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排序方式: 共有3353条查询结果,搜索用时 93 毫秒
1.
Hendrik Kröning Thomas Göhler Thomas Decker Marc Grundeis Georgi Kojouharoff Jörg Lipke Dieter Semsek Enno Moorahrend Annette Sauer Harald-Robert Bruch Rüdiger Liersch Arnd Nusch Ursula Vehling-Kaiser Manfred Welslau Ralf Grunewald Hanns-Detlev Harich Marcel Stephany Jens Uhlig Rebecca de Buhr Melanie Frank Cathrin Hogrefe Norbert Marschner Karin Potthoff Frank Hartmann Timo Reisländer Ingo Schwaner 《International journal of cancer. Journal international du cancer》2023,153(6):1227-1240
The prospective, multicenter, noninterventional TACTIC study assessed effectiveness and safety of trifluridine/tipiracil (FTD/TPI) in patients with metastatic colorectal cancer (mCRC) in a real-world setting in Germany, thus evaluating the external validity of the findings from the pivotal RECOURSE trial. Primary endpoint was overall survival (OS). Secondary objectives included progression-free survival (PFS), safety, and quality of life (QoL). Subgroups comprised patients with good (<3 metastatic sites at inclusion, ≥18 months from diagnosis of first metastasis to inclusion) or poor (remaining patients) prognostic characteristics (GPC/PPC). GPC without liver metastases was considered best prognostic characteristics (BPC). In total, 307 eligible patients (pretreated or not suitable for other available therapies) were treated with FTD/TPI. Overall, median [95%-CI] OS was 7.4 months [6.4-8.6], median PFS was 2.9 months [2.8-3.3]. In BPC (n = 65) and GPC (n = 176) compared to PPC (n = 124) subgroup, median OS (13.3 [9.1-17.6] vs 8.9 [7.6-9.8] vs 5.1 [4.4-7.0] months) and median PFS (4.0 [3.3-5.3] vs 3.4 [3.0-3.7] vs 2.6 [2.4-2.8] months) were longer. Patient-reported QoL, assessed by validated questionnaires (EQ-5D-5L, PRO-CTCAE), was stable throughout FTD/TPI treatment. Predominant FTD/TPI-related adverse events of grades 3 or 4 were neutropenia (13.0%), leukopenia (7.5%), and anemia (5.2%). Altogether, palliative FTD/TPI therapy in patients with pretreated mCRC was associated with prolonged survival, delayed progression, maintained health-related QoL, and manageable toxicity. Low metastatic burden and indolent disease were favorable prognostic factors for survival. TACTIC confirms the effectiveness and safety of FTD/TPI, highlighting its value in routine clinical practice. 相似文献
2.
Volker Heinemann Ludwig Fischer von Weikersthal Thomas Decker Alexander Kiani Florian Kaiser Salah-Edin Al-Batran Tobias Heintges Christoph Lerchenmüller Christoph Kahl Gernot Seipelt Frank Kullmann Markus Moehler Werner Scheithauer Swantje Held Lisa Miller-Phillips Dominik Paul Modest Andreas Jung Thomas Kirchner Sebastian Stintzing 《British journal of cancer》2021,124(3):587
Background Cetuximab plus FOLFIRI improved overall survival compared with bevacizumab plus FOLFIRI in KRAS wild-type metastatic colorectal cancer (mCRC) in FIRE-3, but no corresponding benefit was found for progression-free survival. This analysis aimed to determine whether cetuximab improves response and survival versus bevacizumab among response-evaluable patients receiving first-line FOLFIRI for RAS wild-type mCRC and the effect of primary tumour side on outcomes.Methods The intent-to-treat population included 593 patients with KRAS exon 2 wild-type mCRC. Further testing identified 400 patients with extended RAS wild-type disease; of these, 352 (88%) who received ≥3 cycles of therapy and had ≥1 post-baseline scan were evaluable for response and constituted the per-protocol population (169 cetuximab and 183 bevacizumab). Patients received 5-fluorouracil, folinic acid and irinotecan (FOLFIRI) with either weekly cetuximab or biweekly bevacizumab given on day 1 of each 14-day cycle until response, progression or toxicity occurred. The primary endpoint was the objective response rate (ORR) in the per-protocol population. Secondary endpoints included overall survival (OS) and progression-free survival (PFS). The effect of primary tumour location was evaluated.Results Median OS in the RAS wild-type population was 31 vs 26 months in the cetuximab and bevacizumab groups, respectively (HR 0.76, P = 0.012). In the per-protocol population, outcomes favoured cetuximab for ORR (77% vs 65%, P = 0.014) and median OS (33 vs 26 months, HR 0.75, P = 0.011), while PFS was comparable between groups. The advantage of cetuximab over bevacizumab occurred only in patients with left-sided primary tumours.Conclusions FOLFIRI plus cetuximab resulted in a significantly higher ORR and longer OS compared to FOLFIRI plus bevacizumab among patients with left-sided tumours. The superior response associated with cetuximab may particularly benefit patients with symptomatic tumours or borderline-resectable metastases.ClinicalTrials.gov identifier .Subject terms: NCT00433927Oncology, Biomarkers 相似文献
3.
