Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer

BACKGROUND: Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy. METHODS: From 1978 through 1986, 318 premenopausal women with node-positive breast cancer were randomly assigned, after modified radical mastectomy, to receive chemotherapy plus radiotherapy or chemotherapy alone. Radiotherapy was given to the chest wall and locoregional lymph nodes between the fourth and fifth cycles of cyclophosphamide, methotrexate, and fluorouracil. RESULTS: After 15 years of follow-up, the women assigned to chemotherapy plus radiotherapy had a 33 percent reduction in the rate of recurrence (relative risk, 0.67; 95 percent confidence interval, 0.50 to 0.90) and a 29 percent reduction in mortality from breast cancer (relative risk, 0.71; 95 percent confidence interval, 0.51 to 0.99), as compared with the women treated with chemotherapy alone. CONCLUSIONS: Radiotherapy combined with chemotherapy after modified radical mastectomy decreases rates of locoregional and systemic relapse and reduces mortality from breast cancer.     

Efficacy of oral pyronaridine for the treatment of acute uncomplicated falciparum malaria in African children

Pyronaridine is a new antimalarial agent developed in China. In this randomized, unblinded study, the safety, tolerance, and clinical efficacy of pyronaridine (n = 44) were evaluated and compared with those of chloroquine (n = 44), the standard first-line antimalarial drug in most of Africa, in 88 Cameroonian children with acute uncomplicated falciparum malaria. The target sample size was determined to detect a 35% difference in in vivo resistance between the two treatment groups, with 95% power. Clinical and parasitological responses were monitored for 14 days on an outpatient basis. Seven children (3 treated with pyronaridine and 4 treated with chloroquine) were lost to follow-up and were excluded from the analysis. All 41 patients treated with pyronaridine were cured. Treatment failure was observed in 16 (40%) of the 40 children treated with chloroquine. In vitro assays indicated that 23 of 40 clinical isolates obtained from patients treated with pyronaridine were resistant in vitro to chloroquine. Side effects associated with pyronaridine intake were minor and transient. Pyronaridine is safe and well tolerated by symptomatic Cameroonian children, and it is highly efficacious in Africa, where chloroquine resistance is well established.     

In vitro culture and drug sensitivity assay of Plasmodium falciparum with nonserum substitute and acute-phase sera

The short-term in vitro growth of Plasmodium falciparum parasites in the asexual erythrocytic stage and the in vitro activities of eight standard antimalarial drugs were assessed and compared by using RPMI 1640 medium supplemented with 10% nonimmune human serum, 10% autologous or homologous acute-phase serum, or 0.5% Albumax I (lipid-enriched bovine serum albumin). In general, parasite growth was maximal with autologous (or homologous) serum, followed by Albumax I and nonimmune serum. The 50% inhibitory concentrations (IC50s) varied widely, depending on the serum or serum substitute. The comparison of IC50s between assays with autologous and nonimmune sera showed that monodesethylamodiaquine, halofantrine, pyrimethamine, and cycloguanil had similar IC50s. Although the IC50s of chloroquine, monodesethylamodiaquine, and dihydroartemisinin were similar with Albumax I and autologous sera, the IC50s of all test compounds obtained with Albumax I differed considerably from the corresponding values obtained with nonimmune serum. Our results suggest that Albumax I and autologous and homologous sera from symptomatic, malaria-infected patients may be useful alternative sources of serum for in vitro culture of P. falciparum isolates in the field. However, autologous sera and Albumax I do not seem to be suitable for the standardization of isotopic in vitro assays for all antimalarial drugs.     

Self-taught learning via exponential family sparse coding for cost-effective patient thought record categorization

