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Rituximab Chimeric Anti-CD20 Monoclonal Antibody Therapy for Relapsed Indolent Lymphoma: Half of Patients Respond to a Four-Dose Treatment Program. J Clin Oncol 2023; 41:154-162. [PMID: 36603541 DOI: 10.1200/jco.22.02403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The CD20 antigen is expressed on more than 90% of B-cell lymphomas. It is appealing for targeted therapy, because it does not shed or modulate. A chimeric monoclonal antibody more effectively mediates host effector functions and is itself less immunogenic than are murine antibodies. PATIENTS AND METHODS This was a multiinstitutional trial of the chimeric anti-CD20 antibody, IDEC-C2B8. Patients with relapsed low grade or follicular lymphoma received an outpatient treatment course of IDEC-C2B8 375 mg/m2 intravenously weekly for four doses. RESULTS From 31 centers, 166 patients were entered. Of this intent-to-treat group, 48% responded. With a median follow-up duration of 11.8 months, the projected median time to progression for responders is 13.0 months. Serum antibody levels were sustained longer after the fourth infusion than after the first, and were higher in responders and in patients with lower tumor burden. The majority of adverse events occurred during the first infusion and were grade 1 or 2; fever and chills were the most common events. Only 12% of patients had grade 3 and 3% grade 4 toxicities. A human antichimeric antibody was detected in only one patient. CONCLUSION The response rate of 48% with IDEC-C2B8 is comparable to results with single-agent cytotoxic chemotherapy. Toxicity was mild. Attention needs to be paid to the rate of antibody infusion, with titration according to toxicity. Further investigation of this agent is warranted, including its use in conjunction with standard chemotherapy.
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The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions. BMC Psychiatry 2022; 22:479. [PMID: 35850709 PMCID: PMC9295434 DOI: 10.1186/s12888-022-04117-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals. METHODS A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically. RESULTS Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs. CONCLUSION The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.
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PRELIMINARY RESULTS OF ASTX660, A NOVEL NON-PEPTIDOMIMETIC cIAP1/2 AND XIAP ANTAGONIST, IN RELAPSED/REFRACTORY PERIPHERAL T-CELL LYMPHOMA AND CUTANEOUS T CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.211_2631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Use of a Novel 3D‐Printed Anatomical Model for Ultrasound‐Guided Hip Arthrocentesis in Emergency Department Training Sessions. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.444.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Adjuvant sunitinib following chemoradiotherapy and surgery for locally advanced esophageal cancer: a phase II trial. Dis Esophagus 2016; 29:1152-1158. [PMID: 26663741 DOI: 10.1111/dote.12444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prognosis for locally advanced esophageal cancer is poor despite the use of trimodality therapy. In this phase II study, we report the feasibility, tolerability and efficacy of adjuvant sunitinib. Included were patients with stage IIa, IIB or III cancer of the thoracic esophagus or gastroesophageal junction. Neoadjuvant therapy involved Irinotecan (65 mg/m2 ) + Cisplatin (30 mg/m2 ) on weeks 1 and 2, 4 and 5, 7 and 8 with concurrent radiation (50Gy/25 fractions) on weeks 4-8. Sunitinib was commenced 4-13 weeks after surgery and continued for one year. Sixty-one patients were included in the final analysis, 36 patients commenced adjuvant sunitinib. Fourteen patients discontinued sunitinib due to disease recurrence (39%) within the 12-month period, 12 (33%) discontinued due to toxicity, and 3 (8%) requested cessation of therapy. In the overall population, median survival was 26 months with a 2 and 3-year survival rate of 52% and 35%, respectively. The median survival for the 36 patients treated with sunitinib was 35 months and 2-year survival probability of 68%. In a historical control, a prior phase II study with the same trimodality therapy (n = 43), median survival was 36 months, with a 2-year survival of 67%. Initiation of adjuvant sunitinib is feasible, but poorly tolerated, with no signal of additional benefit over trimodality therapy for locally advanced esophageal cancer.
