ABSTRACT
Commercially produced ultrasound coupling gel is often a scarce resource in rural regions of low-income countries that use sonography as their main imaging modality and, when available, may be cost prohibitive. Various homemade gels were created and tested to assure image quality was not compromised. Glucomannan-based gel and guar gum-based gel had superior physical properties in initial testing and showed no substantial difference compared with commercially available ultrasound gel on subject and phantom imaging and analysis (P > .05 using a 1-tailed sign test). Neither gel required heating, attracted insects, damaged ultrasound transducers, stained samples of clothing, or had harmful effects to subjects.
Subject(s)
Gels/standards , Image Interpretation, Computer-Assisted/instrumentation , Ultrasonography/methods , Costs and Cost Analysis , Developing Countries , Galactans/chemistry , Galactans/economics , Gels/chemistry , Gels/economics , Humans , Image Interpretation, Computer-Assisted/standards , Mannans/chemistry , Mannans/economics , Phantoms, Imaging , Plant Gums/chemistry , Plant Gums/economics , Poverty , Ultrasonography/economics , Ultrasonography/standards , ViscosityABSTRACT
Cyclin dependent kinase 4 of 6 inhibitors (CDKi) are key therapeutics in the treatment of advanced breast cancer and have recently been approved in small cell lung cancer for the prevention of myelosuppression. Thrombotic events have emerged as a significant treatment related adverse event in up to 5% of patients in clinical trials and has been reported at higher rates, up to 10%, in real world analysis. The prothrombotic mechanisms of CDKis, however, remain unknown. Cancer specific risk assessment models exist to identify who may be at highest risk of thrombosis and who could potentially benefit from prophylactic anticoagulation. However, these models may not be accurate in patients taking CDKis and may not fully capture recently identified thrombotic risk factors such as tumor specific somatic mutations. In the following manuscript, we summarize the literature on thrombotic events with CDKis in clinical trials and real-world settings, review the existing thrombosis risk assessment models for ambulatory cancer patients, and discuss the literature on tumor mutations and role in cancer associated thrombosis.