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Optimum Treatment (optimum + treatment)
Selected AbstractsConcurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patientsDISEASES OF THE ESOPHAGUS, Issue 2 2009H. Yamashita SUMMARY Small-cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report clinical outcomes of limited-disease small-cell carcinoma of the esophagus from the analysis of nine patients. Between 2003 and 2006, nine consecutive patients with small-cell carcinoma of the esophagus were treated in our single institution, representing 2.8% of all esophageal malignancies treated with curative concurrent chemoradiation during this period. All the patients received four cycles of etoposide (100 mg/m2, days 1,3), combined with cisplatin (80 mg/m2, day 1), plus radiation therapy (50 Gy in daily doses of 2 Gy, 5 days/week). At the time of analysis, the median follow-up time was 10.8 months (range: 4.2,42.8 months) and 21.8 months in five living patients (56%). Of all the nine patients, five patients (56%) had a complete response, and the actuarial 3-year overall survival rate was 55.6%. This regimen resulted in a favorable 3-year survival rate. We conclude that the optimum treatment seems to be the same as for small-cell carcinomas of the lung, that is, a multidrug combination chemotherapy regimen used with concurrent radiation. [source] Blunt abdominal trauma in childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2000CH Rance Abstract: Blunt abdominal trauma is the commonest cause of intra-abdominal injuries in children. The use of computerized axial tomography and non-operative management of haemoperitoneum are two significant developments in the last two decades in the management of blunt abdominal trauma in children. The concept of non-operative management was introduced in late 1979 and wherever possible remains the optimum treatment. Computerized tomography scan for paediatric abdominal trauma was first described in 1980 and remains the investigation of choice. There is no substitute, however, for a good history, astute physical examination, and strict adherence to the principles of primary and secondary survey, prompt resuscitation, vigilant monitoring and repeated evaluation. [source] Effect of benzyl isothiocyanate on tomato fruit infection development by Alternaria alternataJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 9 2005R Troncoso-Rojas Abstract Benzyl isothiocyanate (BITC) is known to be a strong antifungal compound in vitro against different fungi. The effectiveness of benzyl isothiocyanate to control Alternaria alternata growth in vitro and in vivo was tested. BITC in vitro activity was evaluated in A alternata growing on potato dextrose agar and exposed to 0.025, 0.05, 0.1, 0.2 or 0.4 mg ml,1. In vivo activity was evaluated by exposing A alternata -inoculated tomato fruits for either 18 or 36 h to 0.28 or 0.56 mg ml,1 BITC packed on low-density polyethylene film (LDPF) bags. Additionally, the effect of BITC on post-harvest physiology and tomato quality throughout storage at 20 °C was evaluated daily by monitoring respiration rate and ethylene production, whereas total soluble solids, pH, titratable acidity and fresh weight loss were measured every 3 days. Results showed that the minimal inhibitory concentration of BITC in vitro was 0.1 mg ml,1. A combined use of 0.56 mg ml,1 BITC with LDPF for 18 h was the optimum treatment to control Alternaria rot in packed tomato fruit. No effect of BITC on respiration rate, ethylene production, total soluble solids, pH, weight loss and titratable acidity was observed. Results suggest that BITC can be used as a post-harvest treatment to control Alternaria rot in tomato fruit without detrimental effects on the tomato post-harvest quality. Copyright © 2005 Society of Chemical Industry [source] Effect of hot air treatments on senescence and quality parameters of harvested broccoli (Brassica oleracea L var Italica) headsJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 7 2005María L Costa Abstract Treatments with hot air were applied to broccoli (Brassica oleracea L) florets to investigate the effect on several quality and senescence parameters. To select the optimum treatment, florets were treated with different combinations of time/temperature ranging from 1 to 3 h and 37 to 50 °C and then placed in darkness at 20 °C. Most treatments delayed yellowing and loss of chlorophylls, except those performed at 37 °C, which accelerated senescence. Treatment at 48 °C for 3 h caused the highest delay in chlorophyll loss and was chosen to analyse its effect on quality and senescence. Non-treated florets showed yellowing and reduced their chlorophyll content during storage. Heat treatment delayed the onset of chlorophyll catabolism by 1 day and slowed down the rate of degradation. Treated florets also showed lower losses of total sugars and proteins and an inhibition of protein solubilisation. Control heads showed an increment in CO2 production, which was not detected in heat-treated florets. Total antioxidants decreased and thiobarbituric acid-reactive substances (TBARS) increased during storage. The treatment delayed the decrease in antioxidant content and inhibited the increment in TBARS. In conclusion, treatment at 48 °C for 3 h delayed broccoli senescence at 20 °C and contributed to maintaining an overall better quality of the product. Copyright © 2005 Society of Chemical Industry [source] Lay constructions of decision-making in cancerPSYCHO-ONCOLOGY, Issue 4 2002M.J. Henman In recent years there has been increased emphasis on involving people in decision-making about their medical care. However, few studies have addressed the questions of why women with cancer want information, and what they believe to be the important factors influencing their decision-making. In order to examine these questions 20 women with cancer were interviewed via telephone 2 weeks after their first consultation with one of 6 medical oncologists. Recruitment continued until informational redundancy was achieved. While women cited the risk of recurrence, life expectancy, side-effects, and quality of life as influencing their decisions, they placed at least as much emphasis on their personal relationship with the specialist. These ,personal' factors included: feeling that the doctor cared for, understood and respected them; that they could trust and have confidence in the doctor; that the doctor