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1.
Psychogeriatrics ; 12(2): 137-41, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22712651

RESUMO

People with dementia face all sorts of troubles in their daily lives. However, it is difficult to understand fully the extent of these troubles. Even spouses and family members who know their daily routines and habits have difficulty caring for those with dementia because these patients are unable to express themselves as a result of their condition. Given these problems, one must consider the capabilities of institutional caregivers to observe and understand dementia patients, as well as accurately report on their daily condition. To overcome these potential problems, a key solution could be to document patients' activities on video. If mutual trust is established between the patient and caregiver, video documentation could record the hidden daily life of dementia patients and document their daily activities and the confusion that they face. This article discusses the efficacy of using video as a means of understanding early onset dementia patients' feelings and actions by documenting their daily lives and treatment approaches based on these observations.


Assuntos
Atividades Cotidianas/classificação , Doença de Alzheimer/diagnóstico , Avaliação da Deficiência , Estilo de Vida , Gravação em Vídeo , Atividades Cotidianas/psicologia , Idoso , Doença de Alzheimer/psicologia , Atenção , Terapia Comportamental/métodos , Hospital Dia , Humanos , Masculino , Orientação
2.
Exp Hematol ; 37(8): 956-68, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19409955

RESUMO

OBJECTIVE: To evaluate the potential anti-tumor activity of zoledronate-activated Vgamma9gammadelta T cells in vivo, we initiated a pilot study involving administration of zoledronate-activated Vgamma9gammadelta T lymphocyte-activated killer (LAK) cells to patients with multiple myeloma. MATERIALS AND METHODS: Subjects (n = 6) received four intravenous infusions at 2-week intervals of zoledronate-activated Vgamma9gammadelta T LAK cells generated from the culture of peripheral blood mononuclear cells (PBMCs) in the presence of zoledronate and interleukin-2. If the M-protein level in the patient's serum remained at baseline following four intravenous infusions, the patient underwent four more treatments at 4-week intervals. Subjects (n = 6) received a median of 0.99 x 10(9) Vgamma9gammadelta T LAK cells per infusion. RESULTS: No serious treatment-related adverse effects were observed during the study period. The percentage of Vgamma9gammadelta T cells in PBMCs and absolute numbers of Vgamma9gammadelta T cells in peripheral blood, particularly those of CD45RA(-)CD27(-) effector memory (TEM) Vgamma9gammadelta T-cell subsets increased in all the patients. Percentages of Vgamma9gammadelta T cells and TEM Vgamma9gammadelta T cells in bone marrow also increased in all the patients so far tested. M-protein levels in the serum remained at baseline in four of six patients and increased in two of six patients. Soluble major histocompatibility complex class I chain-related antigen A was detected only in the serum of patients whose M-protein level increased. CONCLUSION: Administration of zoledronate-activated Vgamma9gammadelta T LAK cells is a safe and promising immunotherapy approach for treatment of patients with multiple myeloma.


Assuntos
Difosfonatos/administração & dosagem , Imidazóis/administração & dosagem , Imunoterapia Adotiva/métodos , Células Matadoras Ativadas por Linfocina/transplante , Ativação Linfocitária/efeitos dos fármacos , Mieloma Múltiplo/terapia , Receptores de Antígenos de Linfócitos T gama-delta/imunologia , Adulto , Idoso , Células Sanguíneas/citologia , Conservadores da Densidade Óssea/administração & dosagem , Células da Medula Óssea/citologia , Técnicas de Cultura de Células , Feminino , Humanos , Interleucina-2/farmacologia , Células Matadoras Ativadas por Linfocina/imunologia , Contagem de Linfócitos , Subpopulações de Linfócitos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Resultado do Tratamento , Ácido Zoledrônico
3.
Pancreas ; 38(3): e69-74, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19276867

RESUMO

OBJECTIVES: Dendritic cell (DC) therapy frequently induces a measurable immune response. However clinical responses are seen in a minority of patients, presumably due to insufficient expansion of antigen-specific cytotoxic T lymphocytes (CTLs) capable of eradicating tumor cells. To increase therapeutic efficacy of DC-based vaccination, we have undertaken the first clinical trial involving a combination therapy of gemcitabine (GEM) with immunotherapy for patients with inoperable locally advanced pancreatic cancer. METHODS: Patients (n = 5) received the treatment course, which consisted of intravenous GEM administration at 1000 mg/m (day 1) and the endoscopic ultrasound-guided fine-needle injection of OK432-pulsed DCs into a tumor, followed by intravenous infusion of lymphokine-activated killer cells stimulated with anti-CD3 monoclonal antibody (CD3-LAKs) (day 4), at 2-week intervals. RESULTS: No serious treatment-related adverse events were observed during the study period. Three of the 5 patients demonstrated effective responses to this clinical trial; 1 had partial remission and 2 had long stable disease more than 6 months. In the patient with partial remission, it has been shown that DC-based vaccination combined with GEM administration induces tumor antigen-specific CTLs. CONCLUSION: This combined therapy was considered to be synergistically effective and may have a role in the therapy of pancreatic cancer for inducing tumor antigen-specific CTLs.


