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13 results

  • Chapter 2 - The effect of chemotherapy and radiotherapy on the human reproductive system

  • from Section 1 - Introduction
  • Edited by Jacques Donnez, Université Catholique de Louvain, Belgium, S. Samuel Kim, University of Kansas
  • Book:
    Principles and Practice of Fertility Preservation
    Published online:
    04 February 2011
    Print publication:
    03 February 2011, pp 11-22

  • Summary

    Cancer is more common after puberty during the reproductive life span of men and women, and many of the patients will be cured by combination treatment with surgery, chemotherapy and radiotherapy. The model of human ovarian reserve allows us to estimate the number of non-growing follicles (NGFs) present in the ovary at any given age, and it suggests that 81% of the variance in NGF populations is due to age alone. The ovary is susceptible to chemotherapy-induced damage, particularly following treatment with alkylating agents such as cyclophosphamide. Ovarian damage is drug- and dose-dependent and is related to age at the time of treatment, with progressively smaller doses required to produce ovarian failure with increasing age. Preventing chemotherapy-induced damage to the ovary or testes remains an elusive ideal in the field of fertility preservation. Both chemotherapy and radiotherapy can impair future fertility, and treatments for certain cancers can be sterilizing.

  • Chapter 2 - Identifying risk factors for cognitive change in the Women's Health Initiative: a neural networks approach

  • from Section 1 - Estrogens and cognition: perspectives and opportunities in the wake of the Women's Health Initiative Memory Study
  • Edited by Eef Hogervorst, Loughborough University, Victor W. Henderson, Stanford University, California, Robert B. Gibbs, University of Pittsburgh, Roberta Diaz Brinton, University of Southern California
  • Book:
    Hormones, Cognition and Dementia
    Published online:
    06 July 2010
    Print publication:
    24 September 2009, pp 11-24

  • Summary

    Editors' introduction

    The Women's Health Initiative Memory Study (WHIMS) has been much criticized and it has been suggested that subgroups of women exist for whom hormone therapy (HT) might improve or impair cognitive function. Possible modifying variables could be age, smoking, body mass index, and menopausal symptoms. These were included in artificial neural networks (ANN) analyses, which allow testing of complex non-linear higher order interactions of variables to predict outcomes. Artificial neural networks analyses without hidden units could predict responders and non-responders to treatment as well as logistic regression models that included only main effects, which indicated that higher order interactions were not necessary and did not add to the value of the models. There seemed to be no subgroups (e.g., older women who smoke and have a high body mass) for whom HT has a worse or better effect on cognitive function over time. This study also showed that cross-validation is essential in building robust models with many independent variables and should be applied as a standard technique in complex multivariate analyses.

  • 57 - Late effects of the treatment of childhood cancer

  • from Part VI - Oncology
    • By Mark F. H. Brougham, Department of Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK, W. Hamish B. Wallace, Department of Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK
  • Edited by Mark D. Stringer, Keith T. Oldham, Pierre D. E. Mouriquand
  • Book:
    Pediatric Surgery and Urology
    Published online:
    08 January 2010
    Print publication:
    09 November 2006, pp 727-744

  • Summary

    Introduction

    Survival from childhood cancer has markedly improved over recent decades following major advances in available treatments and supportive care, such that now around 75%–80% of children with cancer will be alive 5 years from diagnosis. The number of long-term survivors is therefore increasing, and it has been estimated that, by the year 2010, about one in 715 of the adult population will have been treated for cancer in childhood. Because of this, the emphasis in the management of childhood cancer has changed, from “cure at any cost” to one in which quality of life after treatment has become increasingly important. Thus, whilst continuing to strive for improved survival, attention must be directed towards minimizing the late effects of treatment.

