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At least 415 records · Page 23Linked to original sources
PubMed1996

[Treatment for hormone-refractory or relapsing prostatic cancer].

Androgen ablative treatments for advanced prostatic cancer have achieved great progress with new concepts of therapy in the last decade such as chemical castration with LH-RH analogue and total androgen ablation. However, in treatment for hormone-refractory or relapsing prostatic cancer it remains controversial whether cytotoxic chemotherapy is acceptable or palliative, and whether there is an alternative treatment for this incurable disease. The current status of cytotoxic chemotherapy for advanced prostatic cancer patients in Nara Medical University since 1980 is reported in this paper with the some review of recent advances in hormone-independent prostatic cancer treatment. The overall objective response rate of CDDP-based multi-drug regimens including CDDP monotherapy was 49.6% (CR 0% + PR 49.6%). Response rate of primary chemotherapy group constituted with untreated patient was 67.2%, against 23.9% in the hormone refractory or relapse group. Five-year survival rate was 61.1% in the primary chemotherapy group, 35.5% in the hormone refractory group and 40.6% in the relapse group. Basically, there was no significant difference in response rates and survival rates among the groups of CDDP monotherapy, CDDP+bleomycin+vinblastine, CDDP+cyclophosphamide+adriamycin or CDDP+etoposide. The different response rates among the regimens seemed mainly to depend on the population of refractory or relapsing cases in each group. The important problems remaining unsolved in the research of chemotherapy for prostatic cancer are that there is no effective breakthrough agent and the lack of the harmonization in response criteria. The new agents are under development based on the cellular biology of hormone-refractory prostatic cancer, and there is a bright future in the treatment of this intractable disease.

Aged↗
PubMed1997

[A fibroepithelial polyp of the ureter. A report of 2 new cases].

Primal neoplasias of the ureter are very rare and account for less than 1% of all genitourinary tumours. Only 20% of them are benign, and the fibroepithelial lineage is the more frequent. We contribute two cases of fibroepithelial polyps of the ureter; a brief comment on the etiology of these lesions, the routine diagnosis procedures and current therapeutical options is presented. Due to breakthroughs in radiologic and endoscopic techniques for the upper urinary tract, a more precise pre-operative diagnosis of these lesions has been achieved as well as a more conservative therapy which avoids incorrect and unnecessary nephroureterectomies, so frequent in past times, considering the benign nature of this unusual pathology.

Adult↗
PubMed2005

Breakthrough disseminated Aspergillus ustus infection in allogeneic hematopoietic stem cell transplant recipients receiving voriconazole or caspofungin prophylaxis.

Aspergillus ustus is an uncommon clinical species which is poorly susceptible to antifungals. We report two cases of A. ustus infections that occurred in allogeneic stem cell transplant recipients while they were receiving either voriconazole or caspofungin. Prolonged use of these new antifungal agents may increase the risk of the emergence of resistant organisms.

Adolescent↗
PubMed2004

Oral transmucosal fentanyl citrate for the treatment of migraine headache pain in outpatients: a case series.

