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Treatment Cessation (treatment + cessation)
Selected AbstractsConcentration of IL-2, IL-6, IL-8, IL-10 and TNF-alpha in children with acute lymphoblastic leukemia after cessation of chemotherapyHEMATOLOGICAL ONCOLOGY, Issue 1 2004Bogdan Mazur Abstract The immunosuppressive effect of cytotoxic drugs, basic therapeutic agents in the treatment of childhood acute leukemias, requires monitoring of the immune system following cessation of therapy. The cytokines are soluble proteins that play a key role in the immunoregulation of the lymphocyte function. The cytokines regulate growth, differentiation and function of various cells in normal conditions. The aim of our study was to estimate serum levels of IL-2, IL-6, IL-8, IL-10 and TNF-alpha in children with acute lymphoblastic leukemia (ALL) after cessation of chemotherapy. The study involved 150 children with ALL. This group consisted of: 30 children 1 month after treatment cessation; 30 children, 3 months later; 30 children 6 months later; 30 children, 9 months later and 30 children, 12 months later. The control group consisted of 30 healthy children. The levels of the cytokines under study were assayed using the immunoassay kits (R&D Systems, USA). During the study significant differences in TNF-alpha, IL-2 and IL-8 serum concentrations were observed among treated children and controls. However there were no differences in IL-6 and IL-10 concentrations. Copyright © 2004 John Wiley & Sons, Ltd. [source] A review of the literature on the impact of renal cancer therapy on quality of lifeJOURNAL OF CLINICAL NURSING, Issue 20 2009Joanne Bird Aim., To explore the impact of renal cancer treatment on patients' quality of life. Background., Renal cancer accounts for 95,000 deaths worldwide and its incidence rate is rising. At present there are several therapeutic approaches to the treatment of renal cancer, ranging through surgery, immunological therapies and vaccine treatment. Each of these therapies may have a substantial effect upon patients' quality of life. However, a systematic appraisal of the empirical evidence about treatment impact is lacking. Design., Literature review. Methods., A structured review of the empirical literature on the impact of renal cancer treatment upon quality of life was undertaken. Literature was appraised and themed according to the treatment modalities included in the study. Results., From 873 papers initially identified 52 were retrieved for detailed scrutiny resulting in a final 16 papers being included in the review. Conclusions., This review discusses the complex effect of renal cancer upon a patient's quality of life as treatment modalities change. The need for nursing education and awareness of these issues is therefore highlighted to maximise patient care. Relevance to clinical practice., Understanding the impact of treatment for renal cancer enables nurses to empathise more significantly with patients and also act as mediators in regard to treatment choice and treatment cessation. It also enables nurses to inform and educate renal cancer patients prior to making treatment choices. [source] Review article: optimizing SVR and management of the haematological side effects of peginterferon/ribavirin antiviral therapy for HCV , the role of epoetin, G-CSF and novel agentsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2010R. MAC NICHOLAS Aliment Pharmacol Ther,31, 929,937 Summary Background, Chronic hepatitis C is one of the leading causes for chronic liver disease globally. The past two decades have seen many advances in hepatitis C treatment. Despite these advances, side effects of treatment are common. Haematological complications of treatment can result in treatment cessation and suboptimal results. Recent data have suggested a role for epoetin/granulocyte colony stimulating factor (G-CSF) in optimizing sustained virological response (SVR). Aim, To investigate the nature, frequency and management of haematological side effects in the treatment of chronic hepatitis C infection. Methods, The terms hepatitis C, hepatitis C virus (HCV), treatment, side effects, interferon, peginterferon, ribavirin, anaemia, haemoglobin, neutropenia, thrombocytopenia, haematological, growth factor, erythropoietin and G-CSF were searched on MEDLINE for the period 1991,2009. References from selected articles were also included. Results, Haematological side effects such as anaemia, neutropenia and thrombocytopenia are frequent in anti-HCV treatment. The off-label use of haematological growth factors is common and effective. Conclusions, Erythropoietic agents are effective in treating anaemia, preventing ribavirin dose reduction, improving patients' quality of life, but the effect on SVR is not fully elucidated. G-CSF is effective in raising absolute neutrophil count; however, neutropenic HCV-infected patients on combination treatment may not experience increased bacterial infections. Eltrombopag, a new oral thrombopoietin mimetic, may allow combination treatment in patients with thrombocytopenia. [source] Interferon-induced retinopathy and its risk in patients with diabetes and hypertension undergoing treatment for chronic hepatitis C virus infectionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2009J. D. PANETTA Summary Background, Ocular complications are amongst many side-effects of interferon based therapy for hepatitis C virus (HCV) infection. Some suggest that diabetic and hypertensive patients are at increased risk of these complications. Aim, To determine the frequency of ophthalmological complications related to interferon use. Methods, Retrospective analysis of patients undergoing HCV treatment with pegylated interferon ,-2a, ,-2b or consensus interferon plus ribavirin between 2005 and 2007. All patients underwent a baseline eye examination and any visual complaints during treatment prompted a repeat examination. Data recorded included HCV genotype, treatment duration, interferon type, pre-treatment and on treatment visual complaints, known ocular pathology, and retinal findings at baseline and at follow-up. Results, Of 183 patients, 29 (16%) had diabetes and 85 (46%) had hypertension. Seventy-one (38%) received interferon ,-2a, 100 (55%) ,-2b, and 12 (7%) consensus interferon. Seven (3.8%) had retinal changes on follow-up and treatment was discontinued in 3 (1.6%). Of seven with