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Surveillance of invasive Streptococcus pneumoniae in Taiwan, 2002-2003. | A total of 522 Streptococcus pneumoniae invasive isolates from diverse sources were collected from January 2002 to December 2003 in Taiwan in order to understand the serotype distribution of invasive isolates in Taiwan. The most frequently isolated serotypes of S. pneumoniae were types 14 (18.4%); 23F (15.1%); 3 (13.8%); 19F (13.4%); 6B (8.2%); 9V (3.6%) and 4 (2.5%). The majority of cases were either under 5 years of age (24.1%) or older than 65 years (36.6%). Serotype distribution in adults aged over 14 y | 16849732 | [
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Surveillance of invasive Streptococcus pneumoniae in Taiwan, 2002-2003. | ears and children aged under 2 years was similar; except for that of type 3; which was more prevalent in adults. Penicillin-non-susceptible strains accounted for 67.7% of all strains and were the predominant strains of serotypes 23F; 19F; 6B and 14. Most strains were susceptible to cephem drug; 85.7% of isolates were susceptible to cefotaxime and 92.9% were susceptible to ceftriaxone. A total of 72.6% (379/522) of the isolates were resistant to at least two antibiotics. The 23-valent vaccine in the current | 16849732 | [
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Surveillance of invasive Streptococcus pneumoniae in Taiwan, 2002-2003. | commercial market would cover 87.2% of the serotypes and 100% of the penicillin-non-susceptible serotypes of S. pneumoniae in Taiwan. The coverage of 7- and 11-valent protein conjugate vaccines of the serotypes in children under 2 years of age would be 78.8 and 86.5%; respectively. These results will help to assess the adequacy of the vaccine formulations marketed in Taiwan. | 16849732 | [
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Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain. | Group A streptococcus (GAS) has been described as an emerging cause of severe invasive infections. A retrospective hospital-based study was conducted; including GAS isolates causing invasive or non-invasive infections from January 1999 to June 2003 in Barcelona. Demographic and clinical information on the invasive cases was obtained from medical files. GAS isolates collected from 27 patients with invasive infections and 99 patients with non-invasive infections were characterized by emm type and subtype; sup | 16849733 | [
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Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain. | erantigen (SAg) gene profile (speA-C; speF-J; speL; speM; ssa and smeZ); allelic variants of speA and smeZ genes; antibiotic susceptibility and genetic resistance determinants. The most prevalent emm type was emm1 (17.5%); followed by emm3 (8.7%); emm4 (8.7%); emm12 (7.1%) and emm28 (7.1%). The smeZ allele and SAg gene profiles were closely associated with the emm type. The speA2; speA3 and speA4 alleles were found in emm1; emm3 and emm6 isolates; respectively. Overall; 27.8; 25.4 and 11.9% of isolates were | 16849733 | [
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Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain. | resistant to erythromycin; tetracycline or both agents; respectively. Reduced susceptibility to ciprofloxacin and levofloxacin (MIC 2-4 microg ml(-1)) was found in 3.2% of isolates. mef(A)-positive emm types 4; 12 and 75; and erm(B)-positive emm types 11 and 25 were responsible for up to 80% of the erythromycin-resistant isolates. No significant differences in emm-type distribution; SAg gene profile or resistance rates were found between invasive and non-invasive isolates. The SAg and antibiotic resistance | 16849733 | [
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Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain. | genes appeared to be associated with the emm type and were independent of the disease type. | 16849733 | [
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Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia. | Multidrug-resistant Escherichia coli (MDREC) expressing AmpC beta-lactamases have emerged as a cause of opportunistic infections in dogs. Following a cluster of extraintestinal infections caused by two distinct clonal groups (CGs) of bla(CMY)-producing MDREC; a 12-month infection control study was undertaken at a veterinary teaching hospital in Brisbane; Australia. Swabs from the rectum of hospitalized dogs (n=780); hospital staff (n=16) and the hospital environment (n=220) were plated onto selective agar t | 16849734 | [
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Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia. | o obtain multidrug-resistant (MDR) coliforms. These were then tested by multiplex PCR for E. coli uspA; bla(CMY) and the class 1 integron-associated dfrA17-aadA5 gene cassette for rapid identification of MDREC CG 1 (positive for all three genes) and CG 2 (positive for uspA and bla(CMY) only). A total of 16.5 % of the dog rectal swabs and 4.1% of the hospital environmental swabs yielded MDREC; and on the basis of multiplex PCR; PFGE and plasmid profiling; these were confirmed to belong to either CG 1 or CG 2 | 16849734 | [
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Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia. | . Both CG 1 and CG 2 isolates were obtained from clinical cases of extraintestinal infection and rectal swabs from hospitalized dogs over the same period of time; whereas only CG 1 isolates were obtained from the hospital environment. Both CGs were prevalent during the first 6 months; but only CG 2 was isolated during the second 6 months of the study. Two isolates obtained from rectal swabs of staff working in the hospital belonged to CG 2; with one of the isolates possessing the same REDP as nine isolates | 16849734 | [
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Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia. | from dogs; including six isolates associated with cases of extraintestinal infection. CG 1 isolates belonged to E. coli serotypes O162 : H-; OR : H- or Ont : H-; whereas CG 2 isolates belonged to O153 : HR; OR : HR or OR : H34. These results confirm that in this particular outbreak; canine MDREC were highly clonal and CG 2 MDREC may colonize both humans and dogs. | 16849734 | [
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Isolation and characterization of Streptococcus mutans in heart valve and dental plaque specimens from a patient with infective endocarditis. | Streptococcus mutans; known to be an aetiologic agent of dental caries; also causes infective endocarditis (IE); although a comparison of isolates from the oral cavity and infected heart valve of the same patient has not been reported. In the present study; infected heart valve and dental plaque samples from a patient with IE were analysed. Broad-range PCR with DNA sequencing revealed that 50 clones from the dental plaque isolates were composed of oral streptococci and periodontopathic bacteria; whereas onl | 16849735 | [
