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1
Agarwalla, Avinesh, Anirudh K. Gowd, Joseph N. Liu, Simon P. Lalehzarian, David R. Christian, Brian J. Cole, Brian Forsythe, and Nikhil N. Verma. "Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy." Orthopaedic Journal of Sports Medicine 7, no. 4 (April 1, 2019): 232596711983794. http://dx.doi.org/10.1177/2325967119837940.
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Background: Return to sport (RTS) after meniscectomy is an important metric for young, active patients. However, the impact of the duration from surgery to RTS on clinical outcomes is not fully understood and is not reflected in outcome scores. Purpose: To establish when patients RTS after meniscectomy and to determine predictive measures for the ability to return to their preinjury activity. Study Design: Case-control study; Level of evidence, 3. Methods: All patients undergoing meniscectomy between 2016 and 2017 from a single institution were assessed for inclusion. RTS, type of activity, and level of function upon returning were obtained. The minimal clinically important difference (MCID), substantial clinical benefit, and patient acceptable symptom state (PASS) were calculated for the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaire using anchor-based and distribution-based approaches. Preoperative knee-specific and generic quality-of-life scores were analyzed to determine their predictive power of RTS. A multivariate logistical analysis was also performed to determine which demographic variables corresponded to RTS. Results: Overall, 94 patients (mean age, 51.0 ± 11.1 years) who underwent meniscectomy participated in sports within 6 months of surgery. Of these patients, 76.6% returned to sport without permanent restrictions at a mean of 8.6 ± 6.9 weeks postoperatively. RTS rates for low-, medium-, and high-intensity activities were 75.0%, 70.0%, and 82.5%, respectively. RTS was associated with achieving the PASS for the KOOS–Physical Function short form (PS), KOOS-Pain, and KOOS-Sports ( P = .004, P = .007, and P = .006, respectively) but not for the IKDC questionnaire ( P = .3). Achieving the MCID was associated with RTS for the KOOS-Sports, KOOS-Pain, and IKDC questionnaire ( P < .001, P = .03, and P = .001, respectively). There was no preoperative or intraoperative variable that was predictive of RTS. Preoperative KOOS-PS scores ≥37.8 (area under the curve = 76.3%) and KOOS-Pain scores ≥51.4 (area under the curve = 72.5%) were predictive of RTS. Conclusion: Approximately 77% of patients returned to sport after meniscectomy at a mean of 2 months postoperatively. The level of activity intensity did not significantly alter the rate of RTS. Higher preoperative scores on the KOOS-PS and KOOS-Pain were predictive of RTS. Identifying these factors allows physicians to counsel patients on expected outcomes after meniscectomy.
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Gómez-Seguí, Inés, Esperanza Such, Jose Cervera, Pascual Fernandez, Lurdes Zamora, Mara Andres, Irene Luna, et al. "Gene Microdeletions in Adult and Pediatric Acute Lymphoblastic Leukemia,." Blood 118, no. 21 (November 18, 2011): 3539. http://dx.doi.org/10.1182/blood.v118.21.3539.3539.
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Abstract Abstract 3539 Background: Microdeletions of genes involved in B lymphopoiesis and cell-cycle regulation, such as CDKN2A/B, PAX5, IKZF1, ETV6, RB1, BTG1 and EBF1 have been reported as a frequent event in pediatric acute lymphoblastic leukemia (ALL). Whether these findings are found in adulthood and the possible differences with childhood ALL, as well as its prognostic implication, are still unknown. Aims: To assess the differences between two cohorts of children and adults diagnosed with ALL on the frequency of deletions in these genes and their relationship with clinical data and prognosis. Methods: We studied 70 children and 83 adults diagnosed with ALL with available DNA sample at diagnosis. In children, median age was 4y. (1 – 14), median leukocytes 10.3×109/L (0.7 – 675) and the cytogenetic risk distribution was 42(39%), 30(27%) and 12(11%) for favourable [t(12;21) and hyperdiploidy], intermediate (normal karyotype and miscellaneous) and high risk [t(9;22), t(4;11), hypodiploid and complex karyotype], respectively. In adults, median age was 38y. (15 – 85), median leukocytes 16.8×109/L (1 – 371) and 29(35%) patients belonged to the high risk cytogenetic group. We performed Multiplex Ligation Probe Amplification (MLPA) using SALSA kit P335-A1 (MRC-Holland). PCR products were separated on an ABIPRISM 310 DNA Analyzer and analyzed using GeneMapper v3.2 (Applied Biosystems). Results: Frequency of deletions in the studied genes was similar in children and adults, except for IKZF1 deletions that were more frequent in adults (P<.001) (Table 1). In children, ETV6 deletions occurred more frequently in patients with t(12;21) (67% of patients with deletion vs. 17% without, P <.001); CDKN2A/B deletions were found in patients assigned to the intermediate cytogenetic risk group (59% of patients with deletion vs. 23% without, P =.028); and the three cases with RB1 deletions were found in patients with hypodiploidy (P <.001). In adults, ETV6 and CDKN2A/B deletions occurred more frequently in women (67% vs. 39%, P =.022 and 77% vs. 42%, P =.021, for patients with and without deletions, respectively); PAX5 and IKZF1 deletions appeared more frequently in patients with >30×109/L leukocytes (60% vs. 27%, P =.032 and 52% vs. 21%, P =.007, for patients with and without deletions, respectively); besides, PAX5 deletions occurred in patients who belonged to the standard cytogenetic risk group (55% vs. 6% for patients with and without deletions, P <.001). In the pediatric cohort, the leukocytes >30×109/L and the cytogenetic risk group were the variables that reached statistical significance for both overall survival (OS) and relapse free survival (RFS) and also age >10y. for OS, but in the multivariate analyses, just the cytogenetic risk classification remained significant [HR: 4 (CI 95%: 1.6 – 10), P =. 004 for OS and HR: 3.5 (CI 95%: 1.7 – 7.2), P =. 001 for RFS]. In the adult cohort, multivariate analysis for OS including all significant variables in the univariate analysis (age >60y, karyotype, CDKN2A/B and ETV6 deletions) showed as independent variables: age >60y. [HR: 4.3 (CI 95%: 2.1 – 8.6), P<. 001] and CDKN2A/B deletions [HR: 2.6 (CI 95%: 1.4 – 5.3), P=. 004]. Similarly, taking into account karyotype, CDKN2A/B and ETV6 deletions for the RFS multivariate analyses, just ETV6 deletions arose as an independent factor [HR: 3.8 (CI 95%: 1.5 – 9.4), P=. 004]. In fact, having CDKN2A/B and/or ETV6 deletions conferred a worse prognosis to patients in both standard risk cytogenetic group (3y. RFS: 45% vs. 70% for patients with and without deletions, respectively; P =.049) and high risk cytogenetic group (3y. RFS: 14% vs. 66% for patients with and without deletions, respectively; P =.025). Conclusions: This study shows the high incidence of deletions in genes of cell-cycle and B-lymphopoiesis in adult and pediatric ALL. However, the biological and prognostic implications of these deletions seem to differ between both patient groups: while cytogenetics was the strongest variable for risk assessment in children, gene microdeletions in CDKN2A/B and ETV6 added a prognostic value to karyotype in our adult cohort. Fundings: AP-194/10, R06/0020/0031, BES2008–008053, CM10/00321, CM09/00038, and CA08/00141. Disclosures: No relevant conflicts of interest to declare.
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Castro, Elena, Chee Goh, David Olmos, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, et al. "Germline BRCA Mutations Are Associated With Higher Risk of Nodal Involvement, Distant Metastasis, and Poor Survival Outcomes in Prostate Cancer." Journal of Clinical Oncology 31, no. 14 (May 10, 2013): 1748–57. http://dx.doi.org/10.1200/jco.2012.43.1882.
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Purpose To analyze the baseline clinicopathologic characteristics of prostate tumors with germline BRCA1 and BRCA2 (BRCA1/2) mutations and the prognostic value of those mutations on prostate cancer (PCa) outcomes. Patients and Methods This study analyzed the tumor features and outcomes of 2,019 patients with PCa (18 BRCA1 carriers, 61 BRCA2 carriers, and 1,940 noncarriers). The Kaplan-Meier method and Cox regression analysis were used to evaluate the associations between BRCA1/2 status and other PCa prognostic factors with overall survival (OS), cause-specific OS (CSS), CSS in localized PCa (CSS_M0), metastasis-free survival (MFS), and CSS from metastasis (CSS_M1). Results PCa with germline BRCA1/2 mutations were more frequently associated with Gleason ≥ 8 (P = .00003), T3/T4 stage (P = .003), nodal involvement (P = .00005), and metastases at diagnosis (P = .005) than PCa in noncarriers. CSS was significantly longer in noncarriers than in carriers (15.7 v 8.6 years, multivariable analyses [MVA] P = .015; hazard ratio [HR] = 1.8). For localized PCa, 5-year CSS and MFS were significantly higher in noncarriers (96% v 82%; MVA P = .01; HR = 2.6%; and 93% v 77%; MVA P = .009; HR = 2.7, respectively). Subgroup analyses confirmed the poor outcomes in BRCA2 patients, whereas the role of BRCA1 was not well defined due to the limited size and follow-up in this subgroup. Conclusion Our results confirm that BRCA1/2 mutations confer a more aggressive PCa phenotype with a higher probability of nodal involvement and distant metastasis. BRCA mutations are associated with poor survival outcomes and this should be considered for tailoring clinical management of these patients.
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Goekbuget, Nicola, Anja Baumann, Joachim Beck, Monika Brueggemann, Helmut Diedrich, Andreas Huettmann, Lothar Leimer, et al. "PEG-Asparaginase Intensification In Adult Acute Lymphoblastic Leukemia (ALL): Significant Improvement of Outcome with Moderate Increase of Liver Toxicity In the German Multicenter Study Group for Adult ALL (GMALL) Study 07/2003." Blood 116, no. 21 (November 19, 2010): 494. http://dx.doi.org/10.1182/blood.v116.21.494.494.
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Abstract Abstract 494 Several randomised pediatric trials have demonstrated that intensification of Asparaginase (ASP) treatment in ALL can contribute to improved outcome. In adult ALL few data are availabe and optimal ASP preparation, schedule and intensity with respect to efficacy and tolerability have to be defined. The optimisation of ASP treatment is therefore an essential aim of the GMALL. Treatment: Induction treatment of the ongoing study 07/2003 consists of dexamethasone, vincristine, daunorubicine, pegylated asparaginase (PEG-ASP) (phase I), mercaptopurine, cyclophosphamide and cytarabine (phase II) as previously described (Brueggemann et al, Blood 2006: 107; 1116). During the study the dose for PEG-ASP was increased from 1000 to 2000 U/m2 in induction and from 500 to 2000 U/m2 in consolidation (combined with HDMTX and MP) for pts aged between 15 and 55 years. 1 application for high risk and 7 applications for standard risk (SR) were scheduled during the first year and the aim was improvement of overall survival (OS) and remission duration (RD). Patients: From more than 100 centers in Germany 1226 pts with a median age of 35 (15-55) yrs were evaluable. 826 pts were treated with 1000 U/m2 (cohort 1) and 400 pts with 2000 U/m2 (cohort 2) and both groups were comparable regarding major entry criteria. The analysis was restricted to pts who received one of the scheduled PEG-ASP doses during induction. Outcome: CR rate after induction was 91% vs 91% in cohort 1 and 2 resp., with comparable rates for early death (4% vs 5%) and failure (5% vs 4%). Data on molecular response (MRD below 10−4) after induction are available in a subset and showed no difference between both cohorts after induction (79% vs 82%). OS after 3 years was improved in cohort 2 (60% vs 67%; p>.05). The positive effect was specifically evident in SR patients (N=407 vs 190) with respect to OS (68% vs 80%; p=.02) and RD (61% vs 74%; p=.02). It was demonstrated in younger pts (15-45 yrs) (71% vs 82%; p=.02) and older pt (45-55 yrs) (56% vs 74%; p>.05). Excellent results were achieved in young adults (15-25 years) with respect to OS (77% vs 86%; p>.05) and RD (60% vs 78%; p>.05). Toxicity: The analysis of toxicity was focused on grade III-IV events during induction with potential correlation to PEG-ASP (764/382 pts in cohort 1/cohort 2)). Incidences are as follows: GOT or GPT (30%/30%), bilirubine (10%/16%), thrombosis (5%/5%) and hypersensitivity (<1%/<1%). In a subset of pts additional AEs were assessed as amylase (5%/13%), lipase (23%/15%) and glucose (10%/12%). Significantly less toxicity was observed during consolidation cycles. Bilirubine °III/IV occurred median 16d after PEG-ASP during phase II of induction. In univariate analysis it was correlated to dose (10% vs 16%; p=.004), age <> 45 yrs (11% vs 17%; p=.005), BMI <> 30 (12% vs 18%; p=.04) and rituximab application (11% vs 18%; p=.009). Hepatomegaly, infections or imatinib application had no significant effect. In multivariate analysis dose and age remained independent significant prognostic factors. Bilirubine increase during induction was associated with treatment delays and inferior prognosis. Conclusions: This is the largest cohort of adult ALL treated with PEG-ASP. Due to prolonged activity fewer applications are required which is a pre-requisite for realisation of ASP intensification in the context of an intensive multidrug chemotherapy for adult ALL. Although CR rate and molecular CR were not significantly improved PEG-ASP intensification was associated with an improved OS and RD. The improvement was specifically evident in SR pts treated with up to 7 doses of PEG-ASP. Overall intensified PEG-ASP was feasible. The rate of grade III-IV bilirubine elevation increased after dose escalation and led to treatment delays in individual pts which were prognostically relevant. It would be an important goal to identify parameters to predict severe ASP related toxicity. Further intensification of ASP by additional applications would be of interest. Supported by Deutsche Krebshilfe 70–2657-Ho2 and partly BMBF 01GI 9971 and Medac GmbH. Disclosures: Goekbuget: Medac: Consultancy, Research Funding, Speakers Bureau. Hoelzer: Medac: Speakers Bureau.
