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<p>Objectives: We developed versions 2 and 3 of the Biological Prognostic Score (BPS) for advanced cancer patients and confirmed the prediction accuracy. Methods: We conducted a parametric survival analysis using blood test data, performance status (PS), clinical symptoms, age, sex, and cancer type as variables for advanced cancer patients who completed or suspended cancer treatment, in the development of BPS2 and BPS3. We then prospectively compared the accuracy between BPS2/BPS3 and the Palliative Prognostic Index (PPI). Results: We developed the BPS2 and BPS3 based on the data from 589 patients in a development cohort. While the former version was calculated based on the cholinesterase, blood urea nitrogen, and white blood cell counts, the latter was calculated based on the BPS2, ECOG PS and edema. For 206 patients in a validation cohort, the overall accuracy in prediction of survival for 3 and 6 weeks using the BPS2 and BPS3 were significantly higher than those for the PPI. Conclusion: The usefulness of BPS2 and BPS3 was suggested.</p>
ABSTRACT
<p>Consultations with patients who bring drugs, especially on the high risk drug list, to a hospital is an important role of pharmacists. However, many incident reports occur though pharmacists generally make an effort to check such medications. In Japan, incidents are mostly reported just in terms of numbers but not in terms of the prevalence of a target group. We aim to reveal the prevalence of incidents related to medicine brought-in by patients undergoing surgery in National Hospital Organization (NHO) hospitals. For our study, we extracted patients undergoing surgery who were prescribed antidiabetic agents from the Medical data bank (MIA) in NHO. Chart reviews were performed on patients to evaluate the number of incidents in relation to brought-in medicine. The prevalence of incidents of interest was 4.4% (41/931, 95%CL : 3.2-5.9%). Pre-avoidable incidents represented 56.1% (23/41, p<0.0001). We found that pharmacists play a role in making incidents less severe.</p>
ABSTRACT
PREAVOID is pharmaceutical intervention that is utilized to illustrate pharmacists’ contributions to medical care. Currently, there is a great need for pharmacists to provide good medical services to inpatients; as a result, many pharmacists conduct pharmaceutical management in hospital wards. However, pharmacists who have limited experience in working in the ward do not know exactly what they should check with respect to pharmaceutical management. To resolve this problem, we determined 16 pharmaceutical-management items based on PREAVOID that was conducted at Nagara Medical Center. Moreover, we conducted a pre-questionnaire survey assessing whether pharmacists who had worked in the ward for fewer than 4 years attended to these 16 check items in their daily work prior to our introducing the list to them. The results indicated that pharmacists who had fewer than 2 years of experience working in wards attended to the 16 check items less than those who had more than 2 years of experience, and approximately half of the pharmacists had not received adequate guidance before beginning work at the ward. In addition, most pharmacists indicated that clear check points were useful for conducting pharmaceutical management and the 16 check items were useful for their daily work. These results indicate that the 16 check items are a useful educational tool for enabling pharmacists to conduct high quality pharmaceutical management from the initial stage and that using the 16 check items is superior to pharmacists only gaining this ability via prolonged experience working in the ward.
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Objective: To develop and confirm the validity of a Biological Prognostic Score using only blood test results for prediction of prognosis in patients with advanced cancer. Methods: We conducted parametric survival time analysis using blood test results, age, sex, and primary diagnosis as independent variables, and event of death as a dependent variable, among patients in a palliative care unit (a development cohort). We then developed the Biological Prognostic Score (BPS). Thereafter, we confirmed the accuracy of the BPS and the Palliative Prognostic Index (PPI) prospectively among patients, who withdrew or withheld further curative or life-prolonging therapies, in other facilities (a validation cohort). Results: We developed the BPS, which consists of cholinesterase, blood urea nitrogen, and total iron-binding capacity, from 122 patients in a development cohort. We then examined 195 patients in a validation cohort and found that the area under the receiver operating characteristic curve for 1-9 week survival prediction was BPS=0.76-0.86 and PPI=0.69-0.73. Discussion: Our results suggest that the BPS was valid. It will be necessary to perform further examinations in multiple facilities and to explore more generalized parameters that could replace total iron-binding capacity in our BPS.
