Belgian recommendations on perioperative maintenance fluid management of surgical pediatric population.

The European recommendations on perioperative maintenance fluids in children have recently been adapted from hypotonic to isotonic electrolyte solutions with lower glucose concentrations. In Belgium, however, the commercially approved solutions do not match with these recommendations and there is neither consensus nor mandate about the composition and volume of perioperative maintenance fluids in children undergoing surgery despite the continuing controversy in literature. This paper highlights the significant challenges and shortcomings while prescribing fluid therapy for pediatric surgical patients in Belgium.

Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses: treatment results for 47 patients.

Purpose: Ethmoid sinus cancer is a rare malignancy. Treatment results are mostly reported together with other sinonasal tumors, grouping a wide range of different histologies and treatment approaches. This study reports on the treatment outcome of 47 patients diagnosed with adenocarcinoma of the ethmoid sinuses and treated with surgery and high-dose postoperative radiation therapy.

Intensity modulated radiation therapy for oropharyngeal and oral cavity tumors: clinical use and experience.

Background and purpose. Intensity modulated radiation therapy (IMRT) offers an opportunity to generate dose distributions highly conformal to the target volume. Head and neck cancer patients, referred for radiotherapy, may be good candidates to benefit from IMRT.

Drastic performance improvement of hand-operated sterilizers.

In a great number of low-income countries, hand-operated sterilizers are commonly used for the sterilization of medical supplies, including porous loads and hollow instruments. Due to the socio-economic situation in these countries the introduction of fully automatic sterilizers is not (yet) feasible. During a course on sterilization technology for hospital technicians at the Polytechnic in Mombasa, Kenya, some performance tests have been done with locally used sterilizers with standard test loads and loads as are common in the hospitals that were visited.

Collagen vascular diseases and radiation therapy: a critical review.

Purpose: Although many oncologists have the impression that patients with collagen vascular disease tolerate radiotherapy less well than other patients, until now this was never described in a review article.

Methods And Results: The principal objective was to determine whether patients with collagen vascular diseases have a greater risk of severe radiation therapy complications, than those without a collagen vascular disease. However, most of the publications found on this topic are short anecdotal case reports of patients with increased toxicity after radiation.

Primary sinonasal mucosal melanoma: three different therapeutic approaches to inoperable local disease or recurrence and a review of the literature.

Sinonasal melanoma is an uncommon disease with a bad prognosis and a high local recurrence rate. The use of radiotherapy in such conditions remains controversial. A review of the literature is presented in an attempt to answer some of the questions regarding therapeutic options.

An unusual evolution of the serum CA 125 level in a ovarian cancer patient.

The usefulness of serum CA 125 measurements in monitoring ovarian cancer has been firmly established in recent years. The CA 125 levels correlate well with tumor status, have a predictive value for second-look operations, indicate responsiveness to chemotherapy, and are a strong independent prognostic factor for survival. We report here a patient with an unusual evolution of the CA 125.

A comparison of ondansetron with metoclopramide in the prophylaxis of chemotherapy-induced nausea and vomiting: a randomized, double-blind study. International Emesis Study Group.

The efficacy of ondansetron was compared with metoclopramide in the prophylaxis of nausea and vomiting induced by cyclophosphamide greater than or equal to 500 mg/m2 in combination with doxorubicin greater than or equal to 40 mg/m2 or epirubicin greater than or equal to 40 mg/m2. complete anti-emetic protection in the 24 h following chemotherapy was achieved in 26 of 40 (65%) patients treated with ondansetron compared with 17 of 42 (41%) patients treated with metoclopramide. Severe nausea was present in 3% of patients in the ondansetron group and 31% in the metoclopramide group.

Radiation treatment of rectal adenocarcinoma.

The author makes an overview of the place of radiotherapy in the management of patients suffering from rectal cancer: pre-operative and post-operative radiotherapy, treatment of inoperable and recurrent disease are discussed.

