23 research outputs found

    Comparative evaluation of [(99m)tc]tilmanocept for sentinel lymph node mapping in breast cancer patients: results of two phase 3 trials.

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    BackgroundSentinel lymph node (SLN) surgery is used worldwide for staging breast cancer patients and helps limit axillary lymph node dissection. [(99m)Tc]Tilmanocept is a novel receptor-targeted radiopharmaceutical evaluated in 2 open-label, nonrandomized, within-patient, phase 3 trials designed to assess the lymphatic mapping performance.MethodsA total of 13 centers contributed 148 patients with breast cancer. Each patient received [(99m)Tc]tilmanocept and vital blue dye (VBD). Lymph nodes identified intraoperatively as radioactive and/or blue stained were excised and histologically examined. The primary endpoint, concordance (lower boundary set point at 90 %), was the proportion of nodes detected by VBD and [(99m)Tc]tilmanocept.ResultsA total of 13 centers contributed 148 patients who were injected with both agents. Intraoperatively, 207 of 209 nodes detected by VBD were also detected by [(99m)Tc]tilmanocept for a concordance rate of 99.04 % (p¬†<¬†0.0001). [(99m)Tc]tilmanocept detected a total of 320 nodes, of which 207 (64.7¬†%) were detected by VBD. [(99m)Tc]Tilmanocept detected at least 1 SLN in more patients (146) than did VBD (131, p¬†<¬†0.0001). In 129 of 131 patients with ‚Č•1 blue node, all blue nodes were radioactive. Of 33 pathology-positive nodes (18.2¬†% patient pathology rate), [(99m)Tc]tilmanocept detected 31 of 33, whereas VBD detected only 25 of 33 (p¬†=¬†0.0312). No pathology-positive SLNs were detected exclusively by VBD. No serious adverse events were attributed to [(99m)Tc]tilmanocept.Conclusion[(99m)Tc]Tilmanocept demonstrated success in detecting a SLN while meeting the primary endpoint. Interestingly, [(99m)Tc]tilmanocept was additionally noted to identify more SLNs in more patients. This localization represented a higher number of metastatic breast cancer lymph nodes than that of VBD

    Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome.

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    BACKGROUND: Sj√∂gren¬īs syndrome (SS) is an autoimmune rheumatic disease that is characterised by decreased exocrine gland function and frequent ocular symptoms associated with eye dryness. Significantly, dry eyes can lead to corneal abrasions, infection, ulceration, chronic scarring and, in severe cases, perforation. The available conventional therapies have limited efficacy and there are no biologic therapies licensed for use in SS patients. MATERIALS AND METHODS: A literature search of PubMed (MEDLINE) and EMBASE electronic data bases was performed covering the period from January 1994 to September 2014. Evidence was graded in categories I-IV and a treatment algorithm, comprising first line, second line and rescue therapies for ocular dryness associated with SS was proposed. It is based on the current evidence of efficacy of different therapies and explores their link with the pathogenesis of ocular dryness associated with SS. RESULTS: Recent developments in the understanding of the pathogenesis of SS provided evidence that the ocular dryness is associated with pathologic infiltration and dysfunction of the lacrimal glands and changes in the tear composition, together with abnormalities involving the neurosecreting circuits. There is good evidence for the efficacy of topical artificial tears, antiinflammatories and Cyclosporine, and oral Pilocarpine and Cevimeline in controlling the symptoms of ocular dryness associated with SS. CONCLUSIONS: Conventional DMARDs are not particularly effective in addressing the symptoms of ocular dryness associated with SS, despite being commonly prescribed for other SS manifestations. Emerging evidence suggests that B cell and co-stimulatory targeted therapy may play a role in the future

    Profiling the Planetary Boundary Layer Wind with a StreamLine XR Doppler LiDAR: Comparison to In-Situ Observations and WRF Model Simulations

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    Halo-Photonics StreamLine XR Doppler LiDAR measurements are performed using several scan configurations (Velocity Azimuth Display-VAD and Doppler Beam Swing-DBS) and elevation angles of 60° and 80°. The measurements are compared to wind observations conducted by various in situ instruments (tethered balloon, meteorological mast, and radiosondes). Good agreement is obtained, with R2 over 0.90 for wind speed and a standard error ≤ 18.6° for wind direction. The best performance was attained for lower elevation scans (60°), which is consistent with the higher spatial horizontal homogeneity exhibited by lower angle scans. VAD and DBS scans performed almost equally well with slight advantage for VAD in higher altitudes and for DBS for lower altitudes. The boundary layer structure along a diurnal cycle is analyzed by utilizing retrieved backscatter data and wind measurements in conjunction with Weather Research and Forecast (WRF) simulations. The presence of multiple inversions which allow the coexistence of different layers within the studied profile is also verified using data acquired by several radiosondes. Synergic use of LiDAR data with WRF simulations for low SNR regions is demonstrated

    Disparities in Overall Survival for Male Breast Cancer Patients in the State of Florida (1996-2007)

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    Little is known regarding population-based disparities in male breast cancer (MBC). Data between 1996 and 2007 from the Florida Cancer Data System, the Agency for Health Care Administration, and the US Census were linked for MBC patients (n = 1589). Survival disparities among socioeconomic status groups were most apparent in our study. Improved access to screening and health care utilization might attenuate these differences. Little is known regarding population-based disparities in male breast cancer (MBC). We analyzed this for Florida using data from 1996 to 2007. Data from the Florida Cancer Data System, the Agency for Health Care Administration, and the US Census were linked for MBC patients (n = 1589). Survival time was our primary end point, with adjustments for sociodemographic status, neighborhood-based poverty measures, clinical and hospital characteristics, and comorbidity measures based on linkage with in- and outpatient treatment records. Survival time was modeled using univariate and multivariate Cox regression models. Five-year overall survival was 65.7%. Overall mean survival time in years was 7.7, but shorter in black (5.9) than white (7.8) individuals, in non-Hispanic (7.7) than Hispanic (8.5) individuals, and in the lowest socioeconomic status (SES) group (5.9) than in the highest (8.2) SES group. Patients with low SES also presented at a more advanced stage with only 75/175 [42.9%] of low SES patients who presented with localized disease compared with 311/621 [50.1%] for middle-high SES and 162/334 [48.5%] for the highest SES. Univariate hazard regressions found only the highest (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.46-0.85) and middle-high (HR, 0.71; 95% CI, 0.54-0.94) SES were at improved survival compared with lowest SES but this advantage did not remain significant in the fully adjusted model. Marital status, age, smoking status, stage, treatments, and comorbidities were also predictors of survival. Survival disparities among SES groups were most apparent in our study. Improved access to screening and health care utilization might attenuate these differences. Understanding other survival disparities can aid in public health and clinical care choices