Utilisation de l’aprépitant pour les nausées et les vomissements réfractaires secondaires à la chimiothérapie chez une adolescente
Bibliographic record
Abstract
Resume Objectif : Presenter un cas d’utilisation de l’aprepitant. Resume du cas : Il s’agit d’une patiente de 15 ans atteinte d’un osteosarcome et traitee par chimiotherapie hautement emetisante a base de cisplatine. La patiente a eprouve, lors de ses premiers cycles de traitement, des nausees et des vomissements aigus et retardes tres importants, refractaires aux antiemetiques habituels. Un essai a l’aprepitant a ete tente. Ce medicament n’etant pas commercialise au Canada, il a du etre obtenu par le biais du Programme d’acces special aux medicaments (PAS) de Sante Canada. L’aprepitant a ameliore de facon significative le controle des nausees et des vomissements chez cette patiente. Discussion : L’aprepitant est un antagoniste des recepteurs de la neurokinine-1 (NK-1). Il est administre par voie orale en combinaison avec les antinauseeux conventionnels, incluant les antagonistes des recepteurs 5-HT3. Plusieurs regimes ont ete testes post-cisplatine, demontrant tous une meilleure efficacite dans la prevention des nausees et des vomissements aigus et retardes, comparativement a la therapie standard seule. Conclusion : L’aprepitant est un antiemetique qui semble prometteur, particulierement dans le traitement des nausees et des vomissements retardes. Toutefois, certaines questions doivent encore etre elucidees par des etudes cliniques, surtout chez les enfants et les adolescents. Abstract Objective: To report the use of aprepitant in a case. Case Summary: A 15 year old patient with osteosarcoma was treated with highly emetogenic cisplatinbased chemotherapy. The patient suffered severe acute and delayed nausea and vomiting, which were refractory to standard anti-emetic medication. Aprepitant was administered in this patient. Since this medication is not commercially available in Canada, it was obtained through the Health Canada Special Access Programme. Aprepitant significantly improved the control of nausea and vomiting in this patient. Discussion: Aprepitant is a neurokinin-1 receptor antagonist (NK1). It is administered orally in combination with standard anti-emetics, including the 5-HT3 receptor antagonists. Many schedules have been evaluated post-cisplatin administration and improved efficacy in the prevention of acute and delayed nausea and vomiting has been demonstrated, as compared to standard therapy. Conclusion: Aprepitant is a promising anti-emetic, particularly in the treatment of delayed nausea and vomiting. Nonetheless, many questions remain to be answered with further clinical trials, especially in children and adolescents. Key Words: aprepitant, anti-emetics, substance P, NK-1 receptor antagonists, cisplatin
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".