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Isolation and characterization of Streptococcus mutans in heart valve and dental plaque specimens from a patient with infective endocarditis. | y Streptococcus mutans was detected in 50 clones from the heart valve. Eighteen strains of Streptococcus mutans were isolated from dental plaque and seven from the heart valve; and the biochemical properties of each were in accordance with those of Streptococcus mutans. DNA fingerprinting analysis revealed that all the oral isolates of Streptococcus mutans had similar patterns; which were different from those of the isolates from the infected heart valve. Western blotting using glucosyltransferase (GTF)-spe | 16849735 | [
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Isolation and characterization of Streptococcus mutans in heart valve and dental plaque specimens from a patient with infective endocarditis. | cific antiserum showed that the seven strains from the heart valve lacked the three types of intact GTF. In addition; the sucrose-dependent adhesion rates of these isolates were significantly lower than those of the oral isolates (P<0.001). Furthermore; the isolates from the heart valve were less susceptible to erythromycin and kanamycin. These results indicate that the properties of the Streptococcus mutans strains isolated from the infected valve were different from those of typical oral strains; which ma | 16849735 | [
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Isolation and characterization of Streptococcus mutans in heart valve and dental plaque specimens from a patient with infective endocarditis. | y be related to the effects of IE. | 16849735 | [
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The bacteriology of biopsies differs between newly diagnosed, untreated, Crohn's disease and ulcerative colitis patients. | The bacterial community (microbiota) that inhabits the gut of humans appears to be an important source of antigens that drive the chronic immunological processes characteristic of Crohn's disease (CD) and ulcerative colitis (UC). Most of the members of the microbiota have not yet been cultured; but nucleic-acid-based methods of detection and enumeration can provide information about the community. This investigation used these methods to obtain information about the bacteria associated with mucosal surfaces | 16849736 | [
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The bacteriology of biopsies differs between newly diagnosed, untreated, Crohn's disease and ulcerative colitis patients. | in the gut of 20 CD and 15 UC patients. Biopsies were collected from inflamed and non-inflamed sites in the intestines of newly diagnosed; untreated patients. Biopsies were also collected from several intestinal sites of 14 healthy subjects. The bacterial collections associated with the biopsies were analysed by generating PCR/denaturing gradient gel electrophoresis (DGGE) profiles; the preparation of 16S rRNA gene clone libraries; and qualitative PCR to detect specific groups of bacteria. The total number | 16849736 | [
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The bacteriology of biopsies differs between newly diagnosed, untreated, Crohn's disease and ulcerative colitis patients. | s of bacteria associated with the biopsies were determined by real-time quantitative PCR. DGGE profiles generated from the terminal ileum and various colonic regions were characteristic of each individual but differed between subjects. DGGE profiles and 16S rRNA gene libraries showed that the bacteria associated with inflamed and non-inflamed tissues did not differ. UC patients had more bacteria associated with biopsies than did CD patients (P<0.01). Statistical analysis of the composition of 16S rRNA gene | 16849736 | [
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The bacteriology of biopsies differs between newly diagnosed, untreated, Crohn's disease and ulcerative colitis patients. | libraries showed that the bacterial collections in UC and CD patients differed (P<0.05). Unclassified members of the phylum Bacteroidetes were more prevalent in CD than in UC patients. Therefore; the types and numbers of bacteria associated with biopsy samples were distinctly different for UC and CD patients. The observations made in this study should permit targeting of specific bacteriological abnormalities in investigations of the pathogenesis of inflammatory bowel diseases and provide targets for medica | 16849736 | [
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Bacteraemic pneumonia caused by Neisseria lactamica with reduced susceptibility to penicillin and ciprofloxacin in an adult with liver cirrhosis. | This report presents a case of bacteraemic pneumonia caused by Neisseria lactamica in an adult patient with liver cirrhosis who was successfully treated with ceftriaxone. The isolate was confirmed as N. lactamica by analysis of a partial sequence of the 16S rRNA gene; it had reduced susceptibilities to penicillin (MIC 0.75 microg ml(-1)) and ciprofloxacin (MIC > or =0.5 mg l(-1)). | 16849737 | [
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Central line-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myeloid leukaemia in Piraeus, Greece. | A case of central venous catheter-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myelogenous leukaemia is reported. The patient was successfully treated with amikacin and piperacillin-tazobactam. The clinical isolate was identified as R. mucosa by 16S rRNA gene sequencing. | 16849738 | [
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Direct detection of heteroresistance in Mycobacterium tuberculosis using molecular techniques. | nan | 16849739 | [
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Myths and facts on adjuvant carboplatin for stage I seminoma. | nan | 16849740 | [
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Treatment complications in neuroblastoma patients: lessons from screening studies. | nan | 16849741 | [
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Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. | Mediastinal restaging after induction therapy for non-small-cell lung cancer remains a difficult and controversial issue. The goal of this prospective study was to compare the performance of integrated positron emission tomography (PET)--computed tomography (CT) and remediastinoscopy in the evaluation of mediastinal lymph node metastasis after induction chemotherapy.Thirty consecutive stage IIIA-N2 non-small-cell lung cancer patients surgically treated at our institution were entered onto this prospective s | 16849747 | [