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The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis. Bone Marrow Transplant 2016; 51:573-80. [PMID: 26726945 PMCID: PMC4823157 DOI: 10.1038/bmt.2015.316] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/13/2015] [Accepted: 11/01/2015] [Indexed: 11/09/2022]
Abstract
Pneumocystis jiroveci pneumonia (PJP) is associated with high morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Little is known about PJP infections after HSCT because of the rarity of disease given routine prophylaxis. We report the results of a Center for International Blood and Marrow Transplant Research study evaluating the incidence, timing, prophylaxis agents, risk factors and mortality of PJP after autologous (auto) and allogeneic (allo) HSCT. Between 1995 and 2005, 0.63% allo recipients and 0.28% auto recipients of first HSCT developed PJP. Cases occurred as early as 30 days to beyond a year after allo HSCT. A nested case cohort analysis with supplemental data (n=68 allo cases, n=111 allo controls) revealed that risk factors for PJP infection included lymphopenia and mismatch after HSCT. After allo or auto HSCT, overall survival was significantly poorer among cases vs controls (P=0.0004). After controlling for significant variables, the proportional hazards model revealed that PJP cases were 6.87 times more likely to die vs matched controls (P<0.0001). We conclude PJP infection is rare after HSCT but is associated with high mortality. Factors associated with GVHD and with poor immune reconstitution are among the risk factors for PJP and suggest that protracted prophylaxis for PJP in high-risk HSCT recipients may improve outcomes.
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Cost-Effectiveness Comparison Of Botulinum Toxin Type A Plus Best Supportive Care Versus Best Supportive Care Alone In The Treatment Of Idiopathic Overactive Bladder With Urinary Incontinence Among Patients Not Adequately Managed By Anticholinergic Therapy In France. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A470. [PMID: 27201348 DOI: 10.1016/j.jval.2014.08.1330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Rapid Relative Effectiveness Assessment of Pharmaceuticals: Transferability and Completeness of Information Derived From Global Value Dossiers To Complete A Eunethta Submission. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A440. [PMID: 27201176 DOI: 10.1016/j.jval.2014.08.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Comparaison du rapport coût–efficacité de la toxine botulinique de type A associé aux meilleurs soins de support vs les meilleurs soins de support seuls dans le traitement de l’hyperactivité vésicale idiopathique avec incontinence urinaire chez les patients réfractaires au traitement anti-cholinergique en France. Prog Urol 2014; 24:799-800. [DOI: 10.1016/j.purol.2014.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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EG-12 * NOVEL CHROMATIN REGULATORY ACTIVITY OF ESCO2 IN CANCER AND NEURAL DEVELOPMENT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou254.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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The genetic heterogeneity and mutational burden of engineered melanomas in zebrafish models. Genome Biol 2014; 14:R113. [PMID: 24148783 PMCID: PMC3983654 DOI: 10.1186/gb-2013-14-10-r113] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/23/2013] [Indexed: 11/30/2022] Open
Abstract
Background Melanoma is the most deadly form of skin cancer. Expression of oncogenic BRAF or NRAS, which are frequently mutated in human melanomas, promote the formation of nevi but are not sufficient for tumorigenesis. Even with germline mutated p53, these engineered melanomas present with variable onset and pathology, implicating additional somatic mutations in a multi-hit tumorigenic process. Results To decipher the genetics of these melanomas, we sequence the protein coding exons of 53 primary melanomas generated from several BRAFV600E or NRASQ61K driven transgenic zebrafish lines. We find that engineered zebrafish melanomas show an overall low mutation burden, which has a strong, inverse association with the number of initiating germline drivers. Although tumors reveal distinct mutation spectrums, they show mostly C > T transitions without UV light exposure, and enrichment of mutations in melanogenesis, p53 and MAPK signaling. Importantly, a recurrent amplification occurring with pre-configured drivers BRAFV600E and p53-/- suggests a novel path of BRAF cooperativity through the protein kinase A pathway. Conclusion This is the first analysis of a melanoma mutational landscape in the absence of UV light, where tumors manifest with remarkably low mutation burden and high heterogeneity. Genotype specific amplification of protein kinase A in cooperation with BRAF and p53 mutation suggests the involvement of melanogenesis in these tumors. This work is important for defining the spectrum of events in BRAF or NRAS driven melanoma in the absence of UV light, and for informed exploitation of models such as transgenic zebrafish to better understand mechanisms leading to human melanoma formation.
