Prevention of Alopecia in Medical and Interventional Chemotherapy Patients

2015 ◽  
Vol 19 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Adam A. Dmytriw ◽  
Wojciech Morzycki ◽  
Peter J. Green
Keyword(s):  
Hair Growth ◽  
Literature Search ◽  
Chemotherapy Regimen ◽  
Pediatric Population ◽  
Standard Of Care ◽  
Relevant Evidence ◽  
Interventional Chemotherapy ◽  
Chemotherapy Patients ◽  
Pharmacologic Therapies

Background: Chemotherapy-induced alopecia is one of the most distressing side effects of cancer treatment. Although there have been a number of investigated strategies to reduce this, there is no standard of care for treatment. Objective: This review aims to summarize the relevant evidence for the treatments available for chemotherapy-induced alopecia. Methods: A literature search using PubMed and the MEDLINE subengine was completed. The terms “chemotherapy,” “alopecia,” “quality of life,” and “strategies” were used, and articles from the last 10 years were considered. The pediatric population was not investigated. Results: Physical therapies for alopecia prevention have shown some promise but range from insufficient to detrimental depending on the type of cancer. Cold caps may be more effective than tourniquets and may be associated with fewer metastatic events. Pharmacologic therapies, both immunomodulators and growth factors, have stood the test of several trials to date. In particular, cyclosporine has been shown either to prevent alopecia or promote hair growth during a chemotherapy regimen. Conclusion: Although the evidence is not yet overwhelming, it is becoming clear that a combination of mechanical and chemical interventions may help compensate for the downfalls of either therapy alone.

scholarly journals Effectiveness of Fosaprepitant in Combination with 5-HT3 Receptor Antagonist and Dexamethasone in Management of Chemotherapy Induced Nausea and Vomiting

2018 ◽  
Vol 2 (1) ◽  
pp. 43-47
Author(s):  
Guru Sharan Sah ◽  
Ashok Sapkota ◽  
Amog Dwadi ◽  
Sagar Tiwari ◽  
Yogesh Regmi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Receptor Antagonist ◽  
Chemotherapy Regimen ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
The Common ◽  
Chemotherapy Patients ◽  
Triplet Regimen

Introduction: Chemotherapy-induced nausea and vomiting (CINV) is one of the common side effects of cancer chemotherapy, that affects patient’s physical and psychological aspects, decreasing patients quality of life and compliance with therapy. CINV can be acute, delayed or anticipatory. This study assessed effectiveness of fosaprepitant (NK-1 receptor antagonist) in combination with 5-hydroxytryptamine-3 receptor antagonist (5-HT3 RA) plus dexamethasone in prevention and management of nausea and vomiting in patients receiving broad range of chemotherapy regimens. Materials and methods: The current study is prospective study conducted on randomly selected 72 patients during first and second cycle of standard chemotherapeutic regimens. During 144 cycles of chemotherapy patients were randomly assigned in two different anti emetic regimen; triplet regimen (aprepitant, 5-HT3 RA, dexamethasone) and duplet regimen (5-HT3 RA, dexamethasone). All the patients were interviewed using MASCC antiemesis tool (MAT) for incidence of nausea and vomiting. Nausea and vomiting was assessed for 5 days following 1st day of each chemotherapy cycle. Results: During the period of study, duplet regimen was administered in 68 cycles and triplet regimen was administered in 76 cycles of chemotherapy. Most of the chemotherapy regimen were platinum based compounds (61%). In duplet regimen 76.6 % (52/68) and 72.1% (49/68) patients had acute and delayed vomiting respectively whereas in triplet regimen 7.9% (6/76) and 5.3% (4/76) patients had acute and delayed vomiting respectively. Complete response in triplet regimen were achieved in 89 % of chemotherapy cycles which were significantly low in duplet regimen 10 % only. Conclusions: This study concludes that addition of fosaprepitant in combination with 5-HT3 RA and dexamethasone prevents CIMV in cancer patients receiving chemotherapy.

Nutraceuticals in the prophylaxis of pediatric migraine: Evidence-based review and recommendations

Cephalalgia ◽  
2014 ◽  
Vol 34 (8) ◽  
pp. 568-583 ◽  
Author(s):  
Serena L Orr ◽  
Sunita Venkateswaran
Keyword(s):  
Observational Studies ◽  
Literature Search ◽  
Pediatric Population ◽  
Coenzyme Q ◽  
Migraine Prophylaxis ◽  
Evidence Based ◽  
Research Needs ◽  
Randomized Controlled ◽  
Pediatric Migraine

