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At least 379 records · Page 21Linked to original sources
PubMed1993

Higher overall nosocomial infection rate because of increased attack rate of methicillin-resistant Staphylococcus aureus.

BACKGROUND: Methicillin-resistant Staphylococcus aureus has become a frequent cause of hospital-acquired infectious disease. However, the impact of methicillin-resistant S. aureus on the overall nosocomial infection rate has not been clearly defined. METHODS: The University of Alabama at Birmingham Hospital is a tertiary care facility and participant in the National Nosocomial Infections Surveillance system. Prospective, hospital-wide surveillance for nosocomial infections was conducted for 8 months per year during 1986 through 1991. RESULTS: The total nosocomial infection rate increased from 4.5% in 1987 to 5.9% in 1990. This was temporally associated with a rise in the attack rate of methicillin-resistant S. aureus from 0% to 0.4%. The remainder of the increase was caused by other gram-positive microorganisms, including methicillin-sensitive S. aureus. We identified methicillin-resistant S. aureus most commonly in the surgical intensive care unit and as a cause of lower respiratory tract infections. In contrast, methicillin-sensitive S. aureus was most frequently found in the neurologic intensive care unit and as the etiologic agent of surgical wound infections. CONCLUSIONS: Methicillin-resistant S. aureus has become a common nosocomial pathogen. There has been no decrease in the attack rate of methicillin-sensitive S. aureus or other gram-positive cocci. The total nosocomial infection rate has increased as a result equally of the emergence of methicillin-resistant S. aureus and of the renewed activity of other gram-positive pathogens. Methicillin-resistant S. aureus has added to the overall burden of nosocomial infectious disease.

Alabama↗
PubMed1983

Overall prognosis as the primary criterion of outcome in a clinical trial.

In a randomized trial on premature infants, with follow-up to 1 year of age only, the goal is to identify which one among the compared strategies of intervention affords the best outcome throughout life. This requires the assessment of lifetime prognosis at the end of follow-up as the primary criterion of outcome. Moreover, with the treatments potentially influencing a variety of organ systems, it is necessary to combine their separate prospects into an overall prognosis as a basis for identifying the preferable mode of intervention. The development of the scheme of rating overall prognosis posed considerable challenges, in theory as well as in application.

Clinical Trials as Topic↗
PubMed1990

HER-2 oncogene amplification and overall survival of breast carcinoma patients.

DNA was extracted from tumour samples of 77 patients with primary breast carcinoma and HER-2 proto-oncogene amplification was assessed. Prognostic indices such as number of positive lymph nodes, tumour size and histological grading were strongly associated with overall survival. No statistically significant correlation between amplification of HER-2 and overall survival was observed. In addition, prognostic indices, HER-2 amplification and disease-free interval was not correlated. Analysis of HER-2 amplification alone is not a useful guide in the management of patients with mammary carcinoma.

Breast Neoplasms↗
PubMed1983

The influence of the number of fractions and of overall treatment time on local control and late complication rate in squamous cell carcinoma of the larynx.

Three hundred and ten patients with T3/T4, N0, M0 squamous cell carcinoma were irradiated with 200 kV X rays with total doses ranging from 4,900 to 6,200 rad, given in 21 to 35 fractions in 32-63 days. After a minimum follow-up period of 3 years, the local control rate was 50%; 21 severe late complications were observed among the patients. The dependence of local control rate and of late complication rate on the dose per fraction and on overall treatment time was analyzed by various statistical methods. Whereas the late complication rate depended significantly on dose per fraction, local tumor control depended strongly on overall treatment time.

Carcinoma, Squamous Cell↗
PubMed1993

Predictive value of in vitro radiosensitivity parameters in head and neck cancers and cervical carcinomas: preliminary correlations with local control and overall survival.