BACKGROUND: Migraine headache pain that does not respond to traditional antimigraine medications frequently requires treatment in the emergency department (ED) with parenteral opioids. Rapid onset of pain relief in an outpatient setting for migraine headache is the primary objective of patients and clinicians. Oral transmucosal fentanyl citrate (OTFC; ACTIQ) is a novel opioid product designed to deliver rapid analgesia to patients who experience breakthrough pain (BTP). OBJECTIVE: To evaluate the effectiveness, tolerability, and patient satisfaction with OTFC for the outpatient treatment of acute, refractory migraine headache pain. PATIENTS AND METHODS: Twenty patients with recurrent acute, refractory migraine headaches who had been referred to this headache clinic are reported in this case series. All patients had a history of tolerating parenteral opioids in the ED when experiencing refractory migraine pain and had been treated with outpatient opioid therapies in attempts to manage their migraine pain. Patients were prescribed OTFC (400 microg) as rescue treatment for moderate or severe migraine headache pain as outpatients. Patients were instructed to self-administer OTFC at home and complete a diary recording: pain intensity (11-point scale; 10 = worst pain imaginable to 0 = no pain) before and 15, 30, 60, and 120 minutes after OTFC; satisfaction with the effectiveness of OTFC (selecting 1 of 7 categories ranging from "very dissatisfied" through "very satisfied") rated at 120 minutes; and adverse events. RESULTS: Eighteen patients (13 female) experienced a migraine and self-administered OTFC. OTFC successfully treated migraine episodes in all 18 outpatients; no patient went to an ED. OTFC rapidly reduced pain intensity, with significant improvement at 15 minutes that was sustained and provided progressively more pain relief at 30, 60, and 120 minutes (all P <.01). Mean (SEM) pain intensity significantly declined from 8.83 (0.35) pretreatment to 2.28 (0.67) at 120 minutes, an average reduction of 75% (P <.01). Patients' satisfaction ratings with OTFC were overwhelmingly positive, with 94% being satisfied and more than half (56%) being "very satisfied." Three (17%) patients experienced nausea, two (11%) somnolence, and one (6%) each itching, vomiting, and dry mouth. All adverse events were mild or moderate in severity. CONCLUSIONS: OTFC rapidly and significantly relieved acute, refractory migraine pain in outpatients, prevented the need for an ED visit, and was associated with high patient satisfaction ratings. The rapid onset of migraine headache pain relief in this case series is consistent with the analgesic effect reported with the use of OTFC in patients with BTP. OTFC was well tolerated in these patients who had a history of tolerating parenteral opioids in the ED when experiencing refractory migraine pain and had been treated with outpatient opioid therapies in attempts to manage their migraine pain. OTFC may be effective for outpatient treatment of acute, refractory migraine headache pain. Further controlled studies are warranted.

Acute Disease↗
PubMed2001

Catheter ablation of idiopathic left ventricular tachycardia with multiple breakthrough sites guided by an electroanatomical mapping system.

Idiopathic ventricular tachycardia (VT) has been considered to be amenable to radiofrequency catheter ablation guided by Purkinje potentials. However, there appear to be various types of reentrant circuits associated with this VT deduced from the results of the successful radiofrequency catheter ablation cases. We describe in this report a patient with idiopathic left ventricular tachycardia which was electrically inducible and verapamil sensitive. Multiple earliest ventricular activation sites during tachycardia were detected with electroanatomical mapping using the CARTO system. Multiple applications at these sites failed to eliminate the VT. The earliest Purkinje potential was recorded at least 1.5 cm away from the earliest ventricular activation sites, and the radiofrequency current application at this site resulted in the complete abolition of this VT. The reentrant circuit of this tachycardia seemed to have multiple breakthrough sites to the ventricular myocardium, which were distant from the requisite part of the reentrant circuit of this VT involving the Purkinje fiber network conduction system.

Adult↗
PubMed2005

Novel use of the BD FACS SPA to automate custom monoclonal antibody panel preparations for immunophenotyping.