Introduction The literature on complementary and alternative medicine (CAM) is expanding. One of the most common conditions for which CAM is studied in the pediatric population is migraine. Nutraceuticals are a form of CAM that is being used for pediatric migraine prophylaxis. Methods A literature search was carried out in order to identify both observational studies and randomized controlled trials on the use of nutraceuticals for the prophylaxis of pediatric migraine. Adult studies on included nutraceuticals were also reviewed. Review Thirty studies were reviewed on six different nutraceuticals: butterbur, riboflavin, ginkgolide B, magnesium, coenzyme Q10 and polyunsaturated fatty acids. Conclusion Overall, the quality of the evidence for the use of nutraceuticals in pediatric migraine prophylaxis is poor. Further research needs to be done in order to study the efficacy of nutraceuticals for the prophylaxis of pediatric migraine.

scholarly journals Use of an advanced collagen matrix dressing on patients with complex chronic lower extremity ulcers: A case series

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110136
Author(s):  
Afsaneh Alavi ◽  
Jeannine Archer ◽  
Patricia Coutts
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Ethylenediaminetetraacetic Acid ◽  
Case Series ◽  
Standard Of Care ◽  
Collagen Matrix ◽  
Contact Layer ◽  
Complete Healing ◽  
Average Decrease

The objective of this case series was to assess the wound healing effectiveness of a collagen matrix wound dressing containing partially denatured collagen, carboxymethyl cellulose, alginate and ethylenediaminetetraacetic acid in chronic lower extremity ulcers. A total of nine patients with refractory lower extremity ulcers were treated with the collagen contact layer in addition to standard of care. Wound healing progress was measured at 2, 4 and 8 weeks. An average decrease in wound size of 73% was achieved across patients at week 8, with complete healing in two patients. The intervention was easy to use and well tolerated by patients. The results of this study, although preliminary, suggest that the advanced collagen matrix dressing represents an effective and safe treatment strategy for healing refractory chronic lower extremity ulcers of varying etiologies. Further investigation is needed to evaluate efficacy in a larger randomized clinical trial with focus on cost-effectiveness and impact on patient’s quality-of-life.

scholarly journals Impact of simple, specific, verbal instructions on the quality of bowel preparation in hospitalized patients undergoing colonoscopy: a multicenter randomized controlled trial

2021 ◽  
Vol 09 (03) ◽  
pp. E378-E387
Author(s):  
Konstantinos Triantafyllou ◽  
Paraskevas Gkolfakis ◽  
Alexandros Skamnelos ◽  
Georgia Diamantopoulou ◽  
Athanasios Dagas ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Intervention Group ◽  
Standard Of Care ◽  
Hospitalized Patients ◽  
Verbal Instructions ◽  
Multicenter Randomized Controlled Trial ◽  
The Impact

Abstract Background and study aims Bowel preparation for colonoscopy is frequently inadequate in hospitalized patients. We explored the impact of specific verbal instructions on the quality of inpatients bowel preparation and factors associated with preparation failure. Patients and methods Randomized (1:1), two strata (mobilized vs. bedridden; 3:2) trial of consecutive inpatients from four tertiary centers, who received either specific, verbal instructions or the standard of care (SOC) ward instructions about bowel preparation. The rate of adequate bowel preparation (Boston Bowel Preparation Score [BBPS] ≥ 6, no segment < 2) comprised the primary endpoint. Mean BBPS score, good (BBPS score ≥ 7, no segment score < 2) and excellent (BBPS = 9) were among secondary endpoints. Results We randomized 300 inpatients (180 mobile) aged 71.7 ± 15.1 years in the intervention (49.7 %) and SOC (50.3 %) groups, respectively. Overall, more patients in the intervention group achieved adequate bowel preparation, but this difference did not reach statistical significance neither in the intention-to-treat [90/149 (60.4 %) vs. 82/151 (54.3 %); P = 0.29] nor in the per-protocol analysis [90/129 (69.8 %) vs. 82/132 (62.1 %); P = 0.19]. Overall BBPS score did not differ statistical significantly in the two groups, but the provision of specific verbal instructions was associated with significant higher rates of good (58.1 % vs. 43.2 %; P = 0.02) and excellent (31.8 % vs. 16.7 %; P = 0.004) bowel preparation compared to the SOC group. Administration of same-day bowel preparation and patient American Society of Anesthesiologists score > 2 were identified as risk factors for inadequate bowel preparation. Conclusions Provision of specific verbal instructions did not increase the rate of adequate bowel preparation in a population of mobilized and bedridden hospitalized patients.

scholarly journals Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Classification System ◽  
Methodological Quality ◽  
Literature Search ◽  
Adult Spinal Deformity ◽  
Classification Systems ◽  
Systematic Literature Search ◽  
Patient Profile

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.

