scholarly journals Surgical management of oncologic patient during and after the COVID-19 outbreak: practical recommendations from the Italian society of Surgical Oncology

2020 ◽  
Author(s):  
Davide Cavaliere ◽  
◽  
Dario Parini ◽  
Luigi Marano ◽  
Federica Cipriani ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Phase 1 ◽  
Surgical Oncology ◽  
Minimal Invasive ◽  
Italian Society ◽  
Phase 2 ◽  
Energy Devices ◽  
Oncologic Patients ◽  
Phase Phase ◽  
Practical Recommendations

AbstractThe recent outbreak of COVID-19 in Italy caused a limitation of the resources of the health system, which necessarily led to their rationalization in the critical phase (phase 1) and a reorganization of the system in the following phase (phase 2). The Italian Society of Oncological Surgery–SICO has drafted these practical recommendations, calibrated on the most recent scientific literature and taking into account current health regulations and common sense. Surgical activity during phase 1 and 2 should follow a dynamic model, considering architectural structures, hospital mission, organizational models. Surgical delay should not affect oncological prognosis. However, COVID-19-positive cancer patients should be postponed until the infection is cured. The patients to consider more carefully before delaying surgery are those who have completed neoadjuvant therapy, patients with high biological aggressiveness tumors or without therapeutic alternatives. The multidisciplinary discussions are fundamental for sharing clinical decisions; videoconference meetings are preferable and use of telemedicine for follow-up is recommended. Especially in phase 1, maximum effort must be made to reduce the spread of the pandemic. Prefer intra-corporeal rather than open anastomosis during laparoscopy and mechanical rather than hand-sewn anastomosis in open surgery. Consider PPE for caregivers during stoma management. Minimal invasive surgery is not discouraged, because there is little evidence for augmented risk. Specific procedures have to be followed and use of energy devices has to be limited. Training programs with COVID-19 + patients are not recommended. All staff in OR should be trained with specific courses on specific PPE use. Differentiate recommendations are presented for every district cancer. Surgical oncology during phase 2 should be guaranteed by individual and distinct protocols and pathways between cancer patients and COVID-19 + patients with resources specifically addressed to the two distinct kind of patients to limit diagnostic/therapeutic interferences or slowdowns. These recommendations are based on currently available evidence about management of oncologic patients during COVID-19 pandemic, were endorsed by the SICO Executive Board, and are considered suitable for nationwide diffusion. They will be subject to updates and revisions in case of new and relevant scientific acquisitions.

Population Pharmacokinetics of Total and Free Erdafitinib in Adult Healthy Volunteers and Cancer Patients: Analysis of Phase 1 and Phase 2 Studies

2019 ◽  
Vol 60 (4) ◽  
pp. 515-527 ◽  
Author(s):  
Anne‐Gaelle Dosne ◽  
Elodie Valade ◽  
Kim Stuyckens ◽  
Lilian Y. Li ◽  
Daniele Ouellet ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Population Pharmacokinetics ◽  
Cancer Patients ◽  
Phase 1 ◽  
Phase 2

Hypoxic release of calcium from the sarcoplasmic reticulum of pulmonary artery smooth muscle

2001 ◽  
Vol 281 (2) ◽  
pp. L318-L325 ◽  
Author(s):  
Michelle Dipp ◽  
Piers C. G. Nye ◽  
A. Mark Evans
Keyword(s):  
Smooth Muscle ◽  
Sarcoplasmic Reticulum ◽  
Phase 1 ◽  
Transient Phase ◽  
Phase 2 ◽  
Hypoxic Response ◽  
Pulmonary Vessels ◽  
Intracellular Ca ◽  
Pulmonary Artery Smooth Muscle ◽  
Phase Phase