PURPOSE: To determine whether in vitro radiosensitivity parameters are predictive of treatment outcome. METHODS AND MATERIALS: Biopsies were obtained from patients with head and neck cancers (57) and cervical carcinomas (20) and in vitro radiosensitivity parameters were obtained using the CAM plate assay. RESULTS: In most cases (75%) patients were treated with radiation alone. The median follow up was 461 days. When the whole group of head and neck cancers and cervical carcinomas was considered, patients with a SF2 value below 0.36 had a higher 2-year local control rate (93% versus 68%) and a higher 2-year survival rate (71% vs. 62%) than those with SF2 values above that threshold, but differences were not significant. These trends persisted when head and neck cancers were considered alone with a higher local control rate (86% vs. 67%) and a higher survival rate (75% vs. 52.5%) obtained for patients with a SF2 value below 0.36. When the alpha value was evaluated for the whole group of patients a significantly higher local control rate (80.5% vs. 40.5%) and overall survival rate (71% versus 37.5%) at 2 years were obtained for patients with alpha values above 0.07 Gy-1. When only the group of head and neck cancers was considered, local control rate was significantly higher (79% vs. 33%) but overall survival rate (65.5% vs. 33%) was not significantly higher for alpha values above 0.07 Gy-1. CONCLUSION: These results are encouraging but need to be confirmed with a larger number of patients with a longer follow-up.

Carcinoma, Squamous Cell↗
PubMed1994

In vitro parameters and treatment outcome in head and neck cancers treated with surgery and/or radiation: cell characterization and correlations with local control and overall survival.

PURPOSE: To determine whether in vivo parameters (surviving fraction at 2 Gy, alpha values, and calculated cell growth fraction) were predictive of the treatment outcome. METHODS AND MATERIALS: Biopsies were obtained from patients with a head and neck tumor. In vitro parameters were determined using the CAM plate assay. Cell characterization by cytogenetic analysis was performed on 19 different cell cultures. In 25 additional cell cultures, cell clonogenicity was tested using the Courtenay Mills assay. RESULTS: Biopsies were obtained from 156 patients with a head and neck tumor and the oropharynx was the predominant primary site. In vitro parameters were obtained in 113 cases (72%) (SF2 in 93 cases and calculated cell growth fraction in 103 cases). Cell characterization showed that cells in CAM plates were diploid with no clonal chromosome abnormalities and gave colonies in soft agar with a mean cloning efficiency of 1.610(-3). Only patients treated with surgery and/or radiation (76), were considered eligible for in vitro parameters and treatment outcome correlation studies. The mean follow-up is over 2 years (range 9-47 months). The local control rate was significantly higher (p = 0.04) for patients with alpha values above the cut-off point of 0.07 Gy-1 (69% vs. 38% at 2 years). The local control rate was also significantly higher (p = 0.04) for patients with calculated cell growth fraction values about the cut-off point of 0.06% (70% vs. 48% at 2 years). Moreover for these latter patients the overall survival rate was also significantly higher (p = 0.004) (54% vs. 26% at 2 years). It is worth noting that alpha and calculated cell growth fraction values below the cut-off points identified a small group of patients (about 20%) who were at a significantly high risk of local failure. From a pragmatic point of view, as only radiosensitivity or calculated cell growth fraction values could be obtained in a certain number of experiments due to technical reasons, the treatment outcome of patients who had either alpha and/or calculated cell growth fraction values below the cut-off levels (about 30% of all patients) was analyzed. This group of patients fared significantly worse (p = 0.02) in terms of local control (50% vs. 68% at 2 years) and (p = 0.04) overall survival (36% vs. 50% at 2 years). CONCLUSION: These results suggest that in vitro parameters using the CAM plate assay, might be useful in predicting the treatment outcome of patients with a head and neck tumor treated with surgery and postoperative radiation, or radiation alone. However, they must be considered as preliminary because the cut offs used in the study were chosen for exploratory purposes. Only a multivariate analysis including all clinical and biologic factors will allow us to draw any firm conclusions.

Carcinoma, Squamous Cell↗
PubMed1995

Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation: do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local control?

