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Daily administration of 2-chlorodeoxyadenosine (Cladribine, CDA) is a standard treatment for hairy cell leukemia, but may cause severe neutropenia and neutropenic fever. This trial compared toxicity and efficacy of weekly versus daily CDA administration. One hundred patients were randomized to receive standard (CDA 0.14 mg/kg/day day 1-5 [Arm A]) or experimental treatment (CDA 0.14 mg/kg/day once weekly for 5 weeks [Arm B]). The primary endpoint was average leukocyte count within 6 weeks from randomization. Secondary endpoints included response rates, other acute hematotoxicity, acute infection rate, hospital admission, remission duration, event-free, and overall survival. There was no significant difference in average leukocyte count. Response rate (complete + partial remission) at week 10 was 78% (95% confidence interval (CI) 64-88%) in Arm A and 68% (95% CI 54-80%) in Arm B (p = 0.13). Best response rates during follow-up were identical (86%) in both arms. No significant difference was found in the rate of grade 3+4 leukocytopenia (94%vs. 84%), grade 3+4 neutropenia (90%vs. 80%), acute infection (44%vs. 40%), hospitalization (38%vs. 34%), and erythrocyte support (22%vs. 30%) within 10 weeks. Overall, these findings indicate that there are no apparent advantages in toxicity and efficacy by giving CDA weekly rather than daily. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate strategies to prevent and treat cetuximab-induced skin reactions and their perceived effectiveness in patients with metastatic colorectal cancer (mCRC) and recurrent/metastatic squamous cell cancer of the head and neck (SCCHN)., Methods: This open-label, prospective observational study was conducted in Switzerland., Results: A total of 125 patients were included (n = 91 mCRC, n = 34 SCCHN; mean age 63.3 years; 73.6% males). The frequency of acneiform rash grade ≥ 2 increased from 12.6% at week 2 to 21.7% at week 16. The proportion of patients who reported no skin reaction decreased from 75.6% at week 2 to 43.3% at week 16. The most frequently used skin products at any time of observation were moisturizing (77.6%), lipid-regenerating (56.8%) or urea-containing products (52%), systemic antibiotics (49.6%), and vitamin K1 cream (43.2%). There was no clear effectiveness pattern for all product classes: in given patients, either the product showed no effect at all or a moderate/strong effect, consistently over time., Conclusions: A great variety of low-cost general skin care products were commonly used. According to physician's preference, systemic antibiotics and vitamin K1 cream are an appropriate approach to prevent or treat cetuximab-related skin toxicity.

Background: The aim was to evaluate quality of life (QoL), pain, and fatigue in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with different regimens after first-line docetaxel, as well as disease progression., Patients and Methods: Patients with mCRPC having received first-line chemotherapy with docetaxel were eligible. Second-line treatment choice was at the discretion of the local investigator. All patients had regular assessments of QoL with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, of fatigue with the Brief Fatigue Inventory, and of pain with the McGill Pain Questionnaire-Short Form. The primary end point was QoL maintenance defined as having a maximum decrease in 2 functional domains of the FACT-P., Results: One hundred thirty-eight patients were included in 36 oncology centers across Switzerland. QoL analysis was available for all patients (59 who received cabazitaxel; 79 who received other therapy [OT] including 75 who received abiraterone). No significant differences for any of the end points were found between groups. A numerically higher number of patients had QoL maintenance with OT (25 of 79 patients, 32%) compared with cabazitaxel (8 of 59 patients, 14%). QoL improvement was found in 20% of patients (12 of 59) who received cabazitaxel and 24% (19 of 79) who received OT. Mean FACT-P score did not change in a clinically relevant manner over time in either group. Pain was present in 70% of patients (96 of 138), and a pain response to treatment was noted in 22% (13 of 59) who received cabazitaxel and 29% (23 of 79) who received OT. A similar but minor improvement of fatigue was noted in both groups., Conclusion: Some degree of QoL decrease was seen in most patients regardless of second-line treatment. No significant differences in QoL parameters between cabazitaxel or other second line treatments were found., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Peripherally inserted central venous catheters (PICCs) are of growing interest because they allow intravenous therapies up to several months. The appropriate management of the PICCs is crucial to minimize complications and largely depends on the right information for everyone who cares for the patient. To reach this goal we develop the mobile application "PICC App" to provide the necessary information for all involved persons in the outpatient setting. We expect to be able to report about the PICC App and the results of the usability evaluation with pilot users.

The malignant lymphomas comprise a heterogeneous group of neoplastic diseases of the lymphatic system. In the WHO classification 70 different entities are subdivided. Each type of lymphoma is defined as a disease with specific clinical characteristics, as well as morphological, immunophenotypic and genetic characteristics. The indolent lymphomas include follicular lymphoma, marginal zone lymphoma, Lymphoplasmacytic lymphoma, small cell lymphocytic lymhoma/chronic lymphocytic leukemia, prolymphocytic leukemia and hairy cell leukemia. Indolent lymphomas are characterized by slow growth and a chronic course of the disease. Antibody-based therapies, have significantly improved the prognosis, nevertheless there is no curative treatment. Watch and wait is still an reasonable option in asymptomatic patients. The goal of therapy has been to maintain the best quality of life. and to avoid late toxicities. The following review presents the current treatment options.

