25 research outputs found
Leiomyoma of the tunica albuginea, a case report of a rare tumour of the testis and review of the literature
Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000â14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries
Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed
data for children (aged 0â14 years) and adults (aged 15â99 years) diagnosed with a haematological malignancy
during 2000â14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and
morphology, in young patients (aged 0â24 years).
Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3
that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0â14 years),
adolescents (15â19 years), and young adults (20â24 years). We categorised leukaemia subtypes according to the
International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases
for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs,
using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by
country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age
survival estimates were standardised to the marginal distribution of young people with leukaemia included in the
analysis.
Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and
20272 (12·3%) young adults. In 2010â14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients)
and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and
young adults for all leukaemias combined during 2010â14 varied widely, ranging from 46% in Mexico to more than
85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better
age-standardised survival (from 43% in Ecuador to â„80% in parts of Europe, North America, Oceania, and Asia) than
those with acute myeloid leukaemia (from 32% in Peru to â„70% in most high-income countries in Europe,
North America, and Oceania). Throughout 2000â14, survival from all leukaemias combined remained consistently
higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young
adults in most countries.
Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children,
adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower
survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators
of the quality of cancer management in this age group.peer-reviewe
Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000â2014 (CONCORD-3)
Background:
Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.
Methods:
We analyzed individual data for adults (15â99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000â2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.
Results:
The study included 556,237 adults. In 2010â2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%â38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000â2004 and 2005â2009. These improvements were more noticeable among adults diagnosed aged 40â70 years than among younger adults.
Conclusions:
To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines
Population pharmacodynamic analysis of effect of three increasing doses of fludrocortisone on phenylephrine-mean arterial pressure dose-response relationship in healthy volunteers
International audienceSpecial Issue: SI Meeting Abstract: CO - 01
Case Report - PrĂ©sentation clinique atypique dâun kyste hydatique thymique primitif: Ă propos dâune observation Marocaine
Le kyste hydatique est une affection encore endémique au Maroc. Il peut toucher tous les organes notamment le foie et le poumon. La localisation médiastinale est rare et souvent primitive. Elle représente moins de 1% des localisations intrathoraciques et l’atteinte thymique est exceptionnelle. Nous rapportons un cas de kyste hydatique thymique primitif chez une fille de 9 ans hospitalisée pour une masse cervicale médiane antérieure. Nous étudierons les aspects épidémiologiques, cliniques et les démarches diagnostiques pour cette localisation exceptionnelle du kyste hydatique. Les aspects cliniques, radiologiques et épidémiologiques de l’hydatidose restent des éléments de présomption. L’examen histologique a toute sa valeur devant les localisations inhabituelles
Population pharmacokinetics and dosing simulations of amoxicillin in obese adults receiving co-amoxiclav
International audienceBackground Pneumonia, skin and soft tissue infections are more frequent in obese patients and are most often treated by co-amoxiclav, using similar dosing regimens to those used for non-obese subjects. No data are available on amoxicillin pharmacokinetics among obese subjects receiving co-amoxiclav. Materials and methods Prospective, single-centre, open-label, non-randomized, crossover pharmacokinetic trial having enrolled obese otherwise healthy adult subjects. A first dose of co-amoxiclav (amoxicillin/clavulanate 1000/200âmg) was infused IV over 30âmin, followed by a second dose (1000/125âmg) administered orally, separated by a washout period of â„24âh. We assayed concentrations of amoxicillin by a validated ultra HPLCâtandem MS technique. We estimated population pharmacokinetic parameters of amoxicillin by non-linear mixed-effect modelling using the SAEM algorithm developed by Monolix. Results Twenty-seven subjects were included in the IV study, with 24 included in the oral part of the study. Median body weight and BMI were 109.3âkg and 40.6âkg/m2, respectively. Amoxicillin pharmacokinetics were best described by a two-compartment model with first-order elimination. Mean values for clearance, central volume, intercompartmental clearance and peripheral volume were, respectively, 14.6âL/h, 9.0âL, 4.2âL/h and 6.4âL for amoxicillin. Oral bioavailability of amoxicillin was 79.7%. Amoxicillin Cmax after oral administration significantly reduced with weight (Pâ=â0.013). Dosing simulations for amoxicillin predicted that most of the population will achieve the pharmacodynamic target of fT>MIC â„40% with the regimen of co-amoxiclav 1000/200âmg (IV) or 1000/125âmg (oral) q8h for MICs titrated up to 0.5âmg/L (IV) and 1âmg/L (oral). Conclusions Pharmacokinetic/pharmacodynamic goals for amoxicillin can be obtained in obese subjects