ABSTRACT
Myeloablative chemotherapy administered prior to autologous stem cell transplantation (auto-SCT) is associated with a significant amount of chemotherapy-induced nausea and vomiting (CINV). We conducted a phase II trial to assess the safety, efficacy, and impact on quality of life when palonosetron (PAL) 0.25 mg combined with dexamethasone were given on the final or only day of myeloablative chemotherapy for auto-SCT. The primary end point of this study was the incidence of achieving a delayed CINV complete response defined as no emetic episode and no use of rescue medications during the 24-120 h period post chemotherapy. Eighty-five patients were enrolled in the study and received PAL. A delayed CINV complete response was achieved in 15% of patients. A multivariate analysis demonstrated no associated differences between age, gender, diagnosis, or regimen. By day 5 after PAL, the mean nausea severity was 0.91 ± 2.45 vs. 0.09 ± 1.58 at baseline (p = 0.012). Quality of life measurements demonstrated similar quality of life between baseline and day 3. By day 6 however, nausea alone had a statistically significant impact on quality of life. In our study, PAL controlled nausea severity and sustained quality of life, but further strategies are needed to control delayed CINV associated with the auto-SCT process.
Subject(s)
Antiemetics/administration & dosage , Dexamethasone/administration & dosage , Nausea/prevention & control , Ondansetron/administration & dosage , Palonosetron/administration & dosage , Vomiting/prevention & control , Adult , Aged , Drug Administration Schedule , Female , Hematopoietic Stem Cell Transplantation , Humans , Male , Middle Aged , Myeloablative Agonists/adverse effects , Nausea/chemically induced , Quality of Life , Severity of Illness Index , Transplantation Conditioning/adverse effects , Transplantation, Autologous , Vomiting/chemically induced , Young AdultABSTRACT
Adipose tissue inflammation and reduced pancreatic ß-cell function are key issues in the development of cardiovascular disease and progressive metabolic dysfunction in type 2 diabetes mellitus. The aim of this study was to determine the effect of the DPP IV inhibitor sitagliptin on adipose tissue and pancreatic islet inflammation in a diet-induced obesity model. C57Bl/6J mice were placed on a high-fat (60% kcal fat) diet for 12 wk, with or without sitagliptin (4 g/kg) as a food admix. Sitagliptin significantly reduced fasting blood glucose by 21% as well as insulin by â¼25%. Sitagliptin treatment reduced body weight without changes in overall body mass index or in the epididymal and retroperitoneal fat mass. However, sitagliptin treatment led to triple the number of small adipocytes despite reducing the number of the very large adipocytes. Sitagliptin significantly reduced inflammation in the adipose tissue and pancreatic islet. Macrophage infiltration in adipose tissue evaluated by immunostaining for Mac2 was reduced by sitagliptin (P < 0.01), as was the percentage of CD11b+/F4/80+ cells in the stromal vascular fraction (P < 0.02). Sitagliptin also reduced adipocyte mRNA expression of inflammatory genes, including IL-6, TNFα, IL-12(p35), and IL-12(p40), 2.5- to fivefold as well as 12-lipoxygenase protein expression. Pancreatic islets were isolated from animals after treatments. Sitagliptin significantly reduced mRNA expression of the following inflammatory cytokines: MCP-1 (3.3-fold), IL-6 (2-fold), IL-12(p40) (2.2-fold), IL-12(p35) (5-fold, P < 0.01), and IP-10 (2-fold). Collectively, the results indicate that sitagliptin has anti-inflammatory effects in adipose tissue and in pancreatic islets that accompany the insulinotropic effect.
Subject(s)
Adipose Tissue/pathology , Anti-Inflammatory Agents , Dipeptidyl-Peptidase IV Inhibitors/pharmacology , Inflammation/pathology , Islets of Langerhans/pathology , Pyrazines/pharmacology , Triazoles/pharmacology , Adipocytes/pathology , Adipocytes/ultrastructure , Adiposity/drug effects , Animals , Body Weight/drug effects , Cytokines/metabolism , Flow Cytometry , Glucose/metabolism , Glucose/pharmacology , Glucose Intolerance/metabolism , Glucose Tolerance Test , Immunohistochemistry , Insulin/metabolism , Macrophages/drug effects , Male , Mice , Mice, Inbred C57BL , Mice, Obese , Neutrophil Infiltration/drug effects , Reverse Transcriptase Polymerase Chain Reaction , Sitagliptin PhosphateABSTRACT
We report an isolated musculocutaneous neuropathy caused by a proximal humeral osteochondroma that became symptomatic after the patient played recreational basketball. Lesion resection resulted in complete deficit resolution. Mass lesions involving the musculocutaneous nerve should be considered in patients with atraumatic, isolated musculocutaneous neuropathies that are recurrent or fail to recover, even in the setting of strenuous exercise.
Subject(s)
Bone Neoplasms/complications , Humerus , Musculocutaneous Nerve/physiopathology , Osteochondroma/complications , Peripheral Nervous System Diseases/etiology , Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Brachial Plexus/physiopathology , Humans , Magnetic Resonance Imaging , Male , Osteochondroma/diagnosis , Osteochondroma/surgery , Physical ExertionSubject(s)
Amyotrophic Lateral Sclerosis/complications , Lymphoproliferative Disorders/complications , Motor Neuron Disease/complications , Aged , Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/physiopathology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Lymphoproliferative Disorders/diagnosis , Lymphoproliferative Disorders/physiopathology , Male , Motor Neuron Disease/diagnosis , Motor Neuron Disease/physiopathology , Paraproteinemias/complicationsABSTRACT
Acrokeratosis paraneoplastica of Bazex is a rare cutaneous syndrome associated with malignant neoplasms of the pulmonary and upper gastrointestinal tract, or cervical metastatic adenopathy, usually seen in middle-aged white men. We present a unique case of Bazex syndrome in that the patient was young, black, and a woman.
Subject(s)
Keratosis/pathology , Paraneoplastic Syndromes/pathology , Adult , Facial Dermatoses/pathology , Female , Fingers/pathology , Hand Dermatoses/pathology , Humans , Lung Neoplasms/pathology , Sex FactorsABSTRACT
El objetivo de este trabajo es establecer el intervalo postmortem mediante el análisis químico de muestras de hueso. Como parámetros se estudiaron los porcentajes de hierro, fósforo, nitrógeno, humedad, cenizas secas y el nivel de fluorescencia. De ellos solamente el logaritmo del porcentje de nitrógeno y de cenizas secas mosstraron una correlación útil. Palabras claves: Intervalo postmortem, métodos químicos, muestras óseas.