216 research outputs found
Management of Skin Reactions During Cetuximab Treatment in Association With Chemotherapy or Radiotherapy Update of the Italian Expert Recommendations
No full textObjectives: Cetuximab was shown in phase III clinical trials to improve chemotherapy efficacy in patients with advanced colorectal and head-neck cancer. Appropriate management of skin reactions associated with epidermal growth factor receptor inhibitor therapy is necessary to allow adequate drug compliance and to improve patient quality of life and outcomes. Methods: The RAND/UCLA Appropriateness Method was used by a group of experts to produce new Italian recommendations on the management of skin reactions in this setting. Statements were generated on the basis of an updated systematic review of the literature and rated twice by a panel of 38 expert physicians. A meeting of the panel was held after the first rating session. Results: Skin reactions included acneiformic rash, skin dryness (xerosis), pruritus, paronychia, hair abnormalities, mucositis, and increased growth of eyelashes or facial hair. Updates of the previous recommendations on the prevention and treatment of each type of reaction were proposed. Conclusions: This updated Expert Opinion focuses on how to assess and correctly grade skin reactions according to the latest National Cancer Institute Common Terminology Criteria for Adverse Events and on how to manage these adverse events in clinical practic
El animé como lienzo para analizar las tensiones entre prácticas epistémicas ancestrales y tecnocientíficas
No full textThis essay analyzes the tensions between ancestral epistemic practices and technoscientific epistemic practices represented in the contents and narratives of Japanese anime. Based on the analysis of three anime series, interpretations are developed around these tensions, to transcend the context of animation and bring reflections to the analogous world in the face of the current conditions of conflict between Latin American ancestral epistemic practices and western technoscientific epistemic practices. Thus, anime can be understood as an expressive and representative art, alternative to Western narratives, or as a technoscientific propaganda device.El presente ensayo analiza las tensiones entre las prácticas epistémicas ancestrales y las prácticas epistémicas tecnocientíficas representadas en los contenidos y las narrativas del animé japonés. A partir del análisis de tres series de animé, se elaboran interpretaciones en torno a dichas tensiones, para trascender el contexto de la animación y llevar las reflexiones al mundo análogo frente a las actuales condiciones de pugna entre las prácticas epistémicas ancestrales latinoamericanas y las prácticas epistémicas tecnocientíficas occidentales. Así, el animé puede ser entendido como un arte expresivo y representativo alternativo a las narrativas occidentales, o como un dispositivo de propaganda tecnocientífica.Acevedo Merlano, Alvaro-will be generated-orcid-0000-0002-0131-0276-60
Early detection, prevention and management of cutaneous adverse events due to sorafenib: Recommendations from the Sorafenib Working Group
No full textCutaneous adverse events commonly reported with tyrosine kinase inhibitors (TKIs) in the treatment of malignancies, represent an important clinical concern since they can limit the optimal use of these novel drugs. Although there are numerous reports in the literature of these events there are no practical guidelines on how they should be managed. The Sorafenib Working Group (SWG) was established with the objective of developing recommendations to allow the early detection, prevention and management of cutaneous adverse events in everyday clinical practice. The SWG was a multidisciplinary team made up of experts in the field who were closely involved in the sorafenib clinical development program. This review provides an overview of the nature and incidence of cutaneous adverse events which manifest with sorafenib treatment and provides recommendations for their early detection and effective management in clinical practice. (c) 2011 Elsevier Ireland Ltd. All rights reserved
Impact of treatment expertise on the outcome of patients with head and neck cancer treated within 6 randomized trials
No full textBackground: We evaluated the impact of center expertise, in terms of number of patients treated, on the overall survival (OS) and progression-free survival (PFS) of patients with head and neck squamous cell carcinoma (SCC).
Methods: We performed a pooled analysis including data from 6 randomized trials in head and neck SCC conducted in Italy. We evaluated the association between OS or PFS and the number of patients recruited by the center.