would give them enough time; that they would be listened to; and that the doctor would be open and honest. If these factors were felt to be present, many women were happy to accept the doctor's recommendation, confident that they would receive the optimum treatment. However, many women felt there was no decision to be made: further treatment must be undertaken to reduce risk, and minor variations in the treatment protocol were of little significance. These results underline the importance of establishing patient priorities and concerns before embarking on discussions about treatment. Copyright © 2002 John Wiley & Sons, Ltd. [source] Treatment by Mycophenolate Mofetil of Advanced Graft Vascular Disease in Non-Human Primate Recipients of Orthotopic Aortic AllograftsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2003Jochen Klupp Failure to control chronic graft dysfunction [e.g. graft vascular disease (GVD)] is the primary cause of immunologic graft failure. This is the first study of mycophenolate mofetil (MMF) for the treatment of GVD in non-human primate recipients of aortic allografts. Abdominal aortic allografts were exchanged between mixed leukocyte reaction (MLR) -mismatched, blood-group-compatible cynomolgus monkeys. Six control recipients were untreated. Individualized treatment with frequent dose adjustments of MMF insured that treatment was close to the maximum tolerated dose (mean 99.2 mg/kg/day). Immune-mediated injury proceeded unhindered until day 45, after which MMF treatment began. Changes in intimal volume (IV) were quantified by intravascular ultrasound (IVUS) and compared to histology on day 105. Serial IVUS measurements of IV (mm3) in controls showed progressive GVD. In four out of six animals, MMF was well tolerated, thus enabling optimum treatment; in all these animals, IV was significantly less than in the control animals (p = 0.02). In the two remaining animals, high doses were not tolerated; at day 105, there was no significant difference in IV between them and the controls. We found a significant correlation between the mean MMF tolerated dose and the inhibition of progression of IV (r = ,0.88, p = 0.015). When high MMF doses were tolerated, MMF slowed progression of GVD. [source] Results of multimodality therapy for squamous cell carcinoma of maxillary sinusCANCER, Issue 5 2002Ken-ichi Nibu M.D., Ph.D. Abstract BACKGROUND A wide variety of modalities, including surgery, radiation therapy, and chemotherapy, alone or in combination, have been used for the treatment of squamous cell carcinoma (SCC) of the maxillary sinus to obtain better local control and maintain functions. However, there is still much controversy with regard to the optimum treatment. METHODS From 1987 to 1999, 33 patients with SCC of maxillary sinus were treated at the Department of Otolaryngology,Head and Neck Surgery, University of Tokyo Hospital. The treatment consisted of 30,40 grays (Gy) of preoperative radiotherapy with concomitant intraarterial infusion of 5-fluorouracil and cisplatin followed by surgery and 30,40 Gy of postoperative radiotherapy, for tumors without skull base invasion. For tumors invading the skull base, preoperative systemic chemotherapy with or without radiotherapy was performed, instead of intraarterial chemotherapy, then followed by skull base surgery. The surgical procedures varied according to the extent of tumor. Results were compared with those of the 108 patients treated in our hospital from 1976 to 1982. RESULTS Partial maxillectomy was performed in 2 T2 patients and 12 T3 patients. Total maxillectomy was performed in 1 T2 patient, 3 T2 patients, and 7 T4 patients. Skull base surgery was performed in eight T4 patients. Orbital content and hard palate were preserved in 22 patients and 18 patients, respectively. The overall 5-year survival rates were 86% in T 3 patients and 67 % in T4 patients, respectively. CONCLUSIONS Our multimodal treatment has provided favorable local control and survival outcome with good functional results. Cancer 2002;94:1476,82. © 2002 American Cancer Society. DOI 10.1002/cncr.10253 [source] The creation of an international audit and database of equine colic surgery: Survey of attitudes of surgeonsEQUINE VETERINARY JOURNAL, Issue 4 2008T. S. MAIR Summary Reasons for performing study: Currently, there is a lack of available evidence-based data concerning the optimum treatments for horses affected by different types of colic and this precludes the application of clinical audit in this area. In order to accumulate such data, a large-scale, multicentre database of the outcomes of colic surgery is proposed. The attitudes of surgeons is an important consideration in determining the feasibility of developing this database. Objectives: To assess attitudes and opinions of equine surgeons concerning clinical audit and to assess the perceived advantages and problems of setting up a large-scale international audit/database of colic surgery. Methods: Interviews were conducted with 30 equine surgeons (large animal/equine surgeons who are diplomates of either the American College of Veterinary Surgeons or the European College of Veterinary Surgeons). Questionnaires were sent by e-mail to 98 equine surgeons. Results: Face to face interviews were conducted (n = 30) and 43/98 completed questionnaires received (44%). The results of the 2 techniques were very similar. There was generally a high level of interest in the development of a large scale database of colic surgery, but perceived problems included time to collect and submit data, and confidentiality issues. A minority of surgeons reported that they were undertaking any form of specific monitoring of the results of colic surgery within their hospitals. Conclusions: There is a good level of interest among equine surgeons to develop a large scale database of colic surgery and most would be willing to contribute data from their own hospitals provided that data collection is quick and easy, and that confidentiality is maintained. Potential relevance: A large scale audit and database would provide relevant information to equine surgeons concerning the current success and complication rates of colic surgery. Such evidence-based data could be used in clinical audits within individual equine hospitals. The data would also be useful to identify trends within the discipline and could highlight areas that would benefit from active research. [source] | ||||||||||