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Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. | tudy. N2 disease was proven by cervical mediastinoscopy; at which a mean number of 3.8 lymph node levels were biopsied. After completion of induction chemotherapy; the mediastinum was reassessed by integrated PET-CT and remediastinoscopy. All patients underwent thoracotomy with attempted complete resection and systematic nodal dissection.PET-CT showed no evidence of nodal disease (N0) in 13 patients; Hilar nodal disease (N1) disease in three patients; and residual mediastinal disease (N2) in 14 patients. Re | 16849747 | [
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Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. | mediastinoscopy was positive in only five patients. The preinduction involved lymph node level could be accurately re-evaluated in 18 patients. This was not the case in the other 12 because of extensive fibrosis and adhesions. In 17 patients; persistent N2 disease was found at thoracotomy. The sensitivity; specificity; and accuracy of PET-CT were 77%; 92%; and 83%; respectively. These parameters for remediastinoscopy were 29%; 100%; and 60%; respectively. Sensitivity (P < .0001) and accuracy (P = .012) were | 16849747 | [
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Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. | significantly better for PET-CT.After a thorough staging mediastinoscopy; postinduction remediastinoscopy had a disappointing sensitivity because of adhesions and fibrosis. Integrated PET-CT yielded a better result than that obtained in previous studies with side-by-side PET and CT images. | 16849747 | [
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Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial. | Previously; we reported results of Intergroup N9741; which compared standard bolus fluorouracil (FU); leucovorin; plus irinotecan (IFL) with infused FU; leucovorin; plus oxaliplatin (FOLFOX4) and irinotecan plus oxaliplatin in patients with untreated metastatic colorectal cancer. High rates of grade > or = 3 toxicity on IFL (resulting in some deaths) led us to reduce the starting doses of both irinotecan and FU by 20% (rIFL). This article compares rIFL with FOLFOX4.The primary comparison was time to progres | 16849748 | [
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Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial. | sion; with secondary end points of response rate (RR); overall survival; and toxicity.Three hundred five patients were randomly assigned. The North Central Cancer Treatment Group Data Safety Monitoring Committee interrupted enrollment at a planned interim analysis when outcomes crossed predetermined stopping boundaries. The results were significantly superior for FOLFOX4 compared with rIFL for time to progression (9.7 v 5.5 months; respectively; P < .0001); RR (48% v 32%; respectively; P = .006); and overal | 16849748 | [
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Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial. | l survival (19.0 v 16.3 months; respectively; P = .026). Toxicity profiles were not significantly different between regimens for nausea; vomiting; diarrhea; febrile neutropenia; dehydration; or 60-day all-cause mortality. Sensory neuropathy and neutropenia were significantly more common with FOLFOX4. Approximately 75% of patients in both arms received second-line therapy; 58% of rIFL patients received oxaliplatin-based second-line therapy; and 55% of FOLFOX4 patients received irinotecan-based regimens as se | 16849748 | [
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Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial. | cond-line therapy.FOLFOX4 led to superior RR; time to progression; and overall survival compared with rIFL. The survival benefit for FOLFOX4 observed in the earlier stage of the study was preserved with equal use of either irinotecan or oxaliplatin as second-line therapy. | 16849748 | [
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Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. | To provide bevacizumab (BV) -based therapy to patients with advanced colorectal cancers (CRC) who had exhausted standard chemotherapy options; and to evaluate the response to BV combined with fluorouracil (FU) and leucovorin (LV) in this patient population.This was a multicenter; single-arm treatment trial conducted under the National Cancer Institute Treatment Referral Center network nationwide. Patients were treated with BV 5 mg/kg every 2 weeks combined with FU/LV; FU was administered by bolus or continu | 16849749 | [
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Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. | ous infusion. Eligibility criteria included advanced CRC that had progressed after irinotecan- and oxaliplatin-based chemotherapy; Eastern Cooperative Oncology Group performance status 0 to 2; and absence of thromboembolism. The primary end point was objective response rate (RR) in the first 100 assessable patients. All patients received follow-up for toxicity and survival.Due to rapid accrual; a total of 350 patients were enrolled at 32 participating sites nationwide by October 2003. In the initially plann | 16849749 | [
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Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. | ed cohort of 100 assessable patients; the objective RR was 4% (95% CI; 1.1% to 9.9%) by investigators' assessment and 1% (95% CI; 0% to 5.5%) based on independent review; median progression-free survival was 3.5 months and median overall survival was 9.0 months. The safety profile was similar to prior BV trials in CRC. Grade 3 to 4 hemorrhage occurred in 5% of patients; including 3.8% with bleeding in the GI tract. Other adverse events such as hypertension; thrombosis; and bowel perforation were also observ | 16849749 | [
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Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. | ed at rates consistent with other studies.For patients with advanced CRC that had progressed after both irinotecan-based and oxaliplatin-based chemotherapy regimens; the combination of BV and FU/LV was associated with rare objective responses. | 16849749 | [
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Conservation surgery for breast cancer as the preferred choice: a prospective analysis. | To describe the proportion of women who anticipate having breast-conserving surgery (BCS) versus modified radical mastectomy (MRM); the factors they considered when making treatment choices; the degree to which they perceived they had participated in and had control of the treatment decision; and to explore factors associated with type of planned surgery.Prospective cohort study conducted among patients attending a tertiary care hospital in Alberta; Canada from 1992 to 1995. Participants had a first diagnos | 16849750 | [