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Kireeva, Irina V., Yuriy I. Chumlyakov, Zinaida V. Pobedennaya, Anna V. Vyrodova, and Anastasia A. Saraeva. "High-Strength Behavior of the Al0.3CoCrFeNi High-Entropy Alloy Single Crystals." Metals 10, no. 9 (August 26, 2020): 1149. http://dx.doi.org/10.3390/met10091149.
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The main disadvantage of fcc (face-centred cubic lattice) high-entropy alloys is the low stress level at the yield point (σ0.1) at a test temperature above room temperature. This restricts their practical application at high test temperatures from 773 K to 973 K. In this study, we found that a high stress level was reached at the yield point σ0.1 ≈ G/100–G/160 (G is the shear modulus) of the [001]- and [1¯44]-oriented crystals of the Co23.36Cr23.29Fe23.80Ni21.88Al7.67 (Al0.3CoCrFeNi) high-entropy alloy (HEA) within a wide temperature range of 77–973 K under tension, due to the occurrence, of nanotwins, multipoles, dislocations under plastic deformation at 77 K and the subsequent precipitation of ordered L12 and B2 particles. It was shown that grain boundaries are not formed and the samples remain in a single-crystal state after low-temperature deformation and subsequent ageing at 893 K for 50 h. Achieving a high-strength state in the Al0.3CoCrFeNi HEA single crystals induces the orientation dependence of the critical resolved shear stresses (τcr) at T ≥ 200 K (τcr[1¯44] > τcr[001]), which is absent in the initial single-phase crystals, weakens the temperature dependence of σ0.1 above 573 K, and reduces plasticity to 5–13% in the [1¯44] orientation and 15–20% in the [001] orientation.
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Symons, Martyn CR, and Raymond E. March. "Possible structures for H-Cu-CH3 molecules." Canadian Journal of Chemistry 79, no. 2 (February 1, 2001): 124–26. http://dx.doi.org/10.1139/v01-004.
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EPR spectra for H-Cu-CH3 molecules in glasses at 77 K show 63Cu hyperfine splitting that accords with a d1x2 y2 orbital for the semi-occupied molecular orbital (SOMO) rather than a d1z2 SOMO. The g-values also strongly imply a d1x2 y2 configuration. The estimated spin densities on the H- and -CH3 ligands are small. It is argued that the molecule must be strongly bent in order to favour this SOMO and that this bending may be induced by weak solvation.Key words : H-Cu-CH3, EPR spectra, molecular structure, hyperfine splitting.
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Nham, Benjamin, Nicole Reid, Emma Argaet, Allison Young, Kendall Bein, Gabor M. Halmagyi, and Miriam S. Welgampola. "004 Vestibular event monitoring in the emergency department." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A2.1—A2. http://dx.doi.org/10.1136/jnnp-2019-anzan.4.
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IntroductionAcute vertigo is often accompanied by ictal-nystagmus which may assist with diagnosis. We examine the merits of a structured assessment combined with vestibular event-monitoring in the Emergency Department (ED).MethodsWe undertook a structured clinical assessment and video-nystagmography in 220 non-consecutive patients presenting to a public-hospital ED with acute vertigo, during a 10-month period. The records of 115 consecutive vertiginous patients who underwent standard-assessment were compared.ResultsFor the structured assessment group: 54% presented with acute vestibular syndrome (AVS), 24% with episodic spontaneous vertigo (EVS), and 20% with recurrent positional-vertigo (RPV).For AVS (n=119), most common diagnoses were vestibular neuritis (34%), stroke (34%) and vestibular migraine (13%). Nystagmus slow-phase velocity (SPV) for VN, stroke and VM were 11±5.5o/s, 5.6±2.5o/s, 5.4±5.9o/s; Mean ipsilesional video-head impulse gains were 0.51±0.29, 0.89±0.20 and 0.96±0.13. For EVS(n=53), diagnoses included vestibular migraine (63%), Meniere’s Disease (11%) and others (26%). Nystagmus SPV was 5.4±3.6o/s, 7.6±6.3o/s, 4.1±1.5o/s. In RPV (n=43), common diagnoses were posterior-canal BPPV (66%), horizontal-canal BPPV (23%), migraine (7%). Positional nystagmus SPV profile showed Peak SPV of 42.5o/s, 77.6o/s, 20.64o/s and Time-constants of 6.52s, 22.51s, 34.56s for Posterior-canal BPPV, Horizontal-canal BPPV and Atypical Positional-Vertigo. A final diagnosis was reached in 96% of patients.In the ED control group, only 77% were separated into spontaneous or positional-vertigo. A diagnosis was provided in 57% and was concordant with the history and examination in 34%.ConclusionVestibular event-monitoring and structured clinical assessment secured a diagnosis in 96% of cases compared with 34% for the control group, reinforcing its merit.
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Sanabria Rojas, Hernán, Carolina Tarqui-Mamani, Juan Arias Pachas, and Nelly Lam Figueroa. "Impacto de la fortificación de la harina de trigo con ácido fólico en los defectos del tubo neural, en Lima, Perú." Anales de la Facultad de Medicina 74, no. 3 (October 15, 2013): 175. http://dx.doi.org/10.15381/anales.v74i3.2631.
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En los últimos años, estudios observacionales en algunos países de América Latina y el mundo demostraron una asociación favorable entre la fortificación de la harina con ácido fólico y la reducción de casos con defectos del tubo neural (DTN). Objetivos: Determinar la tasa de incidencia global (TIG) de DTN y su reducción en el periodo posfortificación (2006-2010) de la harina de trigo con ácido fólico. Diseño: Observacional, descriptivo y retrospectivo. Lugar: Instituto Nacional Materno Perinatal INMP, Lima, Perú. Participantes: Recién nacidos entre los años 2006-2010. Intervenciones: Se revisó 88 236 historias clínicas de recién nacidos. Se obtuvo promedios, desviación estándar, frecuencias absolutas y relativas; la tendencia de las incidencias fue medida con Prais Winsten. Se calculó el IC 95% para la TIG con la prueba de Poissón. Principales medidas de resultados: Tasa de Incidencia global de DTN. Resultados: Hubo 77 historias de RN con DTN, que representaron una TIG de 8,73 por 10 000 (IC 95%: 6,9 a 10,9), siendo la incidencia más alta 15,6 x 10 000 (IC 95%: 10,2 a 22,9) el año 2006 y la más baja 7,6 por 10 000 (IC95%: 4,1 a 13,0) el año 2010. Las incidencias de los tipos DTN fueron: espina bífida 6,7 por 10 000 (IC 95%: 5,1 a 8,6), anencefalia 1,9 por 10 000 (IC 95%: 1,1 a 3,1) y encefalocele 1 por 10 000 (IC 95%: 0,1 a 0,6). Conclusiones: La incidencia de los DTN en el INMP disminuyó a 8,7 por 10 000 RN en el periodo posfortificación (2006-2010) de la harina de trigo con ácido fólico, evidenciando impacto positivo de la intervención.
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A.P., Ilin, Kochetkov S.P., Bryl S.V., and Rukhlin G.V. "Problems and prospects of usage of secondary products of processing of natural phosphates for construction materials." Ekologiya i stroitelstvo 4 (2016): 21–29. http://dx.doi.org/10.35688/2413-8452-2016-04-004.
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In the article the problems and prospects of using of secondary products of processing of natural phosphates for obtaining building materials. This technology for production of complex fertilizers is carried out on a Chemical enterprises in Russia: Veliky Novgorod, Dorogouge and Kirovo-Chepetsk. It is noted that from 1 ton of P2O5 of apatite it is produced of CaCO3 about 80 kg. Total output of manmade chalk if you use apatite concentrate represented 896 thousand ton and does not solve the problem of the shortfall of cement in Russia technogenic raw materials, in addition, all obtained in this process, liquid wastes and solid by-products are utilized within these companies without reference to the construction industry. To use the maximum amount of phosphogypsum waste produced by the best Perera-motivate on the spot in sulphuric acid, the who-rotated in the manufacturing associated with obtaining cement, sinter for road construction or lime (depending on the needs of the market). According to classical method on 1 ton of 100% sulfuric acid and 1 ton port lancement spent 2.05 ton hosphogypsum (in terms of dry dihydrate).
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Pollock, Bruce E., Michael J. Link, Scott L. Stafford, Yolanda I. Garces, and Robert L. Foote. "Stereotactic Radiosurgery for Arteriovenous Malformations." Neurosurgery 78, no. 4 (October 30, 2015): 499–509. http://dx.doi.org/10.1227/neu.0000000000001085.
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Abstract BACKGROUND: Stereotactic radiosurgery (SRS) has been performed on patients with cerebral arteriovenous malformations (AVMs) for over 40 years. OBJECTIVE: To evaluate the impact of treatment period on obliteration, intracranial hemorrhage (ICH), and radiation-induced complications (RICs). METHODS: Retrospective comparison of 381 AVM patients having SRS during a 20-year period (group 1, January 1990 through March 1997, n = 160; group 2, April 1997 through December 2009, n = 221). The median radiological and clinical follow-up after initial SRS was 77 months and 93 months, respectively. RESULTS: Obliteration was 59.1% at 4 years and 85.1% at 8 years. Obliteration was more common in patients with hemispheric or cerebellar AVMs (P = .001), smaller prescription isodose volume (PIV) (P < .001), and group 1 patients (P < .001). The ICH rate was 7.7% at 4 years and 10.6% at 8 years. ICH was more common in older patients (P = .02), patients with deep AVM (P = .01), and larger PIV (P < .001). There was no difference in the ICH rate between the treatment groups (P = .18). The rate of permanent RICs was 4.4% at 4 years and 8.6% at 8 years. RICs were more common with larger PIVs (P < .001) and group 1 patients (P = .02). There was no difference in the number of patients having obliteration without new deficits between the 2 treatment periods (68.8% vs 73.3%, P = .33). CONCLUSION: Advances in SRS procedures over the past 20 years have resulted in a lower risk of RIC, but fewer patients had AVM obliteration. Increasing the prescription dose for patients with medium- and large-volume AVMs by using current conformal dose-planning techniques may improve the obliteration rate while maintaining a low risk of RICs.
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Marcondes, Eduardo. "CARGAS DEPARTAMENTAIS NA ESTRUTURA CURRICULAR DA GRADUAÇÃO EM MEDICINA DA FACULDADE DE MEDICINA DA UNIVERSIDADE DE SÃO PAULO." Revista Brasileira de Educação Médica 12, no. 1 (April 1988): 14–16. http://dx.doi.org/10.1590/1981-5271v12.1-004.
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Resumo: O autor relata algumas características da reorientação curricular do curso de graduação da Faculdade de Medicina da Universidade de São Paulo, apresentando as cargas horárias dos Departamentos que integram a graduação em Medicina. A carga horária total é de 11.040 horas, sendo 8.520 horas (77, 17%) destinadas à Faculdade de Medicina. As áreas fundamentais da formação profissional do aluno (Clínica Médica, Clínica Cirúrgica, Pediatria, Tocoginecologia e Clínica de Moléstias Infecciosas e Parasitárias) detém 50, 72% do total da graduação. Os estágios em emergência somam 900 horas (8,15% da graduação). O autor comenta, também, a carga horária restrita do Departamento de Psiquiatria, bem como das disciplinas oferecidas no Centro de Saúde Escola.
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Roggero, Enrico, Busi Giancarla, Palumbo Antonella, and Pedrazzini Augusto. "Gefitinib (‘Iressa’, ZD1839) is active against brain metastases in a 77 year old patient." Journal of Neuro-Oncology 71, no. 3 (February 2005): 277–80. http://dx.doi.org/10.1007/s11060-004-1719-x.
