Objective We have analyzed short- and long-term variations of pulmonary function in locally advanced non–small cell lung cancer after induction chemoradiotherapy. Methods Twenty-seven patients with ...stage IIIA (N2) non–small cell lung cancer underwent resection with radical intent after induction chemoradiotherapy in the period 2003 to 2006. Pulmonary function has been evaluated by spirometry, diffusing capacity of the lung for carbon monoxide, and blood gas analysis before induction chemoradiotherapy (T0), 4 weeks after induction chemoradiotherapy and before surgery (T1), and 1 (T2), 3 (T3), 6 (T4), and 12 months (T5) after surgery. Results A 22.80% decrease of diffusing capacity of the lung for carbon monoxide ( P < .001) was observed at T1. At T2 significant decreases in the following were present: vital capacity, −20.50% ( P < .001); forced vital capacity, −22.50% ( P < .001); forced expiratory volume in 1 second, −23.00% ( P < .001); peak expiratory flow, −29.0 ( P < .001); forced expiratory flow 25% to 75%, −13.7% ( P = .005); and diffusing capacity of the lung for carbon monoxide, 43.6% ( P < .001). However, in the interval between T2 and T5, a progressive improvement of lung function in most parameters was observed, but only diffusing capacity of the lung for carbon monoxide presented a significant increase ( P < .001). Within the same time gap (T2 to T5), subjects 65 years of age or younger showed an increasing trend for vital capacity, forced expiratory volume in 1 second, total lung capacity, and residual volume significantly different from that of elderly patients, in whom a decrease in these parameters is reported. Conclusions An impairment of respiratory function is evident in the immediate postoperative setting in patients with non–small cell lung cancer receiving induction chemoradiotherapy. In the long-term period, a general recovery in diffusing capacity of the lung for carbon monoxide was found, whereas an improvement of forced expiratory volume in 1 second, vital capacity, total lung capacity, and residual volume was detected in the younger population only.
It is now recognized that long-duration gamma-ray Bursts (GRBs) are linked to the collapse of massive stars, based on the association between (low redshift) GRBs and (Type Ic) core-collapse ...supernovae (SNe). The census of massive stars and GRBs reveals, however, that not all massive stars produce a GRB. Only similar to 1% of core-collapse SNe are able to produce a highly relatlvlstic collimated outflow, and hence a GRB. The extra crucial parameter has long been suspected to be metallicity and/or rotation. We find observational evidence strongly supporting that both ingredients are necessary in order to make a GRB out of a core-collapsing star. A detailed study of the absorption pattern in the X-ray spectrum of GRB 060218 reveals evidence of material highly enriched in low-atomic-number metals ejected before the SN/GRB explosion. We find that, within the current scenarios of stellar evolution, only a progenitor star characterized by a fast stellar rotation and subsolar initial metallicity could produce such a metal enrichment in its close surrounding.
Chronic liver infections related to hepatitis B and C viruses are a common problem in renal transplant patients with a prevalence of 1.5 to 50% in different countries. There is no uniform agreement ...regarding their influence on the incidence of acute rejection, graft outcome and survival of renal transplant patients. We retrospectively evaluated the influence of antiHBc, antiHCV and HBsAg positive status; gender; age over 50 years of age at the time of transplantation; pre and postransplantation alaninaminotransferase (ALT) elevation; acute rejection; type of graft; number of transplants; and maintenance and induction immunosuppression treatment on the incidence of acute rejection and both graft and patient survival in the population transplanted in our center between 1991 and 1998. The univariate analysis showed that antiHCV, HBsAg and antiHBc status, more than one renal transplant and one or more episodes of acute rejection were associated with diminished graft survival; and being over the age of 50 at the time of transplantation was also associated with diminished patient survival. In the multivariate analysis HBsAg positive and one or more episodes of rejection were associated with a diminished graft survival, and none of the variables studied was associated with diminished patient survival. In conclusion antiHCV and HBsAg positive status was associated with an increased risk of losing the transplanted kidney, and HBsAg positivity was associated with an increased risk of death, but this was not a statistically significant association.
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