone stent to treat tracheobronchial lesions: results of 35 patients.

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Saueressig, Maurício G; Sanches, Paulo R S; Macedo Neto, Amarilio V; Moreschi, Alexandre H; Oliveira, Hugo G; Xavier, Rogerio G

2010-12-01

We describe a case series of 35 patients with either benign (14) or malignant (21) tracheal stenosis who were treated using a novel silicone stent, the HCPA-1, designed to prevent migration. Between March 2001 and September 2008, 13 women and 22 men received 41 HCPA-1 stents. The median duration of stenting in benign cases was 457 days (range, 4-2,961 days). Successful stent removal with curative results was accomplished in 2 patients with tracheomalacia and 1 with post-intubation stenosis. In malignant cases, the median duration of stenting was 162 days (range, 1-1,279 days). Five patients had tumor progression with obstruction requiring repeated laser resection, dilatation, or additional stents. Two patients died due to airway obstruction despite bronchoscopic intervention. Twelve patients with malignant lesions died with the stent in place. At the end of the study, 3 patients with malignant disease remained alive; 2 were lost to follow-up. The HCPA-1 stent proved to be safe, with no severe complications during the study period, and effective in improving quality of life with relief of dyspnea.

Nail involvement in patients with moderate-to-severe alopecia areata treated with oral tofacitinib.

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Lee, Ji Su; Huh, Chang-Hun; Kwon, Ohsang; Yoon, Hyun-Sun; Cho, Soyun; Park, Hyun-Sun

2018-05-07

A few anecdotal case reports demonstrated that tofacitinib improved nail changes associated with AA. To investigate nail changes in patients with AA treated with tofacitinib and evaluate the relationship between nail and hair responses to tofacitinib. This is a retrospective study of 33 adult patients with moderate-to-severe AA treated with oral tofacitinib monotherapy for at least 4 months. Fifteen patients had nail involvement and demonstrated more severe hair loss than those without nail involvement (p = .040). However, there was no significant difference in hair regrowth between two groups. Of 15 patients with nail involvement, 11 (73.3%) showed improvement regardless of type of nail change; the first improvement was observed at a median of 5 months (range, 1-11) after administration. Nail improvement was associated with neither initial severity of hair loss nor hair response to tofacitinib. Nail improvement tended to occur later than hair regrowth. Oral tofacitinib monotherapy improves nail involvement associated with AA. Nail involvement is not a poor prognosis factor in hair regrowth with tofacitinib treatment and there is no evident relationship between nail and hair responses.

Rocky Mountain Spotted Fever in a patient treated with anti-TNF-alpha inhibitors.

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Mays, Rana M; Gordon, Rachel A; Durham, K Celeste; LaPolla, Whitney J; Tyring, Stephen K

2013-03-15

Rocky Mountain Spotted Fever (RMSF) is a tick-bourne illness, which can be fatal if unrecognized. We discuss the case of a patient treated with an anti-TNF-alpha inhibitor for rheumatoid arthritis who later developed a generalized erythematous macular eruption accompanied by fever. The clinical findings were suggestive of RMSF, which was later confirmed with serology. Prompt treatment with doxyclycine is recommended for all patients with clinical suspicion of RMSF.

Incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with cetuximab

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Tomohiro Enokida

2016-09-01

Full Text Available Background Hypomagnesemia is a common adverse event during cetuximab (Cmab treatment. However, few reports have investigated the incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with Cmab. Methods We retrospectively reviewed 131 head and neck cancer patients who received Cmab-containing therapy. Main eligibility criteria were ≥3 Cmab administrations, no prior EGFR-directed therapy, and no prophylactic Mg supplementation.Results Median baseline serum Mg level and number of Cmab administrations were 2.2 mg/dl and eight, respectively. Overall incidence of hypomagnesemia was 50.4% (grade 1, 46.6%; grade 2, 3.1%; grade 3, 0%; grade 4, 0.8% and differed between patients treated with palliative chemotherapy and bioradiation (Cmab and radiation (63% vs. 24%; p<0.01. Independent risk factors were low baseline serum Mg [Odds ratio (OR 161.988, 95% confidence interval (CI 9.436-2780.895], ≥7 Cmab administrations (OR 3.56, 95% CI 1.16-13.98, and concurrent administration of platinum (cisplatin; OR 23.695, 95% CI 5.219-107.574, carboplatin; OR 5.487, 95% CI 1.831-16.439. Respective incidence of hypomagnesemia in patients in high- (concurrent platinum and ≥7 Cmab administrations and low-risk (no concurrent platinum and <7 Cmab administrations groups was 66.0% and 6.6% (P<0.001, OR 28.0. Conclusion Cmab is associated with a significant risk of hypomagnesemia in patients with head and neck cancer with longer term administration and concurrent platinum therapy. High-risk patients should be treated with particular care.

Urinary incontinence in prostate cancer patients treated with external beam radiotherapy

International Nuclear Information System (INIS)

Liu, Mitchell; Pickles, Tom; Berthelet, Eric; Agranovich, Alexander; Kwan, Winkle; Tyldesley, Scott; McKenzie, Michael; Keyes, Mira; Morris, James; Pai, Howard

2005-01-01

Background and purpose: To describe the incidence of urinary incontinence among prostate cancer patients treated with external beam radiotherapy (RT) and to investigate associated risk factors. Patients and methods: One thousand and hundred ninety-two patients with ≥24 months follow-up were the subjects of this series. All patients received between 50 and 72 Gy in 20-37 fractions (median 66 Gy/33). Post-RT urinary incontinence was scored by direct patient interviewing according to the modified RTOG/SOMA scale: Grade 1-occasional use of incontinence pads, Grade 2-intermittent use of incontinence pads, Grade 3-persistent use of incontinence pads, and Grade 4-permanent catheter. Risk-factors investigated were: age, diabetes, TURP prior to RT, elapsed time from TURP to RT, clinical stage, RT dose and presence of Grade ≥2 acute GU and GI toxicity. Non-parametric, actuarial univariate (Kaplan-Meier) and multivariate tests (MVA, Cox regression) were performed. Results: Median follow-up for the group is 52 months (24-109). Thirty-four patients (2.9%) had incontinence prior to RT, which was more common in TURP patients (7.8% vs 1.6% P<0.001). These are excluded from further analysis. Fifty-seven patients (4.9%) developed Grade 1 incontinence, 7 (0.6%) Grade 2, and 7 (0.6%) Grade 3. There was no Grade 4 incontinence. Actuarial rates for Grade ≥1 and ≥2 incontinence at 5 years are 7 and 1.7%, respectively. Risk factors on MVA associated with the development of Grade 1 or worse incontinence are pre-RT TURP (5-year rates 10% vs 6%, P=0.026), presence of Grade ≥2 acute GU toxicity (5-year rates 11% vs 5%, P=0.002). Age, diabetes, clinical stage, elapsed time from TURP to RT, RT dose or fraction size, acute GI toxicity were not significant. Patients who underwent post-RT TURP or dilatation for obstructive symptoms (4.3%), were more likely to develop Grade 2-3 incontinence (5-year rate 8 vs 1.5%, P=0.0015). Conclusions: Grade 2 or greater urinary incontinence is rare

Survival and prognostic factors in 321 patients treated with stereotactic body radiotherapy for oligo-metastases

DEFF Research Database (Denmark)

Fode, Mette Marie; Høyer, Morten

2015-01-01

BACKGROUND AND PURPOSE: To establish a model to predict survival after SBRT for oligo-metastases in patients considered ineligible for surgical resection (SR) and radiofrequency ablation (RFA). MATERIAL AND METHODS: Overall survival (OS) rates were estimated in 321 patients treated for 587...... metastases with SBRT over 13years. Patients were treated for a variety of metastasis types with colorectal cancer (CRC) being the most frequent (n=201). RESULTS: With a median follow-up time of 5.0years, the median OS was 2.4years (95% CI 2.3-2.7) and the survival rates were 80%, 39%, 23% and 12% at 1, 3, 5...... and 7.5years after SBRT, respectively. WHO performance status (PS) (0-1) (HR 0.49; pSBRT chemotherapy (HR 0.59; p

Discriminación de reacciones simultáneas por espectrometría de masa en la descomposición térmica de carbonatos básicos de níquel y de cobalto

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Julio C. Llópiz-Yurell

2010-03-01

Full Text Available Se determinaron, por espectrometría de masa y termogravimetría convencional, los parámetros y modelos cinéticos de los procesos de salida de agua y dióxido de carbono en la descomposición térmica de carbonatos básicos de níquel y de cobalto. Se demostró la ventaja de la espectrometría de masa para individualizar la cinética de procesos complejos de descomposición térmica, cuando las reacciones ocurren simultáneamente y de forma competitiva en un intervalo de temperatura. Se estudió además la cinética de la descomposición térmica del carbonato de calcio por ambas técnicas para comparar los resultados. Se observó la semejanza entre los resultados de las dos técnicas, en cuanto a modelo y parámetros cinéticos, cuando ocurre un proceso único durante la trasformación de la muestra, como en el carbonato de calcio, mientras que para los carbonatos básicos de níquel y de cobalto en la salida de agua y dióxido de carbono, que son reacciones simultáneas en el mismo intervalo de temperatura y además son competitivas, los valores de los parámetros cinéticos difieren notablemente de los obtenidos por el análisis termogravimétrico, que no puede discriminar la cinética de ambos procesos, aunque el modelo cinético resultó el mismo por ambas técnicas.

Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel.

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Doll, Jacob A; Neely, Megan L; Roe, Matthew T; Armstrong, Paul W; White, Harvey D; Prabhakaran, Dorairaj; Winters, Kenneth J; Duvvuru, Suman; Sundseth, Scott S; Jakubowski, Joseph A; Gurbel, Paul A; Bhatt, Deepak L; Ohman, E Magnus; Fox, Keith A A

2016-03-01

Certain alleles of the CYP2C19 gene are associated with higher platelet reactivity and increased ischemic events among patients treated with clopidogrel. However, the relationship of CYP2C19 genotype and outcomes in medically managed patients with acute coronary syndromes (ACS) is not known. This study sought to assess the effect of CYP2C19 genotype on ischemic outcomes in patients with ACS initially managed medically without revascularization who were randomized to either clopidogrel or prasugrel. We classified patients as extensive metabolizers (EM) or reduced metabolizers (RM) based on CYP2C19 genotype and evaluated ischemic outcomes and platelet reactivity. Among 9,326 patients enrolled from 2008 to 2011, 5,736 participated in the genetics cohort; of these, 2,236 had platelet function testing data. There was no association between CYP2C19 metabolizer status (EM vs. RM) and the primary composite endpoint of cardiovascular death, myocardial infarction (MI), or stroke (hazard ratio [HR]: 0.86). EM and RM patients had similar rates of the primary endpoint whether treated with prasugrel (HR: 0.82) or clopidogrel (HR: 0.91; p for interaction = 0.495). After adjusting for clinical and treatment variables, EM patients had a lower risk of MI versus RM patients (HR: 0.80), but risks of other outcomes were similar. RM patients had significantly higher mean P2Y12 reaction units versus EM patients when treated with clopidogrel (39.93), but not with prasugrel (3.87). CYP2C19 metabolizer status is not associated with the composite outcome of cardiovascular death, MI, or stroke in medically managed ACS patients treated with clopidogrel or prasugrel. Our findings do not support routine CYP2C19 genetic testing in this population. (A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects [TRILOGY ACS]; NCT00699998). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Evaluation of permanent alopecia in pediatric medulloblastoma patients treated with proton radiation

International Nuclear Information System (INIS)

Min, Chul Hee; Paganetti, Harald; Winey, Brian A; Adams, Judith; MacDonald, Shannon M; Tarbell, Nancy J; Yock, Torunn I

2014-01-01

To precisely calculate skin dose and thus to evaluate the relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with proton beams. The dosimetry and alopecia outcomes of 12 children with medulloblastoma (ages 4-15 years) comprise the study cohort. Permanent alopecia was assessed and graded after completion of the entire therapy. Skin threshold doses of permanent alopecia were calculated based on the skin dose from the craniospinal irradiation (CSI) plan using the concept of generalized equivalent uniform dose (gEUD) and accounting for chemotherapy intensity. Monte Carlo simulations were employed to accurately assess uncertainties due to beam range prediction and secondary particles. Increasing the dose of the CSI field or the dose given by the boost field to the posterior fossa increased total skin dose delivered in that region. It was found that permanent alopecia could be correlated with CSI dose with a threshold of about 21 Gy (relative biological effectiveness, RBE) with high dose chemotherapy and 30 Gy (RBE) with conventional chemotherapy. Our results based on 12 patients provide a relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with protons. The alopecia risk as assessed with gEUD could be predicted based on the treatment plan information

Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients With mCRPC Treated With Abiraterone

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Cristian Lolli

2016-10-01

Full Text Available Background: A systemic immune-inflammation index (SII based on neutrophil (N, lymphocyte (L, and platelet (P counts has shown a prognostic impact in several solid tumors. The aim of this study is to evaluate the prognostic role of SII in mCRPC patients treated with abiraterone post docetaxel.Patients and Methods: We retrospectively reviewed consecutive mCRPC patients treated with abiraterone after docetaxel in our Institutions. X-tile 3.6.1 software, cut-off values of SII, NLR defined as N/L and PLR as P/L. Overall survival (OS and their 95% Confidence Intervals (95% CI was estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of SII, PLR and NLR on OS was evaluated by Cox regression analyses and on PSA response rates were evaluated by binary logistic regression.Results: A total of 230 mCRPC patients treated abiraterone were included. SII ≥535, NLR ≥3 and PLR ≥210 were considered as elevated levels (high risk groups. The median OS was 17.3 months, 21.8 months in SII <535 group and 14.7 months in SII ≥535 (p < 0.0001. At univariate analysis ECOG performance status, previous enzalutamide, visceral metastases, SII, NLR and PLR predicted OS. In multivariate analysis, ECOG performance status, previous enzalutamide, visceral metastases, SII and NLR remained significant predictors of OS (HR = 5.08, p < 0.0001; HR = 2.12, p = 0.009, HR = 1.77, 95% p = 0.012; HR = 1.80, p = 0.002; and HR = 1.90, p = 0.001, respectively, whereas, PLR showed a borderline ability only (HR = 1.41, p = 0.068.Conclusion: SII and NLR might represent an early and easy prognostic marker in mCRPC patients treated with abiraterone. Further studies are needed to better define their impact and role in these patients.

