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Tierarztliche Praxis. Ausgabe K,... Jun 2021A number of different rescue protocols for relapsed canine multicentric large-cell lymphoma have been described. The aim of this pilot study was to evaluate the efficacy...
OBJECTIVE
A number of different rescue protocols for relapsed canine multicentric large-cell lymphoma have been described. The aim of this pilot study was to evaluate the efficacy of a maintenance treatment in dogs that experienced a second complete remission after a short L-CHOP-rescue protocol.
MATERIAL AND METHODS
Included in the study were dogs experiencing the first lymphoma relapse during a treatment-free period which were treated with a short L-CHOP protocol, achieved a complete remission and were afterwards treated with a continuous maintenance phase (MP) protocol. The L-CHOP protocol consisted of weekly treatments, with at least 3 additional treatments following complete remission. Thereafter the MP protocol with 2-week treatment intervals was conducted. It consisted of alternating oral home administration of different alkylating agents and one intravenously administered cytotoxic agent of a different mechanism of action. The dogs were presented either every 4 or 6 weeks for intravenous treatment and at this time a complete blood count was performed. The durations of the first remission, disease-free interval and overall survival time were evaluated.
RESULTS
A total of 20 dogs were included in the study. A median of 7 weekly applications were given before the treatment was switched to the MP protocol. During MP, 14 dogs were treated intravenously every 6 weeks and 6 dogs every 4 weeks. Haematological adverse events were mainly mild. During the L-CHOP-protocol, one septic event occurred, and 2 dogs were hospitalized due to gastrointestinal adverse events. No patient required hospitalization during the MP. Fifteen dogs completed at least one cycle in the MP and a median of 8.5 chemotherapeutic treatments were administered. The median disease-free interval was 264 days and the median overall survival time was 737 days.
CONCLUSION AND CLINICAL RELEVANCE
The protocol was generally well tolerated. Since 5 patients showed disease progression during the first cycle of the MP, dogs should ideally be evaluated for minimal residual disease before being switched to the MP. The case number in the presented study was low and the treatment relatively heterogeneous. Therefore, more dogs have to be treated with the proposed protocol before general recommendations can be made.
Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Dog Diseases; Dogs; Doxorubicin; Lymphoma; Pilot Projects; Prednisone; Treatment Outcome; Vincristine
PubMed: 34157760
DOI: 10.1055/a-1481-7066 -
ISA Transactions Jun 2023In this paper, we study the adaptive fixed-time consensus control for stochastic multi-agent systems (SMASs) with uncertain actuator faults. Firstly, a fully distributed...
In this paper, we study the adaptive fixed-time consensus control for stochastic multi-agent systems (SMASs) with uncertain actuator faults. Firstly, a fully distributed adaptive consensus protocol and an adaptive fault-tolerant consensus protocol are proposed, respectively, to ensure that the fixed-time consensus of SMASs with actuator faults can be reached. Secondly, an adaptive fault-tolerant containment consensus protocol is further proposed for the SMASs by leveraging the signum function, and this protocol can effectively solve the containment consensus in the unbalanced communication network. Finally, some simulation examples are given to verify the effectiveness of our consensus protocols.
PubMed: 36623994
DOI: 10.1016/j.isatra.2023.01.003 -
Journal of Magnetic Resonance Imaging :... May 2005To design an ideal first-pass profile for MR angiography (MRA) by optimizing a multiphasic injection protocol based on two experimental animal models.
PURPOSE
To design an ideal first-pass profile for MR angiography (MRA) by optimizing a multiphasic injection protocol based on two experimental animal models.
MATERIALS AND METHODS
An equivalent contrast-enhanced (CE) MRA injection protocol was developed with controlled injection modalities (injection rate, volume, and dose) in rabbits and pigs. P792, a blood pool contrast agent, was injected in 17 male New Zealand rabbits and five farm pigs with variable injection schemes (mono- and multiphasic). From the gadolinium (Gd) blood concentration data, a simulation of an MR acquisition was performed to evaluate the impact of such an injection protocol on MR arterial signal and to select the best injection protocol.
RESULTS
An empirical relationship between the arterial peak concentration and the injection parameters was found in the rabbits and pigs, allowing precise prediction of the first-pass profile. Of the four injection scheme strategies tested (standard bolus and bi-, tri-, and multiphasic injection protocols), the multiphasic "ramp" injection protocol provided the most optimal contrast agent pharmacokinetics with a durable plateau of concentration.
