47 research outputs found

    Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial

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    Background Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS. Methods In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358. Results Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6–8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64–1·23]). The non-inferiority of anastrozole was established (upper 95% CI <1·25), but its superiority to tamoxifen was not (p=0·49). A total of 69 deaths were recorded (33 for anastrozole vs 36 for tamoxifen; HR 0·93 [95% CI 0·58–1·50], p=0·78), and no specific cause was more common in one group than the other. The number of women reporting any adverse event was similar between anastrozole (1323 women, 91%) and tamoxifen (1379 women, 93%); the side-effect profiles of the two drugs differed, with more fractures, musculoskeletal events, hypercholesterolaemia, and strokes with anastrozole and more muscle spasm, gynaecological cancers and symptoms, vasomotor symptoms, and deep vein thromboses with tamoxifen. Conclusions No clear efficacy differences were seen between the two treatments. Anastrozole offers another treatment option for postmenopausal women with hormone-receptor-positive DCIS, which may be be more appropriate for some women with contraindications for tamoxifen. Longer follow-up will be necessary to fully evaluate treatment differences

    Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): A double-blind, randomised controlled trial

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    Makrohämaturie-Abklärung in Salami-Taktik

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    Plasmonic focusing on metal and semiconductor disks under radially polarized terahertz illumination

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    Optimal focusing of surface plasmon polaritons in the center of a metal disc illuminated by radially polarized terahertz pulses is demonstrated. Due to the cylinder symmetrical structure surface plasmons can be excited along the entire circumference, which interfere constructively in the center of the disk forming a sharp frequency-depended focal spot. We map the field distribution on the disk by THz near-field microscopy and compare our result to numerical simulations. For comparison, behavior under linearly polarized THz illumination is characterized. Furthermore, first results of semiconducting plasmonic lenses are presented.http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=666539

    Northern Goshawk (Accipiter gentilis) Genetic Diversity and Connectivity among the Naturally Fragmented Forests of the Northern Great Basin, USA.

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    Forest fragmentation limits movement of individuals, and even highly mobile species, like birds, can fail to disperse across such landscapes. The naturally fragmented forests of the northern Great Basin are thought to have led to the evolution of unique species. Other species in these forests may also exhibit unique genetic diversity. The Northern Goshawk, a species occupying these forests, has shown low integration between geographically dispersed populations elsewhere in its range. We evaluated genetic diversity and connectivity of the goshawks in the northern Great Basin by extracting mitochondrial DNA and placing the birds in biogeographical context of other populations in the West. We utilized blood and feather samples from nestling and adult birds from five forest islands in south-central Idaho, as well as, the Owyhee Mountains in South West Idaho and Malheur National Forest in Eastern Oregon to compare mitochondrial DNA sequences among individuals. Our work provides a continuation of understanding the genetic ecology of Goshawks in the northern Great Basin, and the genetic health and integration of these birds compared with other populations

    Wavelength scaling of THz emissions by two-color filaments in air

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    Producing terahertz (THz) radiation by ultrashort laser pulses has become an active field of research because of its promising applications in, e.g., spectroscopy and medical imaging [1]. Efficient THz emitters can be obtained by focusing into air a two-color femtosecond light pulse, composed of fundamental (FH) and second (SH) harmonics, in order to create a plasma channel that acts as a frequency converter [2]. Recent studies [3,4] showed that increasing the pump wavelength enhances the THz energy. However, there is no consensus on the gain factors expected when pushing the FH wavelength, λ 0 , from the near-IR to the mid-IR range. Clerici et al. [3] reported THz energy yields scaling like λ 2 0 in the range 0.8–1.8 μm. By contrast, according to the local-current model [2,4], the largest THz energy attained by two colors with π/2 relative phase should follow a scaling in λ 2 0 only

    Terahertz emission from laser-driven gas-plasmas: a plasmonic point of view

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    We investigate terahertz generation in two-color laser-induced gas plasmas. Resonances attributed to plasmonic effects are shown to broaden the emission spectra significantly, when electrons are excited along a direction where the plasma size is smaller than the plasma wavelength. We demonstrate that such resonances can be turned on and off by changing the polarization properties of elliptically-shaped driving laser-pulses. Both 3D Maxwell consistent simulations and experimental results confirm that a significant THz pulse shortening and spectral broadening can be achieved by exploiting the transverse driving laser-beam shape as an additional degree of freedom
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