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Degree of tumor shrinkage following neoadjuvant chemoradiotherapy: a potential predictor for complete pathological response in esophageal cancer? Dis Esophagus 2014; 27:552-9. [PMID: 23121504 DOI: 10.1111/j.1442-2050.2012.01445.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Neoadjuvant chemoradiotherapy (CRT) before surgery results in a pathological complete response (pCR) rate in about 1/3 of the patients, which is correlated with survival. It was hypothesized that volumetric tumor response to CRT would correlate with outcomes. Patients who completed trimodality therapy, where planning, pre-, and post-CRT computed tomography scans were available, and pathology was reviewed by a central pathologist, were eligible for analysis. Absolute and relative tumor volume change pretreatment and post-treatment were correlated with pCR, locoregional recurrence (LRR), disease-free survival, and overall survival. Fifty-six patients were analyzed. pCR was observed in 30% of patients. Median follow up was 20.3 (range 4-89) months. The 2- and 4-year overall survival was 61.3% (95% confidence interval [CI]: 45-74) and 25.0% (95%CI: 11-41); proportion disease free was 32.1% (95% CI: 19-46) and 20.6% (9-36) at 2 and 4 years, respectively. The median relative volume reduction was 17% (95% CI: -24, -3%). Using 20% as the criteria, the proportion of patients with pCR of ≥20% versus <20% was 13/25 (52%) versus 4/31 (13%) for those who did not (odds ratio 7.3; 95% CI: 2-27). The LRR at 2 and 4 years were 29.5% (95% CI: 16-43) and 36.2% (95% CI: 23-50). The relative tumor reduction ≥20% was significantly correlated with LRR (hazard ratio 0.24; 95% CI: 0.07-0.8; p 0.02) at 2 and 4 years, respectively. Relative tumor volume reduction following CRT is correlated with pCR and LRR. Further investigations are warranted to examine the effect of volume change, alone or in conjunction with other factors as potential predictors for pathological response.
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Prototyping and testing of the Continuous External Rogowski ITER magnetic sensor. FUSION ENGINEERING AND DESIGN 2013. [DOI: 10.1016/j.fusengdes.2012.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of cognitive training on attention allocation and speed of processing in older adults: An ERP study. J Vis 2011. [DOI: 10.1167/11.11.203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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How for-profit organisations got their hands on the NHS. West J Med 2011. [DOI: 10.1136/bmj.d4535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adjuvant sunitinib (Su) for locally advanced esophageal cancer (LAEC): Results of a phase II trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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An Address on the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 2:515-7. [PMID: 20745325 DOI: 10.1136/bmj.2.411.515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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An Address on the Effect of the Antiseptic Treatment upon the General Salubrity of Surgical Hospitals. BRITISH MEDICAL JOURNAL 2011; 2:769-71. [PMID: 20748054 DOI: 10.1136/bmj.2.782.769] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Remarks on Micro-Organisms: their Relation to Disease. BRITISH MEDICAL JOURNAL 2011; 2:363-5. [PMID: 20749661 DOI: 10.1136/bmj.2.1027.363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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An Address on the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 2:53-6. [PMID: 20745202 DOI: 10.1136/bmj.2.394.53] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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An Address on the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 2:101-2. [PMID: 20745212 DOI: 10.1136/bmj.2.396.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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An Address on the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 2:461-3. [PMID: 20745310 DOI: 10.1136/bmj.2.409.461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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An Address on the Influence of Position upon Local Circulation. BRITISH MEDICAL JOURNAL 2011; 1:923-6. [PMID: 20749232 DOI: 10.1136/bmj.1.964.923] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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An Address on the Antiseptic Management of Wounds: Delivered at King's College Hospital in the London Post-Graduate Course, January 18th, 1893. BRITISH MEDICAL JOURNAL 2011; 1:277-8. [PMID: 20754047 DOI: 10.1136/bmj.1.1676.