ocular changes two had hypertension and one had both hypertension and diabetes. Conclusion, The incidence of symptomatic retinopathy in HCV patients undergoing interferon therapy appears low and treatment cessation is rarely needed. Furthermore, patients with hypertension and diabetes may not be at higher risk for interferon-induced retinopathy. [source] Community-based treatment for chronic hepatitis C in drug users: high rates of compliance with therapy despite ongoing drug useALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009M. WILKINSON Summary Background, Chronic hepatitis C infection is common in drug users. Treatment of injectors is possible under controlled conditions, but many have not yet been included in treatment programmes as there are concerns about their ability to comply with therapy. It is not known which factors influence compliance. Aim, To examine the hypothesis that active drug users would comply with anti-viral therapy if treatment was delivered in a convenient manner. Methods, We established a community-based treatment programme and offered anti-viral therapy to all drug users who wanted it. Few pre-treatment requirements were imposed and, by design, compliance with therapy was reviewed after 50 patients had completed treatment. Results, Of the 441 patients who were known to be HCV RNA positive and attended the specialist addiction services during the period of this study, eighty three patients considered therapy. Twenty patients did not undergo treatment: 14 declined and 6 had medical conditions that precluded it. In 60 episodes (58 patients) where treatment had been completed, compliance was greater than 80% and homelessness, active illicit drug use and pre-treatment antidepressant therapy were not associated with noncompliance. In 25 of 49 treatment episodes that were assessed 6 months after treatment cessation, a sustained virological response (51%) was seen. Conclusion, Active drug users using illicit drugs can be successfully treated in community-based clinics. [source] Effects of anti-CD154 treatment on B cells in murine systemic lupus erythematosusARTHRITIS & RHEUMATISM, Issue 2 2003Xiaobo Wang Objective To determine the immunologic effects of anti-CD154 (CD40L) therapy in the (NZB × NZW)F1 mouse model of systemic lupus erythematosus. Methods Twenty-week-old and 26-week-old (NZB × NZW)F1 mice were treated with continuous anti-CD154 therapy. Mice were followed up clinically, and their spleens were studied at intervals for B and T cell numbers and subsets and frequency of anti,double-stranded DNA (anti-dsDNA),producing B cells. T cell,dependent immunity was assessed by studying the humoral response to the hapten oxazolone. Results IgG anti-dsDNA antibodies decreased during therapy and disease onset was delayed, but immune tolerance did not occur. During treatment, there was marked depletion of CD19+ cells in the spleen; however, autoreactive IgM-producing B cells could still be detected by enzyme-linked immunospot assay. In contrast, few IgG- and IgG anti-dsDNA,secreting B cells were detected. Eight weeks after treatment cessation, the frequency of B cells producing IgG anti-dsDNA antibodies was still decreased in 50% of the mice, and activation and transition of T cells from the naive to the memory compartment were blocked. Anti-CD154 treatment blocked both class switching and somatic mutation and induced a variable period of relative unresponsiveness of IgG anti-dsDNA,producing B cells, as shown by decreased expression of the CD69 marker and failure to generate spontaneous IgG anti-dsDNA,producing hybridomas. Treated mice mounted an attenuated IgM response to the hapten oxazolone and produced no IgG antioxazolone antibodies. Conclusion Anti-CD154 is a B cell,depleting therapy that affects multiple B cell subsets. Activation of both B and T cells is prevented during therapy. After treatment cessation, autoreactive B cells progress through a series of activation steps before they become fully competent antibody-producing cells. The general immunosuppression induced during treatment will need to be taken into account when using B cell,depleting regimens in humans. [source] Parent-administered modified dry-bed training for childhood nocturnal enuresis: evidence for superiority over urine-alarm conditioning when delivery factors are controlledBEHAVIORAL INTERVENTIONS, Issue 4 2002Shazia Nawaz We compared the relative efficacy of modified dry-bed training and standard urine-alarm conditioning for treating functional nocturnal enuresis in 36 children aged 7,12 years attending health centres in Glasgow, Scotland. A minimal intervention, self-help approach was adopted. Parents and children received standardized instruction, which, for each method, consisted of one clinic interview and a manual and videotape for home viewing. Outcomes were contrasted with those from untreated controls. Twelve children were randomly assigned to each condition. All groups were matched for age, gender, social class (deprivation category), and baseline wetting frequency. In the two treated groups, an intake interview was followed by two review appointments, otherwise families carried out the programmes independently at home with fortnightly telephone support either until the success criterion of 14 consecutive dry nights was met or the 16 week maximum treatment period expired. Of the 12 children treated by dry-bed training, eight achieved initial success compared with only three of the 12 treated by the conventional urine-alarm method. One waiting-list control child remitted spontaneously. ANOVA showed highly significant differences in wet nights per week immediately after intervention for both treatment and time factors (p,<,0.001) and their interaction (p,<,0.01). The dry-bed group averaged 0.8 nights per week wet on treatment cessation, a frequency which was significantly superior to the average of 3.25 for the urine-alarm group and 5.00 for the controls. Six months after attaining initial success, one child in each treated group had relapsed. Our results show an outcome of 58% long-term remission (67% initial arrest, 13% relapse) for dry-bed training when delivered by minimal intervention methods and indicate dry-bed training as being more effective than orthodox urine-alarm conditioning for the same input of clinic time and instruction. Copyright © 2002 John Wiley & Sons, Ltd. [source] | ||||||||||