cetuximab in combination with platinum based chemotherapy or radiotherapy in patients with recurrent and or metastatic sschn in clinical routine updated interim results of the prospective soccer study

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Unveiling Soft Gamma-Ray Repeaters with INTEGRAL

Thanks to INTEGRAL's long exposures of the Galactic Plane, the two brightest Soft Gamma-Ray Repeaters, SGR 1806-20 and SGR 1900+14, have been monitored and studied in detail for the first time at hard-X/soft gamma rays. This has produced a wealth of new scientific results, which we will review here. Since SGR 1806-20 was particularly active during the last two years, more than 300 short bursts have been observed with INTEGRAL. and their characteristics have been studied with unprecedented sensitivity in the 15-200 keV range. A hardness-intensity anticorrelation within the bursts has been discovered and the overall Number-Intensity distribution of the bursts has been determined. In addition, a particularly active state, during which ~100 bursts were emitted in ~10 minutes, has been observed on October 5 2004, indicating that the source activity was rapidly increasing. This eventually led to the Giant Flare of December 27th 2004, for which a possible soft gamma-ray (>80 keV) early afterglow has been detected. The deep observations allowed us to discover the persistent emission in hard X-rays (20-150 keV) from 1806-20 and 1900+14, the latter being in a quiescent state, and to directly compare the spectral characteristics of all Magnetars (two SGRs and three Anomalous X-ray Pulsars) detected with INTEGRAL.Comment: 8 pages, 7 figures, Presented at the conference "Isolated Neutron Stars: from the Surface to the Interior", London, UK, 24-28 April 200

Preventive Antibacterial Therapy in Acute Ischemic Stroke: A Randomized Controlled Trial

BACKGROUND: Pneumonia is a major risk factor of death after acute stroke. In a mouse model, preventive antibacterial therapy with moxifloxacin not only prevents the development of post-stroke infections, it also reduces mortality, and improves neurological outcome significantly. In this study we investigate whether this approach is effective in stroke patients. METHODS: Preventive ANtibacterial THERapy in acute Ischemic Stroke (PANTHERIS) is a randomized, double-blind, placebo-controlled trial in 80 patients with severe, non-lacunar, ischemic stroke (NIHSS>11) in the middle cerebral artery (MCA) territory. Patients received either intravenous moxifloxacin (400 mg daily) or placebo for 5 days starting within 36 hours after stroke onset. Primary endpoint was infection within 11 days. Secondary endpoints included neurological outcome, survival, development of stroke-induced immunodepression, and induction of bacterial resistance. FINDINGS: On intention-to treat analysis (79 patients), the infection rate at day 11 in the moxifloxacin treated group was 15.4% compared to 32.5% in the placebo treated group (p = 0.114). On per protocol analysis (n = 66), moxifloxacin significantly reduced infection rate from 41.9% to 17.1% (p = 0.032). Stroke associated infections were associated with a lower survival rate. In this study, neurological outcome and survival were not significantly influenced by treatment with moxifloxacin. Frequency of fluoroquinolone resistance in both treatment groups did not differ. On logistic regression analysis, treatment arm as well as the interaction between treatment arm and monocytic HLA-DR expression (a marker for immunodepression) at day 1 after stroke onset was independently and highly predictive for post-stroke infections. INTERPRETATION: PANTHERIS suggests that preventive administration of moxifloxacin is superior in reducing infections after severe non-lacunar ischemic stroke compared to placebo. In addition, the results emphasize the pivotal role of immunodepression in developing post-stroke infections. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN74386719