Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation

Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients’ reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients’ assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group.     

Suitable survival and half-life of red cells after frozen storage in excess of 10 years

To examine the appropriateness of the Food and Drug Administration's 10-year storage time for previously frozen red cells, 24-hour posttransfusion survival studies were performed, and the half-life of 3 units of autologous red cells that had been stored for 13.5, 14, and 17 years, respectively, was measured. The units had acceptable freeze-thaw-wash recovery (83.3-91.4%). When a 51Cr label was used for the previously frozen red cells and a simultaneous 52Cr label for freshly drawn autologous red cells was used as a comparison, it was seen that the previously frozen cells had normal 24-hour posttransfusion survival (75.1-88.4%) as well as normal half-life (23-33.7 days). These findings support further extension of the maximum allowable storage time for previously frozen red cells.     

Curative to Palliative Care-Transition and Communication Issues: Surgeons Perspective

Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.     

CD3AK细胞两种输入方法的不良反应观察

目的探讨减少CD3AK细胞输入不良反应的最佳技术操作方法。方法将62例接受CD3AK细胞输入治疗的慢性乙型肝炎患者分为两组:用CD3AK细胞输入与白介素-2混合静脉输入的15例患者为混合输入组,采用CD3AK细胞、白介素-2分别单独静脉输入的47例患者为分开输入组,观察两组输入反应情况。结果两组头痛、发热、畏寒的发生率,经统计学处理,有显著性差异(P<0.01)。结论取CD3AK细胞、白介素-2加入生理盐水分别单独输入的方法,可减轻患者不良反应,顺利完成疗程,达到预期的治疗效果。