BACKGROUND: The effective and accurate diagnosis of hematologic malignancies relies on flow cytometric immunophenotyping. Selected combinations of monoclonal antibodies (mAbs) arranged in multicolor panels allow for the accurate definition of normal and abnormal hematologic cell populations. The most time-consuming and crucial step in the staining process involves dispensing combinations of multiple mAbs into their appropriate staining tubes. This step is prone to error, requires concentration and accuracy, and is dependent on technologist experience. The Becton Dickinson BioScience (BD) FACS Sample Prep Assistant (SPA) is touted as a breakthrough in automated in vitro diagnostic sample preparation. The SPA is designed to automate BD MultiTESk and BD TriTest lyse/no-wash assays. However, because most cases in our laboratory require tedious application of unique four-color mAb cocktails for leukemia and lymphoma testing, we wondered whether the SPA would be helpful in accurately dispensing these mixtures. METHODS: The mAb panels were prepared by the SPA in two separate timed runs and on separate days. Eleven specimens (nine from patients and two from normal volunteers) were split and stained with four-color cocktails created by the SPA or manually. The percentage of positive (%P) cells and mean fluorescent intensity for each mAb pair were determined. These values were plotted against each other and correlation values were calculated. To quantitate timesaving in the laboratory, two technologists prepared individually the same mAb panels and were timed. RESULTS: The correlation between the two methods was high; r(2) was 0.988 for 158 %P antigen pairs; no bias between the manual and robotic methods was detected with the Wilcoxon rank test. Bland-Altman analysis indicated no obvious relation between the difference and the mean of %P cells, suggesting that the SPA successfully dispensed antibodies for leukemia/lymphoma panels. The two methods may be interchangeable, although the limited sample size prohibits this conclusion from Bland-Altman statistics alone. In addition, one possible error was detected in the SPA-prepared panels. The SPA averaged 65 min/run, the experienced technologist 12.95 min/run, and the inexperienced technologist 54.9 min/run. CONCLUSIONS: SPA dispensing time was twice the average manual dispensing time; however, SPA use was completely automated and freed the technologist to perform other tasks. SPA use permitted preemptive preparation of mAb panels and thus streamlined processing; however, the cost of the assay and the amount of reagent waste increased. It is certain that software modifications by BD could decrease the SPA reagent dispense time and decrease the cost associated with reagent waste when the SPA is used in this novel fashion.

Antigens, CD↗
PubMed2001

[Outcome of non-operated adrenal masses in 126 patients observed from 1986 to 1999].

STUDY AIM: CT scan performed for non-adrenal related symptoms detects an adrenal mass or 'incidentaloma' in 0.4 to 4.3% of cases, and most authors advocate a non-operative policy, after minimal but careful work-up aimed at excluding pheochromocytoma and aldosteronoma. The breakthrough of laparoscopic adrenalectomy has led some to challenge this attitude. This retrospective study focused on the outcome of non-operated adrenal masses. PATIENTS AND METHOD: From 1986 through 1999, 126 patients (64 men and 62 women) presented with an incidental mass of the adrenal fossa, and a non-surgical attitude was elicited. Mean size was 36.5 mm in diameter. All patients underwent an in-depth clinical, biochemical and imaging work-up. They have been stratified into two groups: group I: no contraindication to surgery (n = 95); and group II: contraindication to surgery (frail patients, invasive adrenal or metastatic extra-adrenal cancer) (n = 31). RESULTS: With a mean follow-up of 4.3 years, 17 patients were lost to follow-up (13.5%), including 11/95 in group I; 36 were dead (28.5%), including 12/95 in group I (no adrenal-related death) and 24/31 in group II; 72 were alive and well without operation, including only one in group II; one patient was operated for a benign adrenal adenoma removed at the time of surgery for aortic aneurysm. CONCLUSION: Careful clinical, biochemical, imaging and nor-iodo-cholesterol scintigraphy with definite uptake by the adrenal mass, a strong indicator of benignancy, allows surgical indication to be postponed, and is likely to cancel it if, at one-year follow-up, imaging studies show no change in the mass.

Adenoma↗
PubMed2003

Vaccinology: past achievements, present roadblocks and future promises.

