Response to fluorouracil therapy in cancer patients: the role of tumoral dihydropyrimidine dehydrogenase activity.

1995 ◽  
Vol 13 (7) ◽  
pp. 1663-1670 ◽  
Author(s):  
M C Etienne ◽  
S Chéradame ◽  
J L Fischel ◽  
P Formento ◽  
O Dassonville ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tumor Staging ◽  
Dihydropyrimidine Dehydrogenase ◽  
Stage Iv ◽  
Target Cells ◽  
Tumor Biopsy ◽  
Cellular Target ◽  
Significant Difference ◽  
And Control

PURPOSE The aim of the present study was to analyze the role of thymidylate synthase (TS; main cellular target of fluorouracil [FU]) and dihydropyrimidine dehydrogenase (DPD; rate-limiting enzyme of FU catabolism) in tumoral biopsies with respect to FU responsiveness. PATIENTS AND METHODS This prospective study was conducted on 62 head and neck cancer patients (six stage II, 16 stage III, and 40 stage IV). All received first-line chemotherapy with biomodulated FU (5-day continuous infusion). Before treatment, a tumor biopsy and control biopsy (symmetrical nontumoral area) were obtained. Cytosolic TS and DPD activities were measured using radioenzymatic assays. RESULTS DPD activity was detectable in all samples, without a significant difference between tumoral (median, 60 pmol/min/mg protein; range, 13 to 193) and nontumoral samples (median, 68 pmol/min/mg protein; range, 12 to 150). Tumoral TS and tumoral DPD were not significantly influenced by tumor localization or tumor staging. Among 52 tumors assessable for clinical response, we observed 46% complete responses (CRs), 33% partial responses (PRs), and 21% no responses (NRs). No relationship was demonstrated between TS activity and response to FU therapy. The comparison of tumoral DPD between complete responders and partial or nonresponders showed a trend toward significance (P = .06). In an attempt to reduce variability, we analyzed the tumoral/nontumoral DPD activity ratio; complete responders exhibited a significantly lower normalized DPD than partial or nonresponding patients (median, 0.86, 1.18, and 1.42 for CR, PR, and NR, respectively; CR v PR plus NR, P = .03). CONCLUSION Although resistance to FU is multifactorial, the present clinical study suggests that FU catabolism in target cells is probably a determinant factor for FU responsiveness in cancer patients and justifies the clinical use of specific DPD inhibitors as FU biomodulators.

Role of chemotherapy in improving survival in stage IV colon cancer patients without surgery: An NCDB analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15058-e15058
Author(s):  
Lakshmi Manogna Chintalacheruvu ◽  
Avanija Buddam ◽  
Osama Diab ◽  
Peter T. Silberstein ◽  
Ryan W Walters
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Median Survival ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Stage Iv ◽  
Cancer Data ◽  
Co Morbidity ◽  
Significant Difference

e15058 Background: Approximately 20% of patients with colorectal cancer have metastases at the time of presentation. Use of systemic chemotherapy for stage IV colon cancer has greatly increased over past several years with newer advancements. With advancements in chemotherapy annual rate of Primary tumor resection dropped from 74.5 percent in 1988 to 57.4 percent in 2010 with improved survival rates. Methods: A total of 39,428 patients with stage IV colon cancer were analyzed from the national cancer data base (NCDB). Differences in demographic and clinical co-variates were compared using Fisher’s exact test, where as survival differences were estimated by the Kaplan-Meier method and associated log-rank test; p < 0.05 indicated statistical significance. Results: The log-rank tests indicated statistically significant difference in survival (p < 0.001), such that patients receiving chemotherapy survived significantly longer (median survival = 12.0 months, 95% CI = 11.8 to 12.2 months) compared to patients not receiving chemotherapy (median survival = 1.5 months, 95% CI = 1.5 to 1.5 months). Patients receiving chemotherapy were younger (63.2 +/- 13.2 vs 73.8 +/- 13.0 ) with lesser co morbidity when compared to people who did not receive chemotherapy. Conclusions: Patients receiving chemotherapy are considerably younger, with less co-morbidity, and they survive significantly longer. This study signifies the survival advantage with chemotherapy in Stage IV colon cancer patients who did not get any type of surgery. Further studies need to be establish to define the role of chemotherapy comparing to surgery in stage 4 colon cancer patients.