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Conservation surgery for breast cancer as the preferred choice: a prospective analysis. | is of localized unilateral breast cancer; and were; in the opinions of their surgeons; candidates for either BCS or MRM.Of 157 participants; 71.3% anticipated having BCS and 28.7% anticipated MRM. Referents perceived to play an important role in decision making included self; doctor; and significant other. The two top-ranked items perceived to have influenced treatment choice were doctor's advice and possibility of complete cure. Most women (60%) participated in treatment choice to the degree that they pref | 16849750 | [
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Conservation surgery for breast cancer as the preferred choice: a prospective analysis. | erred; but only 13.6% received their preferred amount of information. The type of planned surgery was predicted by surgeon; contribution of doctor to choice of treatment; importance of breasts to sexuality; self-efficacy; and concerns about cancer recurrence from a multivariable logistic regression model.Both patient and surgeon factors are important predictors of type of planned surgery. There is a gap between women's preferences and actual experiences with regard to information provided and patient partic | 16849750 | [
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Conservation surgery for breast cancer as the preferred choice: a prospective analysis. | ipation in treatment choices; with women's desire for more information about their treatment being most prevalent. | 16849750 | [
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Multicentric breast cancer: a new indication for sentinel node biopsy--a multi-institutional validation study. | Multicentric breast cancer has been considered to be a contraindication for sentinel node (SN) biopsy (SNB). In this prospective multi-institutional trial; SNB-feasibility and accuracy was evaluated in 142 patients with multicentric cancer from the Austrian Sentinel Node Study Group (ASNSG) and compared with data from 3;216 patients with unicentric cancer.Between 1996 and 2004; 3;730 patients underwent SNB at 15 ASNSG-affiliated hospitals. Patient data were entered in a multicenter database. One hundred for | 16849751 | [
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Multicentric breast cancer: a new indication for sentinel node biopsy--a multi-institutional validation study. | ty-two patients presented with multicentric invasive breast cancer and underwent SNB.Intraoperatively; a mean number of 1.67 SNs were excised (identification-rate; 91.5%). The incidence of SN metastases was 60.8% (79 of 130). This was confirmed by axillary lymph node dissection (ALND) in 125 patients. Of patients with positive SNs; 60.8% (48 of 79) showed involvement of nonsentinel nodes (NSNs); as did three patients with negative SNs (false-negative rate; 4.0). Sensitivity; negative predictive value; and o | 16849751 | [
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Multicentric breast cancer: a new indication for sentinel node biopsy--a multi-institutional validation study. | verall accuracy were 96.0%; 93.3%; and 97.3%; respectively. Ninety-one percent of the patients underwent mastectomy; and 9% were treated with breast conserving surgery. None of the patients have shown axillary recurrence so far (mean follow-up; 28.8 months). Compared with 3;216 patients with unicentric cancer; there was a significantly higher rate of SN metastases as well as in NSNs; whereas there was no difference in detection and false-negative rates.Multicentric breast cancer is a new indication for SNB | 16849751 | [
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Multicentric breast cancer: a new indication for sentinel node biopsy--a multi-institutional validation study. | without routine ALND in controlled trials. Given adequate quality control and an interdisciplinary teamwork of surgical; nuclear medicine; and pathology units; SNB is both feasible and accurate in this disease entity. | 16849751 | [
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Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. | To evaluate potential prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression (MSCC).The following potential prognostic factors were investigated retrospectively in 1;852 patients irradiated for MSCC: age; sex; performance status; primary tumor; interval between tumor diagnosis and MSCC (< or = 15 v > 15 months); number of involved vertebrae (one to two v > or = three); other bone metastases; visceral metastases; pretreatment ambulatory status; time of deve | 16849752 | [
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Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. | loping motor deficits before radiotherapy (faster; 1 to 14 v slower; > 14 days); and radiation schedule (short-course v long-course radiotherapy).On univariate analysis; improved local control of MSCC was associated significantly with favorable histology (breast cancer; prostate cancer; lymphoma/myeloma); no visceral metastases; and long-course radiotherapy. On multivariate analysis; absence of visceral metastases and radiation schedule maintained significance. On univariate analysis; improved survival was | 16849752 | [
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Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. | associated significantly with female sex; favorable histology; no visceral or other bone metastases; good performance status; being ambulatory before radiotherapy; longer interval between tumor diagnosis and MSCC; and slower development of motor deficits before radiotherapy. Long-course radiotherapy showed a trend. On multivariate analysis; histology; visceral metastases; other bone metastases; ambulatory status before radiotherapy; interval between tumor diagnosis and MSCC; and time of developing motor def | 16849752 | [
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Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. | icits maintained significance.Poorer local control after radiotherapy for MSCC is associated with visceral metastases and short-course radiotherapy. Long-course radiotherapy seems preferable for patients with more favorable prognoses; given that these patients may live long enough to develop MSCC recurrences. Long-term survival after radiotherapy for MSCC may be predicted if several prognostic factors are considered. | 16849752 | [