PURPOSE: To evaluate potential prognostic factors in the treatment of extremity soft tissue sarcomas that may influence local control, distant metastases, and overall survival. METHODS AND MATERIALS: Sixty-seven patients with extremity soft tissue sarcomas were treated with curative intent by limb-sparing surgery and postoperative radiation therapy at the Fox Chase Cancer Center or the Hospital of the University of Pennsylvania, between October 1970 and March 1991. Follow-up ranged from 4-218 months. The median external beam dose was 60.4 Gy. In 13 patients, interstitial brachytherapy was used as a component of treatment. RESULTS: The 5-year local control rate for all patients was 87%. The 5-year local control rate for patients who received < or = 62.5 Gy was 78% compared to 95% for patients who received > 62.5 Gy had larger tumors (p = 0.008) and a higher percentage of Grade 3 tumors and positive margins than patients who received < or = 62.5 Gy. The 5-year local control rate for patients with negative or close margins was 100% vs. 56% in patients with positive margins (p = 0.002). Cox proportional hazards regression analysis was performed using the following variables as covariates: tumor dose, overall treatment time, interval from surgery to initiation of radiation therapy, margin status, grade, and tumor size. Total dose (p = 0.04) and margin status (p = 0.02) were found to significantly influence local control. Only tumor size significantly influenced distant metastasis (p = 0.01) or survival (p = 0.03). CONCLUSION: Postoperative radiation therapy doses > 62.5 Gy were noted to significantly improve local control in patients with extremity soft tissue sarcomas. This is the first analysis in the literature to demonstrate the independent influence of total dose on local control of extremity soft tissue sarcomas treated with adjuvant postoperative irradiation.

Adolescent↗
PubMed1996

The impact of overall treatment time on the results of radiotherapy for nonsmall cell lung carcinoma.

PURPOSE: We evaluated the impact of overall treatment time on the disease-free survival (DFS) and local control after radiotherapy for nonsmall cell lung carcinoma. METHODS AND MATERIALS: One hundred fifty-three cases considered as responders to radiotherapy were retrospectively analyzed. Patients with Karnofsky status < 70, pretreated with chemotherapy and with pleural or pericardial effusion, were excluded from the analysis. Radiation dose homogenization was done with calculation of the normalized total dose without (NTD) and with time correction (NTD-T) for alpha/beta = 10 Gy. RESULTS: Kaplan-Meier curves for 2-year DFS showed that any analysis based on radiation dose can prove to be erroneous when the time factor is neglected. Although there was no difference between the 47-55 Gy and 56-64 Gy NTD groups, a log rank test revealed a strong difference (p < 0.0002) between NTD-T groups. No difference was observed for patients with mediastinal involvement. Logistic regression analysis showed a statistical association of dose on 2-year local progression-free probability for different time compartments. For those cases without mediastinal involvement, the daily dose lost because of treatment protraction beyond 20 days after the beginning of radiotherapy was estimated to 0.2 Gy/day. When all cases were considered together this was calculated to 0.45 Gy/day. CONCLUSION: Time factor should not be underestimated when evaluating the results of radiotherapy for nonsmall cell lung cancer. There is strong evidence that prolonged overall treatment time could be a major cause of the failure of radiotherapy to control the local disease.

Carcinoma, Non-Small-Cell Lung↗
PubMed1995

Repair of some active genes in Cockayne syndrome cells is at the genome overall rate.

Repair of UV (254 nm)-induced DNA damage in cells from patients with the genetic disease Cockayne syndrome (CS; CS3BE, CS2BE) has been examined in several different genomic regions. These regions include those that contain the actively transcribed beta-actin and adenosine deaminase (ADA) genes and the inactive insulin and 754 loci. The beta-actin, ADA and insulin regions are repaired at about the same rate, one which is equal to the genome overall repair rate. The 754 locus is repaired considerably more slowly. The insulin region is repaired at the same rate in both CS and normal cells as is the 754 locus. The only difference from normal is that the active genes, while repaired well, are not preferentially repaired relative to the genome overall. Our results are consistent with the hypothesis that the repair defect in CS is due to an inactive transcription-repair coupling factor (TRCF). However, the results also indicate that factors other than TRCF and active transcription must also promote repair of some regions relative to others in both normal and CS cells.

Actins↗
PubMed2005

Why do postmenopausal African-American women not benefit from overall breast cancer mortality decline?

