5,146 research outputs found

    Successful Desensitization to Docetaxel after Severe Hypersensitivity Reactions in Two Patients

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    Purpose Two cases of successful desensitization to docetaxel after severe hypersensitivity reactions are reported. Summary Two patients with gynecological malignancies (uterine leiomyosarcoma and ovarian adenocarcinoma) experienced severe hypersensitivity reactions with docetaxel, including flushing, numbness, sharp radiating pain, severe nausea and vomiting, apnea, and unresponsiveness. Both patients received ondansetron before docetaxel. One patient received dexamethasone, diphenhydramine, and famotidine premedication before docetaxel, as she had previously reacted to paclitaxel. Docetaxel infusions were stopped, and the reactions were treated with diphenhydramine and dexamethasone (one patient also received famotidine). After resolution of symptoms, the docetaxel was not reinitiated due to the nature of the reactions. For the next cycle, both patients received a graded drug challenge or desensitization. Both were pre-medicated with dexamethasone, diphenhydramine, and famotidine. The docetaxel was given as infusions of 0.1%, 1%, and 10% of the dose, with each infusion given over one hour. After this, the remainder of the dose was infused over one hour. Both patients tolerated this desensitization well and completed a total of three and four cycles each. The first patient to receive the desensitization did complain of chest pain during the first desensitization, and the infusion rate was decreased to administer the drug over two hours. After she tolerated two cycles of two-hour infusions, the infusion rate was increased to administer each docetaxel infusion over one hour. Conclusion Two patients who had severe hypersensitivity reactions to docetaxel successfully received further docetaxel doses via a desensitization procedure that involved the sequential administration of solutions containing increasing concentrations of the drug

    Paying the price of the failure to retain legitimacy in a national charity: the CORSO story

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    The Council for the Organisation of Relief Services Overseas (CORSO), established in 1944, was dedicated to the relief of poverty overseas. It was a New Zealand organisation which acted to co-ordinate the activities of different national bodies; all of whom shared a vision of working towards such relief of the poverty. CORSO’s primary vision for such relief being organised “under one umbrella” attracted 50 member organisations by 1967. Legitimacy theory provides an undemanding theoretical frame for early CORSO. It also explains the period of crisis in relation to reduced legitimacy when, in the 1960s, CORSO began to focus increasingly on development to build foundations for impoverished peoples overseas to gain greater self-reliance. This change in strategic direction was insufficiently communicated to the general public, though it was generally accepted within the organisation. From the 1970s the increased politicisation of society impacted on CORSO’s membership, and Maori radicals became prominent in CORSO along with ‘leftist’ individuals and groups. The early strong coalition was progressively replaced with divisiveness from the mid-1970s amid growing public mistrust of CORSO; as it changed from an apolitical body to one increasingly focused on issues from an anticapitalist stance. Polarisation and the subsequent consequences are similar to other not-for-profit coalitions. Deterioration in budgeting was concomitant with CORSO’s declining Appeal proceeds. Without suggesting a central role for accounting in CORSO’s decline, the correlation of robust or deficient accounting processes respectively with economic good and poor health appears positive. Until the late 1960s, evidence indicates a robust accounting process which subsequently deteriorated, from the 1975 Treasurer’s Report onwards. In examining CORSO’s decline from 1970, until its ‘functional death’ in 1991, the causes of this decline provide a valuable illustration of the importance of political independence and integrity for charitable organisations’ survival. The data for this study is derived from primary and secondary sources including newspaper articles, annual reports, correspondence and opinion surveys. This research also analyses accounting data, evidencing a correlation of robust or deficient accounting processes respectively with economic excellent or poor health. To this extent the accounting data provides a ‘bio-marker’ of organisational health. Key to CORSO’s demise was a change in strategic direction brokered by governing members which resulted in a philosophical shift unsupported by many of its core orthodox member bodies, with ‘fatal’ consequences. CORSO from 1990 was not a broad-based coalition, but survives as a persistent, yet impaired, brand name employed by a small coalition of socialists and Maori radicals. CORSO failed to erect barriers to capture, or to recognise it. This historic perspective on the demise of such a giant in New Zealand charities provides a clear illustration of a failure to sense and adapt sufficiently to its dynamic political landscape, and illustrates how the not-forprofit sector is more dependant than other sectors on continuing legitimisation processes in its implicit contract with the society to which it offers its vision

    Thermotolerance of an inactivated rabies vaccine for dogs

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    This study provides the first robust data that the antibody response of dogs vaccinated with Nobivac® Rabies vaccine stored for several months at high temperatures (up to 30 °C) is not inferior to that of dogs vaccinated with vaccine stored under recommended cold-chain conditions (2–8 °C). A controlled and randomized non-inferiority study was carried out comparing the four-week post vaccination serological responses of Tanzanian village dogs inoculated with vaccine which had been stored at elevated temperatures for different periods of time with those of dogs vaccinated with the same product stored according to label recommendations. Specifically, the neutralizing antibody response following the use of vaccine which had been stored for up to six months at 25 °C or for three months at 30 °C was not inferior to that following the use of cold-chain stored vaccine. These findings provide reassurance that the vaccine is likely to remain efficacious even if exposed to elevated temperatures for limited periods of time and, under these circumstances, it can safely be used and not necessarily destroyed or discarded. The availability of thermotolerant vaccines has been an important factor in the success of several disease control and elimination programs and could greatly increase the capacity of rabies vaccination campaigns to access hard to reach communities in Africa and Asia. We have not confirmed a 3-year duration of immunity for the high temperature stored vaccine, however because annual re-vaccination is usually practiced for dogs presented for vaccination during campaigns in Africa and Asia this should not be a cause for concern. These findings will provide confidence that, for rabies control and elimination programs using this vaccine in low-income settings, more flexible delivery models could be explored, including those that involve limited periods of transportation and storage at temperatures higher than that currently recommended

