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Positron Emission Tomography for Neck Evaluation Following Definitive Treatment with Chemoradiotherapy for Locoregionally Advanced Head and Neck Squamous Cell Carcinoma
Bar Ad V. Mishra M. Ohri N and Intenzo C
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00012]
Esophagitis, Treatment-Related Toxicity In Non-Small Cell Lung Cancer
Bar Ad V, Ohri N and Werner-Wasik M
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00013]
The Potential Role of Radiation Therapy in Bowen’s Disease: a Review of the Current Literature
Zygogianni A, Kouvaris J, Tolia M, Kyrgias G, Beli I, Kantzou I, Soulimioti G and Kouloulias V
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00014]
Vascular Effects of Estrogenic Menopausal Hormone Therapy
Ossama M. Reslan and Raouf A. Khalil
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00015]
Prevention and Treatment of Diabetic Retinopathy: Evidence from Large, Randomized Trials. The Emerging role of Fenofibrate
Rafael Simó and Cristina Hernández
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00016]
Use Of Antibiotics In Bronchiectasis
Paul T King and Peter W Holmes
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00017]
Therapeutic intervention in cancer and chronic viral infections: Antibody mediated manipulation of PD-1/PD-L1 interaction
Priya Sakthivel, Marcus Gereke and Dunja Bruder
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00018]
Clinical Pharmacology of Paliperidone Palmitate A Parenteral Long-Acting Formulation for the Treatment of Schizophrenia
Elizabeth Gilday and Henry A. Nasrallah
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00019]
The Role Of Venous Abnormalities in Neurological Disease
E. Mark Haacke, Clive B. Beggs and Charbel Habib
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00020]
Biophysics of venous return from the brain from the perspective of the pathophysiology of chronic cerebrospinal venous insufficiency
Maciej Zaniewski and Marian Simka
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00021]
Internal jugular vein valve morphology in the patients with chronic cerebrospinal venous insufficiency (CCSVI); angiographic findings and schematic demonstrations
Ma'moon Hasan Al-Omari and Areen Al-Bashir
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00022]
A Review of Family-Based Treatment for Adolescents with Eating Disorders
Colleen Stiles-Shields, Renee Rienecke Hostea, Peter M. Doyleb and Daniel Le Grangea
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00023]
Non-pharmacological treatment of depressive disorders: a review of evidence-based treatment options
J. Dirmaier, M. Steinmann, T. Krattenmacher, B. Watzke, D. Barghaan, U. Koch and H. Schulz
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00024]
Is the use of cholesterol-lowering drugs for the prevention of cardiovascular complications in type 2 diabetics evidence-based? A systematic review
Michel de Lorgeril, Tomohito Hamazaki, Willy Kostucki, Harumi Okuyama, Bruno Pavy, Anne-Thea McGill and Mikael Rabaeus
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00025]
Assessment Of Prescription Pattern In Asthma Therapy At Shamli Hospitals
Rishabh Srivastava, Sanjay Sharma, Lav Keshri and Pranay wal
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00026]
Radial approach for percutaneous coronary intervention
Andrea Rognoni, Alessandro Lupi, Mara Sansa, Gioel Gabrio Secco, Matteo Santagostino and Angelo Sante Bongo
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00027]
Pharmacokinetic Study of Weekly (days 1-5) Low-dose S-1 in Patients with Non-small-cell Lung Cancer
Tsuyoshi Shoji, Makoto Sonobe, Hiroaki Sakai, Takuji Fujinaga, Toshihiko Sato, Fengshi Chen, Ryo Miyahara, Toru Bando, Hiromi Wada and Hiroshi Date
[Abstract] [FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00028]
Abstracts
Positron Emission Tomography for Neck Evaluation Following Definitive Treatment with Chemoradiotherapy for Locoregionally Advanced Head and Neck Squamous Cell Carcinoma
Bar Ad V. Mishra M. Ohri N and Intenzo C
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00012]
Objectives: The objective of the current review was to assess published data on the role of Positron Emission Tomography (PET) for evaluation of nodal residual disease after definitive chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).
Methods: Studies were identified by searching PubMed electronic databases. Only studies using a post-chemoradiotherapy PET for nodal residual disease evaluation were included in the present review. Both prospective and retrospective studies were included. Information regarding sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET for detecting nodal residual disease after definitive chemoradiotherapy for HNSCC was extracted and analyzed.