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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On a Case Illustrating the Present Aspect of the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 1:30-2. [PMID: 20746076 DOI: 10.1136/bmj.1.524.30] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Remarks on the Antiseptic System of Treatment in Surgery. BRITISH MEDICAL JOURNAL 2011; 1:301-4. [PMID: 20745475 DOI: 10.1136/bmj.1.431.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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An Address on the Present Position of Antiseptic Surgery. BRITISH MEDICAL JOURNAL 2011; 2:377-9. [PMID: 20753109 DOI: 10.1136/bmj.2.1546.377] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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An Address on the Treatment of Fracture of the Patella. BRITISH MEDICAL JOURNAL 2011; 2:855-60. [PMID: 20750744 DOI: 10.1136/bmj.2.1192.855] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Introductory Address Delivered in the Medical Department of King's College. BRITISH MEDICAL JOURNAL 2011; 2:465-9. [PMID: 20748639 DOI: 10.1136/bmj.2.875.465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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A Method of Antiseptic Treatment Applicable to Wounded Soldiers in the Present War. BRITISH MEDICAL JOURNAL 2011; 2:243-4. [PMID: 20745963 DOI: 10.1136/bmj.2.505.243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Galiximab, an anti-CD80 primatized monoclonal antibody, in relapsed Hodgkin lymphoma: Final results of CALGB 50602. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Phase II study of marqibo in adult patients with refractory or relapsed philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Viability And Potency Of Hematopoietic Progenitor Cells After Prolonged Cryopreservation At -80 °C. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Amphotericin B Lipid Complex (Abelcet) in the treatment of invasive mycoses: the North American experience. Eur J Haematol Suppl 2009; 57:18-23. [PMID: 8706812 DOI: 10.1111/j.1600-0609.1996.tb01348.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Abelcet, or Amphotericin B lipid Complex, is unique formulation, comprising an equimolar mixture of amphotericin B complexed with two lipids. In preclinical studies, Abelcet was clearly demonstrated to be less toxic than amphotericin B desoxycholate and to be effective in models where amphotericin B was ineffective at its maximum tolerated dose. Pharmacokinetic studies in animals also showed that the concentration of Abelcet in blood is similar or reduced compared to levels seen with conventional amphotericin B, with accumulation in the liver, lungs and spleen. Phase I clinical trials determined the optimum tolerated dose of Abelcet to be 5 mg/kg d-1. Data are now available for 228 cases (including 51 paediatric cases) of invasive fungal infection treated with Abelcet in an open-label emergency-release protocol. All patients had to have failed on previous amphotericin B or other conventional antifungals, or to have unacceptable toxicity on amphotericin B, or underlying renal disease, or nephrotoxicity due to other drugs. Abelcet was administered at a dose of 5 mg/kg d-1 for 4 wk. Approximately one-third of patients had candidiasis, one-third aspergillosis and one-third other infections, including fusariosis. Of 183 cases evaluable for response, 126 (69%) had a clinical response (cure or improvement) which was mycologically confirmed in 55% (61/110 tested). Results in paediatric cases were similar to or better than those seen in the group as a whole. When comparisons were made between cases with different types of infection, underlying disease/immunosuppressive disorder, and degree of neutropenia, the response rates were very consistent from group to group. Treatment with Abelcet was well tolerated and mean serum creatinine levels actually declined during therapy, particularly in patients with pre-existing renal dysfunction.
