Long-term follow-up of a randomized post-induction therapy trial in acute myelogenous leukemia (a Southeastern Cancer Study Group trial)

A phase III clinical trial was designed to determine if more intensive induction and consolidation therapy for acute myeloblastic leukemia increases the remission rate and prolongs survival. A minor objective was to determine if the use of non-cross resistant drugs was more effective than the same drugs used for induction. Patients with untreated leukemia between the ages of 15 and 50 were given daunorubicin 45 mg/m2 for the first 3 days of a 10-day continuous infusion of cytosine arabinoside, initially at a dose of 2000 mg/m2 but reduced to 100 mg/m2 because of toxicity. Those under 36 achieving a complete remission and with an histocompatible donor were assigned to a transplant arm. The rest were randomized to receive one of three consolidation arms: A, cytosine arabinoside, 200 mg/m2 daily for 7 days and daunorubicin 45 mg/m2 daily for 3 days for three courses; B, one course as in Arm A followed by amsacrine, 120 mg/m2 daily for 5 days followed by a 5-day continuous infusion of azacytidine, 150 mg/m2/day; C, thioguanine and cytosine arabinoside, 100 mg/m2 every 12 h and daunorubicin 10 mg/m2 daily for 5 days for three courses followed by four maintenance courses of cytosine arabinoside, 100 mg/m2 daily for 5 days and daunorubicin, 45 mg/m2 for 2 days every 13 weeks. From 1981 to 1986, 398 eligible patients were enrolled and 219 achieved a complete remission. The initial induction dose of cytosine arabinoside was reduced after five of 29 patients exhibited fatal gastrointestinal toxicity. Only 11 patients were assigned to the transplant arm. There were no significant differences in the consolidation arms. The 5 year disease-free survivals were 38, 31 and 27% in arms A, B, and C respectively. Intensive consolidation therapy with the same or different drugs used in induction was as effective as lower dose consolidation followed by maintenance therapy.     

Short contact time dissolution of vitrinite and inertinite concentrates

The short contact time dissolution of vitrinite and inertinite concentrates of an Australian bituminous coal was studied under isothermal conditions with tetralin as solvent. The reactivity of the two maceral types and the yields and nature of the products were determined for a range of reaction temperatures (400, 420 and 440 °C) and reaction times (2–20 min). The dissolution of vitrinite proceeded at a significantly greater rate than for inertinite and was associated with greater selectivity to soluble non-gaseous products. At very short reaction times (2 min), the vitrinite underwent solubilizing reactions to yield products of higher molecular weight and greater oxygen functionality than was the case for inertinite, for which changes in the chemical nature of the products were negligible over the range of conditions studied. At longer reaction times (5 min), the composition of the vitrinite-derived products was similar to that of the inertinite-derived products.     

Perceived stress management skill mediates the relationship between optimism and positive mood following radical prostatectomy.

This study evaluated relations among optimism, perceived stress management skills (PSMS), and positive mood in 46 men who had surgical treatment for localized prostate cancer. The authors found that optimism, PSMS, and positive mood scores were positively correlated. Positive mood was unrelated to demographic and disease-related control variables. In a hierarchical regression model controlling for PSMS, the relationship between optimism and positive mood became nonsignificant, whereas PSMS remained a correlate of positive mood. Results suggest that the relationship between optimism and positive mood may be mediated by belief in being able to use stress management techniques effectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Iron–cobalt catalysts synthesized by a reverse micelle impregnation method for controlled growth of carbon nanotubes

Fe–Co bimetallic metals supported on CaCO₃ support have been prepared using three different methods for the preparation of the catalysts; wet impregnation (IMP), deposition–precipitation (DP) and reverse micelle impregnation (RM). By careful choice and optimization of CVD reaction conditions and catalyst preparation procedures, we have tailored the nanofabrication of CNTs using 5 wt.% Fe–Co/CaCO₃. High yields of ‘clean’ MWNTs with near 100% selectivity and excellent reproducibility were obtained (1215% and 835% yields for the IMP and DP methods respectively). The RM technique enabled more precise control over the size of the CNTs and a narrower diameter distribution (3–5 nm i.d. and 10–15 nm o.d.) was obtained.     

Treatment of shoulder dislocation: is a sling appropriate?

Acute anterior shoulder dislocations, when managed non-operatively, have traditionally been treated by placing the arm in a sling. There is no formal evidence that this treatment is of benefit. Three recently reported studies, one in cadavers and two in patients, suggest that the detachment of the structures in the front of the shoulder is made worse when the shoulder is placed in internal rotation, as when the arm is in a sling. By contrast, the structures are realigned when the arm is placed in external rotation. Shoulder dislocations, if managed non-operatively, should not be treated by placing arms in a sling. Rather, placing them in a splint or using a pillow so that the the arm is externally rotated should be considered.     

Electrostatic Droplet Growth in a Neutrally Buoyant Emulsion

Droplet growth is examined in a water-in-oil type emulsion where the droplets are subjected exclusively to viscous and dielectrophoretic forces. The latter are produced by the interaction of the droplets with an otherwise uniformly imposed electric field. Theoretical considerations are presented as a basis for understanding and interpreting the experiments. An emulsion consisting of deionized water droplets in a silicone oil of specific gravity I is subjected to a uniform 60 Hz, ac electrostatic field. Initially, the droplets are fairly monodisperse with mean diameters of approximately 25 , sm. The changes in droplet size distributions with time are examined with a laser diffraction system for water volume fractions ranging from 0.001 to 0.1 and applied fields ranging from 52 to 520 kVm-1. The average droplet size increases exponentially with time; we examine the exponent's dependence on average field strength and droplet volume fraction.     

Unfavorable mechanical effects of heat and moisture exchangers in ventilated patients

OBJECTIVE: To investigate the mechanical effects of artificial noses. SETTING: A general intensive care unit of a university hospital. PATIENTS: 10 patients in pressure support ventilation for acute respiratory failure. INTERVENTIONS: The following three conditions were randomly tested on each patient: the use of a heated humidifier (control condition), the use of a heat and moisture exchanger without filtering function (HME), and the use of a combined heat and moisture exchanger and mechanical filter (HMEF). The pressure support level was automatically adapted by means of a closed-loop control in order to obtain constancy, throughout the study, of patient inspiratory effort as evaluated from airway occlusion pressure at 0.1 s (P0.1). Patient's ventilatory pattern, P0.1, work of breathing, and blood gases were recorded. MEASUREMENTS AND MAIN RESULTS: The artificial noses increased different components of the inspiratory load: inspiratory resistance, ventilation requirements (due to increased dead space ventilation), and dynamic intrinsic positive end-expiratory pressure (PEEP). The additional load imposed by the artificial noses was entirely undertaken by the ventilator, being the closed-loop control of P0.1 effective to maintain constancy of patient inspiratory work by means of adequate increases in pressure support level. CONCLUSIONS: The artificial noses cause unfavorable mechanical effects by increasing inspiratory resistance, ventilation requirements, and dynamic intrinsic PEEP. Clinicians should consider these effects when setting mechanical ventilation and when assessing patients' ability to breathe spontaneously.