Management and Supportive Care of Patients Undergoing Immunotherapy

In many tumor types, where the prognosis was shown to be extremely dismal before, immunotherapy is now a new beacon of hope to many patients. Immunotherapy has been approved for use in a many different cancers including metastatic melanoma, advanced non-small cell lung cancer, metastatic renal cell carcinoma, refractory Hodgkin’s lymphoma, metastatic bladder cancer advanced head and neck cancer, and the list keeps growing each day. It seems to be generally better tolerated in most patients and less toxic compared to what we have seen in different anticancer treatments from before. However, the toxicities here are termed immune-related adverse events. There is almost no prospective data on these toxicities, and guidelines or recommendations are mostly based on symptomatic management from the ongoing clinical trials. Treating oncologists need to be aware of the subtleties in presentation and the huge difference in the way we mange these side effects. Although most adverse events are low-grade and manageable, they have the potential to be life-threatening if not treated promptly. In this chapter, we address the different immune-related adverse events relating to the organ system they can involve, presentation and symptomatology, general recommendations of management, and individual toxicities. Keywords: immunotherapy, PD-1, CTLA-4

Reflexology versus reflexology and colour therapy combined for treating chronic sinusitis

Published ArticleAccording to Wills reflexology entails the division of the body into ten zones, concentrating on the pressure points on the feet, with each foot representing five zones (2006: Online). Colour therapy uses the vibrational frequencies of colour to restore the client's health. Colour zone therapy on the other hand, is a combination of reflexology and colour therapy. Zone refers to the working of key points on the feet, where colour refers to the assessment of the condition and treating it with the correct colour's frequency (Gimbel, 1993: 2-3). Reflexology uses a physical stimulus and colour therapy, emotional stimulus, thus colour zone therapy addresses both. In this study the researcher's objective was to investigate treatments with reflexology compared with treatments of colour zone therapy, by treating chronic sinusitis to explore the influence of colour on the outcome of reflexology treatments. Ten chronic sinusitis-suffering clients were treated with reflexology in a white cubicle. Another ten clients were treated with colour zone therapy (thus colour therapy as well as reflexology). They had indigo coloured paper in their hands. Results were obtained as case studies, with clients reporting how they felt before and after each treatment. Each client received five treatments. The results indicated that the reflexology clients did experience an improvement after the fourth treatment. By the fifth treatment three of the ten clients had discharged some mucus. However, clients treated with colour zone therapy showed results after the second treatment. At the fourth treatment, already seven of the ten colour zone therapy clients had discharged a large amount of mucus. This concludes that treating a condition with colour, in combination with another treatment provides better and quicker results

Job insecurity and the emotional and behavioural consequences thereof

The aim of this study was to investigate the relations among negative emotional reactions (reduced affective organisational commitment and higher job-related stress), and behavioural reactions to job insecurity (coping behaviour). A non-experimental correlation research design was used and the participants were a convenience sample of employees working for a private hospital in Gauteng, South Africa (N = 242). The measuring instruments included the Job Insecurity Inventory, the Organisational Commitment Questionnaire, the Experience of Work and Life Circumstances Questionnaire, and the COPE Questionnaire. The results showed that job insecurity was associated with job-related stress. Affective job insecurity was associated with detachment from the organisation, while cognitive job insecurity was associated with low identification with the organisation. Experiences of affective job insecurity, job-related stress, and low organisational commitment were associated with the use of avoidance coping strategies. Employees who experienced cognitive job insecurity (compared to those who experienced lower cognitive job insecurity) were less inclined to apply active coping strategies, even if their job-related stress was low

Past, Present and Future use of Municipal Water and Freshwater Resources of the Bekkersdal Community, Westonaria, South Africa

Water is a human right which is recognised globally, with an increasing focus being placed on the ethical considerations of water use. The paper focuses on investigating access and perceptions surrounding this basic need in the Bekkersdal community and the Wonderfonteinspruit, in the Gauteng Province, South Africa. It is hypothesised that several challenges exist both internally and externally in the process of ensuring the right to water in Bekkersdal, from both an environmental and service provision perspective. Through the use of a questionnaire conducted with a statistically representative group from the Bekkersdal community, the following issues were investigated: current water use of municipal and river water, challenges regarding water availability and quality, perceptions regarding the state of the Wonderfonteinspruit and future water use wants and needs. The results indicate a strong reliance on municipal water complicated with water service delivery issues, which resulted in 10% of the residents making use of the polluted Wonderfonteinspruit on a regular basis. Furthermore, the need for solutions to water supply and availability solutions should be developed in conjunction with community members. This research represents some of the first steps that need to be taken to do so

Perpustakaan UMP anjur NCOAL

Kuantan 17 Mac - Seramai 70 peserta dari Perpustakaan awam dan swasta yang menyertai Persidangan Kebangsaan Perpustakaan Akademik (NCOAL) 2015 selama dua hari bertempat di Hotel MS Garden, Kuantan