BACKGROUND: An overall decline in U.S. female breast cancer mortality in the 1990s has been reported. However, several studies have shown that mortality trends are different for White women and African-American (AA) women. The purpose of this study was to assess differences in time trends and patterns of female breast cancer mortality among women by race and age in Ohio. MATERIAL AND METHODS: Joinpoint regression (JR) and age-period-cohort (APC) approaches were used to evaluate temporal changes in mortality and to assess period and birth generation impacts on observed patterns. Logistic regression was used to assess racial differences in tumor staging and grading among women diagnosed with breast cancer in Ohio from 1996 to 2000. Mortality data were obtained from NCHS (National Center for Health Statistics) via Surveillance Research Program, National Cancer Institute SEER*Stat software; Ohio incidence data were provided by the Ohio Cancer Incidence Surveillance System. RESULTS: Among women aged 30-74, a significant decline of 2.8% was noted since 1988 for White women. AA women in this age group have experienced significant decline (by 0.9%) since 1983. White women aged 30-39 years experienced a decline in mortality of 3.5% per year in the period 1986-2001, while decline by 2.3% was observed among Black women of that age since 1984. Among the age categories 40-49, 50-59, and 60-74, a decline in mortality rates was observed among White women in the 1990s. The decline was observed also among AA women aged 40-49, beginning in the mid 1980s, but not in the older AA age groups. Specifically, in AA women 60-74 and 75+, a mortality increase was observed within the entire study period (0.9% and 1.4%, respectively). CONCLUSIONS: Analysis of the data for Ohio suggests that AA women do not equally benefit from the overall decline in breast cancer mortality that is often sited. This is especially true for AA postmenopausal women who continue to experience an increase in breast cancer mortality. In light of existing literature and this analysis of data from the state of Ohio, we conclude that the reason for these differences lies mostly in disparities in access to care, as well as in differences in stage at diagnosis and biological determinants (grading) between White and Black women.

Adult↗
PubMed2005

No overall hyposialylation in hereditary inclusion body myopathy myoblasts carrying the homozygous M712T GNE mutation.

Hereditary inclusion body myopathy (HIBM) is a unique group of neuromuscular disorders characterized by adult-onset, slowly progressive distal and proximal muscle weakness, which is caused by mutations in UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase (GNE), the key enzyme in the biosynthetic pathway of sialic acid. In order to investigate the consequences of the mutated GNE enzyme in muscle cells, we have established cell cultures from muscle biopsies carrying either kinase or epimerase mutations. While all myoblasts carrying a mutated GNE gene show a reduction in their epimerase activity, only the cells derived from the patient carrying a homozygous epimerase mutation present also a significant reduction in the overall membrane bound sialic acid. These results indicate that although mutations in each of the two GNE domains result in an impaired enzymatic activity and the same HIBM phenotype, they do not equally affect the overall sialylation of muscle cells. This lack of correlation suggests that the pathological mechanism of the disease may not be linked solely to the well-characterized sialic acid pathway.

Cell Membrane↗
PubMed2004

Adsorption characteristics of Ni(II) on gamma-type alumina particles and its determination of overall adsorption rate by a differential bed reactor.

The adsorption experiment of nickel ion [Ni(II)] on gamma-type alumina by a differential bed reactor in aqueous solutions was investigated to determine the adsorption characteristics and overall adsorption rate. The adsorbed amount increased rapidly with pH from pH 2 to 6 and kept constant over pH 6. The adsorbed amount of Ni(II) increased with temperature from 20 to 50 degrees C. Correlation coefficients (R2) of Langmuir and Freundlich adsorption isotherms were 0.9268 and 0.9489, respectively, and Freundlich isotherm was more suitable for adsorption on gamma-type alumina than Langmuir isotherm. The overall adsorption rate of Ni(II) on gamma-type alumina at pH 6 by a differential bed rector was determined as follows: r = 68.77Ce(1.61) - 17.60qe(0.36). Al(III) ions in solutions were away from the alumina surface during the adsorption of Ni(II) and Al(III) concentration increased with an increasing Ni(II) adsorbed amount on alumina.

