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Second Cycle (second + cycle)
Selected AbstractsA SECOND CYCLE OF TAMSULOSIN IN PATIENTS WITH DISTAL URETERIC STONES: A PROSPECTIVE RANDOMIZED TRIALBJU INTERNATIONAL, Issue 12 2009Gianluca Giannarini No abstract is available for this article. [source] Gemcitabine induced digital ischaemia and necrosisEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010A. HOLSTEIN md HOLSTEIN A., BÄTGE R. & EGBERTS E.-H. (2010) European Journal of Cancer Care19, 408,409 Gemcitabine induced digital ischaemia and necrosis A 70-year-old woman presented with a 7-day history of severe pain, paresthesia, oedema, acrocyanosis and punctate haemorrhagic lesions on her fingertips. The complaints began 2 days after the second cycle of a first-line chemotherapy consisting of cisplatin or carboplatin, and gemcitabine due to advanced urothelial carcinoma. At the fingertips of both hands, haemorrhagic and partly ulcerative lesions were found; these were attributed to vascular toxicity of gemcitabine. Therapeutically sympathicolysis by bilateral blockade of the brachial plexus was performed, accompanied by intravenous administration of the prostacyclin analog iloprost, fractionated heparin subcutaneously and oral therapy with corticosteroids and aspirin. Digital amputation could be avoided. Acral ischemia is a rare but probably underreported adverse effect of gemcitabine therapy and a potential source of misdiagnosis. [source] Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanesEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2008N. TSAVARIS md Even though significant progress has been made, chemotherapy-induced emesis remains a challenging problem. Few studies focus on emesis in patients treated with carboplatin and the observation period is limited to the initial 24 h following chemotherapy. Thus, we investigated if tropisetron (T) monotherapy can adequately prevent acute and delayed emesis in non-small-cell lung cancer (NSCLC) patients receiving a moderately emetogenic chemotherapy (MEC) (carboplatin-containing) regimen. Furthermore, we explored the merits of adding dexamethasone (D) or alprazolam (A) to T, especially in the setting of a pre-existing high level of stress. We studied 60 patients with advanced NSCLC receiving carboplatin and taxanes in three consecutive cycles. During the first cycle, patients received 5 mg of T intravenously before chemotherapy and the same dose per os on each of the following 3 days. In the second cycle, T was co-administered with 8 mg of D once a day, while, during the third cycle, T was combined with per os A 0.25 mg every 12 h and continued over the following 3 days. Finally, we evaluated the impact of stress on the anti-emetic response achieved with the previously described regimens. The combination of T + A was superior to T monotherapy and the combination of T + D, regarding the prevention of acute and delayed emesis. Both T + A and T + D combinations led to appetite improvement, while patients receiving T + A experienced sedation more frequently. Interestingly, subgroup analysis revealed that patients without underlying stress obtained no further benefit by the addition of A or D, while both T + A and T + D combinations led to a better anti-emetic response in patients with stress. In conclusion, T monotherapy provides a satisfactory result in controlling nausea and emesis caused by a MEC regimen in patients without stress. However, the addition of D and, mainly, A improves its anti-emetic effect in patients with obvious stress. [source] Bleomycin-induced flagellate dermatitisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2007Jeroen D. D. Vuerstaek MD A 62-year-old man with testis carcinoma was treated with bleomycin, cisplatin, and etoposide (BEP). During the second cycle of this chemotherapeutic regimen, he developed nonpruritic, linear erythematous lesions in a flagellate-like fashion on the trunk and extremities. After a short-term oral prednison therapy and ceasing bleomycin administration, these lesions completely resolved. Herein, the characteristic cutaneous side effects of bleomycin are discussed. [source] Eccrine squamous syringometaplasia mimicking a herpetic infectionINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Vicent Alonso MD A 69-year-old woman with a history of hypertension and essential tremor was diagnosed with a Burkitt-like diffuse large-cell lymphoma. She received chemotherapy with cyclophosphamide, vincristine and adriamycin (HyperCVAD). Ten days after starting the second cycle of chemotherapy (HyperCVAD), she presented with well-defined, intense, erythematous