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Hemorrhagic Cystitis (HC) in Hematopoietic Stem Cell Transplant (HSCT) Recipients Using Ablative Fludarabine/Busulfan (FB) Conditioning with and without Total Body Irradiation (TBI). Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mortality of Hematopoietic Stem Cell Transplant Recipients Admitted to A Medical Intensive Care Unit (MICU) as Predicted by the Hematopoietic Cell Transplantation Comorbidity Index (HCTCI). Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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265: Daptomycin Plus Cefepime for Moderate and High-Risk Febrile Neutropenic Patients with Increased Risk of Gram-Positive Infection. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Prosthetic Substitution of Thoracic Esophagus in Puppies: Use of Marlex Mesh with Collagen or Anterior Rectus Sheath. Ann Surg 2007; 162:812-24. [PMID: 17859786 PMCID: PMC1476973 DOI: 10.1097/00000658-196511000-00003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
7089 Background: The Myelodysplastic syndrome (MDS) is characterized by aberrant hematopoietic progenitor cell maturation resulting in ineffective hematopoiesis, cytopenia and progression to acute myeloid leukemia. Some individuals with MDS also have fibrosis within the marrow. MDS with marrow fibrosis appears to be biologically and clinically distinct from myeloproliferative disorders with marrow fibrosis such as agnogenic myeloid metaplasia. While azacitidine (AZA), a DNA methyl transferase inhibitor has known activity in MDS, little is known about its efficacy in patients with MDS with marrow fibrosis. Methods: The records of 41 patients with MDS with marrow fibrosis treated with AZA were reviewed. The degree of fibrosis was determined by reticulin staining and ranged from 1+ to 3+. Patients who received at least 2 cycles were considered evaluable for response. All patients were evaluated for toxicity. The International Working Group standardized response criteria for MDS were used for evaluation of response. Results: Patients had a median age of 69 years (range = 44–84). All FAB subtypes were represented (RA = 16, RARS = 6, RAEB = 5, CMML = 8, RAEB-t = 6). The mean International Prognostic Scoring System score was 1.3 and ranged from 0–3.5.. The overall response rate was 63% (26/41): CR = 7% (3/41), PR = 20 % (8/41), major hematological improvement (MHI) = 29% (12/41), and minor hematological improvement (mHI) = 7% (3/41). The response rates did correlate with FAB subgroup or IPSS score. Treatment was well tolerated. The most common side effects were nausea, vomiting, diarrhea and cytopenia. Conclusions: Azacitidine appears to be effective and well tolerated in patients with MDS with marrow fibrosis. Results of this study demonstrate a response rate similar to that reported in previous studies treating MDS regardless of marrow histology. There does not appear to be a material difference in response to AZA between MDS patients with and without marrow fibrosis. [Table: see text]
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Arsenic trioxide, ascorbic acid, filgrastim and erythropoietin for the treatment of myelodysplastic syndromes. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17519 Background: Arsenic trioxide (ATO) has been reported to have activity when used as monotherapy for the myelodysplastic syndromes (MDS). Herein we report the results of MDS patients treated with ATO as a differentiating agent coupled with ascorbic acid and cytokine pharmacotherapy. Methods: Nine patients with MDS, regardless of IPSS category and prior treatment, were enrolled in this study. Patients with the proliferative variant of CMML and those with significant cardiac dysfunction or a prolonged QT interval were excluded. They received ATO and ascorbic acid combined with growth factors. All patients received induction therapy with ATO at 0.25 mg/kg IV infusion daily x 5 for one week, followed by twice weekly for seven weeks. Responders were eligible for one consolidation cycle of twice weekly ATO for eight weeks. Four patients received one cycle of consolidation. G-CSF 300 mcg was given thrice weekly and EPO 40,000 units twice weekly. Ascorbic acid 1 gm was given intravenously 30 minutes after each dose of ATO. Response to treatment was assessed using the International Working Group (IWG) criteria for MDS. Results: Median age of patients was 69.5 years (range = 56 to 83 years). IPSS scores were: Int-1 = 5, Int-2 = 2, High = 2. Patients had received prior therapy with azacitidine (n = 8), cytokines (n = 4), and transfusions alone (n = 1). The overall response rate was 56% (5/9): partial response (PR) = 2, hematologic improvement (HI) = 3. Platelet responses were seen in 44% of patients (4/9). Four patients had stable disease (44%). The average duration of response for PR and HI was 122 days and 70 days, respectively. The overall median duration of HI was 3.5 months (range = 0.6 to 4.1 months). There were no cytogenetic responses noted in four evaluable patients. Four patients died during the study. Two patients died due to disease related illness and two due to complications of their comorbid conditions. No treatment related mortality was seen. Conclusions: Arsenic trioxide in combination with ascorbic acid and cytokines has activity in patients with MDS. Larger studies are necessary to establish the efficacy of this regimen earlier in the treatment schema of MDS. No significant financial relationships to disclose.
