bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unrelated donor marrow transplantation for myelodysplastic syndromes: outcome analysis in 510 transplants facilitated by the National Marrow Donor Program
Authors: Castro-Malaspina Hugo , Harris Richard E. , Gajewski James , Ramsay Norma , Collins Robert , Dharan Bernie , King Roberta , Deeg H. Joachim 
Published: October 2002

AbstractBetween April 1988 and July 1998, 510 patients with myelodysplastic syndromes (MDS) underwent unrelated donor bone marrow transplantation (BMT) facilitated by the National Marrow Donor Program. Median age was 38 years (range, &lt;1-62 years). Several conditioning regimens and graft-versus-host disease (GVHD) prophylaxis methods were used, and T-cell depletion was used in 121 patients. Donors were serologically matched for HLA-A, -B, and -DRB1 antigens for 74% of patients. Of 437 patients evaluable for engraftment, 24 (5% cumulative incidence, with 95% confidence interval [CI] of 3%-7%) failed to engraft, and an additional 33 (8% cumulative incidence; 95% CI, 6%-10%) had late graft failure. Grades II to IV GVHD developed in 47% of patients (95% CI, 43%-49%), and limited and extensive chronic GVHD developed at 2 years in 27% (95% CI, 24%-30%). The incidence of relapse at 2 years was 14% (95% CI, 11%-17%). Greater relapse was independently associated with advanced MDS subtype and no acute GVHD. The estimated probability of disease-free survival (DFS) at 2 years was 29% (95% CI, 25%-33%). Improved DFS was independently associated with less advanced MDS subtype, higher cell dose, recipient cytomegalovirus (CMV) seronegativity, shorter interval from diagnosis to transplantation, and transplantation in recent years. Common causes of death were treatment-related complications accounting for 82% of fatalities. The 2-year cumulative incidence of treatment-related mortality (TRM) was 54% (95% CI, 53%-61%). Sixty-nine percent of TRM occurred within the first 100 days, and 93% occurred within the first year of transplantation. Higher TRM was independently associated with older recipient and donor age, HLA mismatch, and recipient CMV seropositivity. This study demonstrates that unrelated donor BMT cures a significant proportion of patients with MDS. TRM is the major problem limiting the success of unrelated donor BMT in MDS. The observations made in this study should facilitate the design of prospective trials aimed at improving the results of unrelated donor stem cell transplantation for MDS.
Spouses of first-ever stroke patients: their view of the future during the first phase after stroke
Authors: Forsberg-Wärleby Gunilla , Möller Anders , Blomstrand Christian 
Published: October 2002

Background: A partner’s stroke can be perceived as a critical event by a spouse. Previous studies have focused primarily on the impact of stroke on spouses’ psychosocial well-being over the long term. However, the experience of spouses in the ”rst phase after stroke is not well known. Aim: To investigate spouses’ perception of their future daily life after stroke and the association between this perception and the objective characteristics of the stroke. Method: Eighty-three consecutively enrolled spouses of ”rst-ever stroke patients <75 years admitted to Sahlgrenska University Hospital in Göteborg, Sweden participated. The mean age of the spouses was 57 years. Sixty-two of the spouses were women and 21 men. Interviews about their experiences 10 days after onset were generally made at the hospital. The interviews were analysed, categorized and combined with statistical analyses of variables such as ages and sex of the spouses, type of lesion and presence of neurological impairments in the stroke patient. Results: Four different categories of the concept ‘view of the future’ were developed on the basis of the interviews. Of the different characteristics of the stroke, the severity of the sensorimotor impairment seemed to have the greatest impact on the spouses’ view of the future. The spouses of stroke patients with pure sensorimotor impairment were more likely to have an optimistic view of the future than when the sensorimotor impairment was combined with cognitive de”cits. There was a broad distribution of the different characteristics of stroke between the four categories. Conclusions: Although the perception of future daily life varied, it was possible to categorize the spouses’ cognitive image of future life according to degree of optimism. While the severity of stroke was of importance, the individual perception of the disease, impact on future activities and the spouses’ own coping capacity was of great signi”cance for the perception of future daily life.
A study to compare the reliability of composite finger flexion with goniometry for measurement of range of motion in the hand
Authors: Ellis Bridget , Bruton Anne 
Published: October 2002

