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Search Results: 1 - 10 of 14115 matches for " Induction Therapy "
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Completion of Maintenance Bacillus Calmette-Guerin Therapy Might Prolong Recurrence-Free Survival in Patients with Non Muscle Invasive Bladder Cancer  [PDF]
Zaher Bahouth, Ismail Masarwa, Ofer Nativ, Sarel Halachmi
Open Journal of Urology (OJU) , 2015, DOI: 10.4236/oju.2015.56012
Abstract: Objective: The aim of our study was to compare recurrence-free survival between patients who completed treatment with maintenance Bacillus Calmette-Guerin (BCG) and patients who did not complete the planned treatment. Materials and Methods: Data on 115 patients with intermediate- and high-risk Non-Muscle Invasive Bladder Cancer (NMIBC) who were treated with BCG were available for analysis. Patients were categorized into 4 groups based on treatment duration: patients who completed three years of maintenance treatment, patients who stopped treatment while on maintenance, patients who were still on-treatment and patients who were treated with induction course only. Results: Of 115 patients, 86 were men and 29 were women with mean age of 67.8 (range 40 - 93) years. 51% had high-grade tumors and 49% had low-grade tumors. Seventy-three patients (63%) had multiple tumors. Thirty patients (26%) were treated with induction-only, 18 patients (16%) are on-treatment, 14 patients (12%) finished maintenance protocol and 53 patients (46%) discontinued treatment. Reasons for stopping treatment were disease recurrence in 13 patients and toxicity in 40 patients. 5-year recurrence-free survival was 100%, 63%, 60% and 56% in patients who completed maintenance treatment, stopped during maintenance treatment, were on-treatment and those who received induction only therapy, respectively. Conclusions: Patients should be encouraged to adhere to maintenance BCG treatment because of its favorable effect on recurrence-free survival probability.
Modern Immunosuppressive Therapy in Kidney Transplantation  [PDF]
Rubin Zhang
Open Journal of Organ Transplant Surgery (OJOTS) , 2013, DOI: 10.4236/ojots.2013.32005
Abstract:

Immunosuppressive therapy is a key component for successful kidney transplantation. It is commonly believed that more intensive immunosuppression is needed initially to prevent rejection episodes and less immunosuppression is subsequently maintained to minimize the overall risk of infection and malignancy. The selection of drugs should be guided by a comprehensive assessment of the immunologic risk, patient comorbidities, financial cost, drug efficacy and adverse effects. Lymphocyte-depleting antibody induction is recommended for patients with high immunologic risk, while IL-2R antibody can be used for low or moderate risk patients. Patients with very low risk may be induced with intravenous steroids without using an antibody. A maintenance regimen typically consists of a low-dose of steroid combined with two of the four class drugs: calcineurin inhibitor (tacrolimus or cyclosporine), antimetabolite (mycophenolate mofetil or enteric coated mycophenolate sodium), mTOR inhibitor (sirolimus or everolimus) and costimulation blocker (belatacept). Currently in the USA, the most popular maintenance is the combination of corticosteroid, mycophenolic acid and tacrolimus. Steroid minimization, or calcineurin inhibitor free or withdrawal should be limited to the highly selected patients with low immunological risk. Recently, the novel biological agent belatacept-based maintenance has demonstrated a significantly better renal function and improved cardiovascular and metabolic profile, which may provide hope for an ultimate survival benefit.

Induction therapy in heart transplantation
H. Lehmkuhl,M. Dandel,N. Hiemann,C. Knosalla
Transplantationsmedizin , 2011,
Abstract: Survival after heart transplantation (HTx) has improved considerably over the past 20 years. Half of all patients now live more than 13 years, and approximately more than 25% live more than 20 years. The long-term results of cardiac transplantation have continued to improve due to improved peri-operative care and immunosuppression regimens. The risk for acute rejection is highest early after HTx and therefore many transplant centers use a strategy of peri-operative induction therapy in order to provide a rapid and effective protection against acute allograft rejection (1,2).
