Adjuvant high-dose medroxyprogesterone acetate for early breast cancer: 13 years update in a multicentre randomized trial

The authors updated their report on a randomized trial initiated in 1982 comparing, in early breast cancer, high-dose IM Medroxyprogesterone acetate (HD-MPA) adjuvant hormonotherapy during 6 months with no hormonotherapy; node-positive patients also received 6 courses of IV CMF (day 1, day 8; q.4 weeks). 246 node-negative (NN) and 270 node-positive (NP) patients had been followed for a median duration of 13 years. Previous results were confirmed in this analysis on mature data. In NN patients, relapse-free survival (RFS) was improved in the adjuvant hormonotherapy arm, regardless of age while overall survival (OAS) was also increased in younger (less then 50 years) patients. In the whole group of NP patients, no difference was seen regarding RFS or OAS. However, an age-dependant opposite effect was observed: younger patients (< 50) experienced a worse and significant outcome of relapse-free and overall survivals when receiving adjuvant HD-MPA while older patients (> = 50) enjoyed a significant improvement of their relapse-free survival. For both NN and NP patients, differences in overall survivals observed in older women with a shorter follow-up, were no longer detected. © 2001 Cancer Research Campaign http://www.bjcancer.co

Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys

Background: Rates of caesarean section surgery are rising worldwide, but the determinants of this increase, especially in low-income and middle-income countries, are controversial. In this study, we aimed to analyse the contribution of specific obstetric populations to changes in caesarean section rates, by using the Robson classification in two WHO multicountry surveys of deliveries in health-care facilities. The Robson system classifies all deliveries into one of ten groups on the basis of five parameters: obstetric history, onset of labour, fetal lie, number of neonates, and gestational age. Methods: We studied deliveries in 287 facilities in 21 countries that were included in both the WHO Global Survey of Maternal and Perinatal Health (WHOGS; 2004–08) and the WHO Multi-Country Survey of Maternal and Newborn Health (WHOMCS; 2010–11). We used the data from these surveys to establish the average annual percentage change (AAPC) in caesarean section rates per country. Countries were stratified according to Human Development Index (HDI) group (very high/high, medium, or low) and the Robson criteria were applied to both datasets. We report the relative size of each Robson group, the caesarean section rate in each Robson group, and the absolute and relative contributions made by each to the overall caesarean section rate. Findings: The caesarean section rate increased overall between the two surveys (from 26·4% in the WHOGS to 31·2% in the WHOMCS, p=0·003) and in all countries except Japan. Use of obstetric interventions (induction, prelabour caesarean section, and overall caesarean section) increased over time. Caesarean section rates increased across most Robson groups in all HDI categories. Use of induction and prelabour caesarean section increased in very high/high and low HDI countries, and the caesarean section rate after induction in multiparous women increased significantly across all HDI groups. The proportion of women who had previously had a caesarean section increased in moderate and low HDI countries, as did the caesarean section rate in these women. Interpretation: Use of the Robson criteria allows standardised comparisons of data across countries and timepoints and identifies the subpopulations driving changes in caesarean section rates. Women who have previously had a caesarean section are an increasingly important determinant of overall caesarean section rates in countries with a moderate or low HDI. Strategies to reduce the frequency of the procedure should include avoidance of medically unnecessary primary caesarean section. Improved case selection for induction and prelabour caesarean section could also reduce caesarean section rates

Nature of conduction in doped silicon

Via ultrafast optoelectronic THz techniques, we are able to test alternative theories of conduction by precisely measuring the complex conductivity of doped silicon from low frequencies to frequencies higher than the plasma frequency and the carrier damping rate. These results, obtained for both n and p-type samples, spanning a range of more than 2 orders of magnitude in the carrier density, do not fit any standard theory. We only find agreement over the full frequency range with the complex conductivity given by a Cole-Davidson type distribution applied here for the first time to a crystalline semiconductor, and thereby demonstrate that fractal conductivity is not just found in disordered material.Peer reviewedElectrical and Computer Engineerin

Carrier dynamics of electrons and holes in moderately doped silicon

A time-domain spectroscopic technique, based on the generation and detection of a collimated beam of subpicosecond broadband terahertz pulses, is used to measure the absorption and dispersion of n- and p-type silicon, with resistivities of 0.1, 1, and 10 Ohm-cm in the submillimeter range of 0.1-2 THz. From the transmission measurements performed at room temperature and at 80 K, the absorption and dispersion, and concomitantly the full complex conductivity, of the doped silicon could be obtained. The results provide an accurate view on the dynamics of the electrons and the holes. Although the simple Drude model, with an energy-independent relaxation time, gives a surprisingly accurate description of the observed carrier dynamics, the measurements do show that some refinements are needed. An extended model, with an energy-dependent carrier-relaxation rate, can explain most of the observed deviations from the simple Drude model.Peer reviewedElectrical and Computer Engineerin

Docetaxel-induced subungual hemorrhage.

Docetaxel (RP 56976 or Taxotere), a semisynthetic drug belonging to the family of taxoids, is a new chemotherapeutic agent used in phase II trials for breast, ovarian and lung cancer. We report 2 cases of subungual hemorrhages, which, to our knowledge, have yet to be cited in association with the use of docetaxel. Although not incapacitating, the patient should be made aware of the potential risk of this drug reaction.Case ReportsJournal Articleinfo:eu-repo/semantics/publishe

Subungual abscess: a new ungual side-effect related to docetaxel therapy

Case ReportsLetterFLWINinfo:eu-repo/semantics/publishe

Efficacy of twice daily versus three times daily oral ondansetron in the prevention of chemotherapy induced emesis: A randomized, single-blind, multicentre study

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Modifications, adaptations and recommendations for implementing and interpreting the Robson classification according to the authors/users of the 73 articles included in this systematic review, and effect size (the proportion of articles which recommended each of them).

<p>Modifications, adaptations and recommendations for implementing and interpreting the Robson classification according to the authors/users of the 73 articles included in this systematic review, and effect size (the proportion of articles which recommended each of them).</p