45 research outputs found
Thalidomide in the Management of Multiple Myeloma
No full textThe discovery that multiple myeloma is associated with new vessel formation and is correlated with survival and proliferation led initially to the use of thalidomide for patients with relapsed or refractory disease. The outcome with conventional chemotherapy in this setting has historically been very poor. New insights into the biology of the disease suggests that thalidomide may work via a number of other mechanisms and the advent of the thalidomide analogues with their differential effects on survival and proliferation pathways has opened up a new era in the understanding and treatment of the disease. The encouraging results from phase I/II trials of these agents has meant that for the first time in 50 years there is the opportunity to improve outcome. Further work is in progress to define how best to use these drugs and their role in treatment at different stages of the disease. [References: 96
Disminución en la calidad de vida de pacientes con dolor torácico no cardíaco: sus causas y efectos
No full textA Preliminary Investigation of Supercharging an Air-Cooled Engine in Flight
No full textThis report presents the results of preliminary tests made on the effects of supercharging an air-cooled engine under airplane flight conditions. Service training airplanes were used in the investigation equipped with production types of Wright J engines. A N.A.C.A. Roots type supercharger was driven from the rear of the engine. In addition to measuring those quantities that would enable the determination of the climb performance, measurements were made of the cylinder-head temperatures and the carburetor pressures and temperatures. The supercharging equipment was not removed from the airplane when making flights without supercharging, but a by-pass valve, which controlled the amount of supercharging by returning to the atmosphere the surplus air delivered by the supercharger, was left full open. With the supercharger so geared that ground-level pressure could be maintained to 18,500 feet, it was found that the absolute ceiling was increased from 19,400 to 32,600 feet, that the time to climb to 16,00 feet was decreased from 32 to 16 minutes, and that this amount of supercharging apparently did not injure the engine. (author
Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma
No full textIn this report, a panel of European myeloma experts discuss the role of pomalidomide in the treatment of relapsed and refractory multiple myeloma (RRMM). Based on the available evidence, the combination of pomalidomide and low-dose dexamethasone is a well-tolerated and effective treatment option for patients with RRMM who have exhausted treatment with lenalidomide and bortezomib. The optimal starting dose of pomalidomide is 4 mg given on days 1-21 of each 28-day cycle, whereas dexamethasone is administered at a dose of 40 mg weekly (reduced to 20 mg for patients aged >75 years). The treatment should continue until evidence of disease progression or unacceptable toxicity. Dose-modification schemes have been established for patients who develop neutropenia, thrombocytopaenia and other grade 3-4 adverse events during pomalidomide therapy. Guidance on the prevention and management of infections and venous thromboembolism is provided, based on the available clinical evidence and the experience of panel members. The use of pomalidomide in special populations, such as patients with advanced age, renal impairment or unfavourable cytogenetic features, is also discussed. © 2014 Macmillan Publishers Limited. All rights reserved
Esophageal motility in eosinophilic esophagitis
No full textAbstractBackgroundEosinophilic esophagitis (EoE) is characterized by eosinophilic infiltration of the esophagus and is a potential cause of dysphagia and food impaction, most commonly affecting young men. Esophageal manometry findings vary from normal motility to aperistalsis, simultaneous contractions, diffuse esophageal spasm, nutcracker esophagus or hypotonic lower esophageal sphincter (LES). It remains unclear whether esophageal dysmotility plays a significant role in the clinical symptoms of EoE.AimOur aim is to review the pathogenesis, diagnosis, and effect of treatment on esophageal dysmotility in EoE.MethodsA literature search utilizing the PubMed database was performed using keywords: eosinophilic esophagitis, esophageal dysmotility, motility, manometry, impedance planimetry, barium esophagogram, endoscopic ultrasound, and dysphagia.ResultsFifteen studies, totaling 387 patients with eosinophilic esophagitis were identified as keeping in accordance with the aim of this study and included in this review. The occurrence of abnormal esophageal manometry was reported to be between 4 and 87% among patients with EoE. Esophageal motility studies have shown reduced distensibilty, abnormal peristalsis, and hypotonicity of the LES in patients with EoE, which may also mimic other esophageal motility disorders such as achalasia or nutcracker esophagus. Studies have shown conflicting results regarding the presence of esophageal dysmotility and symptoms with some reports suggesting a higher rate of food impaction, while others report no correlation between motor function and dysphagia.ConclusionsMotility dysfunction of the esophagus in EoE has not been well reported in the literature and studies have reported conflicting evidence regarding the clinical significance of dysmotility seen in EoE. The correlation between esophageal dysmotility and symptoms of EoE remains unclear. Larger studies are needed to investigate the incidence of esophageal dysmotility, clinical implications, and effect of treatment on patients with EoE