macules which coalesced to form a symmetric diffuse erythema located on the upper back. Later, the lesions progressed and affected the lower back and perineal areas, extending to the groin. In a few days, a gradual diminution of the erythema was seen, with subsequent development of postinflammatory gray-brownish hyperpigmentation. On the lower back, there were also superficial erosions. Some asymptomatic, closely grouped, gray papules, vesicles, and blisters were found in the groin, resembling the typical lesions of herpetic infection (Fig. 1). Two biopsies of the groin and one of the upper back were performed, and were processed for histopathologic and microbiologic study. Figure 1. Closely grouped gray papules, vesicles, and blisters on the groin mimicking a herpetic infection The histopathologic study showed epidermal hyperplasia with acanthosis and papillomatosis. In both biopsies, eccrine ducts covered by mature squamous epithelium were found in the reticular dermis (Fig. 2a,c). In the sample from the groin, an intracorneal bulla was found. Numerous normal isolated cornified cells were seen within the lumen of the bulla (Fig. 2d). An inflammatory mononuclear infiltrate was also present in a periductal and perivascular distribution. No multinucleation, ground-glass nuclei, or peripheral margination of chromatin were found. Therefore, no morphologic evidence of herpes virus infection was present. Figure 2. Low (a), medium (b), and high (c) magnification showing epidermal hyperplasia and squamous syringometaplasia involving dermal eccrine ducts. (d) Medium power magnification of the intracorneal bulla (hematoxylin and eosin staining; a, ×40; b, ×100; c, ×400; d, ×100) Cultures and serologic analyses for herpes simplex virus (HSV) 1 and 2, varicella zoster virus (VZV), and cytomegalovirus (CMV) were negative. The lesions were treated with topical corticosteroids, with a good response in a few days. [source] Osmium-Catalyzed Olefin Dihydroxylation and Aminohydroxylation in the Second Catalytic CycleADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 9 2006Peng Wu Abstract Two catalytic cycles operate in the osmium-catalyzed olefin dihydroxylation and aminohydroxylation. Slow hydrolysis of the Os(VI) monoglycolate (or monoazaglycolate in aminohydroxylation) intermediate often results in the addition of another molecule of olefin thereby shunting the catalysis into the second catalytic cycle. As a result, both enantio- and chemoselectivity are reduced. A series of new chelating ligands were devised, which force the catalysis into the second cycle while maintaining enantiocontrol in the olefin addition step. Excellent catalytic turnover and moderate to good enantioselectivity were achieved. [source] Control of Environmental Lighting and Its Effects on Behaviors of the Alzheimer's TypeJOURNAL OF INTERIOR DESIGN, Issue 2 2002Melinda La Garce M.F.A. ABSTRACT The study investigates environmental lighting interventions designed to control the natural daylight effects of the setting sun and resultant behavior change. The purpose of this study was to determine if the frequency of disruptive behaviors of the Alzheimer's type that are defined across the literature to include wandering, anxiousness, combativeness, negative verbalizations, pilfering/hoarding, inappropriate sexual behavior, inappropriate emotional behavior, attention seeking, repetitive statements, and behaviors that are apparently precipitated and/or intensified by the effects of the setting sun i.e., changes in color, angles, and intensity of daylight, can be altered by environmental lighting interventions designed to control the daylight effects of the setting sun. This learning/practice partnership brought together the diverse expertise of research team members and provided new ways of examining research questions. Subjects were evaluated by medical practitioners to determine the probable presence of Alzheimer's disease. Disruptive behaviors were identified by trained observers reviewing 100 hours of videotaped observation, and videotaped observations of the subjects continued as subjects rotated monthly for four months between two apparently identical environments,one controlled and one experimental using environmental lighting interventions. Trained observers made double blind observation of subjects and recorded the frequency of disruptive behaviors on behavior observation checksheets. Tabulations of the disruptive behaviors were made, and percentage of change was calculated. A drop of 41% in the disruptive behaviors of subjects, while in the experimental environment, was demonstrated in the first rotation