Obesity, diabetes, serum glucose, and risk of primary liver cancer by birth cohort, race/ethnicity, and sex: Multiphasic health checkup study

Obesity and diabetes have been associated with liver cancer. However, recent US-based studies have suggested a lack of association between obesity and liver cancer among blacks and women

Quantitative lateral flow strip assays as user-friendly tools to detect biomarker profiles for leprosy

Leprosy is a debilitating, infectious disease caused by Mycobacterium leprae. Despite the availability of multidrug therapy, transmission is unremitting. Thus, early identification of M. leprae infection is essential to reduce transmission. The immune response to M. leprae is determined by host genetics, resulting in paucibacillary (PB) and multibacillary (MB) leprosy associated with dominant cellular or humoral immunity, respectively. This spectral pathology of leprosy compels detection of immunity to M. leprae to be based on multiple, diverse biomarkers. In this study we have applied quantitative user friendly lateral flow assays (LFAs) for four immune markers (anti-PGL-I antibodies, IL-10, CCL4 and IP-10) for whole blood samples from a longitudinal BCG vaccination field-trial in Bangladesh. Different biomarker profiles, in contrast to single markers, distinguished M. leprae infected from non-infected test groups, patients from household contacts (HHC) and endemic controls (EC), or MB from PB patients. The test protocol presented in this study merging detection of innate, adaptive cellular as well as humoral immunity, thus provides a convenient tool to measure specific biomarker profiles for M. leprae infection and leprosy utilizing a field-friendly technology

Does Closed Incision Negative Pressure Wound Therapy Reduce Surgical Site Infection in Endometrial Carcinoma Patients Undergoing Laparotomy? A Multicentre Retrospective Cohort Study

Abstract Background: Endometrial cancer is the most common gynaecological cancer and has a strong association with obesity. Surgical site infection (SSI) carries high morbidity and is more frequent in obese patients. Closed incision negative pressure wound therapy (ciNPWT) has been proposed to reduce wound morbidity but is more expensive than standard dressings whilst the evidence has been very heterogenous. There is limited evidence to justify this expensive dressing as related to its effectiveness in gynaecological oncology patients. ciNPWT was introduced in New Zealand in 2017 based on the available evidence from studies on SSI in the obstetric population. The aim of this study is to investigate the rate of SSI in patients with endometrial carcinoma undergoing laparotomy using standard surgical dressings compared to ciNPWT. Methods: We performed a retrospective analysis of 170 patients who underwent a laparotomy for endometrial carcinoma between 2018 and 2019 across three hospitals in New Zealand after the introduction of ciNPWT. Dressings were applied according to individual surgeons’ preferences. Standard dressings and ciNPWT were compared in the occurrence of SSI, wound dehiscence, readmission and return to theatre rates using logistic regression in order to account for potential confounding due to the patient demographics and oncologic and surgical characteristics. Results: There were 129 patients in the standard dressing group and 41 patients in the ciNPWT group. The mean age was 60.4 years (range 25–86). The mean body mass index (BMI) was 38.2 kg/m2 (range 20–69 kg/m2). The percentage of patients who experienced a SSI was higher in the ciNPWT group (34.2% vs. 20.9%; p = 0.159). There was no significant difference between the dressing groups in the occurrence of superficial SSI rate, return to theatre, or readmission. Wound dehiscence and deep/organ space SSI were however worse with ciNPWT (adjusted odds ratio (aOR) 4.09 and aOR 7.19, respectively). Conclusions: This study demonstrated no evidence for the benefit of ciNPWT, and higher rates of deep/organ space SSI. More randomised trials are needed to investigate whether gynaecological oncology patients may benefit from ciNPWT thus justifying the extra cost of this dressing

The merger of vertically offset quasi-geostrophic vortices

We examine the critical merging distance between two equal-volume, equal-potential-vorticity quasi-geostrophic vortices. We focus on how this distance depends on the vertical offset between the two vortices, each having a unit mean height-to-width aspect ratio. The vertical direction is special in the quasi-geostrophic model (used to capture the leading-order dynamical features of stably stratified and rapidly rotating geophysical flows) since vertical advection is absent. Nevertheless vortex merger may still occur by horizontal advection. In this paper, we first investigate the equilibrium states for the two vortices as a function of their vertical and horizontal separation. We examine their basic properties together with their linear stability. These findings are next compared to numerical simulations of the nonlinear evolution of two spheres of potential vorticity. Three different regimes of interaction are identified, depending on the vertical offset. For a small offset, the interaction differs little from the case when the two vortices are horizontally aligned. On the other hand, when the vertical offset is comparable to the mean vortex radius, strong interaction occurs for greater horizontal gaps than in the horizontally aligned case, and therefore at significantly greater full separation distances. This perhaps surprising result is consistent with the linear stability analysis and appears to be a consequence of the anisotropy of the quasi-geostrophic equations. Finally, for large vertical offsets, vortex merger results in the formation of a metastable tilted dumbbell vortex.Publisher PDFPeer reviewe