1,275 research outputs found

    Topotecan-vincristine-doxorubicin in stage 4 high risk neuroblastoma patients failing to achieve a complete metastatic response to rapid COJEC : a SIOPEN study

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    Purpose : Metastatic response to induction therapy for high-risk neuroblastoma is a prognostic factor. In the International Society of Paediatric Oncology Europe Neuroblastoma (SIOPEN) HR-NBL-1 protocol, only patients with metastatic complete response (CR) or partial response (PR) with <= three abnormal skeletal areas on iodine 123-metaiodobenzylguanidine ([I-123] mIBG) scintigraphy and no bone marrow disease proceed to high dose therapy (HDT). In this study, topotecan-vincristine-doxorubicin (TVD) was evaluated in patients failing to achieve these criteria, with the aim of improving the metastatic response rate. Materials and Methods : Patients with metastatic high-risk neuroblastoma who had not achieved the SIOPEN criteria for HDT after induction received two courses of topotecan 1.5 mg/m(2)/day for 5 days, followed by a 48-hour infusion of vincristine, 2 mg/m(2), and doxorubicin, 45 mg/m(2). Results : Sixty-three patients were eligible and evaluable. Following two courses of TVD, four (6.4%) patients had an overall CR, while 28 (44.4%) had a PR with a combined response rate of 50.8% (95% confidence interval [CI], 37.9 to 63.6). Of these, 23 patients achieved a metastatic CR or a PR with <= 3 mIBG skeletal areas and no bone marrow disease (36.5%; 95% CI, 24.7 to 49.6) and were eligible to receive HDT. Toxicity was mostly haematological, affecting 106 of the 126 courses (84.1%; 95% CI, 76.5 to 90.0), and dose reduction was necessary in six patients. Stomatitis was the second most common nonhematological toxicity, occurring in 20 patients (31.7%). Conclusion : TVD was effective in improving the response rate of high-risk neuroblastoma patients after induction with COJEC enabling them to proceed to HDT. However, the long-term benefits of TVD needs to be determined in randomized clinical trials

    Validity and reliability of the Patient-Reported Arthralgia Inventory; validation of a newly-developed survey instrument to measure arthralgia

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    BACKGROUND: There is a need for a survey instrument to measure arthralgia (joint pain) that has been psychometrically validated in the context of existing reference instruments. We developed the 16-item Patient-Reported Arthralgia Inventory (PRAI) to measure arthralgia severity in 16 joints, in the context of a longitudinal cohort study to assess aromatase inhibitor-associated arthralgia in breast cancer survivors and arthralgia in postmenopausal women without breast cancer. We sought to evaluate the reliability and validity of the PRAI instrument in these populations, as well as to examine the relationship of patient-reported morning stiffness and arthralgia. METHODS: We administered the PRAI on paper in 294 women (94 initiating aromatase inhibitor therapy and 200 postmenopausal women without breast cancer) at weeks 0, 2, 4, 6, 8, 12, 16, and 52, as well as once in 36 women who had taken but were no longer taking aromatase inhibitor therapy. RESULTS: Cronbach’s alpha was 0.9 for internal consistency of the PRAI. Intraclass correlation coefficients of test-retest reliability were in the range of 0.87–0.96 over repeated PRAI administrations; arthralgia severity was higher in the non-cancer group at baseline than at subsequent assessments. Women with joint comorbidities tended to have higher PRAI scores than those without (estimated difference in mean scores: −0.3, 95% confidence interval [CI] −0.5, −0.2; P<0.001). The PRAI was highly correlated with the Functional Assessment of Cancer Therapy-Endocrine Subscale item “I have pain in my joints” (reference instrument; Spearman r range: 0.76–0.82). Greater arthralgia severity on the PRAI was also related to decreased physical function (r=−0.47, 95% CI −0.55, −0.37; P<0.001), higher pain interference (r=0.65, 95% CI 0.57–0.72; P<0.001), less active performance status (estimated difference in location (−0.6, 95% CI −0.9, −0.4; P<0.001), and increased morning stiffness duration (r=0.62, 95% CI 0.54–0.69; P<0.0001). CONCLUSION: We conclude that the psychometric properties of the PRAI are satisfactory for measuring arthralgia severity

    Gaseous time projection chambers for rare event detection: Results from the T-REX project. II. Dark matter

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    As part of the T-REX project, a number of R&D and prototyping activities have been carried out during the last years to explore the applicability of Micromegas-read gaseous TPCs in rare event searches like double beta decay (DBD), axion research and low-mass WIMP searches. While in the companion paper we focus on DBD, in this paper we focus on the results regarding the search for dark matter candidates, both axions and WIMPs. Small ultra-low background Micromegas detectors are used to image the x-ray signal expected in axion helioscopes like CAST at CERN. Background levels as low as 0.8×10−60.8\times 10^{-6} c keV−1^{-1}cm−2^{-2}s−1^{-1} have already been achieved in CAST while values down to ∌10−7\sim10^{-7} c keV−1^{-1}cm−2^{-2}s−1^{-1} have been obtained in a test bench placed underground in the Laboratorio Subterr\'aneo de Canfranc. Prospects to consolidate and further reduce these values down to ∌10−8\sim10^{-8} c keV−1^{-1}cm−2^{-2}s−1^{-1}will be described. Such detectors, placed at the focal point of x-ray telescopes in the future IAXO experiment, would allow for 105^5 better signal-to-noise ratio than CAST, and search for solar axions with gaÎłg_{a\gamma} down to few 1012^{12} GeV−1^{-1}, well into unexplored axion parameter space. In addition, a scaled-up version of these TPCs, properly shielded and placed underground, can be competitive in the search for low-mass WIMPs. The TREX-DM prototype, with ∌\sim0.300 kg of Ar at 10 bar, or alternatively ∌\sim0.160 kg of Ne at 10 bar, and energy threshold well below 1 keV, has been built to test this concept. We will describe the main technical solutions developed, as well as the results from the commissioning phase on surface. The anticipated sensitivity of this technique might reach ∌10−44\sim10^{-44} cm2^2 for low mass (<10<10 GeV) WIMPs, well beyond current experimental limits in this mass range.Comment: Published in JCAP. New version with erratum incorporated (new figure 14

    49Cr: Towards full spectroscopy up to 4 MeV

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    The nucleus 49Cr has been studied analysing gamma-gamma coincidences in the reaction 46Ti(alpha,n)49Cr at the bombarding energy of 12 MeV. The level scheme has been greatly extended at low excitation energy and several new lifetimes have been determined by means of the Doppler Shift Attenuation Method. Shell model calculations in the full pf configuration space reproduce well negative-parity levels. Satisfactory agreement is obtained for positive parity levels by extending the configuration space to include a nucleon-hole either in the 1d3/2 or in the 2s1/2 orbitals. A nearly one-to-one correspondence is found between experimental and theoretical levels up to an excitation energy of 4 MeV. Experimental data and shell model calculations are interpreted in terms of the Nilsson diagram and the particle-rotor model, showing the strongly coupled nature of the bands in this prolate nucleus. Nine values of K(pi) are proposed for the levels observed in this experiment. As a by-result it is shown that the values of the experimental magnetic moments in 1f7/2 nuclei are well reproduced without quenching the nucleon g-factors.Comment: 13 pages, 8 figure
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