Comparison of Vinorelbine-Cisplatin with Gemcitabine-Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer

Purpose The objective of this trial was to compare cisplatin-plus-vinorelbine regimen with cisplatin-plus-gemcitabine regimen in patients with stage IIIB-IV non-small cell lung cancer (NSCLC). Patients and Methods Chemonaive patients with stage IIIB-IV NSCLC received either vinoelbine 30 mg/m 2 (days 1 and 8) plus cisplatin 80 mg/m 2 (day 1) every 21 days (VC arm) or gemcitabine 1250 mg/m 2 (days 1 and 8) plus cisplatin 80 mg/m 2 (day 1) every 21 days (GC arm). Results One hundred thirtyfour patients (67 VC and 67 GC) were included to the study. Overall response rates for the VC arm (31.2%) were not significantly different from that of the GC arm (34.3%). There were no differences in overall survival and one-year survival rates. Median survival and one-year survival rates for the VC and GC groups were 10.6 and 11.5 months, 45% and 46.8%, respectively. Grade 3-4 thrombocytopenia was significantly higher on the GC arm (VC 1.4% v GC 8.9%, p < 0.05), as was febrile neutropenia on the VC arm (VC 8.9% v GC 1.4%, p < 0.05). Conclusion VC and GC demonstrated similar efficacy but there were differences in toxicity profiles

An intracerebral mass: Tuberculosis or sarcoidosis?

PubMed: 23645654Sarcoidosis is an idiopathic, chronic granulomatous disease and it can affect almost any organ. In autopsy series, it has been reported that the central nervous system involvement has occurred in 5-16% of the patients with sarcoidosis, while the neurological symptoms have occurred only in 3-9% of them. A 40-year-old female patient was admitted to the hospital with complaints of aphasia, balance disorder and drowsiness. An intracerebral mass was detected on cranial CT scans and neurosarcoidosis was diagnosed with clinical, radiological and histopathological findings. Copyright 2013 BMJ Publishing Group. All rights reserved

Neural network prediction of thermophilic (65 degrees C) sulfidogenic fluidized-red reactor performance for the treatment of metal-containing wastewater

The performance of a fluidized-bed reactor (FBR) based sulfate reducing bioprocess was predicted using artificial neural network (ANN). The FBR was operated at high (65 degrees C) temperature and it was fed with iron (40-90 mg/ L) and sulfate (1,000-1,500 mg/L) containing acidic (pH = 3.5-6) synthetic wastewater. Ethanol was supplemented as carbon and electron source for sulfate reducing bacteria (SRB). The wastewater pH of 4.3-4.4 was neutralized by the alkalinity produced in acetate oxidation and the average effluent pH was 7.8 +/- 0.8. The oxidation of acetate is the rate-limiting step in the sulfidogenic ethanol oxidation by thermophilic SRB, which resulted in acetate accumulation. Sulfate reduction and acetate oxidation rates showed variation depending on the operational conditions with the maximum rates of 1 g/L/d (0.2 g/g volatile solids (VS)/d) and 0.3 g/L/d (0:06 g/g VS/d), respectively. This study presents an ANN model predicting the performance of the reactor and determining the optimal architecture of this model; such as best back-propagation (BP) algorithm and neuron numbers. The Levenberg-Marquardt algorithm was selected as the best of 12 BP algorithms and optimal neuron number was determined as 20. The developed ANN model predicted acetate (R=0.91), sulfate (R=0.95), sulfide (R=0.97), and alkalinity (R=0.94) in the FBR effluent. Hence, the ANN based model can be used to predict the FBR performance, to control the operational conditions for improved process performance

Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease

Tibel Tuna,1 Sevket Ozkaya,2 Adem Dirican,2 Serhat Findik,3 Atilla G Atici,3 Levent Erkan31Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, 2Department of Pulmonary Medicine, Medical Park Samsun Hospital, 3Department of Pulmonary Medicine, Faculty of Medicine, Samsun Ondokuzmayis University, Samsun, TurkeyBackground: Computed tomography-guided transthoracic needle aspiration (TTNA) and biopsy (TTNB) is a well established, safe, and rapid method of reaching a definitive diagnosis for most thoracic lesions. The present study aimed to determine the roles of TTNA and TTNB in the diagnosis of pulmonary diseases and to compare the results using these two techniques.Methods: TTNB and TTNA were performed in 105 patients admitted to our clinic due to peripheral pulmonary lesions between May 2005 and November 2007. Needle biopsies were performed using 18-gauge Tru-Cut&reg; biopsy needles and aspirations was performed using 18-20-22-gauge Chiba needles.Results: Malignant lesions diagnosed by TTNB were non-small cell lung carcinoma (51 patients, 73%), small cell lung carcinoma (nine patients, 13%), malignant tissue (three patients, 5%), lymphoma (two patients, 3%), thymoma (two patients, 3%), plasmacytoma (one patient, 1%), rhabdomyosarcoma (one patient, 1%), and metastasis (one patient, 1%). The malignant lesions diagnosed by TTNA were non-small cell lung carcinoma in eleven patients (92%) and malignant tissue in one patient (8%). Three (100%) of the benign lesions diagnosed by TTNB were granulomas and two (100%) benign lesions diagnosed by TTNA were infarctions. When the diagnostic value of TTNB and TTNA was compared, TTNB was significantly superior. Malignant lesions were identified in 70 (84%) and benign lesions were identified in three (4%) of the 83 patients in the TTNB group. Ten (12%) patients in the TTNB group could not be diagnosed. Malignant lesions were found in 12 (55%) and benign lesions were found in two (9%) of the 22 patients in the TTNA group. Negative results were obtained in eight (36%) patients. The diagnostic sensitivity, specificity, and accuracy of TTNB was calculated to be 92%, 100%, and 93%, respectively (Table 5). The diagnostic sensitivity, specificity, and accuracy of TTNA was 78%, 100%, and 82%, respectively. TTNB had a sensitivity of 92% (70/76) in malignant cases and 100% (3/3) in benign cases, while the sensitivity of TTNA in malignant and benign cases was 75% (3/4) and 67% (2/3), respectively.Conclusion: TTNB is a safe and easy procedure which provides a highly accurate diagnosis of benign and malignant lung lesions without causing a significant increase in complication rates.Keywords: computed tomography, guided, transthoracic needle aspiration, transthoracic needle aspiration biopsy, pulmonary lesio

Evaluation of intrarater and interrater reliability of the Wisconsin Gait Scale with using the video taped stroke patients in a Turkish sample.

OBJECTIVE: To establish the intrarater and interrater reliability of Wisconsin Gait Scale (WGS) in hemiplegic patients

The Effect Of Quercus Coccifera L. Extract On The Necrosis Of Random-Pattern Skin Flaps In Rats

Aim: Ischemia-reperfusion injury is an important cause of flap loss. We investigated effects of Quercus coccifera L. extract known to have anti-oxidant and anti-inflammatory activity on skin flap viability. Methods: Eighteen Wistar rats were used. Random-pattern skin flaps, 9x3 cm in size, were applied on rats back and then the rats were divided into three groups. Following surgery 2 cc of nitrofurazone cream and 2 cc of Q. coccifera L. water extract were applied daily in groups 2 and 3, respectively. Group 1 received no treatment after surgery. The percentage of necrosis on the flaps was calculated and histopathological examination of the tissue samples was made on day 7. Results: The mean percentage of necrosis was 44.7%, 42.5% and 21.8% group 1, 2 and 3, respectively. The percentage of necrosis was statistically significantly lower in group 3 than in groups 1 and 2 (p<0.001 and p<0.00, respectively). Neutrophil score was found to be significantly lower in group 3 than in groups 1 and 2 (p=0.002 and p=0.002, respectively). Conclusions: Necrosis of skin flaps was decreased through application of Q. coccifera extractsWoSScopu

An Assessment of Hierarchical Linear Modeling in International Business, Management, and Marketing

International marketing research, in most cases, involves at least two levels (e.g., firms within countries) that make the hierarchical linear modeling (HLM) a suitable data analysis technique. Due to its robustness, the use of HLM in the international business (IB) research has increased substantially over the last decade. However there is still a lack of standardization in the fundamental issues that hinders the wide spread use of HLM. This study provides unified approach to HLM use in IB research by providing standards for appropriate use of HLM. To achieve this goal, a detailed analysis of the method\u27s use in 42 IB studies is provided and these studies are compared with 104 non-international studies to determine where IB research stands in terms of HLM use. Finally this study focuses on the good HLM practices and offers suggestions designed to maximize the effective use of HLM and potential in international business studies