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Muñoz-Aguirre, Narcizo, Lilia Martínez-Pérez, Severino Muñoz-Aguirre, Luis Armando Flores-Herrera, Erasto Vergara Hernández, and Orlando Zelaya-Angel. "Luminescent Properties of (004) Highly Oriented Cubic Zinc Blende ZnO Thin Films." Materials 12, no. 20 (October 11, 2019): 3314. http://dx.doi.org/10.3390/ma12203314.
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Photoluminescence properties of cubic zinc blende ZnO thin films grown on glass substrates prepared by the spray pyrolysis method are discussed. X-ray diffraction spectra show the crystalline wurtzite with preferential growth in the (002) orientation and a metastable cubic zinc blende phase highly oriented in the (004) direction. Raman measurements support the ZnO cubic modification growth of the films. Photoluminescence (PL) spectra of zinc blende films are characterized by a new PL band centerd at 2.70 eV, the blue emission, in addition there are two principal bands that are also found in hexagonal ZnO films with the peak positions at 2.83 eV and 2.35 eV. The origin of the 2.70 eV band can be attributed to transitions from Zn-interstitial to Zn-vacancies. It is also important to mention that the PL intensity of the 2.35 eV band of the zinc blende thin films is relatively higher than in the band present in hexagonal ZnO films, which means that zinc blende films have more oxygen vacancies, as was corroborated by means of the energy dispersion spectroscopy (EDS) measurements. PL spectra at 77 °K were measured and the 2.70 eV band was confirmed for the zinc blende films. Some PL bands of cubic films also appeared for the hexagonal phase, which is due, to a certain extent, to the similar ions stacking of both wurtzite and zinc blende symmetries.
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SCHLECHT, E., M. SANGARÉ, and K. BECKER. "Seasonal variations in gastrointestinal tract fill of grazing Zebu cattle in the Sahel." Journal of Agricultural Science 140, no. 4 (June 2003): 461–68. http://dx.doi.org/10.1017/s0021859603003204.
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The gastrointestinal tract (gut) contents of male Zebu cattle (Bos indicus) were studied in the southern Sahelian zone of Mali. Measurements were carried out on 39 animals in mid-dry season (MDS) and 15 at the end of the dry season (late dry season, LDS).After overnight fasting, the animals were weighed and then slaughtered. The different gut compartments were emptied and representative samples of their fill were analysed for contents of dry matter (all) and NDF (reticulo-rumen only).Related to fasted live weight (FLW), gut fresh matter (FM) fill (g FM/kg FLW) increased from 165·7±4·81 g in MDS to 227·5±3·05 g in LDS (P[les ]0·001), liquid gut contents (g fluid/kg FLW) increased from 138·9±4·65 to 193·5±2·49 g (P[les ]0·001) and gut dry matter fill (g DM/kg FLW) increased from 26·8±0·88 to 34·0±0·97 g (P[les ]0·001). Fresh matter content of the reticulo-rumen accounted for 77% and 80% of the entire gut FM fill in MDS and LDS, respectively. While the NDF component in reticulo-rumen fill (g NDF/kg DM) increased from 778·5±5·63 g in MDS to 836·6±6·37 g in LDS (P[les ]0·001), the ratio between dry matter and fluid in the reticulo-rumen (g DM/g fluid) decreased from 193·2±10·17 g in MDS to 169·0±5·54 g in LDS (P[les ]0·05).The data support the notion that African breeds of Zebu cattle adjust to deteriorating feeding conditions by increasing reticulo-rumen dry matter and fluid contents. In-depth studies are needed to quantify the physiological benefits resulting from this strategy.
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Otsuka, H., S. Zaitsu, T. Uchimura, and T. Imasaka. "Generation of an ultrashort optical pulse by four-wave Raman mixing in deuterium cooled at 77 K." Applied Physics B 78, no. 6 (April 2004): 745–51. http://dx.doi.org/10.1007/s00340-004-1468-8.
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Pedersen, Peter Bank, Daniel Pilsgaard Henriksen, Mikkel Brabrand, and Annmarie Touborg Lassen. "Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study." BMJ Open 9, no. 10 (October 2019): e032692. http://dx.doi.org/10.1136/bmjopen-2019-032692.
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ObjectivesThe aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.DesignThis was a population-based cohort study of all citizens in four municipalities (population of 230 000 adults).SettingEmergency department at Odense University Hospital, Denmark.ParticipantsWe included all adult patients who arrived from 1 April 2012 to 31 March 2015.Primary and secondary outcome measuresOrgan failure was defined as a modified Sequential Organ Failure Assessment score≥2 within six possible organ systems: cerebral, circulatory, renal, respiratory, hepatic and coagulation.The primary outcome was prevalence of organ failure, and secondary outcomes were 0–7 days, 8–30 days and 31–365 days all-cause mortality.ResultsWe identified in total 175 278 contacts, of which 70 399 contacts were further evaluated for organ failure. Fifty-two per cent of these were women, median age 62 (IQR 42–77) years. The incidence of new organ failure was 1342/100 000 person-years, corresponding to 5.2% of all emergency department contacts.The 0–7-day, 8–30-day and 31–365-day mortality was 11.0% (95% CI: 10.2% to 11.8%), 5.6% (95% CI: 5.1% to 6.2%) and 13.2% (95% CI: 12.3% to 14.1%), respectively, if the patient had one or more new organ failures at first contact in the observation period, compared with 1.4% (95% CI: 1.3% to 1.6%), 1.2% (95% CI: 1.1% to 1.3%) and 5.2% (95% CI: 5.0% to 5.4%) for patients without. Seven-day mortality ranged from hepatic failure, 6.5% (95% CI: 4.9% to 8.6%), to cerebral failure, 33.8% (95% CI: 31.0% to 36.8%), the 8–30-day mortality ranged from cerebral failure, 3.9% (95% CI: 2.8% to 5.3%), to hepatic failure, 8.6% (95% CI: 6.6% to 10.8%) and 31–365-day mortality ranged from cerebral failure, 9.3% (95% CI: 7.6% to 11.2%), to renal failure, 18.2% (95% CI: 15.5% to 21.1%).ConclusionsThe study revealed an incidence of new organ failure at 1342/100 000 person-years and a prevalence of 5.2% of all emergency department contacts. One-year all-cause mortality was 29.8% among organ failure patients.
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VAN HEST, N. A. H., C. J. P. A. HOEBE, J. W. DEN BOER, J. K. VERMUNT, E. P. F. IJZERMAN, W. G. BOERSMA, and J. H. RICHARDUS. "Incidence and completeness of notification of Legionnaires' disease in The Netherlands: covariate capture–recapture analysis acknowledging regional differences." Epidemiology and Infection 136, no. 4 (June 22, 2007): 540–50. http://dx.doi.org/10.1017/s0950268807008977.
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SUMMARYTo estimate incidence and completeness of notification of Legionnaires' disease (LD) in The Netherlands in 2000 and 2001, we performed a capture–recapture analysis using three registers: Notifications, Laboratory results and Hospital admissions. After record-linkage, 373 of the 780 LD patients identified were notified. Ascertained under-notification was 52·2%. Because of expected and observed regional differences in the incidence rate of LD, alternatively to conventional log-linear capture–recapture models, a covariate (region) capture–recapture model, not previously used for estimating infectious disease incidence, was specified and estimated 886 LD patients (95% confidence interval 827–1022). Estimated under-notification was 57·9%. Notified, ascertained and estimated average annual incidence rates of LD were 1·15, 2·42 and 2·77/100 000 inhabitants respectively, with the highest incidence in the southern region of The Netherlands. Covariate capture–recapture analysis acknowledging regional differences of LD incidence appears to reduce bias in the estimated national incidence rate.
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Picard, Stephane, Karine Titier, Gabriel Etienne, Emmanuelle Teilhet, Dominique Ducint, Marie-Agnes Bernard, Regis Lassalle, et al. "Trough imatinib plasma levels are associated with both cytogenetic and molecular responses to standard-dose imatinib in chronic myeloid leukemia." Blood 109, no. 8 (December 27, 2006): 3496–99. http://dx.doi.org/10.1182/blood-2006-07-036012.
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Abstract Using high-performance liquid chromatography–tandem mass spectrometry, we assessed trough imatinib plasma levels in 68 patients with chronic myeloid leukemia (CML) who responded or not to standard-dose imatinib, after at least 12 months' treatment. Mean trough imatinib plasma levels were significantly higher in the group with complete cytogenetic response (56 patients) than in the group without (12 patients; P = .03) and higher in the group with major molecular response (MMR) than in the group without (34 patients [1452 ± 649 ng/mL] versus 34 patients [869 ± 427 ng/mL]; P < .001). Regarding trough imatinib plasma levels and their discrimination potential for MMR, the area under receiver operating characteristic curve was 0.775, with best sensitivity (77%) and specificity (71%) at a plasma threshold of 1002 ng/mL. Therefore, monitoring of imatinib plasma levels could be very useful for the management of patients with CML or should at least be checked in the case of treatment failure or suboptimal response.
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Ball, David, Feryal Özel, Dimitrios Psaltis, and Chi-kwan Chan. "PARTICLE ACCELERATION AND THE ORIGIN OF X-RAY FLARES IN GRMHD SIMULATIONS OF SGR A*." Astrophysical Journal 826, no. 1 (July 25, 2016): 77. http://dx.doi.org/10.3847/0004-637x/826/1/77.
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Pan, Zhen, and Cong Yu. "ANALYTIC PROPERTIES OF FORCE-FREE JETS IN THE KERR SPACETIME—II." Astrophysical Journal 816, no. 2 (January 14, 2016): 77. http://dx.doi.org/10.3847/0004-637x/816/2/77.
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Schippers, P., N. Meyer Vernet, A. Lecacheux, S. Belheouane, M. Moncuquet, W. S. Kurth, I. Mann, D. G. Mitchell, and N. André. "NANODUST DETECTION BETWEEN 1 AND 5 AU USINGCASSINIWAVE MEASUREMENTS." Astrophysical Journal 806, no. 1 (June 9, 2015): 77. http://dx.doi.org/10.1088/0004-637x/806/1/77.
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Friesen, Tzyynong L., Steven M. Zamora, Ronak Rahmanian, Nour Bundogji, and Matthew T. Brigger. "Predictors of Pediatric Tracheostomy Outcomes in the United States." Otolaryngology–Head and Neck Surgery 163, no. 3 (April 21, 2020): 591–99. http://dx.doi.org/10.1177/0194599820917620.
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Objectives To investigate the outcomes of pediatric tracheostomy as influenced by demographics and comorbidities. Study Design Retrospective national database review. Setting Fifty-two children’s hospitals across the United States. Subjects and Methods Hospitalization records from Pediatric Health Information System database dated 2010 to 2018 with patients younger than 18 years and procedure codes for tracheostomy were extracted. The primary outcome was total length of stay. The secondary outcomes were 30-day readmission, mortality, and posttracheostomy length of stay. Results A total of 14,155 children were included in the analysis. The median total length of stay was 77 days and increased from 59 to 103 days between 2010 and 2018 ( P < .001). The median posttracheostomy length of stay was 34 days and also increased from 27 to 49 days ( P < .001). On multivariate regression analyses, the total and posttracheostomy lengths of stay were significantly increased in children younger than 1 year, patients of black race, hospitals in the non-West regions, those discharged to home, and those with comorbidities. Socioeconomic indicators such as insurance type and estimated household income were associated with no difference or small effect sizes. Regions and comorbidities were associated with differences in 30-day readmission (overall 26%), while in-hospital mortality was primarily associated with age and comorbidities (overall 8.6%). Conclusion Pediatric tracheostomy requires substantial health care resources with length of stay escalating over recent years. Age, race, region, discharge destination, and comorbidities were associated with differences in length of stay.
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Horstmann, Martin, Thilo Kamphausen, Kristian Schweimer, Michael Steinert, J�rg Hacker, Axel Haase, Paul R�sch, Gunter Schweimer, and Cornelius Faber. "Letter to the Editor: 1H, 13C, 15N backbone and sidechain resonance assignment of Mip(77?213) the PPIase domain of the Legionella pneumophila Mip protein." Journal of Biomolecular NMR 31, no. 1 (January 2005): 77–78. http://dx.doi.org/10.1007/s10858-004-6041-6.
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Borthakur, Gautam, Cecilia Ysabel Arana Yi, Jorge E. Cortes, Wei Qiao, Tapan M. Kadia, Farhad Ravandi, Stefan Faderl, Guillermo Garcia-Manero, Mark Brandt, and Hagop M. Kantarjian. "Prognostic impact of trisomy 8 cytogenetic abnormality in acute myelogenous leukemia: Analysis of a large cohort (N=2187) of newly diagnosed patients." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 7089. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.7089.
