Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme.

The benefit of postoperative radiotherapy (RT) has been demonstrated in elderly patients aged 65 years or older with glioblastoma multiforme. Hypofractionated RT schedules can reduce the time and morbidity of treatment while maintaining comparable survival outcomes to lengthy conventional RT. Current international randomized clinical trials are studying the optimized hypofractionated RT regimens, hypofractionated RT in comparison with temozolomide chemotherapy and hypofractionated RT in comparison with the same RT plus temozolomide. Given the guarded prognosis of the elderly and frail patients, quality of life and side effects of treatment should be closely examined. As more than half of cancers in the world occur in developing countries, hypofractionated RT could be better utilized as a cost-effective treatment for this group of patients.

A photometric analysis of the Cepheus OB3 region

Results are presented on Stromgren-Crawford uvby-beta photometry carried out at Calar Alto (Spain) for 45 stars in the Cepheus OB3 region covering an apparent area of 6 deg x 6 deg. The relationship of these stars with the association is examined. Three of these stars (BD +62 deg 2114, BD +62 deg 2152, and BD +62 deg 2156) are identified as members of this association, while two more (BD +64 deg 1714 and BD +64 deg 1717) are classified as possible members. It is noted that intrinsic colors and absolute magnitudes of member stars are consistent with the hypothesis of Blaauw (1964) and Garmany (1973) of the existence of two subgroups with different evolutionary phases.

[Illustrations de De Americaensche Zeerovers...] / [Non identifié] ; Alessandre Olivier Exquemelin dit Oexmelin, aut. du texte

Comprend : [Planche entre pp. 42-43. Portrait de Rock.] [Cote : BNF B11901] ; [Planche en regard du folio 3v ° paginé 46. Portrait de] François Lolonois. [Cote : BNF C39549] ; [Planche en regard de la p. 60. Scène de torture. Un soldat arrache le coeur d'un homme et le fait manger à un autre.] [Cote : BNF C54751] ; [Planche en regard de la p. 82. Scène de massacre.] [Cote : BNF C54752] ; [Planche en regard de la p. 88. Scène de bataille. Prise d'une ville.] [Cote : BNF C76835] ; [Planche en regard de la p. 98. Scène de tortures et de massacres.] [Cote : BNF C76836] ; [Planche dépliante en regard de la p. 102. Combat naval.] [Cote : BNF D4698] ; [Planche dépliante en regard de la p. 130. Carte de Panama.] [Cote : BNF C54753] ; [Planche dépliante en regard de la p. 132. La ville de] Panama. [Cote : BNF C30662]

High-precision satellite positioning system as a new tool to study the biomechanics of human locomotion.

New Global Positioning System (GPS) receivers allow now to measure a location on earth at high frequency (5Hz) with a centimetric precision using phase differential positioning method. We studied whether such technique was accurate enough to retrieve basic parameters of human locomotion. Eight subjects walked on an athletics track at four different imposed step frequencies (70-130steps/min) plus a run at free pace. Differential carrier phase localization between a fixed base station and the mobile antenna mounted on the walking person was calculated. In parallel, a triaxial accelerometer, attached to the low back, recorded body accelerations. The different parameters were averaged for 150 consecutive steps of each run for each subject (total of 6000 steps analyzed). We observed a perfect correlation between average step duration measured by accelerometer and by GPS (r=0.9998, N=40). Two important parameters for the calculation of the external work of walking were also analyzed, namely the vertical lift of the trunk and the velocity variation per step. For an average walking speed of 4.0km/h, average vertical lift and velocity variation were, respectively, 4.8cm and 0.60km/h. The average intra-individual step-to-step variability at a constant speed, which includes GPS errors and the biological gait style variation, were found to be 24. 5% (coefficient of variation) for vertical lift and 44.5% for velocity variation. It is concluded that GPS technique can provide useful biomechanical parameters for the analysis of an unlimited number of strides in an unconstrained free-living environment.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.