Albert De Decker Rosalie Fergusson Benjamin Ondruschka Niels Hammer Johann Zwirner 《Clinical anatomy (New York, N.Y.)》2020,33(4):522-529
For 50 years now, sacrospinous ligament fixation (SSLF) has been used to treat pelvic organ prolapse consequent on altered integrity of the pelvic myofascial structures. It is usually performed vaginally, but it has recently been performed laparoscopically through either an anterior or a posterior approach, with the broad ligament as a landmark to differentiate the two. In the present study, these two laparoscopic approaches were assessed using Thiel-embalmed cadavers. The anterior and posterior approaches were compared in terms of the closest distance to anatomical structures at risk, including pelvic viscera, the obturator nerve, and vascular structures. The posterior approach was more often closer to the investigated vessels and the rectum. The obturator nerve and the ureter were close to both the anterior and posterior approaches. The urinary bladder was closer using the anterior approach. From an anatomical standpoint, therefore, the anterior laparoscopic approach for SSLF is more likely to cause injury to the urinary bladder, whereas the posterior approach is more prone to causing rectal and vessel injuries. This study illustrates, from a basic science perspective, the importance of combining fascia research, novel endoscopic or minimally invasive surgical exposures informed by anatomy, and contemporary trends in gynecology in order to improve patient outcomes. Clin. Anat. 33:522–529, 2020. © 2019 Wiley Periodicals, Inc. 相似文献
4.
Charvonne N. Holliday Elizabeth Miller Michele R. Decker Jessica G. Burke Patricia I. Documet Sonya B. Borrero Jay G. Silverman Daniel J. Tancredi Edmund Ricci Heather L. McCauley 《Women's health issues》2018,28(3):205-211
Background
Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC.Study Design
Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania.Results
Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women.Conclusions
Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status. 相似文献5.
6.
目的 观察表皮生长因子受体(EGFR)、p53在糖尿病小鼠颌下腺中的表达。方法 选取3、4、6、8、10月龄db/db糖尿病小鼠及相应月龄的db/+m正常小鼠颌下腺。应用HE染色及免疫组织化学方法染色后进行图像分析,统计EGFR、p53在颌下腺组织内表达的细胞阳性率。结果 随着糖尿病的发展,颌下腺组织出现腺叶萎缩及实质细胞排列不整齐,堆集呈簇。纤维及血管增多;EGFR、p53在对 照组及糖尿病组颌下腺中均有表达。其细胞阳性率随月龄增大均呈增高趋势。且糖尿病组显著高于对照组。结论 ①db/db糖尿病可导致颌下腺组织萎缩及实质细胞形态学改变。②EGFR、p53表达增多。说明糖尿病时EGFR作为多效应受体,可能被激活从而诱导了颌下腺的细胞凋亡;p53表达的上升。提示随着糖尿病发展,颌下腺实质细胞有凋亡趋势。 相似文献
7.
