Sonographic diagnosis of pylephlebitis in children

We present a case of inflammatory bowel disease in which the diagnosis of pylephlebitis was made by ultrasonography. The patient was treated with antibiotics and aspirin and had an uneventful recovery. The sonographic findings are described.     

A cystic fibrosis patient homozygous for the new frameshift mutation 936delTA: description and clinical data.

We report the identification of a new frameshift mutation (936delTA) in exon 6b of the CFTR gene. In the screening of 486 unrelated Spanish CF patients we found a patient homozygous for 936delTA (with consanguineous parents) and a patient heterozygous for delta F508 and 936delTA. Genotype-phenotype correlation studies showed that 936delTA is associated with pancreatic insufficiency and chronic pulmonary colonisation.     

Astrogliosis in von Economo's and postencephalitic Parkinson's diseases supports probable viral etiology.

A marked generalized astrogliosis was observed in the frontal and temporal white matter from a case of von Economo's disease and another of postencephalitic Parkinson's disease, which areas were otherwise devoid of any other demonstrable microscopic lesions. No similar astrocytic reaction of any severity was observed in the same areas in a number of other brain diseases or controls, except when other kinds of lesions were present in the same section, with reactive astrocytes being present within the primary or defining lesion or immediately close by. The marked astrogliosis in von Economo's and postencephalitic Parkinson's diseases in areas "distant" from the primary lesions seeming to indicate extensive pathological involvement, added to the strong qualitative and quantitative similarity of this reaction to that observed in concurrently studied cases of encephalitides caused by the human immunodeficiency virus, lend further factual support to the hypothesis of a viral etiology, albeit unspecified, in both von Economo's and postencephalitic Parkinson's diseases.     

Factores pronósticos del cáncer de mama. Modelo predictivo

Introduction. Breast cancer remains the most frecuent tumor among women in developed countries. The prognosis is linked to a great variety clinic and pathological factors. The objectives from this study are to identify markers related to survival of patients with primary diagnosis of breast cancer. Material and methods. We have reviewed the medical dossier from 2.227 consecutive women diagnosed for infiltrating breast cancer between January 1966 and december 2000 in a single institution. For statistic analysis we used 10.0 SPSS software. Results. In the univariate analysis, factors with the strongest predictive value for overall survival were: PEV, estrogene and progesterone receptors, TNM stage, lymphatic vessel involvement, histologic grade, Scarff differentiation and mitosis rate, elastosis, presence of histiocitosis, and the percentage of involved stage I and III lymph nodes (Berg clasification). In the multivariate analysis, 5 factors; progesterone receptors, Scarff mitotic rate, lymphatic vessel involvement, percentage of involved stage I lymph nodes, and presence of metastasis; were independent prognostic markers of survival. Conclusions. Many independent factors interact in the survival of patients with primary breast cancer. Determination of hormonal receptors, mainly progesterone’s, appear as the most powerful indicators. The analysis has generated a prognostic simplified classification, based in the 5 independent variables, that provides specific rates for survival at 2, 5 and 10 years.     

The serological relationships of Nairobi sheep disease virus.

Nairobi sheep disease virus has been shown to be identical with or very closely related to Ganjam virus, which has been isolated from ticks and mosquitoes in India. The virus of NSD also shows some serological relationships on complement-fixation with Dugbe virus and certain strains of Congo.Another Kenyan tick-borne virus shares this close serological relationship with NSD. Some relationships, which are not evident on complement-fixation tests, can be demonstrated by fluorescent antibody or indirect haemagglutination tests between NSD and other strains of Congo and Hazara virus. These would seem to be less significant.     