Role of Nutrition Counseling and Lifestyle Modification in Managing Prediabetes

2021 ◽  
pp. 037957212110254
Author(s):  
Harleen Kaur ◽  
Neerja Singla ◽  
Rohini Jain
Keyword(s):  
Hemoglobin A1c ◽  
Lifestyle Modification ◽  
Fasting Blood Glucose ◽  
Nutrition Intervention ◽  
Control Group ◽  
Population Prevalence ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Objective: India is the second country after China having the highest population prevalence of diabetes. Several research studies investigating diabetes have been done, but not much work has been done on prediabetes. The purpose of this study was to investigate the effect of nutrition and lifestyle modification on prediabetic females. Methods: A total of 120 prediabetic females from Ludhiana city were divided into 2 matched groups: control group (n = 60) and experimental group (n = 60). Impact of nutrition intervention for dietary and lifestyle modification (for 3 months) was assessed on the anthropometric, dietary, biochemical parameters, and diabetes risk score of the experimental group and control group (no intervention). Results: All the selected 120 subjects completed the study (experimental group = 60; control group = 60). There was significant difference in the changes between the 2 groups throughout the study. The fasting blood glucose and glycated hemoglobin A1c levels of the experimental group subjects reduced significantly ( P ≤ .01). However, no change was observed among the control group subjects. The lipid profile of the experimental group showed a significant improvement ( P ≤ .01). Conclusion: Nutrition counselling of the prediabetics regarding dietary and lifestyle modification is recommended so as to improve their metabolic control, thus preventing them from being diabetics.

Outcomes for and Risk Factors Associated With Vancomycin-ResistantEnterococcus faecalisand Vancomycin-ResistantEnterococcus faeciumBacteremia in Cancer Patients

2007 ◽  
Vol 28 (9) ◽  
pp. 1054-1059 ◽  
Author(s):  
G. Ghanem ◽  
R. Hachem ◽  
Y. Jiang ◽  
R. F. Chemaly ◽  
I. Raad
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Independent Risk Factor ◽  
Response To Therapy ◽  
Aminoglycoside Therapy ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
And Control

Objective.Vancomycin-resistant enterococci (VRE) are a major cause of nosocomial infection. We sought to compare vancomycin-resistant (VR)Enterococcus faecalisbacteremia and VREnterococcus faeciumbacteremia in cancer patients with respect to risk factors, clinical presentation, microbiological characteristics, antimicrobial therapy, and outcomes.Methods.We identified 210 cancer patients with VRE bacteremia who had been treated between January 1996 and December 2004; 16 of these 210 had VRE. faecalisbacteremia and were matched with 32 patients with VRE. faeciumbacteremia and 32 control patients. A retrospective review of medical records was conducted.Results.Logistic regression analysis showed that, compared with VRE. faecalisbacteremia, VRE. faeciumbacteremia was associated with a worse clinical response to therapy (odds ratio [OR], 0.3 [95% confidence interval (CI), 0.07-0.98];P= .046) and a higher overall mortality rate (OR, 8.3 [95% CI, 1.9-35.3];P= .004), but the VRE-related mortality rate did not show a statistically significant difference (OR, 6.8 [95% CI, 0.7-61.8];P= .09). Compared with control patients, patients with VRE. faecalisbacteremia were more likely to have received an aminoglycoside in the 30 days before the onset of bacteremia (OR, 5.8 [95% CI, 1.2-27.6];P= .03), whereas patients with VRE. faeciumbacteremia were more likely to have received a carbapenem in the 30 days before the onset of bacteremia (OR, 11.7 [95% CI, 3.6-38.6];P<.001). In a multivariate model that compared patients with VRE. faeciumbacteremia and control patients, predictors of mortality included acute renal failure on presentation (OR, 15.1 [95% CI, 2.3-99.2];P= .004) and VRE. faeciumbacteremia (OR, 11 [95% CI, 2.7-45.1];P<.001). No difference in outcomes was found between patients with VRE. faecalisbacteremia and control patients.Conclusions.VRE. faeciumbacteremia in cancer patients was associated with a poorer outcome than was VRE. faecalisbacteremia. Recent receipt of carbapenem therapy was an independent risk factor for VRE. faeciumbacteremia, and recent receipt of aminoglycoside therapy was independent risk factor forE. faecalisbacteremia.