Schiffman EL Look JO Hodges JS Swift JQ Decker KL Hathaway KM Templeton RB Fricton JR 《Journal of dental research》2007,86(1):58-63
For individuals with temporomandibular joint (TMJ) disc displacement without reduction with limited mouth opening (closed lock), interventions vary from minimal treatment to surgery. In a single-blind trial, 106 individuals with TMJ closed lock were randomized among medical management, rehabilitation, arthroscopic surgery with post-operative rehabilitation, or arthroplasty with post-operative rehabilitation. Evaluations at baseline, 3, 6, 12, 18, 24, and 60 months used the Craniomandibular Index (CMI) and Symptom Severity Index (SSI) for jaw function and TMJ pain respectively. Using an intention-to-treat analysis, we observed no between-group difference at any follow-up for CMI (p > or = 0.33) or SSI (p > or = 0.08). Both outcomes showed within-group improvement (p < 0.0001) for all groups. The findings of this study suggest that primary treatment for individuals with TMJ closed lock should consist of medical management or rehabilitation. The use of this approach will avoid unnecessary surgical procedures. 相似文献
8.
Background
Only some states provide coverage of nonemergency dental services for adult Medicaid enrollees. This study examined the association between coverage of Medicaid adult nonemergency dental services and dental services use and expenditures.Methods
The authors analyzed data from the 2000 through 2015 Medical Expenditure Panel Survey Household Component for adults 21 years or older enrolled in Medicaid. The authors examined a range of outcomes such as dental visits, preventive and 5 other types of dental services, and total and out-of-pocket dental expenditures. Multivariate regression models were used to estimate the differences in outcomes for Medicaid enrollees between states that provided coverage of nonemergency dental services and states that did not, controlling for potentially confounding factors.Results
Compared with Medicaid enrollees in states that did not provide coverage, enrollees in states that provided coverage of nonemergency dental services were approximately 9 percentage points more likely to have a dental visit, approximately 7 percentage points more likely to have any preventive dental service, and more likely to have all other types of dental services except oral surgery services. Among enrollees with any visit, out-of-pocket share of dental expenditures was approximately 19 percentage points lower among those in covered states than those in uncovered states.Conclusions
Medicaid adult nonemergency dental benefits were associated with higher use of preventive and other types of dental services and lower out-of-pocket share of dental costs.Practical Implications
Our results may help inform policy makers as they consider ways of improving dental health of adults through Medicaid. 相似文献9.
The object of this study was to monitor the proportion of vital bacteria (microbial vitality: VF in %) present in subgingival
dental plaque following one single subgingival irrigation with saline (S), chlorhexidine (CHX) or povidone iodine (I2), but without any subgingival instrumentation. Its effect on the main composition of the microflora was also assessed. Seventeen
patients with adult periodontitis took part in this investigation. In each patient four initially untreated pockets (pocket
depth 5–11 mm) associated with bleeding were selected for the standardised pocket irrigation and plaque sampling at baseline
(0 h) and after the following 1 h, 24 h, 7 days and 31 days. The subgingival irrigation was only performed once (0 h). One
pocket per quadrant was irrigated using 0.9% prereduced S, 0.2% CHX or 0.05% I2 (Iso-Betadine Buccale). The remaining untreated pocket without any irrigation served as an additional control (C). Using
an acrylic splint as a guide, paperpoints were inserted into the pocket precisely at the same site to collect subgingival
plaque. The bleeding on sampling (BOS) was thereafter noted. The proportions of bacterial morphotypes were examined by darkfield
microscopy. VF was evaluated using a vital fluorescence staining. The undisturbed subgingival dental plaque was composed of
86% (median value) vital bacteria. The sampling procedure alone and the saline irrigation led to a decrease in the number
of spirochetes but had no influence on the vitality of the flora. Large variations in VF could be observed in the short-term
(1 h, 24 h) irrigation effect of CHX and I2. The reduction of VF was still significant after 7 days (VFCHX 30–80%, VFI2 35–80%) but persisted up to 31 days only after I2 irrigation (VFI2 12–90%). The findings indicated that all single subgingival irrigations resulted in a temporary change of the subgingival
microflora while povidone iodine produced the longest lasting antimicrobial effect. Any clinical advantage of this situation
should be further investigated.
Received: 16 February 1998 / Accepted: 29 May 1998 相似文献