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Cancer Chemother Pharmacol. 2003 Aug;52(2):147-52. Epub 2003 May 23.
Gemcitabine and vinorelbine as second-line treatment in patients with metastatic breast cancer: a phase II study.

Donadio M, Ardine M, Berruti A, Ritorto G, Fea E, Mistrangelo M, Coccorullo Z, Bergnolo P, Comandone A, Bertetto O.

Oncologia Medica, Centro Oncologico Ematologico Subalpino, Azienda Ospedaliera Molinette, Corso Bramante 33, 10126, Turin, Italy, magoaibero.it

BACKGROUND. To evaluate the feasibility and activity of gemcitabine and vinorelbine as a second/third-line approach in patients with advanced breast cancer. METHODS. Entered into the study were 51 consecutive patients. All had been previously treated with anthracyclines. Of these 51 patients, 36 had experienced failure or relapse after one chemotherapy line for advanced disease, and 15 after two chemotherapy lines. The dominant sites of involvement were brain in 4 patients (7.8%), liver in 22 (43.2%), lung in 10 (19.6%), bone in 10 (19.6), and soft-tissue in 5 (9.8%). Treatment consisted of vinorelbine 25 mg/m(2) and gemcitabine 1000 mg/m(2) administered on days 1 and 8 every 21 days. RESULTS. The scheme was well tolerated. Grade 3/4 neutropenia was observed in 11% of patients. Grade 3 nausea and vomiting occurred in 6%, and grade 2 neurotoxicity in 6%. No patients experienced grade 3/4 alopecia. The median relative dose intensity was 94.6% (49.7-100%) and 90.0% (23.1-100%) for vinorelbine and gemcitabine, respectively. Two patients (3.9%) were not evaluable for disease response, 4 (7.8%) attained a clinical complete response, 13 (25.5%) a partial response (for an overall response rate of 33.3%, 95% coefficient interval 20.0-46.0%), 23 (45.2%) showed stable disease, and 9 (17.6%) progressed. The median time to progression of responding patients was 10.8 months, and the median overall survival of the entire population was 17.8 months. CONCLUSIONS. Vinorelbine and gemcitabine is a manageable scheme with moderate activity in pretreated patients with advanced breast cancer.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12764672&dopt=Abstract [PubMed - in process]

J Clin Oncol. 2002 Dec 15;20(24):4628-35.
Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study.

Jonat W, Kaufmann M, Sauerbrei W, Blamey R, Cuzick J, Namer M, Fogelman I, de Haes JC, de Matteis A, Stewart A, Eiermann W, Szakolczai I, Palmer M, Schumacher M, Geberth M, Lisboa B; Zoladex Early Breast Cancer Research Association Study.

Klinik fur Gynakologie und Gerburtshilfe, University of Kiel, Germany. jonamail.uni-kiel.de

PURPOSE: Current adjuvant therapies have improved survival for premenopausal patients with breast cancer but may have short-term toxic effects and long-term effects associated with premature menopause. PATIENTS AND METHODS: The Zoladex Early Breast Cancer Research Association study assessed the efficacy and tolerability of goserelin (3.6 mg every 28 days for 2 years; n = 817) versus cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy (six 28-day cycles; n = 823) for adjuvant treatment in premenopausal patients with node-positive breast cancer. RESULTS: Analysis was performed when 684 events had been achieved, and the median follow-up was 6 years. A significant interaction between treatment and estrogen receptor (ER) status was found (P =.0016). In ER-positive patients (approximately 74%), goserelin was equivalent to CMF for disease-free survival (DFS) (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.84 to 1.20). In ER-negative patients, goserelin was inferior to CMF for DFS (HR, 1.76; 95% CI, 1.27 to 2.44). Amenorrhea occurred in more than 95% of goserelin patients by 6 months versus 58.6% of CMF patients. Menses returned in most goserelin patients after therapy stopped, whereas amenorrhea was generally permanent in CMF patients (22.6% v 76.9% amenorrheic at 3 years). Chemotherapy-related side effects such as nausea/vomiting, alopecia, and infection were higher with CMF than with goserelin during CMF treatment. Side effects related to estrogen suppression were initially higher with goserelin, but when goserelin treatment stopped, reduced to a level below that observed in the CMF group. CONCLUSION: Goserelin offers an effective, well-tolerated alternative to CMF in premenopausal patients with ER-positive and node-positive early breast cancer.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12488406&dopt=Abstract

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2000 Feb;35(1):35-8.
[Pedicled galeal flap in the reconstruction of head and neck tumor defects]

[Article in Chinese]

Zhang B, Tang P, Qi Y.

Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. binzhanublic.bta.net.cn

OBJECTIVE: To evaluate the advantage and applications of pedicled galeal flap in head and neck region. METHODS: A consecutive series of 17 patients underwent surgical reconstruction with pedicled galeal flaps after head and neck tumor resection. The defects included nasopharnx, skull base, maxilla, orbital base, oropharynx and oral cavity and the size ranged from 5 cm x 5 cm to 10 cm x 10 cm. The technique for using this flap was described and application was illustrated with 3 case reports. RESULTS: Complete success of galeal flaps for the reconstruction of head and neck defects was achieved in 13 of the 17 cases (76.5%) and partial necrosis was observed in the remaining 4 cases (23.4%). Immediate wound complications occurred in four cases, which resolved spontaneously. Four delayed complications were observed in 4 of 9 survival cases that included trismus (3) and alopecia (1). CONCLUSION: Galeal flap is a thin, pliable and well vascularised reconstruction tissue and is highly reliable. The donor site morbidity is minor. We have found the flap to be useful in the reconstruction of a variety of defects in head and neck, especially in skull base, orbital base, nasopharynx and oropharynx.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12768687&dopt=Abstract [PubMed - in process]

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