EPI Update, August 14, 2009

Weekly newsletter for Center For Acute Disease Epidemiology of Iowa Department of Public Health.

Longer Intervals Between Hematopoietic Stem Cell Transplantation and Subsequent 90Y-Ibritumomab Radioimmunotherapy May Correlate With Better Tolerance.

PURPOSE: This study aimed to evaluate the efficacy and toxicity of radioimmunotherapy (RIT) in recurrent lymphoma after hematopoietic stem cell transplantation (HSCT). METHODS: We reviewed 9 patients, 7 with follicular lymphoma (DLBCL), 1 with mantle cell lymphoma (MCL), and 1 with diffuse large B-cell lymphoma treated with Y-ibritumomab tiuxetan 6 to 140 months after HSCT. Patients underwent In-ibritumomab scintigraphy and were treated 1 week later with standard 14.8 MBq/kg (n = 4) or 11.1 MBq/kg (n = 4) Y-ibritumomab. One patient who had allo-HSCT had reduced activity (70%) treatment. RESULTS: Among the 7 FL patients, we observed complete response (CR) in 2 patients and partial response (PR) in 5 patients. One patient with CR relapsed after 15 months; the other persisted 43.5 months after RIT. Of 5 patients with PR, 3 relapsed between 13 and 17 months; 1 persisted until unrelated death at 11.5 months. The fifth patient with PR received adoptive immunotherapy and improved to metabolic (FDG-PET) CR that persists 45.5 and 41 months after Y-ibritumomab and immunotherapy, respectively. Patients with MCL and DLBCL progressed or experienced stabilization (5 months), respectively. Six patients had grade 1 to 3 bone marrow (BM) toxicity and recovered within 3 months. Three patients having Y-ibritumomab 6, 14, and 24 months after HSCT experienced grade 4 BM toxicity. One of them (RIT 24 months after HSCT) recovered after 3 months, another delayed after 9 months, and the third patient only partially recovered, eventually developed myelodysplasia, and was allografted. CONCLUSIONS: Radioimmunotherapy after HSCT is an effective rescue therapy in FL. However, BM toxicity may be important; 3 of 8 patients treated with standard Y-ibritumomab activity experienced grade 4 BM toxicity, with incomplete recovery 3 months after RIT in 2 patients, both treated early (6 and 14 months) after HSCT.

A High-Resolution 2D/3D Seismic Study of a Thrust Fault Zone in Lake Geneva, Switzerland

P130 A HIGH-RESOLUTION 2D/3D SEISMIC STUDY OF A THRUST FAULT ZONE IN LAKE GENEVA SWITZERLAND M. SCHEIDHAUER M. BERES D. DUPUY and F. MARILLIER Institute of Geophysics University of Lausanne 1015 Lausanne, Switzerland Summary A high-resolution three-dimensional (3D) seismic reflection survey has been conducted in Lake Geneva near the city of Lausanne Switzerland where the faulted molasse basement (Tertiary sandstones) is overlain by complex Quaternary sedimentary structures. Using a single 48-channel streamer an area of 1200 m x 600 m was surveyed in 10 days. With a 5-m shot spacing and a receiver spacing of 2.5 m in the inline direction and 7.5 m in the crossline direction, a 12-fold data coverage was achieved. A maximum penetration depth of ~150 m was achieved with a 15 cu. in. water gun operated at 140 bars. The multi-channel data allow the determination of an accurate velocity field for 3D processing, and they show particularly clean images of the fault zone and the overlying sediments in horizontal and vertical sections. In order to compare different sources, inline 55 was repeated with a 30/30 and a 15/15 cu. in. double-chamber air gun (Mini GI) operated at 100 and 80 bars, respectively. A maximum penetration depth of ~450 m was achieved with this source.

