Randomized controlled trial on the effect of 1-hour infusion of vincristine versus push injection on neuropathy in children with cancer (final analysis)

Introduction: Vincristine is an integral component of treatment for children with cancer. Its main dose-limiting side effect is vincristine-induced peripheral neuropathy (VIPN). The VINCA trial was a randomized controlled trial that explored the effect of 1-hour infusion compared with push injection of vincristine on the development of VIPN in children with cancer. The short-term outcomes (median follow-up 9 months) showed that there was no difference in VIPN between the randomization groups. However, 1-hour infusion was less toxic in children who also received azoles. We now report the results of the final analyses (median follow-up 20 months), which includes treatment outcome as a secondary objective (follow-up 3 years). Methods: VIPN was measured 1–7 times per participant using the Common Terminology Criteria for Adverse Events (CTCAE) and the pediatric-modified total neuropathy score. Poisson mixed model and logistic generalized estimating equation analysis for repeated measures were performed.Results: Forty-five participants per randomization group were included. There was no significant effect of 1-hour infusion compared with push injection on VIPN. In participants receiving concurrent azoles, the total CTCAE score was significantly lower in the one-hour group (rate ratio 0.52, 95% confidence interval 0.33–0.80, p = 0.003). Four patients in the one-hour group and one patient in the push group relapsed. Two patients in the one-hour group died. Conclusion:1-hour infusion of vincristine is not protective against VIPN. However, in patients receiving concurrent azoles, 1-hour infusion may be less toxic. The difference in treatment outcome is most likely the result of differences in risk profile.</p

Vincristine-induced peripheral neuropathy in pediatric oncology: A randomized controlled trial comparing push injections with one-hour infusions (the vinca trial)

Vincristine (VCR) is a frequently used chemotherapeutic agent. However, it can lead to VCR-induced peripheral neuropathy (VIPN). In this study we investigated if one-hour infusions of VCR instead of push-injections reduces VIPN in pediatric oncology patients. We conducted a multicenter randomized controlled trial in which participants received all VCR administrations through push injections or one-hour infusions. VIPN was measured at baseline and 1–5 times during treatment using Common Terminology Criteria of Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score. Moreover, data on co-medication, such as azole antifungals, were collected. Overall, results showed no effect of administration duration on total CTCAE score or ped-mTNS score. However, total CTCAE score was significantly lower in patients receiving one-hour infusions concurrently treated with azole antifungal therapy (β = −1.58; p = 0.04). In conclusion, generally VCR administration through one-hour infusions does not lead to less VIPN compared to VC

A cross-sectional study about the relationship between morphology and kinematic parameters in children between 15 and 36 months

A

How to engage the museum visitor in the ethic debate on the display of human remains: the Post Mortem exhibition as a case study

The University of Ghent plans to open a new science museum in 2019. Academic collections from various disciplines, currently scattered throughout the campus, will be centralized in a permanent exhibition on the nature of science. In her mission statement the Ghent University Museum focuses on a philosophical storyline, a metaphysic rather than a historical vision on science. The museological scenography will aim to engage the visitor through evoking ethical reflections on science and scientific practice. To test and fine-tune this approach, the museum is currently engaged in putting on temporary exhibitions. From the 15th of October to the 20th of December (2015) the “Post Mortem” exhibition ran in the library, laboratory and autopsy room of the department of Forensic Medicine, shortly after the department had moved. The show addressed the confrontation with the dead body through an art-science dialogue. The visitor was guided on a tour through a clinical setting juxtaposing medical, zoological, archeological and ethnographic collections alongside contemporary works of art. This created a stimulating platform that provoked numerous ethical questions such as “How and why does the scientist approach the dead body as a study object?”, “How can collections that result from medical research, be exhibited to the broad public without objectifying human remains?”. By including contemporary art, visitors became more aware and receptive to human aspects in those scientific disciplines that deal with the dead body. The show opened to a positive response from the press, attracting more than 5000 visitors over the course of 10 weekends

