Quantitative assessment of the efficacy of oral ketoconazole for oral candidosis in HIV-infected patients

Fifteen male patients with manifest oral candidosis due to Candida albicans, suffering from AIDS-related complex (ARC) or full-blown AIDS, were investigated both clinically and microbiologically before and about 1 and 4 weeks after 7 to 10 days of treatment with 200 mg ketoconazole p.o. per day. Candida albicans was quantitated in mouthwash fluid. The antimicrobial susceptibility of the Candida albicans isolates was assessed using the IC30 test. In the short term, clinical cure was obtained in 87%, mycological cure in 53%. In the long term, the corresponding figures were 56 and 9%, respectively. Eradication of Candida albicans was not possible if IC30 values exceeded 256 micrograms ml-1. While pretreatment counts of Candida albicans in those patients also taking zidovudine did not differ from those in the rest of the study population, both the clinical and the mycological efficacy of ketoconazole seem to be higher both in the short and the long term when administered together with zidovudine. In consideration of the high relapse rate after about 4 weeks, an interval treatment protocol with oral ketoconazole is proposed.     

Preoperative risk assessment and prevention of complications in patients with esophageal cancer

In this review the preoperative risk assessment and prevention of complications in patients undergoing esophagectomy for cancer is discussed. Age, pulmonary and cardiovascular condition, nutritional status, and neoadjuvant chemo(radio)therapy are known predictive factors. None of these factors is a valid exclusion criterion for esophagectomy, but may help in careful patient selection. Both anesthetists and surgeons play an important role in intraoperative risk reduction by means of appropriate fluid management and application of optimal surgical techniques. J. Surg. Oncol. 2010; 101:270–278. © 2010 Wiley‐Liss, Inc.     

伏立康唑一级预防急性白血病患者化疗期间并发真菌感染的临床疗效北大核心

目的:探讨初诊急性白血病患者化疗期间应用伏立康唑进行预防侵袭性真菌病(IFD)的临床疗效及安全性。方法:回顾性分析2016年02月至2018年03月期间我院血液科收治的初诊急性白血病行化疗的患者166例,按照是否使用抗真菌药进行预防性治疗分为观察组(应用伏立康唑进行预防治疗,n=103)和对照组(未应用抗真菌药物,n=63),比较两组患者IFD发生率差异,并分析抗真菌药物应用的不良反应。结果:观察组IFD发生率为10.7%,对照组为33.3%,两组患者的IFD发生率有明显差异(P<0.05);所有应用伏立康唑进行预防治疗的患者均未出现严重的不良反应。结论:伏立康唑可以有效减低急性白血病患者化疗期间IFD发生率,并且有着较好的安全性,值得在临床推广应用。     

The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia

Aim: The use of complementary and alternative medicine (CAM) by cancer patients is growing. However, few studies have examined the perceived benefits and adverse effects resulting from the use of CAM by cancer patients. The aim of this study was to evaluate CAM use by cancer patients and to explore their perceptions of the benefit, safety and efficacy of CAM in general. Methods: Oncologists from three university teaching hospitals screened patients for eligibility. Eligible patients (N = 1323) were mailed a letter of invitation with a questionnaire between January and May 2008. Results: Overall 381 questionnaires were returned, showing that 65% of cancer patients used at least one form of CAM. Patients considered taking biological CAM before, during and after chemotherapy. Up to 90% of CAM users believed that CAM provided potential health benefits and less than 3% reported adverse effects experienced from the use of CAM. Most respondents (80%) believed CAM can provide health benefits even when efficacy has not been proven. Most patients (90%) believed that doctors should consider learning about CAM to provide appropriate advice to their cancer patients, and most (83%) indicated they would be happier to accept CAM if it was offered by the hospital. Conclusion: A substantial portion of Australian cancer patients use CAM. Given the limited data on efficacy and safety for most CAM, it may be reasonable to offer CAM within the hospital environment so its use can be monitored and patients can receive more evidence‐based care.     

Rhinocerebral mucormycosis,risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz,Iran 2007‐2017

Inadequate data are available on the global epidemiology of mucormycosis, mainly derived from the evaluation of specific population groups. Rhinocerebral mucormycosis is an invading and fatal mycosis, particularly among diabetic patients. In the present study, patients hospitalised in Imam Reza Hospital in Tabriz, from 2007 to 2017, were evaluated. The hospital information system (HIS) was used to collect the records of the patients. A total of 42 patients with a diagnosis of mucormycosis were included in the study, 40 cases (95%) of which had a diagnosis of the rhinocerebral form. Of these 40 patients, 21 (52.5%) and 19 (47.5%) were male and female, respectively. Seven cases (17.5%) of rhinocerebral mucormycosis were due to dental procedures. The most predisposing factor in the patients was diabetes with 36 (90%) cases. In our study, the role of tooth extraction in patients with uncontrolled diabetes was identified as an important factor. It may show the important role of dentists in preventing of the disease in diabetic patients.     