Français 916

Contient : 1° « Les Lamentacions monseigneur sainct BERNARD » ; 2° « Le Livre des Meditacions monseigneur saint BERnard » ; 3° « Les Contemplacions monseigneur saint AUGUSTIN » ; 4° « Une belle Oroison de saint AUGUSTIN » (fol. 55) : ; 5° « Les Meditacions saint AUGUSTIN pensant à Dieu » ; 6° « Ung Traitié comment on doit Dieu amer de tout son cueir » ; 7° « L'Ordonnance du char Heliez le prophete » (fol. 67) : ; 8° « Un Preschement de Nostre Seigneur Jhesu Crist » (fol. 69), parabole de la semence ; 9° « Ce sont les sept choses que cuer en qui Dieu habite doit avoir » (fol. 71) : ; 10° « Comment.IIII. pechiés mortelz sont signifiés par.IIII. bestes sauvaiges » (fol. 72) : ; 11° « De la Demande que fist la mere de saint Jehan et de saint Jaques à Nostre Seigneur Jhesu Crist » ; 12° « Le Livre de la misere de l'omme », par « LOTHIER » ; 13° « Le Livre des biens que tribulacion fait à l'ame » ; 14° « Aucuns bons Enseignements pour eschiver les pechies de luxure, d'avarice et d'accide » ; 15° « De l'Aage Adam, et comment il envoya Seth son filz en paradis terrestre » (fol. 130) : ; 16° « La Devise de la messe » (fol. 132) : ; 17° « L'Ordonnance comment on se doit confesser » (fol. 135) : ; 18° « Les Enseignements que le bon roy saint Loys fist et escript de sa main, et les envoya de Cartaige où il estoit au roy Phelippes son filz » ; 19° « Les Enseignements que... saint Loys... envoya... à la royne de Navarre sa fille » (fol. 140) : ; 20° « La Fin que le bon roy saint Loys ot à sa mort, que l'evesque de Thunes envoya à Thibaut, roy de Navarre » (fol. 141) : ; 21° « Le Livre maistre HUGUES DE SAINT VICTOR » ; 22° « Les Proverbes de SENEQUE, en prose » ; 23° « Les Dictz et Proverbes des Saiges », cinquantecinq quatrains ; 24° « Le Dit des philosophes du grant roy Alixandre, quant il fut mort », en seize vers (fol. 172) ; 25° « Ung beau Dictié c'on appelle : Je vois mourir », quarante-cinq sixains ; 26° « Le Pater noster en françois » ; 27° « La Meditacion de la mort »

Long-term data from the swiss pulmonary hypertension registry.

BACKGROUND: Registries are important for real-life epidemiology on different pulmonary hypertension (PH) groups. OBJECTIVE: To provide long-term data of the Swiss PH registry of 1998-2012. METHODS: PH patients have been classified into 5 groups and registered upon written informed consent at 5 university and 8 associated hospitals since 1998. New York Heart Association (NYHA) class, 6-min walk distance, hemodynamics and therapy were registered at baseline. Patients were regularly followed, and therapy and events (death, transplantation, endarterectomy or loss to follow-up) registered. The data were stratified according to the time of diagnosis into prevalent before 2000 and incident during 2000-2004, 2005-2008 and 2009-2012. RESULTS: From 996 (53% female) PH patients, 549 had pulmonary arterial hypertension (PAH), 36 PH due to left heart disease, 127 due to lung disease, 249 to chronic thromboembolic PH (CTEPH) and 35 to miscellaneous PH. Age and BMI significantly increased over time, whereas hemodynamic severity decreased. Overall, event-free survival was 84, 72, 64 and 58% for the years 1-4 and similar for time periods since 2000, but better during the more recent periods for PAH and CTEPH. Of all PAH cases, 89% had target medical therapy and 43% combination therapy. Of CTEPH patients, 14 and 2% underwent pulmonary endarterectomy or transplantation, respectively; 87% were treated with PAH target therapy. CONCLUSION: Since 2000, the incident Swiss PH patients registered were older, hemodynamically better and mostly treated with PAH target therapies. Survival has been better for PAH and CTEPH diagnosed since 2008 compared with earlier diagnosis or other classifications.

Can smaller-scale comprehensive cancer centers provide outstanding care in abdominal and thoracic pediatric solid tumor surgery? Results of a 14-year retrospective single-center analysis.

PURPOSE: Quality of care and its measurement represent a considerable challenge for pediatric smaller-scale comprehensive cancer centers (pSSCC) providing surgical oncology services. It remains unclear whether center size and/or yearly case-flow numbers influence the quality of care, and therefore impact outcomes for this population of patients. PATIENTS AND METHODS: We performed a 14-year, retrospective, single-center analysis, assessing adherence to treatment protocols and surgical adverse events as quality indicators in abdominal and thoracic pediatric solid tumor surgery. RESULTS: Forty-eight patients, enrolled in a research-associated treatment protocol, underwent 51 cancer-oriented surgical procedures. All the protocols contain precise technical criteria, indications, and instructions for tumor surgery. Overall, compliance with such items was very high, with 997/1,035 items (95 %) meeting protocol requirements. There was no surgical mortality. Twenty-one patients (43 %) had one or more complications, for a total of 34 complications (66 % of procedures). Overall, 85 % of complications were grade 1 or 2 according to Clavien-Dindo classification requiring observation or minor medical treatment. Case-sample and outcome/effectiveness data were comparable to published series. Overall, our data suggest that even with the modest caseload of a pSSCC within a Swiss tertiary academic hospital, compliance with international standards can be very high, and the incidence of adverse events can be kept minimal. CONCLUSION: Open and objective data sharing, and discussion between pSSCCs, will ultimately benefit our patient populations. Our study is an initial step towards the enhancement of critical self-review and quality-of-care measurements in this setting.

Loistavia luentoja ja rentouttavaa yhteisoloa : Suomen eläinlääkäripraktikot 14.-16.3.1997 Tampereella

Fia Westerholm

Fiscal Update, February 14, 2000

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, August 14, 2000

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, December 14, 2000

The Fiscal Division newsletter, published weekly during session and periodically during the interim.