The Association of Quality of Life and Survival in Cancer Patients

Abstract

The incorporation of 'targeted therapies' into standard cancer care has changed how clinicians treat cancer. Small molecule inhibitors, antibodies, and conjugated agents target cancer cells more specifically than traditional chemotherapy. These therapies can be used alone or in combination with chemotherapy in first-line, refractory, or relapsed settings. Although designed to spare normal tissue, these agents do have systemic toxicity. Notably, their toxicity profiles are distinct from those encountered with chemotherapy. These agents have demonstrated efficacy in terms of improved tumour response, survival, symptom control, and/or quality of life. Cancer treatment will continue to change as additional targeted agents are evaluated in clinical trials and are brought into standard medical care. The palliative care clinician is likely to encounter these agents with increasing frequency, making decisions to continue or discontinue therapy, adding targeted agents to improve symptoms, performance status, or quality of life, or advising patients to return to their oncologists for further advice as new agents become available. Presented here, Part 1 of this review focuses on small molecules. All but one of these agents are oral, and they are all relatively well tolerated. In the future, Part 2 will introduce antibodies and conjugated agents.     

Immobilization Hypercalcemia in Critical Illness Following Bariatric Surgery

Background: Immobilization hypercalcemia has been previously reported in a number of entities but not as a complication of bariatric surgery.We recognized this complication in two consecutive bariatric patients requiring intensive care unit (ICU) admission. Methods:These two patients are reported in detail, and a review of our ICU database is also reported. Results: Treatment of immobilization hypercalcemia in these two patients with pamidronate was successful. Conclusion: Immobilization hypercalcemia complicating the course of bariatric patients requiring ICU admission is a newly recognized and treatable entity.     

双源CT CARE Dose4D技术在儿童牙齿扫描中的应用

目的 探讨双源CT CARE Dose 4D(管电流调节技术)在儿童牙齿CT扫描中的运用价值.方法 疑牙齿畸形行CT平扫及重建了解根尖情况的患儿70例,按时间先后分A、B两组,A组常规扫描(100 kVp/150 mAs),B组开启CARE Dose4D扫描(100 kVp/参考电流150 mAs),其余条件保持不变.比较A、B两纽扫描方案的辐射剂量及所得图像的平均CT值、噪声、信号噪声比(SNR)、对比噪声比(CNR)、主观评分等.结果 A、B两组辐射剂量差异有统计学意义(t=-2.24,P=0.03).与A组比较,B组有效剂量(ED)下降约23.15％;图像的平均CT值、噪声、SNR、CNR及主观评分比较差异无统计学意义(P＞0.05).结论 应用双源CT CARE Dose 4D技术行儿童牙齿CT扫描,在降低辐射剂量的同时,不影响图像质量,值得临床推广.     

CTCA中应用低kV和CARE Dose 4D技术对钙化积分测量的影响

目的：探讨冠状动脉成像（CTCA）检查中应用低kV和CARE Dose 4D管电流调节技术对钙化积分测量的影响。方法选择2013年2月～7月于本院行冠状动脉成像的患者268例,随机分成两组,A组134例每位患者分别用常规120 kV及120 kV,CARE Dose 4D技术扫描钙化积分;B组134例患者分别用常规120 kV及100 kV,CARE Dose 4D技术扫描钙化积分,分别测量和计算钙化积分、平均容积CT剂量指数、剂量长度乘积、有效剂量,并将得到的结果进行统计分析。结果A组两种扫描方法得到的钙化积分值分别为（235.45±285.26）和（224.18±270.81）;平均容积CT剂量指数分别为（2.13±0.017） mGy和（1.61±0.28） mGy;剂量长度乘积分别为（31.84±2.91） mGy·cm和（24.15±4.46） mGy·cm;有效剂量分别为（0.476±0.046） mSv和（0.366±0.081） mSv;A组两种扫描方法所得数据差异均有统计学意义。B组两种扫描方法得到的钙化积分值分别为（181.46±204.79）和（185.14±207.55）;平均容积CT剂量指数分别为（2.13±0.01） mGy和（0.90±0.18） mGy;剂量长度乘积分别为（30.69±.017） mGy·cm和（12.90±2.40） mGy·cm;有效剂量分别为（0.448±0.019） mSv和（0.189±0.035） mSv,B组两种扫描方法所得剂量差异有统计学意义,钙化积分差异没有统计学意义。结论保持120 kV并使用CARE Dose 4D技术虽然降低了辐射剂量,但是对钙化积分测量有影响;而100 kV和CARE Dose 4D技术同时使用,在不影响钙化积分计算的同时大幅度降低了辐射剂量,值得推广。     

Phenylbutazone self-poisoning treated by charcoal haemoperfusion

A case is presented of a patient who ingested a potentially fatal dose of phenylbutazone. Her clinical condition deteriorated despite adequate supportive therapy and the use of charcoal haemoperfusion proved life-saving.