Progression of carpal tunnel syndrome according to electrodiagnostic testing in nonoperatively treated patients

NARCIS (Netherlands)

van Suchtelen, Mark; Becker, Stéphanie J. E.; Gruber, Jillian S.; Ring, David

2014-01-01

This study tested the null hypothesis that nonoperatively treated patients would not show disease progression of carpal tunnel syndrome (CTS) over time according to median nerve distal motor latency (DML) on two electrodiagnostic tests. This retrospective study analyzed sixty-two adult

Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion.

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Moreno-Fernandez, Jesus; Pazos-Couselo, Marcos; González-Rodriguez, Maria; Rozas, Pedro; Delgado, Manuel; Aguirre, Miguel; Garcia-Lopez, Jose Manuel

2018-06-12

To analyze the clinical impact of the Flash glucose monitoring system in patients with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). A 24-week retrospective cohort study in CSII-treated T1DM patients exposed (1:1) to the Flash glucose monitoring system vs. self-monitoring of capillary blood glucose (SMBG). The primary outcome was the difference in hemoglobin A1c (HbA1c) levels between both groups at the end of the study. Thirty-six patients with a mean age of 38.2 years (range 22-55) and a mean T1DM duration of 20.9±7.8 years, treated with CSII for 7.1±5.4 years, were enrolled into the study. At the end of the study, mean HbA1c levels improved in patients in the Flash group (7.1±0.7 vs. 7.8±1.0, p=0.04). Only the Flash group showed a significant decrease in HbA1c levels of -0.4% (95% CI, -0.6, -0.2; p=0.004) during follow-up. Flash patients captured 93.9% of data through 17.8±9.9 scans daily. In fact, the Flash cohort showed a three-fold increase in daily self-monitoring of glucose, while daily frequency of SMBG decreased during the study (-1.8 tests/24h (95% CI -3, -0.7; p=0.01). No safety issues related to Flash use were recorded. The Flash glucose monitoring system is a novel approach to improve blood glucose control in CSII-treated T1DM patients. Randomized controlled trials are needed to assess the effectiveness of this system in CSII-treated T1DM patients. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy

International Nuclear Information System (INIS)

Moeller, Benjamin J; Chintagumpala, Murali; Philip, Jimmy J; Grosshans, David R; McAleer, Mary F; Woo, Shiao Y; Gidley, Paul W; Vats, Tribhawan S; Mahajan, Anita

2011-01-01

Hearing loss is common following chemoradiotherapy for children with medulloblastoma. Compared to photons, proton radiotherapy reduces radiation dose to the cochlea for these patients. Here we examine whether this dosimetric advantage leads to a clinical benefit in audiometric outcomes. From 2006-2009, 23 children treated with proton radiotherapy for medulloblastoma were enrolled on a prospective observational study, through which they underwent pre- and 1 year post-radiotherapy pure-tone audiometric testing. Ears with moderate to severe hearing loss prior to therapy were censored, leaving 35 ears in 19 patients available for analysis. The predicted mean cochlear radiation dose was 30 60 Co-Gy Equivalents (range 19-43), and the mean cumulative cisplatin dose was 303 mg/m 2 (range 298-330). Hearing sensitivity significantly declined following radiotherapy across all frequencies analyzed (P < 0.05). There was partial sparing of mean post-radiation hearing thresholds at low-to-midrange frequencies and, consequently, the rate of high-grade (grade 3 or 4) ototoxicity at 1 year was favorable (5%). Ototoxicity did not correlate with predicted dose to the auditory apparatus for proton-treated patients, potentially reflecting a lower-limit threshold for radiation effect on the cochlea. Rates of high-grade early post-radiation ototoxicity following proton radiotherapy for pediatric medulloblastoma are low. Preservation of hearing in the audible speech range, as observed here, may improve both quality of life and cognitive functioning for these patients

Organ donation in cardiac arrest patients treated with extracorporeal CPR: A single centre observational study.

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Casadio, Maria Chiara; Coppo, Anna; Vargiolu, Alessia; Villa, Jacopo; Rota, Matteo; Avalli, Leonello; Citerio, Giuseppe

2017-09-01

In a consecutive cohort of cardiac arrest (CA) treated with extracorporeal cardiopulmonary resuscitation (eCPR), we describe the incidence of brain death (BD), the eligibility for organ donation and the short-term follow-up of the transplanted organs. All refractory in- and out-of-hospital CA admitted to our Cardiac Intensive Care Unit between January 2011 and September 2016 treated with eCPR were enrolled in the study. 112 CA patients received eCPR. 82 (73.2%) died in hospital, 25 BD (22.3%) and 57 for other causes (50.9%). At the time of first neurological evaluation after rewarming, variables related to evolution to BD were a lower GCS (3 [3-3] vs. 8 [3-11], pdonation in BD patients was 56%, with 39 donated organs: 23 kidneys, 12 livers, and 4 lungs. 89.74% of the transplanted organs reached an early good functional recovery. In refractory CA patients treated with eCPR, the prevalence of BD is high. This population has a high potential for considering organ donation. Donated organs have a good outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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Carl Magnus Sköld

2016-07-01

Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients: a double-blind placebo-controlled study.

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Poyurovsky, Michael; Fuchs, Camil; Pashinian, Artashez; Levi, Aya; Faragian, Sarit; Maayan, Rachel; Gil-Ad, Irit

2007-06-01

Search for safe and effective strategies to diminish weight gain associated with second generation antipsychotics (SGAs) is imperative. In the present study, we sought to replicate our preliminary findings, which indicated that coadministration of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain. Fifty-nine patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in this randomized double-blind study. Reboxetine (4 mg/day; 31 patients) or placebo (29 patients) was coadministered with olanzapine (10 mg/day) for 6 weeks. Analysis was by intention-to-treat. Nine patients in each group prematurely discontinued the trial. Olanzapine/reboxetine-treated patients showed a significantly lower increase in body weight (mean = 3.31 kg, SD = 2.73) than their olanzapine/placebo-treated counterparts (mean = 4.91 kg, SD = 2.45). Significantly fewer olanzapine/reboxetine-treated patients gained at least 7% of their initial weight, the cutoff for clinically significant weight gain (6 [19.4%] of 31 patients vs 13 [46.4%] of 28 patients). Seven (22.6%) olanzapine/reboxetine-treated patients compared to only one patient (3.6%) in the olanzapine/placebo group revealed no weight change or even modest weight loss. Appetite increase was significantly lower in the olanzapine/reboxetine than olanzapine/placebo group and was correlated with attenuation of weight gain. Reboxetine addition was safe and well tolerated. The results confirm that coadministration of reboxetine promotes a clinically meaningful attenuation of olanzapine-induced weight gain in schizophrenia patients. If substantiated in long-term studies, along with behavioral management and diet counseling, reboxetine may have a clinical utility in controlling SGA-induced weight gain.

Refractory epilepsy treated by hemispherectomy, experience, retrospective analysis and results on the casuistry of patients treated at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014

International Nuclear Information System (INIS)

Murillo Alvarez, Ricardo

2015-01-01

A retrospective analysis is realized on the casuistry of patients treated with hemispherectomy in the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014. The bases of refractory epilepsy and the need of surgery as therapeutic are reviewed in patients treated. The hemispherectomies are quantified in the period between 1993-2014. The results obtained of the work carried at the Unidad de Monitoreo y Cirugia de Epilepsia from Hospital Nacional de Ninos is analyzed in the group of patients. The improvement in quality of life is documented in patients treated with hemispherectomy. Reduction in the amount of drugs used and suppression of subsequent seizures to surgery are determined in patients [es

Treatment outcomes and survival in patients with primary central nervous system lymphomas treated between 1995 and 2010 – a single centre report

International Nuclear Information System (INIS)

Jezersek Novakovic, Barbara

2012-01-01

Primary central nervous system lymphomas (PCNSL) are rare variants of extranodal non-Hodgkin’s lymphomas that are nowadays primarily treated with high-dose methotrexate or methotrexate-based chemotherapy with or without radiation therapy. The optimal treatment of PCNSL is still unknown and there are differences in clinical practice. With a retrospective research we evaluated our series of patients with PCNSL in regards to the patient’s characteristics, treatment results, disease specific survival and overall survival. Fifty nine patients who attended the Institute of Oncology Ljubljana between 1995 and 2010 were treated according to the protocol that was valid at the time of the patient’s admission. Between 1995 and 1999, the systemic treatment was classical CHOP (cyclophosphamide, doxorubicin, vincristine, steroids) chemotherapy, and later on high-dose methotrexate either alone or in combination with other agents. From 1999 onwards, radiation therapy was applied according to the patient’s age and response to chemotherapy, prior to that all patients treated with CHOP were also irradiated. Patients ineligible for the systemic treatment were treated with sole radiation therapy. There was a strong female predominance in our series and the median age at diagnosis was 59.8 years. Patients had predominantly aggressive B cell lymphomas (69.5%), one patient had marginal cell lymphoma and two patients T cell lymphoma. In total, 20.3% of patients were treated just with chemotherapy, 33.9% with combined therapy and 42.4% with sole radiation therapy. The overall response rate to the primary treatment in patients treated with sole chemotherapy was 33.3%, in patients treated with combined therapy 65% and in patients treated only with radiation therapy 56%, respectively. In terms of response duration, significantly better results were achieved with combined therapy or radiation therapy alone compared to sole chemotherapy (p<0.0006). The median overall survival of the

Comparison of the effectiveness of brand-name and generic antipsychotic drugs for treating patients with schizophrenia in Taiwan.

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Hsu, Chih-Wei; Lee, Sheng-Yu; Wang, Liang-Jen

2018-03-01

The purpose of this nationwide population-based study is to compare the long-term effectiveness of brand-name antipsychotics with generic antipsychotics for treating schizophrenia. We identified patients with schizophrenia who were prescribed antipsychotics from a random sample of one million records from Taiwan's National Health Insurance database, observed between January 1, 2000 and December 31, 2012. Only those with no prior use of antipsychotics for at least 180days were included. We selected patients who were prescribed brand-name risperidone (N=404), generic risperidone (N=145), brand-name sulpiride (N=334), or generic sulpiride (N=991). The effectiveness of the treatments researched in this study consisted of average daily doses, rates of treatment discontinuation, augmentation therapy, and psychiatric hospitalization. We found that compared to patients treated with generic risperidone, those treated with brand-name risperidone required lower daily doses (2.14mg vs. 2.61mg). However, the two groups demonstrated similar rates of treatment discontinuation, augmentation, and psychiatric hospitalization. On the other hand, in comparison with patients prescribed generic sulpiride, those treated with brand-name sulpiride not only required lower daily doses (302.72mg vs. 340.71mg) but also had lower psychiatric admission rates (adjusted hazard ratio: 0.24, 95% confidence interval: 0.10-0.56). In conclusion, for both risperidone and sulpiride, higher daily doses of the respective generic drugs were prescribed than with brand-name drugs in clinical settings. Furthermore, the brand-name sulpiride is more effective at preventing patients from hospitalization than generic sulpiride. These findings can serve as an important reference for clinical practices and healthcare economics for treating schizophrenic patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

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Flannery, Todd W.; Suntharalingam, Mohan; Regine, William F.; Chin, Lawrence S.; Krasna, Mark J.; Shehata, Michael K.; Edelman, Martin J.; Kremer, Marnie; Patchell, Roy A.; Kwok, Young

2008-01-01

Purpose: To report the outcome of patients with synchronous, solitary brain metastasis from non-small-cell lung cancer (NSCLC) treated with gamma knife stereotactic radiosurgery (GKSRS). Patients and Methods: Forty-two patients diagnosed with synchronous, solitary brain metastasis from NSCLC were treated with GKSRS between 1993 and 2006. The median Karnofsky performance status (KPS) was 90. Patients had thoracic Stage I-III disease (American Joint Committee on Cancer 2002 guidelines). Definitive thoracic therapy was delivered to 26/42 (62%) patients; 9 patients underwent chemotherapy and radiation, 12 patients had surgical resection, and 5 patients underwent preoperative chemoradiation and surgical resection. Results: The median overall survival (OS) was 18 months. The 1-, 2-, and 5-year actuarial OS rates were 71.3%, 34.1%, and 21%, respectively. For patients who underwent definitive thoracic therapy, the median OS was 26.4 months compared with 13.1 months for those who had nondefinitive therapy, and the 5-year actuarial OS was 34.6% vs. 0% (p < 0.0001). Median OS was significantly longer for patients with a KPS ≥90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: This is one of the largest series of patients diagnosed with synchronous, solitary brain metastasis from NSCLC treated with GKSRS. Definitive thoracic therapy and KPS significantly impacted OS. The 5-year OS of 21% demonstrates the potential for long-term survival in patients treated with GKSRS; therefore, patients with good KPS should be considered for definitive thoracic therapy

Metformin-treated patients with type 2 diabetes have normal mitochondrial complex I respiration

DEFF Research Database (Denmark)

Larsen, Steen; Rabøl, R; Hansen, C N

2012-01-01

The glucose-lowering drug metformin has been shown to inhibit complex I of the mitochondrial electron transport chain in skeletal muscle. To investigate this effect in vivo we studied skeletal muscle mitochondrial respiratory capacity and content from patients with type 2 diabetes treated...

Mortality and morbidity in elderly patients with fracture neck of femur treated by hemi arthroplasty

International Nuclear Information System (INIS)

Ahmad, I.

