Analysis of trunk impact conditions in motorcycle road accidents based on epidemiological, accidentological data and multibody simulations.

Motorcycle accidents lead to a high rate of traffic mortality and morbidity. While helmet development and mandatory wearing have reduced head injuries, little progress has been made regarding trunk protection. Wearable airbag devices represent a promising solution to prevent trunk injuries. Nevertheless, research investigations need to be performed to assess and optimise the efficiency of such devices. This work consisted in the analysis of motorcyclist trunk impact conditions involved in various crash configurations to provide critical information in order to evaluate and improve the performances of airbag devices. First, an epidemiological and an accidentological analysis of data collection related to 252 real accidents, focusing on victims admitted into the shock rooms of two French trauma centres were performed. The data obtained was combined with numerical multibody parametric investigations, allowing the reproduction of 240 accident situations. An original and representative analysis of motorcyclists' impact conditions was provided, weighting the numerical study output data according to the real accident database. The impacted regions of the human body, the impact velocity and the accident chronology obtained in this work made it possible to define critical information for airbag efficiency assessment: the zones and levels of protection, the impacted surfaces as well as the airbag intervention time and the duration of maintained inflation of the airbag.

Cytogenetic Alterations in Multiple Myeloma: Prognostic Significance and the Choice of Frontline Therapy.

Multiple myeloma tumor cells demonstrate multiple and often complex genetic lesions as evaluated by standard cytogenetic/FISH studies. Over the past decade, specific abnormalities have been associated with standard or high-risk clinical behavior and they have become strong prognostic indicators. Further, as evidenced by recent randomized clinical trials, the choice of front-line therapy (transplant vs. no transplant, inclusion of novel drugs such as bortezomib, thalidomide, and lenalidomide) may be able to overcome the adverse effect of high-risk genetic lesions.

Frontline therapy for multiple myeloma: a concise review of the evidence based on randomized clinical trials.

The past decade has seen significant progress in the development of new and effective therapies for multiple myeloma. Stem cell transplantation and the introduction of novel agents, such as thalidomide, lenalidomide, and bortezomib, have significantly improved outcomes of myeloma patients. In the current review, we analyzed the available data provided by published randomized clinical trials for the frontline therapy of myeloma patients. We attempted to assess the relative contribution and impact of these new therapies in the setting of both, transplant eligible and transplant ineligible patients.

Inhibition of nuclear factor kappa B activation in early-stage chronic lymphocytic leukemia by omega-3 fatty acids.

Targeting the nuclear factor kappa B (NFκB) pathway is proposed as therapy for chronic lymphocytic leukemia (CLL). We hypothesized that an omega-3 fatty acids (n-3) supplement would suppress NFκB activation in lymphocytes of Rai Stage 0-1 CLL patients. The initial dose of 2.4 g n-3/day was gradually increased to 7.2 g n-3/day. After n-3 consumption: 1) plasma n-3 increased; 2) NFκB activation was suppressed in lymphocytes; 3) in vitro sensitivity of lymphocytes to doxorubicin was increased; and 4) expression of 32 genes in lymphocytes was significantly decreased.

Prevention of breast cancer (Part II): risk reduction strategies.

Until recently, the best protection against breast cancer mortality was early diagnosis through mammographic screening. However, the possibility that breast cancer in some cases can be prevented has come to light over the past 30 years. Various risk reduction strategies of breast cancer have been explored including lifestyle modification, prophylactic surgeries, and the use of chemopreventive agents. This article is the second portion of a two-part series on breast cancer prevention, and will focus its discussion on the available risk reduction interventions that have been shown to prevent breast cancer in women considered high risk for the disease. (See Part I in Cancer Investigation, 28:743­750, 2010)

Prevention of breast cancer (part I): epidemiology, risk factors, and risk assessment tools.

Advances in breast cancer research have led to declining death rates from this disease because of early detection through mammographic screening and improved therapy for breast cancer. The concept that breast cancer, in some cases, can be prevented has been explored over the last three decades. This article, part I of a two-part series, will focus on the epidemiology, the risk factors associated with breast cancer, and the available risk assessment tools, which can help define who should be considered for risk reduction strategies. Part II will focus on discussing risk reduction strategies.

RBC and WBC fatty acid composition following consumption of an omega 3 supplement: lessons for future clinical trials.

BACKGROUND: Results from increasing numbers of in vitro and in vivo studies have demonstrated that omega 3 fatty acids incorporated in cell culture media or in the diet of the animals can suppress the growth of cancers. When human clinical trials are initiated to determine the ability of omega 3 fatty acids to alter growth or response to chemotherapeutic interventions of cancers, it will be essential to determine the omega 3 intake of individuals in the trial to determine compliance with consumption of the supplement and to correlate with endpoints of efficacy. We wondered if the fatty acid composition of RBCs might accurately indicate incorporation of omega 3 fatty acids in the WBCs. In this report we determine and compare the changes in fatty acid compositions of red blood cells and white blood cells in response to consumption of three doses of an omega 3 fatty acid supplement. RESULTS: We found that the fraction of omega 3 fatty acids in both red blood cells and white blood cells increased following consumption of the supplement. There was a linear, dose responsive increase in the fraction of omega 3 fatty acids in red blood cells but the increase in omega 3 in white blood cells was not linear. The magnitude of increase in omega 3 fatty acids was different between the two cell types. CONCLUSIONS: Fatty acid analysis of red blood cells is a good measure of compliance with supplement consumption. However, fatty acid analysis of white blood cells is needed to correlate changes in fatty acid composition of white blood cells with other biochemical changes in the white blood cells. TRIAL REGISTRATION: ClinicalTrials.gov NCT00899353.

The emperor's new clothes or the current practice of clinical trials for multiple myeloma in the USA.

Phase III clinical trials help define standard therapies by comparing the outcomes of a new (experimental) treatment arm to the best established (control) arm. Superior outcomes should only be defined in measures of patient benefit. Two recent trials for upfront therapy of patients with multiple myeloma (ECOG E1A00 and E4A03) failed to conform to traditional Phase III trial design. Consequently they failed to provide any useful scientific data.

Hematopoietic stem cell transplantation in the elderly.

Hematopoietic stem cell (HSC) transplantation may improve outcomes of patients with hematologic malignancies not curable with conventional therapies. In some clinical settings, transplantation represents the only curative option. The feasibility and efficacy of this approach in older patients are undefined, since this population has been excluded from nearly all clinical trials. Advances in supportive care, HSC harvesting, and safer conditioning regimens have made this therapy available to patients well into their 6th and 7th decades of life. Recent evidence suggests that elderly patients with good performance status and no comorbidities could, in fact, not only survive the transplant with reasonable risk, but also benefit in the same measure as younger patients.

Bone Marrow TransplantationCurrent Clinical Practice: High-Dose Chemotherapy and Stem Cell Transplantation for Non-Hodgkin's Lymphoma: Review of Recent Advances.

The past decade has seen impressive achievements in the development of HDT/SCT for NHL, but much remains to be accomplished. Attention can be focused now on high risk patients whose outcome with HDT/SCT, as currently practiced, is poor. This is particularly true for patients with refractory or resistant disease. The preliminary research work summarized in this review leads us to believe that further progress is forthcoming, to the benefit of the patient's survival and quality of life.