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Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. | To compare the effects of cannabis extract (CE); delta-9-tetrahydrocannabinol (THC); and placebo (PL) on appetite and quality of life (QOL) in patients with cancer-related anorexia-cachexia syndrome (CACS).Adult patients with advanced cancer; CACS; weight loss (> or = 5% over 6 months); and Eastern Cooperative Oncology Group (ECOG) performance status (PS) < or = 2 were randomly assigned (2:2:1) to receive CE (standardized for 2.5 mg THC and 1 mg cannabidiol) or THC (2.5 mg) or PL orally; twice daily for 6 w | 16849753 | [
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Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. | eeks. Appetite; mood; and nausea were monitored daily with a visual analog scale (VAS); QOL was assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (composite score: questions 29 and 30). Cannabinoid-related toxicity was assessed every 2 weeks.Of 289 patients screened; 243 were randomly assigned and 164 (CE; 66 of 95 patients; THC; 65 of 100 patients; and PL; 33 of 48 patients) completed treatment. At baseline; groups were comparable for age (mean; | 16849753 | [
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Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. | 61 years); sex (54% men); weight loss (32% > or = 10%); PS (13% ECOG = 2); antineoplastic treatment (50%); appetite (mean VAS score; 31/100 mm); and QOL (mean score; 30/100). Intent-to-treat analysis showed no significant differences between the three arms for appetite; QOL; or cannabinoid-related toxicity. Increased appetite was reported by 73%; 58%; and 69% of patients receiving CE; THC; or PL; respectively. An independent data review board recommended termination of recruitment because of insufficient di | 16849753 | [
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Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. | fferences between study arms.CE at the oral dose administered was well tolerated by these patients with CACS. No differences in patients' appetite or QOL were found either between CE; THC; and PL or between CE and THC at the dosages investigated. | 16849753 | [
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Double-blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia. | Eicosapentaenoic acid (EPA) has been proposed to have specific anticachectic effects. This trial compared EPA diethyl ester with placebo in cachectic cancer patients for effects on weight and lean body mass.Five hundred eighteen weight-losing patients with advanced gastrointestinal or lung cancer were studied in a multicenter; double-blind; placebo controlled trial. Patients were randomly assigned to receive a novel preparation of pure EPA at a dose of 2 g or 4 g daily or placebo (2g EPA; n = 175; 4 g EPA; | 16849754 | [
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Double-blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia. | n = 172; placebo; n = 171). Patients were assessed at 4 weeks and 8 weeks.The groups were well balanced at baseline. Mean weight loss at baseline was 18% (n = 518). Over the 8-week treatment period; both intention-to-treat analysis and per protocol analysis revealed no statistically significant improvements in survival; weight; or other nutritional variables. There was; however; a trend in favor of EPA with analysis of the primary end point; weight; at 8 weeks showing a borderline; nonsignificant treatment | 16849754 | [
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Double-blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia. | effect (P = .066). Relative to placebo; mean weight increased by 1.2 kg with 2 g EPA (95% CI; 0 kg to 2.3 kg) and by 0.3 kg with 4 g EPA (-0.9 kg to 1.5 kg).The results indicate no statistically significant benefit from single agent EPA in the treatment of cancer cachexia. Future studies should concentrate on other agents or combination regimens. | 16849754 | [
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Differential impact of combination antiretroviral therapy in preventing Kaposi's sarcoma with and without visceral involvement. | To study the impact of different potent combined antiretroviral treatment (cART) on the incidence of HIV-associated Kaposi's sarcoma (KS) with and without visceral involvement.Patients were selected from the French Hospital Database on HIV; a large hospital cohort. The risk of KS was estimated by using Cox proportional hazards models adjusting for age; the CD4 cell nadir; the HIV exposure category; prior AIDS; cART; and the type of cART regimen. cART regimens were distinguished according to whether they con | 16849755 | [
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Differential impact of combination antiretroviral therapy in preventing Kaposi's sarcoma with and without visceral involvement. | tained protease inhibitor (PI); non-nucleoside analog (NNRTI); both; or only nucleoside analog (NRTI). Separate analyzes were conducted according to the initial visceral involvement of KS.Among the 54;999 patients included in this study (182;756 person-years of follow-up); 1;634 patients were diagnosed with KS during follow-up; of whom 421 had visceral involvement at diagnosis. The KS incidence rate fell from 32 per 1;000 person-years in 1993 to 1994 to 3 per 1;000 person-years after 1999. PI-containing and | 16849755 | [
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] |
Differential impact of combination antiretroviral therapy in preventing Kaposi's sarcoma with and without visceral involvement. | NNRTI-containing cART regimens were associated with similar reductions in the risk of KS (hazard ratio; 0.68; 95%CI; 0.61 to 0.75; HR; 0.62; 95% CI; 0.54 to 0.71; respectively). The risk of visceral KS fell more strongly than the risk of cutaneous KS (> 50% and < 30%; respectively).The incidence of KS; and especially visceral KS; has fallen sharply since the advent of cART. This effect is likely due to immune restoration rather than to a specific effect on the tumoral process; as PI-containing and NNRTI-co | 16849755 | [
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Differential impact of combination antiretroviral therapy in preventing Kaposi's sarcoma with and without visceral involvement. | ntaining regimens had similar preventive efficacy. | 16849755 | [
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Pooled analysis of phase II window studies in children with contemporary high-risk metastatic rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. | The Soft Tissue Sarcoma Committee of the Children's Oncology Group has conducted five upfront window trials in patients with newly diagnosed metastatic rhabdomyosarcoma to identify promising new treatment agents.This pooled analysis identified a total of 420 patients (115 from Intergroup Rhabdomyosarcoma Study III [IRS-III] and 305 from the five window trials). We assessed window therapy response rate; failure-free survival (FFS); and overall survival (OS).Response rates (complete + partial response) assess | 16849756 | [
