Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Mar 2003
ReviewEstablished and potential therapeutic applications of cannabinoids in oncology.
Cannabis occurs naturally in the dried flowering or fruiting tops of the Cannabis sativa plant. Cannabis is most often consumed by smoking marihuana. Cannabinoids are the active compounds extracted from cannabis. ⋯ CB2 receptors are found in certain nonneuronal tissues, particularly in the immune cells. Recent discovery of both the cannabinoid receptors and endocannabinoids has opened a new era in research on the pharmaceutical applications of cannabinoids. The use of cannabinoids should be continued in the areas indicated, and further studies are needed to evaluate other potential uses in clinical oncology.
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Support Care Cancer · Mar 2003
Clinical TrialEvaluation of an ultrasound-guided technique for central venous access via the internal jugular vein in 493 patients.
Ultrasound guidance for percutaneous puncture of the internal jugular vein provides many advantages over the classic landmark-guided technique, particularly in complicated cases (e.g. thrombocytopenia, obesity, dyspnea). The present prospective investigation involved analysis of 493 punctures and provides patient- and operator-dependent variables with respect to the impact on puncture success and the complication rate. These 493 punctures of the internal jugular vein were performed using identical puncturing equipment and a standardized two-operator catheterization technique and were prospectively recorded on the hematology-oncology ward of a university hospital. ⋯ Ultrasound-guided cannulation of the internal jugular vein provides safe central venous access with high success rates and low complication rates. Difficulties due to patient-inherent risk factors (e.g. thrombocytopenia, obesity, dyspnea) can be managed well using ultrasonographic guidance. The success rate achieved and the frequency of complications are decisively influenced not by the experience of the physician performing the puncture, but by the experience of the physician acting as sonographer.
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The two commercially available taxanes (paclitaxel and docetaxel) are widely employed in standard oncologic practice. Toxicity of the agents includes bone marrow suppression (principally neutropenia), complete alopecia, and hypersensitivity reactions. ⋯ Docetaxel can be associated with the development of significant fluid retention (e.g., edema, ascites, pleural effusions), the incidence and severity of which appear to be limited by prophylactic treatment with corticosteroids both before and after each treatment. If patients are monitored closely (e.g., for hypersensitivity reactions, bone marrow suppression) the taxanes have a favorable side effect profile, and it is currently uncommon for treatment to be discontinued because of the development of excessive toxicity.