cycle, and an 11 % drop in disruptive behaviors was found in a second cycle. Inter-rater reliability across all tapes was 70%. Individuals exhibiting the highest frequencies of disruptive behaviors also demonstrated the most dramatic decreases in these behaviors while in the experimental environment. Environmental lighting interventions designed for this study appear to lessen the detrimental behavioral| effects of the setting sun on the behaviors of individuals with Alzheimer's disease. [source] High-dose cytosine arabinoside-induced cutaneous reactionsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2002P Cetkovská Abstract Background High-dose cytosine arabinoside (HDAC) is being used increasingly to treat haematological malignancies. The therapy is associated with various non-haematological negative side-effects, frequently involving the skin. Objective Our aim was to evaluate the actual occurrence of adverse skin reactions to HDAC over the 10-year period from 1989 to 1999. Methods One hundred and seventy-two subjects, 118 with acute myelogenous leukaemia and 54 with acute lymphoblastic leukaemia, between 16 and 71 years of age were treated with 226 post-remission consolidation regimens with HDAC (54 subjects underwent two cycles of treatment). Treatment was combined with standard doses of other cytotoxic drugs. A prospective study of the skin changes was then performed. Results The overall incidence of cutaneous reactions was almost 53%, with rashes occurring in 72.7% and 40.6% of subjects who received total doses of 30 and 24 g/m2, respectively. In the group of subjects who received a second cycle of treatment not all of those who experienced exanthema after the first cycle (44.4%) experienced this reaction after the second cycle (only 33.3%). The most commonly observed reactions were morbilliform eruptions on the trunk and extremities and acral erythema, although severe reactions with swelling and generalized urticaria developed in some cases. Conclusions HDAC-induced cutaneous reactions in 53% of subjects. The skin changes were found to be dose related and most cleared spontaneously without requiring treatment. A clinical grading of cutaneous toxicity has been proposed to allow better comparison of cutaneous adverse effects in different reports. [source] Management of nonresponse to rituximab in rheumatoid arthritis: Predictors and outcome of re-treatmentARTHRITIS & RHEUMATISM, Issue 5 2010E. M. Vital Objective A proportion of patients with rheumatoid arthritis (RA) have disease that fails to respond to an initial cycle of rituximab. Using highly sensitive flow cytometry (HSFC), it has been shown that most patients who do not exhibit a response, as measured using the European League Against Rheumatism (EULAR) criteria, have persistent circulating B cell levels at week 2 after initial treatment with rituximab. This study was undertaken to examine whether an additional cycle of rituximab would improve B cell depletion and clinical response in patients whose disease did not respond to the initial cycle. Methods Patients with RA (n = 158) were treated with a first cycle of rituximab (2 infusions of 1 gm each). Clinical responses were assessed using EULAR criteria, and patients were categorized as either first-cycle responders or first-cycle nonresponders. Baseline characteristics of first-cycle nonresponders (n = 38) and first-cycle responders (n = 65) with complete data were compared. First-cycle nonresponders (n = 25) were treated with a second cycle of rituximab at least 6 months after the first cycle. HSFC was performed at baseline, immediately prior to the second infusion (week 2), 1 month after the second infusion (week 6), and then every 3 months for each cycle of rituximab. Complete B cell depletion was defined as being <0.0001 × 109 cells/liter. Results At baseline, the number of preplasma cells was significantly higher in first-cycle nonresponders than in first-cycle responders (P = 0.003). Following the first infusion of the first cycle of rituximab, only 9% of first-cycle nonresponders (3 of 34) exhibited complete depletion of B-lineage cells, compared with 37% of first-cycle responders (22 of 59) (P = 0.007). Following the first infusion of the second cycle of rituximab, 38% of first-cycle nonresponders exhibited complete depletion. Twenty-six weeks after the second cycle, there was a significant improvement in the Disease Activity Score in 28 joints, with 72% of patients exhibiting a EULAR response. Conclusion RA patients whose disease did not respond to an initial cycle of rituximab have higher circulating preplasma cell numbers at baseline and incomplete