2006-01-01

To determine mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty (Austin Moore Prosthesis) during one year postoperatively. During the study period, all patients with fracture neck of femur, who were 65 years of age or above and treated by Austin Moore Prosthesis (AMP), were included. The patients were followed for one year at intervals of 2 weeks, 4 weeks, 6 months, and one year. All surviving patients were assessed for complications, both general and mechanical, related to the implant. The mortality and morbidity were compared for various age subgroups, and in patients with and without systemic co-morbidities.Chi square test was applied to see the significance of results. The total number of patients was 46 with average age of 70 years. Male to female ratio was 1:2. There were 70% patients who had one or more associated systemic disease. The mortality at 2 weeks was 4.3%, 17.4% at 6 months and 26% at one year. The overall dislocation rate was 4.3%. Two patients had infection and 17.4% patients had thigh pain at one year. The mortality and morbidity was high in patients with systemic comorbidities, and those above 70 years of age, but this was statistically not significant (p value >0.05). The functional assessment of surviving patients at one year was graded as excellent or good in 76.4% of patients. (author)

Associations between deepness of response and clinical outcomes among Japanese patients with metastatic colorectal cancer treated with second-line FOLFIRI plus cetuximab

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Osumi H

2015-08-01

Full Text Available Hiroki Osumi, Satoshi Matsusaka, Mitsukuni Suenaga, Eiji Shinozaki, Nobuyuki Mizunuma Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan Background: In the FIRE-3 trial, overall survival (OS was significantly longer in patients treated with FOLFIRI plus cetuximab (C-mab than in those treated with FOLFIRI plus bevacizumab (Bev, but progression-free survival (PFS was not significantly different. This may be associated with the deepness of response (DpR in patients treated with FOLFIRI plus C-mab. We aimed to evaluate the relationship between clinical outcome and DpR in metastatic colorectal cancer (mCRC patients treated with second-line FOLFIRI plus C-mab.Methods: A total of 112 patients with histopathologically confirmed mCRC treated with second-line FOLFIRI in combination with C-mab (N=42 or Bev (N=70 were retrospectively enrolled between October 2008 and June 2013. The relationship between DpR and clinical outcome in patients treated with FOLFIRI plus C-mab or Bev was determined.Results: Forty-two patients treated with FOLFIRI plus C-mab had a mean DpR of 6.1% (interquartile range: -13.7%, 20.8% and a minimum DpR of -62.7%. On the other hand, 70 patients treated with FOLFIRI plus Bev had a mean DpR of 0% (interquartile range: -16%, 10% and a minimum DpR of -111%. DpR ≥30% was associated with significantly longer OS and PFS when compared with DpR ≤30% in patients given FOLFIRI plus C-mab. DpR (≥30% was independently associated with prolongation of OS and PFS. In patients treated with FOLFIRI plus C-mab, there was a moderate positive correlation between DpR and clinical outcomes (OS: r=0.51, P<0.001; PFS: r=0.54, P<0.001.Conclusion: FOLFIRI plus C-mab yielded a stronger correlation between DpR and clinical outcomes. These results indicate the potential of DpR as a new measure of efficacy in mCRC patients treated with second-line chemotherapy plus C-mab. Keywords: deepness of

[Erectile dysfunction in patients treated for bladder and prostate cancer].

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Tkocz, Michał T; Kupajski, Maciej T

2009-01-01

The disorders of the erectile dysfunction are well-known complication connected with the operating interventions of abdominal and pelvic surgery. Radical treatment of the malignancy, vascular operations and transurethral resection can lead to the rise of these disorders. The majority of these interventions is carried out at patients in the old age at which the disorders of the erection already existed about the various degree of intensification before treating operating how also the presence of the illnesses of the leaders to their rise or intensification after finishing the treatment (diabetes, arterial hypertension, arteriosclerosis). Patients in the young aged wait not only curing from the malignancy from second side, but also the behaviour of the quality of the life (QOL - quality of life), which the correct erection enabling is one of elements satisfying living together.

Application of cryoprecipitate in patients treated by portaazygous devascularization

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YANG Zhaoxu

2013-01-01

Full Text Available ObjectiveTo evaluate the effect of cryoprecipitate-based blood component therapy on reducing perioperative risk in patients treated with portaazygous devascularization and to assess its influence on risk of post-operative complications. MethodsSixty-eight patients with portal hypertension who were scheduled for portaazygous devascularization were randomly assigned to receive either the standard surgery (control group, n=34 or surgery combined with perioperative transfusion of 10U cryoprecipitate (treatment group, n=34. Data recorded for inter-group comparative analysis (t-test included postoperative blood loss, prothrombin time, and recovery time, as well as incidences of re-hemorrhage in the gastrointestinal tract and of portal vein thrombosis. ResultsCompared with the control group, the cryoprecipitate-transfused patients showed significantly lower amount of blood loss after surgery and significantly lower incidence of postoperative bleeding and of re-hemorrhage in the gastrointestinal tract. The cryoprecipitate-transfused patients also experienced a shorter duration recovery period, with less days of in-hospital stay. There was no increase in the incidence of portal vein thrombosis after the use of cryoprecipitate. ConclusionApplication of cryoprecipitate during portaazygous devascularization surgery is safe and can improve coagulation function and reduce the risk of perioperative bleeding. Perioperative cryoprecipitate administration also benefits postoperative recovery and does not increase the incidence of portal vein thrombosis.

An outcome analysis of seventeen patients treated surgically for intractable extratemporal epilepsy.

LENUS (Irish Health Repository)

Mulholland, D

2010-07-01

We studied the outcomes of seventeen patients treated surgically for extratemporal lobe epilepsy. A retrospective case review of medical charts was performed. Seizure freedom post surgery was appraised using the Engel classification system. Post-operatively seven patients (41%) were seizure free (Engel class I), four patients were class II (23.5%), two in class III (11.76%) and four in class IV (23.5%). Three patients (17.6%) suffered traumatic injuries due to seizures. The mean duration of epilepsy prior to surgery was 12.2 years and the mean number of anti-epileptic medications given was 6.5. Seizure freedom rates for surgical treatment of extratemporal epilepsy in this centre are similar to those of other centres. Post-operative morbidity in this centre was similar to other centres. Any complications resolved with no lasting impairment.

Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Treated by Noninvasive Mechanic Ventilation

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Zekeriya Küçükdurmaz

2011-08-01

Full Text Available Aims: This study aimed to investigate heart rate variability (HRV of patients with severe COPD who are treated by noninvasive mechanic ventilation (NIMV.Patients and Method: Twenty-seven patient (58±8 years, 9 F with severe COPD treated by nocturnal NIMV at home and 23 sex and age matched volunteers (56±8 years, 11 F who has not dyspnea as a control group recruited in the study. Subjects underwent spirometry, blood gas analysis, transthoracic echocardiography, 24 hours ambulatory ECG analysis. Time domain HRV analysis performed from ambulatory ECG records. Results: 52% of patients at NYHA functional class II, 36% at class III, and 12% at class IV when they have been treated by NIMV. Groups were similar for age and sex (p>0.05 for both. Heart rates of patients were higher significantly than controls’ (p0.05. But, systolic pulmonary pressures were higher of COPD group (p<0.01. 24 hours heart rate was higher, and standard deviation of normal R-R intervals (SDNN 24 hours, SDNN night, SDNN day, SDNN index (SDNNI and standard deviation of mean R-R intervals (SDANNI values were lower in COPD group significantly. SDNN was inversely correlated with duration of daily NIMV usage, intensive care unit administration and entubation rate and PaCO2. SDNNI was inversely correlated with functional class, duration of daily NIMV usage, intensive care unit administration rate and PaCO2. Else, SDNNI was correlated with predicted forced vital capacity % (FVC% and predicted forced expiratory volume at 1 second % (FEV1%.Conclusion: Time domain HRV decreases in patients with severe COPD. Decrease is correlated with severity of disease, and it presents in despite of the chronic nocturnal NIMV application. These patients have high risk for cardiovascular morbidity and mortality and should be monitored and manegement for cardiovascular events.

Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States.

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Jung, Kyoungwon; Matsumoto, Shokei; Smith, Alan; Hwang, Kyungjin; Lee, John Cook-Jong; Coimbra, Raul

2018-06-05

The South Korean government recently developed a master plan for establishing a national trauma system based on the implementation of regional trauma centers. We aimed to compare outcomes between severely injured patients treated at a recently established South Korean trauma center and matched patients treated in American level-1 trauma centers. Two cohorts were selected from an institutional trauma database at Ajou University Medical Center (AUMC) and the American National Trauma Data Bank. Adult patients with an Injury Severity Score of ≥9 were included. Patients were matched based on covariates that affect mortality, using 1:1 propensity score matching. We compared outcomes between the two datasets and performed survival analyses. We created 1,451 and 2,103 matched pairs for the pre-trauma center and post-trauma center periods, respectively. The in-hospital mortality rate was higher in the institutional trauma database pre-trauma center period compared with the American National Trauma Data Bank (11.6% versus 8.1%, P<.001). However, the mortality rate decreased in the institutional trauma database post-trauma center period and was similar to that in the American National Trauma Data Bank (6.9% versus 6.8%, P=.903). Being treated at Ajou University Medical Center Trauma Center was significantly associated with higher mortality during the pre-trauma center period (OR: 1.842, 95% CI: 1.336-2.540; P<.001), although no significant association was observed during the post-trauma center period (OR: 1.102, 95% CI: 0.827-1.468; P=.509). The mortality rate improved after a trauma center was established in a South Korean hospital and is similar to that from matched cases treated at American level-1 trauma centers. Thus, creating trauma centers and a regional trauma system may improve outcomes in major trauma cases. Copyright © 2018 Elsevier Inc. All rights reserved.

Long-term Treatment Response and Patient Outcomes for Vestibular Schwannoma Patients Treated with Hypofractionated Stereotactic Radiotherapy

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Mira A. Patel

2017-09-01

Full Text Available PurposeThe aim of this study is to evaluate long-term treatment outcome and toxicities among vestibular schwannoma (VS patients treated with hypofractionated stereotactic radiotherapy (HSRT.Methods383 patients with unilateral VS treated with HSRT (25 Gy, five fractions between 1995 and 2007 were retrospectively reviewed. Treatment failure was defined as requiring salvage microsurgery. Posttreatment new/progressive clinical symptoms or increases in baseline tumor volume (BTV due to treatment effect or progression were noted. Symptom outcomes were reported as baseline and posttreatment ± improvement, respectively. Symptoms were grouped by cranial nerve (CN VII or CNVIII. Audiometry was assessed baseline and posttreatment hearing. Patients were grouped as having greater than serviceable hearing [Gardner Robertson (GR score 1–2] or less than non-serviceable hearing (GR score 3–5 by audiometry.ResultsMedian follow-up was 72.0 months. Nine (2.3% experienced treatment failure. At last follow-up, 74 (19.3% had new/progressive symptoms and were categorized as radiologic non-responders, whereas 300 (78.3% had no tumor progression and were grouped as radiologic responders. Average pretreatment BTV for treatment failures, radiologic non-responders, and radiologic responders was 2.11, 0.44, and 1.87 cm3, respectively. Pretreatment CNVII and CNVIII symptoms were present in 9.4 and 93.4% of patients, respectively. Eight (24% with pre-HSRT CNVII and 37 (10% with pre-HSRT CNVIII symptoms recovered CN function post-HSRT. Thirty-five (9% and 36 (9.4% experienced new CNVII and CNVIII deficit, respectively, after HSRT. Of these, 20 (57% and 18 (50% recovered CNVII and CNVIII function, respectively, after HSRT. Evaluable audiograms were available in 199 patients. At baseline and at last follow-up, 65.8 and 36.2% had serviceable hearing, respectively. Fifty-one percent had preservation of serviceable hearing at last follow-up.ConclusionTreatment of VS

Defining Prolonged Length of Acute Care Stay for Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage: A Population-Based Analysis

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Marco Stein

2016-01-01

Full Text Available Background. The definition of prolonged length of stay (LOS during acute care remains unclear among surgically and conservatively treated patients with intracerebral hemorrhage (ICH. Methods. Using a population-based quality assessment registry, we calculated change points in LOS for surgically and conservatively treated patients with ICH. The influence of comorbidities, baseline characteristics at admission, and in-hospital complications on prolonged LOS was evaluated in a multivariate model. Results. Overall, 13272 patients with ICH were included in the analysis. Surgical therapy of the hematoma was documented in 1405 (10.6% patients. Change points for LOS were 22 days (CI: 8, 22; CL 98% for surgically treated patients and 16 days (CI: 16, 16; CL: 99% for conservatively treated patients. Ventilation therapy was related to prolonged LOS in surgically (OR: 2.2, 95% CI: 1.5–3.1; P<0.001 and conservatively treated patients (OR: 2.5, 95% CI: 2.2–2.9; P<0.001. Two or more in-hospital complications in surgical patients (OR: 2.7, 95% CI: 2.1–3.5 and ≥1 in conservative patients (OR: 3.0, 95% CI: 2.7–3.3 were predictors of prolonged LOS. Conclusion. The definition of prolonged LOS after ICH could be useful for several aspects of quality management and research. Preventing in-hospital complications could decrease the number of patients with prolonged LOS.

REACCIONES ADVERSAS A LAS QUINOLONAS EN ATENCIÓN PRIMARIA. PINAR DEL RÍO, CUBA 2009.

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Ismary Alfonso Orta

2010-01-01

Full Text Available Introduction: The irrational use of antibiotics can cause resistance, adverse reactions and increased cost. Quinolones used in Cuba are exempt from this problem.Objectives: To characterize the adverse reactions to quinolones in Pinar del Rio, 2009.Method: An observational, descriptive and cross through a surveillance study of such intensive monitoring of patients treated with nalidixic acid and ciprofloxacin in 2009, in the province of Pinar del Río.Main results: There is contraindication to ciprofloxacin and nalidixic acid, 35.0% of patients, in 30.6% of patients were RAM, and a large number were: epigastric pain, nausea, headache and vomiting. The 71.7 of these ADRs were mild, 75.3% possible, frequent ADRs accounted for 75.9% and 75.3% preventable.Conclusion: The types of adverse drug reactions were prevalent: epigastragia, nausea and headache, highlights the likely adverse reactions frequent, serious and preventable.

Bezoar in a Pediatric Oncology Patient Treated with Coca-Cola.

Science.gov (United States)

Naramore, Sara; Virojanapa, Amy; Bell, Moshe; Jhaveri, Punit N

2015-01-01

A bezoar is a mass of indigestible material. Bezoars can present with a gradual onset of non-specific gastrointestinal symptoms including abdominal pain, nausea and vomiting. However, bezoars can result in more serious conditions such as intestinal bleeding or obstruction. Without quick recognition, particularly in susceptible individuals, the diagnosis and treatment can be delayed. Currently resolution is achieved with enzymatic dissolution, endoscopic fragmentation or surgery. We describe, to our knowledge, the first pediatric patient with lymphoma to have had a bezoar treated with Coca-Cola.

High prevalence of ulcer bleeding risk factors in dual antiplatelet-treated patients after percutaneous coronary intervention

DEFF Research Database (Denmark)

Jensen, Berit Elin S; Hansen, Jane M; Junker, Anders B

2015-01-01

INTRODUCTION: Dual antiplatelet therapy is standard treatment following percutaneous coronary intervention (PCI) and stenting. However, such therapy increases the risk of upper gastrointestinal bleeding (UGIB). The risk factors of UGIB are well-documented and proton pump inhibitor (PPI) treatment...... reduces the risk. The aim was to describe the prevalence of risk factors of UGIB in dual antiplatelet-treated patients. METHODS: A questionnaire was used to assess the prevalence of risk factors of upper gastrointestinal bleeding among dual antiplatelet-treated first-time PCI patients in Western Denmark......: A total of 1,358 patients with a mean age of 64.1 years (range: 33-92 years) were included. The distribution of risk factors was as follows: dyspepsia: 681 patients (50.1%); previous ulcer: 110 (8.1%; 2.3% with bleeding); use of NSAIDs: 214 (15.8%); corticosteroids (2.9%), SSRIs (5.8%) and anticoagulants...