Automatic patient thought record categorization (TR) is important in cognitive behavior therapy, which is an useful augmentation of standard clinic treatment for major depressive disorder. Because both collecting and labeling TR data are expensive, it is usually cost prohibitive to require a large amount of TR data, as well as their corresponding category labels, to train a classification model with high classification accuracy. Because in practice we only have very limited amount of labeled and unlabeled training TR data, traditional semi-supervised learning methods and transfer learning methods, which are the most commonly used strategies to deal with the lack of training data in statistical learning, cannot work well in the task of automatic TR categorization. To address this challenge, we propose to tackle the TR categorization problem from a new perspective via self-taught learning, an emerging technique in machine learning. Self-taught learning is a special type of transfer learning. Instead of requiring labeled data from an auxiliary domain that are relevant to the classification task of interest as in traditional transfer learning methods, it learns the inherent structures of the auxiliary data and does not require their labels. As a result, a classifier achieves decent classification accuracy using the limited amount of labeled TR texts, with the assistance from the large amount of text data obtained from some inexpensive, or even no-cost, resources. That is, a cost-effective TR categorization system can be built that may be particularly useful for diagnosis of patients and training of new therapists. By further taking into account the discrete nature input text data, instead of using the traditional Gaussian sparse coding in self-taught learning, we use exponential family sparse coding to better simulate the distribution of the input data. We apply the proposed method to the task of classifying patient homework texts. Experimental results show the effectiveness of the proposed automatic TR classification framework.     

Analysis of the Plasmodium vivax dihydrofolate reductase-thymidylate synthase gene sequence

Phosphoinositide-specific phospholipase Cgamma (PLCgamma) is a key regulatory enzyme that binds to the phosphoryl-tyrosine residues in the cytoplasmic domain of certain activated receptors and catalyses the hydrolysis of phosphatidylinositol 4,5-bisphosphate [PtdIns(4,5)P2] forming IP3 and diacylglycerol (DAG) in response to several mitogenic factors. Previously, we determined that microinjected PLCgamma induces DNA synthesis in G0-arrested NIH 3T3 cells, suggesting the possibility that PLCgamma may have an oncogenic potential. In this report, we demonstrate that overexpression of PLCgamma in NIH 3T3 cells results in altered growth properties and cellular transformation. The PLCgamma/3T3 transfectants do not require serum growth factors to proliferate, display anchorage-independent growth in soft agar and induce tumors when transplanted into nude mice. These findings suggest that overexpression of PLCgamma facilitates the transformation of NIH 3T3 cells. Furthermore, PLCgamma expression and activity have been shown to be elevated in many human tumors. Thus, PLCgamma signaling may contribute to the promotion and/or progression of human cancers.     

In vitro activity of artemisinin derivatives against African isolates and clones of Plasmodium falciparum

To evaluate the effect of intensive physical exercise on intraocular pressure (IOP) in 66- to 85-year-old subjects IOP was measured before and after a maximal bicycle ergometer test. The non-glaucomatous subjects comprised 85 males and 36 female athletes and 16 male and 22 female controls of corresponding age drawn from a population register. IOP was measured using a non-contact tonometer. The results indicated a decrease (> or = 2 mmHg) in 34% of the subjects, no change in 57% and an increase in 9%. The decrease was more pronounced in subjects with higher pre-test values. In all four subjects with a pre-test value above 22 mmHg a reduction from 4 to 11 mmHg was observed. The change in IOP during physical loading was not significantly associated with the intensity and duration of exercise test. Three of the 5 male subjects with diagnosed glaucoma and undergoing hypotensive medication, who were analyzed separately, also showed a reduction in IOP during loading. In the pre- or post-test values there were no differences between the athletes and controls, while women tended to have higher IOP values than men. It is concluded that physical loading has predominantly a moderating effect, if any, on IOP in elderly men and women.     

Evolution of chloroquine resistance in central and west Africa

Congenital deformities occur in approximately 1% of all live births. The exact incidence of congenital foot deformities is unknown. The presence of a circumferential nail of the toe is a very rare deformity. In our review of the literature, we have encountered only two previously reported cases of circumferential toenails. In these cases the patients were siblings and also had circumferential fingernails. This report describes circumferential toenails without other hand or other congenital deformities.     

Communication and intimacy in the marriages of depressed patients.

Marital discord is common among depressed patients. To explain the concurrence of depression and marital discord, it was hypothesized that depressed patients and their spouses have weak relationship-coping abilities, specifically communication, problem solving, and capacity for intimacy. 17 depressed patients and their spouses were compared with 17 control couples on a communication task, an intimacy interview, and self-reports of marital satisfaction. Results indicated that, compared with control Ss, the depressed patients and their spouses (1) reported greater marital dissatisfaction, (2) demonstrated poorer communication and problem-solving ability, and (3) were more likely to have an impaired capacity for establishing and maintaining intimacy. The implications for understanding the development of depression and marital discord are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)