Results: The outcome of 903 patients who had received radiotherapy (RT) was analyzed (median follow-up 76 months). The hazard ratio (HR) comparing the third and the first quartiles of the distribution of number of patients per center
showed an advantage in PFS (HR 0.59, range 0.53-0.65, P < .0001) and in OS (HR 0.70, 0.60-0.81, P < .0001) for centers with a higher number of patients recruited. A similar benefit was observed in PFS (HR 0.63, 0.60-0.66) and OS
(HR 0.74, 0.69-0.79) considering the mean number of patients per year.
Conclusions: The PFS and OS were longer for patients treated in high-casevolume centers
Activation of immune responses in patients with relapsed-metastatic head and neck cancer (CONFRONT phase I-II trial): Multimodality immunotherapy with avelumab, short-course radiotherapy, and cyclophosphamide
No full textINTRODUCTION AND BACKGROUND:
Second-line treatment of platinum-resistant relapsed/metastatic (R/M) head and neck cancer (HNC) is a currently unmet clinical need. Clinical trials showed improvement in overall survival and quality of life of R/M-HNC patients treated with anti-PD-1 regardless of the number of prior chemotherapy lines; however, the percentage of long-term survivors remains limited.This study aims to test the hypothesis that attacking the tumor microenvironment at multiple levels can increase immunogenicity of R/M-HNC without worsening the safety profile of immune checkpoint inhibitors.
METHODS/DESIGN:
In this open label, multi-center, single-arm, Phase Ib/II, R/M-HNC patients pretreated with at least one line of therapy containing platinum, fluorouracil, and cetuximab will receive a daily metronomic dose of 50 mg cyclophosphamide without a drug-free break, 10 mg/kg avelumab on day 1 and every other week until progression, and a single fraction of 8 Gy radiotherapy on day 8.
DISCUSSION:
The treatment protocol aims to reverse immune evasion of the tumor through a radiotherapy-induced self-vaccination effect, suppression of CD4+ CD25+ FoxP3+ regulatory T-cell function by metronomic cyclophosphamide, and effector T-cell reactivation owing to the inhibition of the PD-1-PD-L1 axis by avelumab.The immunologic interplay induced by the proposed combined treatment may theoretically improve the activity of avelumab without increasing its toxicity profile.Finally, an ancillary translational study will be extended to all the patients' population.
TRIAL REGISTRATION:
EudraCT n. 2017-000353-39
To hyperfractionate or not to hyperfractionate-Is it really a question?
No full textDespite technical advances the last decade, patients with HPV/p16 negative head and neck cancer (being smokers and having affected performance and co-morbidities), still have a poor outcome after treatment. Hyperfractionated radiotherapy with concurrent cisplatin might be a reasonable way to pursue for improving their outcome. This strategy requires that adequate supportive care is available
Acute skin toxicity management in head and neck cancer patients treated with radiotherapy and chemotherapy or EGFR inhibitors: Literature review and consensus
No full textThe adverse effects of radiation therapy, often integrated with chemotherapy and/or targeted therapies, on the skin include severe acute and chronic dermatitis associated with pain, discomfort, itching, and burning, and may heavily affect patients' quality of life. The management of these skin adverse effects in head and neck cancer patients (HNCPs) are very heterogeneous due to the lack of shared rigorous classification systems and evidence based treatments. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of dermatitis in HNCPs treated with radiotherapy with or without systemic therapies in order to improve skin toxicity management. The Delphi Appropriateness Method was used. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. This paper offers contains seven clusters of statements about the management of dermatitis in HNCPs and a review of recent literature on these topics
Immune escape mechanisms in head and neck squamous cell carcinoma and implication for new immunotherapy approach
No full textComunicación política en la esfera pública digital: representaciones, poder y subjevitidades