La motilidad esofágica en la esofagitis eosinofílica
No full textResumenAntecedentesLa esofagitis eosinofílica (EE) se caracteriza por la infiltración de eosinofilos en el esófago y es una causa potencial de disfagia e impactación alimentaria que en general afecta a jóvenes adultos. Los resultados obtenidos con la manometría esofágica son variados, y se ha observado motilidad normal y aperistalsis, contracciones simultáneas, esófago en cascanueces o esfínter esofágico inferior hipotónico. Aún no está claro si la dismotilidad esofágica desempeña un papel importante en los síntomas clínicos de la EE.ObjetivoRevisar la patogenia, el diagnóstico y el efecto del tratamiento de la dismotilidad esofágica en la EE.MétodosSe llevó a cabo una búsqueda de la bibliografía médica en PubMed utilizando los términos “esofagitis eosinofílica”, “dismotilidad esofágica”, “motilidad”, “manometría”, “impedancia planimétrica”, “esofagograma con contraste de bario”, “ultrasonido endoscópico” y “disfagia”.ResultadosSe identificaron 15 estudios que se ajustaban al objetivo, que incluyeron a 387 pacientes con esofagitis eosinofílica,, y se incluyeron en esta revisión. La incidencia de manometría esofágica anormal reportada en los pacientes con EE fue del 4 al 87%. Estudios de motilidad esofágica han mostrado distensibilidad reducida, peristaltismo anormal e hipotonicidad del esfínter esofágico en pacientes con EE, que a la vez pueden mimetizar otros trastornos de motilidad esofágica, como la acalasia o el esófago en cascanueces. Los estudios han mostrado resultados contradictorios en relación con la presencia de dismotilidad esofágica y síntomas; así, hay reportes que sugieren tasas elevadas de impactación alimentaria mientras que otros no muestran ninguna relación directa entre la función motora y la disfagia.ConclusionesLa disfunción de la motilidad esofágica en EE no se ha reportado en profundidad en la bibliografía y algunos estudios muestran evidencia contraria en cuanto a la importancia clínica de la dismotilidad observada en la EE. La correlación entre la dismotilidad esofágica y los síntomas de EE permanece aún poco clara. Se requieren estudios más amplios para investigar la incidencia de la dismotilidad esofágica, sus implicaciones clínicas y el efecto del tratamiento en pacientes con EE.AbstractBackgroundEosinophilic esophagitis (EoE) is characterized by eosinophilic infiltration of the esophagus and is a potential cause of dysphagia and food impaction, most commonly affecting young men. Esophageal manometry findings vary from normal motility to aperistalsis, simultaneous contractions, diffuse esophageal spasm, nutcracker esophagus or hypotonic lower esophageal sphincter (LES). It remains unclear whether esophageal dysmotility plays a significant role in the clinical symptoms of EoE.AimOur aim is to review the pathogenesis, diagnosis, and effect of treatment on esophageal dysmotility in EoE.MethodsA literature search utilizing the PubMed database was performed using keywords: eosinophilic esophagitis, esophageal dysmotility, motility, manometry, impedance planimetry, barium esophagogram, endoscopic ultrasound, and dysphagia.ResultsFifteen studies, totaling 387 patients with eosinophilic esophagitis were identified as keeping in accordance with the aim of this study and included in this review. The occurrence of abnormal esophageal manometry was reported to be between 4 and 87% among patients with EoE. Esophageal motility studies have shown reduced distensibilty, abnormal peristalsis, and hypotonicity of the LES in patients with EoE, which may also mimic other esophageal motility disorders such as achalasia or nutcracker esophagus. Studies have shown conflicting results regarding the presence of esophageal dysmotility and symptoms with some reports suggesting a higher rate of food impaction, while others report no correlation between motor function and dysphagia.ConclusionsMotility dysfunction of the esophagus in EoE has not been well reported in the literature and studies have reported conflicting evidence regarding the clinical significance of dysmotility seen in EoE. The correlation between esophageal dysmotility and symptoms of EoE remains unclear. Larger studies are needed to investigate the incidence of esophageal dysmotility, clinical implications, and effect of treatment on patients with EoE
