973 resultados para Kaplan


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BACKGROUND: To compare the prognostic value of different anatomical and functional metabolic parameters determined using [(18)F]FDG-PET/CT with other clinical and pathological prognostic parameters in cervical cancer (CC). METHODS: Thirty-eight patients treated with standard curative doses of chemo-radiotherapy (CRT) underwent pre- and post-therapy [(18)F]FDG-PET/CT. [(18)F]FDG-PET/CT parameters including mean tumor standardized uptake values (SUV), metabolic tumor volume (MTV) and tumor glycolytic volume (TGV) were measured before the start of CRT. The post-treatment tumor metabolic response was evaluated. These parameters were compared to other clinical prognostic factors. Survival curves were estimated by using the Kaplan-Meier method. Cox regression analysis was performed to determine the independent contribution of each prognostic factor. RESULTS: After 37 months of median follow-up (range, 12-106), overall survival (OS) was 71 % [95 % confidence interval (CI), 54-88], disease-free survival (DFS) 61 % [95 % CI, 44-78] and loco-regional control (LRC) 76 % [95 % CI, 62-90]. In univariate analyses the [(18)F]FDG-PET/CT parameters unfavorably influencing OS, DFS and LRC were pre-treatment TGV-cutoff ≥562 (37 vs. 76 %, p = 0.01; 33 vs. 70 %, p = 0.002; and 55 vs. 83 %, p = 0.005, respectively), mean pre-treatment tumor SUV cutoff ≥5 (57 vs. 86 %, p = 0.03; 36 vs. 88 %, p = 0.004; 65 vs. 88 %, p = 0.04, respectively) and a partial tumor metabolic response after treatment (9 vs. 29 %, p = 0.0008; 0 vs. 83 %, p < 0.0001; 22 vs. 96 %, p < 0.0001, respectively). After multivariate analyses a partial tumor metabolic response after treatment remained as an independent prognostic factor unfavorably influencing DFS and LRC (RR 1:7.7, p < 0.0001, and RR 1:22.6, p = 0.0003, respectively) while the pre-treatment TGV-cutoff ≥562 negatively influenced OS and DFS (RR 1:2, p = 0.03, and RR 1:2.75, p = 0.05). CONCLUSIONS: Parameters capturing the pre-treatment glycolytic volume and metabolic activity of [(18)F]FDG-positive disease provide important prognostic information in patients with CC treated with CRT. The post-therapy [(18)F]FDG-PET/CT uptake (partial tumor metabolic response) is predictive of disease outcome.

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The general aim of this paper is to explore and illustrate the role of the physical and psychological surrounding in narrative making ofthe personal identity. A qualitative study is put forward. It consists of a reduced version of the autobiographical multi-methodology(Bagnoli, 2004). That has been applied to a sample of six students of the Universidad Intercultural de Chiapas. The specific goals are: a) to illustrate, through citations obtained from interviews and graphical material, the theoretical concepts of attachment to theplace (Pol, 2002; Vidal y colaboradores, 2004) and community sense (Kim y Kaplan, 2004); and b) to detect the most relevantfactors of such concepts manifested in the students. Data was analyzed through the Atlas.ti computer program, version 5.0 (Muñoz, 2005). The findings suggest that sense of connection and participation in the community (action - transformation) has been observed as the most significant factors in our studied sample

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Objectif : D'analyser l'évolution naturelle de la taille de la tumeur et de l'audition chez 151 patients avec schwannome vestibulaire (VS) en suivi et d'évaluer les mêmes paramètres pour une partie du group traité par Radiochirurgie Stéréotaxique Linac (SRS). Méthodes: Etude prospective des patients bilantés par IRM et tests audio-vestibulaires à l'inclusion, pendant la période du suivi et après SRS. L'audition a été gradé selon l'échelle de Gardner-Robertson (GR) et la taille tumorale selon l'échelle de Koos. L'analyse statistique inclut l'analyse de survie de Kaplan-Meier, analyse multivariée avec régression linéaire et logistique. Les patients avec une audition utile ont étés spécifiquement analysés. Résultats: Pendant la période du suivi (moyenne 24 mois, déviation 6-96), le risqué annuel de dégradation de la classe GR était 6% pour les patients GRI et 15% pour les GRII. La perte auditive comme symptôme initial était un facteur signifïcativement prédictif pour une aggravation auditive ultérieure (p=0.003). La croissance tumorale était de 25% à la dernière observation pendant le suivi. Pour les patients traités par Linac, la préservation d'une audition utile était 51% à 1 an et 36% à 3 ans. Le contrôle tumoral était 94 % and 91% respectivement. Conclusion: Chez les patients avec VS, la perte auditive déjà présente au diagnostique est un facteur prédictif négatif pour l'évolution de l'audition. La Radiochirurgie Stéréotaxique Linac est efficace pour le contrôle tumoral. Les patients ayant préservés leur status auditif prétraitement présentent un rythme annuel de perte auditive diminué après SRS compare à celle-ci avant le traitement. Cette constatation suggère un effet protectif potentiel de la SRS, à condition que la fonction cochléaire soit préservée.

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Corniflorae (sensu Dahlgren, 1980) is a superorder of the Angiospermae formed by the orders Fouquieriales, Ericales, Eucommiales, Sarraceniales, Cornales and Dipsacales, comprising 50 families with more than 7000 cosmopolitan species. Many of these species are used in tradicional medicine and some of them had their pharmacological activities confirmed. The chemistry of these plants is very diversified. Iridoids, triterpenoids and flavonoids were used as taxonomic markers.

