Objectives: To evaluate the management of adverse reactions in patients receiving initial capecitabine plus oxaliplatin (CapeOX) and bevacizumab (BV) therapy by a team consisting of doctors, pharmacists, and a nurse.
Methods: The study included 30 patients with advanced recurrent colorectal cancer whose initial therapy was CapeOX + BV. Each member of the multidisciplinary team had predefined tasks. The team held meetings weekly to decide on measures to be taken against adverse reactions at the upcoming outpatient visit. At these meetings, the nurse provided information obtained by weekly telephone support. Treatment outcomes and the incidence of adverse reactions were examined. Additionally, the effectiveness of telephone support provided by the nurse in terms of patient satisfaction was evaluated by questionnaire.
Results: The response and disease control rates were 66.7% and 96.7%, respectively. Grade 2 hand-foot syndrome occurred in 10.0% of the patients, none of these reactions being Grade 3 or greater. All patients were satisfied with telephone support.
Conclusions: Team management of adverse reactions in patients receiving CapeOX + BV therapy resulted in increased disease control rates and reduced the incidence of adverse events compared with a control group. Telephone support provided by the nurse contributed to improved patient satisfaction and provision of additional information to healthcare professionals.
Objectives: Asthma and chronic obstructive pulmonary disease (COPD) are representative respiratory diseases characterized by obstructive ventilatory impairment. Asthma–COPD overlap syndrome (ACOS) has recently attracted attention. This study aimed to analyze the pathology of obstructive ventilatory impairment by assessment of respiratory function and impedance in smokers with fixed airflow obstruction, regardless of the disease entity.
Methods: Thirty-eight elderly patients with a minimum of a 10 pack-year smoking history and fixed airflow obstruction with a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% after bronchodilator administration were included. Respiratory function and impedance parameters were measured and compared across four phenotypes. Phenotypes were based on the pulmonary diffusing capacity and airway reactivity to inhaled bronchodilators. Groups 1 and 2 included carbon monoxide diffusion capacity (DLCO) <80% without and with positive airway reactivity, respectively. Groups 3 and 4 included DLCO ≥80% without and with positive airway reactivity, respectively.
Results: FEV1 (% predicted) was significantly correlated with lung resistance at 5 Hz (R5), 20 Hz (R20), and R5−R20 in patients with fixed airflow obstruction. The correlation with R5 and R5−R20 was stronger than that with R20. These results are similar to those reported for patients with COPD, and suggest that small airways are primarily affected in patients with fixed airflow obstruction. Group 2 patients tended to show lower FEV1/FVC and higher ∆X5 values than patients in the other groups.. In some Group 2 patients, FEV1 and respiratory impedance values improved after addition of or a dose increase in inhaled corticosteroids, and this suggested the presence of ACOS.
Conclusions: Evaluation of older patients with fixed airflow obstruction using various approaches is useful for determining the underlying pathology.
Objective: Radiation pneumonitis and organizing pneumonia (OP) are the two primary forms of lung damage that can occur following lung irradiation. The goal of this study was to clarify the clinical characteristics of OP after stereotactic body radiation therapy (SBRT) for lung malignancies.
Methods: This study included 75 patients with lung malignancies who underwent SBRT from April 2013 to January 2015. The diagnosis of OP was based on lung computed tomography findings and previously established criteria.
Results: OP was observed in 6 of 75 patients (8%) and occurred in regions with a steep dose gradient ranging from 30% to 90%. The time to OP occurrence ranged from 1 to 4 months after completion of SBRT (mean, 84 days). No patients had symptoms suggestive of pneumonia, such as a fever or cough, at the time of computed tomography.
Conclusion: OP developed in regions with a steep dose gradient. This mechanism explains why the incidence of OP after SBRT was higher than that after postoperative radiation for breast cancer and non-SBRT irradiation for lung cancer.
Serious complications following arthroscopic knee surgery are unusual. In the present case, the patient had no predictive factors for complications of compartment syndrome other than age. Compartment syndrome might have developed due to the invasiveness of the varicose vein surgery. Delayed diagnosis of compartment syndrome is associated with irreversible neurological dysfunction. Careful observation of the lower leg is necessary during the perioperative period.
We herein report a relatively rare case of an inflammatory myofibroblastic tumor (IMT) of the bladder in a young woman. In contrast to IMTs of other organs, IMTs of the lower urinary tract involve the mixture of a non-neoplastic lesion with a neoplastic lesion; therefore, the determination of whether other neoplastic lesions are present is important. In this case, magnetic resonance imaging confirmed a pedunculated lobulated tumor that protruded from the posterior left bladder wall into the lumen. The lobulated area exhibited a low-intensity signal on T1-weighted imaging (T1WI) and a high-intensity signal similar to that of urine on T2-weighted imaging (T2WI). Morphologically, the peduncle resembled a submucosal mass with faint low-intensity signaling on T1WI and faint high-intensity signaling on T2WI. These findings differ from those of a neoplastic lesion of the bladder mucous membrane. The presence of lesions from the muscularis propria to the submucosa and in areas with markedly high-intensity signals exhibiting a nodular fasciitis pattern on T2WI is considered useful for the differential diagnosis of IMT on imaging examination.