The hypoxic constriction of isolated pulmonary vessels is composed of an initial transient phase ( phase 1) followed by a slowly developing increase in tone ( phase 2). We investigated the roles of the endothelium and of intracellular Ca2+ stores in both preconstricted and unpreconstricted intrapulmonary rabbit arteries when challenged with hypoxia (Po 2 16–21 Torr). Removing the endothelium did not affect phase 1, but phase 2 appeared as a steady plateau. Removing extracellular Ca2+ had essentially the same effect as removing the endothelium. Depletion of sarcoplasmic reticulum Ca2+stores with caffeine and ryanodine abolished the hypoxic response. Omitting preconstriction reduced the amplitude of the hypoxic response but did not qualitatively affect any of the above responses. We conclude that hypoxia releases intracellular Ca2+ from ryanodine-sensitive stores by a mechanism intrinsic to pulmonary vascular smooth muscle without the need for Ca2+ influx across the plasmalemma or an endothelial factor. Our results also suggest that extracellular Ca2+ is required for the release of an endothelium-derived vasoconstrictor.

scholarly journals Creating an Interactive Aid to Mediate Obesity Diagnosis and Management

2019 ◽  
Vol 43 (2) ◽  
Author(s):  
Shariwa Oke ◽  
Kristin Mount ◽  
Kristina Varady ◽  
Samantha Bond
Keyword(s):  
Phase 1 ◽  
Comfort Level ◽  
Health And Wellness ◽  
Phase 2 ◽  
Future Health ◽  
Group Discussions ◽  
Iterative Design ◽  
Post Test ◽  
Phase Group ◽  
Phase Phase

The purpose of this research was to design an application using iterative design and usability testing to convey nutrition, exercise, and obesity information to a patient with obesity. The study consisted of three phases: the research phase (Pre-phase), prototype phase (Phase 1), and application phase (Phase 2).In the pre-phase, group discussions were held with four experts, where they discussed the desired functionality of the proposed application. Their suggestions were incorporated into a paper prototype that was developed for iterative design testing in Phase 1. Experts first answered questions about their patients and then were given tasks to complete using the prototype.In Phase 2, the application was developed in the Unity 2D gaming engine. User feedback from Phase 1 testing was considered for Phase 2 design and functionality choices. Test subjects were given either the mobile application or a handout with the identical written content. All subjects were given a pre-test, including questions about comfort level with their health care provider and knowledge of exercise and nutrition, before they were given either the application or the handout. A post-test was given after subjects had interacted with their materials for one week.Qualitative data from prototyping and iterative design testing is a valuable tool for improving future health and wellness applications.

scholarly journals Kinetic studies on mammalian cytochrome c modified with 2-hydroxy-5-hydroxy-5-nitrobenzyl bromide

1975 ◽  
Vol 149 (1) ◽  
pp. 179-185 ◽  
Author(s):  
T Brittain ◽  
C Greenwood
Keyword(s):  
Cytochrome C ◽  
Flash Photolysis ◽  
Ph Dependence ◽  
Phase 1 ◽  
Kinetic Studies ◽  
Chromium Concentration ◽  
Stopped Flow ◽  
Phase 2 ◽  
Difference Spectra ◽  
Phase Phase

The reduction of 2-hydroxy-5-nitrobenzyl tryptophyl cytochrome c by the chromous ion was studied by stopped-flow techniques. At pH6.5 the reduction of 2-hydroxy-5-nitrobenzyl tryptophyl cytochrome c is complex, showing the presence of three distinct phases. Two chromium concentration-dependent phases are observed (1.1 × 105 M-1-S-1, phase 1; 1.25 × 104M-1-S-1, phase 2) and one slow first-order process (0.25S-1, phase 3). A comparison of the static and kinetic difference spectra, along with the data from the reduction of the reoxidized reduced protein, suggests that the slow chromium concentration-independent phase is due to a slow conformational event after fast reduction of the NO2 group. The rates of the chromium concentration-dependent phases show a marked variation with pH above 7.5. The activation energies for the three processes were also measured at 33.2, 38.6 and 69.7 kJ-mol-1 for phases 1, 2 and 3 respectively. The reaction of reduced 2-hydroxy-5-nitrobenzyl tryptophyl cytochrome c with CO was foollowed by means of both stopped-flow and flash photolysis. The combination with CO at pH 6.8 as measured in stopped-flow experiments showed two phases, one CO-dependent phase (phase 2, 2.4 × 102M-1-S-1) and one CO-independent phase (phase 1, 0.015S-1). Investigation of the pH-dependence of the phases showed both the rates and amounts of each phase to be pH-invariant. CO recombination, after photolytic removal, was found to be biphasic; a CO-dependent phase (phase 2, 2.4 × 102M-1-S-1) and a CO-independent phase (phase 1, 1.0s-1) were observed. A tentative model which can accommodate these observations is proposed.

