Phase III trial of consolidation therapy with yttrium-90-ibritumomab tiuxetan compared with no additional therapy after first remission in advanced follicular lymphoma.

PURPOSE: We conducted an international, randomized, phase III trial to evaluate the efficacy and safety of consolidation with yttrium-90 ((90)Y)-ibritumomab tiuxetan in patients with advanced-stage follicular lymphoma in first remission. PATIENTS AND METHODS: Patients with CD20(+) stage III or IV follicular lymphoma, who achieved a complete response (CR)/unconfirmed CR (CRu) or partial response (PR) after first-line induction treatment, were randomly assigned to receive (90)Y-ibritumomab tiuxetan (rituximab 250 mg/m(2) on day -7 and day 0 followed on day 0 by (90)Y-ibritumomab tiuxetan 14.8 MBq/kg; maximum of 1,184 MBq) or no further treatment (control). The primary end point was progression-free survival (PFS), which was calculated from the time of random assignment. RESULTS: A total of 414 patients (consolidation, n = 208; control, n = 206) were enrolled at 77 centers. (90)Y-ibritumomab tiuxetan consolidation significantly prolonged median PFS (after a median observation time of 3.5 years) in all patients (36.5 v 13.3 months in control arm; hazard ratio [HR] = 0.465; P < .0001) and regardless of whether patients achieved PR (29.3 v 6.2 months in control arm; HR = 0.304; P < .0001) or CR/CRu (53.9 v 29.5 months in control arm; HR = 0.613; P = .0154) after induction treatment. Median PFS with consolidation was prolonged in all Follicular Lymphoma International Prognostic Index risk subgroups. After (90)Y-ibritumomab tiuxetan consolidation, 77% of patients in PR after induction converted to CR/CRu, resulting in a final CR rate of 87%. The most common toxicity with (90)Y-ibritumomab tiuxetan was hematologic, and grade 3 or 4 infections occurred in 8% of patients. CONCLUSION: Consolidation of first remission with (90)Y-ibritumomab tiuxetan in advanced-stage follicular lymphoma is highly effective with no unexpected toxicities, prolonging PFS by 2 years and resulting in high PR-to-CR conversion rates regardless of type of first-line induction treatment.

Non-pharmacological interventions for chronic pain in people with spinal cord injury.

BACKGROUND: Chronic pain is frequent in persons living with spinal cord injury (SCI). Conventionally, the pain is treated pharmacologically, yet long-term pain medication is often refractory and associated with side effects. Non-pharmacological interventions are frequently advocated, although the benefit and harm profiles of these treatments are not well established, in part because of methodological weaknesses of available studies. OBJECTIVES: To critically appraise and synthesise available research evidence on the effects of non-pharmacological interventions for the treatment of chronic neuropathic and nociceptive pain in people living with SCI. SEARCH METHODS: The search was run on the 1st March 2011. We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), four other databases and clinical trials registers. In addition, we manually searched the proceedings of three major scientific conferences on SCI. We updated this search in November 2014 but these results have not yet been incorporated. SELECTION CRITERIA: Randomised controlled trials of any intervention not involving intake of medication or other active substances to treat chronic pain in people with SCI. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias in the included studies. The primary outcome was any measure of pain intensity or pain relief. Secondary outcomes included adverse events, anxiety, depression and quality of life. When possible, meta-analyses were performed to calculate standardised mean differences for each type of intervention. MAIN RESULTS: We identified 16 trials involving a total of 616 participants. Eight different types of interventions were studied. Eight trials investigated the effects of electrical brain stimulation (transcranial direct current stimulation (tDCS) and cranial electrotherapy stimulation (CES); five trials) or repetitive transcranial magnetic stimulation (rTMS; three trials). Interventions in the remaining studies included exercise programmes (three trials); acupuncture (two trials); self-hypnosis (one trial); transcutaneous electrical nerve stimulation (TENS) (one trial); and a cognitive behavioural programme (one trial). None of the included trials were considered to have low overall risk of bias. Twelve studies had high overall risk of bias, and in four studies risk of bias was unclear. The overall quality of the included studies was weak. Their validity was impaired by methodological weaknesses such as inappropriate choice of control groups. An additional search in November 2014 identified more recent studies that will be included in an update of this review.For tDCS the pooled mean difference between intervention and control groups in pain scores on an 11-point visual analogue scale (VAS) (0-10) was a reduction of -1.90 units (95% confidence interval (CI) -3.48 to -0.33; P value 0.02) in the short term and of -1.87 (95% CI -3.30 to -0.45; P value 0.01) in the mid term. Exercise programmes led to mean reductions in chronic shoulder pain of -1.9 score points for the Short Form (SF)-36 item for pain experience (95% CI -3.4 to -0.4; P value 0.01) and -2.8 pain VAS units (95% CI -3.77 to -1.83; P value < 0.00001); this represented the largest observed treatment effects in the included studies. Trials using rTMS, CES, acupuncture, self-hypnosis, TENS or a cognitive behavioural programme provided no evidence that these interventions reduce chronic pain. Ten trials examined study endpoints other than pain, including anxiety, depression and quality of life, but available data were too scarce for firm conclusions to be drawn. In four trials no side effects were reported with study interventions. Five trials reported transient mild side effects. Overall, a paucity of evidence was found on any serious or long-lasting side effects of the interventions. AUTHORS' CONCLUSIONS: Evidence is insufficient to suggest that non-pharmacological treatments are effective in reducing chronic pain in people living with SCI. The benefits and harms of commonly used non-pharmacological pain treatments should be investigated in randomised controlled trials with adequate sample size and study methodology.

