RESUMEN
BACKGROUND: Interim PET after two ABVD cycles (iPET2) predicts treatment outcome in classical Hodgkin's lymphoma. To test whether an earlier assessment of chemosensitivity would improve the prediction accuracy, we launched a prospective, multicenter observational study aimed at assessing the predictive value of iPET after one ABVD (iPET1) and the kinetics of response assessed by sequential PET scanning. PATIENTS AND METHODS: Consecutive patients with newly diagnosed classical Hodgkin's lymphoma underwent interim PET scan after one ABVD course (iPET1). PETs were interpreted according to the Deauville score (DS) as negative (-) (DS 1-3) and positive (+) (DS 4, 5). Patients with iPET1 DS 3-5 underwent iPET2. RESULTS: About 106 early (I-IIA) and 204 advanced (IIB-IV) patients were enrolled between January 2008 and October 2014. iPET1 was (-) in 87/106 (82%) or (+) in 19/106 (18%) of early, and (-) in 133/204 (65%) or (+) in 71/204 (35%) of advanced stage patients, respectively. Twenty-four patients were excluded from response analysis due to treatment escalation. After a median follow-up of 38.2 (3.2-90.2) months, 9/102 (9%) early and 43/184 (23%) advanced patients experienced a progression-free survival event. At 36 months, negative and positive predictive value for iPET1 were 94% and 41% (early) and 84% and 43% (advanced), respectively. The kinetics of PET response was assessed in 198 patients with both iPETs. All 116 patients with iPET1(-) remained iPET2(-) (fast responders), 41/82 with IPET1(+) became iPET2(-) (slow responders), and the remaining 41 stayed iPET2(+) (non-responders); progression-free survival at 36 months for fast, slow and non-responders was 0.88, 0.79 and 0.34, respectively. CONCLUSION: The optimal tool to predict ABVD outcome in HL remains iPET2 because it distinguishes responders, whatever their time to response, from non-responders. However, iPET1 identified fast responders with the best outcome and might guide early treatment de-escalation in both early and advanced-stage HL.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedad de Hodgkin/diagnóstico por imagen , Enfermedad de Hodgkin/tratamiento farmacológico , Tomografía de Emisión de Positrones/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Bleomicina/administración & dosificación , Quimioradioterapia , Dacarbazina/administración & dosificación , Doxorrubicina/administración & dosificación , Femenino , Enfermedad de Hodgkin/patología , Enfermedad de Hodgkin/radioterapia , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tomografía Computarizada por Tomografía de Emisión de Positrones , Valor Predictivo de las Pruebas , Vinblastina/administración & dosificación , Adulto JovenRESUMEN
OBJECTIVE: The aim of the study was to analyze health-related factors associated with poor nutritional status (PNS) of a representative group of Polish older people, based on data from the PolSenior project (the first nation-wide study of Polish senior citizens). PATIENTS AND METHODS: Nutritional status was assessed in 3751 community-dwelling older people (1770 females, mean age: 77.4±8.0 years) using the Mini Nutritional Assessment - Short Form. Elements of comprehensive geriatric assessment (cognitive and mood screening), selected medical data were analyzed in relation to the nutritional status. These were: the number of medications, the number of chronic diseases, selected diseases potentially related to malnutrition (anaemia, stroke, peptic ulcer, Parkinson's disease, cancer - past or present), total edentulism, use of dentures, and chronic pain. RESULTS: PNS was observed in 44.2% of participants. Female sex [OR 1.72, 95% Cl (1.45-2.04)], advanced age [OR 2.16 (1.80-2.58)], symptoms of depression [OR 11.52 (9.24-14.38)], cognitive impairment [OR 1.52 (1.20-1.93], multimorbidity [OR 1.27 (1.04-1.57)], anaemia [OR 1.80 (1.41-2.29)] and total edentulism [OR 1.26 (1.06-1.49)] were independently correlated with PNS. CONCLUSIONS: PNS in Polish elderly population is strongly related to the occurrence of symptoms of depression. People in advanced age with symptoms of depression, cognitive impairment, multimorbidity, anaemia and total edentulism should be screened and monitored for early symptoms of malnutrition.
Asunto(s)
Evaluación Geriátrica , Estado de Salud , Desnutrición/epidemiología , Evaluación Nutricional , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Estado Nutricional , Polonia , PrevalenciaRESUMEN
The polypropylene-polyester prostheses were investigated in respect of their usefulness in cranioplasty. Experiments were performed upon 2 to 10 years old mongrels. It was stated that polypropylene-polyester prostheses did not produce any general reactions. X-ray examinations did not show any evidences of pathological changes in cranial bones adjoining the prosthesis. Histological investigations revealed slight inflammation and moderate foreign body reaction caused by the operation. The prosthesis had good mechanical resistance and it was well fixed in the place of implantation. Mechanical resistance and good tolerance may be the basis for the use of the prostheses in clinical cases.
Asunto(s)
Materiales Biocompatibles , Plásticos , Poliésteres , Polipropilenos , Prótesis e Implantes , Cráneo/cirugía , Animales , Materiales Biocompatibles/toxicidad , Perros , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Masculino , Poliésteres/toxicidad , Polipropilenos/toxicidadRESUMEN
1. The authors' model of paratopic cardiac replacement by means of a branched Dacron prosthesis is considered a simple method for left-heart replacement. 2. This experimental model is a suitable temporary left-heart substitute in acute cardiac failure. Removal after rejection is easy. 3. The modified model can also be used in experimental acute right-heart failure.