Adsorption↗
PubMed2007

Soluble MICA as an independent prognostic factor for the overall survival and progression-free survival of multiple myeloma patients.

Major histocompatibility complex class I-related chain A (MICA) molecules are frequently expressed in lymphoproliferative malignancies including multiple myeloma (MM). MICA activates NK cells and co-stimulates T cells by interaction with its immunoreceptor NKG2D. In contrast, soluble MICA (sMICA) molecules impair the functions of NKG2D(+) T and NK cells, which may facilitate tumor cell escape from immunosurveillance. Here, we analyzed the clinical relevance of sMICA in 97 MM patients. sMICA (mean+/-SEM pg/ml) was significantly increased (p<0.0001) in patients (429+/-20) compared to controls (230+/-20; N=43). Serial determination showed a strong correlation between increments of sMICA and paraprotein levels (r=0.543, p<0.0001, N=49). sMICA levels >305 pg/ml are associated with a poor overall (p=0.004) and progression-free survival (p=0.002). Multivariate analysis revealed sMICA as an independent predictive factor for overall (p=0.007) and progression-free survival (p=0.002). Thus, our results suggest sMICA as a potent prognostic marker in MM, which may be useful to identify risk patients.

Biomarkers, Tumor↗
PubMed2004

Motion velocity thresholds in deaf signers: changes in lateralization but not in overall sensitivity.

In a series of three experiments, we tested whether deaf native signers process motion velocity information differently from hearing nonsigners. In Experiment 1, participants watched radially moving dots and were asked to detect the quadrant in which the velocity of the dots had changed. Similar 79% thresholds were observed in the two populations. In Experiments 2 and 3, peripheral and central thresholds were assessed separately as previous studies suggest early deafness leads mainly to changes in the processing of visual peripheral information. Neither condition produced an overall population difference. These negative results were not due to a lack of sensitivity in our experiments. Indeed, as has been previously reported, deaf native signers exhibited better thresholds in the right than in the left visual field, whereas the opposite pattern was observed in the hearing. This effect appears triggered by experience with American Sign Language (ASL) rather than deafness per se. Overall, this study confirms that early deafness does not enhance motion processing, and suggests that most of the changes previously described in the literature are instead attributable to changes in attention, and possibly special alterations of attention-to-motion processes.

Adult↗
PubMed2006

Overall and disease-specific survival of patients with screen-detected prostate cancer in the European randomized study of screening for prostate cancer, section Rotterdam.

INTRODUCTION: This report describes survival data of participants of the European Randomized Study of Screening for Prostate Cancer (ERSPC), section Rotterdam, diagnosed with prostate cancer (pCA) during the first round of screening, the prevalence screen. PATIENTS AND METHODS: pCA characteristics from cases diagnosed during the first screening round from December 1993 to March 2000 are shown. During follow-up, data were collected by semiannual patient chart review for the first 5 yr and annually thereafter. The causes of death are scored according to the diagnosis of the treating physician and are not based on the review of the independent causes-of-death committee. Overall and disease-specific survival graphs are shown in Kaplan-Maier projections and compared with expected survival outcomes for males in the same age categories from the Dutch provinces of North Holland and Flevoland. Statistical evaluation was based on Cox regression analysis. RESULTS: During the prevalence screening, 1014 patients were diagnosed with pCA. Median follow up was 55 mo, 126 (12.4%) patients died, 20 (2.0%) of pCA. Overall 5-yr observed and expected disease-specific survival was 97.7% and 82%, respectively. In the multivariate analysis, a Gleason sum of 4+4 or higher (p=0.025) was predictive of pCA death. CONCLUSIONS: The observed survival data are in line with the literature and the expected favorable outcome for a screened population. The proportion of men dying from pCA is still small, and a 10-yr follow-up period for the final evaluation of the ERSPC may be too short.

Aged↗
PubMed2005

The first characterisation of the overall variability of repetitive units in a species reveals unexpected features of satellite DNA.

