No abstract

These data confirm the benefit of extending adjuvant tamoxifen therapy beyond 5 years with anastrozole compared with no further treatment. Further research is required to define the optimum length of extended adjuvant therapy and to investigate the possibility of tailoring this period to suit different disease types.

ABSTRACT. Objective. To prospectively investigate the development of amplitude-integrated electroencephalographic (aEEG) activity during the first 2 weeks of life in neurologically normal and clinically stable preterm infants <30 weeks' gestational age (GA).Patients and Methods. Infants with a GA of <30 weeks admitted to the neonatal intensive care unit of the Vienna University Children's Hospital (Vienna, Austria) were studied prospectively by using aEEG and cranial ultrasound. Clinically stable infants without clinical or sonographic evidence of neurologic abnormalities were eligible for inclusion in the reference group. The distribution of 3 background aEEG activity patterns (discontinuous low-voltage, discontinuous high-voltage, and continuous), presence of sleep-wake cycles, and number of bursts per hour in the reference group were determined by visual analysis.Results. Seventy-five infants (median GA: 27 weeks; range: 23-29 weeks) were eligible for inclusion in the reference group and had aEEG recordings during the first 2 weeks of life available. Analysis of aEEG background activity showed that with higher GA the relative amount of continuous activity increased while discontinuous patterns decreased. The number of bursts per hour decreased with increasing GA. Cyclical changes in aEEG background activity resembling early sleep-wake cycles were observed in all infants.Conclusions. Normal values for aEEG background activity were determined in preterm infants <30 weeks' GA. Clinically stable and neurologically normal preterm infants exhibit at least 2 different patterns of aEEG activity. There is a correlation between the GA and the relative duration of continuous aEEG activity. A dvances in neonatal intensive care during the last decades have led to an increased survival rate of extremely low birth weight infants. However, neurologic and developmental disability is still common among survivors. 1 Prevention of brain injury in these patients has become one of the main goals of modern neonatology. Continuous monitoring of neonatal brain function may aid in the identification of risk factors and patients at increased risk for neurologic morbidity. Early recognition and modification of potentially harmful environmental factors may prevent secondary brain injury.Conventional electroencephalography (EEG) is one of the most useful tools for intermittent and continuous assessment of brain function and prediction of neurologic outcome in term infants and children. 2-4 However, conventional EEG has limitations in its application for extremely low birth weight infants. Registration and interpretation of conventional EEG in this age group are difficult because of the electrical interferences on the neonatal intensive care unit, the large volume of data generated during a longer recording, and the need for 24-hour availability of a skilled examiner experienced in EEG of preterm infants. Further, data on normal EEG patterns in extremely premature infants are still limited. 5,6 Recently, amplitude-integrated EEG (aEEG) pro...

Purpose: The present pilot study was performed to elucidate whether early changes in serum Her-2/neu extracellular domain (ECD) levels during trastuzumab-based treatment would predict the clinical course of disease in patients with metastatic breast cancer.Experimental Design: Sera from 55 patients with Her-2/neu-overexpressing metastatic breast cancer obtained immediately before each weekly administration of trastuzumab were analyzed by a serum Her-2/neu ELISA.Results: Whereas response rates were significantly higher in patients with elevated (>15 ng/ml) ECD levels before initiation of treatment (35% versus 7%, P ‫؍‬ 0.045), progression-free and overall survival did not differ significantly between patients with normal and elevated ECD levels. In patients responding to treatment, ECD levels decreased significantly as early as from day 8 of treatment onwards (all P for weekly measurements versus baseline <0.001). In contrast, no significant change in ECD levels was observed in patients with progressive disease. Multiple logistic regression analyses identified kinetics of ECD levels as the only factor that allowed for the accurate prediction of response likelihood as early as from day 8 of trastuzumabbased treatment onwards (P ‫؍‬ 0.020). In addition, determination of serial ECD levels allowed for the prediction of the risk for disease progression within the observed period as early as day 15 of treatment (P ‫؍‬ 0.010).Conclusions: Serial monitoring of the ECD may represent a valuable tool for early prediction of the probability of response and progression-free survival to trastuzumabbased treatment and is thus likely to contribute to an optimization of treatment and resource allocation.

Percutaneous saline-enhanced and impedance-controlled radiofrequency ablation can be effective in the treatment of unresectable hepatic tumors and minimizes potential carbonization. A greater number of radiofrequency applications, general anesthesia, and increasing experience provide significantly better results.