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P150 Karyotype does not predict response to azacitidine in patients with myelodysplastic syndrome. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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SAFETY AND EFFICACY OF RETREATING FOLLICULAR NON-HODGKINʼS LYMPHOMA WITH 90Y IBRITUMOMAB TIUXETAN (ZEVALIN). J Investig Med 2007. [DOI: 10.1097/00042871-200701010-00844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Development of a Video-based Evaluation Tool in Rett Syndrome. J Autism Dev Disord 2006; 37:1636-46. [PMID: 17180458 DOI: 10.1007/s10803-006-0293-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Accepted: 09/20/2006] [Indexed: 11/30/2022]
Abstract
This paper describes the development of a video-based evaluation tool for use in Rett syndrome (RTT). Components include a parent-report checklist, and video filming and coding protocols that contain items on eating, drinking, communication, hand function and movements, personal care and mobility. Ninety-seven of the 169 families who initially agreed to participate returned a videotape within 8 months of the first request. Subjects whose videos were returned had a similar age profile to those who did not provide a video but were more likely to have classical than atypical RTT. Evidence of the content and social validity and inter-rater reliability on 11 videos is provided. Video may provide detailed, objective assessment of function and behaviour in RTT.
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Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. AJNR Am J Neuroradiol 2006; 27:2179-90. [PMID: 17110690 PMCID: PMC7977225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND PURPOSE The cause of "posterior reversible encephalopathy syndrome" (PRES) is not established. We recently encountered several patients who developed PRES in the setting of severe infection. In this study, we comprehensively reviewed the clinical and imaging features in a large cohort of patients who developed PRES, with particular attention to those with isolated infection, sepsis, or shock (I/S/S). METHODS The clinical/imaging features of 106 patients who developed PRES were comprehensively evaluated. In 25 of these patients, PRES occurred in association with severe I/S/S separate from transplantation. The clinical/imaging features (computer tomography, MR imaging, and MR angiography [MRA]) of the patients with I/S/S were further evaluated, including organ/tissue/blood culture results, mean arterial blood pressure (MAP) at toxicity, extent of cerebral edema, and presence of vasospasm. RESULTS PRES occurred in association with I/S/S in 25 of 106 patients (23.6%), in addition to 4 other major clinical settings, including cyclosporine/FK-506 (post-transplant) neurotoxicity (46.2%), autoimmune disease (10.4%), postchemotherapy (3.7%), and eclampsia (10.4%). In the 25 patients with I/S/S, available cultures demonstrated a predominance of gram-positive organisms (84%). Blood pressure was "normal" at toxicity in 10 patients (MAP, 95 mm Hg); "severe" hypertension was present in 15 patients (MAP, 137 mm Hg). Extent of brain edema graded on imaging studies was greater in the normal MAP group compared with the severe hypertension group (P < .05). MRA demonstrated vasospasm in patients with severe hypertension and vessel "pruning" in the normal MAP group. CONCLUSION Infection/sepsis/shock may be an important cause of PRES, particularly in relation to infection with gram-positive organisms.
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