Análisis de la producción científica visible en internet de los técnicos de salud ambiental del Servicio Andaluz de Salud

Internet it is a powerful interactive communication channel with world scope, through which can be multiplied the visibility of the research of the professionals whose scientific production has a difficult diffusion by the conventionals media. It is presented an analysis of the scientific publications observed in the web in order to understand the different communication processes accomplished by the superior corps of environmental health technical of the Andalusian Health Service. Using the nominal relationship of the professionals, we used Google ‘search engine’ for all scientific publications located in the internet; we were made different bibliometric indicators as of the recovered records and was analyzed the time evolution of the scientific production, documental categories, geografic distribution, language, coauthors and institutional collaboration. It was identified a growing trend in the productivity of the publications in the last decade, mainly through communications to congresses (70.4%) and journals articles (16.9%). The publications mainly are located in spanish journals, that they are indexed on national and international databases. In all the Andalusian provinces was identified some published scientific communication. The indicator of coauthors is very high (95.77%) although the institutional participation is limited mainly to the primary attention districts, occupational centers of each professional (85.21%). The scientific publication patterns visualized in the web represent an important contribution for the knowledge of the characteristics of the environmental health professionals of the Andalusian health service, what provides avaluable information for the support of the information systems in public health.

Collectio sermonum de dominicis, de festis et de sanctis, ad usum Fratrum Minorum.