    Finding qualitative research: an evaluation of search strategies

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    BACKGROUND: Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. METHODS: Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). RESULTS: A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. CONCLUSIONS: These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made

    Preserved appendages in a Silurian binodicope: implications for the evolutionary history of ostracod crustaceans

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    Ostracod crustaceans originated at least 500 Ma ago. Their tiny bivalved shells represent the most species-abundant fossil arthropods, and ostracods are omnipresent in a wide array of freshwater and marine environments today and in the past. Derima paparme gen. et sp. nov. from the Herefordshire Silurian Lagerstätte (~430 Ma) in the Welsh Borderland, UK, is one of only a handful of exceptionally preserved ostracods (with soft parts as well as the shell) known from the Palaeozoic. A male specimen provides the first evidence of the appendages of Binodicopina, a major group of Palaeozoic ostracods comprising some 135 Ordovician to Permian genera. The appendage morphology of D. paparme, but not its shell, indicates that binodicopes belong to Podocopa. The discovery that the soft-part morphology of binodicopes allies them with podocopes affirms that using the shell alone is an unreliable basis for classifying certain fossil ostracods, and knowledge of soft-part morphology is critical for the task. Current assignment of many fossil ostracods to higher taxa, and therefore the evolutionary history of the group, may require reconsideration

    Preserved appendages in a Silurian binodicope: implications for the evolutionary history of ostracod crustaceans

    Get PDF
    Ostracod crustaceans originated at least 500 Ma ago. Their tiny bivalved shells represent the most species-abundant fossil arthropods, and ostracods are omnipresent in a wide array of freshwater and marine environments today and in the past. Derima paparme gen. et sp. nov. from the Herefordshire Silurian Lagerstätte (~430 Ma) in the Welsh Borderland, UK, is one of only a handful of exceptionally preserved ostracods (with soft parts as well as the shell) known from the Palaeozoic. A male specimen provides the first evidence of the appendages of Binodicopina, a major group of Palaeozoic ostracods comprising some 135 Ordovician to Permian genera. The appendage morphology of D. paparme, but not its shell, indicates that binodicopes belong to Podocopa. The discovery that the soft-part morphology of binodicopes allies them with podocopes affirms that using the shell alone is an unreliable basis for classifying certain fossil ostracods, and knowledge of soft-part morphology is critical for the task. Current assignment of many fossil ostracods to higher taxa, and therefore the evolutionary history of the group, may require reconsideration

    Magnetic force microscopy study of magnetization reversal in sputtered FeSiAl(N) films

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    The magnetization reversal in a series of rf-sputtered FeSiAl(N) films has been studied using magnetic force microscopy. A system has been developed which has the capability to image domain structure while an in-plane magnetic field is applied in situ. All films exhibited a stripe domain structure in zero applied field which was indicative of a perpendicular component of domain magnetization which alternates in sign. All films showed a similar sequence of magnetization processes: on reducing the applied field from saturation a fine stripe domain structure nucleated and then coarsened as the field was decreased to zero. Local switching of domain contrast was observed along the steepest part of the hysteresis loop as the perpendicular component reversed. As the reverse field was increased toward saturation, the stripe domains disintegrated into smaller regions. This observation is consistent with an interpretation that the domain magnetization rotated locally into the sample plane. The saturation field and the film stress exhibited similar trends with nitrogen partial pressure. The results suggest that the perpendicular anisotropy that caused the formation of the stripe domain structure could be induced by the film stress via magnetoelastic coupling

    Alleviation of Brain Injury-Induced Cerebral Metabolic Depression by Amphetamine: A Cytochrome Oxidase Histochemistry Study

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    Measurements of oxidative metabolic capacity following the ablation of rat sensorimotor cortex and ,he administration of amphetamine were examined to determine their effects on the metabolic dysfunction that follows brain injury. Twenty-four hours after surgery, rats sustaining either sham operations or unilateral cortical ablation were administered a single injection of D-amphetamine (2 mg/kg; i.p.) or saline and then sacrificed 24 h later. Brain tissue was processed for cytochrome oxidase histochemistry, and 12 bilateral cerebral areas were measured, using optical density as an index of the relative amounts of the enzyme. Compared with that of the control groups, cytochrome oxidase in the injured animals was significantly reduced throughout the cerebral cortex and in 5 of II subcortical structures. This injury-induced depression of oxidative capacity was most pronounced in regions of the hemisphere ipsilateral to the ablation. Animals given D-amphetamine had less depression of oxidative capacity, which was most pronounced bilaterally in the cerebral cortex, red nucleus, and superior colliculus; and in the nucleus accumbens, caudateputamen, and globus pallidus ipsilaterai to the ablation. The ability of D-amphetamine to alleviate depressed cerebral oxidative metabolism following cortical injury may be one mechanism by which drugs increasing noradrenaline release accelerate functional recovery in both animals and humans
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