No full textEl lugar de la prensa en la configuración del imaginario nacional integró proyectos hegemónicos que habrían de materializar prácticas de estado1 y gobierno sobre territorios y gentes que no se conocían entre sí, pero que además por su distancia geográfica y cultural podrían, en alguna medida, pertenecer o dar lugar a otros procesos de identificación y movilización de nación (Anderson, 2006). Aun así, países como Colombia no han cerrado su proceso de organización de un estado-nación cuyo consenso unifique sus pueblos. Quizás, algunos apegados a la moral como único punto de partida para escudriñar la realidad en su espacialidad y tiempo, dirán que allí radica el problema, y entonces, los pueblos tendrían que abandonar el sentido de lo propio para dar paso a la uniformidad de la pregonada unificación, o, por el contrario, otros apelarían a la pureza genética y cultural como elemento de virtud y orgullo. Al respecto y sobre ambas posiciones queda un largo listado de preguntas sobre el porqué de la pretensión homogeneizadora y segregadora de no pocos pensamientos políticos en nuestra historia reciente, y el porqué se están fortaleciendo luego de las victorias de procesos multiculturales y diversos sobre otras esferas de la vida social.Presentación 9 -- Primera Parte -- Medios digitales, filosofía y poder 29 -- Capítulo 1. Comunicación política y mentira romántica. Un diálogo entre Carl Schmitt y René Girard. Juan Sebastián Ballén Rodríguez 30 -- Capítulo 2 Karl Kraus y el problema de la presentación de los hechos en la prensa escrita. Ronald Zuleyman Rico Sandoval 79 -- Capítulo 3. Apuntes sobre los patrones de inclusión-exclusión en Latinoamérica: dimensiones socioculturales y políticas de la globalización. Joy Helena González Güeto 115 -- Parte 2 -- Gobierno, política y medios digitales 141 -- Capítulo 4. Las caras de la Comunicación Política en la era digital. Yuraima Inés Acevedo Merlano 142 -- Capítulo 5. Marketing político y redes sociales: Espacios digitales para jóvenes electos y políticos del oriente colombiano. Giovanni Bohórquez Pereira, Blanca Aracely López Rueda, Juan Diego Flórez Quintero 169 -- Capítulo 6. Transparencia web en el gobierno digital de las Américas. Ángel Emiro Páez Moreno, Julieta Montoya Roja, Silvia Alejandra Matheus Rubio 203 – Capítulo 7. El gobierno electrónico en retrospectiva. Margarita Quintero León, Yair Alfonso Murillo Rincón, Angie Julieth Fontalvo Ortiz 251 -- Capítulo 8. Corrupción pública y prensa: “Caso Odebrecht”. Laura Fernanda Tamayo Goyeneche, Jaqueline Estévez Lizarazo 285 -- Capítulo 9. Gestión pública en clave de TIC: Ventajas y desventajas que perciben los habitantes del Distrito de Barranquilla. Zulma Zoraida Ortiz Záccaro, Harold Ballesteros Valencia, Juan Carlos Jiménez Rodríguez, Luis Gabriel Turizo Martínez 337 -- Tercera Parte -- Medios digitales: discursos, representaciones y subjetividades 373 -- Capítulo 10. Discursividad en Twitter: aproximación a su estudio. Iván Fernando Rodrigo Mendizábal 374 -- Capítulo 11. ¿Consumidores o ciberciudadanos? Apropiación tecnológica, subjetividades, y campañas presidencia en Twitter. Gladys Lucía Acosta Valencia, Claudia María Maya Franco, Álvaro Acevedo Merlano, Joseph Livingston Crawford Visbal 42
Comportamiento psicométrico de la escala pacs (penn alcohol craving scale, versión en español) en adolescentes en la ciudad de Manizales, Colombia
No full textFiguras, tablasEl trastorno por consumo de alcohol representa uno de los problemas de salud mental más extendidos globalmente, que afecta a aproximadamente al 5,1% de la población (4.9-5.4%). En Colombia para el 2016, la prevalencia se estima entre el 6,1% y el 8% en mayores de 15 años. Este trastorno tiene un impacto importante en la salud pública, aunque la mayoría de los pacientes no reciben tratamiento; con solo un 21,9% de los casos atendidos a nivel mundial. El craving, reintroducido en el DSM-5 como uno de los criterios diagnósticos del trastorno por consumo de alcohol, se correlaciona con su gravedad y predice recaídas en el consumo. A pesar de su importancia, existe controversia sobre cómo evaluarlo. El Penn Alcohol Craving Scale, un instrumento diseñado para medir el craving, no ha sido adaptado ni validado para adolescentes colombianos. Por esto, se propone con esta investigación evaluar la validez de constructo y la confiabilidad del Penn Alcohol Craving Scale en adolescentes colombianos mediante análisis factorial de la teoría clásica de los test.
