Gemcitabine monotherapy in patients with locally advanced or metastatic pancreatic cancer: a prospective observational study

Pancreatic cancer has one of the worst prognosis of any malignant disease. Systemic therapy is often administered because the disease is usually detected at advanced stages. Gemcitabine (Gemzar trade mark, Eli Lilly & Co.) has proven activity in the treatment of pancreatic cancer. Gemcitabine 1000 mg/m(2) was given on days 1, 8 and 15, every 4 weeks. A total of 100 chemonaive patients with locally advanced or metastatic pancreatic cancer were enrolled; 32 and 68% had stage III and IV disease, respectively. The average number of administered cycles was 3.5 (range: 1 - 12). The overall response rate was 13%, with 13 partial responders. The median time to progression was 13.5 weeks (range: 3 - 56; 95% CI = 12 - 14). The median survival was 32 weeks (range: 4 - 104; 95% CI = 27 - 36). Clinical benefit response was acheived for 26 patients (26%). Grade 3/4 haematological toxicities occurred infrequently (anaemia: 5%; neutropenia: 8% and thrombocytopenia: 3% of patients). Grade 3/4 non-haematological toxicities were not observed. There were no treatment-related deaths. Gemcitabine treatment of patients with locally advanced or metastatic pancreatic cancer is effective and well-tolerated.     

Chinese hamsters and diabetes mellitus

Summary In the Chinese Hamster inbreeding and exposure to stressful situations are capable of precipitating Diabetes mellitus. The condition produced by gene-mutation is hereditary and the signs and symptoms of the disease, including degenerative vascular lesions, resemble closely those observed in human subjects.

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Zusammenfassung Die Zuechtung und Einwirkung von stressierenden Situationen sind imstande, beimChinese Hamster das Auftreten eines Diabetes mellitus zu verursachen. Diese durch eine Gen-Mutation hervorgerufene Situation ist erblich und die Aeusserungen und Symptome der Krankheit, einschliesslich der degenerativen Schaedigungen der Gefaesse, erinnern sehr an die, welche beim Menschen beobachtet werden.

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Resumen La cría y la exposiciòn a situaciones stressantes estan en grado de determinar en elChinese Hamster el aparecer de una diabetes mellitus. Esta situaciòn producida de un cambio génico es hereditaria y los signos y los síntomos de la enfermedad, comprendidas las lesiones degenerativas de los vasos, recuerdan de cerca aquellas observadas en el hombre.

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Resume L'élevage et l'exposition à des conditions stressantes peuvent déterminer chez leChinese Hamster la manifestation d'un diabète sucré. Une pareille situation, produite par une mutation génique, est héréditaire et les signes et symptômes de cette maladie (y compris les lésions de dégénération vasculaire) rappellent de près ceux qu'on observe chez l'homme.

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Riassunto L'allevamento e l'esposizione a situazioni stressanti sono in grado di determinare nelChinese Hamster l'insorgenza di un diabete mellito. Questa situazione prodotta da una mutazione genica è ereditaria ed i segni ed i sintomi della malattia, comprese le lesioni degenerative dei vasi, ricordano da vicino quelle osservate nell'uomo.

     

The recognition and characterisation of Finnish Clostridium difficile isolates resembling PCR-ribotype 027

Purpose

To characterise and compare twenty-eight Finnish Clostridium difficile RT027-like isolates, selected based on the presence of 18 bp deletion in the tcdC gene and toxin gene profile (A, B, binary), with eleven RT027 isolates from different Finnish geographical areas and time periods.

