The advantage of chemotherapy in asymptomatic patients with advanced colorectal cancer is debatable. Whether early chemotherapy improves survival and the length of the symptom-free period versus no ...therapy until symptoms appear was studied in a randomized trial.
A total of 183 patients with advanced, but asymptomatic colorectal cancer were randomly allocated to receive either initial treatment with sequential methotrexate 250 mg/m2 during the first 2 hours, and fluorouracil (5-FU) 500 mg/m2 at hours 3 and 23 followed by leucovorin rescue initiated at hour 24 (MFL) for 12 courses or to primary expectancy with chemotherapy not considered until symptoms appeared. One patient was ineligible and excluded from analysis. Nine patients did not fulfill the inclusion criteria and five patients refused treatment allocation; these patients were not excluded from the study population so as not to introduce bias. So far, 51 of 90 (60%) patients in the expectancy group have received chemotherapy.
Overall survival was better in the MFL group than in the expectancy group (Breslow-Gehan, P less than .02; log-rank, P = .13) with a difference in median survival of approximately 5 months. Also the symptom-free period and the time to disease progression were longer in the MFL group (P less than .001), with median differences of 8 and 4 months, respectively. Toxicity to MFL treatment was low; however, three patients died because of toxicity--none of them should have received therapy because of poor performance or S-creatinine elevation. The patients maintained an excellent performance throughout the MFL treatment unless the disease was progressive.
We concluded that early treatment with MFL in asymptomatic patients with advanced colorectal cancer prolongs survival, the asymptomatic period, and the time to disease progression by approximately 6 months over primary expectancy.
Acute asthma attacks strike unpredictably and may lead to hospitalization in otherwise healthy individuals. The burden of asthma hospitalization on the US health care system has greatly interested ...health care workers, many of whom see the incidence of asthma as increasing.
To examine the annual incidence of hospitalization and the frequency of subsequent hospitalization for asthma among all active-duty US military personnel between 1994 and 2004 and to determine demographic and occupational risk factors of asthma hospitalization within this generally healthy US population.
Annual demographic and occupational data were combined with electronic hospitalization records for patients with a discharge diagnosis of asthma. Using Cox proportional hazard modeling, the authors investigated demographic and occupational risk factors for asthma hospitalization.
Women, married persons, health care workers, enlisted personnel, US Army personnel, and older persons were found to have a significantly greater risk of asthma hospitalization. Yearly rates of hospitalization declined from 22.3 per 100,000 persons to 12.6 per 100,000 persons between 1994 and 2004.
Although these data have some limitations, they suggest that the burden of asthma hospitalizations in the large, healthy population of US military personnel has declined during the last decade. The decrease in hospitalization potentially reflects improved outpatient management strategies.
Health Informatics Hansen, D. P; Maeder, A. J; Schaper, L. K
2011, Letnik:
168
eBook
Australia has a long history of involvement in the progress of health informatics, and Australian contributors have made an impact on the world health informatics scene in numerous areas, including ...software development, standardisation, evaluation, policy development and education.The Health Informatics Society of Australia (HISA), has been reporting on these developments for 19 years, and its annual Health Informatics Conference (HIC) constitutes the premier Australian academic platform for a wide range of topics in health informatics.This book presents the proceedings of full scientific papers from this annual conference for the first time in monograph format. The focus of HIC 2011 draws on a fundamental aspect of health informatics: its ability to transform processes and practices within healthcare through innovation. The 24 papers were selected after a rigorous double-blind peer review process from the 39 submitted. The topics included cover a wide range of different sectors in the health system, from primary and acute care to preventative and public health. Many of the papers not only provide solid background and technical substance, but also exhibit practical implementations and demonstrations of their worth.The book offers a comprehensive profile of active research areas in Australian health informatics.
One hundred and one DNA markers previously assigned to the short arm of the human X chromosome were localized on a hybrid mapping panel consisting of ten radiation-reduced, and four classical somatic ...cell hybrids. Of the 101 DNA markers, 16 are genes, two are pseudogenes, 13 are expressed sequence tags, 32 are simple tandem repeats (STRs), four are restriction fragment length polymorphisms, one is a variable number of tandem repeats, and 33 are sequence tagged sites (STSs). Three of these markers, two STSs and one STR, were generated from the products of an inter-Alu PCR library of a radiation-reduced hybrid containing Xp11.4-->p11.22 as its only human DNA content. A second STR was isolated from a region-specific cosmid containing the gene ZNF21. The 101 DNA markers fell into 22 bins based on their retention on the hybrids of this panel, which, in combination with YAC contig data, could be further resolved into 24 bins. This hybrid map of Xp11 has an average resolution of approximately 0.8 Mb.