Induction therapy in heart transplantation
H. Lehmkuhl,M. Dandel,N. Hiemann,C. Knosalla
Applied Cardiopulmonary Pathophysiology , 2011,
Abstract: Survival after heart transplantation (HTx) has improved considerably over the past 20 years. Half of all patients now live more than 13 years, and approximately more than 25% live more than 20 years. The long-term results of cardiac transplantation have continued to improve due to improved peri-operative care and immunosuppression regimens. The risk for acute rejection is highest early after HTx and therefore many transplant centers use a strategy of peri-operative induction therapy in order to provide a rapid and effective protection against acute allograft rejection (1,2).
Augmented Post-Induction Therapy for Children with High-Risk Acute Lymphoblastic Leukemia and a Slow Response to Initial Therapy
ATMA Rahman,SK Gupta,MA Mannan,K Nahar
Kathmandu University Medical Journal , 2012, DOI: 10.3126/kumj.v10i4.10996
Abstract: Background Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a poor outcome despite intensive therapy. We conducted a randomized trial in which such patients were treated with either an augmented intensive regimen of post-induction chemotherapy or a standard regimen of intensive post-induction chemotherapy. Objective To compare the effect of augmented therapy with standard intensive post induction therapy in children with high-risk ALL who entered remission after a slow response to initial therapy. Methods Between January 2005 and December 2011, 311 children with newly diagnosed ALL who were either 1 to 9 years of age with white cell counts of at least 50,000 per cubic millimeter or 10 years of age or older, had a slow response to initial therapy, and entered remission at the end of induction chemotherapy were randomly assigned to receive standard therapy (156 children) or augmented therapy (155). Those with lymphomatous features were excluded. Event-free survival and overall survival were assessed from the end of induction treatment. Results The outcome at five years was significantly better in the augmented-therapy group than in the standard-therapy group. The difference between treatments was most pronounced among patients one to nine years of age, all of whom had white-cell counts of at least 50,000 per cubic millimeter (P<0.001). Risk factors for an adverse event in the entire cohort included a white-cell count of 200,000 per cubic millimeter or higher (P=0.004). The toxic effects of augmented therapy were considerable but manageable. Conclusion Augmented post-induction chemotherapy results in an excellent outcome for most patients with high-risk ALL and a slow response to initial therapy. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10996 Kathmandu Univ Med J 2012;10(4):53-59
Brief review: management of lupus nephritis–randomized controlled trials: an update  [PDF]
Shih-Han S. Huang, Ainslie Hildebrand, William F. Clark
Open Journal of Internal Medicine (OJIM) , 2011, DOI: 10.4236/ojim.2011.12006
Abstract: Lupus nephritis leads to significant morbidity and mortality in patients with systemic lupus erythematous. Immunosuppressive agents are recommended in management of Class III, IV and V lupus nephritis. The goals of therapy are to control the disease and to prevent relapse while minimizing side-effects of therapy. Most of the evidences in managements of Class III and IV lupus nephritis comes from randomized controlled trials using intravenous cyclophosphamides, oral mycophenolate mofetil and oral azathioprine. In Class V lupus nephritis, there are few studies available and they have assessed the use of intravenous cyclophsophamide, oral mycophenolates mofetil and oral cyclosporine. In this review article, we have summarized the major randomized controlled trials in managements of Class III, IV and V lupus nephritis and offer an interpretation of the evidence to date.
Prognostic factors of resected node-positive lung cancer: location, extent of nodal metastases, and multimodal treatment
Alessandro Marra,Gunther Richardsen,Wolfgang Wagner,Carsten Müller-Tidow
GMS Thoracic Surgical Science , 2011,
Abstract: Objective: To investigate the prognostic significance of location and extent of lymph node metastasis in resected non-small cell lung cancer (NSCLC), and to weigh up the influence of treatment modalities on survival. Patients and method: On exploratory analysis, patients were grouped according to location and time of diagnosis of nodal metastasis: group I, pN2-disease in the aortopulmonary region (N=14); group II, pN2-disease at other level (N=30); group III, cN2-disease with response to induction treatment (ypN0; N=21); group IV, cN2-disease without response to induction treatment (ypN1-2; N=27); group V, pN1-disease (N=66). Results: From 1999 to 2005, 158 patients (median age: 64 years) with node-positive NSCLC were treated at our institution either by neoadjuvant chemo-radiotherapy plus surgery or by surgery plus adjuvant therapy (chemotherapy, radiotherapy, or both). Operative mortality and major morbidity rates were 2% and 15%. Five-year survival rates were 19% for group I, 12% for group II, 66% for group III, 15% for group IV, and 29% for group V (P<.05). On multivariate analysis, time of N+-diagnosis, extent of nodal involvement and therapy approach were significantly linked to prognosis. Conclusion: The survival of patients with node-positive NSCLC does not depend on anatomical location of nodal disease, but strongly correlates to extent of nodal metastases and treatment modality. Combined therapy approaches including chemotherapy and surgery may improve long-term survival.