Persistent lipid abnormalities in statin-treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study

NARCIS (Netherlands)

Leiter, L. A.; Lundman, P.; da Silva, P. M.; Drexel, H.; Jünger, C.; Gitt, A. K.; Absenger, Guun; Albrich, Ernst; Allinger, Berndt; Allinger, Stephan; Anacher, Gerald; Angermayr, Gertraud; Angermeier, Hermann; Anzengruber, Aneas; Archimanitis, Gabriele; Arnsteiner, Patricia; Auberger, Wolfgang; Azhary, Mawaheb; Barfuss, Michael; Bauer, Christian; Bauer, Birgit Elisabeth; Beclin, Thomas; Binder, Thomas; Binder, Gabriele; Böhler, Dietmar; Brändle, Johann; Breslmair, Jörg; Brettlecker, Marlis; Bürger, Michael; Calvi, Inge; Dorfinger, Werner; Doringer-Schnepf, Elisabeth; Eer, Anton; Eckmayr, Christine; Eder, Franz; Egermann, Margit; Erath, Michael; Etzinger, Michael; Etzinger, Claudia; Fiedler, Lothar; Filip, Wolfgang; Filip, Michaela; Föchterle, Johann; Fodor, Anita; Frieden, Thomas; Gareiss, Mertens; Gföllner, Peter; Ghamarian, Thomas; Goritschan, Michael; Haar, Klaus; Habeler, Gerhard; Hadjiivanov, Valery; Haiböck, Christian; Hammer, Regina; Hartmann, Siegfried; Haschkovitz, Herbert; Hauer, Walter; Hauer, Josef; Haunschmidt, Christian; Heimayr, Christine; Hengl, Wolfgang; Hengl, Gunter; Hermann, Rudolf; Herrmann, Rainer; Hillebrand, Roswitha; Hintersteininger, Otto; Hirsch, Michael; Hitzinger, Martin; Hochegger, Tanja; Hockl, Wolfgang; Hoi, Michael; Hörmann, Jan; Hudler, Brigitte; Imb, Gerhard; Joichl, Anea; Jungbauer, Karl; Kapl, Gerlinde; Kerschbaum, Margit; Kienesberger, Franz; Killinger, Gerhard; Kitzler, Gerhard; Klein, Franz; Kleinbichler, Dietmar; Kohr, Anton; Kopetzky, Michael; Korthals, Christian; Kortschak, Werner; Koschutnik, Martin; Kraus, Werner A.; Kurzemann, Susanne; Lavicka, Claus; Lehner, Guido; Lenz, Jürgen; Lepuschütz, Sabine; Lichtenwallner, Michael; Lober, Reinhard; Loidl, Christine; Lopatka, Eduard; Ludwig, Rudolf; Maca, Thomas; Mair, Anneliese; Mandak, Michael; Margreiter, Maria; Margreiter, Anea; Markovics, Michael; Matejicek, Frieich; Mohilla, Maximillian; Moll, Christian; Mörz, Beate; Mörz, Reinhard; Nagl, Heinz; Neumayr, Günther; Oberroitmair, Helmut; Oberzinner, Michael; Pallamar, Walter; Pangratz, Sibylle; Parandian, Laurenz; Paulus, Alexana; Pfaffenwimmer, Christoph; Plaichinger, Peter; Pokorn, Thomas; Polanec, Helmuth; Pöll-Weiss, Barbara; Pralea, Doralina; Puttinger, Johann; Quinton, Thomas; Ranegger, Matthias; Rass, Sepp; Rauch, Heribert; Riehs, Manfred; Robetin, Erich; Rohringer, Jörg; Rupprechter, Josef; Sadjed, Eduard; Schimbach, Johann Alois; Schmid, Jutta; Schneiderbauer, Rotraud; Schopper, Wolfgang; Schulze-Bauer, Alfred; Schuster, Gottfried; Schwarz, Johann; Schwarz, Maria; Schweighofer, Christoph; Schwelle, Franz; Simma, Hanspeter; Sock, Renate; Sock, Reinhard; Sprenger, Fritz; Stiglmayr, Thomas; Stocker, Ilse; Stütz, Pia; Tama, Mustafa; Teleky, Ursula; Tschauko, Werner; Veits, Martin; Vikydal, Gerhard; Vlaschitz, Karl; Wais, Elisabeth; Wais, Adam; Wegmann, Robert; Wehle, Franz; Weindl, Manfred; Weinhandl, Manuela; Wendt, Ursula; Wendt, Klaus; Werner-Tutschku, Volker; Werner-Tutschku, Christine; Wilscher, Josef; Wind, Norbert; Winter, Aneas; Wolfschütz, Gerald; Wolfsgruber, Markus; Wolfsgruber, Brigitte; Wurm, Renate; Ziebart-Schroth, Arno; Zimmermann, Maximillian; Zinnagl, Aneas; Zirm, Anea; Zirm Canada, Bernhard; Bokenfohr, Grace Mary; Liu, Edmond K. H.; Melling, Gordon W.; Papp, Edward William; Sachdeva, Ashok K.; Snyman, Ernst Retief; Varma, Sonya; Ward, Richard A.; Tiong Wong, Anew Pak; Basson, Paul J.; Brodie, Brian D.; Chahal, Sukhjiwan Jeevyn; Chan, William Y.; Chow, John C.; Cormack, Maura; Eddy, Donald H. J.; Ezekiel, Daniel; Farquhar, Anew; Gu, Shian; Hii, Ting H.; Ho-Asjoe, Marianne P. K.; Hosie, Anew; Jaffer, Shahin; Jakubowski, Anew T.; Karim, Mandy; Kiai, Cristina; Kooy, Jacobus; Lytle, Craig R.; Mcleod, Kevin Lain; Morgan, David C.; Myckatyn, Michael M.; Ng, John P. Y.; Schriemer, Ronnald; Schumacher, Gerhard; Grey Stopforth, James; Hoo Tsui, Winston Wai; Wilson, Robin T.; Wong, Danny; Wong, Wilfred T.; Yeung, Margaret M. W.; Cram, David Harvey; Kumari Dissanayake, Dilani Tamara; Gerber, Johan Daniel W.; Haligowski, David; Hrabarchuk, Blair; Kroczak, Tadeusz J.; Lipson, Alan H.; Mahay, Raj K.; Wessels Mare, Abraham Carel; Mohamdee, Feisal John; Olynyk, Frederick Theodore; Pieterse, Wickus; Ramgoolam, Rajenanath; Rothova, Anna; Saunders, Kevin Kenneth; Szajkowski, Stanley; van Gend, Richard F.; van Rensburg, Nicolaas Marthinus Jansen; Anand, Sanjiv; Baer, Carolyn E. H.; Basque, Eric J. Y.; Benaya, Sebastian; Bessoudo, Ricardo; Bhalla, Jaswinder; Chettiar, Nataraj V.; Craig, Brian N.; Desrosiers, France; Ranjani Imbulgoda, Manel; Morgan, Gareth M.; Nowak, Zbigniew J.; Scott, Daniel G.; Searles, Gregory R.; Slorach, J. Ninian; Stevenson, Robert N.; Browne, Noel John; Bruff, Karl Joseph; Collingwood, John Maurice; Collins, Wayne; Over, Aidan; Gabriel, Anthony M.; Govender, Moonsamy; Hart, David G.; Hatcher, Lydia B.; Janes, John; Kielty, John F.; Krisdaphongs, Michoke; Lush, Richard Boyd; Moulton, William Bertram; Riche, Cyril R.; Rideout, Gary M.; Roberts, Bernard C.; Walsh, Paul E.; Wight, Harold G.; Woodland, K. Heather; Woodland, Robert C.; Atkinson, Bradley Charles; Chow, Carlyle S. H. A.; Collins, James A.; Graham, Robert D.; Hosein, Jalal; Machel, Teresa M.; Mahaney, Gordon Ralston; Mclean, James Robert Bruce; Murray, Michael R.; Myatt, Gregory Alexander; Ozere, Christopher P.; Saha, Amal Krishna; Sanders, David Herbert; Seaman, Donald Maxwell; Seaman, James Gordon; Swinamer, Deanna; Voon Yee, Kenny Yew; Ali, Mohamed Mustapha; Bankay, Clarence D. C.; Beduhn, Eitel Erich Reinhold; Callaghan, Denis J.; Chan, Yun Kai; Chaudhri, Arif R.; Chen, Richard Y. Y.; Conway, James Robin; Cunningham, William L.; Cusimano, Steven Lawrence; Souza, Eleanor De; de Souza, Selwyn X.; Deyoung, John Paul; Epstein, Ralph; Faiers, Alan Arthur; Figurado, Victor John; Forbes, F. Basil Trayer; Gabor, Zsuzsanna; Gallardo, Rodolfo Canonizado; Gaur, Shiva K.; George, Elizabeth; Hartford, Brian J.; Shiu-Chung Ho, Michael; Ho, Chung; Ismail, Shiraz H.; Bhushan Kalra, Bharat; Koprowicz, Kinga; Kumar, Naresh; Lam, Clement; Lau, Ming-Jarm; Law, Hugo Kwok Cheung; Fung, Max Leung Sui; Liutkus, Joanne Frances; Lotfallah, Talaat K.; Luton, Robert G.; Meneses, Gloria S.; Miller, Mark Lee; Nagji, Noorbegum; Ng, Ken H. M.; Ng Thow Hing, Roland E.; Pandey, Amritanshu Shekhar; Petrov, Ivan; Rosenthall, Wendy; Rudner, Howard; Russell, Alan Douglas; Sanchez, Zenia A.; Shaban, Joseph A.; Shariff, Shiraz B. K.; Shih, Chung Ming; Sinclair, Duncan W.; Spink, Donald Richard; Tung, Tommy Hak Tsun; Vizel, Saul; Yanover, David Frederick; Zavodni, Louis S.; Cusack, Paul; Dewar, Charles M.; Hooley, Peter; Kassner, Rachel Anne; Mackinnon, Randy James; Molyneaux, Harold W.; Shetty, Karunakara Naduhithlu; Barrière, Ginette; Berjat, Maria B.; Bernucci, Bruno; Bérubé, Claude; Boueau, Ghyslain; Chehayeb, Raja; Ciricillo, Domenico; Constance, Christian M.; Côté, Gilles; Desroches, Jacques; Gagnon, Robert; Gaueau, Gilles; Godbout, Jean Louis; Harvey, Pierre; Hassan, Youssef; Hoang, Ngoc Vinh; Houde, Danielle; Lalonde, Alain-Paul; Lavoie, Régis; Leclair, Normand; Meagher, Luc; Ouimet, Alain; Plourde, Simon; Rioux, Denis W.; Roberge, Claude; Roy, Bruno; Sasseville, Richard; Serfaty, Samuel; Theriault, Lyne; Timothée, Jean R.; Tjia, Sabine; Tremblay, Bruno; Turcotte, Jean; Bose, Sabyasachi; Aletta Bouwer, Hester; Chernesky, Patricia A.; Johnson, Mervin Louis; Kemp, David R.; Lai, Raymond Pong-Che; Lee, Frank R.; Lipsett, William G. C.; Lombard, Schalk J.; Majid, Falah S.; Malan, Johannes J.; Maree, Narinda; Nayar, Arun; Nel, Mandi; Oduntan, Oluwole O.; Rajakumar, Alphonsus R. J.; Baraka Ramadan, Fauzi; Shamsuzzaman, Mohammed; Vermeulen, Abraham P. M.; Fred, C.; Anthonsen, Birgitte; Ardest, Steen Pennerup; Arnold-Larsen, Susanne Kajsa; Axelsen, Allan; Barfoed, Klaus; Birkler, Niels Erik; Blokkebak, Jens; Boserup, Jørgen; Kettrup Brassøe, Jens Ole; Chovanec, Martin; Lykke Christensen, Bendt; Christensen, Micael; Skjøth Christensen, Randi; Eidner, Per Olav; Eisbo, Jørn; Elsvor, Jan; Engmann, Ida Veng-Christensen; Eriksen, Rene Milling; Frederiksen, Thorkil; Frølund, Hanne Charlotte; Garne, Susanne; Giørtz, Agnete; Gregersen, Bettina; Halkier, Merete Lundbye; Hansen, Jens Georg; Harder, Jan; Jørgen, Hans; Henriksen, O.; Kirkeby Hoffmann, Michael; Holk, Erik; Hollensen, Jan; Jacobsen, Rune; Jakobsen, Lotte; Jensen, Christian; Jensen, Morten; Jensen, Vibeke; Jepsen, Peter; Johannsen, Jens Arne; Verner Johansen, Lars; Johansen, Ole Steen; Juul, Kristian; Jørgensen, Arvid Frank; Jørgensen, Peter; Jørgensen, Ulrik Miilmann; Kensmark, Lars; Kjellerup, Carsten; Kjaer, Ejner; Kjaersgaard, Morten; Klubien, Peter; Kolby, Peter; Korsgaard Thomsen, Kristian; Krebs, Peter; Kristiansen, Tom; Lyng, Flemming; Madsen, Natalia V.; Meyer-Christensen, Jesper; Mogensen, Ole; Mortensen, Finn; Nielsen, Lotta Marie; Nielsen, Per Schiwe; Nielsen, Søren Kjærem; Ommen, Henrik; Juhl Otte, Jens; Østergaard Paridon, Volle; Parm, Michael; Peampour, Kian; Petersen, Kirsten; Pilgaard, Peder Jensen; Poulsen, Svend Erik; Preisler, Thomas; Hast Prins, Søren Ulrik; Randløv, Annette; Rasmussen, Birgit Reindahl; Elmegaard Rasmussen, Peter; Rasmussen, Regnar; Roed, Søren Flemming; Sander, Kirsten Foltmar; Schmidt, Ejnar Ørum; Jørgen Schultz, Paul; Smidemann, Margit; Solgaard, Jørgen; Stripp, Tommy; Søderlund, Michael Rene M.; Søgaard, Henning; Søndergaard, Dorte E.; Sørensen, Birgitte H.; Sørensen, Gerhard Seth; Thøgersen, Niels; Toftdahl, Hans; Uggerhøj, Hanne; Uhrenholt, Bjarne; Veronika Ullisch, Eva; Valentiner-Branth, Christian; Vinberg, Jørgen; Vinter, Svend Aage; Vittrup, Preben; Winther-Pedersen, Niels; Wøldike, Anne Grete; Zederkof, Jørgen M.; Thue Østergaard, Merete; Abiven, Patrick; Abraham, Dominique; de Beaumais, Philippe Adam; Ado, Jean Pierre; Affres, Helene; Agache, Regis; Airault Leman, Anne Marie; Moussarih, Abdallah Al; Albaric, Christian; Allaouchiche, Thierry; Allignol, Christian; Ammor, Mohammed; Ammoun Bourdelas, Corinne; Amsallem, Luc; Anquez, Denis; Antonini, Jean Michel; Assuied, Virginia; Attia, Gerard; Audebert, Olivier; Audibert, Henri; Ayach, Claude; Bagdadlian, Serge; Bagni, Marina; Baillet, Jean; Ballivian