This study examines the tail disconnection event on 2007 April 20 on comet 2P/Encke, caused by a coronal mass ejection (CME) at a heliocentric distance of 0.34 AU. During their interaction, both the ...CME and the comet are visible with high temporal and spatial resolution by the STEREO-A spacecraft. Previously, only current sheets or shocks have been accepted as possible reasons for comet tail disconnections, so it is puzzling that the CME caused this event. The MHD simulation presented in this work reproduces the interaction process and demonstrates how the CME triggered a tail disconnection in the April 20 event. It is found that the CME disturbs the comet with a combination of a 180 deg. sudden rotation of the interplanetary magnetic field (IMF), followed by a 90 deg. gradual rotation. Such an interpretation applies our understanding of solar wind-comet interactions to determine the in situ IMF orientation of the CME encountering Encke.
We present successful extraction of a 10 GHz clock from single-wavelength 160 and 320 Gbps OTDM data streams, using an opto-electronic phase-locked loop based on three-wave mixing in ...periodically-poled lithium niobate as a phase comparator.
The molecular basis of enhanced ischemic tissue survival in flaps preconditioned by surgical delay is poorly understood. Because elevated expression of so-called heat shock or stress proteins has ...been shown to protect tissues/organs against ischemic injury, the authors examined whether the levels of the most highly induced stress protein-hsp72-were elevated in delayed muscle flaps using a rat muscle flap model. Bilateral latissimus dorsi muscle flaps based on the thoracodorsal vessels were elevated in 16 male Sprague-Dawley rats. For each animal, one side was selected randomly to undergo preconditioning by surgical delay for a 7-day period prior to elevation. Delay was accomplished by preserving the thoracodorsal pedicle and a single large distal intercostal perforating vessel. After bilateral flap elevation, latissimus dorsi tissue was harvested from proximal, central, and distal flap segments 0, 1, 3, and 7 days postoperatively (N = 4 for each group), and was analyzed for the expression of hsp72 via Western blot analysis. At the time of harvest, flap viability was assessed by staining with nitroblue tetrazolium. Flap perfusion was measured prior to muscle elevation and harvest using laser Doppler flowmetry. The results demonstrate that delayed muscle flaps had significantly greater total perfusion (p < 0.05) and survival (p < 0.03) 1, 3, and 7 days after elevation compared with the acutely elevated control tissue. Western blot analysis revealed that tissues harvested from the delayed flaps expressed substantially higher levels of hsp72 compared with the acutely elevated control samples. Segmental analysis also revealed a proximal > middle > distal expression of hsp72 in the delayed flaps (p < 0.05). Flap preconditioning by surgical delay increases the expression of hsp72. Moreover, regional differences in hsp72 gene expression are associated with differences in perfusion and survival of delayed muscle flaps. These results indicate that hsp72 may play a substantial role in mediating the delay phenomenon.
A 2
Mb contig was constructed of yeast artificial chromosomes (YACs) and P1 artificial chromosomes (PACs), extending from DXS6849 to a new marker EC7034R, 1
Mb distal to UBE1, within the p11.3 region ...of the human X chromosome. This contig, which has on average four-fold cloned coverage, was assembled using 37 markers, including 13 new sequence tagged sites (STSs) developed from YAC and PAC end-fragments, for an average inter-marker distance of 55
kb. The inferred marker order predicted from SEGMAP analysis, STS content and cell hybrid data is Xpter–EC7034R–EC8058R–FB20E11–DXS7804–DXS8308–(DXS1264, DXS1055)–DXS1003–UBE1–(UHX), PCTK1)–DXS1364–DXS1266–DXS337–SYN1–DXS6849-cen. One (TC)
n dinucleotide sequence from an end-clone was identified and found to be polymorphic (48% heterozygosity). The contig is merged with published physical maps both in the distal and in the centromeric direction of Xp, and provides reagents to aid in the DNA sequencing and the finding of genes in this region of the human genome.
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