Results: Twenty published studies were included in the present review. Existing data suggest that a negative post-chemoradiotherapy PET scan is associated with a negative predictive value up to 100%. The sensitivity of PET in detecting nodal residual disease is greater for scans performed > 10 weeks after definitive treatment with chemoradiotherapy for HNSCC.
Conclusions: Further studies are needed to quantify the reliability of PET in detecting nodal residual disease after chemoradiotherapy for locoregionally advanced HNSCC. The optimal timing of PET imaging after chemoradiotherapy remains to be defined.
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Esophagitis, Treatment-Related Toxicity In Non-Small Cell Lung Cancer
Bar Ad V, Ohri N and Werner-Wasik M
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00013]
Objectives: Radiation esophagitis represents a significant complication experienced by non-small cell cancer (NSCLC) patients receiving thoracic irradiation. The objective of the current review was to assess the clinical and dosimetrical parameters that may predict radiation esophagitis.
Methods: Studies were identified by searching PubMed electronic databases. Both prospective and retrospective studies were included. Information regarding clinical and dosimetrical parameters predicting for radiation-induced esophagitis was extracted and analyzed.
Results: The esophageal clinical and dosimetric parameters that best predict acute esophagitis remain unclear. In many reports, Vx (the volume of esophagus receiving x Gy) stands out, with values of x ranging from 20-70 Gy. Other studies conclude that the maximal dose received by any point of the esophagus is the best predictor of esophagitis. Another metric implicated with esophageal toxicity in some reports is the proportion of the esophageal circumference or surface area that receives high doses of radiation.
Conclusions: Technological advancements in patient immobilization, setup verification, and radiotherapy delivery are increasingly being employed to limit the toxicity of thoracic irradiation. Future efforts are required to determine how these complex techniques should best be implemented to minimize the risks of acute and long-term esophageal injury.
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The Potential Role of Radiation Therapy in Bowen’s Disease: a Review of the Current Literature
Zygogianni A, Kouvaris J, Tolia M, Kyrgias G, Beli I, Kantzou I, Soulimioti G and Kouloulias V
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00014]
BACKGROUND: Bowen’s disease is a form of squamous cell carcinoma in situ that can be transformed into invasive squamous cell carcinoma and should be treated according to its anatomical position. The aim of this article is to offer an overview of treatment options with an emphasis on radiation therapy in the treatment of Bowen's disease.
METHODS AND MATERIALS: We performed overview of the literature based on database searches in PubMed/MEDLINE and we included articles till December 2010. Only papers published in English were included.
RESULTS: There was no standard fractionation regimen: some physicians prescribed high doses, such as the ones of invasive skin cancer, whereas others prescribed lower doses because of the noninvasive nature of the disease, the sensitive anatomic location (e.g., extremity) and the large treatment area. Various studies demonstrate high rates of tumor control with minimal morbidity following definitive radiation therapy in the treatment of Bowen’s Disease. Through a multidisciplinary assessment, the treatment of Bowen’s disease can be individualized to optimize patient care.
CONCLUSIONS: Radiation therapy is an effective treatment option for Bowen's disease of the skin. Local recurrences seem to be equally low in patients treated with high- and low-dose regimens. Radiotherapy preserves normal tissues ensuring a superior esthetic and functional outcome.
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Vascular Effects of Estrogenic Menopausal Hormone Therapy
Ossama M. Reslan and Raouf A. Khalil
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00015]
Cardiovascular disease (CVD) is more common in men and postmenopausal women (Post-MW) than premenopausal women (Pre-MW). Despite recent advances in preventive measures, the incidence of CVD in women has shown a rise that matched the increase in the Post-MW population. The increased incidence of CVD in Post-MW has been related to the decline in estrogen levels, and hence suggested vascular benefits of endogenous estrogen. Experimental studies have identified estrogen receptor ERα, ERβ and a novel estrogen binding membrane protein GPR30 (GPER) in blood vessels of humans and experimental animals. The interaction of estrogen with vascular ERs mediates both genomic and non-genomic effects. Estrogen promotes endothelium-dependent relaxation by increasing nitric oxide, prostacyclin, and hyperpolarizing factor. Estrogen also inhibits the mechanisms of vascular smooth muscle (VSM) contraction including [Ca2+]i, protein kinase C and Rho-kinase. Additional effects of estrogen on the vascular cytoskeleton, extracellular matrix, lipid profile and the vascular inflammatory response have been reported. In addition to the experimental evidence in animal models and vascular cells, initial observational studies in women using menopausal hormonal therapy (MHT) have suggested that estrogen may protect against CVD. However, randomized clinical trials (RCTs) such as the Heart and Estrogen/progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI), which examined the effects of conjugated equine estrogens (CEE) in older women with established CVD (HERS) or without overt CVD (WHI), failed to demonstrate protective vascular effects of estrogen treatment. Despite the initial set-back from the results of MHT RCTs, growing evidence now supports the ‘timing hypothesis’, which suggests that MHT could increase the risk of CVD if started late after menopause, but may produce beneficial cardiovascular effects in younger women during the perimenopausal period. The choice of an appropriate MHT dose, route of administration, and estrogen/progestin combination could maximize the vascular benefits of MHT and minimize other adverse effects, especially if given within a reasonably short time after menopause to women that seek MHT for the relief of menopausal symptoms.