Cardozo, Fernando; Baranes, Robert; Barbier, Patricia; Barousse, Francoise; Bas, Sylvie; Battaglia, Jean Marc; Baudonnat, Bruno; Bauple, Jean Louis; Domengetroy, Frederic Baylac; Beard, Thierry; Beaumier, Eric; Beaumont, Jean Francois; Baylac Domengetroy, Frederic; Beck, Christian; Behar, Michel; Behr, Bernard; Benady, Richard; Benghanem, Mohamed Mounir; Benichou, Herve; Bensoussan, Jean Marc; Bensussan, Pierre; Bercegeay, Pascal; Berneau, Jean Baptiste; Bertolotti, Alexane; Bertrand, Sylviane; Besson, Alain; Bezanson, Christophe; Bezier, Christophe; Bezzina, Remy; Bichon, Herve; Bickar, Pierre; Billot, Pierre; Billot Belmere, Marie Claude; Bisson, Francois; Blanc, Dominique; Bloch, Jean Luc; Bloch, Bernard; Blondin, Hyacinthe; Blot, Jacques; Bloud, Raymond; Blouin, Pascal; Boesch, Christophe; Boiteux, Jean Luc; Bonnafous, Pierre; Bonneau, Yanick; Bonnefoy, Laurent; Borg, Bernard; Borys, Jean Michel; Brunehaut Petaut, Myriam; Boschmans, Sabine; Said, Rami Bou; Bouallouche, Abderrahmane; Bouchet, Jacques; Bouchlaghem, Khaled; Boulen, Yvon; Bouline, Benoit; Bounekhla, Mohamed Salah; Bouquin, Vincent; Bourgeois, Marie Brigitte; Bourgois, Didier; Brandily, Christian; Brandt, Pierre; Branquart, Frederic; Breilh, Patrick; Brilleman, Fabrice; Brisson, Thierry; Brocard, Francis; Bruel, Pierre; Brun, Jean Pierre; Buisson, Jean Gabriel; Buisson Virmoux, Isabelle; Bur, Christian; Cabal Malville, Elodie; Cabantous, Serge; Cabrol, Pierre; Cagnoli Gromovoi, Sylviane; Caillaux, Bruno Xavier; Caillot, Didier; Canchon Ottaviani, Isabelle; Canu, Philippe; Caramella, Alexana; Caramella, Alexane; Cardaillac, Christian; Carrivale, Alain; Cartal, Jean Pierre; Cassany, Bernard; Cauon, Bernard; Causeret, Jean Marie; Caye, Philippe; Cayet, Jean Paul; Cazor, Gilles; Cesarini, Joel; Chakra, Georges; Chambeau, Bernadette; Chambon, Valerie; Chanas, Jack; Chapuzot, Patrick; Charon, Ane; Charpin, Eric; Charton, Frederic; Cheikel, Jean; Chemin, Philippe; Chennouf, Kamel; Chequel, Henri; Chevrier, Denis; Ciroux, Patrick; Cissou, Yves; Claeys, Jean Luc; Clariond, Yves; Classen, Olivier; Cloerec, Ane; Clouet, Sophie; Cloup Lefeuvre, Anne Marie; Cochet, Chantal; Cocuau, Didier; Cohen, Henri; Cohen Presberg, Pascale Cohen; Colin, Stephane; Colin, Remy; Colucci, Robert; Come, Philippe; Condouret, Pierre; Conturie, Agnes; Corbin, Ane; Corticelli, Paola; Coste, Daniel; Cotrel, Olivier; Coueau, Sylvie; Coulon, Paul; Courdy, Christian; Courtin, Marc; Courtot, Pierre; Coutrey, Laurent; Couval, Rene; Cravello, Patrick; Cressey, Olivier; Cuisinier, Yves; Cunin, Bernard; Cunnington, Bernard; Cusseau, Herve; Cuvelier, Christian; Arailh, Bruno D.; Dabboura, Adib; Dages, Laurence; Dahmani, Noureddine; Dandignac, Jean Christophe; Daney, Dominique; Dannel, Bernard; Darbois, Dominique; Dareths, Philippe; Daubin, Daniel; David, Jean Claude; de Foiard, Patrick; de Mallmann Guyot, Veronique De; de Wit, Marie Astrid; Debast, Francoise; Deboute, Eric; Debuc, Jean Pierre; Dechoux, Edouard; Decloux, Olivier; Decruyenaere, Yannick; Dejans, Jacques Maurice; Delarue, Michel; Delattre, Xavier; Delmaire, Patrick; Denis, Lucien; Deschamps Ben Ayed, Myriam; Devins, Pascal; Dezou, Sylvie; Dieuzaide, Pierre; Dirheimer, Bertrand; Dominguez, Paul; Donadille, Florence; Dondain, Benoit; Doridan, Pierre; Ouhet, Pascal; Dubois, Arnaud; Dubois, Ane; Ducharme, Pascal; Duchez, Paul; Dulard, Catherine; Dumoulin, Marc; Duprey, Georges; Durand, Jacques; Mohamed, Ibrahim; Chehab, El; Emery, Bernard; Emmanuel, Georges; Ashari, Ghazaleh Esna; Evrard, Eric; Fargeot Lamy, Aleth; Farges, Jean Louis; Faucher, Patrick; Faucie, Alain; Faure, Yves; Favre, Jean Jacques; Felipe, Jean Louis; Feret, Daniel; Ferragu, Alain; Ferrandin, Gerard; Ferriot, Francois; Finelle, Laurent; Flond, Jacques; Foieri, Jean; Fol, Stephane; Fontaine, Brigitte; Forichon, Dominique; Foucry, Michel; Fournier, Jean Francois; Fregeac, Bernard; Fuchs, Martin; Gabriel, Franck; Gaimard, Didier; Gallois, Stephane; Garapon, Georges; Garas, Mamdouh; Garcia, Pierre; Garcia, Jean Michel; Garcia, Marie Pierre; Garman, Waddah; Garzuel, Dominique; Gaspard, Jean Marc; Gauci, Laurent; Gautheron, Patrick; Gauthier, Jacques; Gauthier Lafaye, Pierre Yves; Gay, Michel Charles; Gay Duc, Bernadette; Gayout, Olivier; Gegu, Yann; Gentile, Francois; Germain, Emmanuel; Gharbi, Gerard; Gigandet Tamarelle, Catherine; Gilardie, Alain; Gilles Verliat, Martine; Gillet, Thierry; Gnana, Philippe; Goguey, Alain; Gombert, Alain; Gonin, Bernard; Gonzales, Philippe; Goulesque, Xavier; Graba, Jean Marc; Granier, Alain; Greiner, Olivier; Groboz, Martial; Gromoff, Serge; Grossemy, Xavier; Grossi, Christian; Guenin, Frederic; Gueranger, Pierre; Guerin, Patrick; Guerineau, Jean Pierre; Guessous Zghal, Fathia; Guicheux, Dominique; Guillere, Jacqueline; Guyonnet, Gilles; Haddad, Samir; Hadj, Nordine; Hamani, Djamel; Hamm, Jacky; Hammoudi, Djamal; Harle, Xavier; Harnie Coussau, Pierre; Hazen, Richard; Hembert, Francois; Hemon, Pierre; Hergue, Michel; Hestin, Christian; Heyraud, Luc; Hindennach, Dieter; Hirot, Etienne; Ho Wang Yin, Chan Shing; Hocquelet Denis, Catherine; Hoppe, Patrice; Horovitz, Daniel; Hours, Jean Michel; Houta, Benjamin; Hua, Gerard; Hui Bon Hoa, Nicole; Humez, Philippe; Hurier, Michel; Husson, Gerald; Hyvernat, Guy; Ichard, Jean Francois; Impens, Claude; Iovescu, Decebal; Jacob, Philippe; Jacob, Gildas; Jacquemart, Jean Pierre; Jacquier, Philippe; Jahanshahi Honorat, Shideh; Jalladeau, Jean Francois; Jan, Luc; Jannel, Yves; Jarrige, Vincent; Jeremiasz, Richard; Annick Jestin Depond, Marie; Joseph, Michel; Joseph Henri Fargue, Helene; Joubrel, Alain; Jouet, Alain; Julien, Bruno; Jullien, Francois; Jullien, Jean Louis; Kadoche, David; Kahl, Etienne; Kanawati, Aiman; Khalife, Sami; Khettou, Christophe; Kiers, Jean Paul; Kissel, Christian; Klein, Jean Claude; Klopfenstein, Samuel; Koch, Alexis; Koenig, Georges; Kohler, Philippe; Koriche, Abdelmalek; Labernardiere, Nicole; Labet, Philippe; Lablanche, Fabien; Laborde Laulhe, Vincent; Lagorce, Xavier; Laine, Eric; Lalague, Pascal; Laleu, Jean Noel; Lambert, Michel; Lambert Ledain, Mireille Lambert; Lambertyn, Xavier; Lame, Jean Francois; Langlois, Frederic; Lanoix, Eric; Laprade, Michel; Lasseri, Charaf; Laterrade, Bernard; Laurent, Jean Claude; Laurier, Bernard; Laval, Laurent; Le Borgne, Patrick; Le Franc, Pierre; Le Henaff, Patrick; Le Noir de Carlan, Herve; Le Roy, Jean Pierre; Le Roy Hennion, Florence; Lebon, Louis; Lecler, Olivier; Leclerc, Philippe; Ledieu, Christian; Lefebvre, Bernard; Lefevre, Philippe; Lehujeur, Catherine; Leiber, Christian; Leick, Gerard; Lemberthe, Thierry; Lenevez, Norbert; Lenoble, Patrick; Leriche, Philippe; Leroux, Eric; Leroy, Jean Michel; Leroy, Christian; Lescaillez, Dominique; Leurele, Christian; Lhermann, Sophie; Libermann, Pierre; Licari, Gilbert; Lo Re, Antoine; Long, Philippe; Long, Jean Louis; Lormeau, Boris; Louchart, Jean Christophe; Lucas, Jean Pierre; Luquet, Thierry; Lussato, Philippe; Maarouf, Moustapha; Mabilais, Francois; Magnier Sinclair, Christine; Mahot Moreau, Pascale; Malafosse, Denis; Mandirac, Jean Paul; Manolis, Jerome; Mante, Jean Pierre; Maquaire, Claude; Marchal, Thierry; Marchand, Guillaume; Marillesse, Olivier; Marmier, Gabriel; Herve Maron, Yves; Marrachelli, Nadine; Marsaux, Michel; Martin, Bruno; Martin, Michel; Deiss, Pascale Martin; Masson, Arnaud; Mativa, Bruno; Matton, Jean Francois; Mauffrey, Jean; Mauriere, Serge; Maurois, Georges; Maury, Joceline; Mayer, Frederic; Menu, Pierre; Mercier, Bernard; Messmer, Daniel; Mestiri, Sami; Meyer, Gilles; Michaelides, Michael; Michaud, Gilles; Michenaud, Bernard; Mielot, Stephane; Millory Marco, Jerry Anne; Mingam, Stephane; Mira, Reginald; Mius, Stephane; Monnier Meteau, Marie Paule; Mora, Francis; Morbois Trabut, Louise; Morosi, Laurent; Mougeolle, Jean Luc; Mouget, Jean Louis; Mouroux, Daniel; Mouthon, Jean Marie; Muller, Jacques; Nakache, Ane; Narbonne, Herve; Navarranne Roumec, Anne; Navarro, Pierre; Neubrand, Jean Yves; Nguyen, Quang Thieu; Nguyen Quang, Guy; Nguyen Xuan, Thong; Niot, Patrice; Oudart, Jean Maurice; Outteryck, Alain; Pages, Jean Marie; Paillet, Charles; Pain, Jean Marie; Pangaud de Gouville, Patricia; Paquin, Olivier; Parent, Vincent; Parer Richard, Claire; Parrot, Francine; Parthenay, Pascal; Pascariello, Jean Claude; Passebon, Jean Claude; Pere, Alain; Perelstein, Laurent; Perot, Michel; Petit, Richard; Petit, Philippe; Petit, Francois; Petruzzi, Philippe; Phelipeau, Denis; Philippon, Jean Claude; Philippon, Gilles; Picard, Bruno; Picard, Jean Claude; Picot, Bernard; Piera, Jean Francois; Pieri, Alain; Piffoux, Eric; Pilard, Patrick; Pillet, Alain; Pinot, Philippe; Pinzani, Alain; Pleskof, Alain; Plessier, Jean Claude; Plisson, Alain; Pochon, Claude; Poggi, Valerie; Poirat, Alain; Poiree, Maurice; Polleux, Janick; Noel Pontecaille, Jean; Posocco, Regis; Pospiech, Jean Claude; Pradies, Felix; Prevot, Remi; Pueyo, Jean Bernard; Quaelli, Jacques; Rabbia, Michel; Rabemananjara, Aimery; Rami, Saad; Rapin, Jean Jacques; Rasquin, Corinne; Ratinaud, Didier; Reboud, Bruno; Reboul, Philippe; Reichman, Jean Jacques; Reinhardt, Patrick; Renard Houta, Catherine Renard; Reverdy, Olivier; Revol, Michel; Rey, Pierre Alain; Richardeau, Yves; Rives, Bernard; Robida, Christine; Rochez Fraiberg, Muriel; Rodet, Jean Pierre; Rolland, Jean Francois; Romand, Bruno; Romano, Jean Paul; Rosati Gretere, Chantal; Rosey, Alain; Rosset, Martial; Rossi, Jean Pierre; Rouquette, Georges; Rousseau, Michel; Rousselon, Xavier; Roy, Christophe; Royer, Denis; Ruetsch, Marcel; Saade, Maurice; Saby Kuchler, Nicolas; Samar, Guy; Sanchez, Pierre Yves; Sane, Alain; Sanz, Jean Paul; Sardon, Michel; Sarrazin, Marc Eric; Sasportes, Gilbert; Saudou, Francis; Sauze, Elisabeth; Savary, Pascal; Schenowitz, Alain; Schmartz, Pierre; Schoepfer, Marc Olivier; Seewagen, Jacques; Serramoune, Denis; Serre, Christian; Sicard Guroo, Helene; Sichãc, Jean Philippe; Sifaoui, Sylvain; Simoncello, Marc; Simonin, Marie Jeanne; Simonnet, Jean Francois; Spindler, Didier; Steier, Alain; Sultan, Charles Raphael; Taghipour, Kouroch; Talayrach, Bruno; Talbot, Francois; Talhouarn, Vanessa; Tallec, Yves; Tarasco Schenrey, Elisabeth; Tarrene, Michel; Tater, Dominique; Tessier, Bernard; Teste, Marie; Thierry, Dominique; Thiollier, Patrice; Thoreau, Frederic; Thual, Jean; Traen, Vincent; Trigano, Jacques