Multidisciplinary treatment ofadult patients with Class III malocclusion

This article describes the multidisciplinary treatment of an adult patient presenting with Angle Class III malocclusion, alteration of the mandibular position, vertical alveolar bone loss and absence of teeth in the lower posterior region. With advancing age the existence of occlusal interference due to loss of teeth or tooth structure is very common, resulting in periodontal problems due to occlusal trauma. The options for treatment of Class III malocclusion in adolescent and adult patients include compensatory orthodontic treatment in mild to moderate cases and orthognathic surgery for moderate to severe cases. The combination of various dental specialties enabled improvement in the social circumstances of the patient. This can be observed objectively by the final dental relationship and by the skeletal and tegumentary cephalometric comparison between the situation at the beginning and at the end of the treatment. The compensatory treatment performed permitted the successful correction of a Class III malocclusion in the clinical case presented.

Sorafenib in Combination With Capecitabine: An Oral Regimen for Patients With HER2-Negative Locally Advanced or Metastatic Breast Cancer

Purpose Sorafenib is a multikinase inhibitor with antiangiogenic/antiproliferative activity. A randomized, double-blind, placebo-controlled phase IIB trial assessed sorafenib with capecitabine for locally advanced or metastatic human epidermal growth factor receptor 2 (HER2) -negative breast cancer. Patients and Methods Patients were randomly assigned to first-or second-line capecitabine 1,000 mg/m(2) orally twice a day for days 1 to 14 of every 21-day cycle with sorafenib 400 mg orally twice a day or placebo. The primary end point was progression-free survival (PFS). Results In total, 229 patients were enrolled. The addition of sorafenib to capecitabine resulted in a significant improvement in PFS versus placebo (median, 6.4 v 4.1 months; hazard ratio [HR], 0.58; 95% CI, 0.41 to 0.81; P = .001) with sorafenib favored across subgroups, including first-line (HR, 0.50; 95% CI, 0.30 to 0.82) and second-line (HR, 0.65; 95% CI, 0.41 to 1.04) treatment. There was no significant improvement for overall survival (median, 22.2 v 20.9 months; HR, 0.86; 95% CI, 0.61 to 1.23; P = .42) and overall response (38% v 31%; P = .25). Toxicities (sorafenib v placebo) of any grade included rash (22% v 8%), diarrhea (58% v 30%), mucosal inflammation (33% v 21%), neutropenia (13% v 4%), hypertension (18% v 12%), and hand-foot skin reaction/hand-foot syndrome (HFSR/HFS; 90% v 66%); grade 3 to 4 toxicities were comparable between treatment arms except HFSR/HFS (44% v 14%). Reasons for discontinuation in the sorafenib and placebo arms included disease progression (63% v 82%, respectively), adverse events (20% v 9%, respectively), and death (0% v 1%, respectively). Conclusion Addition of sorafenib to capecitabine improved PFS in patients with HER2-negative advanced breast cancer. The dose of sorafenib used in this trial resulted in unacceptable toxicity for many patients. A phase III confirmatory trial has been initiated with a reduced sorafenib dose.

Gefitinib in Combination with Irradiation with or Without Cisplatin in Patients with Inoperable Stage III Non-Small Cell Lung Cancer: A Phase I Trial

To establish the feasibility and tolerability of gefitinib (ZD1839, Iressa) with radiation (RT) or concurrent chemoradiation (CRT) with cisplatin (CDDP) in patients with advanced non-small cell lung cancer (NSCLC).

Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94)

This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RT +/- concomitant cisplatin in locally advanced head and neck cancer.

Lack of extended venous thromboembolism prophylaxis in high-risk patients undergoing major orthopaedic or major cancer surgery. Electronic Assessment of VTE Prophylaxis in High-Risk Surgical Patients at Discharge from Swiss Hospitals (ESSENTIAL)

Extended pharmacological venous thromboembolism (VTE) prophylaxis beyond discharge is recommended for patients undergoing high-risk surgery. We prospectively investigated prophylaxis in 1,046 consecutive patients undergoing major orthopaedic (70%) or major cancer surgery (30%) in 14 Swiss hospitals. Appropriate in-hospital prophylaxis was used in 1,003 (96%) patients. At discharge, 638 (61%) patients received prescription for extended pharmacological prophylaxis: 564 (77%) after orthopaedic surgery, and 74 (23%) after cancer surgery (p < 0.001). Patients with knee replacement (94%), hip replacement (81%), major trauma (80%), and curative arthroscopy (73%) had the highest prescription rates for extended VTE prophylaxis; the lowest rates were found in patients undergoing major surgery for thoracic (7%), gastrointestinal (19%), and hepatobiliary (33%) cancer. The median duration of prescribed extended prophylaxis was longer in patients with orthopaedic surgery (32 days, interquartile range 14-40 days) than in patients with cancer surgery (23 days, interquartile range 11-30 days; p<0.001). Among the 278 patients with an extended prophylaxis order after hip replacement, knee replacement, or hip fracture surgery, 120 (43%) received a prescription for at least 35 days, and among the 74 patients with an extended prophylaxis order after major cancer surgery, 20 (27%) received a prescription for at least 28 days. In conclusion, approximately one quarter of the patients with major orthopaedic surgery and more than three quarters of the patients with major cancer surgery did not receive prescription for extended VTE prophylaxis. Future effort should focus on the improvement of extended VTE prophylaxis, particularly in patients undergoing major cancer surgery.

