Glanders is a contagious zoonotic disease caused by Burkholderia mallei. Following the detection of glanders positive horses using the OIE complement fixation test, the tissues of two horses were analysed by PCR. While PCR systems targeting the Burkholderia pseudomallei complex gave positive signals, the species-specific PCR systems targeting B. mallei (fliP-IS407A) and B. pseudomallei (orf11)-the OIE recommended targets-resulted in negative signals. However, the presence of B. mallei in these tissues was confirmed with a recently described B. mallei-specific real-time PCR system and genotyping with MLST-and SNP-based methods, performed on the most positive tissue, identified a genotype closely related to B. mallei strains recently isolated in the Middle East. This study leads to recommendations regarding the use of PCR systems for the molecular diagnosis of glanders, especially in regions where the circulating B. mallei strains have not yet been fully genetically characterized.
Interventional oncology represents a relatively new clinical discipline based upon minimally invasive therapies applicable to almost every human organ and disease. Over the last several decades, rapidly evolving research developments have introduced a newer generation of treatment devices, reagents, and image-guidance systems to expand the armamentarium of interventional oncology across a wide spectrum of disease sites, offering potential cure, control, or palliative care for many types of cancer patients. Due to the widespread use of locoregional procedures, a comprehensive review of the methodologic and technical considerations to optimize patient selection with the aim of performing a safe procedure is mandatory. This article summarizes the expert discussion and report from the Mediterranean Interventional Oncology Live Congress (MIOLive 2020) held in Rome, Italy, integrating evidence-reported literature and experience-based perceptions as a means for providing guidance on prudent ways to reduce complications. The aim of the paper is to provide an updated guiding tool not only to residents and fellows but also to colleagues approaching locoregional treatments.
Sixty-five children with 76 hand anomalies had brachial angiography performed to help plan appropriate surgical management. Three different methods of angiography were used. The study showed that the direct exposure method is safe and simple, has few complications and gives the best visualisation of the arterial supply of the hand. It also showed that each type of congenital hand deformity is frequently associated with specific vascular alterations. Angiography is an important and safe investigation in the pre-operative assessment of cases of complex congenital hand deformities.
Background: The second interim analysis of the BCIRG001 trial at a median follow up of 55 months showed that adjuvant chemotherapy with TAC improves disease-free survival (DFS: HR 0.72; P=0.001) and overall survival (OS: HR 0.70; P=0.008) compared with FAC in women with operable node-positive breast cancer (N Engl J Med 2005;352:2302-13). We now report the final analysis of DFS, OS, and long-term safety after 10 years of follow-up.
Patients and Methods: Women with node-positive breast cancer were randomized to adjuvant treatment with either TAC or FAC every 3 weeks for 6 cycles. The primary end point was DFS. Secondary end points included OS and safety.
Results: Between June 1997 and June 1999, 1491 women (TAC N=745; FAC=746) from 20 countries were enrolled. Median follow up was 120 months. As of the cut-off date for this analysis (11 March 2010), there were a total of 620 DFS events (287 events with TAC; 333 with FAC). Ten-year DFS rates were 62% with TAC and 55% with FAC. TAC improved DFS irrespective of nodal status, hormone receptor status, and HER2/neu status. There have been 429 deaths (188 deaths with TAC; 241 with FAC) and 10-year OS rates were 76% with TAC and 69% with FAC. There was no statistically significant difference in rates of grade 3-4 congestive heart failure (CHF): TAC 3.5% vs FAC 2.3%, P=0.18. Deaths due to CHF have occurred in 2 patients in the TAC group and 4 patients in the FAC group. Rates of asymptomatic left ventricular dysfunction will be presented. A total of 6 patients have developed acute myeloid leukemia (TAC N=4; FAC N=2).
table 1
ITT, intention-to-treat
Conclusion: Ten-year follow up analysis of the BCIRG 001 trial confirmed that TAC significantly improves DFS and OS compared with FAC in women with node-positive early breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S4-3.
Sixty-five children with 76 hand anomalies had brachial angiography performed to help plan appropriate surgical management. Three different methods of angiography were used. The study showed that the direct exposure method is safe and simple, has few complications and gives the best visualisation of the arterial supply of the hand. It also showed that each type of congenital hand deformity is frequently associated with specific vascular alterations. Angiography is an important and safe investigation in the pre-operative assessment of cases of complex congenital hand deformities.
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