Objective: To establish the intra and inter-rater reliability of composite finger flexion (CFF), and to compare this with goniometry. Design: Fifty-one physiotherapists and occupational therapists took part in the study. The hand of a normal subject was splinted in three different positions. Using a goniometer and a ruler alternately, each therapist measured both the proximal interphalangeal joint and CFF of three digits, following a standardized protocol. This process was repeated three times. Setting: Eighteen NHS hospital sites in the UK. Results: The two measurement methods produced different ranges and standard deviations for each digit. The repeatability coef”cient shows that repeated intra-rater goniometric measures fall within 4–5 degrees of each other 95% of the time. Inter-rater goniometric measures fall within 7–9 degrees. Repeated intra-rater CFF measures fall within 5–6 mm of each other, whereas inter-rater fall within 7–9 mm. The in‘uence of occupation, experience in hand therapy, years of practice and routine use were found to have no effect on reliability. Scaling of the two methods of measurement allowed comparison between them to be made. CFF and goniometry are equally reliable when comparing inter-rater reliability, but goniometry displays less variability than composite ”nger ‘exion for intra-rater measurements. Conclusion: In this study involving a subject with normal joints, goniometry is more reliable than CFF when only one measurer is involved. However, CFF may be a useful alternative where multiple joint measures are required, or when goniometry is impracticable.
Factors associated with cardiac rehabilitation attendance: a systematic review of the literature
Authors: Cooper A F , Jackson G , Weinman J , Horne R 
Published: October 2002

Background: Many eligible patients fail to attend cardiac rehabilitation courses. Objective: To undertake a systematic literature review of studies that have investigated factors associated with cardiac rehabilitation attendance. Methods: Literature published between 1978 and 2001 was searched using the MEDLINE, PSYCINFO and CINAHL computerized databases. Studies were sought that examined course attendance in eligible patient samples. Studies had to include at least one baseline predictor variable. Results: Fifteen studies were identified and predictor variables were usually categorized as sociodemographic, medical and psychological. Nonattenders are more likely to be older, to have lower income/greater deprivation, to deny the severity of their illness; they are less likely to believe they can influence its outcome or to perceive that their physician recommends cardiac rehabilitation. Job status, gender and health concerns play an indirect role in attendance behaviour. Comparison of results between studies could be influenced by different case-mix, measurement instruments and country of origin. Conclusion: A number of factors predict cardiac rehabilitation attendance and some of these are potentially modifiable.
Capecitabine: a novel, orally administered, tumour-activated treatment for breast cancer
Authors: Summerhayes Maxwell 
Published: October 2002

Objective. To provide a comprehensive review of the preclinical and clinical pharmacology and toxicology of the fluoropyrimidine, capecitabine, with particular reference to its use in metastatic breast cancer. Data Sources. A MEDLINE search was conducted using the term ‘capecitabine’ for the period 1995 -2001. The reference lists from retrieved articles were reviewed and other relevant papers identified. The abstract books from the annual meetings of the American Society of Clinical and Oncology and the European Society of Medical Oncology were also reviewed. Data Extraction. The aim of the review was to be comprehensive and descriptive. All studies containing information deemed to be of interest were reviewed by the author; none was excluded on grounds of quality. Data Summary. Capecitabine is a prodrug of the widely used cytotoxic agent 5-fluorouracil (5-FU). Unlike 5-FU, it is extensively and reliably absorbed after oral administration and does not require folinate (FA) potentiation. The activation of capecitabine is a three-step enzymatic process. The final activating enzyme - thymidine phosphorylase - is found in unusually high concentrations in many solid tumours including breast cancers, resulting in preferential delivery of 5-FU to tumour tissues, and suggesting a greater potential for selective cytotoxicity than is seen with 5-FU. Capecitabine has been examined both alone and in combination with a variety of cytotoxic drugs in the treatment of metastatic breast cancer. To date, clinical evidence supports the use of capecitabine monotherapy in patients relapsing after prior treatment with anthracyclines and taxanes and in combination with docetaxel in patients failing anthracycline treatment. Data from phase II studies indicate that in the first of these situations, capecitabine elicits a response in about one-fifth of patients and that responses are associated with symptomatic relief and extended survival. In the latter situation, a phase III study has shown that the combination of docetaxel and capecitabine elicits superior response rates, remission durations, and overall survival compared with the taxane alone and with no clinically important increase in toxicity. Used alone or in combination, the most notable adverse effect associated with capecitabine is palmar-plantar erythrodysasthesia (hand -foot syndrome), a characteristic complex of reddening, dryness, and soreness of the palms of the hands and soles of the feet, which is rarely disabling and readily managed by treatment interruption and dose reduction.
Clinical effectiveness of trastuzumab: early experience
Authors: Chambers Carole , Dimaculangan Dawn Michelle , Grindrod KA , Hanson John , Pataky Fruzsina , Vu Thanh Thi 
Published: October 2002

