Percutaneous Mitral Commissurotomy in Patients with Calcific Mitral Stenosis

Objective: the study evaluated the clinical and echocardiographic data, before and after percutaneous mitral commissurotomy (PMC) in patients with calcific mitral stenosis.nbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbsp Materials and methods: this is a retrospective study of 215 patients divided into two groups: 148 patients with calcific mitral stenosis (Group 1), and 67 patients without mitral calcifications (Group 2). The study period is between January 2011 to July 2015.Results: the group 1 was significantly older than the group 2 (49,7plusmn12,2 (group 1) versus 42,7plusmn12,8(group 2) , plt0,001), and had significantly more men than women (female gender:75% in group 1 vs.88,1% in group 2, plt0,05). Before PMC: group 1 had significantly higher Wilkins (9,3plusmn0,8(group 1) vs. 8,5plusmn0,6 (group 2)nbspnbsp p lt0,001) and smaller mitral valve area (0,91plusmn0,20 (group1)nbsp vs.0,99plusmn0,20 ( group 2), plt0,05). After PMC: the final valve area was significantly smaller in patients with, than, without calcifications (2,10plusmn0,26 vs.2,20plusmn0,22nbsp plt0,05). However , the rate of good immediate results, defined as valve area ge1,5 cmsup2 with no mitral regurgitation gt2/4 ( 97,9%vs.100% , pgt 0,05), and the rate of post PMC mitral regurgitation (MRge3/4) (2% vs.0% , pgt0,05), were no different between the 2 groups.Conclusion: PMC can be used for the treatment of patients with calcific mitral stenosis safety, with good immediate results.nbsp nbs

safety run in evaluation of the phase i trial of trifluridine tipiracil ftd tpi in combination with oxaliplatin and a monoclonal antibody bevacizumab or nivolumab in patients pts with metastatic colorectal cancer mcrc

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Restricted feedback control of one-dimensional maps

Dynamical control of biological systems is often restricted by the practical constraint of unidirectional parameter perturbations. We show that such a restriction introduces surprising complexity to the stability of one-dimensional map systems and can actually improve controllability. We present experimental cardiac control results that support these analyses. Finally, we develop new control algorithms that exploit the structure of the restricted-control stability zones to automatically adapt the control feedback parameter and thereby achieve improved robustness to noise and drifting system parameters.Comment: 29 pages, 9 embedded figure

Health-related quality of life associated with trifluridine/tipiracil in heavily pretreated metastatic gastric cancer: results from TAGS

Background In TAGS, an international, double-blind, phase 3 trial, trifluridine/tipiracil significantly improved overall survival and progression-free survival compared with placebo in heavily pretreated metastatic gastric cancer patients. This paper reports pre-specified quality of life (QoL) outcomes for TAGS. Methods Patients were randomized 2:1 to trifluridine/tipiracil (35 mg/m2 twice daily on days 1–5 and 8–12 of each 28-day cycle) plus best supportive care (BSC) or placebo plus BSC. QoL was evaluated at baseline and at each treatment cycle, using the EORTC QLQ-C30 and EORTC QLQ-STO22 questionnaires; results were considered valid for analysis only if ≥ 10% of patients completed the questionnaires. Key QoL outcomes were mean changes from baseline and time to deterioration in QoL. A post hoc analysis assessed the association between QoL and time to deterioration of Eastern Cooperative Oncology Group performance score (ECOG PS) to ≥ 2. Results Of 507 randomized patients, 496 had baseline QoL data available. The analysis cut-off was 6 cycles for trifluridine/tipiracil and 3 cycles for placebo. In both treatment groups, there were no clinically significant deteriorations in the mean QLQ-C30 Global Health Status (GHS) score, or in most subscale scores. In a sensitivity analysis including death and disease progression as events, there was a trend towards trifluridine/tipiracil reducing the risk of deterioration of QoL scores compared with placebo. Deterioration in the GHS score was associated with deterioration in ECOG PS. Conclusion QoL was maintained in TAGS, and there was a trend towards trifluridine/tipiracil reducing the risk of QoL deterioration compared with placebo

A retrospective analysis of the outcome of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck refractory to a platinum-based chemotherapy.

AIMS: Recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) develops in around 72,000 people in Europe every year. Treatment options are limited, mainly consisting of platinum-based palliative chemotherapy, with median overall survival times of only 6-8 months. No standard second-line treatment after progression on platinum-based chemotherapy is available. Few data have reported the efficacy of these treatments and the outcome of the patients. In an effort to generate such data, this retrospective study analysed clinical records from 151 patients with SCCHN refractory to platinum-based chemotherapy treated between 1990 and 2000 at seven different centres around Europe. MATERIALS AND METHODS: Most patients (45%) received only best supportive care (BSC), and had a median survival of 56 days. A total of 28.5% of the patients received second-line chemotherapies: 16.6% radiotherapy and 9.9% chemoradiotherapy. RESULTS: No objective response was observed with the various second-line chemotherapies. The overall median survival was 103 days (95% confidence interval [CI]: 77-126 days) for the whole cohort. The overall objective response rate (ORR) to second-line treatment in this population was calculated to be 2.6%. CONCLUSION: These results highlight the need for additional treatment options for this disease. Similar, if not superior, response rates have already been observed in initial clinical studies of novel, targeted anti-cancer agents