scholarly journals A Comparison of Efficiency in Teacher Correction Strategies in Iranian EFL Learners’ Speaking Improvement

2016 ◽  
Vol 6 (6) ◽  
pp. 183
Author(s):  
Roya Keshavarz ◽  
Amin Marzban
Keyword(s):  
Corrective Feedback ◽  
Placement Test ◽  
Control Group ◽  
Teaching Methodology ◽  
Moderator Variable ◽  
Efl Learners ◽  
Feedback Type ◽  
Significant Difference ◽  
And Control

<p>The present study was an attempt to investigate the effect two types of corrective feedback (i.e., recast and metalinguistic) in order to find out which one is more effective on EFL learners’ speaking improvement and also to see if gender could play a role in the relative impact of the two types of corrective feedback on learners’ speaking ability. To this end, 65 EFL learners of intermediate level in one of language institutes in Shiraz, Iran were selected and divided into three groups including two experimental groups and one control. The instruments used to collect the data included IELTS test as the pre and post tests and Oxford Placement Test (OPT) in order to obtain the homogeneity in participants’ English proficiency. The collected data were codified and entered into SPSS Software (Version 22) and were analysed using descriptive statistics, t-test, and Tukey test. The results indicated that although applying these two types of corrective feedback could have made improvement in EFL learners’ speaking ability, there was not observed any significant difference between impacts of recast and metalinguistic on EFL learners’ production. The test results also indicated that there was not any significant difference regarding gender within the three groups. This homogeneity further shows that in this study, the gender variable did not have any effect on the role of corrective feedback and it can be concluded that the observed difference between metalinguistic group, recast group, and control group is just the result of the provided corrective feedback type which has acted as the intervening variable and the moderator variable such as gender did not prove to have any effect in the outcome of this study. The findings can contribute to syllabus design and teaching methodology areas.</p>

scholarly journals Perubahan Status Koagulasi Pasien Kanker Padat Pasca Kemoterapi di Indonesia: Sebuah Studi Prospektif

2020 ◽  
Vol 7 (1) ◽  
pp. 2
Author(s):  
Noorwati Sutandyo ◽  
Lyana Setiawan
Keyword(s):  
Cancer Patients ◽  
Prospective Cohort ◽  
Stage Iv ◽  
Stage Iii ◽  
Solid Cancer ◽  
Significant Difference ◽  
Before And After ◽  
Coagulation Status ◽  
Stage Iv Cancer ◽  
D Dimer