Superabsorbent Wound Dressing for Management of Patients With Moderate-to-Highly Exuding Chronic Leg Ulcers: An Early Stage Model-Based Benefit–Harm Assessment

2021 ◽  
pp. 153473462110093
Author(s):  
Vladica M. Velickovic ◽  
Jean P. Lembelembe ◽  
Francisco Cegri ◽  
Ivana Binic ◽  
Amr B. Abdelaziz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Absolute Risk ◽  
Standard Of Care ◽  
Risk Difference ◽  
Wound Dressings ◽  
Leg Ulcers ◽  
Related Quality ◽  
Health Related

The aim of the research is to assess the benefit–harm of superabsorbent polymers wound dressings based on polyacrylate polymers (SAPs) compared with standard of care (SoC) dressing mix for patients with moderate-to-highly exuding hard-to-heal leg ulcers. The SoC dressings mix was composed of other superabsorbents in 29% of cases, antimicrobials 26%, foams 20%, alginates 5%, and other dressings 19% weighted according to their frequency. We have used the decision-analytic modeling method, Markov process, as an adequate analytical solution for medical prognosis. We have combined the systematic literature search to identify the most relevant inputs for the analysis, with available patient-level clinical data concerning benefits of superabsorbent to generate a robust prediction of patient-relevant outcomes, including healing rates and health-related quality of life. Besides, we have qualitatively described adverse events associated with those treatments. Our research indicates that SAPs when compared with SoC dressing mix in a patient with moderate-to-highly excluding leg ulcers are leading to an improved healing rate with an absolute risk difference of 2.20% in 6 months and a relative risk of 1.07 in favor of SAP dressings. The attributable fraction among those exposed to SAP dressings of 6.6%, meaning that 6.6% of the healed ulcers could be attributed to having had the SAP dressing treatment instead of the SoC dressing treatment. Besides, SAP dressings lead to improved quality of life measured as incremental quality-adjusted life weeks (QALWs) of 0.13 QALWs.

scholarly journals 225Actinium-labeled prostate-specific membrane antigen targeting peptide induces complete response in a metastatic prostate cancer patient

2021 ◽  
Vol 10 (5) ◽  
pp. 205846012110225
Author(s):  
Omer Aras ◽  
Stefan Harmsen ◽  
Richard Ting ◽  
Haluk B Sayman
Keyword(s):  
Prostate Cancer ◽  
Standard Of Care ◽  
Complete Response ◽  
Prostate Specific Membrane Antigen ◽  
Limited Data ◽  
Castrate Resistant Prostate Cancer ◽  
Targeting Peptide ◽  
Castrate Resistant ◽  
Specific Membrane

Targeted radionuclide therapy has emerged as a promising and potentially curative strategy for high-grade prostate cancer. However, limited data are available on efficacy, quality of life, and pretherapeutic biomarkers. Here, we highlight the case of a patient with prostate-specific membrane antigen (PSMA)-positive metastatic castrate-resistant prostate cancer who displayed complete response to 225Ac-PSMA-617 after having been resistant to standard-of-care therapy, then initially partially responsive but later resistant to subsequent immunotherapy, and resistant to successive 177Lu-PSMA-617. In addition, the patient’s baseline germline mutation likely predisposed him to more aggressive disease.

scholarly journals Efficiency of modified Goldman’s technique in open pediatric septoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Omar Sabry ◽  
Hazem Dewidar ◽  
Mosaad abdel Aziz ◽  
Amr Elemam ◽  
Ahmed Nassar
Keyword(s):  
Nasal Septum ◽  
Pediatric Population ◽  
Septal Deviation ◽  
Nasal Resistance ◽  
Deviated Nasal Septum ◽  
Assessment Protocol ◽  
Nose Scale ◽  
Detailed Assessment

Abstract Background Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades. In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively. In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique. They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry. Results There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s. Conclusions Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.

scholarly journals The Potential Preventive Effect of Pregnancy and Breastfeeding on Multiple Sclerosis

2021 ◽  
Vol 84 (2) ◽  
pp. 71-84
Author(s):  
Mohsen Ali Alhomoud ◽  
Abdul Sattar Khan ◽  
Iftetah Alhomoud
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Disease ◽  
Literature Search ◽  
Current Evidence ◽  
Obstetric Outcomes ◽  
Preventive Effect ◽  
Third Trimester ◽  
The Third ◽  
The Central Nervous System

<b><i>Background:</i></b> Multiple sclerosis (MS) is an inflammatory demyelinating chronic neurological disease that affects the central nervous system of young adults and their quality of life. Several studies have investigated the effects of pregnancy and breastfeeding on MS. However, the evidence regarding the influence of pregnancy and breastfeeding on MS is still accumulating. This review aimed to summarize the current evidence regarding the effects of pregnancy and breastfeeding on MS. <b><i>Summary:</i></b> A systematic electronic literature search of the PubMed and Embase databases was conducted to determine relevant published articles. The eligible studies were summarized and evaluated in tables. <b><i>Key Messages:</i></b> The majority of the studies indicated that pregnancy appears to lower the rate of MS relapses, particularly in the third trimester. The evidence regarding the effect of breastfeeding on MS remains inconsistent. Despite reports of negative obstetric outcomes in some pregnant women with MS, pregnancies in women with MS should not be categorized as high-risk pregnancies.

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