    Adverse late effects of childhood cancer treatment are diverse and include growth impairment, disorders of the endocrine system, infertility, abnormalities of cardiac and pulmonary function, renal and hepatic impairment, second malignancies, and cognitive and psychosocial difficulties. This chapter focuses on these consequences of childhood cancer treatment. Long-term follow-up of these patients is essential, in order that adverse effects are diagnosed early and appropriate counselling and therapeutic intervention instituted. Awareness of the etiology and prevalence of late complications will allow modifications of treatment that will improve the quality of life for long-term survivors of childhood cancer.

    Endocrine disorders and growth impairment

    Collectively, disorders of the endocrine system represent the commonest long-term complication of cancer treatment, with one study demonstrating endocrine abnormalities in up to 40% of such patients at follow-up.

  • 32 - Late reproductive sequelae of treatment for childhood cancer

  • from Part III - Management of specific disorders
    • By Angela B. Thomson, Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, UK, Hilary O.D. Critchley, Department of Developmental and Reproductive Sciences, University of Edinburgh, Edinburgh, UK, Christopher J. H. Kelnar, Department of Developmental and Reproductive Sciences, University of Edinburgh, Edinburgh, UK, W. Hamish B. Wallace, Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, UK
  • Edited by Adam H. Balen, Sarah M. Creighton, Melanie C. Davies, University College London, Jane MacDougall, Richard Stanhope
  • Book:
    Paediatric and Adolescent Gynaecology
    Published online:
    04 May 2010
    Print publication:
    01 April 2004, pp 397-415

  • Summary

    Introduction

    Tremendous therapeutic advances in the management of childhood malignancies mean that the majority of children can realistically hope for long-term survival. Cancer in childhood is rare, with about 1400 new cases per year in the UK and a cumulative risk of 1 in 650 by the age of 15 years (Stiller, 1997; Wallace, 1997). With survival rates in excess of 70%, it is estimated that by the year 2010, 1 in 250 of the young adult population will be a long-term survivor of childhood cancer (Fig. 32.1) (Bleyer, 1990). However, the successful treatment of cancer in childhood with chemotherapy and or radiotherapy is associated with a number of unwanted side effects in later life (Wallace et al., 2001). Therefore, the major challenge faced by paediatric oncologists today is to sustain the excellent survival rates while striving to improve the quality of life of the survivors.

    One of the most important issues for the survivors of childhood cancer is the impact of their disease and its treatment on reproductive function and the implications for the health of their offspring. In the female, chemotherapy and radiotherapy may damage the ovary and hasten oocyte depletion, resulting in loss of hormone production, truncated fecundity and a premature menopause (Meirow, 2000; Thomson et al., 2002). Infertility is one of the most commonly encountered and psychologically traumatic late complications of treatment for childhood cancer, and consequently, strategies to preserve fertile potential are being pursued.

  • Studies of Substituted R2 T14 B and R2 Co17 Systems (T = Fe or Co)

  • W. E. Wallace, A. T. Pedziwiatr, E. B. Boltich, H. Kevin Smith, S. Y. Jiang, S. G. Sankar, E. Oswald
  • Journal:
    MRS Online Proceedings Library Archive / Volume 96 / 1987
    Published online by Cambridge University Press:
    25 February 2011, 17
    Print publication:
    1987

  • Certain R2Co17 and R2 T14 B systems (R = a rare earth, T = Fe or Co) are of significance for use in the fabrication of high energy magnets. Improvements in these systems as high energy magnet materials are effected by partially replacing Co or T by appropriate d transition metals. A description is given of the magnetic behavior of a number of systems based on R2 Co17 and R2T14 B. Also, an account is given of recent work dealing with the systems RCo4 B and PrCo4-xFex B. The latter materials have large magnetizations and high Curie temperatures. However, they are not useful permanent magnet materials because they exhibit planar anisotropy.

    Results of some Auger spectroscopy studies of R2 Fe14 B systems (R = Pr,Nd or Er) are presented. This work shows the intergranular region to be rich in B, O and R. This region is undoubtedly non-magnetic, a feature which is most probably of significance in regard to the observed coercivity of R2 Fe14 B magnets.