scholarly journals The Positive Inotropic and Calcium-Mobilizing Effects of Growth Hormone-Releasing Peptides on Rat Heart

Endocrinology ◽  
2003 ◽  
Vol 144 (11) ◽  
pp. 5050-5057 ◽  
Author(s):  
Xiang-Bin Xu ◽  
Ji-Min Cao ◽  
Jing-Jiang Pang ◽  
Rong-Kun Xu ◽  
Chao Ni ◽  
...  
Keyword(s):  
Protein Kinase C ◽  
Protein Kinase ◽  
Ventricular Myocytes ◽  
Phase 1 ◽  
Dependent Manner ◽  
Phase 2 ◽  
Perfused Heart ◽  
Voltage Gated ◽  
Kinase C ◽  
Phase Phase

Abstract GH-releasing peptides (GHRP) are synthetic peptides exerting GH-dependent or GH-independent effects via GH secretagogue receptor on many organs, including the heart. The underlying mechanisms of the cardiotropic properties of GHRP are poorly understood. This study investigates these effects of four GHRP in isolated perfused heart preparations and isolated neonatal and adult ventricular myocytes. The calcium response of cardiocytes to GHRP was visualized using confocal microscopy. All tested GHRP facilitated both ventricular contraction and relaxation in a dose-dependent manner, moderately decreasing coronary flow, but not modifying heart rate. GHRP induced a biphasic increase in intracellular free Ca2+ of the cardiocytes, consisting of a transient phase (phase 1), followed by a plateau phase (phase 2). Phase 1 was abolished by pretreatment with thapsigargin, a Ca2+-adenosine triphosphatase inhibitor of the sarcoplasmic reticulum. The phase 2 response was eliminated by removing extracellular free Ca2+, by verapamil, a voltage-gated Ca2+ channel blocker, or by 24-h pretreatment with phorbol 12-myristate 13-acetate, down-regulating protein kinase C. In isolated (denervated) heart, GHRP have a direct cardiotropic, without chronotropic, effect. GHRP elevate myocardial intracellular free Ca2+ through activating Ca2+ influx via voltage-gated Ca2+ channels and triggering Ca2+ release from thapsigargin-sensitive intracellular Ca2+ stores. Protein kinase C mediates the GHRP-induced Ca2+ influx, but not Ca2+ release. These finding support a number of roles for GHRP in the cardiovascular system.

Phase 1 study of the investigational Aurora A kinase inhibitor alisertib (MLN8237) in East Asian cancer patients: pharmacokinetics and recommended phase 2 dose

2015 ◽  
Vol 33 (4) ◽  
pp. 942-953 ◽  
Author(s):  
Karthik Venkatakrishnan ◽  
Tae Min Kim ◽  
Chia-Chi Lin ◽  
Lim Soon Thye ◽  
Wee Joo Chng ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Kinase Inhibitor ◽  
Phase 1 ◽  
East Asian ◽  
Aurora A Kinase ◽  
Phase 2 ◽  
Aurora A ◽  
Phase 1 Study