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Euphorbia tirucalli [Euphorbiaceae family] an environmental risk factor for Burkitt's lymphoma also has pharmacological activities. In the northeast of region in Brazil its latex is used as an antimicrobial, antiparasitic in the treatment of coughs, rheumatism, cancer and other disease as folk treatment. The prevalent constituents of this plant latex are diterpenes from the Inganen types [ingenol esters] as well as the tigliane [phorbol esters]. Scientifically, there is not any data till now about anticancer effects of the Euphorbia tirucalli Linn., since the Ingenol esters have already presented tumor-promoting ability. Microtubules [MTs], and cytoskeletal proteins are essential in eukaryotic cells for a variety of functions, such as cellular transport, cell motility and mitosis. Single Inganen in cytoplasm can interact with these proteins and affect on their crucial functions. In this study, we showed the effects of Inganen on MT organization using ultraviolet spectrophotometer and fluorometry. The fluorescent spectroscopy showed a significant tubulin conformational change at the presence of Inganen which decrease polymerization of tubulin as well as the ultraviolet spectroscopy results. The aim of this study is to find the potential function of Inganen for treatment of cancer in cells and human organs
Subject(s)
Humans , Euphorbia/chemistry , Microtubules/chemistry , Microtubules/drug effects , Polymers/chemistry , Spectrometry, FluorescenceABSTRACT
This article surveys current technical advancement in neuroendovascular therapy. The technical advancement happens not only in the field of products of microcatheter and guide wire but in the field of diagnosis. In the local intraarterial fibrinolysis, diffusion weighted MR imaging allows us more precise patient selection. In the atherosclerotic lesions, stent is clinically available. Some types of stent can be used in intracranial arteries. In the acutely ruptured aneurysm, intraanerysmal embolization using Guglielmi detachable coil followed by intratechal tissue-type plasminogen activator reduced occurring rate of vasospasm. In the wide neck aneurysm, neck plasty technique brings us better results. Neuroendovascular therapy is still evolving supported by such technical advancement.
Subject(s)
Aneurysm , Aneurysm, Ruptured , Arteries , Diagnosis , Diffusion , Diffusion Magnetic Resonance Imaging , Fibrinolysis , Magnetic Resonance Imaging , Neck , Patient Selection , Stents , Tissue Plasminogen ActivatorABSTRACT
The purpose of this study was to clarify the effects of amino acid supplementation on mental and physical stress during severe exercise. 20 male college students were assigned to amino acid treated group (group AA) and placebo treated group (group P), each containing 10 subjects, and performed 1600 m-run relay for 24 hours. Each subjects of AA group received 1 g of amino acid powder, containing 34% of branched-chain amino acid (BCAA), after each work bout. The score of rating of perceived exertion (RPE) and category rate of pain scale (CPS) for each work bout were recorded. Scoring of profile of mood states (POMS) was performed and blood samples were drawn at pre-, mid-, and post-session. Total running distance was similar in both groups. In group AA, compared with group P, (1) total score of RPE and CPS through 25 work bouts and plasma cortisol concentration (C) at post- was significantly lower, and (2) molar ratio of plasma free testosterone concentration (FTS) to C (FTS/C) at mid- was significantly greater. In group P alone, plasma BCAA concentration, FTS, FTS/C, and POMS score about ‘tension-anxiety’, ‘anger-hostility’ and ‘vigor’ decreased significantly over time. Our data suggest that BCAA administration during severe exercise may diminish mental or physical stress, inhibit FTS/C decrease and be effective in maintaining aggressive mentality.
ABSTRACT
Students and general long distance runners carried out 1600m run for 24 hours and their physical functions were measured with lapse of the relay. Following results were obtained.<BR>1) Prolongation of mean running time of student long distance runners in 1600m runs appeared at about 8th-10th runs, 12.8-16.0km, but that of general long distance runners did at 5th-6th runs, 8-9.6km.<BR>2) There was plus correlation between mean of running time and its standard deviation in 1600m runs. It was r=0.55 and its regression equation was Y=0.58X-162.3. But these of general long distance runners were r=0.53 and Y=0.358X-97.3, respectively.<BR>3) Decreased body weight from 1st-8th run was great and succesive, and occupied about 30%-70% of final decreased body weight. Thereafter, increase or decrease of the body weight was repeated and the time course became slow. There were some runners who showed large and succesive decreased body weight with the runs through the competition. The decreased body weight during the competition was influenced by the wind velocity, which supressed it considerably.<BR>4) Heart rate of a student long distance runner during 1600m run reached 180-189 beats per minute every run. Resting heart rate of general and student long distance groups showed circadian rhythm during the competition, but that of student runners was higher through the competition and their systolic pressure shows a tendency to below in later period of the competition.<BR>5) Threshold of knee jerk was low in the initial few runs and thereafter showed circadian rhythm. Reaction time to light was also facilitated in the initial runs and there-after prolonged about 30msec and maintained till the end of the competition. Frequency of subjective symptoms increased with number of the runs. At middle of the competition, it came over Sakai's standard and the A, B and C symptoms at the end of the competition were 33.0%, 20.0% and 25.0%, respectively.<BR>6) Calorie intake per day of the student long distance runners was in the range of 1240-2540Cal. Total energy consumption was estimated 7457Cal. per day.<BR>7) Blood glucose of the student long distance runners mostly unchanged through the competition, but serum triglyceride and total phospholipids significantly decreased and inversely serum free fatty acids prolongly mobilized.