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At least 109 records · Page 6Linked to original sources
PubMed1992

MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study.

PURPOSE: The prognosis of advanced-stage diffuse large-cell lymphoma (DLCL) has improved with the use of the third-generation regimens such as methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B). However, different results have been reported. Therefore, we started a cooperative study to confirm the efficacy of MACOP-B. An analysis of prognostic factors was also performed to identify poor-prognosis patients. PATIENTS AND METHODS: Between June 1986 and March 1989, 180 patients with advanced-stage DLCL were treated with MACOP-B. MACOP-B was given according to the original scheme. Numerous clinical features possibly predictive for complete response (CR), disease-free survival (DFS), and survival were analyzed in univariate and multivariate analyses. RESULTS: One hundred twenty-seven patients (71%) achieved a complete remission, 20 (11%) achieved a partial remission, 24 (13%) had unchanged or progressive disease, and nine (5%) died due to toxicity. With a median follow-up of 28 months, 71% of 127 CRs remain in first remission. Predicted 3-year survival for all 180 patients is 60%, and 3-year DFS for the 127 CRs is 67%. Overall toxicity was acceptable, with mucositis being the most frequent severe side effect. A multivariate regression analysis identified lactate dehydrogenase (LDH) level, bone marrow involvement, and tumor burden as independent risk factors for survival. These factors were also important for achievement of remission and DFS and allowed us to identify three distinct risk groups of patients with good, intermediate, and poor prognosis, with 3-year survival rates of 80%, 59%, and %29, respectively. CONCLUSIONS: These results confirm the effectiveness of MACOP-B in advanced-stage DLCL at low or intermediate risk; however, high-risk patients are in urgent need of new therapeutic approaches. A better definition of prognostic features would allow a more reliable comparison of different treatment regimens, as well as an effective tailoring of therapy by prognostic groups.

Adolescent↗
PubMed1992

Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COPBLAM/IMVP-16 regimen. A multicenter study. Kiel Lymphoma Study Group.

OBJECTIVE: To describe the clinical course of patients with angioimmunoblastic lymphadenopathy (AILD)-type lymphoma with a sequential treatment with prednisone and COPBLAM/IMVP-16. DESIGN: A multicenter, prospective, nonrandomized trial. SETTING: University medical centers and community hospitals. PATIENTS: Sixty-seven patients were registered, 28 were excluded, and 39 patients were evaluable for response (median age, 59 years; range, 25 to 82 years) (stages I and II, 10%; stages III and IV, 90%; B symptoms, 74%). MEASUREMENTS: Response, survival, and relapse. INTERVENTION: Patients initially received prednisone and no further treatment if a complete remission was achieved. Relapsing or refractory patients were treated with COPBLAM/IMVP-16. Patients with life-threatening tumor progression or extension received COPBLAM/IMVP-16 initially. Treatments were chosen in accordance with tumor extension and response to prednisone. Treatment modalities were not compared. RESULTS: Twenty-eight patients received primary prednisone, 18 received secondary prednisone, and 11 received primary chemotherapy. The complete response rates (with 95% CIs) were 29% (CI, 12% to 46%), 56% (CI, 33% to 79%), and 64% (CI, 36% to 92%), respectively. The median observation time of surviving patients was 28 months (range, 7 to 53). The median overall survival time was 15 months. The probabilities (with 95% CIs) of overall survival, event-free survival, and relapse at 36 months were 40.5% (CI, 24% to 56%), 32.3% (CI, 17% to 47%), and 34.6% (CI, 14% to 56%), respectively. At the time of evaluation, 22 of 39 patients had died, 7 of noninfectious complications and 14 of infections. CONCLUSIONS: Prednisone with or without COPBLAM/IMVP-16 treatment in AILD-type lymphoma leads to complete remissions in about half of the patients and in long-term, disease-free survival for one third.

Adult↗
PubMed1992

Neonatal periventricular-intraventricular hemorrhage after maternal beta-sympathomimetic tocolysis. The March of Dimes Multicenter Study Group.

