Concurrent Weekly Cisplatin Versus Triweekly Cisplatin with Radiotherapy in the Treatment of Cervical Cancer: A Metaanalysis Result

Aims: To evaluate the adverse effect and survival outcome of weekly and triweekly cisplatin with radiotherapyin treatment of cervical cancer. Methods: After an extensive literature search between 1995-2011,we analyzed7 studies to compare weekly cisplatin and triweekly cisplatin combined radiotherapy. Results: Our analysisestablished that weekly cisplatin has a lower risk of hematologic toxicity than triweekly cisplatin with concurrentradiotherapy in the treatment of cervical cancer. However, there were no differences in progression free survivaland overall survival between weekly cisplatin and triweekly cisplatin (p>0.05). Conclusions: Weekly cisplatincombined with concurrent radiation has lower risk in hematologic toxicity than triweekly cisplatin, but does notimprove survival. Triweekly cisplatin treatment has longer intervals and is therefore more convenient. Cliniciansand patients can choose either weekly cisplatin or triweekly cisplatin combined radiotherapy for cervical cancer.     

Association between working overtime and psychological stress reactions in elementary and junior high school teachers in Japan: a large-scale cross-sectional study

This study aimed to investigate the relationship between working overtime and psychological stress reactions among school teachers. It also evaluated the interaction of overtime work types (on weekdays, on holidays, and bringing work home) and task content (educational, peripheral and both). This cross-sectional study was conducted on Japanese elementary and junior high school teachers. Primary outcome was psychological stress reactions measured with the Brief Job Stress Questionnaire. Participants were asked how long they work overtime on weekdays, holidays, and at home. Participants were also asked whether they engaged in educational tasks and/or peripheral tasks during that overtime work. Multiple linear regression analyses were applied and 6,135 participants were included in the analyses after imputing missing data. Working hours of all three types were significantly correlated with higher psychological stress reactions. Moreover, engaging in both educational and peripheral tasks showed higher psychological stress reactions than in only educational tasks when working overtime on weekdays and holidays. In conclusion, reducing overtime work regardless of work types is crucial for mitigating psychological stress reactions for teachers. It might also be possible to manage the psychological stress reactions by splitting the role of task contents, when working overtime on weekdays and holidays at school.     

多西紫杉醇联合奥沙利铂每周疗法治疗30例高龄晚期胃癌的临床观察

目的观察多西他赛（DOC）联合奥沙利铂（OXA）周剂量方案一线治疗高龄晚期胃癌的临床疗效及不良反应。方法对30例晚期胃癌患者,采用DOC 35mg/m^2,静脉滴注d1,d8;OXA 70 mg/m^2,静脉滴注d1,d8;21d为1周期,至少2个周期后评价疗效。结果26例可评价疗效,按RECIST标准评价近期疗效和不良反应,以CR＋PR为有效,其中CR 4例,PR 14例,SD 6例,PD 2例,RR 69.23%,中位疾病进展时间为5.8个月,中位生存期11.8个月。不良反应主要是骨髓抑制,外周神经炎和胃肠道反应,均为可逆性。本组无治疗相关性死亡。结论多西他赛联合奥沙利铂每周疗法治疗晚期胃癌疗效确切,不良反应轻,患者耐受性好,值得临床推广。     

Periodic knee injections of BMP‐7 delay cartilage degeneration induced by excessive running in rats

Strenuous running of rats enhances mechanical stress on the knee, thereby inducing degeneration of articular cartilage. Bone morphogenetic protein‐7 (BMP‐7) has an inhibitory effect on cartilage degeneration, suggesting its usefulness for human osteoarthritis patients. However, its mode of administration should be investigated. We examined whether weekly knee injections of BMP‐7 delayed the progression of cartilage degeneration. Wistar rats were forced to run 30 km in 6 weeks on a rodent treadmill, and BMP‐7 was injected weekly into the knee. Macroscopically and histologically, this strenuous running regimen induced cartilage degeneration. Weekly injections of 250 ng BMP‐7 delayed the progression of cartilage degeneration. Immunohistochemically, in the control knee, type II collagen expression decreased, while BMP‐7 expression in chondrocytes slightly increased. Interestingly, weekly injection of BMP‐7 increased BMP‐7 expression even 9 days after the final injection. Disulfate disaccharide keratan sulfate in serum transiently increased in the control group, while it remained at a low level in the BMP‐7 group. Weekly BMP‐7 injection increased BMP‐7 expression in chondrocytes and its effect seemed to last more than 7 days. The effect of BMP‐7 could be monitored by serum keratan sulfate concentration. Periodical injections of BMP‐7 delayed progression of cartilage degeneration induced by excessive running in rats. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 1088–1092, 2009     

Nursing care adaptations during clinical trials with weekly high-dose cisplatin: evaluation of a process plan

