704 research outputs found
Adjuvant radiotherapy after salvage surgery for melanoma recurrence in a node field following a previous lymph node dissection
Background and Objectives: Adjuvant radiotherapy (RT) can be given to melanoma patients following salvage surgery for node field recurrence after a previous regional node dissection, but the value of this treatment strategy is poorly documented. This study evaluated long-term node field control and survival of patients treated in this way in an era before effective adjuvant systemic therapy became available. Methods: Data for 76 patients treated between 1990 and 2011 were extracted from an institutional database. Baseline patient characteristics, treatment details and oncological outcomes were analysed. Results: Adjuvant RT with conventional fractionation (median dose 48 Gy in 20 fractions) was given to 43 patients (57%) and hypofractionated RT (median dose 33 Gy in 6 fractions) to 33 patients (43%). The 5-year node field control rate was 70%, 5-year recurrence-free survival 17%, 5-year melanoma-specific survival 26% and 5-year overall survival 25%. Conclusions: Salvage surgery with adjuvant RT achieved node field control in 70% of melanoma patients with node field recurrence following a prior node dissection. However, disease progression at distant sites was common and survival outcomes were poor. Prospective data will be required to assess outcomes for contemporary combinations of surgery, adjuvant RT and systemic therapy.</p
Subprime Mortgage Pricing: The Impact of Race, Ethnicity, and Gender on the Cost of Borrowing
Serotonergic Polymorphisms and Psychotic Disorders in Populations From North Spain
There is strong biological evidence relating alterations in the serotonergic
system with mental disorders. These alterations may be originated at the DNA
level by sequence mutations that alter the functioning of serotonin receptors and
transporter. To test this hypothesis we investigated three genetic variants of
the 5-HT2A receptor (-1438G/A, 102T/C and His452Tyr) and two variants of the
serotonin transporter (a VNTR in the second intron and a 44 bp insertion/delition
in the promoter region of the gene) in a clinical sample recruited in a human
isolate and in surrounding areas in Northern Spain (N = 257) and in ethnically
matched controls (N = 334). No clear association was found between 5-HT2A
variants and psychosis. However, marginal associations were observed between the
5-HTT LPR and VNTR variants and psychosis (P < or = 0.05) indicating a minor
contribution to psychosis of genetic alterations in this gene
A randomized, seven-day study to assess the efficacy and safety of a glycopyrrolate/formoterol fumarate fixed-dose combination metered dose inhaler using novel Co-Suspension⢠Delivery Technology in patients with moderate-to-very severe chronic obstructive pulmonary disease
Abstract Background Long-acting muscarinic antagonist/long-acting β 2 -agonist combinations are recommended for patients whose chronic obstructive pulmonary disease (COPD) is not managed with monotherapy. We assessed the efficacy and safety of glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination delivered via a Co-Suspension⢠Delivery Technology-based metered dose inhaler (MDI) (GFF MDI). Methods This was a Phase IIb randomized, multicenter, placebo-controlled, double-blind, chronic-dosing (7 days), crossover study in patients with moderate-to-very severe COPD (NCT01085045). Treatments included GFF MDI twice daily (BID) (GP/FF 72/9.6 Îźg or 36/9.6 Îźg), GP MDI 36 Îźg BID, FF MDI 7.2 and 9.6 Îźg BID, placebo MDI, and open-label formoterol dry powder inhaler (FF DPI) 12 Îźg BID or tiotropium DPI 18 Îźg once daily. The primary endpoint was forced expiratory volume in 1 s area under the curve from 0 to 12 h (FEV 1 AUC 0â12 ) on Day 7 relative to baseline FEV 1 . Secondary endpoints included pharmacokinetics and safety. Results GFF MDI 72/9.6 Îźg or 36/9.6 Îźg led to statistically significant improvements in FEV 1 AUC 0â12 after 7 daysâ treatment versus monocomponent MDIs, placebo MDI, tiotropium, or FF DPI (p ⤠0.0002). GFF MDI 36/9.6 Îźg was non-inferior to GFF MDI 72/9.6 Îźg and monocomponent MDIs were non-inferior to open-label comparators. Pharmacokinetic results showed glycopyrrolate and formoterol exposure were decreased following administration via fixed-dose combination versus monocomponent MDIs; however, this was not clinically meaningful. GFF MDI was well tolerated. Conclusions GFF MDI 72/9.6 Îźg and 36/9.6 Îźg BID improve lung function and are well tolerated in patients with moderate-to-very severe COPD. Trial registration ClinicalTrials.gov NCT01085045. Registered 9 March 2010
Relationships between cerebrospinal fluid characteristics, injury severity, and functional outcome in dogs with and without intervertebral disk herniation
BACKGROUND : Cerebrospinal fluid (CSF) is commonly acquired in dogs with intervertebral disk
herniation (IVDH) and is a common method to assess inflammatory responses following spinal
cord injury (SCI).