OBJECTIVE: Our objective was to determine if the rate of periventricular-intraventricular hemorrhage is increased in the offspring of women who received a beta-sympathomimetic agent as part of the management of preterm labor. STUDY DESIGN: This retrospective study consists of 2827 women who were delivered of a singleton, live infant free of congenital neurologic anomalies between 25 and 36 completed weeks of gestation during a multicenter preterm birth prevention trial. The data were analyzed, adjusting for type of tocolytic agent, race, infant sex, gestational age, birth weight, health care center, route of delivery, indication for delivery, intrapartum fetal distress, respiratory distress syndrome, and neonatal sepsis. RESULTS: The overall incidence of periventricular-intraventricular hemorrhage in this population was 5.6%. In a univariate analysis in which no adjustment was made for potentially confounding variables, beta-sympathomimetic tocolysis was found to be associated with nearly a fourfold increase in the incidence of periventricular-intraventricular hemorrhage when compared with the use of either magnesium sulfate or no tocolytic agent. The results of a multivariate regression analysis revealed that beta-sympathomimetic agents were associated with a statistically significant increase in the overall incidence of periventricular-intraventricular hemorrhage (odds ratio 2.47, 95% confidence interval 1.34 to 4.56, p = 0.004) and a similar, but not significant, increase in the incidence of grades 3 and 4 periventricular-intraventricular hemorrhage (odds ratio 2.50, 95% confidence interval 0.96 to 6.48, p = 0.06). CONCLUSION: beta-Sympathomimetic tocolytic therapy may be associated with a more than twofold increase in the incidence of neonatal periventricular-intraventricular hemorrhage.

Birth Weight↗
PubMed1977

Prostaglandins and abortion. II. Single extra-amniotic administration of 0.92 mg. of 15-methyl prostaglandin F2alpha in Hyskon for termination of pregnancies in weeks 10 to 20 of gestation: an international multicenter study. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility.

In a multicenter comparative trial, 15-methyl prostaglandin F2alpha(PGF2alpha), 0.92 mg., was administered by extra-amniotic injection to 660 patients. Abortion of the fetus occurred within 24 hours in 479 patients (72.6 per cent) and within 36 hours in 530 patient (80.3 per cent). Abortion was complete in 31 per cent of the cases. The commonest side effects were vomiting and diarrhea, but these symptoms were not severe, the mean frequencies being 0.9 episodes of vomiting per patient and 0.7 episodes of diarrhea per patient. It is concluded that this method is safe and effective for the induction of abortion.

Abortion, Induced↗
PubMed2026

Pancreatic neuroendocrine tumors in patients with tuberous sclerosis: a multicenter study and systematic review.

INTRODUCTION: Pancreatic neuroendocrine tumors (pNETs) are a recognized feature of tuberous sclerosis complex (TSC). The current evidence suggests that pNETs occurring in TSC may exhibit a different clinical course from sporadic cases, but their natural history remains poorly characterized. OBJECTIVE: This study aimed to characterize the demographics, clinical presentation, management, and long-term outcomes of TSC-associated-pNETs and to propose possible guidelines for surveillance and management. MATERIALS AND METHODS: We conducted a multicenter retrospective review of TSC-pNET patients from 6 UK TSC specialist clinics and from 3 NET referral centers, from 2008 to 2024. Data on demographics, tumor characteristics, management, and outcomes, were collected. A systematic review of the literature from 2009 to 2026 on TSC-pNETs was also performed. RESULTS: We identified a total of 26 consecutive cases with the TSC-pNET-association in our cohort: 21 cases of pNETs from TSC specialist clinics (1.1% of the population), and 5 cases of TSC-pNETs from the NET referral centers (0.25% of the population). An additional 80 cases were identified from the published literature. We observed a wide spectrum of clinical phenotypes, with the majority being nonfunctioning pNETs (n = 24; 92%), whereas 2 patients were diagnosed with glucagonomas. Surgical intervention was the mainstay initial treatment, the indication being either functional pNETs, or large or symptomatic nonfunctioning pNETs. CONCLUSION: TSC-pNETs are rare and mostly nonfunctioning tumors with variable clinical behavior. Due to their uncertain malignant potential, we suggest that baseline pancreatic imaging should be incorporated into TSC surveillance, and we emphasize the need for heightened pNET surveillance and updated management recommendations.

TS complex↗
PubMed2026

Predictive value of Rectal and Throat-nose Screening for the presence of Multidrug-Resistant Organisms in Duodenal Fluid as a Risk of Duodenoscope Contamination: A Multicenter Study.