Pendahuluan. Hiperkoagulasi merupakan faktor yang mendasari tingginya mortalitas akibat kejadian tromboemboli vena pada pasien kanker. Kemoterapi merupakan salah satu faktor yang diduga berkontribusi terhadap status hiperkoagulasi pada pasien kanker. Studi ini bertujuan untuk mengevaluasi perubahan status koagulasi yang ditandai dengan kadar D-dimer pada pasien kanker yang menjalani kemoterapi.Metode. Studi ini merupakan studi kohort prospektif di Pusat Kanker Nasional Indonesia yang melibatkan pasien kanker yang sudah terkonfirmasi melalui pemeriksaan histopatologi, dan memulai kemoterapi pada periode Mei hingga Juli 2018. Perubahan status koagulasi dinilai melalui kadar D-dimer plasma. Kadar D-dimer diukur sebelum dan 7 hari setelah kemoterapi. Analisis statistik menggunakan uji t berpasangan untuk menilai kemaknaan perubahan kadar D-dimer plasma sebelum dan setelah kemoterapi.Hasil. Sejumlah 89 pasien memenuhi kriteria inklusi, yang mana 74,2% adalah perempuan dan hampir separuh dari keseluruhan subjek terdiagnosis kanker payudara (44,9%). Mayoritas subjek (69,6%) terdiagnosis pada stadium III atau IV. Sejumlah 12,4% dari subjek mendapatkan kemoterapi berbasis cisplatin. Terdapat perbedaan yang bermakna antara kadar D-dimer sebelum dan setelah kemoterapi (p = 0,05). Studi ini juga menemukan perbedaan bermakna kadar D-dimer sebelum dan sesudah kemoterapi pada pasien kanker stadium III (t(35) = 2,48, p = 0,02) dan stadium IV (t(25) = 2,14, p = 0,04). Tidak terdapat perbedaan bermakna antara kadar D-dimer sebelum dan setelah kemoterapi pada pasien stadium I dan II. Analisis lanjutan berdasarkan kelompok kemoterapi menunjukkan bahwa terdapat perubahan kadar D-dimer yang bermakna pada kelompok yang mendapatkan kemoterapi cisplatin (t(10) = 2,31, p = 0,04), namun tidak pada kelompok yang mendapat kemoterapi non-cisplatin (t(77) = 1,50, p = 0,14).Simpulan. Terdapat perbedaan bermakna status koagulasi yang ditandai dengan kadar D-dimer 7 hari pasca mendapatkan kemoterapi, khususnya pada pasien kanker stadium III atau IV dan mendapatkan kemoterapi berbasis cisplatin. Kata Kunci: Cisplatin, kanker, kemoterapi, status koagulasiChange of Coagulation Status in Solid Cancer Patients Undergoing Chemotherapy in Indonesia: A Prospective Cohort StudyIntroduction. Cancer-associated hypercoagulability was an underlying factor of high mortality of cancer due to venous thromboembolism. Chemotherapy is proposed as one of the contributing factors of the hypercoagulable state. We aim to evaluate the change of coagulation status, which was marked by D-dimer level, in cancer patients receiving chemotherapy.Methods. This is a prospective cohort study in Indonesian national cancer center which involves all adult histologically-confirmed-cancer patients who started chemotherapy between May and July 2018. The coagulation status is assessed by plasma of D-dimer level. We measured D-dimer before chemotherapy and one week after chemotherapy. Paired t-test was performed to assess the significant difference in D-dimer levels before and after chemotherapy.Results. A total of 89 patients fulfilled the eligibility criteria, of whom 74.2% were female and almost half of total subjects (44.9%) were breast cancer patients. Majority of subjects (69.6%) were stage III or stage IV cancer. There were 12.4% of subjects received cisplatin-based chemotherapy. There was a marginally significant difference in plasma level of D-dimers before and after chemotherapy (p = 0.05). We also found significant differences between D-dimer level before and after chemotherapy in stage III patients (t(35) = 2.48, p = 0.02) and stage IV patients (t(25) = 2.14, p = 0.04). There was no significant difference between D-dimer level before and after chemotherapy in stage I and stage II patients. Subgroup analyses based on chemotherapy agents showed that there was significant D-dimer change in cisplatin-based chemotherapy subjects (t(10) = 2.31, p = 0.04), but not in non-cisplatin-based chemotherapy subjects (t(77) = 1,50, p = 0.14).Conclusion. Compared to before chemotherapy, there is a significant difference of coagulation status marked by plasma D-dimer level one week after chemotherapy, particularly in patients with stage III or stage IV cancer and in patients receiving cisplatin-based chemotherapy.

scholarly journals Effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals, Bhubaneswar, Odisha

2020 ◽  
Vol 11 (1) ◽  
pp. 1165-1171
Author(s):  
Sasmita Das ◽  
Mary Preety Banra ◽  
Neethu Maria Joseph
Keyword(s):  
Cancer Patients ◽  
Research Design ◽  
Demographic Data ◽  
Large Population ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Food Component ◽  
Significant Difference ◽  
Chi Square Analysis ◽  
And Control