« Sermo adaptabillis b. Laurentio... Dispersit, dedit pauperibus... Quia secundum b. Dionixium in De ecclesiastica Yerarchia... » (1-2) ; — « Sermo de assumptione b. Marie... Quid hoc audio de te... Quid nos tantilly... » (2v-3), suivi d'une note à l'usage des prédicateurs : « Nota quod ne sermo sit deffectuosus... » (3) ; — « Sermo de conceptione b. Marie. Que est ista que progreditur... Karissimi, predicator evangelicus, beatitudinis eterne preco... » (3v-4v) ; — « Sermo de quatuor festis principalibus b. Marie... Que est ista que progreditur... Verba ista sunt tocius curie celestis... » (4v-5v) ; — « Sermo de Purificatione. In mansuetudine suscipite... Secundum b. Gregorium, Mor. 23... » (6-7) ; — « Sermo de b. Francischo... Cujus est ymago hec et superscriptio... Secundum b. Gregorium, omelia 30... » (7v-8v) ; — « Sermo in dominica [in Quinquagesima]. Ecce ascendimus Jerosolimam... Karissimi, sicut scitis, finis est... » (9-10) ; — [Sermo in dominica IIa post Epiphaniam] « Tu servasti vinum bonum usque adhuc... In verbis istis spiritualiter intellectus... » (10-10v) ; — « Sermo de b. Francischo. Ad ymaginem similitudinis sue... Verba ista ad litteram scripta... » (11-12) ; — « Sermo de b. Johane Baptista. Magnus es tu et faciens mirabilia... Secundum Gregorium quia tute... » (12v-13) ; — « Sermo de angelis. Inmittit angelus Domini... Sanctus ille David, acceptus de ovibus... » (13v-14) ; — « In ascensione Domini. Exultavit ut gigas... Duo sunt inter cetera Christi misteria... » (14v-16) ; — « De asumpcione Domine nostre. Ad preceptum tuum elevabitur aquila... Quia, karissimi, Mater Domini... » [FRANCISCUS DE MAYRONIS] ; cf. éd. Bâle, 1498, f. CIV-CIIIV, avec variantes (16v-18) ; — « De Maria Magdalena. Permittuntur [sic pro : Remittuntur] tibi peccata tua... Sicut solent maximi principes... » [Idem], sermon abrégé ; cf. éd. cit., f. LXXXVIIIV-XCI (18-19v) ; — « De s. Johane Evangelista. Dillectus meus michi... Ostenditur b. Johannes prout inflamatus... » [Idem], résumé ; cf. éd. cit., f. XXIX-XXIXV (20) ; — « In festo apostolorum Petri et Pauli. Accepimus gratiam et apostolatum... Gloriosissimi christiane fidei religionis... » (20v-23v) ; — « Sermo de gratia divina acquirenda. Accepimus gratiam etc. Vivat, obsecro, anima mea ... quoniam... » (24) ; — « Accepimus gratiam etc. Restat ostendere via physionomica... » (24v-26) ; — « Sermo de beatitudine, sive gloria celesti, sive in festo Omnium sanctorum. Fons sapientie verbum Dei... Ecce ego sto prope fontem... In hoc festo precipue et anno... » (26-29) ; — « De nativitate Domine nostre. Egredietur virga de radice Jesse... Percutiet terram virga... Clementissimus pastor ovium... » (29v-32) ; — « Sermo de uno confessore pontifice. Rector fratrum et stabilimentum populi... Inter viros eximie sanctitatis... » (32v) ; — « De nativitate Domini. Transeamus usque Bethelem... Innocencius in quodam sermone de predicatione... » (34v-36) ; — « In die nativitatis Domini. Sol ortus est et humiles exaltati sunt... Beatus Augustinus, De Civitate Dei : Anima participacione... » (36-37v) ; — « Dominica infra octavas Nativitatis. Ecce positus est hic in ruinam... Secundum doctrinam Philosophi in diversis locis... » (38-38v) ; — « Dominica quarta in quadragesima. Sequebatur eum multitudo magna... Secundum Damascenum libro primo, capitulo XV°, diversitas actionum... » (39-40v) ; — « De Canane[a], dominica secunda [sic] in quadragesima [Feria 5a post dom. Ia in XLa]. Dimitte illam quia clamat... Si attendamus ordinem generacionis... » (41-42v) ; — « Dominica de Passione. Si veritatem dico vobis... Secundum sententiam Phylosophi primo Metaphysice... » (43-43v) ; — « In cena Domini. Hodie est rex et cras morietur... Omne agens ordinate prius inquirit... » (44-45) ; — « De resurectione. Hec dies quam fecit Dominus... Scilicet est ex dictis Philosophi in diversis locis... » (45v-47) ; — « Dominica in Quadragesima. Ecce nunc tempus acceptabile... Ut dicit Philosophus, secundo de Celo et mundo... » (47-48v) ; — « De b. Clara. Sicut lux meridiana clara est... Secundum Philosophum tertio Methaphysice, si res creatas... » (48v-49v) ; — « Sermo de Cruce. Vidit mulier quod bonum esset lignum... Sicut ex doctrina Philosophi primo Ethicorum... » (50-51) ; — « De