The cognitive effects of modafinil in breast cancer survivors: A randomized clinical trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9004-9004 ◽  
Author(s):  
S. Kohli ◽  
S. G. Fisher ◽  
Y. Tra ◽  
K. Wesnes ◽  
G. R. Morrow
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cancer Patients ◽  
Phase 1 ◽  
Secondary Memory ◽  
Phase 2 ◽  
Breast Cancer Patients ◽  
Memory And Attention

9004 Background: Patients receiving treatment for cancer can experience a diminution of their cognitive abilities which can persist for many years after. The present study examined the potential of modafinil as a cognitive enhancer on memory and attention in a randomized clinical trial in breast cancer patients following completion of treatment. Methods: Breast cancer patients who reported a score of = 2 on the Brief Fatigue Inventory (BFI) an average of 22.8 months following completion of chemotherapy were enrolled. In Phase 1, patients received 200mg modafinil open-label once daily for 4 weeks. In Phase 2, patients with a positive response following Phase 1 were randomized either to an additional 4 weeks of modafinil or to placebo. Tests of memory and attention selected from the Cognitive Drug Research (CDR) computerized cognitive assessment were performed at baseline (before modafinil) and after completing Phase 1 and 2. The difference between scores at baseline and scores at Phase 1 and Phase 2, were subjected to a Wilcoxon's signed rank test. Results: Of the 82 women enrolled, 68 completed all 3 CDR assessments in the study (range=33–83 years, median age=54 years). At the end of Phase 1 (week 4), modafinil had a significant effect on the Speed of Memory Index (p=0.0047) and the Digit Vigilance Test (p=0.0014) but showed no significant effect on Quality of Working Memory (p=0.3528) nor on Power of Attention (p=0.8953). At the end of phase 2 (week 8), the group that continued modafinil demonstrated improved Mean Continuity of Attention (p=0.0002) compared with the placebo group and also demonstrated significantly greater improvements in Quality of Episodic Secondary Memory relative to placebo (p<0.005). This improvement was observed at week 4, and was maintained throughout the study. Finally, continued modafinil demonstrated significantly greater improvement in Speed of Memory relative to placebo (p=0.009). Conclusions: Modafinil provides significant improvements in attention and speed of memory for breast cancer patients following their treatment of cancer. Although further study is needed, these findings suggest that modafinil may enhance quality of life in this patient population. Supported by a grant from Cephalon, Inc and NCI Grants U10-CA37420 and R25- CA102618. No significant financial relationships to disclose.

scholarly journals Coordination and Symmetry Patterns During the Drop Vertical Jump in People With Chronic Ankle Instability and Lateral Ankle Sprain Copers

2016 ◽  
Vol 96 (8) ◽  
pp. 1152-1161 ◽  
Author(s):  
Cailbhe Doherty ◽  
Chris Bleakley ◽  
Jay Hertel ◽  
Brian Caulfield ◽  
John Ryan ◽  
...  
Keyword(s):  
Motor Control ◽  
Ankle Sprain ◽  
Ankle Instability ◽  
Phase 1 ◽  
Vertical Jump ◽  
Phase 2 ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Control Patterns ◽  
Phase Phase

Abstract Background The drop vertical jump (DVJ) task has previously been used to identify movement patterns associated with a number of injury types. However, no current research exists evaluating people with chronic ankle instability (CAI) compared with people coping with lateral ankle sprain (LAS) (referred to as “LAS copers”) during this task. Objective The aim of this study was to identify the coping movement and motor control patterns of LAS copers in comparison with individuals with CAI during the DVJ task. Design This was a case-control study. Methods Seventy individuals were recruited at convenience within 2-weeks of sustaining a first-time acute LAS injury. One year following recruitment, these individuals were stratified into 2 groups: 28 with CAI and 42 LAS copers. They attended the testing laboratory to complete a DVJ task. Three-dimensional kinematic and sagittal-plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump phase (phase 1) and drop landing phase (phase 2) of the DVJ. The rate of impact modulation relative to body weight during both phases of the DVJ also was determined. Results Compared with LAS copers, participants with CAI displayed significant increases in hip flexion on their “involved” limb during phase 1 of the DVJ (23° vs 18°) and bilaterally during phase 2 (15° vs 10°). These movement patterns coincided with altered moment-of-force patterns at the hip on the “uninvolved” limb. Limitations It is unknown whether these movement and motor control patterns preceded or occurred as a result of the initial LAS injury. Conclusions Participants with CAI displayed hip-centered changes in movement and motor control patterns during a DVJ task compared with LAS copers. The findings of this study may give an indication of the coping mechanism underlying outcome following initial LAS injury.