Alexane; Troussier, Jean Bernard; Truong Ky Minh, Bernard; van Melckebeke, Gerard; Vaque, Philippe; Vaucelle, Celine; Vedel, Eric; Venu, Didier; Verdavoine, Patrick; Vergeron, Jean; Viallon, Philippe; Viault, Dominique; Vieules, Jean Max; Vigier, Jean Paul; Vilain, Jean Marie; Villard, Bruno; Vitoux, Jean Francois; Viviand, Paul; Vivien, Olivier; Walter, Patrice; Waquier, Patrick; Waszkiewicz, Jean Marc; Weidich, Stephane; Westerfeld, Raymond; Weynachter, Gerald; Wilhelm, Pierre; Wolff, Claude; Wursthorn, Marc; Zammattio, Didier; Zylinski, Bernard; Lauer, Peter; Kühn, Uwe; Weltzel, Wolfgang; Mohr, Hella; Weyland, Klaus; Spittel, Bärbel; Böhm, Günter; Ferdowsy, Said; Hanusch, Peter; Spiekermann, Josef; Albert, Edwin; Stuff, Karl; Jungmair, Wolfgang; Koller, Sabine; Schubert, Wilhelm; Schlehahn, Fred; Bormann, Gundula; Graf, Kristof; Stiehler, Gisela; Bock, Manfred; Müller, Angelika; Haufe, Michael; Nielsen, Lorenz; Raum, Doris; Rogler, Karin; Bürstner, Joachim; Völk, Hans-Jörg; Sachse, Michael; Escher, Torsten; Doumit, Adel; O'dey, Hildegard; Holzmann, Ulrike; Sauer, Hermann; Schellenberg, Gottfried; Carius, Jürgen; Dänschel, Wilfried; Kopf, Aneas; Zerr, Elena; Tatalovic, Ratko; Rupp, Heiun; Anders, Elfriede; Mende, Marion; Volk, Ulrich; Hagenow, Aneas; Lang, Thomas; Schmitz, Karl-Heinz; Gössling, Jan-Henik; Mutsch, Günther; Steidel, Joachim; Osten, Klaus; Giokoglu, Kiriakos; Bellisch, Sabine; Füll, Katja; Walther, Wolfgang; Flick, Sabine; Dünnebier, Rosemarie; Dharmawan, Ichsan; Schönmehl, Wolfgang; Hoss, Valentin; Kipping, Stephan; Wolf, Hans-Joachim; Wolf, Hans-Frieich; Willmann, Volker; Bugarski, Bruno; Hoffschröer, Josef; Von Wallfeld, Siegrun; Ruhland, Guun; Bulling, Daniel; Häusler, Maren; Haustein, Gabriele; Kallenbach, Cornelia; Schwemmler, Claudia; Frank, Antje; Lodder-Bender, Ulrike; Rawe, Klaus; Reinert, Hans-Ferdinand; Schönhof, Petra; Fahrenschon, Klaus; Schorcht, Elisabeth; Etzold, Erika; Brehm, Michael; Paust, Wolf-Dieter; Schulte-Kemna, Achim; Pötter, Klaus-Werner; Ott-Voigtländer, Ulrike; Schwenke, Reto; Thinesse-Mallwitz, Manuela; Siml, Steffi; Stern, Hirene; Roelen, Harald; Scherhag, Klaus-Peter; Matulla, Petra; Herrmann, Hans Joachim; Neumann, Gerhard; Barbuia, Marius; Vormann, Reinhold; Hitzler, Karl; Linum, Aneas; Hanke, Klaus; Hohberg, Hans-Joachim; Klingel, Roger; Hohnstädter, Rainer; Klasen, Hartmut; Aschermann, Peter; Grau, Wilfried; Killinger, Paul; Gross, Kathrin; Naus, Rainer; Todoroff, Karin; Zühlke, Wolfgang; Kellner, Hanns-Ulrich; Hager, Eva; Thieme, Jochen; Kornitzky, Michael; Rösch, Volker; Heinze, Elke; Hiederer, Wolfgang; Konz, Karl-Heinz; Köhler, Michael; Diekmann, Martin; Junghans, Edith; Dietermann, Friedgard; Kerp, Ekkehard; Schäfer-Lehnhausen, Silvia; Kruck, Irmtraut; Ettelt, Rolf; Hölscher, Aneas; Kittler, Sybil; Jung, Heiun; Mailänder, Albert; Nowara, Peter; Ritschl, Harald; Mödl, Bernhard; Gallwitz, Torsten; Meyer, Stephan; Peter, Anton; Peters, Otto; Pflaum, Petra; Fröhlich, Karl-Heinz; Mertens, Hans-Jürgen; Merlin-Sprünken, Verena; Erpenbach, Klaus; Fervers, Frank; Kuhl, Ulrike; Halsig, Friedemann; Rein, Wilfried; Hauser, Ernst-Richard; Laubenthal, Florin; Richard, Frank; Langer, Claus; Lange, Rainer; Eska, Jan; Mohanty, George; Lange, Isengard; Eltges, Nicole; Kuntz, Christoph; Mechery, Thomas; Vöckl, Josef; Viergutz, Christoph; Stähle-Klose, Claudia; Sohr, Katja; Böhler, Steffen; Brecke, Georg; Burls, Malcolm; Werner, Karl-Michael; Vorpahl, Ralf; Stahl-Weigert, Beate; Bunge, Gerd; Thomsen, Jutta; Blessing, Erwin; Bengel, Bengel; Buhlmann, Ulla; Tröger, Tröger; Sippel, Sippel; Vossschulte, Vossschulte; Wilms, Wilms; Appelt, Appelt; Dauterstedt, Dauterstedt; Witte, Witte; Böttger, Uta; Wyborski, Waltraud; Strache, Sabine; Böttger, Werner; Zeiner, Luise; Wuttke, Wanda; Stoidner- Amann, Annette; Stoermer, Brigitte; Bock, Stephan; Groos-März, Cornelia; Thamm, Maria-Elisabeth; Meier, Josef; Schneider, Martin; Niessen, Ulrich; Storm, Gernot-Rainer; Streitbürger, Elmar; Münkel, Thomas; Palfi, Mihai; Naumann, Ulrich; Tannhof, Gabriele; Streibhardt, Frank; Gebhardt, Wolfgang; Nieswandt, Gerhard; Gerke, Ulrich; Nöhring, Axel; Bott, Jochen; Goertz, Jutta; Winkler, Dietmar; Lotter, Edith; Kraaz, Katja; Bärwinkel, Petra; Hildebrandt, Diana; Weyers, Georg; Kubin-Siring, Birgit; Baier, Eduard; Weber, Thomas; Holz, Dirk-Egbert; Wolfers, Johannes; Kihm, Wolfgang; Kamali-Ernst, Schirin; Amann, Wolfgang; Kaase, Hans-Jürgen; Banning, Ottmar; Voigt, Thomas; Grünert, Frank; Gürtler, Michael; Pferdmenges, Karin; van Treek, Heiko; Möller, Bernd; Weigel, Sybille; Jun Hassler, Normann; Mauer, Helmuth; Beckers, Erwin; Weber, Clemens-August; Hawash, Hana; Ladke, Dietrich; Labitzky, Gerlinde; Kunkel, Petra; Hartung, Wolfgang; Pomykaj, Thomas; Prokop, Heiun; Schleif, Thomas; Cascino, Luisa; Exner, Petra; Daelman, Eric; Dietrich, Aneas; Prasse, Thomas; Brundisch, Stefanie; Schipper, Ralf; Duderstaedt, Bernd; de Haan, Fokko; Schmidt-Reinwald, Astrid; Seidel, Peter; Schmitz, Joachim; Bülent, Ergec; Ja Pique, Pyoong; Ding, Roland; Eggeling, Thomas; Duderstaedt, Elvira; Ferchland, Hans-Peter; Kruth, Renate; Gralla, Dieter; Köhler, Angelika; Laborge, Joachim Rene; Hammer, Harald; Richter, Ilona; Sauldie, Happy; Valk-Denkema, Inge Van Der; van der Valk, Leo; Feely, John; Dunne, Liam; Cox, John; Doyle, Michael; O'Gorman, Mary; Kennedy, John; Maher, Brian; Forde, Derek; Harrington, Peter; Cronin, Brian; Coady, Anew; Craig, John; O'Dowd, Caroline; O'Doherty, Brian; O'Connor, Patrick; Ling, Roland; Perry, Majella; Crowley, James; Keaveney, Lynda; Townley, Eadaoin; O'Shea, Eamonn; Regan, Michael; Cunningham, Seamus; Bluett, Desmond; Whyte, Oliver; Casey, Michael; Ruane, Fergal; Fitzgerald, Eleanor; O'Beirn, Eugene; Faller, Eamonn; Moffatt, Sean; Coleman, Michael; Day, Brendan; Mcadam, Brendan; O'Neill, Daragh; Mac Mahon, Conor; Wheeler, Mark; Byrne, Sheila; Fulcher, Kieran; CAREY, Owen; O'Connell, Kieran; Keane, Jack; Almarsomi, Laith; Vaughan, Carl; O'Callaghan, Tom; Grufferty, Tadgh; Shanahan, Eamon; Crowley, Brendan; Moran, Joe; Cotter, Jeremy; Healy, Colin; Curtin, Tom; Dillon, Joe; Dennehy, Thomas; Murphy, Elaine; Kennedy, Michael; Coffey, Donal; Carroll, Paul O.; Oliver, Barry; Mccarthy, Shane; Joyce, Peter; O'Shea, Gerard; Apperloo, A. J.; Basart, D. C. G.; Bax, M.; Beysens, P. A. J.; Breed, J. G. S.; Derks, A.; Eijgenraam, J. W.; Hermann, J. P. R.; Janus, C. L.; Kaasjager, H. A. H.; Klomps, H. C.; Koole, M. A. C.; Koster, T.; Kroon, C.; Lieverse, A. G.; Massaar-Hagen, B. E. M.; Moghaddam, F.; Oldenburg-Ligtenberg, P. C.; Potter van Loon, B. J.; Stroes, E. S. G.; Twickler, Th B.; van Asperdt, F. G. M. H.; van Asseldonk, J. P. M.; van der Loos, T. L. J. M.; van der Velde, R. Y.; van der Vring, J. A. F.; van Dorp, W. T.; van Essen, G. G.; van Kalmthout, P. M.; van Liebergen, R. A. M.; van Wissem, S.; Waanders, H.; Withagen, A. J. A. M.; Andersen, Per Vidar Klemet; Andersen, Randi F.; Andersson, Egil; Arnstad, Asle; Belguendouz, Larbi; Birkeland, Inge Arve; Bjørkum, Kari; Bredvold, Thor; Brevig, Leif Harald; Buchman, Erik; Burkeland-Matre, Rune; Burski, Krzysztoft; Byre, Roald; Bø, Per Erik; Dahl, Erik; Duch, Anna; Duong, Khoa; Dvergsdal, Peter; Edvardsen, Magne; Ernø, Asbjørn; Fredwall, Svein Otto; Glasø, Morten; Glasø, Jan; Grini, Asbjørn; Hallaråker, Arne; Normann Hansen, Age Normann; Haugland, Helge Haugland; Henrichsen, Svein Høegh; Hestnes, Atle; Idehen, Norman I. E.; Jacobsen, Kristin Løland; Johansen, Ture; Johnsen, Roald; Jonasmo, Kåre; Kirknes, Svetalana; Kjetså, Arild; Kjaer, Peter; Knoph, Erik; Knutssøn, Carl; Koss, Arne; Kravtchenko, Oleg; Krogsæter, Dagfinn; Langaker, Kåre; Lind, Knut W.; Lund, Kjell Rømyhr; Madsbu, Sverre; Mehlum, Yvonne E. Mazurek; Moon, Philipp; Movafagh, Aram; Myhrer, Kurt; Nørager, Dan Michael; Ore, Stephan; Rafat, Hooshang B.; Rød, Reinert; Schmidt-Melbye, Torgeir; Singh, Navneet; Singsås, Tore; Skjelvan, Gunnar; Smet, Arthur; Staalesen, Staale; Storeheier, Espen; Storhaug, Sidsel; Storm-Larsen, Ane; Sundby, Jon Eivind; Syverstad, Dag Eivind; Sørensen, Anne Sissel; Torjusen, Trygve B.; Torkelsen, Arne; Tunby, Jan Reidar; Vanberg, Pål Johan; Vevatne, Audun; Vikse, Arild; Wahlstrøm, Viktor; Walaas, Kirsten; Walløe, Arne Eyolf; Wear-Hansen, Hans-Gunnar; Ole Ystgaard, Ole Aneas; Zimmermann, Birgit; Øvsthus, Knut; Aião, Julio; Albuquerque, Mario; Alves, Fernando; Esteves, Antonio; Amaral, Maria Fatima; Amaral, Fátima; Amorim, Helena; Anade, Benilde; Anade, Maria Benilde; Antonio, Godinho; Araujo, Francisco; Arriaga, Antonio; Baeta, Sonia; Afonso, Francisca Banha; Beato, Vitor; Beirão, Paula; Martins, Ausenda Belo; Bernardes, Jose; Botas, Luis; Baeta, Antonio; Ramos, Manuel Braga; Brandão, Peo; Brandão, Antonio G.; Brandão, Antonio; Raposo, Antonio Caetano; Carrilho, Francisco; Carvalho, Isabel; Carvalho, Patricia; Castel-Branco, Ana; Castellano, Maria Desamparados; Corredoura, Ana; Corredoura, Ana Sofia; Costa, Vitor; Coutinho, João; Crujo, Francisco; Cunha, Damião; Dias, Manuela; Fernandes, Maria Emilia; Ferreira, Gustavo; Ferreira, Dirce; Ferreira, Jorge; Ferreira, Antonio M.; Fonseca, Antonio; Freitas, Paula; Gago, Amandio; Galego, Rosa; Garrett, Antonio Viriato; Gavina, Cristina; Simões, José Geraldes; Gomes, Maria Fatima; Gomes, Norberto; Gomez, Brigitte; Graça, Peo; Gravato, Antonio; Guedes, Nuno Filipe; Guerra, Fernanda; Issa, Custódio; João, Isabel Fernandes; João, Isabel; Jorge, Vasco; Leite, Maria Salome; Lousada, Nuno; Macedo, Filipe M.; Madeira Lopes, João; Magalhães, Jorge; Marinho, Jose Carlos; Marques, Carlos; Marques, Jose Augusto; Marques Ferreira, Antonio; Martins, Jose Carlos; Martins, J. Belo; Matos, Alice; Melo, Miguel; Miguel, Antonia; Monteiro, Filomena; Monteiro, Francisco; Monteiro, Filomena B.; Sarmento, João Morais; Morato Sá, Maria José; Mota, Joana; Moura, Luis; Moura, Brenda; Neves, Lena; Neves, Celestino; Oliveira, Maria; Oliveira Ramos, Manuel; Osorio, Ramos; Pacheco, Joao; Palma, Isabel; Peixoto, Maria Cristina; Pereira, Helder; Pestana, João; Pignatelli, Duarte; Pinho, Hernani; Puig, Jorge; Raindo, Maria; Ramos, Helena; Rebelo, Marta; Roigues, Antonio; Roigues, Alvaro; Roigues, Elisabete; Rola, José; Rovytchcva, Milena; Sa, João; Santos, Fernando; Santos, João Cesar; Sequeira Duarte, Joao; Serra E