Objective. To assess the clinical effectiveness of trastuzumab among metastatic breast cancer (MBC) patients and compare the results to those reported in the two pivotal clinical trials and product monograph. Design. Retrospective chart review of all patients who had initiated trastuzumab monotherapy or combination therapy for MBC within the Alberta Cancer Board (ACB) from August 1998 to May 2001. Setting. Two public tertiary cancer centres in the Canadian province of Alberta. Patients. Of 90 patients reviewed within the ACB, 72 women were eligible for the study. Main outcome measures. The primary endpoints measured were time to treatment failure (TTF) and survival. Secondary end-points measured included adverse events and compliance with ACB guidelines for trastuzumab administration. Results. Among all 72 patients, median TTF was 7.6 months and median survival was 14.4 months. Trastuzumab combination therapy was associated with a significantly longer median TTF compared to trastuzumab monotherapy (P= 0.011). With respect to survival, no significant advantage was seen with combination therapy over monotherapy (P= 0.438). Infusion-related reactions were reported in 11.1% of our patients, while cardiotoxicity was reported in12.5%. Conclusions. Overall, we found that trastuzumab performs better in the clinical setting than it did in the pivotal trials with respect to TTF (2.5 vs. 2.4 months and 8.2 vs. 6.9 months), but not as well with respect to survival (10.0 vs. 13.0 months and 21.0 vs. 25.1 months). In comparison to the product monograph, we report a significantly lower incidence of infusion-related reactions and a slightly higher incidence of cardiotoxicity.
Autonomy and motivation: which comes first?
Authors: Spratt Mary , Humphreys Gillian , Chan Victoria 
Published: October 2002

When motivation has been discussed in relation to autonomy in language learning, it has often been put forward as a product of autonomy. This paper suggests a more complex relationship in which motivation in many cases precedes autonomy. It discusses some of the relevant literature and presents results from a large-scale study of Hong Kong tertiary students. The study aimed to assess students’ readiness for learner autonomy in language learning by examining their views of their responsibilities and those of their teachers’, their confidence in their ability to operate autonomously and their assessment of their level of motivation to learn English. It also investigated their actual practice of autonomous learning in the form of both outside and inside class activities. Results indicated that motivation played a key role in this readiness, and this led the authors to look at the relationship between autonomy and motivation as revealed in the study and in the literature. The findings lead the authors to conclude that motivation is a key factor that influences the extent to which learners are ready to learn autonomously, and that teachers might therefore endeavour to ensure motivation before they train students to become autonomous.
Preradiation Chemotherapy in Primary High-Risk Brainstem Tumors: Phase II Study CCG-9941 of the Children’s Cancer Group
Authors: Jennings Mark T. , Sposto Richard , Boyett James M. , Vezina L. Gilbert , Holmes Emi , Berger Mitchell S. , Bruggers Carol S. , Bruner Janet M. , Chan Ka-Wah , Dusenbery Kathryn E. , Ettinger Lawrence J. , Fitz Charles R. , Lafond Deborah , Mandelbaum David E. , Massey Vicky , McGuire Warren , McNeely Lee , Moulton Thomas , Pollack Ian F. , Shen Violet 
Published: October 2002

