Efficacy of Adjuvant Fluorouracil and Folinic Acid in B2 Colon Cancer

Purpose: The goal of this analysis was to determine whether fluorouracil (FU) and folinic acid (leucovorin, LV) is an effective adjuvant therapy for patients after potentially curative resection of colon cancer in patients with B2 tumors.Patients and Methods: One thousand sixteen patients with B2 colon cancer entered onto five separate trials were randomized to FU + LV or observation, A pooled analysis for event-free (EFS) and overall survival (OS) using a stratified lag-rank and Cox model was performed.Results: The median follow-vp duration was 5.75 years. Patients receiving FU + LV did not experience a significant increase in EFS or OS. The hazards ratio at 5 years was 0.83 (90% confidence interval, 0.72 to 1.07) for EFS and 0.86 (90% confidence interval, 0.68 to 1.07) for OS. The 5-year EFS was 73% for controls and 76% for FU + LV.The 5-year OS war 80% for controls and 82% for FU + LV. Increasing age and pearly differentiated tumors were significant indicators of poor prognosis (P <.02).Conclusion: This data set does not support the routine use of + LV in all patients with B2 colon cancer. ranger follow-up may identify a small benefit. At present, studies in B2 colon cancer designed with a no-treatment control arm should be considered appropriate. J Clin Oncol 17:1356-1363. (C) 1999 by American Society of Clinical Oncology

An assessment of three automatic depression tracking schemes

The performance of three automatic depression tracking schemes developed by Terry & Atlas (1996), Murray & Simmonds (1991a) and Konig et al. (1993) when applied over one month are assessed. The schemes respectively identify depressions by (a) locating the innermost closed contour in a PMSL field, (b) finding maxima in the curvature in a bi-cubic spline fitted to the PMSL data and (c) performing a grid point search to identify a minimum in a PMSL field. The largest number of depressions was found by the Murray and Simmonds scheme, with the Atlas and Terry scheme finding the least. The Murray and Simmonds scheme also found the largest number of tracks, with the other two having comparable numbers of tracks. Two possible explanations for the differences in the number of tracks are considered. Firstly, the case where one or more centres identified by one scheme as corresponding to a single track are not found by the other schemes. Secondly, the case where a single track found by one scheme is split into two or more tracks by the other schemes. All three techniques had a similar latitude of cyclogenesis, although the Atlas and Terry and Konig et al. schemes found more lows at high latitudes as a result of using data on a latitude/longitude grid. The longest mean track length was found with the Konig et al. scheme. A comparison of the PMSL fields with satellite imagery shows that the major NWP centres have trouble producing reliable analyses around the Antarctic because of the lack of data

Évaluation multicentrique et randomisée de l’impact des conseillers en environnement intérieur sur le contrôle de l’asthme : l’étude ECENVIR

International audienceIntroduction (contexte de la recherche)L’exposition répétée des patients asthmatiques aux allergènes intradomiciliaires contribue aux exacerbations de l’asthme. Plusieurs stratégies d’intervention sont proposées, parmi lesquelles, la visite domiciliaire de conseillers en environnement intérieur (CEI). Les CEI établissent un état des lieu au domicile du patient et proposent des mesures de remédiation afin d’améliorer les fonctions respiratoires. Plusieurs études monocentriques ont montré l’intérêt d’une telle démarche.ObjectifL’étude ECENVIR est un essai clinique, multicentrique, prospectif et randomisé qui vise à évaluer l’impact des CEI sur le niveau de contrôle de l’asthme.MéthodesAu total, 104 patients ont été inclus dont 85 patients ont été suivis médicalement et randomisés dans 2 groupes : le Groupe Intervention (GI) a bénéficié d’une visite de CEI avec prélèvements pour mesures d’allergènes et conseils à l’inclusion et après 12 mois de suivi ; et le groupe témoin (GT) a bénéficié d’une même visite de contrôle uniquement à M12.RésultatsLe critère de jugement principal a été analysé chez 71/85 patients : 34 dans le GI et 37 dans le GT. A M12, une amélioration du contrôle de l’asthme était notée dans le GI avec une diminution du nombre d’asthme sévère et une augmentation d’asthme intermittent (p = 0,05) comparativement au GT (p = 0,24). En comparaison intergroupe, 50 % (17/34) des patients du GI ont montré une amélioration clinique comparativement au GT (p = 0,43). Bien que non statistiquement significative probablement dû à un manque de puissance, les patients du GI avaient 1,5 fois plus de chance de s’améliorer cliniquement en analyse multivariée (OR 1,47 CI95 % [0,57–3,75]. Les analyses secondaires montrent que : (i) dans la population des asthmes sévères, 12/16 patients (75 %) du GI se sont améliorés contre 7/16 du GT(44 %)(p = 0,06) ; (ii) la consommation des corticoïdes oraux et le taux d’hospitalisation sont significativement diminués dans le groupe ayant bénéficié de conseils (p = 0,029 et p = 0,042, respectivement).ConclusionsL’intervention des CEI est bénéfique cliniquement sur le niveau du contrôle de l’asthme et permet sur le plan économique une diminution de la consommation de soins, en cours d’investigation via les données d’Assurance maladie

STOIC: a study of coupled model climatology and variability in tropical ocean regions

We describe the behaviour of 23 dynamical ocean-atmosphere models, in the context of comparison with observations in a common framework. Fields of tropical sea surface temperature (SST), surface wind stress and upper ocean vertically averaged temperature (VAT) are assessed with regard to annual mean, seasonal cycle, and interannual variability characteristics. Of the participating models, 21 are coupled GCMs, of which 13 use no form of flux adjustment in the tropics. The models vary widely in design, components and purpose: nevertheless several common features are apparent. In most models without flux adjustment, the annual mean equatorial SST in the central Pacific is too cool and the Atlantic zonal SST gradient has the wrong sign. Annual mean wind stress is often too weak in the central Pacific and in the Atlantic, but too strong in the west Pacific. Few models have an upper ocean VAT seasonal cycle like that observed in the equatorial Pacific. Interannual variability is commonly too weak in the models: in particular, wind stress variability is low in the equatorial Pacific. Most models have difficulty in reproducing the observed Pacific 'horseshoe' pattern of negative SST correlations with interannual Niño3 SST anomalies, or the observed Indian-Pacific lag correlations. The results for the fields examined indicate that several substantial model improvements are needed, particularly with regard to surface wind stress