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7089 Background: Trisomy 8 is grouped as intermediate risk in cytogenetic (CG) classifications of acute myelogenous leukemia (AML). In a multi-variate analysis of MRC data, trisomy 8 was associated with worse overall survival (OS). Methods: Between years 1993-2012, 2,187 patients (pts) with newly diagnosed AML presented at MD Anderson Cancer Center and 21 (10%) were with a trisomy 8 CG abnormality. The median age of trisomy 8 pts was 63 years (range, 17-89 years) and 59% were males. Sixty four (30%) had isolated trisomy 8, 45 (21%) had trisomy 8 +≤2 additional cytogenetic abnormalities and 102 (49%) had trisomy 8 + ≥3 additional abnormalities. Thirty three percent of pts with trisomy 8+≤2 additional abnormalities, had secondary AML compared to 21% of diploid CG (p=.007). Mutations in the FLT3 gene was seen in 9% and N or KRAS gene in 8%. Results: The overall remission rate (RR) was 47%, 53% and 43% among pts with trisomy 8 alone, trisomy 8+≤2 and trisomy 8+≥3 abnormalities respectively. Among pts <60 years of age and with trisomy 8 + ≤2 abnormalities, RR was 71% and the same was 77% for pts with diploid CG. For pts ≥ 60 years, the RRs were 26% and 57% respectively. Among pts ≥ 60 years and trisomy 8 with complex CG (≥3 additional abnormalities) the RR was 38% and that for patients with complex (non-trisomy 8) CG was 41%. Patients with trisomy 8 either alone or ≤2 additional abnormalities had a shorter OS (p= .04 and .05 respectively, median 10.8 and 8.6 months vs 16.5 months) compared to those with diploid CG. Event free survival was also shorter among patient with isolated trisomy 8 versus those with diploid CG (p=.008, median 2.9 versus 7.5 months). On the other hand, patients with trisomy 8+≥3 abnormalities had outcomes comparable to non-trisomy 8 CG group. Conclusions: Non-complex CG trisomy 8 is associated with worse clinical outcome in patients with AML than those with diploid CG and its inclusion in intermediate risk group may need reconsideration. The most adverse impact appears to be from lower RR among patients with trisomy 8+≤2 additional abnormalities and ≥60 years of age.
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Fan, C. X., and G. G. Siu. "The AC Josephson and DC superconducting quantum interference device (SQUID) effects in YBCO large bridge devices at 77 K." Superconductor Science and Technology 5, no. 1 (January 1, 1992): 22–26. http://dx.doi.org/10.1088/0953-2048/5/1/004.
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Ferrante, Pierpaolo. "Asbestosis and silicosis hospitalizations in Italy (2001–2015): results from the National Hospital Discharge Registry." European Journal of Public Health 29, no. 5 (February 7, 2019): 876–82. http://dx.doi.org/10.1093/eurpub/ckz003.
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Abstract Background This work is aimed at evaluating the quality of Italian hospitalizations data about asbestosis and silicosis, assessing the impact of these diseases on the national health system and providing advice related to public health. Methods Italian hospital discharge data (2001–15) with diagnosis of asbestosis or silicosis were analysed by the multiple correspondence analysis and diseases epidemics were evaluated through hospitalization rates. Results Hospitalizations were concentrated in the northwestern area, referred mainly to males and oldest people, the most treated tumors were lung cancer and mesothelioma (for asbestosis) and cares were aimed at reducing symptoms and increasing blood oxygenation. Overall adjusted Italian hospitalization rates of asbestosis and silicosis were, respectively, 25.2 and 74.9 per 1 000 000 residents. With respect to asbestosis, hospitalizations treating silicosis reported doubled mortality (10.5 vs. 5.7%), longer stays (10.4 vs. 8.6 mean days) and older patients (77 vs. 72 years on average). Diseases rates reduced over time (with a steeper slope for silicosis) and in both fibroses increased hospital mortality (92.1% in asbestoses, 59.5% in silicoses) and percentage of urgent hospitalizations (116.0% in asbestoses, 56.6% in silicoses). Conclusion Hospitalizations data regarding asbestosis and silicosis are consistent. Silicosis had a higher impact than asbestosis on the Italian health system. Although data show decreasing incidence of both fibroses, multiple correspondence analysis highlights that levels of illness severity were higher in silicosis and increased over time in both diseases. Further studies investigating the effectiveness of the current health surveillance programs concerning these diseases are suggested.
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Sullivan-Baca, E., K. Naylon, A. Zartman, B. Ardolf, and J. Westhafer. "A-05 Gender differences in veterans referred for neuropsychological evaluation in an outpatient neuropsychology consultation service." Archives of Clinical Neuropsychology 34, no. 6 (July 25, 2019): 864. http://dx.doi.org/10.1093/arclin/acz034.05.
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Abstract Objective Women represent a growing population within the VA Healthcare System about which little is known from a neuropsychological perspective. The present study explored sex differences in veterans presenting for neuropsychological evaluation to delineate trends in demographics, referral questions, effort, and outcome diagnoses. Method A database derived from an outpatient neuropsychology clinic at a VA medical center spanning 2013 to 2019 was analyzed (n = 232 women/2642 men). Initial analyses explored demographic features of the full sample. Further analyses separated the sample into younger (n = 836 men, 155 women) and older adult (n = 1805 men, 77 women). Results Groups differed in age (t(1,2872) = 10.41, p < .001) and education (t(1,2830) = 6.68, p < .001). Men were older, less educated, and had greater vascular risk factors. In the younger group, men were more often referred for TBI (X2(1,1) = 7.27, p < .01) and women for multiple sclerosis (X2(1,1) = 13.56, p < .01). In the older group, men performed worse on effort measures (WMT IR: t(1,42.24) = 2.36, p < .05; WMT MC: t(1,327) = 2.57, p < .05; TOMM Trial 2: t(1,199) = 2.17, p < .05). Older women evidenced higher scores on GDS (t(1,43.04) = 2.94, p < .01) and were more commonly diagnosed with depression (X2(1,1) = 12.66, p < .01). Conclusions Sex differences in demographics, medical conditions, referral question, effort, and outcome diagnoses emerged in a large sample of veterans referred for outpatient neuropsychological assessment. These differences point to important diagnostic considerations for neuropsychologists in VA settings.
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Nazha, Bassel, Sharon Wu, Jacqueline T. Brown, Daniel Magee, Bradley Curtis Carthon, Omer Kucuk, W. Michael Korn, et al. "Comprehensive genomic profiling of penile squamous cell carcinoma and impact of HPV status on immune-checkpoint inhibition-related biomarkers." Journal of Clinical Oncology 40, no. 6_suppl (February 20, 2022): 4. http://dx.doi.org/10.1200/jco.2022.40.6_suppl.004.
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4 Background: Penile squamous cell carcinoma (SCC) is a rare and aggressive malignancy with few treatments in the advanced setting and little success of immune-checkpoint inhibitions (ICI). Around half of penile SCC cases are linked to HPV infection. We aimed to report the landscape of somatic alterations and ICI-related biomarkers in penile SCC in the Caris Life Sciences dataset and to establish signatures for HPV-dependent and HPV-independent oncogenesis. Methods: Penile SCC tumors were analyzed using next-generation sequencing of DNA (TruSeq, 45 genes; NextSeq, 592 genes and NovaSeq, whole exome sequencing (WES)) and RNA (NovaSeq). PD-L1 expression was tested by IHC using SP142. Microsatellite instability (MSI) was tested by fragment analysis, IHC and NGS. Tumor mutational burden (TMB) was measured by counting all somatic mutations found per tumor (TMB-high: >10 mutations per MB). HPV16/18 status was determined using WES when available. Significance was determined using chi-square and Wilcoxon rank sum test and adjusted for multiple comparisons (q-value <0.05). Results: Among the entire cohort (N=108), the median age was 66 years and 79.6% of tumors were primary and 20.4% of tumors were metastatic. In the overall cohort, the most frequently detected mutations were TP53 (46%), CKDN2A (26%), PIK3CA (25%), TERT promoter (22%), KMT2C (16%) and NOTCH1 (14%), consistent with previous reports. Overall, 51% of tumors were PD-L1+ (SP142, >1%), 10.7% had high TMB, and 1.1% had dMMR/MSI-H. Of the 108 tumors, 29 had HPV status tested by WES (HPV16/18+, n=13 and HPV16/18-, n=16). KMT2C mutations (33% vs 0%) and FGF3 amplifications (30.8% vs 0%) were specific to HPV16/18+ tumors, while CDKN2A mutations (37.5% vs 0%) were exclusive to HPV16/18- tumors. HPV16/18+ tumors also had a trend towards decreased TP53 (7.7% vs 63%) and TERT promoter (25% vs 77%) alterations (Table). TMB-high were exclusively found in the HPV16/18+ group (30.8% vs 0%), while PD-L1 and dMMR/MSI-H status were comparable between the two groups. Conclusions: To our knowledge, our comprehensive NGS study of penile SCC somatic alterations is the largest to date. HPV16/18+ vs HPV16/18- penile SCC were molecularly distinct tumors, consistent with previous reports. Our finding that TMB-high was exclusive to patients with HPV16/18+ tumors requires confirmation in larger datasets and could be used for better patient stratification in ICI clinical trials.[Table: see text]
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FLEGR, J., and D. Q. ESCUDERO. "Impaired health status and increased incidence of diseases in Toxoplasma-seropositive subjects – an explorative cross-sectional study." Parasitology 143, no. 14 (October 10, 2016): 1974–89. http://dx.doi.org/10.1017/s0031182016001785.
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SUMMARYThe global seroprevalence of latent toxoplasmosis is estimated to be higher than 30%. The presence of slowly dividing parasites in tissue cysts located mainly in immunoprivileged organs was long considered asymptomatic. Recently, many studies have shown that latent Toxoplasma infections could have serious impacts on human health. Here we ran a cross-sectional study in a population of 1486 volunteers. The results showed that 333 infected subjects scored worse than 1153 controls in 28 of 29 health-related variables. Similarly, they reported higher rates of 77 of a list of 134 disorders reported by at least 10 participants of the study. Toxoplasmosis was associated most strongly with musculoskeletal (τ = 0·107, P < 0·0005), followed by neurological (τ = 0·088, P < 0·0005), immune (τ = 0·085, p < 0·0005), metabolic (τ = 0·079, P < 0·0005), respiratory (τ = 0·068, P = 0·0001), allergic (τ = 0·053, P = 0·004), digestive system (τ = 0·052, P = 0·004) and mental health disorders (τ = 0·050, P = 0·008). Results of the present cohort study, along with the previous data from many case-control studies or ecological studies suggest that latent toxoplasmosis represents a large and so far underrated public health problem.
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Nakae, Yoshiki, Rie Kojima, Aki Chizuka, Yuko Osajima, Toshiyuki Noguchi, Kou Miyamoto, Masatsugu Oota, and Shigesaburo Miyakoshi. "Reduced-Intensity Unrelated Cord Blood Transplantation (RICBT) for Elderly Patients with Hematological Malignancies." Blood 116, no. 21 (November 19, 2010): 2349. http://dx.doi.org/10.1182/blood.v116.21.2349.2349.
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Abstract Abstract 2349 Introduction: Incidence of hematological malignancies is higher in elderly population. However, standard chemotherapy has not been established and the potential role of RICBT has remained unclear. This study reports the results of RICBT for elderly patients with hematological malignancies, retrospectively. Objective: To investigate the feasibility of RICBT. Primary endpoints were engraftment and overall survival (OS). secondary endpoint was transplant-related mortality (TRM). Patients and Methods: Between Feb.2009 and Jun.2010, 29 patients (median age 70 years, range 58–76) received RICBT for hematological malignancies. Primary diseases were divided into 2 groups; advanced (intermediate and high risk; n=21) or standard (n=8). All cases in 70's were included in the high risk. Median follow up time was 238 days (range 8–464).Conditioning regimen and GVHD prophylaxis consisted of fludarabine, busulfan or cyclophosphamide, and TBI 2Gy with tacrolimus± MTX for <70 years(n=18), fludarabine, busulfan or cyclophospamide, and ATG 7.5mg/kg with cyclosporine ± MTX for >70 years (n=11) and <70 years with comorbidities. Median total transplanted nucleated cells: 3.2 × 10|jE7 cells (2.0–4.8); Median CD34+: 0.4× 10|jE5 cells (0.3–2.9); HLA match: 5/6 (n=1), 4/6 (n=28). Time to event curves were plotted by using the actuarial method of Kaplan-Meier, and differences between curves were analyzed by log-rank tests. Results: Neutrophile (>500/μL) and platelet engraftment (>20,000/μL) were observed in 89.6% (95% CI; 79–100) at day 60 (median; 18.0 days, range; 13–28), and 62.1% at day 100 (median; 36.5 days, range; 17–60), respectively. Neutrophile engraftment was 100% in TBI regimen (median; 18 days, range; 13–28), 75% in ATG regimen (95% CI; 51–100, median; 19 days, range; 16–27)(p=0.04). Platelet engraftment was 77% in TBI regimen, 42% in ATG regimen, respectively (p=0.06). Primary graft failure occurred in 3% of all cases. Cumulative incidence of acute GVHD (II-IV) was 58% (95% CI; 39–78) at day 100 (median; 27.5 days, range; 13–82), 81% (95% CI; 62–100, median; 28 days, range; 17–82) in TBI regimen and 12.5% (95% CI; 0–35, median; 13 days, range; 13) in ATG regimen, respectively (p=0.01). The 1-year estimated OS was 51% (95% CI: 25–77) in all cases, 51% (95% CI: 13–90) in TBI, and 48% (95% CI: 18–77) in ATG, respectively (p=0.08). According to the age, OS was 80% (95% CI: 45–80) in 50's, 53% (95% CI: 20–86) in 60's, and 38% (95% CI: 0–77) in 70's (P=0.0765). Causes of TRM included infections (n=5 including 3 cases in 70's), TMA (n=2). Incidence of TRM at day 100 was 20% (95% CI; 4–35, median; 47 days, range; 8–79), 7% in TBI regimen (95% CI; 0–21, median; 79days), 41% in ATG regimen (95% CI; 9–72, median; 30 days, range; 9–72). Incidence of TRM, according to the age, was 40%,0%, and 52% in 50's,60's, 70's, respectively. Discussion and Conclusion: Because of the high incidence of high risk disease and TRM, despite low incidence of GVHD, RICBT is associated with a low OS in patients over 70 years compared with those who are under 70 years. Eligibility of RICBT needs to be investigated, especially in 70's patients, and further studies are warranted to clarify the safety in elderly patients. Disclosures: No relevant conflicts of interest to declare.