PURPOSE: This Children’s Cancer Group group-wide phase II trial evaluated the efficacy and toxicity of two chemotherapy arms administered before hyperfractionated external-beam radiotherapy (HFEBRT). PATIENTS AND METHODS: Thirty-two patients with newly diagnosed brainstem gliomas were randomly assigned to regimen A and 31 to regimen B. Regimen A comprised three courses of carboplatin, etoposide, and vincristine; regimen B comprised cisplatin, etoposide, cyclophosphamide, and vincristine. Both arms included granulocyte colony-stimulating factor. Patients were evaluated by magnetic resonance imaging after induction chemotherapy and HFEBRT at a dose of 72 Gy. RESULTS: Ten percent ± 5% of regimen A patients objectively responded to chemotherapy. For combined induction and radiotherapy, 27% ± 9% of patients improved. The neuroradiographic response rate for regimen B was 19% ± 8% for chemotherapy and 23% ± 9% after HFEBRT. Response rates were not statistically significant between regimens after induction or chemotherapy/HFEBRT. Event-free survival was 17% ± 5% (estimate ± SE) at 1 year and 6% ± 3% at 2 years. Survival was significantly longer among patients who responded to chemotherapy (P < .05). Among patients who received regimen A induction, grades 3 and 4 leukopenia were observed in 50% to 65%, with one toxicity-related death. For regimen B, severe leukopenia occurred in 86% to 100%, with febrile neutropenia in 48% to 60% per course. CONCLUSION: Neither chemotherapy regimen meaningfully improved response rate, event-free survival, or overall survival relative to previous series of patients with brainstem gliomas who received radiotherapy with or without chemotherapy.
Fulvestrant, Formerly ICI 182,780, Is as Effective as Anastrozole in Postmenopausal Women With Advanced Breast Cancer Progressing After Prior Endocrine Treatment
Authors: Howell A. , Robertson J.F.R. , Quaresma Albano J. , Aschermannova A. , Mauriac L. , Kleeberg U.R. , Vergote I. , Erikstein B. , Webster A. , Morris C. 
Published: October 2002

PURPOSE: To compare the efficacy and tolerability of fulvestrant (formerly ICI 182,780) and anastrozole in postmenopausal women with advanced breast cancer progressing after prior endocrine treatment.PATIENTS AND METHODS: Patients (n = 451) with advanced breast cancer were randomized to receive fulvestrant 250 mg as a once-monthly (one × 5 mL) intramuscular injection or an oral dose of anastrozole 1 mg in this open, parallel-group, multicenter trial. The primary end point was time to progression (TTP). Secondary end points included objective response (OR) rates, defined as complete response (CR) or partial response (PR), duration of response (DOR), and tolerability.RESULTS: Patients were followed for a median period of 14.4 months. In terms of TTP, fulvestrant was as effective as anastrozole (hazard ratio, 0.98; confidence interval [CI], 0.80 to 1.21; P = .84). Median TTP was 5.5 months for fulvestrant and 5.1 months for anastrozole. OR rates showed a numerical advantage for fulvestrant (20.7%) over anastrozole (15.7%) (odds ratio, 1.38; CI, 0.84 to 2.29; P = .20). Clinical benefit rates (CR + PR + stable disease ≥ 24 weeks) were 44.6% for fulvestrant and 45.0% for anastrozole. Median DOR was 15.0 months for fulvestrant and 14.5 months for anastrozole. Both treatments were well tolerated, with 3.2% and 1.3% of fulvestrant- and anastrozole-treated patients, respectively, withdrawn from treatment because of an adverse event.CONCLUSION: Fulvestrant was as effective as anastrozole. These data confirm that fulvestrant is an additional, effective, and well-tolerated treatment for advanced breast cancer in postmenopausal women whose disease progressed on prior endocrine therapy.
Treatment With Ibritumomab Tiuxetan Radioimmunotherapy in Patients With Rituximab-Refractory Follicular Non-Hodgkin’s Lymphoma
Authors: Witzig Thomas E. , Flinn Ian W. , Gordon Leo I. , Emmanouilides Christos , Czuczman Myron S. , Saleh Mansoor N. , Cripe Larry , Wiseman Gregory , Olejnik Teresa , Multani Pratik S. , White Christine A. 
Published: October 2002