Assuntos
Antimetabólitos Antineoplásicos/farmacologia , Células Dendríticas/transplante , Desoxicitidina/análogos & derivados , Células Matadoras Ativadas por Linfocina/transplante , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/imunologia , Idoso , Antimetabólitos Antineoplásicos/efeitos adversos , Terapia Combinada , Células Dendríticas/imunologia , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Feminino , Humanos , Imunoterapia Adotiva/efeitos adversos , Imunoterapia Adotiva/métodos , Células Matadoras Ativadas por Linfocina/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Projetos Piloto , Índice de Gravidade de Doença , Linfócitos T Citotóxicos/imunologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Gencitabina
5.
Hinyokika Kiyo ; 48(12): 771-9, 2002 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-12613015

RESUMO

TAP-144-SR (3M) is a 3-month sustained releasing injection of a super-active agonist of luteinizing hormone releasing hormone (LH-RH), leuprorelin acetate. At the Department of Urology of Gunma University Hospital, TAP-144-SR (3M) was injected once subcutaneously into 10 prostatic cancer patients who had had no treatment in the past to investigate safety, serum testosterone levels, drug concentrations and efficacy. In safety, no problematic adverse reactions occurred, and the drug was well tolerated. Serum testosterone levels elevated temporarily up to 2 days after injection and then were reduced rapidly. The levels were reduced below the castration level (100 ng/dl) after 3 weeks and then remained reduced up to 12 weeks. Serum TAP-144 levels including metabolite M-I, elevated to maximal plasma concentration up to 3 hours after injection and then were maintained at about 0.2 ng/ml between 1 week and 12 weeks after injection. With respect to the anti-tumor effects, the response rate according to "criteria of prostate cancer" at 12 weeks after injection was 100% (stable response cases) and the ratio of PSA normalization at 12 weeks was 90%. These results showed that an injection of TAP-144-SR (3M) was well tolerated in prostate cancer patients having no prior treatment and inhibited serum testosterone persisting for at least 12 weeks so that TAP-144-SR (3M) was concluded to be safe and clinically effective for prostate cancer patients.


Assuntos
Antineoplásicos Hormonais/administração & dosagem , Hormônio Liberador de Gonadotropina/agonistas , Leuprolida/administração & dosagem , Neoplasias da Próstata/tratamento farmacológico , Idoso , Antineoplásicos Hormonais/farmacocinética , Preparações de Ação Retardada , Humanos , Injeções Subcutâneas , Leuprolida/farmacocinética , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Testosterona/sangue , Fatores de Tempo , Resultado do Tratamento
6.
Hinyokika Kiyo ; 48(12): 781-95, 2002 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-12613016

RESUMO

A randomized, multicenter, double-blind, parallel-group study was conducted in order to evaluate the hormonal kinetics, pharmacokinetics, efficacy and safety of TAP-144-SR (3M) a three-month sustained-release injectable preparation of leuprorelin acetate, a highly active luteinizing hormone-releasing hormone (LH-RH) derivative by comparing the treatment with two subcutaneous doses of the test medication TAP-144-SR (3M) and the treatment with six subcutaneous doses of the reference medication TAP-144-SR (1M), a 1-month sustained-release injectable preparation. Study participants were 103 patients with prostate cancer in whom a stable anti-tumor effect had been obtained with Leuplin Injection 3.75. The hormonal kinetics revealed that the proportion of the patients "maintaining the castration level of serum testosterone (maximum serum testosterone level during treatment below the castration level [100 ng/dl])" was 100% in both treatment groups. With regard to the efficacy, the proportions of the patients in whom the anti-tumor effects (> or = Stable) of the baseline treatment prior to the initiation of the treatment with the study medication were maintained during the study treatment period (6 months) were comparable; 84.0% with TAP-144-SR (1M) and 80.4% with TAP-144-SR (3M). On evaluation of the pharmacokinetics, the mean value of AUC1-12w of the serum TAP-144 concentration (including the metabolite M-I) for the treatment with TAP-144-SR (3M) was 77.0% that of the treatment with TAP-144-SR (1M). Adverse events were similar in the subjects on TAP-144-SR (3M) and in those on TAP-144-SR (1M). There existed no big differences in kind, incidence or time of occurrence of adverse events between two groups. TAP-144-SR (3M) showed no clinically relevant findings in particular. These results indicate that one dose of TAP-144-SR (3M) is comparable to three doses of the already approved Leuplin injection 3.75 in serum testosterone level-inhibitory effect, efficacy and safety. Hence, it is considered that TAP-144-SR (3M) is a drug suitable for treatment of prostate cancer over a prolonged period of time.


Assuntos
Antineoplásicos Hormonais/administração & dosagem , Hormônio Liberador de Gonadotropina/agonistas , Leuprolida/administração & dosagem , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/farmacocinética , Preparações de Ação Retardada , Método Duplo-Cego , Humanos , Injeções Subcutâneas , Leuprolida/farmacocinética , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Testosterona/sangue , Fatores de Tempo , Resultado do Tratamento
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