Of all the branches of modern medicine, vaccinology can claim to be the one that has contributed most to the relief of human misery and the spectacular increase in life expectancy in the last two centuries. It is the only science that has eradicated an infectious disease-smallpox-responsible for 8-20% of all deaths in several European countries in the 18th century. Other disabling and lethal diseases, like poliomyelitis and measles, are targeted for eradication. Currently, it is estimated that immunization saves the lives of 3 million children a year but 2 million more lives could be saved by existing vaccines. The success of vaccines in controlling and eliminating diseases has, paradoxically, been the cause of a revival of the anti-vaccination movement which in the absence, in developed countries, of many erstwhile common infectious diseases such as diphtheria, tetanus, polio, pertussis, measles, rubella and mumps has come to believe that vaccination is not only no longer necessary but is even dangerous. This is because it accepts, as "reactions", any untoward health event that occurs after administration of a vaccine. Most vaccine "reactions", therefore, appear to be more frequent than vaccine-preventable diseases. Public Health Authorities, aware of the great value of vaccines to society, are facing an uphill battle to get them accepted by a growing proportion of so-called educated minorities, thus endangering disease elimination. Other developments, in the last two decades, that have hampered vaccine usage have been the exploding costs of research, development and manufacture of new vaccines and the emphasis still placed on therapy in preference to prevention in medicine. This has led to the erroneous perception that vaccines are expensive although they are, in most cases, more cost-effective than the popular wait-see-treat approach. A favorable trend for vaccinology has been fueled by recent major breakthroughs in the sciences of immunology, molecular biology, genomics, proteomics, physico-chemistry and computers that promise a bright future for prevention, not only of acute infectious diseases, but also treatment of conditions like chronic infections, allergy, auto-immune diseases and cancer where some malfunctioning of the immune system is thought to play a part. Vaccines are being made more user-friendly by the development of combined vaccines and less painful and invasive inoculation techniques than the traditional syringe and needle. Recent new initiatives, like the Global Alliance on Vaccines and Immunization (GAVI),which are gathering new sources of funding for vaccination, should be beneficial for vaccinology.

Bacterial Infections↗
PubMed2005

A pentatricopeptide repeat protein is essential for RNA editing in chloroplasts.

RNA editing is a process of RNA maturation involved in the insertion, deletion or modification of nucleotides. In organellar transcripts of higher plants, specific cytidine residues are converted into uridine residues. In many cases, editing results in the restoration of conserved amino acid residues, a process that is essential for protein function in plastids. Despite the technical breakthrough in establishing systems in vivo and in vitro for analysing RNA editing, its machinery still remains to be identified in higher plants. Here we introduce a genetic approach and report the discovery of a gene responsible for the specific RNA editing event in the chloroplast.

Amino Acid Sequence↗
PubMed1999

Camillo Golgi's scientific biography.

Born in Corteno, a tiny village in the province of Brescia, Camillo Golgi studied at the University of Pavia where he graduated in medicine in 1865 under the guidance of the psychiatrist Cesare Lombroso who sparked his vocation to study the brain. Golgi then began to learn histological techniques under the direction of the pathologist Giulio Bizzozero. In 1872 he moved to Abbiategrasso as chief of a hospital for chronic diseases. In a rudimentary laboratory he developed the silver-bichromate staining technique, the 'black reaction', which was a breakthrough for nervous tissue structure research. While in Abbiategrasso Golgi demonstrated the branching of the axons, and observed striatal and cortical lesions in a case of chorea. He returned to Pavia as Professor of Histology and General Pathology, and made a series of important discoveries that still bear his name: the Golgi tendon organ, the Golgi-Mazzoni corpuscles, another Golgi method to stain nerve cells based on the use of potassium dichromate and mercuric chloride, the canaliculi of the parietal cells of the gastric glands (Muller-Golgi tubules), the Golgi-Rezzonico myelin's annular apparatus (or Golgi-Rezzonico horny funnels), the cycle of malarian parasites (Golgi cycle), the relationship between recurrent malarian fever bouts and the multiplication of the Plasmodium in the blood (Golgi law), the relationship between the vascular pole of the Malpighian glomerulus and the distal tubule, the Golgi's pericellular nets and finally, and most importantly, the cytoplasmic 'internal reticular apparatus' (Golgi apparatus). In 1906 Golgi was awarded the Nobel prize for Medicine or Physiology. He died in Pavia on 21 January 1921.