Silva, Polybio; Silva, Bernardino; Silva, Paula; Silva, Maria; Silva, Francisco; Silva, Dora; Silva, José; Silvestre, Isabel; Simões, Heleno; Soares, Manuela; Sousa, Nelson; Sousa, Antonio; Souto, Delfina; Teixeira, Esmeralda; Torres, Isabel; Valle, Tahydi; Ventura, Carlos; Vicente, Ana; Vieira, Muriel; Alfaro, Rafael; Alonso, Roigo; Alvarez, Juan Carlos; Allut, Germán; Amado, Jose A.; Ampuero, Javier; Angel, Luis Fernando; Antolín, Eduardo; Anton, Javier; Aranda, Jose Luis; Argimon, Jordi; Arques, Francesc; Arribas, Jose Peo; Arroya, Concepción; Arroyo, Jose Antonio; Auladell, Maria Antonia; Bajo, Julian; BALVIN, Alberto; Ballester, Jose Vicente; Barreda Glez, Maria Jesus; Becerra, Antonio; Bermejo, Juan Carlos; Bernacer, Luis; Besada, Ricardo; Blasco, Jesús; Bravo, Manuel; Bueno, Francisco Manuel; Campo, Ignacio; Carrasco, Jose Luis; Catalán, José Ignacio; Cobo, Jose; Coello, Ignacio; Combarro, Jesús; Contreras, Juan A.; Correa, Julian; Cortilla, Alberto; Cuatrecasas, Guillem; Chicharro, Sana; de Dios, Juan; de Los Arcos, Enrique; de Portugal, Jose; del Cañizo, Francisco; del Molino, Fatima; Díaz, Jose Luis; Domingo, Javier; Escobar, Carlos; Escoda, Jaume; Espinosa, Eugenio; Ester, Francisco; Fernandez, Antonio; Ferreiro, Manuel; Fondas, Jose Maria; Fraile, Angel Luis; Franco, Miguel; Fuentes, Francisco; Garcia, Jose Antonio; Garcia, Domingo; Garcia, Manuel Enrique; García, Luis; Garcia, Jesus; Gilabert, Rosa; Goiria, Begoña; Gomez, Purificación; Gomez-Calcerrada, David; Gonzalez, Manuel; Gonzalez, Jose Manuel; Guijarro, Carlos; Guirao Gujarro, Victor; Herrera, Carlos; Herrera, Maria Carmen; Herrero, Miguel; Ibarguren, Amaya; Irigoyen, Luis; Jimenez, Blas; Lamelas, Jose Antonio; Laplaza, Ismael; Laporta, Felix; Lazo, Victor; Leal, Mariano; Ledesma, Vicente; Lopez, Peo; Lopez, Pablo; Lopez, Alberto; López, Maria Jose; Lopez-Cepero, Eduardo; Lorenzo, Francisco; Lucena, Javier; Luquín, Rafael; Lloveras, Ariadna; Maceda, Teresa; Macia, Ramon; Marti, Cristina; Martin, Jose Maria; Martin, Isodoro; Martín Lesende, Iñaki; Martinez, Mercedes; Martinez, Juan Alberto; Martinez, Peo; Martinez, Angel; Mato, Fernando; Medel, Federico; Mederos, Ana Maria; Mediavilla, Javier; Mediavilla, Gregorio; Mestron, Antonio; Michans, Antonio; Millán, Jesús; Molina, Carlos; Monroy, Carmelo; Monte, Inés; Montes, Jose Maria; Morales, Clotilde; Morales, Francisco J.; Morata, Carmen; Mori, Carlos; Muñoz, Jaime; Muñoz, Maria Jose; Núnez, Julio; Nuñez, Alfonso; Ocaña, Fermin; Olaz, Fernando; Ollero Artigas, Anes; Ortega, Juan; Oteo, Olga; Pascual, Jose Maria; Paya, Jose Antonio; Pechuan, Joaquín; Penedo Suarez, Ramón; Perez, Eugenia; Pesquera, Carlos; Pia, Gonzalo; Piea, Maria; Pinilla, Martin; Pita, Alejano; Pose, Antonio; Prieto Díaz, Miguel Angel; Quesada, Carmen; Ramirez, Francisco; Ramirez, Carmen; Ramirez, Luisa; Reinares, Leonardo; Rey, Salvador; Ribas, Montse; Ridaura, Amparo; Ridocci, Francisco; Rigueiro, Peo; Rivera, Salomón; Robles, Antonio; Rodero, Estrella; Roiguez, Jose Angel; Romero, Fernando; Romero Hernandez, Franklin; Romeu, Regina; Rubio Buisán, Lorenzo; Salas, Fernando; Sánchez, Carlos; Sánchez, Jesus; Saponi, Jose Maria; Serres, Miguel; Suarez, Saturnino; Suarez, Carmen; Tato, Maria; Tebar, Francisco Javier; Toda, Maria Roca; Tofe, Santiago; Urdiain, Raquel; Vaamonde, Leopoldo; Valderrama, Javier; Vazquez, Jose Antonio; Velazquez, Osvaldo; Venell, Federico; Vilariño, Ruben; Villa, Maria Jesus; Villar, Maria Dolores; Zarauza, Jesus; Zuñiga, Manuel; Abab, Jose Luis; Abad, Eduardo; Abad, Rafael; Afonso, Carmen; Aguilar, Gerardo; Alberiche, Maria Del Pino; Alcolea, Rosa; Alegria, Eduardo; Almagro, Fátima; Almenara, Africa; Almenos, Maria Cruz; Alonso, Javier; Alvarez, Manuel; Ampudia, Javier; Andia, Victor Manuel; Anglada, Jordi; Aranda, Miguel Ángel; Arbelo, Lorenzo; Armengol, Francesc; Arnau, Asunción; Arrarte, Vicente; Arribas, Bienvenido; Artiñano, Yolanda; Avilés, Benjamín; Ayensa, Javier; Ballestar, Enric; Ballester, Javier; Barcelo, Bartolome; Barcena, Felix; Barranco, Mercedes; Barrena, Isabel; Barriales, Vicente; Barrot, Joan; Bartolome, Jose A.; Belmonte, Joan; Bellés, Amadeo; Benito, Josefina; Bernad, Antonio; Biendicho, Armando; Blanco, Rubén; Boix, Evangelina; Bonora, Carlos; Boxó, Jose Ramon; Brea, Angel; Caballero, Peo; Cabrera, Peo; Cabrero, Juan Jose; Calduch, Lourdes; Calero, Francisco; Calvo Garcia, Jose Javier; Camacho, Jose; Canales, Juan Jose; Caparros, Jorge; Carbonell, Francisco; Caro, Manuel; Castilla, Miguel Angel; Castillo, Luis; Cepero, Daniel; Cerdan, Miguel; Cimbora, Antonio; Civera, Miguel; Colchero, Justo; Comas Fuentes, Angel; Corpas, Clara; Corrales, Juan Antonio; Cotobal, Eusebio; Cruz, Carmen; Cruz, Inmaculada; de La Flor, Manuel D.; de Luis, Alberto; del Alamo, Alberto; del Rosario, Victor; Diego, Carlos; D'Lacoste, Marta; Doganis Peppas, Constantino; Dominguez, Jose Ramon; Durá, Francisco Javier; Durand, Jose L.; Ena, Javier; Encinas, Ana Rosa; Erdozain, Juan Peo; Escribano, Jose; Escriva, Blanca; Esteve, Eduardo; Facila, Lorenzo; Fenoll, Federico; Fernandez, Eugenio; Fernandez, Celia; Fernandez, Maria Jesus; Fernandez, Antonia; Fernandez, Jacinto; Fernandez, Severo; Fernandez, Jose Manuel; Fernandez, Jose Manuel Fernandez; Ferrer, Juan Carlos; Ferrer, Peo; Ferrer Bascuñana, Peo; Fierro, Maria Jose; Flores, Julio; Fuentes, Fernando; Fuertes, Jorge; Galgo, Alberto; Galvez, Angel; Gallego, Anea; Garcia, Maria Angeles; Garcia, Jose; Garcia, Maria Luisa; Garcia, Peo; Garcia, Javier; García, Francisco; Garrido, Nícolas Garrido; Gil, Manuel Gil; Ginés Gascón, Ramón; Godoy, Diego; Gomez, Carlos Manuel; Gonzalez, Miguel; Gonzalez, Rosa; Gonzalez, Rocío; Gonzalez, Enrique; Gonzalez, Juan Jose; Gonzalez, Joaquin; Gonzalez Huambos, Adan; Guerrero, Jordi; Guillen, Rosario; Guirao, Lorenzo; Gutierrez, Fernando; Gutierrez, Diego; Hernandez, Alberto; Hernandez, Antonio; Hernandis, Vicenta; Herrero, Jose Vicente; Herreros, Benjamin; Hevia Roiguez, Eduardo; Horgue, Antonio; Illan, Fatima; Inigo, Pilar; Ibrahim Jaber, Ali; Jimenez, Manuel; Jornet, Agusti; Juanola, Ester; Laguna, Alfonso; Latorre, Juan; Lebron, Jose Antonio; Lecube, Albert; Ledesma, Claudio; Ligorria, Cristina; Lima, Joan; López, Jose Enrique; Lopez, Manuel; López, José Antonio; López, Jaime; López, Isio; Lozano, Jose Vicente; Mangas, Miguel Angel; Mangas, Alipio; Manzano, Antonio; Maraver, Juan; Marco, Maria Dolores; Marchán, Enrique; Marchante, Francisco; Marin, Fernando; Marreo, Josefa Esther; Martin, Manuel; Martin, Alberto; Martin, Francisco Javier; Martinez, Antonio; Martinez, Guillermo; Martínez, Luis; Martinez Barselo, Antonio Pablo; Mas, Emili; Mascareño, Isabel; Mascarós, Enrique; Massa, Rita; Mazón, Pilar; Mediavilla, Juan Diego; Mena, Candido; Mendez, Jose; Mendez, Jose Maria; Mezquita Raya, Peo; Millan, Jose Maria; Millaruelo, Jose; Minguela, Ester; Miret, Pere; Molina, Mariano; Molina, Carmen; Montagud, Blanca; Montalban, Coral; Montiel, Angel; Montoro, Javier; Monze, Bernardo; Moreno, Francisco Luis; Morillas, Antonio; Moro, Jose Antonio; Moya, Ana; Muñiz, Ovidio; Muñoz, Manuel; Navarro, Vicente Luis; Nerin, Jesus; Nicolas, Ricardo; Nogueiras, Concepción; Ojeda, Benito; Olmerilla, Javier; Oller, Guillermo; Ortega, Antonio; Ortega, Manuel; Ortega, Miguel; Ortiz, Maria Jose; Otegui Alarduya, Luis; Palet, Jordi; Palomo, Jesus; Paytubí, Carlos; Peiro, Rafael; Pelaez, Carmen; Peña, Peo; Peñafiel, Javier; Perez, Antonia; Perez, Elvira; Perez, Tomas; Peso, Miguel; Pilar, Juan Manuel; Piñeiro, Carlos; Plaza, Jose Antonio; Polo, Noelia; Portal, Maria; Prieto, Jesus; Prieto, Luis; Prieto Novo, Manuel; Puñal, Peo; Quesada, Miguel; Quindimil, Jose Antonio; Rabade, Jose Manuel; Ramila Beraza, Luis Antonio; Ramirez, José Manuel; Ramos, Jose Antonio; Ramos, Francisco; Rayo, Manuel; Reixa Vizoso, Sol; Reyes, Antonio; Rico, Miguel Angel; Ripoll, Tomas; Rivera, Antonio; Robres, Mariano; Rodilla, Enrique; Roiguez, Miguel Angel; Roiguez, Zoilo Jesus; Roiguez, Carlos; Roiguez, Pilar; Roiguez, Melchor; Roiguez, Alfonso; Rojas, Domingo; Rosell, Luis; Rossignoli, Carlos; Rueda, Antonio; Rueda, Eloy; Ruix, Anes; Ruiz, Jose Antonio; Ruiz, Luis; Saban, Jose; Saez, Francisco Jose; Salleras, Narcis; Sánchez, Gerardo; Sanchez, Gloria; Sanchez, Angel; Sanfeliu, Josep Maria; Sangros Gonzalez, Javier; Santos, Francisco; Santus, Eufrosina; Sebastian, Alfredo; Seguro, Maria Eugenia; Selles, David; Serrano, Daniel; Serrano, Soledad; Serrano, Adalberto; Sestorain, Francisco; Solbes, Ruben; Soriano, Cristina; Suárez, Héctor; Surroca, Maria Luisa; Tarabini, Ada; Tarraga, Peo; Teixido, Eulalia; Terron, Raquel; Torres, Antonio; Tortosa, Jose Maria; Tortosa, Frederic; Valdés, Carmen; Valdés, Peo; Valiente, Jose Ignacio; Varo, Antonio; Vazquez, Enrique; Vázquez, Luis; Vela Ruiz de Morales, Jose Manuel; Vericat, Antonio; Vicioso, Peo; Vilaplana, Carlos; Villazón, Francisco; Lidia Viñas, Lidia Viñas; Zuagoitia, Jose Felix; Nörgaard, Faris; Dziamski, Ryszard; Haglund, Lars; Holm, Daniela; Sars, Mikael; Jagunic, Ivica; Östgård, Per; Kumlin, Lars; Jacobsson, Michael; Hamad, Yousef; Jäger, Wanje; Särhammar, Lars; Olsson, Anders; Boldt-Christmas, Antonina; Nyborg, Karin; Kjellström, Thomas; Ghazal, Faris; Wikström, Lene; Holby, Torulf; Bhiladvala, Pallonji; Kynde, Sara Maria; Eizyk, Enrique Julio; Tengblad, Anders; Christoffersson, Ole; Sjöström, Astrid; Kynde, Christian; Katzman, Per; Tenhunen, Anita; Lennermo, Klas; Lindholm, Carl-Johan; Löndahl, Magnus; Elfstrand, Aino; Grönlund-Brown, Inger; Ziedén, Bo; Minnhagen, Karin; Lindvall, Peter; Fant, Kristina; Kaczynski, Jacek; Wallmark, Anders; Wallén, Carl-Erik; Wallberg, Håkan; Grönquist, Lennart; Hansen, John Albert; Björkander, Inge; Timberg, Ingar; Rosenqvist, Ulf; Fries, Robert; Carlsson, Jan-Erik; Rautio, Aslak Tauno; Sjöberg, Lennart; Wirdby, Alexander; Höök, Peter; Larsson, Åsa; Bergström, Catharina Lysell; Jwayed, Addnan; Smolowicz, Adam; Lindman, Anne-Christine; Nilsson, Per; Tarrach, Gerrit; Carlsson, Ingolf; Wieloch, Mattias; Rindevall, Peter; Strömblad, Gunnar; Holmberg, Göran; Shahnazarian, Henrik; Melchior, Jan; Younan, Kamal; Hansson, Anders; Bjurklint, Dag; Borgencrantz, Bertil; Sjöström, Malin; Mullaart, Mikael; Munoz, Marjatta; Jakkola, Vallentina; Romot, Jaan; Dash, Rabinarayan; Magnusson, Jan-Olof; Ahmed, Saman; Jonsson, Christina; Pipkorn, Owe; Bray, Edward; Wolff, Aneas; Black, Iain; Head, Christopher; Allan, Anthony