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Prevention and Treatment of Diabetic Retinopathy: Evidence from Large, Randomized Trials. The Emerging role of Fenofibrate
Rafael Simó, and Cristina Hernández
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00016]
Diabetic retinopathy (DR) remains a leading cause of preventable vision loss, despite advances in diabetes care. The burden of DR is likely to increase as the evolving pandemic of type 2 diabetes progresses. Tight control of blood glucose levels and blood pressure are essential for preventing or arresting the development of diabetic retinopathy, but are often difficult to achieve, and DR thus develops in a high proportion of patients. Current treatments for DR such as laser photocoagulation, intravitreous injections of corticosteroids or anti-vascular endothelial growth factor (VEGF) agents are indicated for advanced DR and have significant adverse effects. Therefore, new pharmacological treatments for the early stages of DR are needed. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial included a lipid management arm, in which patients satisfying additional inclusion criteria for the atherogenic dyslipidemia phenotype were randomly assigned to fenofibrate or placebo, each with a statin. In the ACCORD-EYE substudy, randomization to fenofibrate was associated with a significant reduction in the risk of progression of DR. These data confirm and extend the results of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, in which type 2 diabetes patients randomized to fenofibrate benefitted from a significantly lower incidence of laser treatment for retinopathy, progression of retinopathy or a composite measure of retinopathy outcomes. The results of ACCORD-EYE, together with those of FIELD, identify a place for fenofibrate for the prevention of retinopathy alongside intensive management of traditional risk factors, such as hyperglycemia and high blood pressure.
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Use Of Antibiotics In Bronchiectasis
Paul T King and Peter W Holmes
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00017]
Bronchiectasis is defined by the presence of abnormal bronchial widening and occurs as a consequence of chronic airway infection. It is an important and common cause of respiratory disease. Antibiotics are the main therapy used for the treatment of this condition. The article will review the use of antibiotics for the treatment of bronchiectasis. Antibiotics can be given as short-term therapy for exacerbations or as long-term/maintenance therapy. Antibiotics given by the inhalational route and macrolides are two relatively new classes of medication that may be useful for long-term therapy. There are significant concerns about the overuse resulting in antibiotic resistance. It should be emphasized that nearly all of the trials in the literature have only had small numbers of subjects. The data that is available describing the use of antibiotics in bronchiectasis can generally be regarded as preliminary.
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Therapeutic intervention in cancer and chronic viral infections: Antibody mediated manipulation of PD-1/PD-L1 interaction
Priya Sakthivel, Marcus Gereke and Dunja Bruder
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00018]
Programmed Death-1(PD-1) is a negative regulator of T cell activation and proliferation that mediates suppressive action by binding to its ligands PD-L1 and PD-L2. The well-established immunosuppressive properties of PD-1/PD-L1 interaction resulting in the re-establishment of peripheral tolerance makes PD-1 an interesting target for therapeutic intervention in cancer patients. In addition to its relevance in tumor-specific immunity, recent studies demonstrate that PD-1 expression on T cells correlates with viral load in HIV and HCV infected patients and further identified PD-1 expression as a marker for exhausted virus-specific CD8+ T cells. In particular, PD-1+CD8+ T cells show impaired effector functions and PD-1 associated T cell exhaustion could be restored by blocking the PD-1/PD-L1 interaction. This results in recovery of virus-specific CD8+ T cell mediated immunity, suggesting that interrupting PD-1 signaling using an antagonistic antibody restores T-cell effector functions. Thus, immunotherapy based on the blockade of PD-1/PD-L1 interaction does not only result in breakdown of effector T-cell tolerance to tumor antigens, but in addition also represents a promising therapeutic strategy for reactivation of virus-specific effector T cells to exert pathogen eradication in chronic viral infections. In this review, we give a comprehensive overview about the immunological functions of PD-1 mediated signaling in T cells with special emphasis on its immune regulatory functions in the context of cancer and chronic viral infections. Moreover, we will summarize recent data obtained in animal models, in-vitro preclinical approaches in patients and their implementation in clinical trials for treating patients with cancer and chronic viral infections.