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Bernard, Paquito, Marion Carayol, Mathieu Gourlan, Julie Boiché, Ahmed Jérôme Romain, Catherine Bortolon, Olivier Lareyre, and Gregory Ninot. "Moderators of Theory-Based Interventions to Promote Physical Activity in 77 Randomized Controlled Trials." Health Education & Behavior 44, no. 2 (July 9, 2016): 227–35. http://dx.doi.org/10.1177/1090198116648667.
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A meta-analysis of randomized controlled trials (RCTs) has recently showed that theory-based interventions designed to promote physical activity (PA) significantly increased PA behavior. The objective of the present study was to investigate the moderators of the efficacy of these theory-based interventions. Seventy-seven RCTs evaluating theory-based interventions were systematically identified. Sample, intervention, methodology, and theory implementation characteristics were extracted, coded by three duos of independent investigators, and tested as moderators of interventions effect in a multiple–meta-regression model. Three moderators were negatively associated with the efficacy of theory-based interventions on PA behavior: intervention length (≥14 weeks; β = −.22, p = .004), number of experimental patients (β = −.10, p = .002), and global methodological quality score (β = −.08, p = .04). Our findings suggest that the efficacy of theory-based interventions to promote PA could be overestimated consequently due to methodological weaknesses of RCTs and that interventions shorter than 14 weeks could maximize the increase of PA behavior.
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Zanjani, Faika, and Annie Rhodes. "Memory Problems During COVID in Low-income Older Adults." Innovation in Aging 5, Supplement_1 (December 1, 2021): 736–37. http://dx.doi.org/10.1093/geroni/igab046.2739.
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Abstract Prevention, with widespread lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, and 45% males (n=18)). Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions/subject were completed. Participants provided positive anecdotal feedback and the need for continued health coaching during COVID. N=30 (75%) of the original sample consented for continued health coaching during the Covid pandemic, 63% female, 88% African American/Black, 60-77 age range (mean age 69 years), and 47% reporting memory problems. Baseline Covid interviews indicated poorer health status associated with reporting memory problems for poor physical health days (F=7.03;p=.01); poor mental health days (F=6.88;p=.01); total mental/physical health poor days (F=2.76;p=.11); sad days (F=15.52;p=.001); worried days (F=6.27;p=.02); tired days (F=9.77;p=.004); feelings of emptiness (F=10.09;p=.004); feelings of rejection (F=3.382;p=.08); feelings of failure (F=7.58;p=.01); little interest/pleasure (F=7.84;p=.009); and feeling down (F=6.75;p=.02). In conclusion, this preliminary work creates the impetus for future large-scale AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults reporting memory problems. This research indicates the subjective reporting of memory problems requires health intervention.
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Livingstone, Katherine M., Gavin Abbott, Steven J. Bowe, Joey Ward, Catherine Milte, and Sarah A. McNaughton. "Diet quality indices, genetic risk and risk of cardiovascular disease and mortality: a longitudinal analysis of 77 004 UK Biobank participants." BMJ Open 11, no. 4 (April 2021): e045362. http://dx.doi.org/10.1136/bmjopen-2020-045362.
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ObjectivesTo examine associations of three diet quality indices and a polygenic risk score with incidence of all-cause mortality, cardiovascular disease (CVD) mortality, myocardial infarction (MI) and stroke.DesignProspective cohort study.SettingUK Biobank, UK.Participants77 004 men and women (40–70 years) recruited between 2006 and 2010.Main outcome measuresA polygenic risk score was created from 300 single nucleotide polymorphisms associated with CVD. Cox proportional HRs were used to estimate independent effects of diet quality and genetic risk on all-cause mortality, CVD mortality, MI and stroke risk. Dietary intake (Oxford WebQ) was used to calculate Recommended Food Score (RFS), Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS).ResultsNew all-cause (n=2409) and CVD (n=364) deaths and MI (n=1141) and stroke (n=748) events were identified during mean follow-ups of 7.9 and 7.8 years, respectively. The adjusted HR associated with one-point higher RFS for all-cause mortality was 0.96 (95% CI: 0.94 to 0.98), CVD mortality was 0.94 (95% CI: 0.90 to 0.98), MI was 0.97 (95% CI: 0.95 to 1.00) and stroke was 0.94 (95% CI: 0.91 to 0.98). The adjusted HR for all-cause mortality associated with one-point higher HDI and MDS was 0.97 (95% CI: 0.93 to 0.99) and 0.95 (95% CI: 0.91 to 0.98), respectively. The adjusted HR associated with one-point higher MDS for stroke was 0.93 (95% CI: 0.87 to 1.00). There was little evidence of associations between HDI and risk of CVD mortality, MI or stroke. There was evidence of an interaction between diet quality and genetic risk score for MI.ConclusionHigher diet quality predicted lower risk of all-cause mortality, independent of genetic risk. Higher RFS was also associated with lower risk of CVD mortality and MI. These findings demonstrate the benefit of following a healthy diet, regardless of genetic risk.
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Schifman, Ron B., Michael Talbert, and Rhona J. Souers. "Delta Check Practices and Outcomes: A Q-Probes Study Involving 49 Health Care Facilities and 6541 Delta Check Alerts." Archives of Pathology & Laboratory Medicine 141, no. 6 (April 12, 2017): 813–23. http://dx.doi.org/10.5858/arpa.2016-0161-cp.
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Context.— Delta checks serve as a patient-based quality control tool to detect testing problems. Objective.— To evaluate delta check practices and outcomes. Design.— Q-Probes participants provided information about delta check policies and procedures. Information about investigations, problems, and corrective actions was prospectively collected for up to 100 testing episodes involving delta check alerts. Results.— Among 4505 testing episodes involving 6541 delta check alerts, the median frequencies of actions taken among 49 laboratories were clinical review, 38.0%; retest, 25.0%, or recheck, 20.2%; current specimen, nothing, 15.4%; analytical check, 5.0%; other; 2%; and retest or check previous specimen, 0%. Rates of any action taken by analyte ranged from 84 of 179 (46.9%) for glucose to 748 of 868 (86.2%) for hemoglobin and potassium. Among 4505 testing episodes, nontesting problems included physiologic causes (1472; 32.7%); treatment causes (1318; 19.2%); and transfusion causes (846; 9.9%). Testing problems included 77 interference (1.7%), 62 contamination (1.4%), 51 clotting (1.1%), 27 other (0.6%), 12 mislabeling (0.3%), and 5 analytical (0.1%). Testing problems by analyte ranged from 13 of 457 (2.8%) for blood urea nitrogen to 12 of 46 (26.1%) for mean corpuscular hemoglobin concentration. Using more delta check analytes was associated with detecting more testing problems (P = .04). More delta check alerts per testing episode resulted in more actions taken (P = .001) and more problems identified (P < .001). The most common outcome among 4500 testing episodes was reporting results without modifications or comments in 2512 (55.8%); results were not reported in 136 (3.0%). Conclusions.— Actions taken in response to delta check alerts varied widely, and most testing problems detected were preanalytical. Using a higher number of different analytes and evaluating previous specimens may improve delta check practices.
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Hudda, Neelakshi, Misha Eliasziw, Scott O. Hersey, Ellin Reisner, Robert D. Brook, Wig Zamore, John L. Durant, and Doug Brugge. "Effect of Reducing Ambient Traffic-Related Air Pollution on Blood Pressure." Hypertension 77, no. 3 (March 3, 2021): 823–32. http://dx.doi.org/10.1161/hypertensionaha.120.15580.
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Exposure to traffic-related air pollution (TRAP) may contribute to increased prevalence of hypertension and elevated blood pressure (BP) for residents of near-highway neighborhoods. Relatively few studies have investigated the effects of reducing TRAP exposure on short-term changes in BP. We assessed whether reducing indoor TRAP concentrations by using stand-alone high-efficiency particulate arrestance (HEPA) filters and limiting infiltration through doors and windows effectively prevented acute (ie, over a span of hours) increases in BP. Using a 3-period crossover design, 77 participants were randomized to attend three 2-hour-long exposure sessions separated by 1-week washout periods. Each participant was exposed to high, medium, and low TRAP concentrations in a room near an interstate highway. Particle number concentrations, black carbon concentrations, and temperature were monitored continuously. Systolic BP (SBP), diastolic BP, and heart rate were measured every 10 minutes. Outcomes were analyzed with a linear mixed model. The primary outcome was the change in SBP from 20 minutes from the start of exposure. SBP increased with exposure duration, and the amount of increase was related to the magnitude of exposure. The mean change in SBP was 0.6 mm Hg for low exposure (mean particle number and black carbon concentrations, 2500 particles/cm 3 and 149 ng/m 3 ), 1.3 mm Hg for medium exposure (mean particle number and black carbon concentrations, 11 000 particles/cm 3 and 409 ng/m 3 ), and 2.8 mm Hg for high exposure (mean particle number and black carbon concentrations, 30 000 particles/cm 3 and 826 ng/m 3 ; linear trend P =0.019). There were no statistically significant differences in the secondary outcomes, diastolic BP, or heart rate. In conclusion, reducing indoor concentrations of TRAP was effective in preventing acute increases in SBP.
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Takahashi, Koichi, Hagop M. Kantarjian, Preetesh Jain, Elias Jabbour, William Wierda, Naveen Pemmaraju, Alessandra Ferrajoli, et al. "Propensity Score Matched Comparison of Dasatinib and Nilotinib As a Frontline Therapy in Newly Diagnosed CML with Chronic Phase." Blood 124, no. 21 (December 6, 2014): 1802. http://dx.doi.org/10.1182/blood.v124.21.1802.1802.
