Small-cell lung cancer (SCLC), a chemotherapy-responsive disease, is characterized by neuroendocrine properties. In contrast, non-small-cell lung cancer (NSCLC) is at best moderately responsive to chemotherapy, and only 10% to 20% of cases demonstrate neuroendocrine properties. The present study is a retrospective analysis of the use of immunoperoxidase markers for neuron-specific enolase (NSE), Leu-7, and chromogranin A in NSCLC patients treated with chemotherapy. It was designed to determine if the presence of neuroendocrine markers predict for response to chemotherapy. The diagnostic slides and blocks were obtained on 52 NSCLC patients who were treated with chemotherapy (26 responders and 26 nonresponders). Immunoperoxidase studies were performed, and slides were scored without knowledge of the patient's response. Markers were positive in responders and nonresponders, respectively, as follows: NSE, 14 of 26 (54%) versus seven of 26 (27%), P = .04; Leu-7, 11 of 25 (44%) versus five of 26 (19%), P = .08; and chromogranin A, three of 26 (12%) versus 0 of 26 (0%), P = .71. Two markers were positive in 10 of 26 responders (38%) and 0 of 26 nonresponders (0%), P less than .01. Responders with two or more positive markers showed superior survival (median, 79 weeks) compared with responders with fewer than two positive markers (median, 51 weeks) and nonresponders (median, 27 weeks). These data suggest that the presence of neuroendocrine markers in NSCLC is associated with an increased likelihood of response to chemotherapy and may add to the standard parameters (performance status, weight loss) used to select patients for chemotherapy.
Summary:risk of GVHD while the risk of graft failure and relapse increase. [2][3][4] Thus the short-term benefit of T cell depletion may not improve the overall survival of patients. The stanWe conducted a study to evaluate the efficacy of the combination of tacrolimus and short-course methotrexdard approach to the prevention of acute GVHD is through pharmacologic immunosuppression. Presently, most regiate for the prevention of acute GVHD in patients with hematologic malignancies. Patients received preparative mens for GVHD prophylaxis are centered on cyclosporine as the main immunosuppressant given in conjunction with regimens specific for their disease category. Twenty-six out of 28 received HLA-identical sibling transplants and various doses and schedules of methylprednisolone and/or methotrexate. [5][6][7][8][9][10] The majority of clinical trials conducted the two remaining patients received one-antigen mismatched transplants from a family member. With a over the past decade suggest the superiority of a combination of cyclosporine and a short course of methotrexate median follow-up of 14 months, the Kaplan-Meier estimate of event-free survival was 50 ؎ 9%. The probover either agent alone. In these trials, acute GVHD still developed in 8-33% of patients who received a marrow ability of grade II-IV GVHD was 15 ؎ 7%. Four patients developed GVHD: two had grade II and one graft from an HLA-matched sibling donor. Tacrolimus is a new immunosuppressive agent which is each developed grade III and IV GVHD. Administration of methotrexate was associated with severe effective in the prevention and treatment of graft rejection in solid organ transplantation. 11,12 The efficacy of tacrolmucositis and there was no correlation between the distribution of the GVHD grade and the cumulative dose imus for the prevention of acute GVHD has been shown in both murine and canine models. 13,14 Several pilot clinical of methotrexate given. Thirteen patients have died; nine from transplant-related complications and four from trials have confirmed the potential of tacrolimus as an agent for GVHD prophylaxis in allogeneic BMT. 15,16 These relapse. The major toxicity of tacrolimus was renal. Nine out of 28 patients (32%) developed renal dysfuncobservations, although preliminary, indicate that tacrolimus is an effective agent for the prevention of acute GVHD in tion attributed to tacrolimus. The combination of tacrolimus and methotrexate is an effective regimen for allogeneic BMT. In this report, we describe our results with 28 patients who received a combination of tacrolimus and GVHD prophylaxis but associated with significant renal and mucosal toxicity. Further studies of tacrolimus as short-course methotrexate for GVHD prophylaxis after allogeneic BMT from sibling donors. a single agent or in combination with either steroids or with a lower dose of methotrexate or with other antiproliferative drugs to modify the adverse events may improve the therapeutic index of this useful and promising agent.Materials and methods Keywords: alloge...
Simulation training improved pediatric residents' central venous catheter insertion procedural skills. Decay in skills was found at 3-month follow-up. This suggests that simulation training for this procedure should occur in close temporal proximity to times when these skills would most likely be used clinically and that frequent refresher training might be beneficial to prevent skills decay.
This study provides some initial evidence to support the validity and reliability of the ILP-anchored GRS. Acceptable internal consistency was found for the checklist instrument. The GRS instrument outperformed the checklist in its discriminant ability and interrater agreement.
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