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Clinical Pharmacology of Paliperidone Palmitate A Parenteral Long-Acting Formulation for the Treatment of Schizophrenia
Elizabeth Gilday and Henry A. Nasrallah
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00019]
Paliperidone Palmitate is a long-acting intramuscular atypical antipsychotic drug indicated for the acute and maintenance treatment of schizophrenia in adults. Its mechanism of action, like all other atypical agents, is attributed to the antagonism of brain dopamine D2 and serotonin 5-HT2A receptors. The pharmacodynamics, pharmacokinetics, and metabolism of paliperidone palmitate are reviewed. Current studies for clinical efficacy of paliperidone palmitate for both acute and maintenance treatment and adherence in a dults with schizophrenia are discussed. Studies for safety and tolerability are also reviewed.
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The Role Of Venous Abnormalities in Neurological Disease
E. Mark Haacke, Clive B. Beggs and Charbel Habib
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00020]
The role of the venous circulation has long been underestimated in clinical practice and in research into neurological diseases. In this review, we present an overview of the existing evidence that venous abnormalities can play a key role in the development and manifestation of neurological and neurodegenerative diseases. We review the history behind the role of venous diseases in multiple sclerosis and their connections with the disease landmarks, the links of chronic venous hypertension to cerebral hydrodynamics and the role of iron in MS. In addition, we highlight the role of venous abnormalities in other diseases including jugular venous reflux, developmental anomalies, hydrocephalus and cerebrospinal fluid flow. Finally, and based on the information presented throughout the whole review, we conclude with the link between chronic cerebrospinal venous insufficiency and MS and the role and power of magnetic resonance in diagnosing venous anomalies.
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Biophysics of venous return from the brain from the perspective of the pathophysiology of chronic cerebrospinal venous insufficiency
Maciej Zaniewski and Marian Simka
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00021]
This article discusses the biophysical aspects of venous outflow from the brain in healthy individuals and in patients with chronic cerebrospinal venous insufficiency. Blood flows out of the brain differently, depending on body position. In the supine position it flows out mainly through internal jugular veins, while in the upright position it uses the vertebral veins. This phenomenon is probably not due to the active regulation of the flow but instead results from the collapse of jugular veins when the head is elevated. Such a collapse is associated with a significant increase in flow resistance, which leads to redirection of the flow towards the vertebral pathway. Theoretical calculations respecting the rules of fluid mechanics indicate that the pressure gradients necessary for moving blood from the brain toward the heart differ significantly between the supine and upright positions. The occlusion of internal jugular veins, according to fluid mechanics, should result in significant increase in the flow resistance and the restriction of cerebral flow, which is in line with clinical observations. Importantly, the biophysical analysis of cerebral venous outflow implies that the brain cannot easily compensate for increased peripheral venous resistance (namely, an occlusion of the large extracranial veins draining this organ), either by elevating the pressure gradient or by decreasing the vascular resistance through the recruitment of additional drainage pathways. This may mean that chronic cerebrospinal venous insufficiency may cause the destruction of the delicate nervous tissue of the central nervous system.
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Internal jugular vein valve morphology in the patients with chronic cerebrospinal venous insufficiency (CCSVI); angiographic findings and schematic demonstrations
Ma'moon Hasan Al-Omari and Areen Al-Bashir
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00022]
Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome recently described in multiple sclerosis patients. It is characterized by abnormal venous hemodynamics resulting from numerous obstacles in the main veins draining the central nervous system, usually: the internal jugular veins and the azygous vein. Internal jugular vein is the most commonly vein affected. Most of the abnormalities in this vein are located at the level of jugular valve. The aim of this review is to give venographic and schematic descriptions of the most common valvular and perivalvular anomalies found in the lower part of internal jugular vein.