This phase II trial investigated rituximab and cladribine in chronic lymphocytic leukemia. Four induction cycles, comprising cladribine (0.1 mg/kg/day days 1-5, cycles 1-4) and rituximab (375 mg/m(2) day 1, cycles 2-4), were given every 28 days. Stem cell mobilization (rituximab 375 mg/m(2) days 1 and 8; cyclophosphamide 4 g/m(2) day 2; and granulocyte colony-stimulating factor 10 microg/kg/day, from day 4) was performed in responders. Of 42 patients, nine achieved complete remission (CR), 15 very good partial remission, and two nodular partial remission (overall response rate 62%). Stem cell mobilization and harvesting (> or = 2 x 10(6) stem cells/kg body weight) were successful in 12 of 20 patients. Rituximab infusion-related adverse events were moderate. The main grade 3/4 adverse events during induction were neutropenia and lymphocytopenia. Rituximab plus cladribine was effective; however, the CR rate was modest and stem cell harvest was impaired in a large number of responding patients.

Dentists, dental hygienists and dental assistants due to the nature of their work-related physical activity often have to deal with physical stress that will cause actual physical damage. The aim of the current survey was to analyse the frequency of job-related pain and associated impairment. The questionnaire for the cervical and lumbal region of the North American Spine Society was modified and used in the present investigation. Out of 6962 subjects, 2025 returned the questionnaire (response rate 34.5%). Between 20% and 36% of the participants suffered from pain in the cervical and lumbal region and were impaired in their daily activities, particularly during the lifting of objects, while standing or sleeping. Almost 40% of the dentists and 53% of the dental hygienists/dental assistants experienced problems related to perceived pain during or after dental treatments. More than half of the participants had already sought out medical help and/or physiotherapy due to job-related pain. The present data indicate that prophylactic and therapeutically based preventative measures should be encouraged in order to prevent cervical and back pain in this affected occupational group.

Malignant tumors may affect the kidney in a direct and in an indirect fashion. In addition, there are multiple paraneoplastic syndromes and the side effects of the tumor therapy. Therefore, clinicians may encounter a wide spectrum of disorders representing almost all aspects of kidney diseases. Importantly, practitioners taking care of patients with glomerulopathies must always consider the possibility of a co-existence of a malignancy, as highlighted by our case report.

Background and Objective: Patients with COPD often have exertional dyspnoea. They are incapacitated less by impairment of pulmonary function than by deconditioning of the cardiovascular and muscular systems. Pulmonary rehabilitation through the currently customary "low intensity" training programme can at best achieve limited improvement of aerobic capacity. The aim of this study was to clarify whether in the course of in-patient rehabilitation with a medical "high intensity" training regimen patients with COPD can better their endurance capacity (e.c.)., Patients and Methods: Eleven patients with mild to moderate COPD (ten men, one woman; average age 59 [54-76] years) participated. In addition to optimal drug treatment they undertook "high intensity" training (to 85-95% of maximally achievable heart rate)., Results: The patients achieved significant (P < 0.05) improvement in maximal oxygen uptake, maximal performance and walking distance in the 6-minute walking test., Conclusion: Medically supervised "high intensity" training can produce a significant rise in endurance capacity even in patients with COPD.

Aquajogging consists of simulated running in deep water aided by a flotation device (vest or belt) that maintains the head above water. In sports, Aquajogging is used as a training for regeneration or a low impact training alternative. In rehabilitation Aquajogging is well used in rheumatology diseases, in the pre- and postoperative management of musculoskeletal diseases and in endurance and power training in cardiorespiratory diseases.

Orthopedists being more engaged in surgery are often asked about problems concerning exercise science. This article will summarize the existing basic knowledge, very close to practice, and put down the leading steps of how to build up a (therapeutical) training programme. A lab block is recommended acting on a preventive as well as on a sportive medical base.

Isolation of Borrelia burgdorferi from the CSF is relatively rare. The present report describes the first three isolations in Switzerland. Clinically, our first observation confirmed the frequent association of B. burgdorferi with peripheral facial paresis in children. The other two cases illustrate the variety of symptoms in neuro-borreliosis. In the first case the culture was positive after 6 weeks. The results of serologic tests (indirect immunofluorescence and ELISA) for detection of antibodies against B. burgdorferi were negative or non-significant in this child's serum. On the other hand, specific antibodies (IgG) were detected in the serum by western blot. Culture of the second CSF already showed Borrelia growth after 10 days. Immunofluorescence revealed high antibody titers (1/256) against B. burgdorferi in this patient's serum. IgG showed a weakly positive reaction in western blot. The reliability of this result was confirmed by isolation of Borrelia. In neither of the two CSF could intrathecal synthesis of specific antibodies be demonstrated. In the third case, however, immunofluorescence showed IgG antibody titers of 1/128 in the CSF and 1/512 in serum. Intrathecal synthesis of specific antibodies was demonstrated with an index of 13.4 (norm < 2). Western blot confirmed the specificity of the reactions observed with the serum and CSF IgG. Culture of CSF produced significant growth of Borrelia within 7 days. Protein profile and reactions with poly- and monoclonal antibodies confirmed that the three strains belonged to B. burgdorferi.(ABSTRACT TRUNCATED AT 250 WORDS)