An Evidence-based Approach to Developing the Collaborative, Client-Centred Nutrition Education (3CNE) Framework and Practice Points

2016 ◽  
Vol 77 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Catherine Morley ◽  
Deborah MacLellan ◽  
Karol Traviss ◽  
Theresa Cividin
Keyword(s):  
Nutrition Education ◽  
Online Survey ◽  
Phase 1 ◽  
Phase 2 ◽  
Phase 3 ◽  
Progressive Development ◽  
Third Phase ◽  
Phase Study ◽  
Subsequent Phase ◽  
Phase Phase

Purpose: The purpose of this, the third phase of a 3-phase research project, was to develop guidelines for client-centred nutrition education (NE). Methods: A 3-phase study was conducted using a progressive development design, where each phase informed the subsequent phase. Phase 1 was a national online survey of dietitians’ perceptions of consumers’ NE needs and preferences; results informed the Phase 2 national online survey of consumers about their NE needs and preferences. Phase 3 involved national 2-part teleconference consultations with dietitians to discuss implications of the Phase 2 findings for NE practice. This paper is the report of Phase 3. Results: Discussion group participants were 22 dietitians from around Canada who had been in practice for an average of 14.5 years. Discussions resulted in the development of the Collaborative Client-Centred Nutrition Education (3CNE) conceptual framework and related Practice Points that explicate the complexity of NE practice. Conclusion: The 3CNE framework and Practice Points provide a means to inform precepting students and interns, and for use in planning for the professional development of practicing dietitians on providing client-centred NE.

scholarly journals Pelatihan Desain Pembelajaran dengan E-learning Berbasis LMS Moodle

2021 ◽  
Vol 1 (1) ◽  
pp. 34-40
Author(s):  
Parulian Silalahi ◽  
Charlota Agripina ◽  
Yang Agita
Keyword(s):  
Phase 1 ◽  
Phase 2 ◽  
Phase 3 ◽  
E Learning ◽  
Phase Phase

Tujuan dari pengabdian ini adalah untuk melatih guru agar memiliki pengetahuan dan keterampilan dalam mendesain dan mengembangkan pembelajaran dengan E-learning berbasis LMS Moodle. Pelatihan ini diberikan pada guru SMP Maria Goretti Sungailiat Bangka. Metode pelaksanaan pengabdian dilakukan dengan tiga phase: phase 1. persiapan; phase 2. pelaksanaan; dan phase 3. Evaluasi. Pelaksanaan pengabdian dilakukan secara tatap muka dan daring. Melalui tatap muka pelatihan diberikan dengan ceramah dan demonstrasi yang diselenggarakan selama 3 kali pertemuan pada bulan Juli 2020 dengan jumlah yang guru yang ikut dalam pelatihan ini sebanyak 10 orang. Secara daring diberikan dengan menggunakan aplikasi Moodle..  Hasil pelatihan menunjukkan bahwa pengetahuan dan keterampilan guru dalam mendesain dan mengembangkan pembelajaran menggunakan aplikasi E-learning LMS Moodle meningkat. Selanjutnya dari aplikasi Moodle yang telah dikembangkan oleh pengabdi untuk pembelajaran yang diberikan guru kepada siswa, dapat  diterapkan dengan baik.  

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