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J Sargent

Publications and source records attributed to J Sargent.

63 records · Page 4Linked to original sources
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Autologous stem cell transplantation in myeloma: the St James's Hospital experience, 1997-2003.

BACKGROUND: High-dose treatment with autologous stem cell transplantation (ASCT) has become the standard of care for patients with myeloma below the age of 65 years. AIMS: We report an audit of 60 patients (median age: 52.5 years) who underwent ASCT in the National Bone Marrow Transplant centre in St James's Hospital in Dublin between 1997 and 2003 inclusive. METHODS: Clinical and laboratory data were retrieved from patient medical records and hospital information management systems. RESULTS: Thirty-six patients had IgG, 11 IgA, 1 IgD, 9 light chain and 3 non-secretory MM. Fifty-seven (95%) patients received anthracycline-corticosteroid combination chemotherapy prior to autografting. There was no transplant-related mortality (TRM). Complete (CR) and Partial Responses (PR) were seen in 16 (29.6%) and 29 (53.7%) of those evaluable (n = 54 (90%)). The actuarial Progression-Free (PFS) and Overall Survival (OS) rates at five years are 13% and 55% respectively. CONCLUSION: Centre outcome is comparable to published international series and supports the use of ASCT in the treatment of this malignancy.

Aged↗
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I.v. access options for AIDS patients with cytomegalovirus disease.

In view of changes over the past 2 years in the intravenous (i.v.) management of patients with AIDS and cytomegalovirus (CMV) disease, a small study was carried out at the Kobler Clinic, an HIV treatment centre in London, to examine optimal i.v. access for CMV induction treatment. Thirty lines were analysed over a period of 4 months: 18 were peripherally inserted central catheters (PICCs) and 12 were midline catheters. Each line was monitored and evaluated for reason for choice of line, insertion data, line survival, patient self-administration, patient comfort scores, infection rate, and other difficulties encountered during treatment induction. The study results indicated noticeable differences between PICC and midline catheter performances, although a change in treatment protocol during the study influenced the choice of line used. There were also marked differences from other studies, carried out predominantly in non-HIV patients, when infection rate, dwell time of lines and thrombus formation were compared. Significant changes in practice have been implemented and further clinical studies/research identified.

AIDS-Related Opportunistic Infections↗
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Theoretical considerations on molecular transport in dialysis and sorbent therapy for uremia.

The technology of uremic blood purification has grown rapidly over the past decade and has provided the clinician with a wide range of therapeutic options. These options involve mass transfer processes which may be primarily due to diffusion or convection, or a combination of both mechanisms. However, regardless of the mechanism of molecular transport, evaluation of the clinical utility of these therapies requires studies which provide sufficient data to solve the appropriate rate equations and to close mass balances. Data from the recent hemodialysis, peritoneal dialysis and sorbent literature are analyzed to show the magnitude of variability in both patient and therapy-related mass balance paramters for urea nitrogen (U) and middle molecules (MM) and to provide unambiguous comparisons for some of these therapies. A theoretical model is developed to describe sorbent-mediated gut elimination of solute as a first-order clearance limited by sorbent saturation. The model is used to analyze data in the literature on AL (OH)3 facilitated gut clearance of phosphate and indicates a gut P clearance of approximately 20 ml/min with maximum removal of approximately 800 mg P/24 hrs. Similar analysis of oxystarch indicated a gut U clearance of 2.5 ml/min and maximum removal of 1.5 gm/24 hrs.

Absorption↗
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Revising routines.

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Cost Control↗