Histology↗
PubMed2003

From waste treatment to integrated resource management.

Wastewater treatment was primarily implemented to enhance urban hygiene. Treatment methods were improved to ensure environmental protection by nutrient removal processes. In this way, energy is consumed and resources like potentially useful minerals and drinking water are disposed of. An integrated management of assets, including drinking water, surface water, energy and nutrients would be required to make wastewater management more sustainable. Exergy analysis provides a good method to quantify different resources, e.g. utilisable energy and nutrients. Dilution is never a solution for pollution. Waste streams should best be managed to prevent dilution of resources. Wastewater and sanitation are not intrinsically linked. Source separation technology seems to be the most promising concept to realise a major breakthrough in wastewater treatment. Research on unit processes, such as struvite recovery and treatment of ammonium rich streams, also shows promising results. In many cases, nutrient removal and recovery can be combined, with possibilities for a gradual change from one system to another.

Conservation of Energy Resources↗
PubMed1992

[Clinical study on the contraceptive effectiveness of trisiston from the Jenapharm firm].

Now triphasic contraceptive preparations are used widely. Some news low dose formulations are available on the market, among them Trisiston. The study was conducted to confirm clinically acceptance and effectiveness of Trisiston. There were 437 volunteers mostly multiparous, with a mean age of +/- 25 years who participated in a multi center study. They were taking pills for a 3 to 12 cycles. Cumulatively 4026 cycles were observed. The investigation was conducted according special protocol. At the admission a complete medical history was obtained and a general physical and gynecological examination was performed. All subject were controlled every 3rd month included laboratory tests (blood levels of Hb, WBC, RBC, ESR, carbohydrate metabolism, clotting factors, bilirubin, creatinine, protein, glucose, albumin, LDL, HDL). There was no case of pregnancy. Pearl index = 0. The Trisiston was well tolerated by most of women (80%). Some effects like headache, vertigo, mastalgia, spotting and breakthrough bleeding, loss of libido, premenstrual syndrome were observed in 20% patients, soma of our patients (20%) discontinued contraceptive.

Adult↗
PubMed1980

Renal shutdown as a complication of severe preeclampsia with premature separation of the placenta.

The author, with long experience in the management of toxemia of pregnancy and its multiple complications, is reporting his first case of complete renal shutdown after severe preeclampsia complicated by premature separation of the placenta, and complications of disseminated intravascular coagulopathy.Multiple hemodialyses provided a breakthrough to what appears to be a complete reversal and return of normal renal function.

Acute Kidney Injury↗
PubMed1998

Aetiology, cost of antimicrobial therapy and outcome in neutropenic patients who developed bacteraemia during antimicrobial prophylaxis: a case-control study.

Sixty four episodes of bacteraemia that appeared during antimicrobial prophylaxis with an oral quinolone plus an azole in neutropenic cancer patients were compared with 128 cases of bacteraemia in a cohort of controls matched for age, sex, underlying disease, neutropenia and vascular catheter in situ to assess differences in aetiology, cost of therapy and outcome. Patients who received prophylaxis had breakthrough bacteraemias of a different aetiology compared with the control group: they had significantly fewer multiply-resistant strains (21.9 vs. 51.5, P < 0.04) and a longer afebrile neutropenic period (9.55 days vs. 4.1, P < 0.001). Patients who received prophylaxis also had bacteraemias that were significantly more frequently caused by viridans streptococci (9.4%, vs. 1.7%, P < 0.01), enterococci (15.6% vs. 7.2%, P < 0.05) and Stenotrophomonas maltophilia (17.2% vs. 3.4%, P < 0.01). The cost of antimicrobial therapy per case (37401 SKK (1091 USD) vs. 31808 SKK (899 USD), P < 0.05) was also significantly higher in cases than controls; however, the number of administered antibiotics (4.18 vs. 3.21 per case, P = NS) was similar in both groups. There were no differences in outcome between both groups. However patients who received prophylaxis had significantly longer periods of afebrile neutropenia (9.55 days vs. 4.1, P < 0.001) and bacteraemia developed later than in controls. Also, the incidence of polymicrobial bacteraemia caused by multiresistant strains was lower among cases (21.9 vs. 51.5, P < 0.04).