Cisplatin is among the most active chemotherapeutic agents available today for the treatment of a variety of cancers. Toxic side-effects have up until now prevented dose escalation and schedule intensification which might be interesting in view of the dose-response relationship and the schedule-response relationship.
Recent developments in supportive care and pharmacology limited these side-effects and thereby rendered dose-intensification feasible.
Currently, we have treated 71 patients with high-dose cisplatin administered in hypertonic saline weekly for 6 weeks. Most cycles were supported by 5HT₃ antagonists to achieve maximal anti-emetic control. The patients participated in a phase I study (MTD 85 mg/m²) or phase II studies (80 mg/m²) in head and neck cancer/mesothelioma/non-small cell lung carcinoma or a pilot study of cisplatin weekly in combination with etoposide orally(MTD 70mg CDDP/m² dl + 8 + 15 etoposide50mg/dd p.o. dl-15 qd282 cycles). The phase II studies are ongoing.
The major problem associated with this treatment schedule was myelosuppression. Less frequently observed side-effects were: nausea/vomiting, nephrotoxicity, anorexia, neuro- and ototoxicity. Besides, the weekly treatment schedule has an impact on the patient's quality of life due to frequent hospitalizations. In order to optimize the care of these patients, continuity of care was provided by a process plan. Optimal patient information and education improved patient motivation and compliance with this regime.
This paper will present information on this process plan and the nursing implications of this regime.     

Montelukast improves symptoms of seasonal allergic rhinitis over a 4-week treatment period

BACKGROUND: Proinflammatory mediators such as the cysteinyl leukotrienes are important in the pathophysiology of allergic rhinitis. This study evaluated the efficacy and tolerability of montelukast, a cysteinyl leukotriene receptor antagonist, given once daily in the morning for treatment of seasonal (fall) allergic rhinitis for 4 weeks. METHODS: This was a randomized, double-blind trial with a placebo run-in and a 4-week treatment period. Patients (n = 1079) with a history of allergic rhinitis and a positive skin test to seasonal pollen allergens were assigned to placebo, montelukast 10 mg, or loratadine 10 mg. Symptoms were assessed with a daily diary. RESULTS: Montelukast was more effective than placebo in improving scores for the primary endpoint of daytime nasal symptoms (P = 0.003) and the secondary endpoints of night-time, composite, and daytime eye symptoms, patient's and physician's global evaluations of allergic rhinitis, and rhinoconjunctivitis quality-of-life (P 相似文献   

Cisplatin-topotecan-paclitaxel weekly administration with G-CSF support for ovarian and small-cell lung cancer patients: a dose-finding study.

Purpose: Paclitaxel (PTX) and topotecan (TPT) have shown promising antitumor activity in both ovarian cancer (OC) and small-cell lung cancer (SCLC) patients. This phase I study was aimed at determining the maximum tolerable dose (MTD) of TPT given weekly over 30 min in combination with fixed doses of cisplatin (CDDP) and (PTX), and with G-CSF support.Patients and methods: Forty-four patients with OC (19) or SCLC (25), either chemo-naïve (20) or pretreated (24) received CDDP 40 mg/m2, PTX 85 mg/m2 (one-hour infusion) and escalating TPT doses (starting from 0.75 mg/ m2) in a 30-min infusion in weekly administration. Filgrastim 5 mg/kg was administered on days 3 to 5 of each week.Results: Eight different dose levels were tested for a total of 295 delivered cycles. The dose escalation was interrupted at the TPT dose of 2.50 mg/m2. No toxic deaths occurred in this study. Grade 3 to 4 neutropenia, thrombocytopenia, and anemia occurred in 15 patients (36 cycles), seven patients (15 cycles), and four patients (five cycles), respectively. Severe vomiting and diarrhoea occurred in seven and four patients. Peripheral neuropathy was recorded in 11 patients (42 cycles), but it was never severe. An overall 11 of 19 (58%) OC and 11 of 25 (44%) SCLC patients obtained objective responses. Eight patients showed complete responses (three OC and three SCLC). Among the 20 chemo-naïve patients, 9 of 11 (82%) OC and seven of nine (78%) SCLC responded.Conclusions: The CDDP/TPT/PTX weekly administration with filgrastim support represents a well-tolerated and active therapeutic approach in both chemo-naïve and pretreated OC and SCLC patients. A weekly dose of TPT of 2.25 mg/m2 is recommended for the phase II study.     

Dietary exposure to essential and toxic trace elements from a Total diet study in an adult Lebanese urban population

This study assesses, by the Total diet study approach, the adequacy of micronutrient intake (Co, Cu, Fe, Mn, Ni, Zn) and the dietary exposure of a Lebanese adult urban population to two toxic elements (Cd, Pb). The foods that made up the average ‘total diet’ were derived from a previous individual consumption survey. A total of 1215 individual foods were collected, prepared and cooked prior to analysis. Analytical quantification was performed using inductively coupled plasma mass spectrometry. Average daily intakes of Co (11.4 μg/day), Cu (1104.19 μg/day), Fe (13.00 mg/day), Mn (2.04 mg/day), Ni (126.27 μg/day) and Zn (10.97 mg/day) were below toxicological reference values and were found to satisfy nutritional recommendations, except for manganese in men and iron in women. Average dietary exposure to Pb and Cd represented 3.2% and 21.7% of the respective provisional tolerable weekly intakes. Estimates of dietary intakes of iron appeared to be inadequate for 63% of adult women. These findings should constitute a current measure of assessing the adequacy and safety of foods consumed in Lebanon and may be a basis for future monitoring studies.