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This work presents a new methodology for searching the present state of chemical evolution for different taxa, grouping five classes of secondary metabolites. Ocurrences of 10370 natural products isolated from Asteraceae were used to exemplify the method. Relationships among tribes are discussed.

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Coumarins are special metabolites well distributed in the Angiospermae, either in Monocotyledoneae or Dicotyledoneae. Simple coumarins, the most widespread type, is found in all coumarin-producing families, such as: Apiaceae, Rutaceae, Asteraceae, Fabaceae, Oleaceae, Moraceae e Thymelaeaceae. The other types, linear- and angular furanocoumarins, linear- and angular pyranocoumarins, lignocoumarins, bis- and triscoumarins, are of more restricted circumscription. Among the families with occurrence numbers (NO) > 100, the more advanced ones are specialized in the production of only one or two coumarin types, while the primitive families are very well diversified in types. Calculations of percentual numbers of occurrence (%NO) show relevant meaning of coumarin-types in the taxonomic positioning of the producing taxa.

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The genus Plumbago belongs to the family Plumbaginaceae, order Plumbaginales. Comparative chemical profile of P. scandens (native) and P. auriculata (cultivated) was obtained by normal and reversed-phase high performance liquid chromatography with photodiode array detector. Comparison of the ultraviolet espectra and the retention times for the compounds allowed to find similar metabolic patterns in roots, stems and leaves. Four flavonoids, one phenolic acid or derivative and the naphtoquinone plumbagin were comparatively identified to standards.

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BACKGROUND: Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment. No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection (olanzapine-LAI) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine. This study aimed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters: hospitalization prevalence, incidence rate, duration, and the time to first hospitalization. Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine. METHODS: This was a post hoc exploratory analysis of data from a randomized, double-blind study comparing the safety and efficacy of olanzapine-LAI (pooled active depot groups: 405 mg/4 weeks, 300 mg/2 weeks, and 150 mg/2 weeks) with oral olanzapine and sub-therapeutic olanzapine-LAI (45 mg/4 weeks) during 6 months' maintenance treatment of clinically stable schizophrenia outpatients (n=1064). The four psychiatric hospitalization parameters were analyzed for each treatment group. Within the olanzapine-LAI group, patients with and without hospitalization were compared on baseline characteristics. Logistic regression and Cox's proportional hazards models were used to identify the best predictors of hospitalization. Comparisons between the treatment groups employed descriptive statistics, the Kaplan-Meier estimator and Cox's proportional hazards models. RESULTS: Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization. Compared with sub-therapeutic olanzapine-LAI, olanzapine-LAI was associated with a significantly lower hospitalization rate (5.2% versus 11.1%, p < 0.01), a lower mean number of hospitalizations (0.1 versus 0.2, p = 0.01), a shorter mean duration of hospitalization (1.5 days versus 2.9 days, p < 0.01), and a similar median time to first hospitalization (35 versus 60 days, p = 0.48). Olanzapine-LAI did not differ significantly from oral olanzapine on the studied hospitalization parameters. CONCLUSIONS: In clinically stable schizophrenia outpatients receiving olanzapine-LAI maintenance treatment, psychiatric hospitalization was best predicted by a history of suicide threats and prior psychiatric hospitalization. Olanzapine-LAI was associated with a significantly lower incidence of psychiatric hospitalization and shorter duration of hospitalization compared with sub-therapeutic olanzapine-LAI. Olanzapine-LAI did not differ significantly from oral olanzapine on hospitalization parameters.

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This thesis was produced for the Technology Marketing unit at the Nokia Research Center. Technology marketing was a new function at Nokia Research Center, and needed an established framework with the capacity to take into account multiple aspects for measuring the team performance. Technology marketing functions had existed in other parts of Nokia, yet no single method had been agreed upon for measuring their performance. The purpose of this study was to develop a performance measurement system for Nokia Research Center Technology Marketing. The target was that Nokia Research Center Technology Marketing had a framework for separate metrics; including benchmarking for starting level and target values in the future planning (numeric values were kept confidential within the company). As a result of this research, the Balanced Scorecard model of Kaplan and Norton, was chosen for the performance measurement system for Nokia Research Center Technology Marketing. This research selected the indicators, which were utilized in the chosen performance measurement system. Furthermore, performance measurement system was defined to guide the Head of Marketing in managing Nokia Research Center Technology Marketing team. During the research process the team mission, vision, strategy and critical success factors were outlined.

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BACKGROUND: With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. METHODS: W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization). RESULTS: 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013). CONCLUSION: Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.

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This work describes the flavonoids and biflavonoids found in species of Ouratea and Luxemburgia as chemical markers that serve to detect the difference between these taxa according to the linkage between the flavonoidal units. A rational nomenclature is proposed and the pharmacological potencial is discussed.

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This paper describes the chemical constituents isolated from leaves and fruits of Licania tomentosa Benth. The plant materials were successively extracted with hexane and methanol. From the extracts the following compounds were obtained: betulinic acid; licanolide, a new triterpene lactone; oleanolic acid, lupeol; palmitoleic and hexadecanoic acid; a mixture of stigmasterol and sitosterol; and a mixture of tormentic, ursolic and betulinic acid. The structures of the natural products were identified on the basis of spectral data.