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Abstract Background: Dasatinib (DAS) and nilotinib (NIL) are standard frontline therapy for chronic myeloid leukemia, chronic phase (CML-CP) based on randomized trials compared to imatinib. However, DAS and NIL have not been compared directly. The purpose of this study is to analyze efficacy, long-term outcome and toxicity of DAS and NIL as a front line therapy in newly diagnosed CML-CP. Method: Newly diagnosed patients (pts) with CML-CP, who received front-line therapy by either one of the phase II trials conducted almost in parallel (DAS: NCT00254423, N = 102 and NIL: NCT00129740, N = 104) are matched with caliper matching by the propensity score (PS) to adjust pre-treatment confounding factors. DAS was given orally by either 50mg twice daily (N = 30) or 100mg daily (N = 77). NIL was given 400mg orally twice daily. Toxicity was recorded according to the CTCAE ver. 4.0. Result: PS matching resulted in 87 pts from each trial to be matched for pre-treatment characteristics including age, Sokal score, lab, and organ function (Table). The median observation duration was 50.9 months (95% CI: 40.1-61.7) vs. 43.0 months (95% CI: 35.3-50.7) (DAS vs. NIL, P = 0.56). Response rate at 3, 6, and 12 months as well as cumulative (best) response are shown in Table. There were no significant differences in measures of response throughout the study period except for a higher rate of complete molecular response at 6 months with NIL (NIL vs. DAS, 11% vs. 3%, P = 0.04). However, at 12 months, this difference was not retained; there was also no difference in the rate of optimal response at 3 months. There was no statistical difference in cumulative response between 2 groups. No statistical difference was observed between 2 groups in any of the survival endpoints at 3 years (overall, event-free, failure-free, and transformation-free survival). Treatment discontinuation was observed in 16 (18%) vs. 17 (19%) pts with (DAS vs. NIL, P = 0.82). Reason for the discontinuation was; 1) toxicity (8 vs. 8, P = 1.00), 2) resistance (5 vs. 8, P = 0.39), and 3) financial (4 vs. 1, P = 0.37) (all presented as DAS vs. NIL, respectively). Adverse event (AE) was observed in 40 (46%) vs. 42 (48%) pts (DAS vs. NIL, P = 0.76), whereas grate 3 or more AE was observed in 19 (22%) vs. 15 (17%) pts (DAS vs. NIL, P = 0.44). Conclusion: In PS matched cohort of newly diagnosed CML-CP pts, the outcome observed with both treatment options (DAS and NIL) is excellent with no clear difference in response or long-term survival endpoints. Incidence of clinically significant AEs was similar between DAS and NIL. Table 1. Pre-treatment patient characteristics and treatment outcome in matched cohort. Variable DAS group(N = 87) NIL group (N = 87) P –value Median age 49 (19-79) 47 (17-80) 0.87 Age ³ 65, N (%) 6 (7) 6 (7) 1.00 Sokal Score Group 0.78 Low (%) 69 (79) 66 (76) Intermediate (%) 14 (16) 15 (17) High (%) 4 (5) 6 (7) WBC, x103/µL 23.9 (0.8-193.0) 39.8 (1.4-342.5) 0.51 HGB, g/dL 11.9 (8.8-16.2) 12.4 (8.9-15.8) 0.65 PLT, x103/µL 337 (86.0-1906.0) 322 (73.0-1356.0) 0.92 BM blast % 2.0 (0.0-6.0) 2.0 (0.0-7.0) 0.53 BM blast > 5 % (%) 3 (4) 3 (4) 1.00 ALB, mg/dL 4.4 (3.7-5.5) 4.4 (3.3-5.5) 0.79 LDH, IU/L 894(393-3648) 1097 (252-3467) 0.37 Cre , mg/dL 0.9 (0.6-1.3) 0.9 (0.6-1.3) 0.27 Tbil , mg/dL 0.4 (0.2-3.4) 0.4 (0.1-1.3) 0.54 AST, IU/L 32 (14-121) 36 (12-101) 0.65 ALT, IU/L 25 (12-154) 27 (11-84) 0.94 BCR-ABL (IS), % 14.1 (0.04-35.4) 14.1 (0.01-35.4) 0.68 Transcript type (%) 0.74 b2a2 32 (37) 34 (39) b3a2 32 (37) 37 (43) b3a3 1 (1) 0 (0) b2a2 and b3a2 21 (24) 15 (17) e1a2 1 (1) 1 (1) Previous use of imatinib (<30 days) 17 (19) 14 (16) 0.55 Response at 3 months MMR 41 (47) 49 (56) 0.18 BCR/ABL (IS) < 10% 81 (93) 82 (94) 0.50 CCyR 67 (77) 73 (84) 0.15 MCyR 79 (91) 81 (93) 0.25 Response at 6 months CMR 3 (3) 10 (11) 0.04 MMR 56 (64) 60 (69) 0.48 CCyR 75 (86) 78 (90) 0.33 MCyR 81 (93) 78 (90) 0.37 Response at 12 months CMR 8 (9) 12 (14) 0.35 MMR 59 (68) 65 (75) 0.19 CCyR 75 (86) 75 (86) 0.20 MCyR 78 (93) 76 (87) 0.51 Cumulative (best) response CMR 44 (51) 42 (48) 0.82 MMR 63 (72) 65 (75) 0.61 CCyR 82 (94) 81 (93) 1.00 MCyR 83 (95) 81 (93) 1.00 Survival at 3 Year OS 99% 93% 0.95 EFS 89% 87% 0.99 FFS 74% 63% 0.71 TFS 95% 89% 0.28 Toxicity Any toxicity 40 (46) 42 (48) 0.76 Any toxicity > grade 2 19 (22) 15 (17) 0.44 Disclosures O'Brien: Amgen, Celgene, GSK: Consultancy; CLL Global Research Foundation: Membership on an entity's Board of Directors or advisory committees; Emergent, Genentech, Gilead, Infinity, Pharmacyclics, Spectrum: Consultancy, Research Funding; MorphoSys, Acerta, TG Therapeutics: Research Funding. Cortes:Ariad: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Teva: Consultancy, Research Funding.
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Maire, A. L., K. Molaverdikhani, S. Desidera, T. Trifonov, P. Mollière, V. D’Orazi, N. Frankel, et al. "Orbital and spectral characterization of the benchmark T-type brown dwarf HD 19467B." Astronomy & Astrophysics 639 (July 2020): A47. http://dx.doi.org/10.1051/0004-6361/202037984.
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Context. Detecting and characterizing substellar companions for which the luminosity, mass, and age can be determined independently is of utter importance to test and calibrate the evolutionary models due to uncertainties in their formation mechanisms. HD 19467 is a bright and nearby star hosting a cool brown dwarf companion detected with radial velocities and imaging, making it a valuable object for such studies. Aims. We aim to further characterize the orbital, spectral, and physical properties of the HD 19467 system. Methods. We present new high-contrast imaging data with the SPHERE and NaCo instruments. We also analyze archival data from the instruments HARPS, NaCo, HIRES, UVES, and ASAS. Furthermore, we use proper motion data of the star from HIPPARCOS and Gaia. Results. We refined the properties of the host star and derived an age of 8.0+2.0−1.0 Gyr based on isochrones, gyrochronology, and chemical and kinematic arguments. This age estimate is slightly younger than previous age estimates of ~9–11 Gyr based on isochrones. No orbital curvature is seen in the current imaging, radial velocity, and astrometric data. From a joint fit of the data, we refined the orbital parameters for HD 19467B, including: a period of 398+95−93 yr, an inclination of 129.8+8.1−5.1 deg, an eccentricity of 0.56 ± 0.09, a longitude of the ascending node of 134.8 ± 4.5 deg, and an argument of the periastron of 64.2+5.5−6.3 deg. We assess a dynamical mass of 74+12−9 MJ. The fit with atmospheric models of the spectrophotometric data of the companion indicates an atmosphere without clouds or with very thin clouds, an effective temperature of 1042+77−71 K, and a high surface gravity of 5.34+0.8−0.9 dex. The comparison to model predictions of the bolometric luminosity and dynamical mass of HD 19467B, assuming our system age estimate, indicates a better agreement with the Burrows et al. (1997, ApJ, 491, 856) models; whereas, the other evolutionary models used tend to underestimate its cooling rate.
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Mielenz, N., M. Kovac, E. Groeneveld, R. Preisinger, M. Schmutz, and L. Schüler. "Genetische Parameter für Merkmale der Eiproduktion geschätzt mit additiven und Dominanzmodellen bei Legehennen." Archives Animal Breeding 46, no. 1 (October 10, 2003): 77–84. http://dx.doi.org/10.5194/aab-46-77-2003.
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Abstract. Title of the paper: Genetic evaluation of egg production traits based on additive and dominance models in laying hens The study was conducted to estimate additive and dominance variances for egg production traits of two commercial purebred lines (A & D) of laying hens using an animal model analysis. Breeding values estimated from a dominance model were compared to those from an additive model. In total, 8625 records of line A and 8968 records of line D from three generations were used in the analysis. Every record contained information on the number of eggs laid between 20 and 28 (EN1-2), 28 and 48 (EN3-7) and between 20 and 48 (EN1-7) weeks of age. Further average egg weight (EW), egg weight at 28 (EW1), 33 (EW2) and 40 (EW3) weeks of age were available. An additive animal model and one- and three-trait dominance models including the inbreeding coefficients as covariates were fitted to the data. Simultaneous estimates of the additive and dominance variance components were obtained using the REML method. The estimates of h2 from the dominance models for EN1-2, EN3-7, EN1-7 and EW were 0.40, 0.15, 0.28 and 0.62 for line A and 0.38, 0.16, 0.26 and 0.53 for line D. The ratios d2 of the dominance variance to total variance were moderate for EN (0.12–0.13) and low for EW (0.04–0.07) within line A but relatively low for EN (0.03–0.12) and high for EW (0.12–0.21) within line D. Between the breeding values of the best 100 hens of each generation estimated with the additive and the dominance models for EN1-2, EN3-7, EN1-7 and EW high rank correlations (0.946, 0.896, 0.945 and 0.991 in line A and 0.996, 0.899, 0.971 and 0.951 in line D were found
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Spunt, Sheri L., Catherine A. Poquette, Yasmeen S. Hurt, Alvida M. Cain, Bhaskar N. Rao, Thomas E. Merchant, Jesse J. Jenkins, Victor M. Santana, Charles B. Pratt, and Alberto S. Pappo. "Prognostic Factors for Children and Adolescents With Surgically Resected Nonrhabdomyosarcoma Soft Tissue Sarcoma: An Analysis of 121 Patients Treated at St Jude Children's Research Hospital." Journal of Clinical Oncology 17, no. 12 (December 1999): 3697–705. http://dx.doi.org/10.1200/jco.1999.17.12.3697.
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PURPOSE: The rarity and heterogeneity of pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) has precluded meaningful analysis of prognostic factors associated with surgically resected disease. To define a population of patients at high risk of treatment failure who might benefit from adjuvant therapies, we evaluated the relationship between various clinicopathologic factors and clinical outcome of children and adolescents with resected NRSTS over a 27-year period at our institution. PATIENTS AND METHODS: We analyzed the records of 121 consecutive patients with NRSTS who underwent surgical resection between August 1969 and December 1996. Demographic data, tumor characteristics, treatment, and outcomes were recorded. Univariate and multivariate analyses of prognostic factors for survival, event-free survival (EFS), and local and distant recurrence were performed. RESULTS: At a median follow-up of 9.2 years, 5-year survival and EFS rates for the entire cohort were 89% ± 3% and 77% ± 4%, respectively. In univariate models, positive surgical margins (P = .004), tumor size ≥ 5 cm (P < .001), invasiveness (P = .002), high grade (P = .028), and intra-abdominal primary tumor site (P = .055) adversely affected EFS. All of these factors except invasiveness remained prognostic of EFS and survival in multivariate models. Positive surgical margins (P = .003), intra-abdominal primary tumor site (P = .028), and the omission of radiation therapy (P = .043) predicted local recurrence, whereas tumor size ≥ 5 cm (P < .001), invasiveness (P < .001), and high grade (P = .004) predicted distant recurrence. CONCLUSION: In this largest single-institution analysis of pediatric patients with surgically resected NRSTS, we identified clinicopathologic features predictive of poor outcome. These variables should be prospectively evaluated as risk-adapted therapies are developed.
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Simpson, Jean F., Robert Gray, Lynn G. Dressler, Charles D. Cobau, Carla I. Falkson, Kennedy W. Gilchrist, Kishan J. Pandya, David L. Page, and Nicholas J. Robert. "Prognostic Value of Histologic Grade and Proliferative Activity in Axillary Node–Positive Breast Cancer: Results From the Eastern Cooperative Oncology Group Companion Study, EST 4189." Journal of Clinical Oncology 18, no. 10 (May 10, 2000): 2059–69. http://dx.doi.org/10.1200/jco.2000.18.10.2059.
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PURPOSE: The identification of a subset of patients with axillary lymph node–positive breast cancer with an improved prognosis would be clinically useful. We report the prognostic importance of histologic grading and proliferative activity in a cohort of patients with axillary lymph node–positive breast cancer and compare these parameters with other established prognostic factors. PATIENTS AND METHODS: This Eastern Cooperative Oncology Group laboratory companion study (E4189) centered on 560 axillary lymph node–positive patients registered onto one of six eligible clinical protocols. Flow cytometric (ploidy and S-phase fraction [SPF]) and histopathologic analyses (Nottingham Combined Histologic Grade and mitotic index) were performed on paraffin-embedded tissue from 368 patients. RESULTS: Disease recurred in 208 patients; in 161 (77%), within the first 5 years. Mitotic index and grade were associated with both ploidy and SPF (P ≤ .01). Within the first 5 years of follow-up, mitotic index (P = .004), grade (P = .004), ploidy (P = .006), and SPF (P = .05) were associated with time to recurrence; there was also a significant association with survival. The effect of mitotic index was largely a result of the difference between 0 to 2 mitoses/10 high-power fields (HPF; 5-year recurrence of 31%) and more than 2 mitoses/10 HPF (5-year recurrence of 52%). The 0 to 2 mitoses/10 HPF group was independently associated with improved prognosis at 5 years (P = .002) in regression models that included other standard prognostic factors. CONCLUSION: A subset of axillary lymph node–positive patients with improved prognosis may be identified using a lower (< 3 mitoses/10 HPF) mitotic count than is usually performed.
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DALMADIYO, GEMBONG, CECE SUHARA, SUPRIYONO SUPRIYONO, and SUDJINDRO SUDJINDRO. "EVALUASI KETAHANAN AKSESI KENAF (Hibiscus cannabinus L.) TERHADAP PENYAKIT LAYU Fusarium oxysporum SCHLECT." Jurnal Penelitian Tanaman Industri 6, no. 2 (July 15, 2020): 29. http://dx.doi.org/10.21082/jlittri.v6n2.2000.29-32.