BACKGROUND: Duodenoscopes have been implicated in patient-to-patient transmission of multidrug-resistant organisms (MDROs). Current gastrointestinal MDRO surveillance relies on rectal screening, yet the duodenum is the primary site of duodenoscope exposure. This study evaluated the predictive value of rectal and throat-nose screening for detecting duodenal MDROs as a marker of duodenoscope contamination risk. METHODS: Adult patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) at tertiary care centers in the Netherlands and India were included. Rectal swabs, throat-nose swabs, and duodenal aspirates were analyzed for MDROs. The detected MDROs were compared using species identification, antibiotic susceptibility patterns, and whole-genome sequencing. RESULTS: Among 512 participants (Netherlands: 339; India: 173), rates of duodenal and rectal MDRO carriage were higher in India (56.6% (98/173); 79.8% (138/173), respectively) than in the Netherlands (5.6% (19/339); 10.3% (35/339)). Given the low prevalence of throat-nose carriage, only the predictive value of rectal screening was assessed. Rectal screening sensitivity for genetically related strains in duodenal fluid was 32.7% in India and 68.4% in the Netherlands . For detecting any duodenal MDRO, sensitivity reached 91.8% in India and 84.2% in the Netherlands, with specificities of 36.0% and 94.1%. Positive predictive value (PPV) was low (India: 65.2%; Netherlands: 45.7%), while negative predictive value was 77.1% and 99%, respectively. CONCLUSIONS: Rectal screening is unreliable for detecting strain-specific duodenal MDROs and overestimates true carriage due to low PPV values. However, it provides excellent rule-out value in low-prevalence settings. Consequently, its utility for guiding infection prevention strategies for duodenoscope contamination is greatest in low-MDRO-prevalence regions.

Bacterial↗
PubMed1978

Sensitivity and precision of activated partial thromboplastin time (APTT) methods. A multicenter study.

The Activated Partial Thromboplastin Time (APTT) test, Cephotest, was compared to other APTT methods in current use in 4 specialized coagulation laboratories. In 3 of 4 laboratories, the sensitivity of Cephotest was superior (P less than 0.001) to that of the local APTT method. There was no statistically significant difference between the APTT methods with regard to precision of repetitive testing. In each laboratory, the normal range of Cephotest was estimated on freshly collected plasma samples from healthy subjects. A mean value between 28.8 and 35.8 s, with a standard deviation of 1.1-3.3 s, was obtained. It is concluded that the composition of the APTT method if of importance for the sensitivity of this test, but does not influence the precision of repetitive testing to a significant degree. The use of a standardized reagent facilitates comparison of the results obtained with the APTT method from one laboratory to another.

Blood Coagulation Tests↗
PubMed1977

Controlled trial of chenodeoxycholic therapy for radiolucent gallstones. A multicenter study.

134 patients with radiolucent gallstones were randomly allocated to receive either placebo or 1 of 3 different doses of chenodeoxycholic acid (CDCA); 750, 1,500, or 3,000 mg). The initial dose was lowered if not well tolerated. 107 patients were treated for more than 3 months. Among them, stones dissolved in 21 and were smaller in 25 patients. Partial or complete dissolution occurred in 4 of the 13 receiving 375 mg/day, 14 of 37 receiving 750 mg, 24 of the 38 receiving 1,500 mg and 4 of 8 receiving 3,000 mg/day. The number of responders to the therapy was significantly greater in the groups of patients receiving 1,500 mg/day or 17-24 mg/kg body weight than in any other group. However, side effects, i.e., diarrhea and transaminase increase, are also dose related. It appears from this study that the optimal dose of CDCA may be between 17 and 20 mg/kg body weight.

Adult↗
PubMed1978

Diet and cholesterol gallstones. A multicenter study.

In France, changes in the incidence of gallstones during the 20 years following World War II paralleled the changes in total calories, protein and lipid of the diet. The incidence of gallstones in autopsy statistics has been compared to the diets in different countries: France, India, Japan, Portugal, South Africa, Sweden and Uganda. Low calorie, low protein, low lipid intake and vegetable diet are associated with a low incidence of gallstones. A positive correlation between calorie intake and gallstones incidence was found at necropsy for calorie intakes lower than 3,000 kcal. In countries with high calorie, high protein and high lipid intakes, such a correlation was not found. These results suggest that a hypocaloric diet associated with a low intake of fat and protein mostly of vegetable origin, is protective against cholelithiasis.