CONCLUSION
Ramp injection protocol provides an optimized first-pass profile for CE-MRA.
Topics: Animals; Contrast Media; Heterocyclic Compounds; Injections; Magnetic Resonance Angiography; Male; Organometallic Compounds; Rabbits; Swine
PubMed: 15834909
DOI: 10.1002/jmri.20324 -
Chemico-biological Interactions Jul 2020Early initiated decontamination is demonstrated to be crucial to avoid systemic effects of highly toxic and low volatile agents exposed on the skin. Skin decontamination...
Early initiated decontamination is demonstrated to be crucial to avoid systemic effects of highly toxic and low volatile agents exposed on the skin. Skin decontamination can be performed by simple procedures, such as washing with soap and water, or by using advanced decontamination products containing absorption and agent degradation properties. Reactive Skin Decontamination Lotion (RSDL) has demonstrated high efficacy to remove nerve agents from the skin. However, contrary to the current operational recommendations, experimental studies have shown that prolonged skin contact time of RSDL is important for efficient decontamination of VX. In the present study, several RSDL-protocols were evaluated for the efficacy to remove neat VX from human skin in vitro. The decontamination efficacies of the RSDL-procedures were compared with the efficacy of the simple procedure of washing off the skin with soapy water. The RSDL-protocols containing repeated swabbing with the sponge and a 10 min skin contact time of RSDL-lotion demonstrated the greatest decontamination efficacy of all procedures evaluated. Repeating the protocol 2 h after the initial decontamination step resulted in a transient increased skin penetration of remaining intact agent on skin and was followed by rapidly declined agent penetration rate. Decontamination performed with soapy water significantly increased agent amounts penetrating skin, most likely caused by skin hydration and agent dilution. In conclusion, a slightly extended procedure for RSDL-decontamination showed improved efficacy and is therefore recommended for removal of nerve agents from the skin. In addition, it is of highest importance that skin decontamination of nerve agents should consist of procedures using low water content.
Topics: Decontamination; Dose-Response Relationship, Drug; Humans; Nerve Agents; Organothiophosphorus Compounds; Skin; Soaps; Time Factors
PubMed: 32428449
DOI: 10.1016/j.cbi.2020.109135 -
Journal of Oncology Pharmacy Practice :... Oct 2023The goal of this study was to create a cleaning procedure by comparing the performance of six different cleaning methods on the surfaces in pharmacy intravenous...
PURPOSE
The goal of this study was to create a cleaning procedure by comparing the performance of six different cleaning methods on the surfaces in pharmacy intravenous admixture service (PIVAS) work area.
METHOD
A stainless steel plate was simulating contaminated by gemcitabine, cyclophosphamide, epirubicin, etoposide, and paclitaxel, which was then dried and cleaned by per current cleaning protocols. The residues were collected and quantified by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Based on the most appropriate cleaning protocol, three cleaning variables were optimized: (1) use of dry gauze after cleaning agent application; (2) cleaning paths (inside-out vs. outside-in); (3) cleaning times (once or twice). Best conditions were tested with real samples from a hospital PIVAS.
RESULTS
This 10 M sodium dodecyl sulfate (SDS) and dry gauze cleaning protocol increases cleaning efficiency as well as saves time. Different from the traditional cleaning manner, we found that cleaning from outside to inside can not only improve the cleaning efficiency but also overcome the uneven distribution of drug residues caused by cleaning action. When simulating contamination at a high dose (4 mg/mL) level, it was found that the decontamination efficacy increased with repeating one more time.
CONCLUSION
The 10 M SDS and dry gauze cleaning protocol could obtain the best cleaning effect. The success of cytotoxic drug decontamination is determined not only by the cleaning solution, but also by the cleaning route and frequency. Compared with the traditional cleaning manner, there was a significant reduction in the contamination levels in the PIVAS work area after the cleaning protocol with 10 M SDS and dry gauze.
