186 research outputs found
Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: A systematic review
Effect of priming with granulocyte colony-stimulating factor on the outcome of chemotherapy for acute myeloid leukemia
BACKGROUND: Sensitization of leukemic cells with hematopoietic growth
factors may enhance the cytotoxicity of chemotherapy in acute myeloid
leukemia (AML). METHODS: In a multicenter randomized trial, we assigned
patients (age range, 18 to 60 years) with newly diagnosed AML to receive
cytarabine plus idarubicin (cycle 1) and cytarabine plus amsacrin (cycle
2) with granulocyte colony-stimulating factor (G-CSF) (321 patients) or
without G-CSF (319). G-CSF was given concurrently with chemotherapy only.
Idarubicin and amsacrin were given at the end of a cycle to allow the
cell-cycle-dependent cytotoxicity of cytarabine in the context of G-CSF to
have a greater effect. The effect of G-CSF on disease-free survival was
assessed in all patients and in cytogenetically distinct prognostic
subgroups. RESULTS: After induction chemotherapy, the rates of response
were not significantly different in the two groups. After a median
follow-up of 55 months, patients in complete remission after induction
chemotherapy plus G-CSF had a higher rate of disease-free survival than
patients who did not receive G-CSF (42 percent vs. 33 percent at four
years, P=0.02), owing to a reduced probability of relapse (relative risk,
0.77; 95 percent confidence interval, 0.61 to 0.99; P=0.04). G-CSF did not
significantly improve overall survival (P=0.16). Although G-CSF did not
improve the outcome in the subgroup with an unfavorable prognosis, the 72
percent of patients with standard-risk AML benefited from G-CSF therapy
(overall survival at four years, 45 percent, as compared with 35 percent
in the group that did not receive G-CSF [relative risk of death, 0.75; 95
percent confidence interval, 0.59 to 0.95; P=0.02]; disease-free survival,
45 percent vs. 33 percent [relative risk, 0.70]; 95 percent confidence
interval, 0.55 to 0.90; P=0.006). CONCLUSIONS: Sensitization of leukemic
cells with growth factors is a clinically applicable means of enhancing
the efficacy of chemotherapy in patients with AML
Efficacy of escalated imatinib combined with cytarabine in newly diagnosed patients with chronic myeloid leukemia
Efficacy of escalated imatinib combined with cytarabine in newly diagnosed patients with chronic myeloid leukemia
Preliminary clinical assessment of the relationship between tumor alphavbeta3 integrin and perfusion in patients studied with [18F]fluciclatide kinetics and [15O]H2O PET
Multitarget Stool DNA Test Performance in an Average-Risk Colorectal Cancer Screening Population
INTRODUCTION: We set out to evaluate the performance of a multitarget stool DNA (MT-sDNA) in an average-risk colonoscopy-controlled colorectal cancer (CRC) screening population. MT-sDNA stool test results were evaluated against fecal immunochemical test (FIT) results for the detection of different lesions, including molecularly defined high-risk adenomas and several other tumor characteristics. METHODS: Whole stool samples (n = 1,047) were prospectively collected and subjected to an MT-sDNA test, which tests for KRAS mutations, NDRG4 and BMP3 promoter methylation, and hemoglobin. Results for detecting CRC (n = 7), advanced precancerous lesions (advanced adenoma [AA] and advanced serrated polyps; n = 119), and non-AAs (n = 191) were compared with those of FIT alone (thresholds of 50, 75, and 100 hemoglobin/mL). AAs with high risk of progression were defined by the presence of specific DNA copy number events as measured by low-pass whole genome sequencing. RESULTS: The MT-sDNA test was more sensitive than FIT alone in detecting advanced precancerous lesions (46% (55/119) vs 27% (32/119), respectively, P < 0.001). Specificities among individuals with nonadvanced or negative findings (controls) were 89% (791/888) and 93% (828/888) for MT-sDNA and FIT testing, respectively. A positive MT-sDNA test was associated with multiple lesions (P = 0.005), larger lesions (P = 0.03), and lesions with tubulovillous architecture (P = 0.04). The sensitivity of the MT-sDNA test or FIT in detecting individuals with high-risk AAs (n = 19) from individuals with low-risk AAs (n = 52) was not significantly different. DISCUSSION: In an average-risk screening population, the MT-sDNA test has an increased sensitivity for detecting advanced precancerous lesions compared with FIT alone. AAs with a high risk of progression were not detected with significantly higher sensitivity by MT-sDNA or FIT
Melanoma: A model for testing new agents in combination therapies
Treatment for both early and advanced melanoma has changed little since the introduction of interferon and IL-2 in the early 1990s. Recent data from trials testing targeted agents or immune modulators suggest the promise of new strategies to treat patients with advanced melanoma. These include a new generation of B-RAF inhibitors with greater selectivity for the mutant protein, c-Kit inhibitors, anti-angiogenesis agents, the immune modulators anti-CTLA4, anti-PD-1, and anti-CD40, and adoptive cellular therapies. The high success rate of mutant B-RAF and c-Kit inhibitors relies on the selection of patients with corresponding mutations. However, although response rates with small molecule inhibitors are high, most are not durable. Moreover, for a large subset of patients, reliable predictive biomarkers especially for immunologic modulators have not yet been identified. Progress may also depend on identifying additional molecular targets, which in turn depends upon a better understanding of the mechanisms leading to response or resistance. More challenging but equally important will be understanding how to optimize the treatment of individual patients using these active agents sequentially or in combination with each other, with other experimental treatment, or with traditional anticancer modalities such as chemotherapy, radiation, or surgery. Compared to the standard approach of developing new single agents for licensing in advanced disease, the identification and validation of patient specific and multi-modality treatments will require increased involvement by several stakeholders in designing trials aimed at identifying, even in early stages of drug development, the most effective way to use molecularly guided approaches to treat tumors as they evolve over time
Herniation Pits in Human Mummies: A CT Investigation in the Capuchin Catacombs of Palermo, Sicily
Herniation pits (HPs) of the femoral neck were first described in a radiological publication in 1982 as round to oval radiolucencies in the proximal superior quadrant of the femoral neck on anteroposterior radiographs of adults. In following early clinical publications, HPs were generally recognized as an incidental finding. In contrast, in current clinical literature they are mentioned in the context of femoroacetabular impingement (FAI) of the hip joint, which is known to cause osteoarthritis (OA). The significance of HPs in chronic skeletal disorders such as OA is still unclear, but they are discussed as a possible radiological indicator for FAI in a large part of clinical studies
Optical and structural properties of polycrystalline CVD diamond films grown on fused silica optical fibres pre-treated by high-power sonication seeding
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