A meta‐analysis was performed to reevaluate the efficacy of dipyridamole for prophylaxis of angina pectoris. We found 10 articles that reported 11 randomized control trials published between 1960 and ...1970. Three trials found a statistically significant benefit for the drug vs placebo, four showed a positive trend, two found no difference, and two showed a slight trend favoring placebo. When the results of all 11 trials were combined, two different statistical methods showed a statistically significant benefit from the drug. These combined results must be interpreted cautiously because of excluded patients and other methodologic variations in the studies, as well as evidence from other studies that dipyridamole may aggravate angina. Nevertheless, we conclude that there is some evidence for efficacy of the drug and believe the question should be restudied in larger and better‐designed trials.
Clinical Pharmacology and Therapeutics (1988) 43, 610–615; doi:10.1038/clpt.1988.84
Surgical resection of asymptomatic primary colorectal cancer in patients presenting with synchronous unresectable metastatic disease is controversial. Concerns and controversies remain over combining ...cytotoxic chemotherapy with bevacizumab in this patient population.
We identified medical records of 99 patients with synchronous metastatic primary colorectal cancer who received chemotherapy with bevacizumab as their initial treatment. The incidence of subsequent use of surgery and surgical outcomes were recorded. Patients were also assessed for overall survival.
Patients who received bevacizumab-containing chemotherapy for synchronous metastatic primary colorectal cancer were divided into the non-surgery and surgery groups according to the resection status of their asymptomatic primary tumor. In the non-surgery group, two patients (4.4%) underwent additional surgery, while three patients (5.7%) required surgery for rectovesical fistula in the surgery group. The median overall survival was 17 months for the non-surgery group (95% CI: 10.6-23.3 months) and 23 months for the surgery group (95% CI: 21.3-24.6 months; P = 0.322).
This study utilizing chemotherapy with bevacizumab did not result in an increased rate of morbidity related to the unresected primary tumor. Survival is not compromised by leaving the primary colon tumor intact.
Introduction
We investigated the impact of modern chemotherapy regimens and bevacizumab following pulmonary metastasectomy (PM) from metastatic colorectal cancer (CRC).
Methods
A total of 122 ...consecutive patients who were curatively resected for pulmonary metastases of CRC in twelve oncology centers were retrospectively analysed between January 2000 and April 2012.
Results
Of 122 patients, 14 did not receive any treatment following PM. The remaining 108 patients received fluoropyrimidine‐based (n = 12), irinotecan‐based (n = 56) and oxaliplatin‐based (n = 40) chemotherapy combinations. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). Median recurrence‐free survival (RFS) was 17 months and median overall survival (OS) has not been reached at a median follow‐up of 25 months after PM. Three and five‐year OS rates were 66% and 53%, respectively. RFS and OS were similar, irrespective of the chemotherapy regimen or BEV use. Positive pulmonary margin, KRAS mutation status, and previous liver metastasectomy were negative independent prognostic factors for RFS, while pathologically confirmed thoracic lymph node involvement was the only negative independent prognostic for OS in multivariate analysis.
Conclusions
No significant RFS or OS difference was observed in respect to chemotherapy regimens with or without BEV in patients with pulmonary metastases of CRC following curative resection.
The transition from system-to information-based security has continued steadily over the last 30 years. Correspondingly, it is increasingly not the computer that is at risk, but the information in ...it. The human operator is ultimately the cornerstone of information security, an integral part of the information infrastructure. We are therefore forced to use techniques and methods that help us understand the role of human actors in the information infrastructure, so that we may make meaningful progress in mitigating insider threat. Malicious versus benign human behavior cannot easily be categorized based on a signature such as conventional virus and intrusion detection approaches. Because the cost of a false positive is high, we must be careful in our classification and subsequent actions. This article outlines our BANDIT (Behavioral Anomaly Detection for Insider Threat) system, using the traditional notion of Motive, Means, and Opportunity, combined with comprehensive behavioral analysis techniques to place each individual on a sliding scale of 'insider risk'. Finally, an insider threat detection cost-benefit analysis, based on classical risk assessment techniques, is presented to quantify how effective the technology has to be for beneficial deployment in a given enterprise.
We report the simultaneous observations of the prompt emission in the gamma-ray and hard X-ray bands by the Swift BAT and the Konus-Wind instruments of the short-hard burst, GRB 060313. The ...observations reveal multiple peaks in both the gamma-ray and hard X-ray bands suggesting a highly variable outflow from the central explosion. We also describe the early-time observations of the X-ray and UV/optical afterglows by the Swift XRT and UVOT instruments. The combination of the X-ray and UV/optical observations provides the most comprehensive light curves to date of a short-hard burst at such an early epoch. The afterglows exhibit complex structure with different decay indices and flaring. This behavior can be explained by the combination of a structured jet, radiative loss of energy, and decreasing microphysics parameters occurring in a circumburst medium with densities varying by a factor of approximately two on a length scale of 10 super(17) cm. These density variations are normally associated with the environment of a massive star and inhomogeneities in its windy medium. However, the mean density of the observed medium (n610 super(4) cm super(3)) is much less than that expected for a massive star. Although the collapse of a massive star as the origin of GRB 060313 is unlikely, the merger of a compact binary also poses problems for explaining the behavior of this burst. Two possible suggestions for explaining this scenario are that some short bursts may arise from a mechanism that does not invoke the conventional compact binary model, or that soft late-time central engine activity is producing UV/optical but no X-ray flaring.
PDF