Topics: Humans; Decontamination; Chromatography, Liquid; Tandem Mass Spectrometry; Antineoplastic Agents; Gemcitabine
PubMed: 36544379
DOI: 10.1177/10781552221138331 -
Gynecologic Oncology Jul 1997From December 1982 to December 1986, 52 patients with recurrent ovarian cancer were treated with single-agent HMM. Chemotherapy was given for a period of 1 year unless... (Clinical Trial)
Clinical Trial Review
From December 1982 to December 1986, 52 patients with recurrent ovarian cancer were treated with single-agent HMM. Chemotherapy was given for a period of 1 year unless progression of disease or toxicity was noted. Survival was determined from the time of diagnosis to the date of death or September 30, 1992. The regimen was well tolerated with only one case of severe gastrointestinal toxicity. Nine patients were found to be clinically free of disease following completion of HMM treatment; they had initially responded to cisplatin-based therapy (i.e., potentially cisplatin-sensitive) and subsequently recurred. Four were found to have gross disease at the time of reassessment laparotomy. Three of these 9 patients are alive 81-92 months since diagnosis, having maintained disease-free intervals of up to 6 years. The median survival for the 9 patients without evidence of disease at the end of therapy was 75 months versus 9 months for the nonresponders. No patient who had progressive disease on first-line cisplatin-based combination chemotherapy (i.e., primary cisplatin-resistant) responded to second-line single-agent oral hexamethylmelamine. With a follow-up close to 10 years, our data show that hexamethylmelamine, with reasonable toxicity, can provide an extended, disease-free interval to a selected group of patients.
Topics: Adult; Aged; Aged, 80 and over; Altretamine; Antineoplastic Agents, Alkylating; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Cyclophosphamide; Doxorubicin; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Recurrence, Local
PubMed: 9234915
DOI: 10.1006/gyno.1997.4725 -
American Journal of Surgery Jun 2019One of the most common reasons for admission to a surgical service is for a partial small bowel obstruction. There is considerable variation in management. Several...
BACKGROUND
One of the most common reasons for admission to a surgical service is for a partial small bowel obstruction. There is considerable variation in management. Several studies suggest that the use of diatrizoate (Gastrografin), a hyperosmolar contrast agent, can be helpful as a diagnostic agent as well as possibly therapeutic, reducing the need for operative intervention. There is a paucity of data on the use of Gastrografin in the community setting. We hypothesized that this standardized algorithm of Gastrografin administration would decrease the need for surgery and shorten a patient's length of stay, even outside the confines of a regulated clinical trial.
METHODS
We performed a retrospective review of all patients admitted to two major hospitals in our network with the diagnosis of partial small bowel obstruction. Patients were excluded if they were admitted within thirty days of bowel surgery or if they were <18 years of age. The primary variable for analysis was the subsets of patients who were placed on our protocol versus no protocol at the other hospital. The primary outcome was hospital length of stay. Secondary outcomes included rate of surgery during the same admission and readmission within 30 days of discharge. All analyses were performed using Fisher's Exact test of Mann-Whitney U Test, as appropriate.
RESULTS
A total of 1302 patients with partial small bowel obstruction were identified (103 on-protocol and 1199 off-protocol at our sister hospital). On-protocol patients had a shorter duration of hospitalization (mean, 4.9 days vs. 6.0 days, p < 0.001), lower rates of surgery (2% vs. 16%, p < 0.001), and similar rates of readmission for the same diagnosis (8% and 5%, p = 0.26), compared to off-protocol patients at our sister institution.
CONCLUSION
A protocol utilizing Gastrografin for the management of partial small bowel obstruction decreases the need for surgery and shortens a patient's length of stay in a diverse community setting.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Clinical Protocols; Contrast Media; Diatrizoate Meglumine; Female; Gastrointestinal Agents; Humans; Intestinal Obstruction; Intestine, Small; Length of Stay; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 30621907
DOI: 10.1016/j.amjsurg.2018.12.063 -
Journal of Dental Research Apr 2019Carbamide peroxide (CP) is widely used as a tooth-whitening agent in self-administered tooth-bleaching products. In this study, the effects of 5% and 10% CP on dentinal...