Post-mortem high-field magnetic resonance imaging: Effect or various factors

Purpose: To evaluate image quality and diagnostic accuracy of high-field post-mortem (PM) magnetic resonance imaging (MRI) on fetuses below 20 weeks of gestation before and after the freeze-thaw process. Materials and methods: Nine fetuses were scanned with three different scanning procedures: "fresh", just after termination of pregnancy (TOP), "non-fresh short scan" and "non-fresh long scan" after being kept at-20°C, followed by a conventional autopsy. The brain, thorax except the heart, heart and abdomen were studied. The qualities of the images for the four different fetal regions and for the three different scanning procedures were reported. Regression analysis was used to investigate the effect on image quality of different factors. Additionally, the diagnostic accuracy was also evaluated. Results: Fetuses at 12.0-19.6 weeks were included. Regression analysis showed that better image quality was correlated to advanced gestation at TOP and scan on fresh fetuses. PM-MRI on fresh fetuses was always diagnostic for the brain and in more than half of cases on non-fresh fetuses and was nearly equally diagnostic for thoracic and abdominal structures. Conclusion: High-field PM-MRI seems to offer a quite reliable alternative to the parents declining conventional PM for fetuses before 20 weeks whether these fetuses are freshly scanned or after being frozen. © 2013 Informa UK Ltd.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Fetal organ weight estimation by postmortem high-field magnetic resonance imaging before 20 weeks' gestation

Objective To ascertain whether high-field magnetic resonance imaging (MRI) allows accurate estimation of the weight of various fetal organs at postmortem before 20 weeks' gestation. Methods From 23 fetuses at 9-20 weeks, following termination of pregnancy or in-utero fetal death (IUFD), 207 assorted fetal organs were evaluated by high-field MRI at 9.4 T prior to conventional autopsy. Fetal organ density was calculated by correlating volume and weight at autopsy using linear regression analysis, and this was used to estimate fetal organ weight by MRI. The relative error in MRI estimation of organ weight was calculated as follows: (SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Development of a continuous reactor for emulsion-based microencapsulation of hexyl acetate with a polyuria shell

Microencapsulation is almost exclusively performed in batch processes. With today's chemistry increasingly performed in flow reactors, this work aims to realise a continuous reactor setup for the encapsulation of an ester with a polyuria (PU) shell. The generation of an emulsion template is performed in a recirculation loop driven by a pump and equipped with static mixers, screen type and Kenics®. Calorimetric measurements are performed to characterise the energy dissipation rate inside the loop. The curing step is performed in a coiled tube reactor with two geometric configurations. Number based capsule size distributions are derived from micrograph analysis. Results indicate that the recycle pump is the main contributor to determine the capsule size distribution. A continuous setup is achieved for PU microcapsules containing hexyl acetate with a production rate of 198 g/h dry capsules, and a mean capsule diameter of 13.3 µm with a core content of 54 wt%.status: publishe

Development of a continuous reactor for emulsion-based microencapsulation of hexyl acetate with a polyuria shell

Microencapsulation is almost exclusively performed in batch processes. With today's chemistry increasingly performed in flow reactors, this work aims to realise a continuous reactor setup for the encapsulation of an ester with a polyuria (PU) shell. The generation of an emulsion template is performed in a recirculation loop driven by a pump and equipped with static mixers, screen type and Kenics((R)). Calorimetric measurements are performed to characterise the energy dissipation rate inside the loop. The curing step is performed in a coiled tube reactor with two geometric configurations. Number based capsule size distributions are derived from micrograph analysis. Results indicate that the recycle pump is the main contributor to determine the capsule size distribution. A continuous setup is achieved for PU microcapsules containing hexyl acetate with a production rate of 198g/h dry capsules, and a mean capsule diameter of 13.3 mu m with a core content of 54wt%