A quasi-experimental research study (posttest only research design) was conducted to evaluate the effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals of Bhubaneswar and to find out the association of level of chemotherapy-induced nausea and vomiting with selected socio-demographic variables. For this study, a quantitative experimental approach and post-test only research design was adopted. 100 patients were selected by convenience sampling technique and categorized into experimental (n=50) and control group (n=50) for this study. Self- structured socio-demographic proforma and self- structured record analysis proforma was used to collect socio-demographic data and modified nausea and vomiting scale was used to measure the level of chemotherapy-induced nausea and vomiting among cancer patients. The data was analyzed by using SPSS version 20.0 (Statistical Package for the Social Science). The post-testt level of chemotherapy-induced nausea and vomiting among experimental and control groups was compared by unpaired‘t’ test and the result showed (p=<0.0001) significant difference between both groups. The chi-square analysis shows a statistically significance association between chemotherapy-induced nausea and vomiting and the emetogenic potential of the drug in both groups and in control group age was also significance associated. The ANOVA test revealed the statistically significance of the posttest level of chemotherapy-induced nausea and vomiting within groups of the emetogenic potential of a drug. The present study concluded that the food component, like ginger tea, is an effective home remedy for the reduction of chemotherapy-induced nausea and vomiting among cancer patients. Further study can be conducted with a large population, different dose and compositions of ginger and with different adjuvant therapy to manage nausea and vomiting among cancer patients.

scholarly journals The role of honey in healing of bedsores in cancer patients

2012 ◽  
Vol 01 (02) ◽  
pp. 66-71 ◽  
Author(s):  
Aramita Saha ◽  
Subrata Chattopadhyay ◽  
Md. Azam ◽  
Prabir Kr. Sur
Keyword(s):  
Wound Healing ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Low Cost ◽  
Critical Difference ◽  
Visual Analogue Pain ◽  
Wound Assessment ◽  
Significant Difference ◽  
Bacteria And Fungi ◽  
And Control

Abstract Bacground: Honey was used to treat infected wounds as long as 2000 years before bacteria were discovered. It has been reported to have inhibitory action to around 50 species of bacteria and fungi (aspergillus, penicillium). Usually, Metronidazole powder is used in our palliative clinic for wound healing due to low cost & effectivity. Honey is cheap, easily available ingredient with high astringent activity. Objective: Objectives of the study were to find out the effectiveness of Honey in terms of rate of wound healing & pain control in bedsores of cancer patients. Materials and Methods: 40 cancer patients with bedsore wounds were randomly assigned (1:1 ratio i.e. 20 in each arm) for Study Arm (Honey plus Metronidazole powder) and Control Arm (only Metronidazole powder), attending Palliative clinic of our department in between July 2010 to September 2011. Washing of the wound with normal saline done daily before application of above medicaments. Change of posture & soft bed were encouraged in both groups. A pre designed interview proforma, standardised Bates Jensen Wound Assessment Tool and Visual Analogue Pain assessment scale were used to collect and assess data. Results: There was significant difference in wound healing status (F value = 6.523; Critical Difference =14.03, P&nit;0.05) from day 10 and pain reduction also (F value = 6.638 and Critical Difference = 1.667, P&nit;0.05) from day 7 in study arm. Conclusion: Application of honey dressing provides a better wound healing, rapid pain relief in cancer patients with bedsores in palliative settings.

Investigating ADAMTS7 and ADAMTS12 levels in prediabetic and Type 2 diabetic patients

2021 ◽  
Author(s):  
Mercan Taştemur ◽  
Selvihan Beysel ◽  
Sema Hepşen ◽  
Sanem Öztekin ◽  
Erman Çakal ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Diabetic Patients ◽  
Control Groups ◽  
Type 2 Diabetic Patients ◽  
Human Enzyme ◽  
Significant Difference ◽  
And Control ◽  
Type 2 Diabetic

