Background. The use of chemotherapy in patients with metastatic carcinoid tumors has been of limited value, and investigation of new agents is necessary. Previous reports have suggested that ...dimethyltriazenoimidazole carboxamide (DTIC) may have antitumor activity.
Methods. A Phase II trial to investigate the clinical response rate to DTIC in patients with metastatic carcinoid tumors was performed. DTIC was administered at low (650 mg/m2) or high (850 mg/m2) doses every 28 days.
Results. Sixty‐three patients were entered into the study, and 56 were evaluable for toxicity and response. Toxicity was moderate, with the most common side effect being nausea and vomiting (88%). Nine patients (16%; 95% confidence interval, 8–28%) had partial responses, 5 of 25 receiving 850 mg/m2 and 4 of 31 receiving 650 mg/m2 of DTIC. Median survival time of all patients was 20 months.
Conclusions. DTIC has minimal activity in patients with metastatic carcinoid tumors. Cancer 1994; 73:1505–8.
The theme of the third annual Spring workshop of the HUPO-PSI was "proteomics and beyond" and its underlying goal was to reach beyond the boundaries of the proteomics community to interact with ...groups working on the similar issues of developing interchange standards and minimal reporting requirements. Significant developments in many of the HUPO-PSI XML interchange formats, minimal reporting requirements and accompanying controlled vocabularies were reported, with many of these now feeding into the broader efforts of the Functional Genomics Experiment (FuGE) data model and Functional Genomics Ontology (FuGO) ontologies.
To establish quantitative Doppler criteria for acute unilateral epididymitis and/or orchitis.
Triplex ultrasonography (US) was used to prospectively evaluate 31 patients with acute hemiscrotal pain ...and 15 asymptomatic control subjects. Morphology and perfusion were assessed, and peak systolic velocities (PSVs) were recorded. Ratios of PSV were calculated by using values from the right and left sides.
PSVs in control subjects differed significantly from those in patients (P < .0001). A PSV > or = 15 cm/sec produced diagnostic accuracy of 90% for orchitis and 93% for epididymitis: Five of six false-negative findings were in patients younger than age 15 years. Epididymal PSV ratios > or = 1.7 or testicular ratios > or = 1.9 were diagnostic of acute inflammation (P < .0001). In three cases, morphologic and color Doppler findings were normal and only the PSV ratios were diagnostic.
PSV and PSV ratios provide diagnostic criteria for acute unilateral epididymitis and/or orchitis that are more accurate than morphologic evaluation and color flow imaging either alone or in combination.
Objective: To identify if whole-brain structural network alterations in patients with temporal lobe epilepsy (TLE) and focal to bilateral tonic-clonic seizures (FBTCS) differ from alterations in ...patients without FBTCS. Methods: We dichotomized a cohort of 83 drug-resistant patients with TLE into those with and without FBTCS and compared each group to 29 healthy controls. For each subject, we used diffusion MRI to construct whole-brain structural networks. First, we measured the extent of alterations by performing FBTCS-negative (FBTCS-) versus control and FBTCS-positive (FBTCS+) versus control comparisons, thereby delineating altered sub-networks of the whole-brain structural network. Second, by standardising networks of each patient using control networks, we measured the subject-specific abnormality at every brain region in the network, thereby quantifying the spatial localisation and the amount of abnormality in every patient. Results: Both FBTCS+ and FBTCS- patient groups had altered sub-networks with reduced fractional anisotropy (FA) and increased mean diffusivity (MD) compared to controls. The altered subnetwork in FBTCS+ patients was more widespread than in FBTCS- patients (441 connections altered at t>3, p<0.001 in FBTCS+ compared to 21 connections altered at t>3, p=0.01 in FBTCS-). Significantly greater abnormalities-aggregated over the entire brain network as well as assessed at the resolution of individual brain areas-were present in FBTCS+ patients (p<0.001, d=0.82). In contrast, the fewer abnormalities present in FBTCS- patients were mainly localised to the temporal and frontal areas. Significance: The whole-brain structural network is altered to a greater and more widespread extent in patients with TLE and FBTCS. We suggest that these abnormal networks may serve as an underlying structural basis or consequence of the greater seizure spread observed in FBTCS.
BACKGROUND AND OBJECTIVES: Each primary care practice should be viewed as a complex adaptive micro-system with its own unique characteristics. To improve safety, under constraints of limited ...resources and numerous competing demands, practices need to identify those vulnerabilities that pose the greatest risks and focus efforts on these. The Objective was to develop and test a novel methodology that forms self-empowered learning teams that can prioritise safety problems based on the combination of error frequency and severity of consequences, and then devise feasible interventions.
METHODS: A survey instrument was designed and used to elicit, in qualitative terms, staff perceptions of frequency, p, and severity, s, of various types/causes of primary care errors. The qualitative responses were quantified using an algorithm that allowed for risk aversion. Relative hazard rate, h = pxs, was used as the basis for prioritising safety problems in two primary care test practices.
RESULTS: Each site identified its own set of priorities with very little overlap. Within each site there was high concordance between priorities identified by physicians, nursing and administrative staff but each site appeared to be unique. Priorities also remained stable with variation in the degree of risk aversiveness assumed in the Hazard calculation.
INTERPRETATION AND CONCLUSIONS: The method aided formation of central ‘attractors’ in the form of self-empowered effective learning teams with a common vision to help their complex micro-systems to adapt and thrive. This pro-active type of methodology helps in creating a sustainable safety culture, and has been adapted for other health-care settings and physician training.
Appliance wear: the patient's point of view Stewart, Fern Ng; Kerr, W. John S.; Taylor, Philip J. S.
European journal of orthodontics,
08/1997, Letnik:
19, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Fifty-two patients (35 female, 17 male) completed questionnaires related to their experiences during the first 7 days of appliance wear (31 fixed, 21 removable) and then after 14 and 90 days. Most ...problems relating to discomfort and pain resolved within 4–7 days. The problems encountered with fixed appliances were generally more severe than with removable appliances. Swallowing and speech were more difficult with removable appliances and these problems persisted to some degree. Surprisingly, the embarrassment caused by wearing the appliance in public was similar whether it was fixed or removable.
In Exp I, 108 (36 Ss at each level) 3rd, 5th, and 7th graders and 36 graduate students read short expository paragraphs and performed tasks that required the generation of macrostructure. Ss chose ...the best title, wrote a summary sentence, or wrote 1 additional sentence for each paragraph. Some paragraphs were not well structured; others contained an anomalous sentence. Results show that performance improved with age. The title task was easier than the summary task, which in turn was easier than the next-sentence task. Only adult Ss reflected the presence of anomalous information, and the effects were different on each of the 3 tasks. In Exp II, the title task with 4 response options was administered to 24 undergraduates. Results show that Ss broadened their representations to encompass the deviant sentence in both related and unrelated paragraphs. In the summary-sentence task, proficient adults--who monitored their own comprehension--responded like children. It is suggested that children need instruction variations in both task and in text, introduced gradually and systematically, in order to deal with potential sources of difficulty. (25 ref)
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