COMPARATIVE EFFICACY OF HYPERTONIC SALINE AND NORMAL SALINE SOLUTIONS IN EXPERIMENTALLY INDUCED ENDOTOXIC SHOCK IN DOGS
M. A. ZAFAR, G. MUHAMMAD, M. H. HUSSAIN, T. AHMAD, A. YOUSAF AND I. SARFARAZ
Pakistan Veterinary Journal , 2009,
Abstract: This study was contemplated to determine the comparative beneficial effects of hypertonic saline solution and sterile saline solution in induced endotoxic shock in dogs. For this purpose, 12 healthy Mongrel dogs were randomly divided into two equal groups (A and B). All the animals were induced endotoxaemia by slow intravenous administration of Escherichia coli endotoxins 0111:B4. Group A was treated with normal saline solution @ 90 ml/kg BW, while group B was given hypertonic saline solution @ 4 ml/kg BW, followed by normal saline solution @ 10 ml/kg BW. Different parameters were observed for evaluation of these fluids including clinical and haematological parameters, serum electrolytes, mean arterial pressure, and blood gases at different time intervals up to 24 hours post treatments. After infusion of respective fluids, all parameters returned to baseline values in both the groups but group B showed better results than group A except bicarbonates, which better recovered in group A. Thus, it was concluded that a small-volume of hypertonic saline solution could be effectively used in reversing the endotoxaemia. Moreover, it provides a rapid and inexpensive resuscitation from endotoxic shock.
Overview of immunosuppression in liver transplantation
Anjana A Pillai, Josh Levitsky
World Journal of Gastroenterology , 2009,
Abstract: Continued advances in surgical techniques and immunosuppressive therapy have allowed liver transplantation to become an extremely successful treatment option for patients with end-stage liver disease. Beginning with the revolutionary discovery of cyclosporine in the 1970s, immunosuppressive regimens have evolved greatly and current statistics confirm one-year graft survival rates in excess of 80%. Immunosuppressive regimens include calcineurin inhibitors, anti-metabolites, mTOR inhibitors, steroids and antibody-based therapies. These agents target different sites in the T cell activation cascade, usually by inhibiting T cell activation or via T cell depletion. They are used as induction therapy in the immediate peri- and post-operative period, as long-term maintenance medications to preserve graft function and as salvage therapy for acute rejection in liver transplant recipients. This review will focus on existing immunosuppressive agents for liver transplantation and consider newer medications on the horizon.
Micro needling - Facts and Fictions
Amit Bahuguna
Asian Journal of Medical Sciences , 2013, DOI: 10.3126/ajms.v4i3.5392
Abstract: On 24th June 2013, the author's name was changed from Bahuga to Bahuguna. Two sentences were added to the section 'Tall Claims' on p.3. The corrected PDF is available by clicking on the link below. Micro needling or what is more commonly known as the derma-rolling is a new minimally-invasive avatar of an age old procedure. Micro needling has recently attained popularity as it is cheap, effective and can be used safely with minimal training. The basic principle is to create a controlled injury, thereby inducing the body to respond by producing more collagen in the treated area. Microneedling can be combined with other acne scar treatments for better results. Although it may not do justice to all the indications claimed by a plethora of manufacturers, if used judiciously it can prove to be a wonderful addition to the armamentarium of a dermatologist. DOI: http://dx.doi.org/10.3126/ajms.v4i3.5392 Asian Journal of Medical Sciences 4(2013) 1-4
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