Amikacin↗
PubMed1987

High pressure pyelocalyceal reflux. Case presentation.

In the absence of vesicoureteral reflux or urinary tract obstruction, conservative management is advocated for children with recurrent urinary tract infection. Conventional radiographic studies and static nuclear imaging techniques, however, may fail to reveal a subclinical but significant structural or functional abnormality. Recurrent breakthrough infections during appropriate medical treatment and high pressure pyelocalyceal reflux may justify a more aggressive therapeutic approach. We propose that a pressure perfusion study with fluoroscopy and continuous pressure monitoring be performed preoperatively to help select those children in whom surgery is an acceptable alternative.

Child↗
PubMed1993

Countering advanced HIS marketing tactics.

An explosion of technological advances and system developments in the information systems industry pushes the envelope in both hardware and software design. Equipment breakthroughs--reduced instruction set computing chips, or RISC, and DEC's 64-bit Alpha chip--herald an exciting new era in price-performance computing. And object-oriented programming systems, or OOPS, and computer-assisted software engineering, or CASE tools, both promise a golden age in programming productivity. At the same time however, marketing mavens at healthcare information system, or HIS, vendors keep pace with their cohorts in Research and Development by blazing new trails in the science of sales and marketing. To help healthcare executives keep pace with new developments in selling, let's review a few infamous breakthroughs in marketing. They put a new twist on the old saw: "caveat emptor." Following each marketing "advance" are counters to new marketing tricks, each recommended to keep savvy CIOs a step ahead.

Computer Systems↗
PubMed2002

Triple antiviral re-therapy for chronic hepatitis C with interferon-alpha, ribavirin and amantadine in nonresponders to interferon-alpha and ribavirin.

BACKGROUND: Therapy options for patients with chronic hepatitis C who failed prior treatment are needed. In recent studies triple antiviral therapy with Interferon-alpha, ribavirin, and amantadine seemed to increase sustained virological response rates in this group. METHOD: To evaluate efficacy, side effects and safety of a triple re-therapy in an open labeled prospective study, we compared 23 nonresponders to interferon monotherapy (9 nonresponders, 3 relapsers, 11 with breakthrough) with 23 nonresponders to standard combination therapy (interferon plus ribavirin) (16 nonresponders, 7 breakthroughs). All outpatients enrolled for re-therapy received interferon-alpha 2a (6 mega units [MU] three times in week), ribavirin (1000-1200 mg daily in divided doses) and amantadine (200 mg daily) for six months. In case of virological re-therapy response (negative qualitative HCV RNA) study medication was continued with interferon monotherapy for another six months. RESULTS: Sustained virological response was achieved in 16 (35%) out of 46 prior therapy nonresponders. Response rates were dependent on pretreatment outcome. In the standard combination therapy group only 1 (6%) primary nonresponder achieved sustained response, but none of the 9 monotherapy nonresponders did. After primary breakthrough sustained response was seen in 8 of 11 (73%) patients in the interferon monotherapy and in 5 of 7 (71%) in the combination therapy group. Of 3 monotherapy relapsers 2 (66%) did also clear the virus sustained. Safety profile under triple therapy was similar to the previous therapy. Compliance was higher and side effects lower in those patients already experienced in combination therapy. CONCLUSION: In patients with a breakthrough or relapse after interferon monotherapy or standard combination therapy with interferon and ribavirin a re-therapy with a triple combination of interferon, ribavirin, and amantadine results in a high rate of sustained virological response.

Adult↗