We investigated the overall variability of the S1a satellite DNA repeats in ten European populations of Rana temporaria by a new procedure that determines the average sequence of the repeats in a genome. The average genomic sequences show that only 17% of the S1a repeat sequence (494 bp) is variable. The variable positions contain the same major and minor bases in all or many of the population samples tested, but the percentages of these bases can greatly vary among populations. This indicates the presence in the species of an enormous number of repeats having a different distribution of bases in these variable positions. Individual genomes contain thousands of repeat variants, but these mixtures have very similar characteristics in all populations because they present the same type of restricted and species-specific variability. Southern blots analyses and sequences of cloned S1a repeats fully support this conclusion. The S1 satellite DNA of other European brown frog species also presents properties indicating the same type of variability. This first characterisation of the overall repeat variability of a satellite DNA in a species has revealed features that cannot be determined by gene conversion and crossing over. Our results suggest that a specific directional process based on rolling circle amplification should play a relevant role in the evolution of satellite DNA.

Animals↗
PubMed2005

Radiotherapy for early glottic carcinoma (T1N0M0): results of prospective randomized study of radiation fraction size and overall treatment time.

PURPOSE: To investigate in a prospective randomized study the effect of radiation fraction size and overall treatment time on the local control of early glottic carcinoma. METHODS AND MATERIALS: Between December 1993 and December 2001, 180 patients with early glottic carcinoma (T1N0M0) were treated at our department. The patients were randomly allocated to either treatment arm A (radiation fraction size 2 Gy, n = 89) or B (2.25 Gy, n = 91). The total radiation dose administered was 60 Gy in 30 fraction within 6 weeks for minimal tumors (two-thirds of the vocal cord or less) or 66 Gy in 33 fractions in 6.6 weeks for larger than minimal tumors (more than two-thirds of the vocal cord) in Arm A and 56.25 Gy in 25 fractions within 5 weeks for minimal tumor or 63 Gy in 28 fractions within 5.6 weeks for larger than minimal tumors in Arm B. RESULTS: The 5-year local control rate was 77% for Arm A and 92% for Arm B (p = 0.004). The corresponding 5-year cause-specific survival rates were 97% and 100% (no significant difference). No significant differences were found between these two arms in terms of rates of acute mucosal reaction, skin reactions, or chronic adverse reactions. CONCLUSION: Use of 2.25-Gy fractions with a shorter overall treatment time for Arm B showed superior local control compared with conventional use of 2-Gy fractions for Arm A without adverse reactions from the greater fraction.

Aged↗
PubMed2005

Prognostic factors predicting functional outcomes, recurrence-free survival, and overall survival after radiotherapy for metastatic spinal cord compression in breast cancer patients.

PURPOSE: To identify significant prognostic factors after irradiation of metastatic spinal cord compression (MSCC) in 335 breast cancer patients. METHODS AND MATERIALS: The potential prognostic factors investigated included involved vertebra, other bone metastases, visceral metastases, performance status, pretreatment ambulatory status, time until motor deficits developed before RT, radiation schedule (shorter-course RT [one fraction of 8 Gy/five fractions of 4 Gy] vs. longer-course RT [10 fractions of 3 Gy/15 fractions of 2.5 Gy/20 fractions of 2 Gy), and the response to RT. RESULTS: On multivariate analysis, better functional outcome was associated with slower development of motor deficits (p <0.001) and being ambulatory before RT (p <0.001). The overall recurrence rate of MSCC was greater if other bone metastases were present (p <0.001) and if shorter-course RT was used (p <0.001). In-field recurrences alone were more frequent after shorter-course RT (p = 0.008). Survival was negatively affected by the presence of visceral metastases (p <0.001), deterioration of motor function after RT (p <0.001), reduced performance status (p <0.001), and the rapid development of motor deficits (p = 0.044). CONCLUSION: Outcomes and survival after RT for MSCC in breast cancer patients are associated with several prognostic factors. Patients with poor expected survival may be treated with shorter-course RT to keep the overall treatment time short. If survival is expected to be relatively favorable, longer-course RT appears preferable, because it is associated with fewer MSCC recurrences.

Breast Neoplasms↗