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<p><strong>Evaluation on the resistance of kenaf accessions (Hibis¬ cus cannabinus /..) to Fusarium oxysporum Schlect</strong></p><p>Resistant variety is one of the most important components controlling of fusarium wilt disease on kenaf caused by Fusarium oxysporum Schlect. To ind out resistant variety an evaluation on kenaf accessions was conducted in the laboratory and screen house of Phytopathology, RITFC, Malang in June-December 1997. The results of the selection on 77 accessions showed that 41 accessions were highly resistant, 1 2 accessions were resistant, 7 accessions were moderate, 12 accessions were susceptible, and 5 accessions were highly susceptible Three resistant and highly resistant accessions were namely 85-9-73, DS/005 H, and FJ/004 He could inhibit F. oxysporum growth about 23.40- 32.43 mm and its discolorisation about 0.0-13.4%.</p>
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Vilela, Marcela Viana, Mariana Domingos Gonçales, and Edney Norio Otsuki. "ANÁLISE DO TÉTANO EM NEONATOS NO ESTADO DO PARANÁ EM SUAS 22 REGIÕES DE SAÚDE, NO PERÍODO DE AGOSTO DE 2015 A AGOSTO DE 2019." Revista UNINGÁ 57, S1 (February 4, 2021): 003–4. http://dx.doi.org/10.46311/2318-0579.57.s1.003-004.
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O tétano neonatal é uma doença infecciosa não contagiosa provocada pelo bacilo anaeróbio Clostridium tetani, através da contaminação do coto umbilical com os esporos da bactéria,que podem ser encontrados em instrumentos não esterilizados utilizados para secção do cordão umbilical, bem como em produtos do hábito cultural das populações.Possui rápida progressão,os primeiros sintomas aparecem entre do 3° e o 14° dia, evoluindo para óbito no período neonatal. Consiste em um importante problema de saúde pública, já que é uma das principais causas de óbito do recém-nascido na maioria dos países subdesenvolvidos. Apresenta alta incidência na população com menor acesso a serviços de saúde obstétricos, pré-natal e nascidos de partos domiciliares, bem como nas populações com baixo índice de informação sanitária. O estudo teve como objetivo investigar o número de internamentos, óbitos e mortalidade decorrente do tétano neonatal em menores de um ano de vida em ambos os sexos, no período de agosto de 2015 a agosto de 2019, no estado do Paraná, comparando as 22 Regiões de Saúde (RS). Para tanto, utilizou-se de um estudo epidemiológico observacional com fonte de dados coletados através do DATASUS, levando-se em consideração sexo, faixa etária, regiões de saúde, internamento, óbito e taxa de mortalidade. No período em questão, ocorreram no estado do Paraná 5086 internações por tétano neonatal na população observada, entre as 22 regiões de saúde do estado. Dessas, 2863 acometeram o sexo masculino e 2223 o sexo feminino. Além disso, a 2ª RS Curitiba contou com maior número de internações (2108 casos, sendo 1195 no sexo masculino e 913 sexo feminino), já a 13ª RS Cianorte teve o menor número (38 casos, sendo 18 no sexo masculino e 20 no sexo feminino). Com relação ao número de óbitos, foram registrados nesse período 167 óbitos (90 no sexo masculino, 77 sexo feminino) sendo a 2ª RS Curitiba com maior número (58 óbitos, 35 no sexo masculino e 23 no sexo feminino), 1ª RS Paranaguá (1 óbito, no sexo feminino) com menor número. Dentre as 22 RS’s, a taxa de mortalidade foi de 3,28, sendo a 19ª RS Jacarezinho a que apresentou maior taxa(8,54), em contrapartida a 16ª RS Apucarana com menor (1,53) e as 4ª RS Irati, 13ª RS Cianorte, 14ª RS Paranavaí, 21ª RS Telêmaco Borba, sem registro de óbito. Apesar da baixa taxa de mortalidade em algumas regiões, o tétano neonatal continua presente no Estado do Paraná e trazendo óbitos, principalmente no sexo masculino. Apesar da enfermidade possuir alta letalidade, a morte pela mesma pode ser evitada com melhora da cobertura, qualidade,atenção pré-natal e programas de vacinação. Para tanto, falhas na implementação das medidas precisam ser superadas, sendo fundamental a busca de estratégias diferenciadas e que alcance os grupos populacionais socialmente mais vulneráveis, esses são os grupos mais acometidos pelo tétano neonatal e os que mais se beneficiariam com as intervenções.
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Nishikubo, Tadatomi, Atsushi Kameyama, Yoshinari Hosono, and Youji Yamada. "Synthesis of Polymers in Aqueous Solutions: Heterogeneous Oxidation of Poly(Amide-Sulphide) in Water." High Performance Polymers 10, no. 1 (March 1998): 23–31. http://dx.doi.org/10.1088/0954-0083/10/1/004.
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The heterogeneous oxidation of N-(2-phenylthioethyl)benzamide in a dispersion of water was performed with twice the amount of hydrogen peroxide at 60 °C for 72 h as a model reaction of the oxidation of poly(amide-sulphide) (polymer 1), and the corresponding N-[2-(phenylsulphoxy)-ethyl]benzamide and N-[2-(phenylsulphonyl)ethyl]benzamide were obtained in 5% and 95% yields respectively. This suggests that the alkyl phenyl sulphide group was easily oxidized with time via the alkyl phenyl sulphoxide group into the alkyl phenyl sulphone group. On the other hand, when heterogeneous oxidation of diphenyl sulphide in a dispersion of water was carried out with twice the amount of hydrogen peroxide at 60 °C for 72 h, the corresponding diphenyl sulphoxide and diphenyl sulphone were obtained in 77% and 23% yields, respectively. Therefore, the oxidation rate of the diphenyl sulphide group was much slower than that of the alkyl phenyl sulphide group, and the heterogeneous oxidation of diphenyl sulphide with excess hydrogen peroxide in a dispersion of water primarily produced diphenyl sulphoxide under the same conditions. On the basis of these model reactions, the heterogeneous oxidation of polymer 1, which was prepared by the polyaddition of bis(4-mercaptophenyl)sulphide with m-phenylenebis(2-oxazoline), was performed with one to three times the amount of hydrogen peroxide in a dispersion of water at 60 °C, and the Tg of the resulting polymers gradually increased with reaction time from 111 °C to 165 °C. When the oxidization was carried out with three times the amount of hydrogen peroxide for 48 h, the polymer with major structure, poly(amide-sulphone) (polymer 3), was obtained. Polymer 3 was also easily prepared by the oxidization of polymer 1 with equivalent amounts of sodium periodate in a dispersion of water at 60 °C for 48 h.
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Safra, Tamar, Dov Hershkovizh, Eliya Shachar, Lyri Adar, Miriam R. Brezis, Yuval Raviv, Lee Galmor, and Shira Peleg Hasson. "Next generation sequencing in ovarian cancer patients: Does personalized medicine improve oncological outcomes?" Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 5553. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.5553.
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5553 Background: Ovarian cancer (OC) is the second most common gynecologic malignancy and the most common cause of gynecologic cancer mortality in the United States. Homologous recombination deficiency (HRD), including the BRCA mutations, are found in 50% of OC tumors. Next generation sequencing (NGS) provides understanding the underlying molecular and genetic patterns to improve OC treatment. This study examines the prognostic and predictive biomarkers identified with NGS in hopes to improve OC patients outcomes. Methods: The patient cohort included 890 consecutive OC patients treated between 2002 and 2020,at the Tel-Aviv Medical Center. We retrospectively evaluated patients with histopathologically confirmed OC. Cox models were used to analyze the clinical impact of various mutations and biomarkers among OC patients with and without FoundationOne CDx NGS testing, by assessing overall survival (OS), progression free survival (PFS), and physicians' timing preferences for referral to NGS testing. Results: Among the 890 OC patients, 103 (11.57%) completed NGS molecular testing. The median OS among patients with and without NGS testing, adjusted for age, stage and recurrence status, was 73.36 and 68.50 months, respectively (P =.02). The median PFS was 17.23 and 17.43 months, respectively (P =.77). We also evaluated physicians' preferences regarding timing of molecular profiling, upon diagnosis, after first recurrence and at advanced line of treatment in 31.95%, 36.08% and 26.8% of practitioners, respectively. Of the patients who completed NGS, 48 (52.75%) harbored actionable mutations, and 21 patients (43.75%) received matched targeted therapy. Forty-five patients were microsatellite stable (MSS) (45%), 55 with undetermined status (55%) and 0 patients with MSI-H. Forty-one (71.93%) patients had low ( < 5) tumor mutation burden status (TMB), 16 (28.07%) intermediate (5-15) and none with high ( > 15) TMB. There was no noticeable survival difference when comparing low with intermediate TMB (P = 0.3). Loss of heterozygosity (LOH) was a significant prognostic biomarker. Patients with high LOH (hLOH > = 16%) had longer OS compared to low LOH (lLOH < 16%), 99.02 vs. 50.23 months, respectively (P <.005). Patients with hLOH and BRCA mutations (BRCA+) had longer OS compared to hLOH/BRCA WT (BRCA-), lLOH/BRCA+, and lLOH/BRCA-, with an unreached median OS of 91.5 vs. 60.48 vs. 45.21 months, respectively (P =.005). Conclusions: Our work demonstrates the clinical benefit of NGS personalized medicine as a cornerstone of future treatment strategies in OC. Our study suggests an OS benefit among the NGS tested cohort. We identified LOH as a prognostic biomarker. Prospective studies evaluating larger cohorts are necessary to generate a more extensive evaluation of additional prognostic and predictive biomarkers among OC patients.
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Klaassen, Robert, John D. Grainger, Arne Riedlinger, Victor S. Blanchette, Tricia Burke, Estela Citrin, Gustavo Dufort y. Alvarez, et al. "Treatment Does Not Correlate with Quality of Life in Children with Immune Thrombocytopenic Purpura: Results From the KIT International Cross-Cultural Validation Study." Blood 114, no. 22 (November 20, 2009): 2501. http://dx.doi.org/10.1182/blood.v114.22.2501.2501.
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Abstract Abstract 2501 Poster Board II-478 Introduction: There is considerable controversy surrounding whether or not children with Immune Thrombocytopenic Purpura (ITP) should be treated if they present without bleeding. One of the potential benefits of treatment would be to improve the child's health-related quality of life (HRQoL). Patients and Methods: Variables including age, sex, type of ITP(acute versus chronic), treatment (observation, IVIG, Anti-D, and prednisone), platelet count and country of origin were analysed by multiple regression to determine their relationship to HRQoL as measured by the Kid's ITP Tools (KIT) child self-report version. Results: 77 children from Uruguay (n=15), France (n=25), Germany (n=13) and the UK (n=24) self-completed the KIT. Mean platelet counts were: 6 for acute ITP patients (mean age 8.6 yrs) and 30 for chronic patients (mean age of 10.8 years). KIT scores by type of ITP and country are shown in the Figure. Multiple regression found that only the type of ITP (p=0.04) and the country of origin (p=0.029) were significantly associated with the KIT scores. Age, sex, platelet count and treatment were not correlated with KIT scores (p>0.16). Conclusion: The method of treatment did not have a significant impact on child-reported HRQoL. However, differences in HRQoL scores were found between acute and chronic groups and by country of origin. Disclosures: Klaassen: Cangene : Research Funding. Blanchette:Cangene: Research Funding. Young:Cangene: Research Funding.
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Davidson, Noveen, Fiona Doig, Eliazar Dimpalapang, John Stirling, Thomas Gentles, Nigel Wilson, John Artrip, and Kirsten Finucane. "Safe Decompression of the Right Ventricle for PAIVS in Neonates With Coronary Fistulae: Including the Selective Use of Fistula Ligation to Avoid Coronary Steal." World Journal for Pediatric and Congenital Heart Surgery 12, no. 2 (March 2021): 185–94. http://dx.doi.org/10.1177/2150135120974395.
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Background: There are a number of surgical and interventional treatment options for infants with pulmonary atresia with intact ventricular septum (PAIVS). In our practice, we characterize coronary fistulae and interruptions with angiography in the newborn and have developed a strategy to safely decompress the right ventricle in association with ligation of fistulae if necessary. Methods: All infants operated for PAIVS at age < 60 days from 1999 to 2018 were retrospectively studied. Pre- and postoperative variables were collected, angiograms were reviewed, and a territory score was created to grade the severity of coronary abnormalities. This study focused on the subgroup of patients who had early surgical decompression of the right ventricle. Results: A total of 77 patients were included, with a mean follow-up of 8.6 years. Of these, 55 (71%) had coronary fistulae, including 28 (36%) with coronary artery interruption. Right ventricular decompression (RVD) was performed in 47 (60.5%) patients. There was no 30-day mortality in those who underwent RVD, whereas 6 (20%) without RVD died within 30 days ( P = .003). Ten-year survival was 97.8% and 73.3% for RVD and non-RVD, respectively. In order to prevent coronary steal, 17 patients underwent coronary fistula ligation as their RV was decompressed with 100% early and late survival. Conclusion: Early and late survival in infants with PAIVS is better if the RV can be decompressed. Coronary fistula ligation with RVD has been introduced without an adverse outcome in selected patients with large fistulae.