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Pooled analysis of phase II window studies in children with contemporary high-risk metastatic rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. | ed at week 6 of window therapy ranged from 41% to 55% and did not predict FFS (P = .073) or OS (P = .31). FFS was influenced by trial (P = .048); patients enrolled onto IRS-III and the ifosfamide/etoposide and ifosfamide/doxorubicin trials fared best. When grouped and compared with topoisomerase I poison trials; ifosfamide/topoisomerase II inhibitor trials had superior FFS (P = .013). However; there was no difference in survival.Upfront phase II window trials can efficiently provide robust estimates of acti | 16849756 | [
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Pooled analysis of phase II window studies in children with contemporary high-risk metastatic rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. | vity for new agents and combinations in newly diagnosed patients with high-risk rhabdomyosarcoma. Our data indicate that; for some phase II window trials; the risk of treatment failure may be increased but that the trend towards lower survival for some of the window trials compared with IRS-III is not statistically significant. Window nonresponders did not suffer worse FFS or OS than patients who responded to window therapy. Finally; these results provide a rationale for incorporating ifosfamide; etoposide; | 16849756 | [
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Pooled analysis of phase II window studies in children with contemporary high-risk metastatic rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. | doxorubicin; and topoisomerase I poisons in future trials of high-risk metastatic rhabdomyosarcoma. | 16849756 | [
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Phase I trial of oral fenretinide in children with high-risk solid tumors: a report from the Children's Oncology Group (CCG 09709). | To determine the maximal tolerated dosage (MTD) of oral fenretinide given as intact capsules for 7 days; repeated every 21 days; in children with high-risk solid tumors.Children 21 years of age or younger received daily doses from 350 mg/m2 to 3;300 mg/m2 (divided into two or three doses); with pharmacokinetics during course one. The MTD was defined as zero to one of six patients with dose-limiting toxicity (DLT); with at least two of three or two of six DLT at next higher dose.Fifty-four patients; age 2 ye | 16849757 | [
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Phase I trial of oral fenretinide in children with high-risk solid tumors: a report from the Children's Oncology Group (CCG 09709). | ars to 20 years (median; 9 years); were treated: neuroblastoma (n = 39); Ewing sarcoma (n = 5); and other (n = 10). Prior therapy included autologous stem cell transplantation (n = 42); 13-cis-RA (n = 35); and 9-cis-RA (n = 1). One of four patients at 1;050 mg/m2 with prior liver transplant had grade 3 ALT/abdominal pain/nausea/dehydration and grade 4 AST/emesis. At 1;860 mg/m2; one of seven patients had grade 3 hypoalbuminemia/hypophosphatemia. At 2;475 mg/m2; one of eight patients had grade 3 alkaline pho | 16849757 | [
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Phase I trial of oral fenretinide in children with high-risk solid tumors: a report from the Children's Oncology Group (CCG 09709). | sphatase; three of five patients had DLT at 3;300 mg/m2: grade 3 AST/ALT (n = 1); grade 4 bilirubin/grade 3 AST/ALT (n = 1); pseudotumor cerebri (n = 1). Pseudotumor cerebri also occurred at 600 mg/m2 and 800 mg/m2. There was one complete response and 13 patients with stable disease (SD) for 8 or more courses in 30 assessable neuroblastoma patients. SD for 8 or more courses was seen in one of five Ewing sarcoma patients and one melanoma patient. Mean N-4-hydroxyphenyl retinamide plasma level (day 7; steady- | 16849757 | [
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Phase I trial of oral fenretinide in children with high-risk solid tumors: a report from the Children's Oncology Group (CCG 09709). | state concentration) was 9.9 mumol/L at MTD.The pediatric MTD of oral capsular fenretinide was 2;475 mg/m2 per day; which achieved levels active against neuroblastoma in vitro with minimal toxicity. Response data support a phase II trial in neuroblastoma. | 16849757 | [
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O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: results from the CCG-945 Cohort. | O6-methylguanine-DNA methyltransferase (MGMT) functions to counteract the cytotoxic effects of alkylating agents; such as nitrosoureas; which play a central role in the treatment of childhood malignant gliomas. Epigenetic silencing of MGMT has been associated with prolonged survival in adults with malignant gliomas; although the association between MGMT expression status and outcome in pediatric malignant gliomas has not been defined.We examined the association between MGMT expression and survival duration | 16849758 | [
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O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: results from the CCG-945 Cohort. | using tumor samples from the Children's Cancer Group 945 study; the largest randomized trial for childhood malignant gliomas completed to date. All patients received alkylator-based chemotherapy as a component of adjuvant therapy. Archival histopathologic material yielded tissue of sufficient quality for immunohistochemical assessment of MGMT expression status in 109 specimens.Twelve of the 109 samples demonstrated overexpression of MGMT compared with normal brain. Five-year progression-free survival was 42 | 16849758 | [
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O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: results from the CCG-945 Cohort. | .1% +/- 5% in the 97 patients whose tumors had low levels of MGMT expression versus 8.3% +/- 8% in the 12 patients whose tumors overexpressed MGMT (P = .017; exact log-rank test). The association between MGMT overexpression and adverse outcome remained significant after stratifying for institutional histologic diagnosis (eg; anaplastic astrocytoma or glioblastoma multiforme); as well as age; amount of residual tumor; and tumor location.Overexpression of MGMT in childhood malignant gliomas is strongly associ | 16849758 | [
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O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: results from the CCG-945 Cohort. | ated with an adverse outcome in children treated with alkylator-based chemotherapy; independently of a variety of clinical prognostic factors. | 16849758 | [