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A Review of Family-Based Treatment for Adolescents with Eating Disorders
Colleen Stiles-Shields, Renee Rienecke Hostea, Peter M. Doyleb and Daniel Le Grangea
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00023]
This review focuses on the use of family-based treatment (FBT) for adolescents with eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN). AN and BN are serious disorders with significant psychiatric and medical morbidity. Data support the use of family treatments for adolescents with eating disorders. Developed at the Maudsley Hospital, FBT is a theoretically agnostic approach that externalizes the illness from the patient and empowers families to actively work to bring about recovery in their relative with an eating disorder. FBT appears to be an effective treatment for adolescents with AN and support is developing for the treatment of adolescents with BN. Manual development is currently underway for the implementation of FBT for young adults with eating disorders, overweight adolescents, and those with subsyndromal AN. Further research is needed to determine the effectiveness of FBT with other populations. In this review, we will provide a critical overview of the literature by focusing upon empirical findings regarding FBT, with particular emphasis on studies conducted with adolescents.
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Non-pharmacological treatment of depressive disorders: a review of evidence-based treatment options
J. Dirmaier, M. Steinmann, T. Krattenmacher, B. Watzke, D. Barghaan, U. Koch and H. Schulz
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00024]
Background: In recent years, the importance of guidelines and standards has increased constantly. This paper describes the development of a standard for the non-pharmacological treatment of patients with depressive disorders.
Aim: The primary goal of this paper is to describe the collection and evaluation regarding evidence for various non-pharmacological treatment options for depressive disorders to establish a basis for the current development of a standard for the treatment of patients with depressive disorders.
Method: In order to identify evidence-based treatment elements, a comprehensive investigation of national and international guidelines was conducted first. The extracted guidelines were then assessed with regard to aspects of methodological quality and evidence-based treatment elements. In a further step, specific and systematic literature searches for residual treatment elements were conducted. For the corresponding literature search, a hierarchical approach was chosen: current guidelines were reviewed first and systematic reviews and meta-analyses second. Psychopharmacological treatments were excluded from the analysis, because this is covered by specific guidelines.
Results: The following treatment elements with an adequate level of evidence were identified: psychotherapeutic interventions, marital/couples/family therapy and counselling, inclusion of family members, psycho education, exercise, problem solving therapy, guided self-help and behavioral activation treatments. Further evidence-based methods include diagnostical treatment elements, participative decision-making, development of the therapeutic alliance, Cognitive Behavioral Analysis System for Psychotherapy, computarized cognitive behavior therapy, psychopharmacological therapy, combined psychopharmacological and psychotherapeutic therapy, electroconvulsive therapy, phototherapy, sleep deprivation, repetitive transcranial magnetic stimulation (rTMS), acupuncture and St. John's wort.
Conclusion: In summary, using a hierarchical approach, it was possible to assign different levels of evidence to the various treatment options for depression.
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Is the use of cholesterol-lowering drugs for the prevention of cardiovascular complications in type 2 diabetics evidence-based? A systematic review
Michel de Lorgeril, Tomohito Hamazaki, Willy Kostucki, Harumi Okuyama, Bruno Pavy, Anne-Thea McGill and Mikael Rabaeus
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00025]
Cholesterol-lowering drugs are often prescribed to patients with type 2 diabetes mellitus despite uncertainty about the benefits of this treatment in the prevention of cardiovascular complications. We here systematically review (PRISMA guidelines) the results of high-quality double blind trials testing whether cholesterol-lowering drugs (statins and fibrates) reduce mortality and cardiovascular complications specifically in type 2 diabetics. Trials with premature termination without pertinent medical justification or using nonrandomized subgroups of diabetics were excluded from the review. Only four trials met our predefined inclusion criteria. Among the 3 statin trials, CARDS was discontinued 2 years before the anticipated end and in the absence of significant effect on both overall and cardiovascular mortality, suggesting that the trial should not have been prematurely stopped. The two other statin trials showed no significant effect on the primary endpoint (relative risk 0.92, 95% CI 0.77 to 1.10 in 4D and 0.90, 95% CI 0.73 to 1.12 in ASPEN) and on both cardiovascular and overall mortality. Finally, the fibrate trial (FIELD) showed no significant benefit on the primary endpoint (relative risk 0.89, 95% CI 0.75 to 1.05) and mortality (relative risk 1.11, 95% CI 0.95 to 1.29). Because of a huge medical heterogeneity between patients in the selected trials, it was consensually decided to stop the analysis at this stage. This review does not support the use of cholesterol-lowering drugs (such as statin and fibrate) to reduce mortality and cardiovascular complications in type 2 diabetics. Official guidelines should be re-examined and reformulated by experts independent from the pharmaceutical industry.