Carbamide peroxide (CP) is widely used as a tooth-whitening agent in self-administered tooth-bleaching products. In this study, the effects of 5% and 10% CP on dentinal collagen structure and chemical properties were evaluated in vitro. Thirty-five intact teeth were exposed to 2 whitening protocols (2 or 4 h daily) with either 5% or 10% CP gel for 1 wk. Shade changes before and after the whitening protocol were captured colorimetrically using a spectroshade. Collagen scaffold models and demineralized dentine disc samples were prepared and exposed to CP droplets (5% or 10%). Structural changes were investigated using electron microscopy. Finally, mineralized dentine disc samples were prepared postbleaching to assess chemical changes resulting from CP exposure in dentinal collagen using Raman spectroscopy. Results showed a difference in tooth shade when exposed to 5% and 10% CP whitening protocols, with a significantly ( P ≤ 0.01) greater change reported for the 10% CP/4-h group. Imaging of the collagen scaffold model following exposure to CP showed a gelatinization process indicating that the free radical by-products from CP are able to disrupt the quaternary structure of noncrosslinked collagen. The most significant damage on the collagen scaffold was seen for the 10% CP exposure for 4 h. Imaging of the demineralized discs displayed the same glassy amorphous layer appearance as found in the collagen scaffold. Raman spectra of the mineralized dentine discs showed a significant decrease ( P ≤ 0.01) in the integrated area of amide I and amide III values in the 4 test groups following CP application. Amide I was more affected as both the exposure time and concentration of CP increased. Despite the claimed safety of whitening agents, this in vitro study concludes that even low concentrations of CP result in a deleterious change in dentinal collagen.
Topics: Carbamide Peroxide; Collagen; Dentin; Drug Combinations; Hydrogen Peroxide; Peroxides; Tooth Bleaching; Tooth Bleaching Agents; Urea
PubMed: 30681930
DOI: 10.1177/0022034518822826 -
La Revue Du Praticien Jun 2023FRONTLINE THERAPY FOR CLASSICAL HODGKIN LYMPHOMA PATIENTS. Upfront first-line chemotherapy is indicated for all features of classical Hodgkin's lymphoma, followed by...
FRONTLINE THERAPY FOR CLASSICAL HODGKIN LYMPHOMA PATIENTS. Upfront first-line chemotherapy is indicated for all features of classical Hodgkin's lymphoma, followed by involved node radiotherapy in early stages; the ABVD protocol (doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine) is the international standard of care. The 7-agent BEACOPP protocol (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine (Oncovin), procarbazine, prednisone) is used in advanced stages in its «escalated» version (BEAesc). During the 2010 decade, it has been demonstrated that strategies guided by positron emission tomography (PET) allows optimizing the benefit/risk ratio of the treatment by decreasing the intensity of therapies for good responders and intensifying treatment of poor responders. Thus, early PET response evaluation is now essential to adapt the treatment intensity. Despite these major advances, several issues remain, including the management of acute and long-term side effects of first-line treatments, the better options for refractory patients, the place and optimization of radiotherapy, and the place for new therapeutic agents such as the anti-CD30 conjugate antibody (brentuximab vedotin) and PD-1 inhibitors in the first-line treatment setting.
Topics: Humans; Hodgkin Disease; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Doxorubicin; Dacarbazine; Vinblastine; Prednisone
PubMed: 37458551
DOI: No ID Found -
Open Veterinary Journal 2021Quality of life (QoL) is an essential factor in therapeutic decision-making for human patients and is commonly used as an endpoint in clinical trials of cancer...
BACKGROUND
Quality of life (QoL) is an essential factor in therapeutic decision-making for human patients and is commonly used as an endpoint in clinical trials of cancer treatments.
AIM
To compare owners' perception of QoL in canine and feline patients affected by different tumor histotypes treated with single-agent or multidrug protocols.
METHODS
Owners were asked to assess the impact on QoL of their pets undergoing chemotherapy treatment by answering a questionnaire and assigning a score to different health-related parameters reported to affect QoL.
RESULTS
Questionnaires of 101 patients (85 dogs and 16 cats), collected at different time points, were analyzed. Fifty-seven patients were given single-agent chemotherapy (carboplatin, doxorubicin, lomustine, melphalan, mitoxantrone, vinblastine, and vinorelbine), whereas 44 were given multiple-agent treatment. When diverse factors including chemotherapy treatment type (single-agent multidrug regimens) and the onset and kind of adverse effects were considered, no significant variations in owners' perceptions of their pets' QoL were discovered.
CONCLUSION
Chemotherapy type (single-agent multidrug protocol) and related adverse events are shown, which did not influence owners' perception of their pet's QoL.Future prospective studies should look into clinical characteristics that might affect QoL, such as the patient's age, tumor stage, and protocol purpose (curative palliative).
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Humans; Neoplasms; Ownership; Prospective Studies; Quality of Life
PubMed: 35070873
DOI: 10.5455/OVJ.2021.v11.i4.28