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Chaidir, Liberty, Kristi Yuliani, and Budy Frasetya Taufik Qurrohman. "Eksplorasi dan Karakterisasi Tanaman Genjer (Limnocharis flava (L.) Buch) di Kabupaten Pangandaran Berdasarkan Karakter Morfologi dan Agronomi." Jurnal Agro 3, no. 2 (December 31, 2016): 53–66. http://dx.doi.org/10.15575/967.
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Genjer merupakan tanaman yang tumbuh liar di area persawahan, rawa, atau sungai yang keberadaannya sering dianggap sebagai gulma. Tanaman genjer memiliki banyak manfaat, diantaranya sebagai bahan penyerap logam berat dalam tanah dan sebagai obat yang memiliki banyak kandungan gizi. Penelitian ini bertujuan untuk mengetahui variasi karakter morfologi dan karakter agronomi untuk mengetahui hubungan kekerabatan tanaman genjer antar daerah di Kabupaten Pangandaran. Penelitian dilaksanakan di Kabupaten Pangandaran pada Mei sampai Oktober 2015. Metode yang digunakan adalah metode eksplorasi purposive sampling pada 77 aksesi genjer yang diambil dari Kabupaten Pangandaran. Hasil penelitian menunjukkan terdapat keragaman fenotipik yang luas pada karakter morfologi ujung daun, warna batang, tekstur daun, warna daun, panjang lekukan bawah daun, warna kelopak bunga dan warna bunga. Karakter agronomi yang mempunyai keragaman yang luas ialah tinggi tanaman, jumlah batang per rumpun, panjang daun, lebar daun, jumlah daun, jumlah bunga dan diameter batang. Tanaman genjer di Kabupaten Pangandaran memiliki kekerabatan yang jauh dengan rentang jarak Euclidian 0,48 sampai 10,17. Aksesi yang memiliki hubungan kekerabatan paling jauh yaitu Ciakar (001) dengan jarak Euclidian 10,17, sedangkan yang memiliki hubungan kekerabatan paling dekat yaitu Cikalong (003) dan Cikalong (004) dengan jarak Euclidian 0,48. Genjer or Yellow velvetleaf is a plant that grows wild in lowland area, swamp or river which existence is considered as a weed. Genjer has a lot of benefits, such as material absorbent for heavy metals in the soil and medicine that has a lot of nutrition. This study aimed to determine the variety of morphological and agronomic characters of Genjer in Pangandaran Regency and to determine the genetic relationship of genjer between regions in Pangandaran. The research was conducted in the Pangandaran Regency on May to October 2015. The method used purposive sampling exploration method in 77 accession genjer collected from Pangandaran Regency. The results showed there were extensively phenotypic variation in tip of leaf, stem color, leaf texture, leaf color, length curve of bottom leaf, petal color and flower color. While agronomic characters for plant height, stem amount, leaf length, leaf width, leaf amount, flower amount and diameter of the stem had wide variation. Relationship between genjer in Pangandaran Regency had Euclidean distance with a range of 0.48 to 10.17. The accession which had the farthest distance was Ciakar (001) with Euclidean distance of 10.17, while those with the closest relationship were Cikalong (003) and Cikalong (004) with Euclidean distance of 0.48.
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Ma, Wei-li, Yu Yun Shao, Chih-Hung Hsu, Kun-Huei Yeh, Ho-Min Chen, Yi-Chun Yeh, Chiu-Lin Lai, Zhong-Zhe Lin, Ann-Lii Cheng, and Mei-Shu Lai. "Regular statin users and colorectal cancer (CRC) prognosis." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 3554. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.3554.
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3554 Background: Statins are frequently used for the control of hyperlipidemia. Statins have multiple anti-cancer properties and may be associated with lower CRC risks among their users. This study tries to go a step further and explores whether statin use affects the prognosis of curatively resected CRC. Methods: We established a population cohort with patients (age ≥ 40 y) who were diagnosed as having stage I or II CRC from 2004 to 2008 and received curative surgery from the database of Taiwan Cancer Registry. Data of medication prescription and co-morbidities were retrieved from the database of National Health Insurance, Taiwan. Regular statin use was defined as taking statins for > 180 days within the observation period from one year before the cancer diagnosis to one year afterward. The database of National Death Registry was used for survival outcomes. Another similar cohort consisting of patients with hepatocellular carcinoma (HCC) was used for comparison. Results: In total, 10762 patients with CRC were enrolled; 891 (8%) patients were regular stain users, 812 (8%) patients took statins but were not regular users, and 9059 (84%) patients never used statins. Regular statin users, compared to never users, were more likely to be female (p < 0.001), older (p < 0.001), have stage I disease (p < 0.001) and co-morbidities such as diabetes, coronary artery disease, and renal disease. Adjuvant therapy was less frequently administered in regular statin users. In univariate analysis, cancer-specific survival (CSS) of regular stating users was significantly longer than that of never users (5-y CSS, 87% vs. 84%, p = 0.022), but overall survival (OS) was not significantly different (5-y OS, 80% vs. 77%, p = 0.156). In multivariate analysis adjusting for age, gender, stage, adjuvant therapy, co-morbidities, and the use of aspirin, regular stating use was an independent predictor both for better CSS (hazard ratio [HR] 0.72, p < 0.001) and for better OS (HR 0.71, p< 0.001). In contrast, no associations were found between statin use and CSS or OS in the HCC comparison cohort. Conclusions: Regular statin use was associated with better prognosis in CRC patients who received curative therapy. (This study was supported by grants DOH-101-TD-B-111-001 and DOH-102-TD-B-111-001).
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Gunes, Adalet Meral, Frédéric Millot, Krzysztof Kalwak, Birgitte Lausen, Petr Sedlacek, Birgitte Versluijs, Michael Dworzak, Barbara De Moerloose, and Meinolf Suttorp. "Features and Outcome of Chronic Myeloid Leukemia (CML) at Very Young Age: Data from the International Pediatric CML Registry (I-CML-Ped Study)." Blood 132, Supplement 1 (November 29, 2018): 1748. http://dx.doi.org/10.1182/blood-2018-99-112905.
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Abstract Introduction: CML is rare in the first two decades of life comprising only 3% of pediatric and adolescent leukemias. The overall annual incidence is approximately 1 per million children and adolescents and it increases with age (median: 12 yrs, range: 1-18) resulting in an extreme rarity of children affected in the first years of life. Data regarding the clinicopathologic characteristics and response to therapy of childhood CML diagnosed at age <3 years has not been reported yet. Aims and objectives: We studied the epidemiologic and clinical features of patients(pts) with CML <3 years of age and evaluated treatment and long term outcome. Material and Methods: Data from pediatric CML pts (age at diagnosis 0-18 yrs) registered from 2010 until 2017 into the International Pediatric CML Registry (Poitiers, France) under the umbrella of the I-BFM Study Group were retrospectively analyzed. Characteristics and treatment outcome of pts <3 yrs at diagnosis were evaluated from standardized forms. Results: 22/479 pts (4.6%, ratio male/female: 14/8) were enrolled with a median age of 22 months (10-34) and a median weight and height were 9.3 kg (8.1-15.5) and 78 cm (73-98), respectively. The median time period from the first symptoms until final diagnosis was 21 days (2-182). Median spleen size was 12 cm (2-20) and median liver size was 3 cm (2-6) below the costal margins. Major complains and symptoms comprised asthenia (30%), fever (30%), abdominal pain (20%), extramedullary signs (14%), hemorrhage (5%), and weight loss (5%). Median WBC, Hb and platelet counts were 154 600/µl (23 000-892 000), 8.7 g/dl (5,6-11,5) and 311 000/µl (51 000-1 820 000), respectively. All pts underwent BM aspiration but, BM biopsy was performed only in 8/22 children. Philadelphia chromosome and BCR-ABL1 gene rearrangement were detected by cytogenetic and/or molecular techniques (FISH and RQ-PCR). In only 2 (9%) children, additional chromosomal abnormalities were detected by cytogenetics classifying one patient in accelerated phase. Overall 19/22 (86%) children were diagnosed in chronic phase and the remaining 3 pts were in advanced phase (CML-AP: n= 2, CML-BP: n= 1). Median follow-up of the cohort was 78 months (7-196). Treatment: 21/22 pts initially received imatinib at the recommended dose of 260-300 mg/sqm/day while one child received IFN + ARA-C. Imatinib was changed to either dasatinib (n= 5) or nilotinib (n= 1) in 6 children (29%). Thus, 15 pts continued on imatinib. During follow-up, 9/22 (41%) pts underwent HSCT including 2 pts after switching to dasatinib. Molecular response: Major molecular response (MR) was achieved in 10/21 (48%) children on TKI. One child (1/21) on TKI was not followed for MR, but he developed complete cytogenetic remission 4 mo after imatinib treatment. The remaining cohort (6/22; 27%) is alive on TKI without major MR with a median follow-up of 77 m (7-186) and 5/22 (23%) achieved complete MR following HSCT. Adverse effects (AE): 194 AE episodes were reported in 18/22 (82%) pts. Most frequently observed AEs were hematologic (20%), gastrointestinal (16%), infectious (14%), musculoskeletal (14%), skin (12%), metabolic (6%), and HSCT-related (GvHD, 5%). Less frequently AEs comprised psychological (3%), edema (3%), tooth development delay (2%), allergic (2%), neurologic (PRESS syndrome,1%), and renal colic (1%). At last follow up, assessment of puberty status revealed that the majority of children were in Tanner stage 1 or 2 (17/22, 77%). Among these, 7 were >10 years old and showed puberty delay, while pubertal development was normal in the remaining 5/22 pts. Data on growth and development was available in 15/22 (68%) children. The majority had experienced decline of height (93%) and weight (73%). In 4 (27%) and 2 (13%) pts, respectively, measurements were found below the 3rd-10th percentiles. Delta z-score analysis for height and weight revealed that the z-scores in total 3 pts were below -2. Survival: 21/22 (95%) children are alive while one patient died of GvHD. Two pts' last molecular status is unknown. 7/19 pts (37%) are in molecular CR following HSCT and the other 12/19 (63%) are still on TKI. Out of these, 3/12 pts achieved durable CMR with TKI (PCR negative) while the remaining 9/12 pts show either fluctuating (n= 3 ) or no major MR (n= 6). Conclusion: This report demonstrates for the first time the efficacy and long term side effects of upfront imatinib in the so far largest cohort of children with CML diagnosed at very young age. Disclosures Kalwak: Sanofi: Other: travel grants; medac: Other: travel grants.
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Choueiri, Toni K., Anne Plantade, Paul Elson, Sylvie Negrier, Alain Ravaud, Stephane Oudard, Ming Zhou, Brian I. Rini, Ronald M. Bukowski, and Bernard Escudier. "Efficacy of Sunitinib and Sorafenib in Metastatic Papillary and Chromophobe Renal Cell Carcinoma." Journal of Clinical Oncology 26, no. 1 (January 1, 2008): 127–31. http://dx.doi.org/10.1200/jco.2007.13.3223.
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Purpose Sunitinib and sorafenib are novel tyrosine kinase inhibitors (TKIs) that have shown significant clinical activity in metastatic clear cell renal cell carcinoma (RCC). The activity of sunitinib and sorafenib in non–clear cell histologies has not been evaluated. Patients and Methods Clinical features at study entry and treatment outcomes were evaluated in patients with metastatic papillary RCC (PRCC) and chromophobe RCC (ChRCC) who received either sunitinib or sorafenib as their initial TKI treatment in five US and French institutions. Response rate and survival were documented. Fisher's exact test was used for categoric variables, and the Kaplan-Meier method was used to estimate survival. Results Fifty-three patients were included. The number of patients with papillary and chromophobe histologies was 41 (77%) and 12 (23%), respectively. Response rate, progression-free survival (PFS) time, and overall survival time for the entire cohort were 10%, 8.6 months, and 19.6 months, respectively. Three (25%) of 12 ChRCC patients achieved a response (two patients treated with sorafenib and one treated with sunitinib), and PFS was 10.6 months. Two (4.8%) of 41 PRCC patients achieved a response (both patients were treated with sunitinib). PFS for the whole cohort was 7.6 months. Sunitinib-treated PRCC patients had a PFS of 11.9 months compared with 5.1 months for sorafenib-treated patients (P < .001). Conclusion Patients with PRCC and ChRCC may have prolonged PFS from sunitinib and sorafenib, although clinical responses remain overall low in PRCC. Additional prospective trials with these agents in non–clear cell RCC will further clarify their use in the future.