Trial of the combination of mitomycin, vindesine, and cisplatin in patients with advanced non-small cell lung cancer

In prior trials, mitomycin, vindesine, and cisplatin have each been shown to have reproducible antitumor activity as single agents when used in the treatment of patients with non-small cell lung cancer. The two-drug combinations of vindesine plus high-dose cisplatin or mitomycin have shown an improved major response rate and manageable toxicity in prior trials. In this report, 90 patients with stage III non-small cell lung cancer were treated with the three-drug combination of mitomycin (8 mg/m2), vindesine (3 mg/m2), and high-dose cisplatin (120 mg/m2). Eighty-seven patients (97%) were adequate for both response and toxicity. Major objective responses occurred in 60% of the patients. The toxicity of this regimen was predictable and manageable when established supportive care measures were employed. Based on the response rate observed, the combination of these three agents merits further study in randomized trials against other chemotherapeutic regimens and consideration of its use in adjuvant and preoperative settings.     

Bacterial Pancarditis with Myocardial Abscess: Successful Surgical Intervention in a 14-Month-Old Boy

A 14-month-old boy with a structurally normal heart presented with signs of cardiac tamponade caused by purulent pericarditis. During his hospital stay, mitral and tricuspid valve endocarditis developed, and a ventricular septal abscess expanded despite appropriate, prolonged antibiotic therapy for methicillin-resistant Staphylococcus aureus. The day before scheduled surgical correction, the abscess ruptured, creating a septal aneurysm. Surgical intervention resulted in an excellent outcome. Throughout the patient''s 67-day hospitalization, the use of echocardiography was crucial in monitoring and diagnosis.In addition to reporting this case, we discuss our diagnostic and treatment considerations. To our knowledge, this is only the 4th report of S. aureus bacterial pancarditis with myocardial abscess.     

New Polylactic Acid Composites Reinforced with Artichoke Fibers

In this work, artichoke fibers were used for the first time to prepare poly(lactic acid) (PLA)-based biocomposites. In particular, two PLA/artichoke composites with the same fiber loading (10% w/w) were prepared by the film-stacking method: the first one (UNID) reinforced with unidirectional long artichoke fibers, the second one (RANDOM) reinforced by randomly-oriented long artichoke fibers. Both composites were mechanically characterized in tensile mode by quasi-static and dynamic mechanical tests. The morphology of the fracture surfaces was analyzed through scanning electron microscopy (SEM). Moreover, a theoretical model, i.e., Hill’s method, was used to fit the experimental Young’s modulus of the biocomposites. The quasi-static tensile tests revealed that the modulus of UNID composites is significantly higher than that of the neat PLA (i.e., ~40%). Moreover, the tensile strength is slightly higher than that of the neat matrix. The other way around, the stiffness of RANDOM composites is not significantly improved, and the tensile strength decreases in comparison to the neat PLA.     

Emergency coronary artery bypass grafting for failed angioplasty: risk factors and outcome

It has been suggested that coronary artery bypass grafting (CABG) performed in the setting of emergent failure of percutaneous transluminal coronary angioplasty causes minimal increased risk compared with routine CABG. We reviewed the records of 103 patients undergoing emergency CABG for failed percutaneous transluminal coronary angioplasty (group 1) and compared them with an identical number of consecutive CABG patients from 1987 (group 2). Group 1 had a lower risk profile evidenced by lower mean age (p less than 0.01), fewer diseased vessels (p less than 0.0001), better ventricular function (p less than 0.001), fewer left main lesions (p less than 0.0001), and fewer patients with acute ischemia requiring intravenous administration of nitroglycerin (p less than 0.01). Despite these differences, the group 1 patients had a higher mortality rate (11% versus 1%; p less than 0.01) and a higher rate of perioperative infarctions (new Q wave) (22% versus 6%; p less than 0.01). An analysis of risk factors was performed in the group 1 patients using 36 preoperative and operative variables. Multivariate analysis revealed that left ventricular score (p less than 0.0001), preoperative (after percutaneous transluminal coronary angioplasty) need for inotropic support (p less than 0.005), and age (p less than 0.025) were independent predictors of operative mortality. In conclusion, emergency CABG after failed percutaneous transluminal coronary angioplasty carries a significantly greater risk of operative death and perioperative infarction than elective CABG.     

The contribution of enhancing lesions in monitoring multiple sclerosis treatment: is gadolinium always necessary?

