Systematic review of the treatment of cancer-associated anorexia and weight loss.

PURPOSE: We systematically assessed the efficacy and safety of appetite stimulants in the management of cancer-related anorexia. Literature databases were searched for randomized controlled trials of appetite stimulants in the treatment of cancer anorexia. MATERIALS AND METHODS: Studies were graded according to quality. Fifty-five studies met inclusion criteria. RESULTS: Only two drugs have evidence to support their use for anorexia (progestins and corticosteroids). There is strong evidence against the use of hydrazine sulfate. The outcomes of these trials have been mixed and patient population heterogeneous. CONCLUSION: The optimal dose, time to start, and duration of treatment for many appetite stimulants for cancer anorexia is still unknown. A more systematic approach to research methodology with universal outcome measure and prospective randomized studies are need. Combination regimens are needed but this cannot at the present time be supported by the data presented.     

Effects of amyotrophic lateral sclerosis serum on cultured chick spinal neurons

We used a quantitative immunoassay to examine the effects of human serum and immunoglobulins on neurofilament protein expression in cultures of chick spinal neurons. Compared with cultures grown in the presence of serum from healthy controls or patients with other neurologic disorders, ALS serum lowered the level of neurofilament proteins. Effects were similar with or without muscle-derived neurotrophic factors; there was no specificity for motor neurons. No neurotoxic activity was found in immunoglobulin fractions, and there was no evidence of circulating antibodies that might neutralize muscle-derived neurotrophic factors or induce cytolysis of spinal neurons.     

The relation between syntactic and morphological recovery in agrammatic aphasia: A case study

BACKGROUND: Production of grammatical morphology is typically impaired in agrammatic aphasic individuals, as is their capacity to produce the syntactic structure responsible for licensing that morphology. Whether these two impairments are causally related has been an issue of long-standing debate. If morphological deficits are a side-effect of underlying syntactic ones, as has been claimed (Friedmann & Grodzinsky, 1997; Izvorski & Ullman, 1999), therapy which improves the syntactic deficit should remediate the morphological deficit as well. This paper reports a case study of one individual with such co-occurring impairments and describes their recovery in response to linguistically-motivated treatment targeting his syntactic deficits. METHODS #ENTITYSTARTX00026; PROCEDURES: MD is a 56 year-old male diagnosed with non-fluent Broca's aphasia subsequent to a left-hemisphere CVA, with limited capacity to produce syntactically complex utterances and grammatical morphology. He was enrolled in therapy using Treatment of Underlying Forms (TUF; Thompson & Shapiro, 2005), targeting production of sentences involving Wh-movement (object relative clauses). MD participated in twice-weekly treatment sessions for approximately two months, with daily probes assessing his production of treated and untreated sentence types. In addition, probes assessing his grammatical morphology and sentence production were administered pre- and post-treatment. OUTCOMES #ENTITYSTARTX00026; RESULTS: Pre-treatment scores in tests of grammatical morphology and sentence production indicated deficits in both domains. During treatment, MD successfully acquired production of a variety of sentence with Wh-movement, though this did not generalize to sentences involving a grammatically distinct movement operation (NP-movement). Post-treatment scores also indicated a lack of improvement in production of grammatical morphology. CONCLUSIONS: The dissociation between MD's morphological and syntactic recovery indicates that the recovery of syntactic and morphological processes in aphasia may occur independently. This result is thus surprising under approaches in which morphological and syntactic impairments are strongly and causally related in aphasia, such as the Tree-Pruning Hypothesis (Friedmann, 2001; Friedmann & Grodzinsky, 1997). Further, these results reinforce the conclusion that aphasia treatment can lead to generalization, but only to linguistic material which is in a subset relation to trained structures (Thompson, Shapiro, Kiran & Sobecks, 2003).     

Mycotic aneurysm of the aorta: MRI and MRA features

Mycotic aneurysms of the abdominal aorta are potentially fatal but uncommon. We report the MRI and MRA features of an abdominal aortic mycotic aneurysm in a patient who presented with nonspecific low back pain. By delineating the saccular nature of the aneurysm and identifying the coexistence of vertebral enhancement, MRI was crucial for the final diagnosis. A potential pitfall of contrast-enhanced MRA is also demonstrated.     

Accuracy of in-vivo assessment of prostatic volume by MRI and transrectal ultrasonography.

More accurate noninvasive estimation of prostate size is important in therapeutic trials for benign prostatic hyperplasia. The accuracy of MRI and transrectal ultrasound (TRUS) in assessing prostate weight was evaluated in 48 patients who underwent radical prostatectomy for stage A or B cancer. The volume derived from the wet weight of the freshly excised specimen was used as a reference. We compared that volume with volume estimates derived from the three-axis linear dimension measurement by MRI and TRUS using a tissue density of 1.05 g/cc and the standard formula for an ellipsoid object. Prostate and seminal vesicle volumes were also computed by contouring T2-weighted 5 mm thick contiguous MR images using a semiautomatic edge detection program and pixel summation. Three-axis volume MRI method versus volume from wet weight has slightly less scatter than TRUS three-axis method (r = 0.85 vs r = 0.81). Contoured MR volume method has the least scatter r = 0.93, statistically better than the linear axis method. Contoured MRI volumetric analysis appears superior to linear MRI or TRUS methods in estimating true prostate volume.     

Comparison of individual follow-up and computerized record linkage using the Canadian Mortality Data Base

We compared two methods of ascertaining mortality in a historical prospective mortality study. Computerized Record Linkage (CRL) with the centralized historical Canadian Mortality Data Base (CMDB) was carried out on 2469 men and an attempt was also made to trace the subjects by individual follow-up (IFU). All but 88 were traced and 60 were reported to be dead. CRL was able to locate the deaths of three men who had been untraced by IFU. Contradictory information on vital status was obtained on 5 subjects--in 4 of them, the discrepancy was resolved in favour of CRL. Overall, CRL using the CMDB performed very well. We also consider factors that affect the relative costs of the two methods, which should be balanced against the accuracy of information obtained.