Scintigraphic imaging of an unusual liver displacement.

The authors present a patient with a mass in the right lung due to a partial herniation of the liver.

High-dose alizapride versus high-dose domperidone: a double-blind comparative study in the management of cis-platinum-induced emesis.

A double-blind, randomized crossover trial was carried out in 44 cancer patients receiving chemotherapy with cis-platinum to compare the anti-emetic effectiveness and tolerance of alizapride and domperidone given in high dosage. Patients received 5 administrations of either 4 mg alizapride/kg body weight or 0.6 mg domperidone/kg during a chemotherapy session and then the alternative anti-emetic during the next session.

Intra-arterial radionuclide infusion as an aid to assess chemotherapy perfusion patterns.

Regional treatment of advanced head and neck cancer by intra-arterial infusion has been tried for several years. The aim of such treatment is to increase the concentration of the drug in the tumor area while decreasing systemic toxicity. The exact localization of the intra-arterial catheter is thereby the key to effective treatment.

Influence of nandrolone decanoate on the repopulation of the thymus after total body irradiation of mice.

It has been reported that nandrolone decanoate is helpful in overcoming the neutropenic phase following irradiation. In the present study the influence of nandrolone decanoate on the thymus' cellularity after total body irradiation was investigated. In comparison with a placebo-treated group, mice receiving nandrolone decanoate showed a similar pattern of thymus repopulation, but a significantly lower number of thymocytes over the whole period of treatment was found.

Ga-67 imaging in Hodgkin's disease.

In order to answer the question if Ga-67 imaging has a practical utility for the management of the patient with Hodgkin's disease, 108 scans performed on 60 patients were reviewed. When used during the initial staging of the disease or during restaging because of recurrences, Ga-67 imaging-at least in our experience-gave many false negative results in the cervical, axillary and inguinal areas, whereas the majority of true positive scans was found at the mediastinal level (including the lower mediastinum), and also in the lung parenchyma and the upper epigastric regions. Because of its lack of sensitivity, Ga-67 imaging cannot replace other staging procedures, but nevertheless is a valuable adjunctive test, as it can identify tumor localization that may have remained undetected by other methods.

Analysis of fluorouracil in human plasma by combined gas-liquid chromatography mass spectrometry.

Fluorouracil in human plasma of a concentration as low as 2 ng ml-1 can be assayed with the use of gas-liquid chromatography and a multiple ion detector. Fluorouracil is isolated from plasma by anion exchange extraction. The extract is butylated and the derivative obtained extracted into a mixture of cyclohexane + dichloromethane (95:5).

Cytostatic-associated vomiting effectively inhibited by domperidone (R 33 812).

The effect of domperidone on vomiting due to cytostatic treatment was studied during a double-blind trial involving 41 patients. One group received the sequence domperidone-placebo and the other the reverse sequence during two consecutive courses of cytostatic therapy (chlormethine alone or in combination with other cytostatics). Domperidone 2 mg/ml or the placebo was injected IV 1 h before the start of the cytostatic treatment.

Total body irradiation with 8 MeV X-rays in generalized malignant disease.

The authors describe their experience with total body irradiation (TBI) with 8 MeV-x rays in the treatment of disseminated tumors. With a dose of 125 rad, given three times with 2-week intervals, some objective remissions (6/26) were obtained, especially in patients with lymphomas. For solid tumors only subjective improvement could be achieved.

Controlled telethermographic study of the peripheral vasoactivity of oral piribedil.

A single-blind crossover study was carried out in 10 subjects with a healthy arterial system to compare the effects of oral piribedil and placebo on the peripheral circulation. Using a telethermographic technique, skin temperature variations from baseline values were measured, at 15 minute intervals over a 2-hour period, after treatment with 3 x 20 mg piribedil tablets, after 1 x 50 mg piribedil in a sustained-release tablet formulation, and after placebo. In contrast to placebo, a vaso-active effect was observed afte piribedil administration on all but 3 occasions.