A NON-VIRULENT,SINGLE-DOSE RABIES VACCINE FOR PROPHYLACTIC IMMUNIZATION OF DOGS

Our studies on rabies vaccines thus far have led us to the view that in order to develop and test vaccines, quantitative methods are necessary, and that such quantitative methods may be exploited to greatest advantage by using mice, preferably W-Swiss, as the test animal. Dogs, due to their variability and susceptibility to intercurrent infections when kept under experimental conditions, are useful chiefly to check whether or not a vaccine produces a high grade of immunity; they remain of limited value in testing the comparative potencies of weak vaccines. A second point is that the Pasteur strain of virus has proved as potent as any tested for the preparation of vaccines. Another point is that virus material for preparing vaccines must titre at least 330,000 mouse doses per cc. to be effective. This requirement has eliminated all culture vaccines thus far reported, with the possible exception of Plotz''s (7) and leaves virus-containing brain tissue as the sole potent source of vaccine. In summary, we believe that a single injection of non-virulent irradiated vaccine, prepared as herein described, immunizes mice and dogs effectively against a subsequent test inoculation of virulent rabies virus and does so to a greater degree than do other vaccines now obtainable. It is easily and quickly prepared, keeps well, and has a low nitrogen content.     

THE QUANTITY OF IRRADIATED NON-VIRULENT RABIES VIRUS REQUIRED TO IMMUNIZE MICE AND DOGS

In the experiments described above, we found with respect to tissue culture rabies virus that 1 cc., which contains approximately 50,000 mouse intracerebral lethal doses, properly irradiated, was required to immunize a mouse; 500 cc., which contain 25,000,000 doses, were required to immunize a 20 pound beagle dog. Tissue culture virus concentrated ten times proved capable of immunizing mice in a dose one-tenth as large as that required for unconcentrated culture virus. Brain virus suspensions were centrifuged so as to remove a large part of the tissue particles without striking loss in the virulence of the supernatant. The centrifuged supernatants of 1 to 5 per cent brain virus suspensions were irradiated so as to destroy virulence and yet retain immunizing potency. Irradiated supernatants of mouse brain virus proved capable of immunizing mice as well as or better than similar supernatants treated with chloroform. 0.1 cc. of a 1 per cent irradiated dog brain virus containing approximately 50,000 mouse intracerebral lethal doses immunized mice effectively.     

Efficacy and safety of everolimus in elderly patients with metastatic renal cell carcinoma: an exploratory analysis of the outcomes of elderly patients in the RECORD-1 Trial

Background

Elderly patients with metastatic renal cell carcinoma (mRCC) may require special treatment considerations, particularly when comorbidities are present. An understanding of the efficacy and safety of targeted agents in elderly patients with mRCC is essential to provide individualized therapy.

Objective

To evaluate the efficacy and safety of everolimus in elderly patients (those ≥65 and ≥70 yr of age) enrolled in RECORD-1.

Design, setting, and participants

The multicenter randomized RECORD-1 phase 3 trial (Clinicaltrials.gov identifier, NCT00410124; http://www.clinicaltrials.gov) enrolled patients with mRCC who progressed during or within 6 mo of stopping sunitinib and/or sorafenib treatment (n = 416).

Intervention

Everolimus 10 mg once daily (n = 277) or placebo (n = 139) plus best supportive care. Treatment was continued until disease progression or unacceptable toxicity.

Measurements

Median progression-free survival (PFS), median overall survival (OS), and time to deterioration in Karnofsky performance status (TTD-KPS) were assessed using the Kaplan-Meier method; the log-rank test was used to compare treatment arms. Other outcomes evaluated included reduction in tumor burden, overall response rate (ORR), and safety.

Results and limitations

In RECORD-1, 36.8% of patients were ≥65 yr and 17.5% were ≥70 yr of age. PFS, OS, TTD-KPS, reduction in tumor burden, and ORR were similar in the elderly and the overall RECORD-1 population. Everolimus was generally well tolerated in elderly patients, and most adverse events were grade 1 or 2 in severity. The toxicity profile of everolimus was generally similar in older patients and the overall population; however, peripheral edema, cough, rash, and diarrhea were reported more frequently in the elderly regardless of treatment. The retrospective nature of the analyses was the major limitation.

Conclusions

Everolimus is effective and tolerable in elderly patients with mRCC. When selecting targeted therapies in these patients, the specific toxicity profile of each agent and any patient comorbidities should be considered.