Effectiveness of radiosynoviorthesis in the treatment of chronic synovitis of small and middle-sized joints affected by rheumatoid arthritis

Our aim was to describe and evaluate our experience in the treatment of radiosynoviorthesis (RSO) of small and middle-sized joints in patients with rheumatoid arthritis (RA). Eighty six patients with RA enrolled in the study. The criterion for enrolment was destructive process of the joint detected by X-rays and classified as a stage II-III according to Larsen. Seventy-six middle-sized joints were treated each with 74MBq or rhenium-186 sulphate and other 80 small joints with 10-40MBq of erbium-169 citrate each. The effect of treatment was evaluated at 6 and 12 months following the RSO treatment. The obtained values were compared with those of the initial state. The inflammatory and structural changes in activity were assessed according to the results of ultrasound examination, regression of pain, swelling of the joint and the improvement in mobility. The data obtained were statistically processed with the Chi-square test. Our results showed that RSO significantly decreased pain of the affected joints, however the influence upon joint motion was minimal. The best treatment results were observed in shoulders and elbows, while the ankles were the worst to respond to the RSO treatment. The significant (P<0.05) beneficial effect of the RSO treatment on pain and swelling reduction were only transient started on 1 week to 1 month and declined over 12 months. In conclusion, our study showed that RSO is a suitable alternative in the treatment of chronic synovitis, with a low potential of adverse effects. However the beneficial effect on pain and swelling reduction was only transient and declined over 12 months.     

I-131 false positive uptake in a huge parapelvic renal cyst

A male patient had undergone total thyroidectomy for thyroid papillary carcinoma. He was administered thyroablation activity of radioiodine. Whole body imaging after diagnostic activity of 131-I demonstrated intense radioiodine uptake in the right side of the upper abdominal region. The serum thyroglobulin level was low. Ultrasonography demonstrated a large irregular anechoic structure in the centre of the right kidney--a cyst in the parapelvic region. Renal cysts can lead to erroneous interpretation of radioiodine scintigraphy.     

Functional autonomies of thyroid and efficacy of radioiodine therapy

In this paper, the authors present their experience with the radioiodine therapy of thyroid functional autonomies. The aims of this study were to establish the efficacy and determine the adverse effects of radioiodine therapy of patients with thyroid functional autonomies. Over a period of 31 years (from 1974 to 2005) 868 patients (766 women, 102 men with the age from 33 to 86 years; average age, 58.5) with unifocal functional autonomy, multifocal functional autonomy, and disseminated functional autonomy, received at least one treatment of radioiodine in our Department of Nuclear Medicine. For diagnostics and the evaluation of the radioiodine therapeutic effect of functional autonomies, a thyroid scintigraphy is the basic and necessary procedure. We have also performed a thyroid ultrasonography, an assessment of a serum level of a total and free thyroxine, total tri-iodothyronine, thyroid-stimulating hormone (TSH), the radioiodine accumulation test, the estimation of the radioiodine effective half-life, and in some patients, thyrotrophin-releasing hormone (TRH)-TSH test. The follow-up examinations were done in all patients after 4-6 months, another examination after 1 year in 585 patients, and after 2 years in 284 patients. One therapeutic dose received 798 patients (91.9%) and it was sufficient for an elimination of functional autonomies. Some patients were retreated if there was the evidence of small or no treatment effect and no elimination of functional autonomies. Sixty-six (66) patients (7.6%) received two radioiodine treatments and 4 patients (0.5%) three treatments. Before radioiodine therapy, an average serum level of total thyroxine was 165.8 nmol/L, of free thyroxine 21.2 pmol/L, and of total triiodothyronine 3.3 nmol/L, and in all patients, TSH was suppressed. Before therapy, patient complaints were cardiovascular in 87%, neurological in 72%, hypermetabolic in 70%, and local in 31% of patients. After therapy, the average serum levels of total thyroxine were 110.9 nmol/L, free thyroxine 12.7 pmol/L, and total triiodothyronine 2.1 nmol/L with an improvement of symptoms in 91.5% of patients, no improvement in 8.2% and a worsening in 0.3% of patients. The suppression of TSH disappeared in 668 of treated patients (77%). An average volume reduction of thyroid of 40% was achieved in any type of functional autonomy after radioiodine treatment. Side-effects were minimal, and in some patients, presented as a transient neck pressure or pain and neck swelling. Postradiation hypothyroidism was diagnosed in 38 patients (4.4%). The results of this study show that the radioiodine therapy of the thyroid functional autonomies is safe, with a low incidence of adverse effects. It is effective, and for patients, is a nondemanding procedure.