Journal of Neurology - MRI is highly sensitive for monitoring of disease activity and treatment efficacy in MS. Patients treated with disease modifying therapy (DMT), who experience MRI activity,...     

Life 1?Year After a Quit Attempt: Real-Time Reports of Quitters and Continuing Smokers

Background

Smokers are often reluctant to quit because they fear long-lasting withdrawal. Yet little research prospectively examines smokers?? withdrawal longer than 1?month post-quit.

Purpose

The aim of this study was to compare successful versus unsuccessful quitters?? withdrawal, positive affect/pleasure, and lifestyle at 1?year post-quit.

Methods

Smokers (N?=?572) in a cessation trial completed ecological momentary assessments four times a day for 1?week pre-quit, 1?week post-quit, and 1?week at 1?year post-quit.

Results

From pre-quit to 1?year later, only quitters reported sizeable declines in craving and restlessness, and fewer stressful events. At 1?year, quitters, on average, reported no significant craving. Continuing smokers reduced their cigarette consumption considerably from pre-quit to 1?year later.

Conclusions

Contrary to smokers?? worries, long-term quitters reported less craving and restlessness than when they smoked (perhaps because cessation eliminates the acute nicotine withdrawal smokers experience between cigarettes). This information may encourage smokers to quit and endure withdrawal.     

Migraine with aura white matter lesions: preliminary data on clinical aspects

A few clinic-based magnetic resonance imaging studies report an increased risk of signal abnormalities in migraineurs brain’s white matter, especially in migraine with aura subjects. A vascular genesis has been hypnotized and migraine with aura was considered an independent risk factor for stroke. Available data of magnetic resonance imaging alterations are often nonspecific and sometimes controversial. The aim of our study is to investigate migraine with aura patients with standardized brain magnetic resonance imaging to detect and to quantify the presence of white matter lesions and to analyze their relation with clinical data. We report preliminary data about first 90 subjects. We did not recognize any clinical aspect in close relationship with these alterations. The only clinical feature that seems to play a role in the presence of alterations is the age, and only in migraineurs women.     

Psychiatric diagnoses of patients with psychogenic non-epileptic seizures.

OBJECTIVE: Our purpose was to present and discuss the psychiatric diagnoses of patients who presented psychogenic non-epileptic seizures (PNES) during video-electroencephalographic monitoring (VEEG). METHODS: Out of 98 patients, a total of 28 patients presented PNES during the diagnostic procedure. In those cases in which the PNES that occurred during VEEG were validated by clinical history (clinical validation), and by showing the recorded event on video to an observer close to the patient (observer validation), was defined psychogenic non-epileptic seizure disorder (PNESD). Psychiatric diagnoses were made according to DSM-IV. RESULTS: In 27, psychogenic non-epileptic seizures disorder was diagnosed. Fourteen patients presented only with psychogenic non-epileptic seizure disorder, 13 with both psychogenic non-epileptic seizures disorder and epilepsy, and one patient with epilepsy only. Psychiatric diagnoses were: 17 (63%) patients with conversion disorder, five (19%) with somatization disorder, two (7%) with dissociative disorder NOS, two (7%) with post-traumatic stress disorder and one (4%) with undifferentiated somatoform disorder. CONCLUSIONS: Dissociative-conversion non-epileptic seizures are the most frequent finding, representing the pseudoneurological manifestation of mental disorders that have these symptoms as a common feature. Provisionally, they may be defined as dissociative-conversion non-epileptic seizure disorders.     

Clozapine or Haloperidol in rats prenatally exposed to methylazoxymethanol, a compound inducing entorhinal-hippocampal deficits, alter brain and blood neurotrophins' concentrations

SUMMARY: Rats exposed during prenatal life to methylazoxymethanol (MAM) display in postnatal age structural and behavioral deficits resembling those observed in schizophrenic patients. These deficits are associated with significant changes in brain nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF), particularly in the hippocampus and entorhinal cortex. In the present study, we used the MAM model to investigate in young rats the effect of antipsychotics, Clozapine and Haloperidol, on brain and blood NGF and BDNF presence. Young animals were used because administration of antipsychotics during adolescence is a common feature of intervention. The results showed that administration of Clozapine and Haloperidol causes significant changes in the concentration of NGF and BDNF in the brain and bloodstream of MAM-treated rats. These findings indicate that these drugs may affect the synthesis and release of neurotrophins in the central nervous system and in the blood circulation. In addition, the MAM model can be a useful tool to investigate the biochemical and molecular mechanisms regarding the effects of antipsychotics.