Sensor-Controlled Scalp Cooling to Prevent Chemotherapy-Induced Alopecia in Female Cancer Patients

Background: Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cOf the 55 patients, 78% underwent scalp cooling untilooling systems demonstrate varying results in terms of effectiveness and tolerability. Methods: For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (WHO) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy. Results: Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel–carboplatin experienced less alopecia. The compound successful outcome (“no head covering” plus “WHO grade 0/1”) was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel–cyclophosphamide or 6 cycles of paclitaxel–carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel–doxorubicin–cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil–epirubicin–cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin–cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens. Conclusions: The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the patient. Use of a compound endpoint with subjective and objective measures provides insightful and practical information when counselling patients

Recommendations for the use of serious games in neurodegenerative disorders: 2016 Delphi Panel

The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer's disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients' treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician. © 2017 Manera, Ben-Sadoun, Aalbers, Agopyan, Askenazy, Benoit, Bensamoun, Bourgeois, Bredin, Bremond, Crispim-Junior, David, De Schutter, Ettore, Fairchild, Foulon, Gazzaley, Gros, Hun, Knoefel, Olde Rikkert, Phan Tran, Politis, Rigaud, Sacco, Serret, Thümmler, Welter and Robert

Gående och cyklister i små orter : resultat av litteraturstudie

De framträdande riktningarna som kan spåras från genomgången av litteraturstudien visar att kunskapen gällande tekniska lösningar samt förståelsen för problemet med oskyddade trafikanterna i den aktuella miljön är relativt stor. En tendens som går att urskilja är att studierna ofta behandlar frågorna var för sig och främst fokuserar på planering, säkerhet och trygghet och inte så mycket på framkomlighet.Det som, utifrån resultaten i databassökningen, saknas är en bredd av studier avseende oskyddade trafikanters möjlighet att färdas med samma typ av transportkvalitet som övriga trafikantgrupper och framför allt på landsbygden eller i små orter. Studier som tar ett helhetsgrepp om de oskyddades situation i den aktuella miljön bör därför ses som önskvärda. Den svenska utformningspricipen för landsbygd utgår från människors resande med bil vilket yttrar sig i detaljerade anvisningar för utformning för fordonstrafik, det finns dock begränsade anvisningar som i samma omfattning tar hänsyn till de oskyddade trafikanternas anspråk.I rapporten redovisas den funna sakkunskapen i befintlig litteratur med uppdelning i olika miljöer och angreppssätt.Godkänd; 2012; 20120330 (petros