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High survival and organ function rates after primary chemoradiotherapy for intermediate-stage squamous cell carcinoma of the head and neck treated in a multicenter phase II trial. | Patients with intermediate-stage squamous cell carcinoma of the head and neck traditionally have been treated with initial surgical resection followed by radiotherapy (RT) alone or chemoradiotherapy. A previous study in this patient population reported a 91% locoregional control rate and 65% overall survival (OS) rate at 5 years; with chemoradiotherapy used as primary treatment. This study was undertaken to assess whether shortening treatment duration with hyperfractionated RT would be feasible and improve | 16849759 | [
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High survival and organ function rates after primary chemoradiotherapy for intermediate-stage squamous cell carcinoma of the head and neck treated in a multicenter phase II trial. | locoregional control; organ preservation; and progression-free survival.Eligible patients with stage II or III disease received fluorouracil; hydroxyurea; and RT given twice daily on a week-on/week-off schedule. Quality-of-life scores were measured using three validated indexes.All 53 patients enrolled are included in the analysis; with a median follow-up of 42 months (range; 5 to 98 months). Grade 3 or 4 in-field mucositis was observed in 77% and 9%; respectively. No patients required surgical salvage at t | 16849759 | [
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High survival and organ function rates after primary chemoradiotherapy for intermediate-stage squamous cell carcinoma of the head and neck treated in a multicenter phase II trial. | he primary tumor site (pathological complete response rate; 100%). The 3-year progression-free and OS rates are 67% and 78%; respectively. The 3-year disease-specific mortality rate is 7%. At the time of analysis; 87% of surviving patients do not require enteral feeding support. Quality-of-life and performance assessment indicated that; although acute treatment toxicities were severe; most patients returned to pretreatment function by 12 months.Concurrent chemoradiotherapy with hyperfractionated RT is feasi | 16849759 | [
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High survival and organ function rates after primary chemoradiotherapy for intermediate-stage squamous cell carcinoma of the head and neck treated in a multicenter phase II trial. | ble in this patient population and yields high local control and cure rates. Compared with our historical control using once-daily fractionation; hyperfractionation is accompanied by increased acute in-field toxicity. | 16849759 | [
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Aggressiveness of familial prostate cancer. | To report on the aggressiveness of sporadic versus familial prostate cancer.The study sample consisted of 4;112 stage T1-3 prostate cancer patients. The outcome of interest was biochemical relapse-free survival (bRFS). The analysis was performed for two distinct time periods; 1986 to 1992 (year < or = 1992) and 1993 to 2002 (year > or = 1993); to encompass both the early and late prostate-specific antigen (PSA) eras.A positive family history (FH positive) was reported in 16%. The 10-year bRFS rates for pati | 16849760 | [
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Aggressiveness of familial prostate cancer. | ents with negative family history (FH negative) versus FH positive were 59% and 63%; respectively (P = .90). However; in the year < or = 1992 period; the 10-year bRFS rates for FH negative versus FH positive were 45% and 34%; respectively (P = .015). In the year > or = 1993 period; the 10-year bRFS rates for FH negative versus FH positive were 61% and 67%; respectively (P = .54). Multivariate analysis failed to reveal family history as an independent predictor of relapse (P = .42). However; in the subset of | 16849760 | [
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Aggressiveness of familial prostate cancer. | patients in each era; family history was an independent predictor of relapse only for those treated in the year < or = 1992 period (P = .038).Family history was an independent predictor of biochemical failure only early in the PSA era; and men with an FH positive presented with more favorable disease later in the PSA era. This suggests that with stage migration and improved therapy; the impact of family history on prognosis has become minimal. However; underlying genetic factors affecting prostate cancer b | 16849760 | [
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Aggressiveness of familial prostate cancer. | ehavior in individuals with familial prostate cancer may still be important in determining individual prognosis. | 16849760 | [
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Phase II study of pemetrexed for second-line treatment of transitional cell cancer of the urothelium. | To assess the antitumor activity and toxicity of pemetrexed as second-line chemotherapy in patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium.Eligible patients had a performance status of 0 or 1; adequate organ function; previous treatment with one prior chemotherapy regimen for locally advanced or metastatic TCC of the urothelium or relapsed within 1 year of adjuvant or neoadjuvant treatment. Patients received pemetrexed 500 mg/m2 intravenously on day 1 every 2 | 16849761 | [
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Phase II study of pemetrexed for second-line treatment of transitional cell cancer of the urothelium. | 1 days; with vitamin B12; folic acid; and dexamethasone prophylaxis.Forty-seven patients were enrolled and included in the intent-to-treat efficacy analysis. Responses: 3 (6.4%) complete responses and 10 (21.3%) partial responses produced an overall response rate of 27.7%. Ten patients (21.3%) had stable disease and 22 patients (46.8%) progressed. The median time to progressive disease was 2.9 months (95% CI; 1.7 months to 4.6 months) and median overall survival was 9.6 months (95% CI; 5.1 months to 14.6 mo | 16849761 | [
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Phase II study of pemetrexed for second-line treatment of transitional cell cancer of the urothelium. | nths). Median duration of response was 5.0 months (95% CI; 3.9 months to 13.8 months). Of the 47 patients assessable for safety; grade 3 or 4 hematologic events were thrombocytopenia (8.5%; 0.0%); neutropenia (4.3%; 4.3%) and anemia (2.1%; 2.1%); respectively. Nonlaboratory toxicities included grade 4 stomatitis/pharyngitis; sepsis syndrome (one patient each); and grade 3 fatigue (three patients) and diarrhea (two patients).Single-agent pemetrexed is safe and active as second-line treatment of patients with | 16849761 | [