PURPOSE: Rituximab is commonly used as a single agent or in combination therapy for non-Hodgkin’s lymphoma (NHL). Ibritumomab tiuxetan radioimmunotherapy targets the same antigen as rituximab and has demonstrated efficacy in rituximab-naïve NHL. This study evaluated ibritumomab tiuxetan in the treatment of rituximab-refractory follicular NHL. PATIENTS AND METHODS: Eligible patients were refractory to rituximab; this was defined as no objective response to rituximab (375 mg/m2 weekly for 4 weeks) or time to progression (TTP) of ≤ 6 months. The ibritumomab tiuxetan treatment regimen consisted of pretreatment with rituximab (250 mg/m2 intravenously on days 1 and 8) to deplete peripheral blood B cells, then yttrium-90 ibritumomab tiuxetan (0.4 mCi/kg; maximum, 32 mCi) intravenously on day 8, administered on an outpatient basis. An imaging/dosimetry dose of indium-111 ibritumomab tiuxetan (5 mCi) was injected after rituximab (day 1) in 28 patients. RESULTS: Fifty-seven patients were treated. The median age was 54 years, 74% had tumors ≥ 5 cm, and all were extensively pretreated (median, four prior therapies; range, one to nine). The estimated radiation-absorbed doses to healthy organs were below the study-defined limit in all patients studied with dosimetry. The overall response rate for the 54 patients with follicular NHL was 74% (15% complete responses and 59% partial responses). The Kaplan-Meier–estimated TTP was 6.8 months (range, 1.1 to ≥ 25.9 months) for all patients and 8.7 months for responders. Adverse events were primarily hematologic; the incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 35%, 9%, and 4%, respectively. CONCLUSION: Ibritumomab tiuxetan radioimmunotherapy is effective in rituximab-refractory patients. The only significant toxicity is hematologic.
Randomized, Placebo-Controlled Trial of Clodronate in Patients With Primary Operable Breast Cancer
Authors: Powles Trevor , Paterson Sandy , Kanis John A. , McCloskey Eugene , Ashley Sue , Tidy Alwynne , Rosenqvist Kirsi , Smith Ian , Ottestad Lars , Legault Sandra , Pajunen Marjo , Nevantaus Auli , Männistö Esa , Suovuori Anne , Atula Sari , Nevalainen Jaakko , Pylkkänen Liisa 
Published: October 2002

PURPOSE: The development of bone metastases depends on tumor-induced osteoclastic resorption of bone, which may be inhibited by the antiosteolytic bisphosphonate clodronate. Given to patients with primary breast cancer, clodronate might reduce the subsequent incidence of bone metastases. PATIENTS AND METHODS: This double-blind, multicenter trial accrued 1,069 assessable patients with operable breast cancer between 1989 and 1995. All patients received surgery, radiotherapy, chemotherapy, and tamoxifen as required. Patients were randomized to receive oral clodronate 1,600 mg/d or a placebo for 2 years starting within 6 months of primary treatment. The primary end point was relapse in bone, analyzed on an intent-to-treat basis, during the medication period and during the total follow-up period (median follow-up, 2,007 days). Secondary end points were relapse in other sites, mortality, and toxicity. RESULTS: During the total follow-up period, there was a nonsignificant reduction in occurrence of bone metastases (clodronate, n = 63; placebo, n = 80; hazards ratio [HR], 0.77; 95% confidence interval [CI], 0.56 to 1.08; P = .127). During the medication period there was a significant reduction in the occurrence of bone metastases (clodronate, n = 12; placebo, n = 28; HR, 0.44; 95% CI, 0.22 to 0.86; P = .016). The occurrence of nonosseous metastases was similar (clodronate, n = 112; placebo, n = 128; P = .257), but there was a significant reduction in mortality (clodronate, n = 98; placebo, n = 129; P = .047) during the total follow-up period. CONCLUSION: Clodronate, given to patients with primary operable breast cancer, may reduce the occurrence of bone metastases, although this reduction was only significant during this medication period. There was a significant reduction in mortality.
Cell Type-Specific Expression and Coregulation of Murine Resistin and Resistin-Like Molecule-α in Adipose Tissue
Authors: Rajala Michael W. , Lin Ying , Ranalletta Mollie , Yang Xiao Man , Qian Hao , Gingerich Ron , Barzilai Nir , Scherer Philipp E. 
Published: October 2002

AbstractAdipocytes are the exclusive or predominant source of several secreted proteins that exert profound effects on systemic carbohydrate and lipid metabolism. Resistin, a 10-kDa adipose tissue specific secretory protein, has recently been implicated in exerting a negative effect on systemic insulin sensitivity. It is, however, not known how resistin mediates this insulin-desensitizing effect or what regulatory mechanisms control resistin expression. Resistin-like molecule-α (RELMα), a homolog of resistin originally identified by its upregulation in asthmatic lung, is another secreted protein expressed in adipose tissue. The regulation of RELMα in adipose tissue and its relationship to resistin expression has not been addressed so far. Here, we demonstrate that the expression of resistin and RELMα are similarly regulated in adipose tissue despite the fact that RELMα is exclusively expressed in the stromal vascular fraction of adipose tissue and not in adipocytes. Interestingly, this coregulation is limited to adipose tissue as the expression of RELMα in lung is independent of metabolic regulation. Additionally, we show that resistin and RELMα levels are not subject to regulation by proinflammatory stimuli. Finally, acute hyperglycemia leads to up-regulation of resistin and RELMα transcription in various adipose depots.