depletion. Our findings indicate that an additional cycle of rituximab administered prior to total B cell repopulation enhances B cell depletion and clinical responses. [source] A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trialBJU INTERNATIONAL, Issue 12 2009Francesco Porpiglia OBJECTIVE To evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET). PATIENTS AND METHODS We evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10-day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety-one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days. Group A (46 patients) received a further cycle of tamsulosin (0.4 mg daily), and group B (45) did not. Age, gender, stone size, time to expulsion, number of acute episodes of colic during treatment and analgesic consumption were recorded. Patients who were not stone-free after the study period had ureteroscopy. The results were compared statistically using Student's t -, chi-square test and Fisher's exact test. RESULTS The groups were comparable inage, gender and stone size (5.93 mm for group A and 6.03 mm for group B). The expulsion rate was significantly higher in group A (80%) than in group B (49%) (P < 0.01), whilst there were no differences between the groups in the number of colic episodes and analgesic use. There were no reported side-effects of medical therapy. CONCLUSIONS A second cycle of 10 days of MET with tamsulosin in nonresponders to a 10-day first cycle of MET with tamsulosin and deflazacort is safe and effective, and therefore should be considered as an option in the management of uncomplicated distal ureteric stones. [source] Early 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography may identify a subset of patients with estrogen receptor-positive breast cancer who will not respond optimally to preoperative chemotherapyCANCER, Issue 4 2010Andrea A. Martoni MD Abstract BACKGROUND: A pathologic complete response (pCR) and minimal residual disease (pMRD) after preoperative chemotherapy (PCT) for early stage or locally advanced breast cancer (BC) correlates with a good prognosis. METHODS: Patients who received from 6 to 8 cycles of PCT for BC were monitored by 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET), and the maximal standardized uptake value (SUVmax) was calculated at baseline, after 2 cycles, after 4 cycles, and at the end of PCT. SUVmax percentage changes (,-SUV) were compared with the pathologic response rate. Patients who had a pCR or pMRD in the tumor and an absence of cancer cells in ipsilateral axillary lymph nodes were defined as having obtained an optimal pathologic response (pR), whereas all the other conditions were classified as a pathologic nonresponse (pNR). RESULTS: Of 34 patients, 7 (21%) achieved a pR (3 patients had a pCR, and 4 patients had pMRD). After the second cycle, the ,-SUV threshold with optimal negative predictive value to predict a pR was 50%. Twenty-six patients (76%) had a ,-SUV >50%, including all 7 patients who had a pR and 19 patients who had a pNR. Conversely, all 8 patients who had a ,-SUV ,50% had a pNR. All 8 of those patients had estrogen recepetor-positive tumors. CONCLUSIONS: Early evaluation of metabolic response by 18F-FDG-PET during PCT was able to identify 30% of patients, all with estrogen receptor-positive tumors, who would not obtain pR after completion of chemotherapy program. Cancer 2010. © 2010 American Cancer Society. [source] Recurrent selection of cocoa populations in Côte d'Ivoire: comparative genetic diversity between the first and second cyclesPLANT BREEDING, Issue 5 2009N. D. Pokou Abstract In Côte d'Ivoire, the cocoa breeding programme has been based on the creation of hybrids between different genetic groups. From 1990 onward, a reciprocal recurrent selection programme has been set up with the purpose of improving simultaneously the characteristics of the two main genetic groups: Upper Amazon Forastero (UA) and a mixture of Lower Amazon Forastero (LA) and Trinitario (T). Based on data obtained from 12 microsatellite primers, the genetic diversity and genetic distances of the parental populations used in the first and second selection cycles are presented. The results revealed that the diversity of populations UA0 and UA1 on the one hand and (LA+T)0 and (LA+T)1 on the other is similar. The genetic distances were small between the parental populations used for the first and second cycles. Genetic diversity was greater in the UA group than in the LA+T group. The number of rare and of private alleles was reduced for both genetic groups, as well as the number of the frequent alleles in the LA+T group. [source] | ||||||||||