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Assessment Of Prescription Pattern In Asthma Therapy At Shamli Hospitals
Rishabh Srivastava, Sanjay Sharma, Lav Keshri and Pranay wal
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00026]
This drug utilization or prescription-monitoring study was conducted to evaluate the drug-prescribing trend of anti-asthmatic drugs in various hospitals (health care centre) of Shamli, (Prabuddha Nagar, Uttar Pradesh, India). The study was conducted in three famous hospitals of Shamli on three hundred thirty (330) patients, using a developed prescription auditing Performa. Data was recorded from the co-operating patients, attending the outpatient department using a chance random sample method for six months by interviewing and information was filled in the performa. The collected data was studied statistically for determining the most prominently prescribed medication for the treatment. The collected information suggested that β-agonist were the most frequently prescribed anti-asthmatic drugs followed by corticosteroids, Methylxanthine, anti-histaminics and leukotriene antagonist. Also the performed prescription analysis revealed that there is significant difference in the prescriptions for multiple drug therapy (90%) as compared to single drug therapy (10%). Also even after the commercial development of pulmonary targeted systems, oral dosage form like tablets (54.93%) were preferred over inhalation (31.69%). Thus, it can be concluded that the present prescribing pattern of anti-asthmatics in Shamli does not completely meet standard guidelines for the asthma treatment. Hence there is a need of awareness amongst the physicians of Shamli so that they can follow the guidelines while treating asthma. Also the patients must be encouraged to use newly developed inhalational drug delivery systems for improving the treatment.
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Radial approach for percutaneous coronary intervention
Andrea Rognoni, Alessandro Lupi, Mara Sansa, Gioel Gabrio Secco, Matteo Santagostino and Angelo Sante Bongo
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00027]
The transradial approach for percutaneous coronary intervention (both diagnostic and therapeutic procedures) has gained progressive acceptance in the last years.
Transradial access have been shown, also, to have several advantages over transfemoral approach; the radial artery is easily compressible, thus bleeding is controllable and hemorrhagic complications are significantly reduced. Furthermore periprocedural bleeding and vascular complications after percutaneous coronary intervention are associated with worse clinical outcomes and increased short and long – mortality.
With increasing experience and availability of dedicated equipment this technique is now been increasingly used for complex catheter intervention.
The main purpose of this review is to highlight the benefits, complications and problems with transradial approach compared with conventional transfemoral approach.
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Pharmacokinetic Study of Weekly (days 1-5) Low-dose S-1 in Patients with Non-small-cell Lung Cancer
Tsuyoshi Shoji, Makoto Sonobe, Hiroaki Sakai, Takuji Fujinaga, Toshihiko Sato, Fengshi Chen, Ryo Miyahara, Toru Bando, Hiromi Wada and Hiroshi Date
[FULL-TEXT INQUIRY] [BSP/RRCT/E-Pub/00028]
Background: S-1, an oral fluoropyrimidine, is usually given for 4 weeks (80 mg/m2/day) followed by a 2-week rest. However, compliance with this regimen is unsatisfactory because of adverse events such as leukopenia, anorexia, and nausea. To reduce adverse effects and improve compliance, we studied a “5-day on/2-day off” low-dose regimen of S-1 and evaluated pharmacokinetics in patients with non-small-cell lung cancer (NSCLC).
Methods: Twelve patients with NSCLC were divided into 2 groups and received S-1 in a dose of 25 mg twice daily (level 1, n = 6) or 40 mg twice daily (level 2, n = 6) for 5 consecutive days followed by a 2-day rest (5 days on/2 days off) every week. Plasma 5-fluorouracil (5-FU) concentrations were measured.
Results: The maximum concentration in plasma and the area under the plasma concentration-time curve from 0 to 9 h were respectively 55.3 ± 21.1 ng/ml and 290.2 ± 95.7 ng• hr/ml for level 1, as compared with 104.2 ± 33.5 ng/ml and 541.9 ± 232.3 ng• hr/ml for level 2. These values were similar to those previously reported for a continuous intravenous infusion of 5-FU. Adverse events were grade 1 fatigue (n = 1 in each group) and anorexia (n = 1 in each group).
Conclusions: A “5-day on/2-day off” low-dose (40 mg twice daily) regimen of S-1 is feasible for the treatment of NSCLC, with acceptable plasma 5-FU concentrations and minimal adverse effects. A phase II or III trial of this regimen in an adjuvant setting is warranted in patients with NSCLC.
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