ABSTRACT
Dacarbazine chemotherapy has been the mainstay of melanoma treatment for >30 years. In the early 2000s, carboplatin (with or without other agents, such as paclitaxel) was the most commonly used second-line therapy in the UK. The aim of the present study was to report a significant response rate to second-line carboplatin in patients from three UK institutions who had been previously treated and failed to respond to dacarbazine, and investigate whether sequential therapy may be more effective compared with combination therapy. A total of 104 patients were identified, the majority of whom were treated with carboplatin (area under the curve 5-6) every 3 weeks for a maximum of 6 cycles. A total of 102 patients were evaluable for response, among whom 11 patients had an objective response (1 complete response and 10 partial responses) and 15 had stable disease, giving an overall response rate of 11% and disease control rate of 26%. The median progression-free survival was 1.8 months (range, 0.2-36+ months) and the median overall survival was 4.6 months (range, 0.2-36+ months). Surprisingly, the majority of the patients who benefited from second-line carboplatin therapy were those with visceral metastases, the survival of whom would not be expected to exceed 6 months after first-line treatment.
ABSTRACT
Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare, chronic, inflammatory disorder with cutaneous and osteoarticular manifestations.1 The aetiology of SAPHO syndrome is unknown and therefore treatment is tailored towards the individual. Non-steroidal anti-inflammatory drugs, bisphosphonates, corticosteriods, antibiotics, disease modifying anti-rheumatic drugs and biologics have all been used with variable success.
Subject(s)
Acquired Hyperostosis Syndrome , Acne Vulgaris/etiology , Acne Vulgaris/pathology , Acquired Hyperostosis Syndrome/complications , Acquired Hyperostosis Syndrome/diagnostic imaging , Acquired Hyperostosis Syndrome/pathology , Female , Humans , Middle Aged , Psoriasis/etiology , Psoriasis/pathology , Radionuclide Imaging , Sacroiliac Joint/diagnostic imaging , Sacroiliac Joint/pathology , Skin/pathology , Sternoclavicular Joint/diagnostic imaging , Sternoclavicular Joint/pathology , Whole Body ImagingABSTRACT
After performing procedures involving sharps, many wards in St George's Hospital have no quick and accessible 'point of care' sharps bin for their safe disposal. Instead one must transport potentially hazardous equipment away from the bedside, risking injury and exposure to persons en route. Results from a questionnaire showed that 73% felt they were indeed poorly placed, 95% felt a portable sharps bin system was a good idea, and 95% felt their introduction would be safer. A one month trial of portable sharps bins on the Acute Medical Unit (AMU) showed that 97% felt that the portable sharps bin system reduced risk to themselves and others, 81% felt safer using them, and 90% felt safer knowing their colleagues were using them too. A recent audit in a six month period within 2012 established there were 148 reported needlestick injuries in St George's Hospital. This quality improvement project showed that a majority consensus felt that a portable sharps bin system would be safer than the system currently used and could potentially help reduce these numbers. This project also comes at a time when new EU legislation calls for safer sharps use and disposal and thus offers a solution to ultimately provide better, safer and more advanced safety practices when disposing of sharp equipment.