Background: This study aims to investigate the role of ADAMTS7 and ADAMTS12 on atherosclerosis and inflammation in prediabetic and diabetic patients. Patients & methods: Serum ADAMTS7 and ADAMTS12 levels were compared with the atherosclerotic and inflammatory markers in diabetic (n = 65, female 30.9%, mean age = 53 years), prediabetic (n = 55, female 36.6%, mean age = 49 years) and control groups (n = 55, females 32.5%, mean age = 49 years). Serum ADAMTS levels were determined by a human enzyme-liked immunoassay. Results: In terms of ADAMTS7, there was no significant difference between diabetic, prediabetic and control groups (50.93, 44.34, 59.07, respectively; p > 0.05). ADAMTS12 is lower in diabetics (p < 0.05), whereas it is similar in prediabetics and controls (14.53, 20.76, 25.05, respectively; p > 0.05). ADAMTS7 and ADAMTS12 levels did not differ in diabetic nephropathy, retinopathy and neuropathy (p > 0.05). Conclusion: While ADAMTS12 was significantly lower in diabetics and prediabetics, ADAMTS7 and ADAMTS12 were not related to diabetic complications (nephropathy, retinopathy and neuropathy).

S-Adenosylmethionine Supplementation May Reduce Cancer-Related Fatigue: A Prospective Evaluation Using the FACIT-F Questionnaire in Colon Cancer Patients Undergoing Oxaliplatin-Based Chemotherapy Regimens

Chemotherapy ◽  
2021 ◽  
pp. 1-8
Author(s):  
Angelo Onorato ◽  
Andrea Napolitano ◽  
Silvia Spoto ◽  
Lorena Incorvaia ◽  
Antonio Russo ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Cancer Patients ◽  
Chronic Fatigue ◽  
University Campus ◽  
Cancer Related Fatigue ◽  
Number Of Patients ◽  
Significant Difference ◽  
The University ◽  
Oncologic Treatment

<b><i>Background:</i></b> Fatigue is a common distressing symptom for patients living with chronic or acute diseases, including liver disorders and cancer (<i>Cancer-Related Fatigue</i>, CRF). Its etiology is multifactorial, and some hypotheses regarding the pathogenesis are summarized, with possible shared mechanisms both in cancer and in chronic liver diseases. A deal of work has investigated the role of a multifunctional molecule in improving symptoms and outcomes in different liver dysfunctions and associated symptoms, including chronic fatigue: S-adenosylmethionine (SAM; AdoMet). The aim of this work is actually to consider its role also in oncologic settings. <b><i>Patients and Methods:</i></b> Between January 2006 and December 2009, at the University Campus Bio-Medico of Rome, 145 patients affected by colorectal cancer in adjuvant (<i>n</i> = 91) or metastatic (<i>n</i> = 54; <i>n</i> = 40 with liver metastases) setting and treated with oxaliplatin-based regimen (FOLFOX for adjuvant and bevacizumab + XELOX for metastatic ones), 76 of which with the supplementation of S-adenosylmethionine (AdoMet; 400 mg b.i.d.) (57% of adjuvant patients and 44% of metastatic ones) and 69 without AdoMet supplementation, were evaluated for fatigue prevalence using the Functional Assessment of Chronic Illnesses Therapy-Fatigue (FACIT-F) questionnaire, at 3 and 6 months after the beginning of oncologic treatment. Notably, the number of patients with liver metastases was well balanced between the group of patients treated with AdoMet and those who were not. <b><i>Results:</i></b> Among patients receiving oxaliplatin-based chemotherapy, both in adjuvant and in metastatic settings, after just 3 months from the beginning of chemotherapy, mean scores from questionnaire domains like FACIT-F subscale (7.9 vs. 3.1, <i>p</i> = 0.006), FACIT physical (6.25 vs. 3.32, <i>p</i> = 0.020), FACIT emotional (4.65 vs. 2.19, <i>p</i> = 0.045), and FACIT-F total score (16.5 vs. 8.27, <i>p</i> = 0.021) were higher in those receiving supplementation of AdoMet, resulting in reduced fatigue; a significant difference was maintained even after 6 months of treatment. <b><i>Discussion and Conclusions:</i></b> Mechanisms and strategies for managing CRF are not fully understood. This work aimed at investigating the possible role of S-adenosylmethionine supplementation in improving fatigue scores in a specific setting of cancer patients, using a FACIT-F questionnaire, a well-validated quality of life instrument widely used for the assessment of CRF in clinical trials.

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