Resultados: El Penn Alcohol Craving Scale modificado presenta buen ajuste con el análisis factorial ajustado (CFI 0.974, TLI 0.96 RMSEA 0.091, SRMR 0.03), moderadas cargas factoriales (entre 0.58-0.88) y una demasiado buena consistencia interna (alfa de Cronbach 0.9 y omega de McDonalds 0.911). El PACS original también mostró buen ajuste (CFI 0.98, TLI 0.96, SRMR 0.027), moderadas cargas factoriales (entre 0.56-0.88) y muy buena consistencia interna (alfa de Cronbach 0.8.75 y omega de McDonalds 0.884)
Conclusión: El PACS presenta buenas propiedades psicométricas y es un instrumento válido y confiable para medir craving del alcohol en población adolescente colombianaAlcohol use disorder represents one of the most widespread mental health problems globally, affecting approximately 5.1% of the population (4.9-5.4%). In Colombia for 2016, the prevalence is estimated between 6.1% and 8% in people over 15 years of age. This disorder has a significant impact on public health, although most patients do not receive treatment; with only 21.9% of cases treated worldwide. Craving, reintroduced in the DSM-5 as one of the diagnostic criteria for alcohol use disorder, correlates with its severity and predicts relapses in consumption. Despite its importance, there is controversy about how to assess it. The Penn Alcohol Craving Scale, an instrument designed to measure craving, has not been adapted or validated for Colombian adolescents. For this reason, this research aims to evaluate the construct validity and reliability of the Penn Alcohol Craving Scale in Colombian adolescents through factor analysis of the classical test theory.
Results: The modified Penn Alcohol Craving Scale presents a good fit with the adjusted factor analysis (CFI 0.974, TLI 0.96 RMSEA 0.091, SRMR 0.03), moderate factor loadings (between 0.58-0.88) and a very good internal consistency (Cronbach's alpha 0.9 and McDonald's omega 0.911). The original PACS also showed good fit (CFI 0.98, TLI 0.96, SRMR 0.027), moderate factor loadings (between 0.56-0.88) and very good internal consistency (Cronbach's alpha 0.8.75 and McDonald's omega 0.884)
Conclusion: The PACS presents good psychometric properties and is a valid and reliable instrument to measure alcohol craving in the Colombian adolescent populationPlanteamiento del problema / Justificación/ Objetivos / Objetivo general / Objetivos específicos/Marco teórico / Abuso, dependencia y adicción / Abuso y Dependencia/ Adicción / Trastornos por consumo de sustancias psicoactivas / Consumo de alcohol / Trastorno por consumo de alcohol /Craving/ Penn Alcohol Craving Scale / Validación de una escala / Metodología / Diseño del estudio /Hipótesis / Población y muestra / Muestra / Criterios de elegibilidad /Variables / Procedimiento / Técnica de recolección de la información / Instrumento / Plan de análisis / Análisis de aspectos éticos/ Resultados/Características sociodemográficas / Análisis descriptivos de ítems de PACS 7 ítems/ Análisis factorial PACS 7 ítems / Análisis factorial exploratorio / Análisis factorial confirmatorio / Análisis factorial PACS original (5 ítems)/ Análisis factorial exploratorio / Análisis factorial confirmatorio / Consistencia interna / Discusión /Conclusión / Recomendaciones/ Referencias bibliográficas / AnexosEspecializaciónEspecialista en Psiquiatrí
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