Chemoradiotherapy With Generic Cisplatin Formulations for Head and Neck Cancers.

The use of generic drugs has been increasing. However, studies of the safety of generic cisplatin (CDDP) for the treatment of head and neck cancer (HNC) have not been reported. This study investigated the treatment completion rates and incidence of CDDP-related adverse events in patients with advanced HNC treated with concurrent chemoradiotherapy (CRT) using generic CDDP. This study included 72 patients who received concurrent CRT using generic CDDP. The number of courses of CDDP was 3 in 45 patients, 2 in 19 patients, and 1 in 8 patients. During 154 courses of 80 mg/m2 generic CDDP, grade 3/4 leukopenia in 21 (14%), neutropenia in 18 (12%), and hypochromia in 8 (5%) cases were reported. Grade 2 elevated serum creatinine occurred in 4 cases (3%), but no grade 3/4 elevated serum creatinine was reported. These results suggest that CRT using generic CDDP is well tolerated in patients with HNC.

Decision making for position-dependent obstructive sleep apnea syndrome on the basis of patient information and physical examinations of the upper airway, acquired on an outpatient basis.

CONCLUSIONS: Patients with body mass index (BMI) < 25 kg/m2 and obstructive sleep apnea syndrome (OSAS) are highly suspicious for position-dependent OSAS. Diagnosis of position-dependent/position-independent OSAS can be difficult in patients satisfying both 'BMI >25 kg/m2' and 'any of tongue enlargement (TE), palatine tonsil hypertrophy (PTH) and obstruction by Muller's maneuver (OMM)'. Polysomnography is warranted in such patients. OBJECTIVES: The objective was to retrospectively elucidate criteria for differentiating position-dependent OSAS on the basis of patient information and physical examinations of the upper airway obtainable in clinics. METHODS: The 643 patients were categorized as positional patients (PPs) or non-positional patients (NPPs). The patient background factors examined were sex, age, BMI, and hypertension. TE, PTH, pharyngeal tonsil hypertrophy, and OMM were evaluated. Cross-validation was performed using even-numbered registrations as the training set group (Group A) and odd-numbered registrations as the test case group (Group B). RESULTS: In Group A, patients with BMI <25 kg/m2 were clearly more frequent among PP than among NPP. In Group A with BMI ≥25 kg/m2, significant differences were found for TE, PTH and OMM. Significant differences were found between 0 and 1/2/3 for number of factors. Results generated from Group A were validated in Group B.

Clinical education and cultural diversity in physical therapy: clinical performance of minority student physical therapists and the expectations of clinical instructors.

Clinical education is an integral part of preparation for the profession of physical therapy and the role of the clinical instructor is critical. The purpose of this study was to investigate clinical instructors' expectations of student physical therapists with different ethnic backgrounds and the clinical performance of the students as assessed using a modification of the Generic Abilities Assessment. For this study, individuals with a Caucasian ethnic background who were raised in the United States were considered as the majority. The remaining individuals (minority) were subdivided into five groups: African American, Hispanic, Asian/Pacific Islander, Caucasian from outside the United States, and Other. Clinical instructors reported their experiences with students from different ethnic backgrounds, their expectation of students' performance, and recollections of specific weaknesses in performance. From the 216 surveys distributed, 192 clinical instructors responded. Fifty-seven percent had supervised a minority student, with a mean of three students each. While 4% reported that they expected a higher standard from majority students, 17% noted a difference in performance between majority and minority students. Results from this study suggest that minority students would benefit from further preparation in communication and interpersonal skills but they are stronger than majority students in stress management and the effective use of time and resources.