OBJECTIVES : The purpose of the study was to describe relationships between cisternal CSF
characteristics, behavioral measures of SCI, T2 weighted (T2W) hyperintensity on magnetic resonance imaging (MRI), and long-term outcome in dogs with IVDH. Diagnostic accuracy of
CSF for differentiating IVDH from other myelopathies was also assessed.
METHODS : The retrospective case series included 727 dogs, 443 with thoracolumbar IVDH, 103
with cervical IVDH, and 181 with other spinal cord diseases. Signalment, initial neurologic
function, ambulatory function at long-term follow-up, T2W MRI, and CSF variables were
recorded for dogs with IVDH. Signalment, etiology, and CSF data were retrieved for dogs with
other myelopathies. Associations between CSF predictors, diagnosis, and outcomes were
assessed.
RESULTS : CSF total nucleated cell count (TNCC) increased with SCI severity (rho -0.256,
P<.001) in dogs with IVDH, TNCC was significantly higher in the presence of T2W
hyperintensity (P = .001) in dogs with thoracolumbar IVDH, but TNCC, RBC count,
microprotein, and percent neutrophils decreased with increasing injury duration (rho -0.253,
P<.001; rho -0.269, P<.001; rho -0.141, P=.004, and rho -0.356, P <.001, respectively). CSF
characteristics were not accurate for differentiating IVDH from other spinal cord diseases.CONCLUSIONS : In dogs with IVDH, CSF TNCC, RBC count, microprotein, and percent
neutrophils are correlated to clinical aspects of SCI such as injury severity and duration, but
cannot differentiate IVDH from other etiologies.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1939-165X2015-09-30hb201
CMR Assessment of endothelial damage and angiogenesis in porcine coronary arteries using gadofosveset
<p>Abstract</p> <p>Background</p> <p>Endothelial damage and angiogenesis are essential for atherosclerotic plaque development and destabilization. We sought to examine whether contrast enhanced cardiovascular magnetic resonance (CMR) using gadofosveset could show endothelial damage and neovessel formation in balloon injured porcine coronary arteries.</p> <p>Methods and Results</p> <p>Data were obtained from seven pigs that all underwent balloon injury of the left anterior descending coronary artery (LAD) to induce endothelial damage and angiogenesis. Between one - 12 days (average four) after balloon injury, in vivo and ex vivo T1-weighted coronary CMR was performed after intravenous injection of gadofosveset. Post contrast, CMR showed contrast enhancement of the coronary arteries with a selective and time-dependent average expansion of the injured LAD segment area of 45% (p = 0.04; CI<sub>95 </sub>= [15%-75%]), indicating local extravasation of gadofosveset. Vascular and perivascular extravasation of albumin (marker of endothelial leakiness) and gadofosveset was demonstrated with agreement between Evans blue staining and ex vivo CMR contrast enhancement (p = 0.026). Coronary MRI contrast enhancement and local microvessel density determined by microscopic examination correlated (Ď = 0.82, p < 0.001).</p> <p>Conclusion</p> <p>Contrast enhanced coronary CMR with gadofosveset can detect experimentally induced endothelial damage and angiogenesis in the porcine coronary artery wall.</p
Quantitative 3-Dimensional Imaging of Murine Neointimal and Atherosclerotic Lesions by Optical Projection Tomography
Traditional methods for the analysis of vascular lesion formation are labour intensive to perform - restricting study to âsnapshotsâ within each vessel. This study was undertaken to determine the suitability of optical projection tomographic (OPT) imaging for the 3-dimensional representation and quantification of intimal lesions in mouse arteries.â=â0.85), confirming both the accuracy of this methodology and its non-destructive nature. It was also possible to record volumetric measurements of lesion and lumen and these were highly reproducible between scans (coefficient of variationâ=â5.36%, 11.39% and 4.79% for wire- and ligation-injury and atherosclerosis, respectively).These data demonstrate the eminent suitability of OPT for imaging of atherosclerotic and neointimal lesion formation, providing a much needed means for the routine 3-dimensional analysis of vascular morphology in studies of this type
Desorption electrospray ionization (DESI) mass spectrometry and tandem mass spectrometry (MS/MS) of phospholipids and sphingolipids: Ionization, adduct formation, and fragmentation
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