s. Anthonio. Misit servum suum hora cene... Sicut in rebus naturalibus docet experiencia... » (51v-52v) ; — « De b. Johane Batista. Tu puer propheta Altissimi... Secundum doctrinam Hugonis in commento de angelica Jerarchia... » (53-54) ; — « De b. Bertholameo [sic]. Dedit illi contra inimicos potenciam... Racio docet et experiencia manifestat... » (54v-55) ; — « De b. Francischo. Amice, ascende superius... Dicit Philosophus quinto Physicorum quod motus... » (55v-56) ; — [De b. Bernardo] « Omnia parata sunt, venite ad nupcias... Sicut videmus in motu naturali... » (56v-57) ; — « De sacerdote novo. Vos elegit Dominus... Ut potest haberi ex dictis Dyonisii... » (57v-58v) ; — « De assumpcione Virginis gloriose. Elevetur tronus David super Israel... Videmus quod triplici racione aliqua corpora... » (58v-59v) ; — « De assumpcione Virginis. Veni de Libano sponsa mea... Secundum testimonium Scripturarum et humane consuetudinis... » (59v-61) ; — « De Trinitate. Tripliciter sol exurens montes... Secundum quod dicit Philosophus, tota nostra noticia... » (61-61v) ; — « De b. Francischo. Hic beatus in facto suo erit... Post doctrinam philosophorum et experienciam... » (62-62v) ; — [De b. Eligio] « Provideat rex virum sapientem... Secundum sententiam (secundum) sapientis primo Metaphysice . » (63-64) ; — « De resurrectione Domini. Tercia dies est hodie... Tripliciter alicujus rei non vise accipimus fidem certam... » (64-65) ; — «Stetit in medio discipulorum et dixit : Pax vobis... Ut dicit b. Augustinus undevicesimo de Civitate Dei... » (65v-67) ; — « De Omnibus sanctis... Gloriosa dicta sunt de te... Aperta est civitas... Doctore egregio Bernardo scilicet attestante... » (67-69) ; — « De b. Johane Batista. Hic venit in testimonium... Sicut potest probari ex dictis Philosophi et exemplis... » (69v-70) ; — « De b. Petro apostolo. Tu pasce populum meum Israel... Secundum sententiam Philosophi tertio Politicorum... » (70v-71) ; — « De assumpcione Virginis gloriose. Transibo in locum tabernaculi... Triplici ratione secundum philosophorum doctrinam aliqua moventur... » (71v-72v) ; — [De b. Francisco] « Adolescens, tibi dico surge... Consideranti sciderum revolucionem... » (73-74v) ; — [De s. Michaele] « Michael et angeli preliabantur... Sicut ex doctrina Phylosophi in pluribus locis patet... » (74v-76) ; — « De b. Nicholao. Petra fundebat michi rivos olei... Secundum philosophicam doctrinam, diversitas effectuum... » (76-77) ; — « In festo apostolorum Petri et Pauli. Fecit Deus duo luminaria magna... Secundum sententiam Philosophi secundo Methaphysice... » (77v-78) ; — « De b. Bertholameo. Vidi angelum fortem... Secundum dictum Philosophi, omnes transferentes... » (78v-79) ; — « Dominica in Quadragesima. Ductus est Jhesus in desertum... Sicut naturalium operationum multiplex experiencia... » (79v-80v) ; — « De s. Thoma apostolo. Ecce cognovi quoniam Deus meus es... Bernardus in sermone : Deus noverim me... » (81-81v) ; — « De sacerdote novo. Misit Dominus servum suum... Secundum quod dicit Philosophus primo Ethicorum, diversarum operationum... » (82-82bis) ; — « In purificatione Virginis. Parasti ante faciem omnium populorum... Si attendamus formationem rerum temporalium... » (82bisv-83v) ; — « De uno martire. Esto vir fortis, et prelia bella Domini... Secundum consuetudinem hominum... » (84-85) ; — « De festo Purificacionis. Lucerna splendens super candelabrum... Doctrina philosophorum et tradit... » (85v-86v) ; — « Feria quarta Cinerum. Cum jejunas unge caput tuum... Morum Philosophi doctrinam perlegens et attendens... » (87-88v) ; — « In quarta feria Cinerum. Cum jejunatis, nolite fieri sicut ypocrite... Sicut ex doctrina Philosophi primo Ethicorum potest colligi... » (88v-89v) ; — « In festo b. Lodovici [episcopi]. Surrexit rex de solio suo... Ut dicit Philosophus quarto Methaphysicorum... » (90-91v) ; — « De b. Jacobo. Vox tonitrui tui in rota... Secundum doctrinam philosophicam formarum naturalium... » (91v-92v) ; — [In festo Annunciationis] « Ecce concipies in utero... Secundum doctrinam Philosophi septimo de Animalibus, ad generationem... » (93-94) ; — « De s. Ludovico [episcopo]. Reposita est michi corona justitie... Secundum sententiam Philosophi secundo Phisicorum, omne agens... » (94-96).

