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Chemical Permeation through Disposable Gloves
Published in Robert N. Phalen, Howard I. Maibach, Protective Gloves for Occupational Use, 2023
Several studies have dealt with the permeation of cytostatic drugs through disposable gloves. Although most of the test results do not show any permeation, in all of the studies at least one of the drugs has permeated one of the tested glove materials. Common NR or PVC examination gloves fail to provide adequate protection in many studies. Mader et al.14 have divided some cytostatic drugs into groups of rapidly permeating, slowly permeating, and nonpermeating drugs. The rapidly permeating drugs were mitoxantrone and carmustine (BCNU), and the slowly permeating drugs were cyclophosphamide and bleomycin. Nonpermeating drugs were methotrexate, arabinosyl-cytosine, 5-fluorouracil, adriamycin, 4′-O-tetrahydropyranyladriamycin, vincristine, etoposide, and cisplatin. Further investigation and explanation of this are provided in the next section.
Ectopic Pregnancy: Extrauterine Pregnancy and Pregnancy of Unknown Location
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
It should be noted that MTX, a cytostatic agent, is associated with several side effects, such as hair loss, depression of bone marrow, stomatitis, liver tissue damage, and lung fibrosis. β-hCG levels must be checked on days 1, 4, and 7 after the injection of MTX. Liver enzymes should also be monitored because MTX is metabolized by the liver. If the decrease in β-hCG is <15% after 1 week, a second dose of MTX must be administered on day 7/8. A third dose may be given if the patient's β-hCG is still high after 2 weeks. In case medical treatment fails, a laparoscopy will be necessary. Systemic therapy is associated with higher rates of tube patency (80%), and the risk of a relapse is reported to be about 7%. MTX is not commonly used at the present time because studies have shown no difference in the success of primary treatment on comparison of single-dose MTX with the watch-and-wait strategy [51] or on comparison of multiple-dose MTX injection with laparoscopic salpingostomy [38]. In both cases, the patient is subject to the side effects of MTX.
Low-Dose Naltrexone
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
The current body of literature on LDN and cancer explores the relationship between OGF and OGFr and their effect on cellular proliferation in ovarian, pancreatic, colorectal, and squamous cell carcinomas. Short-term LDN was observed to influence the OGF–OGFr axis, which is responsible for the regulation of cell proliferation.38 Many other studies have investigated the use of LDN alone or in combination with standard therapies in ovarian cancer and renal carcinomas with promising results. Donahue, McLaughlin, and Zagon39 observed that the combination of LDN and cisplatin in ovarian tumors enhanced the inhibition of tumorigenesis, depressed DNA synthesis, and reduced angiogenesis. Additionally, LDN seemed to reduce adverse events with cisplatin therapy. Another study confirmed that LDN upregulates OGF and OGFr, inhibiting tumorigenesis and cancer proliferation.40 An alternative theory is that LDN prevents the prolonged cellular state of arrest in response to DNA damage, which places the cells in a state of cytostasis. This state of cytostasis reduces the sensitivity of the cell to treatment, preventing the cell from entering the apoptosis pathway. The intermittent binding of LDN does not block cells from entering this apoptosis pathway.41Evidence seems to support LDN as an adjunct to current anticancer regimens, both by enhancing the drugs’ anti-tumorigenesis effects and by decreasing the severity of side effects related to chemotherapy regimens.
Safety and efficacy of Pimecrolimus in atopic dermatitis among Chinese infants: a sub-group analysis of a five-year open-label study
Published in Journal of Dermatological Treatment, 2023
Xia Dou, Lingling Liu, Xuejun Zhu, Weijing Wen, Chunya Ni, Yi Zhao, Zhixin He, Hongchun Li, Qiuning Sun, Qinping Yang, Xinfen Sun, Yifeng Guo
Patients were enrolled into the study between April 2004 and October 2005. Eligible infants were aged ≥3 to 12 months. AD was diagnosed according to the criteria of Seymour et al. (23) (because these criteria were developed for patients aged ≤ 2 years) with disease affecting ≥ 5% of the TBSA. Patients had an IGA score of 2 or 3 (scale range: 0–5), indicating mild-to-moderate disease. Key exclusion criteria were: (i) use of systemic corticosteroids, (ii) use of immunosuppressants, cytostatic drugs, (iii) phototherapy within four weeks of the first application of study medication, (iv) topical tacrolimus ointment or PIM within two weeks, and (v) topical therapy for AD such as TCSs within three days. Immunocompromised patients and those with a history of malignant disease, active acute viral skin infection, or clinically infected AD were also excluded.
Using blood calprotectin as a measure of blood neutrophils
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Arne Åsberg, Lena Løfblad, Amela Felic, Marthe Wedø Aune, Gunhild Garmo Hov, Unn Merete Fagerli
Patients treated at St. Olavs hospital were asked to donate blood in two heparin vacuum tubes if they were treated with cytostatic drugs. The extra blood samples were taken simultaneously with blood samples for routine hematology testing, after written, informed consent was given. Permission was granted by the Regional Committees for Medical and Health Research Ethics (2019/580/REK sør-øst). Blood sampling was complete in 77 patients, 43 women aged 30–79 (median 59) years and 34 men aged 32–84 (median 66) years. They had various clinical diagnoses, 72 had some form of cancer, of which breast cancer was the most frequently diagnosed condition (16 (37%) of women). Consequently, most of the patients (83%) used a variety of cytostatic drugs. Routine blood samples for b-neutrophils and other hematology analyses were taken at relevant times for monitoring the cytotoxic effects and/or disease activity. We also used data from 120 healthy blood donors, part of which are previously published [5]. They were 55 women aged 20–69 (median 34) years, and 65 men aged 22–73 (median 40) years.
Interaction of tumor-associated macrophages and cancer chemotherapy
Published in OncoImmunology, 2019
Irina Larionova, Nadezhda Cherdyntseva, Tengfei Liu, Marina Patysheva, Militsa Rakina, Julia Kzhyshkowska
Enhancing the efficiency of antitumor therapy is the most relevant challenge in clinical oncology. The main goal of the established cytostatic therapeutic schemas is to achieve the maximal cytoreduction of the primary tumor and metastatic foci by inducing apoptosis or necrosis or blocking uncontrolled cancer cell proliferation.1 The outcome of cytostatic treatment depends on the biological (including genetic) characteristics of tumor cells and their sensitivity or resistance to therapeutic agents.2 On average, only 40–60% of the cancer patients benefit from antitumor chemotherapy (CT).3,4 Drug resistance in surviving cancer cells, in fact, leads to an inability to achieve complete pathological regression.5 However, even when complete pathological regression is achieved, tumors can relapse in 10–40% of the cases.3,6