厄洛替尼联合紫杉醇加卡铂治疗老年晚期敏感性EGFR突变肺鳞癌的有效性及安全性

目的:观察厄洛替尼联合紫杉醇加卡铂治疗老年晚期敏感性EGFR突变肺鳞癌有效性和安全性.方法:收集2011年4月-2014年4月92例老年晚期敏感性EGFR突变肺鳞癌初诊患者为研究对象,分成2组(每组46例),对照组紫杉醇加卡铂治疗,研究组在对照组基础上加用厄洛替尼,观察治疗后在疗效、不良反应等指标变化情况.结果:疗效上,对照组有效率47.83%、控制率67.39%,研究组有效率60.87%、控制率82.61%,研究组显著高于对照组(P<0.05);生存期上,对照组12个月、15个月、18个月、>18个月的生存率分别为63.04%、43.48%、32.61%、21.74%,研究组分别为78.26%、65.22%、52.17%、39.13%,研究组显著优于对照组(P<0.05);对照组治疗前后比较差异不显著(P>0.05),研究组治疗末患者生活质量显著高于治疗前(P<0.05),治疗末患者生活质量比较研究组显著优于对照组(P<0.05).不良反应上,对照组Ⅲ-Ⅳ级不良反应白细胞减少、血小板减少、贫血、恶心呕吐、疲劳、口腔黏膜炎发生率分别为21.74%、19.57%、32.61%、10.87%、19.57%、15.22%,显著高于研究组的10.87%、2.17%、17.39%、0%、6.52%、4.35%,两组比较差异显著(P<0.05).结论:厄洛替尼联合紫杉醇加卡铂能提高老年晚期敏感性EGFR突变肺鳞癌患者生存时间,改善生活质量,不良反应低.     

穿心草防治鼻咽癌放射性口腔黏膜反应的临床研究

目的：观察穿心草对鼻咽癌患者放射性口腔粘膜炎的防治效果。方法：将140例鼻咽癌病人随机分为实验组（放疗＋穿心草煎水含服）和对照组（放疗＋复方硼砂含漱液含漱）,观察两组患者出现口腔黏膜反应的时间及反应程度,放疗结束时不同病灶残留的情况。结果：实验组及对照组出现放射性口腔黏膜炎的时问分别为（13．1±2．03）天及（10．5±1．69）天,两组比较有显著性差异（P〈0．05）;放疗开始至第2周末两组发生放射性口腔黏膜炎的分级比较无统计学差异（P〉0．05）;放疗第3、4、5、6、7周末,两组比较有显著性差异（P〈0．01）;实验组及对照组平均放疗时间分别为（52．43±3．18）天及（61．1±2．03）天,（P〈0．05）;实验组的损伤程度明显低于对照组,出现黏膜反应的时间要晚。放疗结束时两组患者鼻咽部及颈部病灶残留情况比较无差异（P〉0．05）。结论：穿心草煎水含服可以延缓口腔黏膜反应发生的时间,改善患者临床症状,提高生活质量,防治鼻咽癌引起的放射性口腔黏膜炎安全有效,值得临床推广应用。     

Randomized, open label, prospective study on the effect of zoledronic acid on the prevention of bone metastases in patients with recurrent solid tumors that did not present with bone metastases at baseline

Objectives: Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skeletal-related complications of bone metastases. Recent in vitro and in vivo evidence suggest that they may also have direct antitumor effects via induction of apoptosis, inhibition of the invasive potential of tumor cell lines in vitro, inhibition of angiogenesis, and reduction in tumor growth indirectly via effects on accessory cells. This is a randomized, open label, prospective study that examined the effect of preventive zoledronic acid treatment on the development of bone metastases in patients with recurrent solid tumors, without bone metastases at the time of randomization. Methods: Forty patients with recurrent or metastatic advanced cancer, without bone metastases, were randomized into the trial to either receive zoledronic acid or no treatment. Patients were followed up until bone metastases were established. Results: The percentage of patients being bone metastases free at 12 mo was 60% in the zoledronic acid and 10% in the control group (p<0.0005), while the percentages at 18 mo were 20% and 5% respectively (p=0.0002). Conclusions: The results have shown that bisphosphonates as adjuvant treatment might be useful for the prevention of bone metastases; however, there is need for blinded randomized data before such an approach would be confirmed. In the meantime preventive use of bisphosphonates in patients without any bone metastases should not be used outside the scope of a clinical trial.