Vizzardi E et al. – Anaemia is one of the most frequent co–morbidities in patients with heart failure. Its prevalence increases from 4% to7% in subjects with asymptomatic left ventricular dysfunction to >30% in patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators and treatment with renin–angiotensin antagonists seem to be its main determinants. The results of many studies agree in providing evidence that anaemia is a powerful independent determinant of survival in patients with heart failure. However, the mechanisms of this relation are still not fully understood. Moreover a favourable effect of the correction of anaemia on prognosis has not yet been shown. Also In addition to this, controlled studies assessing its effects on exercise tolerance have yielded controversial results.
Day: 12/20/2010
Brain tumors
Brain tumors have special oncological significance. The prognosis of brain tumors is mostly poor, and they are also connected to functional and cognitive deficiencies, as well as possible personality changes. Therefore, the social impact of the disease has special significance as it also affects family and friends of patients with brain tumors. This review focuses on different professional arenas that can psychologically facilitate for the patient and/or for their next of kin. The different arenas discussed are: the patient-physician relationship, the specialist nurse function, functional and cognitive rehabilitative efforts, and support groups. The patient-physician relationship is important, but there is a lack of knowledge of its psychological impact outside of information giving. The few studies conducted on the specialist nurse function are quite unanimous about its facilitating value and this mainly seems to pertain to the next of kin. Functional rehabilitative efforts seem to be worthy, but even if there are promising results, there is still lack of knowledge of the potential of cognitive rehabilitation. Although there is a long history of peer support groups for patients with brain tumors, we do not know enough about the potential in professionally initiated supportive groups or different Internet forums. When initiating further studies within the different arenas for the purpose of understanding how to facilitate for patients with brain tumors and their families, we should also consider the psychological meaning of the activity/intervention.
source: springer link
Everolimus in the treatment of renal cell carcinoma and neuroendocrine tumors
Renal cell carcinoma (RCC) and neuroendocrine tumors (NET) are uncommon malignancies, highly resistant to chemotherapy, that have emerged as attractive platforms for evaluating novel targeted regimens. Everolimus is an oral rapamycin derivative within the mammalian target of rapamycin class of agents. Preclinical series have shown that everolimus exhibits anticancer effects in RCC and NET cell lines. A phase 3 placebo-controlled study in advanced clear-cell RCC, known as RECORD-1 (for “REnal Cell cancer treatment with Oral RAD001 given Daily”), documented that everolimus stabilizes tumor progression, prolongs progression-free survival and has acceptable tolerability in patients previously treated with the multikinase inhibitors sunitinib and/or sorafenib. Everolimus has been granted regulatory approval for use in sunitinib-pretreated and/or sorafenib-pretreated advanced RCC and incorporated into clinical practice guidelines, and the RECORD-1 safety data are being used to develop recommendations for managing clinically important adverse events in everolimus-treated patients. Ongoing clinical trials are evaluating everolimus as earlier RCC therapy (first-line for advanced disease and as neoadjuvant therapy), in non-clear-cell tumors, and in combination with various other approved or investigational targeted therapies for RCC. Regarding advanced NET, recently published phase 2 data support the ability of everolimus to improve disease control in patients with advanced NET as monotherapy or in combination with somatostatin analogue therapy, octreotide long-acting release (LAR). Forthcoming data from phase 3 placebo-controlled trials of everolimus, one focused on monotherapy for pancreatic NET and the other on combination use with octreotide LAR for patients with advanced NET and a history of carcinoid syndrome, will provide insight into its future place in NET therapy. The results of a number of ongoing phase 3 evaluations of everolimus will determine its broader applicability in treating breast cancer (in combination with chemotherapy and hormonal therapy), several advanced gastrointestinal cancers, hepatocellular carcinoma, and lymphoma (in the adjuvant setting), as well as the various lesions associated with the tuberous sclerosis complex tumor suppressor gene.
source: springerlink
Anzemet Injection Contraindicated for Nausea, Vomiting Related to Chemotherapy
The injectable form of dolasetron mesylate (Anzemet) should not be used to prevent nausea or vomiting related to chemotherapy because the drug increases the risk for torsade de pointes, the FDA announced on Friday.
The FDA recommends against using Anzemet injections in patients with congenital long-QT syndrome.
The warning does not apply to Anzemet tablets because the risks for developing an abnormal heart rhythm are not as high as with the injections
ARYAN'S BLOG 