Anonymer arabischer Kommentar zu Maimonides' "Führer der Unschlüssigen" : 1. Teil, Kap- 41-61 ; nach Ms. Or. Oct. 258 (hebr.) zum erstenmal herausgegeben

Bern, Univ., Diss., 1906

Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03.

PURPOSE Rituximab maintenance therapy has been shown to improve progression-free survival in patients with follicular lymphoma; however, the optimal duration of maintenance treatment remains unknown. PATIENTS AND METHODS Two hundred seventy patients with untreated, relapsed, stable, or chemotherapy-resistant follicular lymphoma were treated with four doses of rituximab monotherapy in weekly intervals (375 mg/m(2)). Patients achieving at least a partial response were randomly assigned to receive maintenance therapy with one infusion of rituximab every 2 months, either on a short-term schedule (four administrations) or a long-term schedule (maximum of 5 years or until disease progression or unacceptable toxicity). The primary end point was event-free survival (EFS). Progression-free survival, overall survival (OS), and toxicity were secondary end points. Comparisons between the two arms were performed using the log-rank test for survival end points. RESULTS One hundred sixty-five patients were randomly assigned to the short-term (n = 82) or long-term (n = 83) maintenance arms. Because of the low event rate, the final analysis was performed after 95 events had occurred, which was before the targeted event number of 99 had been reached. At a median follow-up period of 6.4 years, the median EFS was 3.4 years (95% CI, 2.1 to 5.3) in the short-term arm and 5.3 years (95% CI, 3.5 to not available) in the long-term arm (P = .14). Patients in the long-term arm experienced more adverse effects than did those in the short-term arm, with 76% v 50% of patients with at least one adverse event (P < .001), five versus one patient with grade 3 and 4 infections, and three versus zero patients discontinuing treatment because of unacceptable toxicity, respectively. There was no difference in OS between the two groups. CONCLUSION Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity.

RETRATO DEL EX.MO É ILL.MO S.OR D.N FRAI JOAQUIN COMPANY [Material gráfico] : Caballero Gran Cruz de la Rl. distinguida Orden de Carlos III Arzobispo antes de Zaragoza y después de Valencia

Resumen: Descripción: retrato de 3/4 en el interior de un óvalo. Viste indumentaria de arzobispo. En el ángulo izqdo., la mitra y báculo

Effects of nutrition on digestión efficiency and gaseous emissions from slurry in growing pigs: III. Influence of varying the dietary level of calcium soap of palm fatty acids distillate with or without orange pulp supplemention

The aim of this study was to establish the relationships between faecal fat concentration and gaseous emissions from pig slurry. Five diets were designed to meet essential nutrient requirements: a control and four experimental feeds including two levels (35 or 70 g/kg) of calcium soap fatty acids distillate (CSP) and 0 or 200 g/kg of orange pulp (OP) combined in a 2 × 2 factorial structure. Thirty growing pigs (six per treatment) were used to measure dry matter (DM) and N balance, coefficients of total tract apparent digestibility (CTTAD) of nutrients, faecal and urine composition and potential emissions of ammonia (NH3) and methane (CH4). Increasing dietary CSP level decreased DM, ether extract (EE) and crude protein (CP) CTTAD (by 4.0, 11.1 and 3.5%, respectively, P < 0.05), but did not influence those of fibrous constituents. It also led to a decrease (from 475 to 412 g/kg DM, P < 0.001) of faecal concentration of neutral detergent fibre (aNDFom) and to an increment (from 138 to 204 g/kg, P < 0.001) of EE in faecal DM that was related to greater CH4 emissions, both per gram of organic matter (P = 0.021) or on a daily basis (P < 0.001). Level of CSP did not affect N content in faeces or urine, but increased daily DM (P < 0.001), and N (P = 0.031) faecal excretion with no effect on urine N excretion. This resulted in lesser (P = 0.036) NH3 potential emission per kg of slurry. Addition of OP decreased CTTAD of EE (by 7.9%, P = 0.044), but increased (P < 0.05) that of all the fibrous fractions. As a consequence, faecal EE content increased (from 165 to 177 g/kg DM; P = 0.012), and aNDFom decreased greatly (from 483 to 404 g/kg DM, P < 0.001), which in all resulted in a lack of effect of OP on CH4 potential emission. Inclusion of OP in the diet also led to a significant decrease of CP CTTAD (by 6.85%, P < 0.001), and to an increase of faecal CP concentration (from 174 to 226 g/kg DM, P < 0.001), with no significant influence on urine N content. These effects resulted in higher N faecal losses, especially those of the undigested dietary origin, without significant effects on potential NH3 emission. No significant interactions between CSP and OP supplementation were observed for the gaseous emissions measured.

La Traca : semanari pa la gent de tro: Año III Número 61 - 21 febrero 1886

Recurso electrónico. Valencia: BVNP, 2014

Europe and the World or Snow White and the Seven Fallacies. Egmont Paper No. 61, October 2013

None.