2011-01-01

To assess the prevalence of persistent lipid abnormalities in statin-treated patients with diabetes with and without the metabolic syndrome. This was a cross-sectional study of 22,063 statin-treated outpatients consecutively recruited by clinicians in Canada and 11 European countries. Patient

The value of prognostic factors for uterine cervical cancer patients treated with irradiation alone

International Nuclear Information System (INIS)

Grigienė, Rūta; Valuckas, Konstantinas P; Aleknavičius, Eduardas; Kurtinaitis, Juozas; Letautienė, Simona R

2007-01-01

The aim of our study was to investigate and evaluate the prognostic value of and correlations between preclinical and clinical factors such as the stage of the disease, blood Hb level before treatment, size of cervix and lymph nodes evaluated by CT, age, dose of irradiation and duration of radiotherapy related to overall survival, disease-free survival, local control and metastases-free survival in cervical cancer patients receiving radiotherapy alone. 162 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIA-IIIB cervical carcinoma treated with irradiation were analysed. Univariate and multivariate analyses using the Cox regression model were performed to determine statistical significance of some tumor-related factors. The Hb level before treatment showed significant influence on overall survival (p = 0.001), desease free survival (p = 0.040) and local control (p = 0.038). The lymph node status (>10 mm) assessed on CT had impact on overall survival (p = 0,030) and local control (p = 0,036). The dose at point A had impact on disease free survival (p = 0,028) and local control (p = 0,021) and the radiotherapy duration had showed significant influence on overall survival (p = 0,045), disease free survival (p = 0,006) and local control (p = 0,033). Anemia is a significant and independent prognostic factor of overall survival, disease-free survival and local control in cervical cancer patients treated with irradiation. The size of lymph nodes in CT is an independent prognostic factor for overall survival and local control in cervical cancer patients. The size of cervix uteri evaluated by CT has no prognostic significance in cervical cancer patients treated with radiotherapy. The prognostic value of FIGO stage of cervical cancer is influenced by other factors, analyzed in this study and is not an independent prognostic factor

Clinical outcome and cosmetics in breast cancer patients treated with conservative surgery and radiotherapy

International Nuclear Information System (INIS)

Li Rongqing; Jin Yening; Wang Yajie

2005-01-01

Objective: To evaluate the effectiveness and the cosmetics result of radiotherapy after conservative surgery for early breast cancer. Methods: Altogether 109 patients were treated by post-operative whole-breast irradiation and a tumor bed boost from May, 1995 to December, 2002. Among them 79 cases received a brachytherapy boost ( 192 Ir HDR implant Nucletron ) of 10-12 Gy(DB) by single plan of implantation with 1.5 cm between the needles for T1 and double plan for T2-4 tumors, and 30 cases received an electron beam boost with 15 Gy. External beam irradiation was applied to the whole breast with 45-52 Gy(mean 48.6 Gy) in 25 fractions over 5 weeks followed or concurrently with chemotherapy (CMF or CEF) and hormonotherapy. The cosmetic result was scored by a doctor and patients via questionnaire. Results: The median follow-up time was 52 months. The actuarial 5-year overall survival rate was 93.8% using Kaplan-Meier method and the within breast recurrence rate was 6.5%. No radiation- induced ulcer in the breast occurred except acute inflammation of skin around the pinholes in 5 patients. Cosmetic results were scored to be good by patients and the doctor (81% and 87%, respectively) for 75 followed-up cases, and good cosmetic rate was reported by the doctor for 82% (39/48) of the cases treated with brachytherapy boost and 85.2%(23/27) for those treated with external beam boost. There was no difference in cosmetic results between these two groups(P>0.05). Conclusion: In patients at high risk for local recurrence, tumor-bed boost with brachytherapy or electron beam carried out after limited surgery and external radiotherapy can provide satisfactory local control without morbidity. Cosmetic result may not be influenced by the boost technique. (authors)

Analysis of economic and social costs of adverse events associated with blood transfusions in Spain

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Borja Ribed-Sánchez

2018-05-01

Full Text Available Objective: To calculate, for the first time, the direct and social costs of transfusion-related adverse events in order to include them in the National Healthcare System's budget, calculation and studies. In Spain more than 1,500 patients yearly are diagnosed with such adverse events. Method: Blood transfusion-related adverse events recorded yearly in Spanish haemovigilance reports were studied retrospectively (2010-2015. The adverse events were coded according to the classification of Diagnosis-Related Groups. The direct healthcare costs were obtained from public information sources. The productivity loss (social cost associated with adverse events was calculated using the human capital and hedonic salary methodologies. Results: In 2015, 1,588 patients had adverse events that resulted in direct health care costs (4,568,914€ and social costs due to hospitalization (200,724€. Three adverse reactions resulted in patient death (at a social cost of 1,364,805€. In total, the cost of blood transfusion-related adverse events was 6,134,443€ in Spain. For the period 2010-2015: the trends show a reduction in the total amount of transfusions (2 vs. 1.91 M€; -4.4%. The number of adverse events increased (822 vs. 1,588; +93%, as well as their related direct healthcare cost (3.22 vs. 4.57M€; +42% and the social cost of hospitalization (110 vs 200M€; +83%. Mortality costs decreased (2.65 vs. 1.36M€; -48%. Discussion: This is the first time that the costs of post-transfusion adverse events have been calculated in Spain. These new figures and trends should be taken into consideration in any cost-effectiveness study or trial of new surgical techniques or sanitary policies that influence blood transfusion activities. Resumen: Objetivo: Calcular por primera vez los costes económicos y sociales relacionados con las reacciones adversas postransfusionales para actualizar estudios e incluirlos en los presupuestos del Sistema Nacional de Salud. En Espa

Cluster-Randomized Trial of a Behavioral Intervention to Incorporate a Treat-to-Target Approach to Care of US Patients With Rheumatoid Arthritis.

Science.gov (United States)

Harrold, Leslie R; Reed, George W; John, Ani; Barr, Christine J; Soe, Kevin; Magner, Robert; Saunders, Katherine C; Ruderman, Eric M; Haselkorn, Tmirah; Greenberg, Jeffrey D; Gibofsky, Allan; Harrington, J Timothy; Kremer, Joel M

2018-03-01

To assess the feasibility and efficacy of implementing a treat-to-target approach versus usual care in a US-based cohort of rheumatoid arthritis patients. In this behavioral intervention trial, rheumatology practices were cluster-randomized to provide treat-to-target care or usual care. Eligible patients with moderate/high disease activity (Clinical Disease Activity Index [CDAI] score >10) were followed for 12 months. Both treat-to-target and usual care patients were seen every 3 months. Treat-to-target providers were to have monthly visits with treatment acceleration at a minimum of every 3 months in patients with CDAI score >10; additional visits and treatment acceleration were at the discretion of usual care providers and patients. Coprimary end points were feasibility, assessed by rate of treatment acceleration conditional on CDAI score >10, and achievement of low disease activity (LDA; CDAI score ≤10) by an intent-to-treat analysis. A total of 14 practice sites per study arm were included (246 patients receiving treat-to-target and 286 receiving usual care). The groups had similar baseline demographic and clinical characteristics. Rates of treatment acceleration (treat-to-target 47% versus usual care 50%; odds ratio [OR] 0.92 [95% confidence interval (95% CI) 0.64, 1.34]) and achievement of LDA (treat-to-target 57% versus usual care 55%; OR 1.05 [95% CI 0.60, 1.84]) were similar between groups. Treat-to-target providers reported patient reluctance and medication lag time as common barriers to treatment acceleration. This study is the first to examine the feasibility and efficacy of a treat-to-target approach in typical US rheumatology practice. Treat-to-target care was not associated with increased likelihood of treatment acceleration or achievement of LDA, and barriers to treatment acceleration were identified. © 2017, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

[Quality of life in patients with subacute low back pain treated with physiotherapy rehabilitation].

Science.gov (United States)

Konstantinović, Ljubica; Devecerski, Gordana; Petronić, Ivana; Jović, Stevan; Cutović, Milisav; Cirović, Dragana

2006-01-01

Low back pain is one of the most frequent health problems. The aim of the study was to investigate clinical effects of complex rehabilitation programs on quality of life of patients with subacute lumbar pain, and also to investigate the relationship between quality of life and the intensity of pain and local functional status of the lumbar spine. The prospective study included 60 patients suffering from subacute low back pain with radiculopathy caused by lumbar disc syndrome, without any previous treatment, and who did not need surgery. In a single blind trial patients were divided into two groups. The first group (A group, n=30) was treated by low level laser therapy (wavelength 904 nm, frequency 4000 Hz, at dose 2J per point); the whole dose of 12J, then with TENS (frequency 80 Hz, 30 minutes, pulse duration 200 micros), with exercise, and simultaneously with conventional therapy with NSAIDs which inhibit COX-2 (meloxicam, 15 mg per day). Patients were treated 5 times a week, a total of 15 treatments. The second group (B group, n =30), was treated only by meloxicam (15 mg per day). The subjects were evaluated before the first treatment and three days after the last treatment (21st to 24th day). Data were analyzed using Student's t test and with analytic statistical methods. The mean Oswestry scores before and after therapy for group A have reduced from 25+/-2 to 16+/-3, with statistical significance (t= 8.84 ppain in group A have been reduced from 82+/-6.50 to 46+/-5.50, (t=7.85, ppain was in positive correlation with Oswestry score (Ft=7.84; ppatients treated only with anti-inflammatory drugs. Also, the 12-item health survey (SF-12) has shown positive correlation with intensity of pain reduction and with Oswestry disability score and so it is valid for measuring the effectiveness of therapeutic modalities in subacute lumbar pain.

Serological analysis of patients treated with a new surgical hemostat containing bovine proteins and autologous plasma.

Science.gov (United States)

Nelson, P A; Powers, J N; Estridge, T D; Elder, E A; Alea, A D; Sidhu, P K; Sehl, L C; DeLustro, F A

2001-01-01

A randomized, controlled clinical study of the management of diffuse bleeding with CoStasis surgical hemostat, a new hemostat containing bovine thrombin and collagen with the patient's own plasma, included patients undergoing cardiac, hepatic, iliac, and general surgery. Sera from 92 patients treated with CoStasis and 84 control patients were collected preoperatively and at a post surgical follow-up of 8 weeks. Among the control group, 57 patients were treated with Instat collagen sponge in noncardiac indications. Results showed that antibody responses in the CoStasis clinical study were similar to the reported literature for all antigens screened and were not associated with any adverse reactions. The bovine thrombin preparations in CoStasis and other commercially available thrombins were compared with the use of SDS-PAGE and Western blot analyses. Within this clinical study, CoStasis was shown to be a safe and effective hemostatic product containing bovine thrombin and bovine collagen and no pooled human blood products. Copyright 2001 John Wiley & Sons, Inc.

Treating dental crowding with mandibular incisor extraction in an Angle Class I patient

Directory of Open Access Journals (Sweden)

Gislana Braga Machado

2015-06-01

Full Text Available Mandibular dental crowding often encourages patients to seek orthodontic treatment. The orthodontist should decide between protrusion of incisors or decrease in dental volume so as to achieve proper alignment and leveling. The present study reports the treatment of an Angle Class I malocclusion adolescent female brachyfacial patient with severe mandibular dental crowding, increased curve of Spee and deep overbite. The patient was treated with extraction of a mandibular incisor. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as a requirement for the title of certified by the BBO.

Reduction of pituitary-tumour size in patients with prolactinomas and acromegaly treated with bromocriptine with or without radiotherapy

International Nuclear Information System (INIS)

Wass, J.A.H.; Moult, P.J.A.; Thorner, M.O.; Dacie, J.E.; Charlesworth, M.; Jones, A.E.; Besser, G.M.

1979-01-01

69 patients with prolactin-secreting or growth-hormone-secreting pituitary tumours were treated with bromocriptine with or without pituitary irradiation and followed up for 6 months to 6 1/2 years. Of 26 patients with prolactinomas, 11 had external pituitary irradiation in addition to bromocriptine. There was evidence of shrinkage of the pituitary tumour (either a reduction in fossa size or loss of visual-field defects) in 6 of these patients (23%), 3 of whom had been treated with bromocriptine alone. Of 43 acromegalic patients, 30 received external pituitary irradiation. 8 (19%) showed evidence of shrinkage of the pituitary tumour, including 2 who had received no radiotherapy. 1 patient treated with bromocriptine alone showed striking reduction in the size of his suprasella extension, as assessed by serial computed-tomography scans over 11 months. At the same time his visual-field defects resolved and his deficient corticotrophin and thyrotrophin reserves returned to normal. Bromocriptine can reduce the size of both prolactin-secreting and growth-hormone-secreting pituitary tumours, and this is of potential importance in their management. (author)