1.° Alexandri de Sancto Elpidio, ordinis Eremitarum sancti Augustini, tractatus de ecclesiastica potestate : inserta est donatio Constantini Magni facta Ecclesiae Romanae. — 2.° Ejusdem expositio in principium evangelii secundum Joannem. — 3.° Ejusdem epitome librorum sancti Augustini de civitate Dei. — 4.° Sancti Isidori, synonymorum, sive soliloquiorum liber. — 5.° Fratris Dionysii de Colle, ordinis Eremitarum sancti Augustini, tractatus de fato et praescientia divina. — 6.° Testimonia duodecim Patriarcharum de Christo. — 7.° Tractatus de Antichristo. — 8.° Excerptum ex tractatu Origenis de novem festivitatibus in Veteri Testamento. — 9.° Bernardi Oliverii, ordinis Eremitarum sancti Augustini, tractatus contra Judaeos. — 10.° Fratris Ricoldi, Florentini, ordinis Praedicatorum, disputatio contra Saracenos et Alcoranum. — 11.° Tractatus qui mensa pauperum inscribitur : authore A. ordinis Eremitarum sancti Augustini

Colbertinus

1.° Bartholomaei Facii ad Alphonsum Regem dialogus de vitae felicitate. — 2.° Ejusdem epistola ad Robertum Strozam. — 3.° Mafei Vegii, Laudensis, dialogus de felicitate et miseria. — 4.° Ejusdem ad Eustachium, fratrem suum, dialogus de injuriis veritati illatis. — 5.° Anonymi dialogus inter Epicureum et Stoïcum de virtute et voluptate. — 6.° Platonis dialogus de morte contemnenda : interprete Cincio, Romano. — 7.° Plutarchi sermo de virtute et vitio : eodem interprete. — 8.° Apologia Socratis : authore Platone ; interprete verò Leonardo Aretino. — 9.° Platonis Crito : interprete anonymo. — 10.° Luciani Toxaris, sive, dialogus de amicitia : interprete anonymo.

Rogerii de Gaignieres

1.° Ars judiciaria secundùm novem Judices : authore anonymo. — 2.° Anonymi liber de inundatione Nili. — 3.° Anonymi liber de coloribus. — 4.° Anonymi liber de bona fortuna. — 5.° Anonymi libellus de lineis invisibilibus. — 6.° Liber de morte Aristotelis. — 7.° Liber de intelligentia Aristotelis. — 8.° Liber de causa motûs animalium. — 9.° Liber de juventute et senectute. — 10.° Liber de respiratione. — 11.° Aristotelis liber de morte et vita.

Colbertinus

1.° M. T. Ciceronis rhetoricorum ad Herennium libri quatuor. — 2.° Joannis Boni Andreae, civis Bononiensis, ars dictaminis. — 3.° Joannis Candidi, Secretarii Imperialis, liber artis novae epistolarum. — 4.° Forma appellationis Raymundi de Oppeda, Sistarciensis Episcopi. — 5.° Ars memoriae secundùm Aristotelem et S. Thomam de Aquino. — 6.° Tractatus de baculo Jacob : authore anonymo. — 7.° Exordia secundùm Cassiodorum, de pace facienda inter Imperatorem et Regem. — 8.° Petri Blesensis epistolae nonnullae. — 9.° Guidonis de Columna historiae Trojanae libri decem priores.

Colbertinus

9

Using analytical tools from game theory, we investigate the relevance of a series of hypotheses concerning natal dispersal, focusing in particular on the interaction between inbreeding and kin competition, as well as on the components of mating and social systems that are likely to interfere with these phenomena. A null model of pure kin competition avoidance predicts a balanced equilibrium in wich both sexes disperse equally. Inbreeding costs have the potential to destabilize the equilibrium, resulting in strongly sex-biased dispersal. This effect is mostly evident when the peculiarities of the mating system induce asymmetries in dispersal and/or inbreeding costs, or when kin cooperation counteracts kin competition. Inbreeding depression, however, is not the only possible cause for sex biases. The relevance of our results to empirical findings is dicussed and suggestions are made for further empirical or modelling work.