Predictors of treatment outcome in patients treated with radical chemoradiotherapy for stage III Non-small Cell Lung Cancer

Proffered SessionBACKGROUND: Chemoradiation has been well established as standard treatment for stage III non-small cell lung cancer (NSCLC). Previous studies have shown that the tumour size as well as its metabolic activity predict treatment outcome after definitive treatment for early-stage disease. We would like to investigate if there are any clinical and metabolic predictors of treatment outcome for stage III NSCLC after chemoradiation. PATIENTS AND METHODS: 56 consecutive patients (46 males and 10 females) treated with radical concurrent chemoradiation for their stage IIIA (n=21) and IIIB (n=35) (AJCC 7th edition) unresectable non-small cell lung cancer between July 2006 to February 2012 were retrospectively reviewed. 42 patients had positron emission tomography with integrated computed tomography (PET-CT) scan performed at diagnosis. Of which 14 patients also had PET-CT scan after induction chemotherapy and before concurrent chemoradiation. All received concurrent chemoradiation +/- induction ...postprin

Comparison of post-treatment plasma EBV DNA with nasopharyngeal biopsy in patients after radical (chemo) radiotherapy for non-metatatic nasopharyngeal cancer

This journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 56th Annual Meeting, ASTRO's 56th Annual Meeting ... 2014Oral Scientific SessionPURPOSE/OBJECTIVE(S): Random nasopharyngeal biopsy after completion of intensity-modulated radiation therapy (IMRT) for non-metastatic nasopharyngeal cancer (NPC) is routinely practiced in Hong Kong to confirm local remission. Plasma EBV DNA is proven an accurate marker for NPC. We carried out a prospective study comparing the correlation between post-IMRT nasopharyngeal biopsy and EBV DNA, to investigate if EBV DNA can substitute biopsy to confirm local remission. MATERIALS/METHODS: Patients with non-metastatic NPC treated with definitive (chemo) IMRT diagnosed between January 2011 and March 2013 were recruited. After baseline workup ...postprin

Social psychological aspects of ACL injury prevention and rehabilitation: An integrated model for behavioral adherence

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Yttrium-90 radioembolization for advanced inoperable hepatocellular carcinoma

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Tolerance to bronchodilation during treatment with long-acting beta-agonists, a randomised controlled trial

BACKGROUND: Regular use of beta-agonists leads to tolerance to their bronchodilator effects. This can be demonstrated by measuring the response to beta-agonist following bronchoconstriction using methacholine. However most studies have demonstrated tolerance after a period of beta-agonist withdrawal, which is not typical of their use in clinical practice. This study assessed tolerance to the bronchodilator action of salbutamol during ongoing treatment with long-acting beta-agonist. METHODS: Random-order, double-blind, placebo-controlled, crossover trial. After 1 week without beta-agonists, 13 asthmatic subjects inhaled formoterol 12 μg twice daily or matching placebo for 1 week. Eight hours after the first and last doses subjects inhaled methacholine to produce a 20% fall in FEV(1). Salbutamol 100, 200 and 400 μg (cumulative dose) was then given at 5-minute intervals and FEV(1 )was measured 5 minutes after each dose. After a 1 week washout subjects crossed over to the other treatment. Unscheduled use of beta-agonists was not allowed during the study. The main outcome variable was the area under the salbutamol response curve. RESULTS: The analysis showed a significant time by treatment interaction indicating that the response to salbutamol fell during formoterol therapy compared to placebo. After 1 week of formoterol the area under the salbutamol response curve was 48% (95% confidence interval 28 to 68%) lower than placebo. This reduction in response remained significant when the analyses were adjusted for changes in the pre-challenge FEV(1 )and dose of methacholine given (p = 0.001). CONCLUSION: The bronchodilator response to salbutamol is significantly reduced in patients taking formoterol. Clinically relevant tolerance to rescue beta-agonist treatment is likely to occur in patients treated with long-acting beta-agonists

ExploRing Persistence in Financial Time Series

Edited by W. Härdle, Z. Hlávka, and S. Klinke</p

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Light delays synaptic deafferentation and potentiates the survival of axotomized retinal ganglion cells

Knowledge of the cellular mechanism underlying the therapeutic effect of stimulation and the optimal doses of such stimulation to maximize neuronal recovery is essential to guide clinical practice in neural rehabilitation. Using hamsters, we transected the optic nerve to demonstrate how light stimulation affects neuronal recovery. The c-fos protein was used as a neuronal connectivity marker. Here we show that: (a) in addition to cell death, a population of cells undergoes synaptic deafferentation and (b) light stimulation delays cell death and deafferentation. Among the three rearing conditions studied (6:18LD, 12:12LD, and 18:6LD), the 12:12LD condition appears to be the one achieving the optimal therapeutic effect. This study provides a solid base in the understanding of the neuroanatomical changes after traumatic brain injury and the need to establish an optimal level and timing for the environmental stimulation. © 2005 Elsevier Ireland Ltd. All rights reserved.link_to_subscribed_fulltex