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71.
Goenka A Magsanoc JM Pei X Schechter M Kollmeier M Cox B Scardino PT Eastham JA Zelefsky MJ 《European urology》2011,60(6):1142-1148
Background
With salvage radiation therapy (SRT) in the postprostatectomy setting, the need to deliver sufficient radiation doses to achieve a high probability of tumor control is balanced with the risk of increased toxicity. Intensity-modulated radiation therapy (IMRT) in the postprostatectomy salvage setting is gaining interest as a treatment strategy.Objective
Compare acute and late toxicities in patients treated with IMRT and three-dimensional conformal radiation therapy (3D-CRT) in the postprostatectomy salvage setting.Design, setting, and participants
A total of 285 patients who were treated at our institution between 1988 and 2007 with SRT after radical prostatectomy for biochemical recurrence were identified. All medical records were reviewed and toxicity recorded. Median follow-up was 60 mo.Intervention
All patients were treated with SRT with either 3D-CRT (n = 109) or IMRT (n = 176). A total of 205 patients (72%) were treated with doses ≥70 Gy.Measurements
Late gastrointestinal (GI) and genitourinary (GU) toxicities were recorded using the Common Terminology Criteria for Adverse Events v. 3.0 definition.Results and limitations
The 5-yr actuarial rates of late grade ≥2 GI and GU toxicity were 5.2% and 17.0%, respectively. IMRT was independently associated with a reduction in grade ≥2 GI toxicity compared with 3D-CRT (5-yr IMRT, 1.9%; 5-yr 3D-CRT, 10.2%; p = 0.02). IMRT was not associated with a reduction in risk of grade ≥2 GU toxicity (5-yr IMRT, 16.8%; 5-yr 3D-CRT, 15.8%; p = 0.86), urinary incontinence (5-yr IMRT, 13.6%; 5-yr 3D-CRT, 7.9%; p = 0.25), or grade 3 erectile dysfunction (5-yr IMRT, 26%; 5-yr 3D-CRT, 30%; p = 0.82). Of patients who developed late grade ≥2 GI or GU toxicity, 38% and 44%, respectively, experienced resolution of their symptoms prior to the last follow-up.Conclusions
Our experience with high-dose IMRT in the postprostatectomy salvage setting demonstrates that the treatment can be delivered safely with an associated reduction in late GI toxicity. 相似文献72.
Atin Kumar Ajit Harishkumar Goenka Anita Choudhary Jitendra Kumar Sahu Sheffali Gulati 《Pediatric radiology》2010,40(2):223-227
Cysticercosis is a parasitic disease caused by infestation with the encysted larval stage of the pork tapeworm, Taenia solium. Disseminated cysticercosis is an exceptional expression of this disease characterized by high morbidity due to massive symptomatic
parasite burden in the central nervous system, striated muscles, subcutaneous tissues and other organs. Less than 50 such
cases have been reported worldwide, and fewer than 10 children. We report on the whole-body MR diagnosis of extensively disseminated
cysticercosis in a child. The critical role of whole-body MR as a stand-alone modality in the diagnosis and management of
this pleomorphic disease is highlighted. Whole-body MR diagnosis of an infectious disease is unique. 相似文献
73.
Goenka AH 《Journal of medical biography》2007,15(4):195-200
Dr Rustom Jal Vakil was India's pioneer in cardiology. He introduced the discipline of cardiology in his country. His mixture of clinical acumen, research and writing has survived him. Through his work with an ancient Indian folk remedy, Rauwolfia serpentina, he ushered in the modern era of effective pharmacotherapy of hypertension. His work was particularly significant since it galvanized other workers into finding more effective agents for the treatment of hypertension. He is remembered fondly by his acquaintances as an unassuming man in whom a multitude of choicest qualities blended seamlessly with each other. 相似文献
74.
Iskandar Idris rew P. Hall John O'Reilly Anthony Barnett Martin Allen Robert Andrews Phillipe Grunstein Keir Lewis Niru Goenka and John P. Wilding 《Diabetes, obesity & metabolism》2009,11(8):733-741
Recent attention has been drawn to the close association between obstructive sleep apnoea (OSA) and type 2 diabetes mellitus (T2DM). Debate has included much discussion about cause and effect with mechanisms proposed whereby one condition might cause the other. However, both clearly share a common phenotype, namely, obesity that overlaps considerably with the other components of the metabolic syndrome, hypertension and hyperlipidaemia. It would therefore appear likely that all are manifestations of the same basic pathological processes. Possible interacting aetiological mechanisms are reviewed along with treatment options. A recent report by the International Diabetes Federation has made recommendations to raise awareness of possible OSA in patients with T2DM and also for screening for hypertension, hyperlipidaemia and T2DM in patients with known OSA. The clinical implications are discussed. 相似文献
75.
76.
True euglycemic diabetic ketoacidosis [blood glucose <200 mg/dl (11.1 mmol/l)] is relatively uncommon and in type 1 diabetes
can be caused by starvation of any cause in conjunction with an intercurrent illness. We report a case of euglycemic diabetic
ketoacidosis precipitated by starvation resulting from severe depression in a patient with type 1 diabetes. He was acidotic
with ketonuria, but his blood glucose was only 105 mg/dl (5.8 mmol/l). He was rehydrated, the acidosis was corrected, and
his depression was later treated. This case involves the complex interplay among type 1 diabetes, depression, ketoacidosis,
and starvation physiology resulting in glucose concentrations in keeping with euglycemic diabetic ketoacidosis. The case also
highlights that even in the absence of hyperglycemia, acid/base status should be assessed in an ill patient with diabetes,
and in cases of euglycemic diabetic ketoacidosis, the diagnosis of depression should be considered as a cause for suppressed
appetite and anorexia. 相似文献
77.
Lydia Anderson Franklin Joseph Niru Goenka Vinod Patel 《The American journal of the medical sciences》2009,337(2):150-152
An 18-year-old girl with multiple autoimmune endocrinopathies was referred to the endocrinology clinic for management of hypothyroidism. She required increasing doses of thyroxine but remained hypothyroid. Daily and weekly supervised thyroxine administration strategies were unsuccessful. She was extensively investigated for malabsorption; however, all the results were normal. She was subsequently commenced on weekly intramuscular thyroxine injections and became biochemically and clinically euthyroid. Subsequent elective hospital admission and administration of thyroxine via nasogastric tube resulted in recurrence of her hypothyroidism. This case demonstrates apparent isolated true levothyroxine malabsorption existing in isolation and suggests that intramuscular thyroxine injections may be a useful therapeutic modality in these patients. 相似文献
78.
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80.
Shobna J. Bhatia D. Nageshwar Reddy Uday C. Ghoshal V. Jayanthi Philip Abraham Gourdas Choudhuri S. L. Broor Vineet Ahuja Philip Augustine V. Balakrishnan D. K. Bhasin Naresh Bhat Ashok Chacko Sunil Dadhich G. K. Dhali Pankaj S. Dhawan Manisha Dwivedi Mahesh K. Goenka Abraham Koshy Ajay Kumar Sri Prakash Misra Shrikant Mukewar E. PedaVeer Raju K. T. Shenoy S. P. Singh Ajit Sood R. Srinivasan 《Indian journal of gastroenterology》2011,30(3):118-127