Cholelithiasis↗
PubMed1979

Laboratory investigations in patients with generalized psoriasis under oral retinoid treatment. A multicenter study of computerized data.

Numerous laboratory parameters were examined 235 patients with generalized psoriasis treated orally with retinoid and in 35 patients treated topically with anthralin as control. Computer evaluation of the obtained data revealed statistical trends to elevation of the total serum bilirubin level and increasing number of blood monocytes after long-term oral treatment. No other statistically significant changes of the laboratory data were found. Particularly, the liver function tests (transaminases, prothrombin and alkaline phosphatase) showed no significant alterations. Only in a few cases did the retinoid compound have an influence on the GPT and GOT levels. The reasons for this individual sensitivity to the drug remain unknown. No significant alterations were found in the control group treated topically with anthralin.

Administration, Oral↗
PubMed1978

A multicentered study of lysine therapy in Herpes simplex infection.

Lysine appears to suppress the clinical manifestations of herpesvirus infection. 45 patients with frequently recurring herpes infection were given 312-1,200 mg of lysine daily in single or multiple doses. The clinical results demonstrated a beneficial effect from supplementary lysine in accelerating recovery from herpes simplex infection and suppressing recurrence. Tissue culture studies have demonstrated an enhancing effect on viral replication when the amino acid ratio of arginine to lysine favors arginine. The opposite, preponderance of lysine to arginine, suppresses viral replication and inhibits cytopathogenicity of herpes simplex virus. The codons characterizing herpes simplex DNA apparently specify production of viral capsids at the expense of host cell histones.

Adolescent↗
PubMedDate not supplied

Diffuse otitis externa: clinical and microbiologic findings in the course of a multicenter study on a new otic solution.

This report reviews the literature on the epidemiology, pathogenesis and bacteriology of diffuse otitis externa. Four departments of otolaryngology undertook identical studies of these factors, as well as the efficacy and safety of two similar antibiotic-corticosteroid formulations; one a suspension and the other a clear solution. A total of 239 patients, or 283 ears, were studied, utilizing objective clinical as well as correlative bacteriologic criteria. A high degree of clinical and bacteriologic efficacy was demonstrated by the medications irrespective of the formulation, infecting organism, patient's age, length of disease history, severity, or geographic location. There was no statistical difference between either formulation, both achieving a clinical efficacy rate of 97% and a bacteriologic efficacy rate of 83%. Drug related side effects occurred in 1.9% of the patients given the solution and in 1.1% of those given the suspension.

Adolescent↗
PubMed1975

Serologic evidence of hepatitis B virus infection in patients with hemophilia B. a multicenter study.

Among sera from 160 patients with hemophilia B from 9 centers in Europe and North and South America, 2.5% were positive for hepatitis B surface antigen (HBsAg), 60for antibody to HBsAg, and 31% for antibody to the hepatitis B core antigen. Evidence of exposure to the hepatitis B virus appeared to be related to severity of disease and age rather than the source and method of manufacturer of factor IX concentrate.

Antibodies, Viral↗
PubMed1979

A multicenter study for analgesia involving fenoprofen, propoxyphene [alone or in combination] with placebo and aspirin controls in postpartum pain.

One investigator at each of 4 institutions followed the requirements of a core protocol designed to evaluate propoxyphene napsylate (50, 100 and 150 mg), fenoprofen calcium (200, 400 and 600 mg) and their combination (50/200, 100/400 and 150/600 mg) in patients reporting postpartum pain. Placebo and aspirin (650 mg) were included as control medications. Analyses were based on subgrouping which isolated individually the interactions between medications and the following factors: dose-observation criteria, the investigator-observer-institution differences, the intensity of pain at the time the medication was given, and postepisiotomy-wound compared to uterine-cramp pain. Each of these factors influenced the absolute scores for analgesia significantly, but had no significant influence on the relative rankings of the medications. The analgesia scores for individual patients in each subgroup were transformed to ridits and then pooled. A linear increase in effectiveness occurred in response to increasing doses of propoxyphene, fenoprofen, and their combination in this dose range. The dose responses were essentially parallel. The combination was more effective than either drug alone.

Analgesia↗