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Phase II study of pemetrexed for second-line treatment of transitional cell cancer of the urothelium. | advanced TCC of the urothelium. Additional evaluation in the first- or second-line setting in TCC of the urothelium is warranted. | 16849761 | [
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5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). | To evaluate the effectiveness of prophylactic dexamethasone for the control of radiation induced emesis (RIE) when added to ondansetron during days 1 to 5 of fractionated radiotherapy. The study had two hypotheses: ondansetron and dexamethasone could provide superior control of RIE over ondansetron alone during the prophylactic period and; the combination could provide sustained control of RIE during subsequent fractions of radiotherapy.Between May 2001 to Jan 2004; 211 patients receiving radiotherapy (> or | 16849762 | [
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5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). | = 15 fractions) to the upper abdomen were randomly assigned to receive ondansetron 8 mg bid with either dexamethasone 4 mg daily or placebo during fractions 1 to 5. Rescue antiemetics were provided.During the prophylactic period there was a trend for improved complete control of nausea in the dexamethasone arm (50% v 38%; P = .06) while complete and partial control of emesis; average nausea score; and use of rescue medications were similar in the two groups. During the overall study period patients receivi | 16849762 | [
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5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). | ng dexamethasone had better complete control of emesis (23% v 12%; P = .02) and a lower average nausea score (0.28 v 0.39; P = .03); there was a trend towards less use of rescue medications with dexamethasone (70% v 80%; P = .09); other outcomes were similar on the two arms. Quality of life analysis showed a significant difference in appetite.The addition of dexamethasone to ondansetron as prophylaxis provides a modest improvement in protection against RIE during moderately emetogenic fractionated radiother | 16849762 | [
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5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). | apy. It is a potentially useful addition to 5-hydroxytryptamine-3 receptor antagonists in this setting. | 16849762 | [
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Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. | Declines in physical functioning (PF) among elderly cancer patients threaten quality of life and the ability to maintain independence. Adherence to healthy lifestyle behaviors may prevent functional decline.Project Leading the Way in Exercise and Diet (LEAD); an intervention development study of the Pepper Older Americans Independence Center; aimed to determine whether breast and prostate cancer survivors (age 65+ years) assigned to a 6-month home-based diet and exercise intervention experienced improvement | 16849763 | [
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Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. | s in PF when compared with an attention control arm receiving general health information. An accrual target was set at 420; and PF (Short Form-36 subscale); physical activity (Community Healthy Activities Models Program for Seniors); and diet quality (index from 3-day recalls) were assessed at baseline and at 6 and 12 months (6 months after intervention).This developmental project did not achieve its accrual target (N = 182); however; PF change scores were in the direction and of the magnitude projected. Ba | 16849763 | [
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Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. | seline to 6-month change scores in the intervention versus the control arms were as follows: PF; +3.1 v -0.5 (P = .23); physical activity energy expenditure; +111 kcal/wk v -400 kcal/wk (P = .13); and diet quality index; +2.2 v -2.9 (P = .003); respectively. Differences between arms diminished during the postintervention period.These findings suggest that home-based diet and exercise interventions hold promise in improving lifestyle behaviors among older cancer survivors; changes that trend toward improved | 16849763 | [
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Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. | PF. Future studies should incorporate larger sample sizes and interventions that sustain long-term effects and also take into account secular trends; these efforts will require adequate planning and resources to overcome the numerous barriers to intervening in this difficult to reach yet vulnerable population. | 16849763 | [
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Radiation therapy after mastectomy between 1991 and 1999 in elderly women: response to clinical trial information. | No systematic study has analyzed the changing patterns of use of postmastectomy radiation therapy (PMRT) during the period of information dissemination regarding the benefit of radiation therapy in this setting. We sought to study the receipt of PMRT in elderly women in this period; using a population-based cohort of women with breast cancer.Using data from the linked Surveillance; Epidemiology; and End Results-Medicare database; we analyzed the use of radiation therapy between 1991 and 1999 in 19;699 women | 16849764 | [
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Radiation therapy after mastectomy between 1991 and 1999 in elderly women: response to clinical trial information. | with stage I to III breast cancer who received mastectomy as definitive surgery. Multivariable logistic regression was used to investigate the association of diagnosis year and the use of PMRT; after controlling for clinical and sociodemographic factors.During the entire period studied; 2;160 (11.0%) patients treated with mastectomy received PMRT. The use of PMRT significantly increased in women diagnosed in 1996 (odds ratio [OR]; 1.26; P = .04); 1997 (OR; 1.70; P < .0001); 1998 (OR; 1.57; P < .0001); and | 16849764 | [
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Radiation therapy after mastectomy between 1991 and 1999 in elderly women: response to clinical trial information. | 1999 (OR; 1.77; P < .0001); relative to those diagnosed in 1991 after controlling for cancer; and sociodemographic and treatment characteristics. There were significant differences in the temporal trends of radiation use among different regions of the country (P < .0001); and between teaching versus nonteaching institutions (P = .04).The use of PMRT in elderly women increased significantly during the period of data dissemination about its efficacy; however; the trends in adoption varied among different prac | 16849764 | [
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