2,431 research outputs found
Bleomycin-induced pneumonitis
The cytotoxic agent bleomycin is feared for its induction of sometimes
fatal pulmonary toxicity, also known as bleomycin-induced pneumonitis
(BIP). The central event in the development of BIP is endothelial damage
of the lung vasculature due to bleomycin-induced cytokines and free
radicals. Ultimately, BIP can progress in lung fibrosis. The diagnosis is
established by a combination of clinical symptoms, radiographic
alterations, and pulmonary function test results, while other disorders
resembling BIP have to be excluded. Pulmonary function assessments most
suitable for detecting BIP are those reflecting lung volumes. The widely
used transfer capacity of the lungs for carbon monoxide appeared recently
not to be specific when bleomycin is used in a polychemotherapeutic
regimen. There are no proven effective treatments for BIP in humans,
although corticosteroids are widely applied. When patients survive BIP,
they almost always recover completely with normalization of radiographic
and pulmonary function abnormalities. This review focuses on BIP,
especially on the pathogenesis, risk factors, and its detection
Tijd om persoonlijk te worden
Rede,
in verkorte vorm uitgesproken
ter gelegenheid van het aanvaarden
van het ambt van bijzonder hoogleraar met als
leeropdracht Translationele Medische Oncologie
aan het Erasmus MC, faculteit van de
Erasmus Universiteit Rotterdam
op 20 april 201
Symptoms and functional status of patients with disseminated cancer visiting outpatient departments
Considerable research has focused on pain and other symptoms in terminal cancer patients referred to hospices and palliative care services. These patients differ from Dutch cancer patients in the palliative stage of their disease because the latter are cared for by general practitioners at home and medical specialists in outpatient departments. To clarify the experience of these Dutch patients, a study was started to investigate the prevalence and severity of pain and other symptoms as well as the functional status of consecutive patients visiting oncology outpatient departments for follow-up. After randomization, one group (I) of patients was interviewed at home by a general practitioner using structured questionnaires. The other group (II) received the questionnaires by mail, and scored the symptoms independently. The results of the symptom assessment show that patients in groups I and II suffered 2.4 (SD = 1.7) and 2.8 (SD = 2.0) symptoms, respectively. Between 30% and 40% of all patients reported constipation, nausea, loss of appetite, coughing, and dyspnea. These percentages were 50% lower when only moderate, severe, or extremely distressing symptoms were included. Sixty percent of all patients had pain, and 20% indicated a daytime pain score of 5 or greater on a scale of 0 to 10. Functional status was measured by the COOPWONCA charts; the mean score for the charts "physical fitness" and "daily activities" was 1.5 points lower for cancer patients than a random sample from the community of the same age and gender. The findings of this study should motivate doctors to put more energy in symptom assessment and interventions in palliative care. Record 29 of 32 - SilverPlatter MEDLINE(R)
Aplastic anaemia: a review
Aplastic anaemia is featured by bone marrow hypocellularity and peripheral
pancytopenia and is a potentially fatal disease. In recent years, insight
in it pathogenesis has increased. It appears that activated autoreactive T
lymphocytes induce apoptosis of haematopoietic stem cells resulting in a
hypocellular bone marrow. Nowadays, it can be treated by stem cell
transplantation or immunosuppressive therapy. This review focuses on the
pathophysiology and treatment of aplastic anaemia
De rol van circulerende tumorcellen bij het urotheelcarcinoom van de blaas
Patients with muscle-invasive urothelial cell carcinoma of the bladder have a 50 % chance to develop distant metastases despite curative local treatment. Reliable markers that predict the risk of developing metastases or that could be used to determine whether or not perioperative systemic treatment should be given are lacking. Circulating tumor cells (CTCs) are cancer cells that are present in the blood stream of patients with solid tumors and originate from tumor lesions that are present in the body. The enumeration of CTCs is an attractive option to assess the chance to develop distant metastases in individual patients. Here, we set out to review the most relevant literature to date regarding the clinical value of CTCs in bladder cancer. Moreover, the CirGuidance study is presented, which is the first interventional trial, which uses CTCs to guide treatment choices regarding the administration of neoadjuvant chemotherapy in patients with muscle-invasive urothelial cell carcinoma
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