Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 4 Articles
Background. Belinostat is a novel histone deacetylase inhibitor. Primary Objectives. Maximum tolerated dose (MTD) and dose\nlimiting toxicities (DLTs) of belinostat (Bel) in combination with doxorubicin (Dox) in solid tumours (phase I) and response rate\n(RR) in soft tissue sarcomas (phase II). Methods. Bel was administered as a 30-minute IV infusion on days 1ââ?¬â??5 and on day 5with Dox.\nThe dose escalation schedule was as follows: cohort 1: Bel 600mg/m2 and 50mg/m2 Dox, cohort 2: Bel 600mg/m2 and 75mg/m2\nDox, cohort 3: Bel 800mg/m2 and 75mg/m2 Dox, and cohort 4: Bel 1000mg/m2 and 75mg/m2 Dox. Results. 41 patients were\nincluded (25 in phase I, 16 in phase II). Adverse events were fatigue (95%), nausea (76%), and alopecia (63%). There was one DLT,\ngrade 3 rash/hand and foot syndrome. MTD was Bel 1000 mg/m2/d and Dox 75mg/m2. Four responses were seen: 2 PR in phase\nI, RR of 8%; in phase II, 1 PR/1 CR, RR of 13%, and 9 patients (56%) with SD. Conclusion. The combination was well tolerated.\nResponse rate was moderate but median time to progression was 6.0 months (95% CI, 1.6ââ?¬â??9.7 months) which is superior to some\nreports of single-agent Dox....
Background: Awareness of preferences regarding medical care should be a central component of the care of\npatients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable\nmanner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and\nprofessional caregivers about patients� values and care preferences. It raises awareness of the need to anticipate\npossible future deterioration of health. ACP has the potential to improve current and future healthcare decisionmaking,\nprovide patients with a sense of control, and improve their quality of life.\nMethods/Design: We will study the effects of the ACP program Respecting Choices on the quality of life of\npatients with advanced lung or colorectal cancer. In a phase III multicenter cluster randomised controlled trial, 22\nhospitals in 6 countries will be randomised. In the intervention sites, patients will be offered interviews with a\ntrained facilitator. In the control sites, patients will receive care as usual. In total, 1360 patients will be included. All\nparticipating patients will be asked to complete questionnaires at inclusion, and again after 2.5 and 4.5 months. If a\npatient dies within a year after inclusion, a relative will be asked to complete a questionnaire on end-of-life care.\nUse of medical care will be assessed by checking medical files. The primary endpoint is patients� quality of life at\n2.5 months post-inclusion. Secondary endpoints are the extent to which care as received is aligned with patients�\npreferences, patients� evaluation of decision-making processes, quality of end-of-life care and cost-effectiveness of\nthe intervention. A complementary qualitative study will be carried out to explore the lived experience of\nengagement with the Respecting Choices program from the perspectives of patients, their Personal\nRepresentatives, healthcare providers and facilitators.\nDiscussion: Transferring the concept of ACP from care of the elderly to patients with advanced cancer, who on\naverage are younger and retain their mental capacity for a larger part of their disease trajectory, is an important\nnext step in an era of increased focus on patient centered healthcare and shared decision-making.\n(Continued on next page)...
Objective: To observe the effect of liquefying the necrotic tendons of diabetic foot and promotion\nof wound healing using the treatment of Huafu Zaisheng. Methods: 98 patients suffering from diabetic\nfoot were randomly divided into Huafu Zaisheng group (35 cases), Huafu group (32 cases),\nZaisheng group (31 cases), and then had eroded debridement timely for its wounds. Since then,\ndifferent methods and drugs applied to deal with the wound, observe the liquefaction time and\ndetachment time of the degeneration and necrosis tendon, and observe the wound healing. Collection\nand preservation of wound secretion, determine the pH value of wound secretion, determination\ncontent of the NO and TGF-1 in wound secretion. Wound tissue containing fascia and tendons\nwas extracted by surgical methods, before treatment and 6, 12 weeks after treatment. All tissue\nsamples were prepared according to Hematoxylin-eosin staining techniques, after which their\nappearance was evaluated for pathological changes using an optical microscope. Immunohistochemistry\nstaining was used to detect the expressions of CD34 and CK19. Results: By comparison\nof the efficacy of the three groups, the curative effect of the HFZS group is superior to HF and ZS\ngroup. The necrotic tendons of Huafu Zaisheng group were liquefied clearer than the other two\ngroups. Three groups of secretions pH value were the trend of first decreased, then increased,\nweakly basic first, and then weak acid, and then close to neutral. Compared to ZS group and HF\ngroup, the difference was statistically significant (P < 0.01). After 4.6 weeks� treatment, compared\nto ZS group and HF group, the NO, TGF-1 content of HFZS group increased significantly, and the\ndifference was statistically significant (P < 0.01). Conclusion: Using the method of Huafu Zaisheng,\nthe necrotic tendons and tissues could be liquefied as early as possible, and then promote the\nwound healing. Application of Huafuzaisheng method to deal with wounds, can remove necrotic\ntendons and fascia tissue as early as possible, can change the wound pH value and provide a variety\nof active factors (NO, TGF-1) and micro-environment for wound healing....
The failure of several Phase II/III clinical trials in Alzheimer�s disease (AD) with drugs targeting ...
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