The clinical impact of vancomycin-resistant Enterococcus colonization and bloodstream infection in patients undergoing autologous transplantation.

BACKGROUND: Although several studies have documented adverse outcomes for vancomycin-resistant Enterococcus (VRE) colonization and infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, data are inadequate for patients undergoing autologous (auto-)HSCT. METHODS: We conducted a retrospective cohort study of 300 consecutive patients receiving an auto-HSCT between 2006 and 2014. Patients had stool cultures for VRE on admission and weekly during hospitalization. RESULTS: Thirty-six percent of patients had VRE gastrointestinal (GI) colonization and 3% developed a VRE bloodstream infection (BSI), all of whom were colonized. VRE strain typing of BSI isolates showed that some patients shared identical patterns. Rates of colonization and BSI in colonized patients were similar to simultaneous patients undergoing allo-HSCT, except that the latter had a higher rate of colonization at admission. A diagnosis of lymphoma was associated with an increased risk of colonization. VRE BSI was associated with longer lengths of stay and possibly higher costs, but no decrease in overall survival, and colonized patients had no VRE infections during the year following discharge. Repeat stool cultures in patients subsequently undergoing allo-HSCT suggested that most, if not all, VRE-positive auto-HSCT patients lose their detectable GI colonization within a few months of discharge. CONCLUSION: VRE colonization is frequent but carries a low risk for infection in patients undergoing auto-HSCT. However, these patients can serve as reservoirs for transmission to higher risk patients. Moreover, patients may remain colonized if proceeding to an allo-HSCT shortly after auto-HSCT, potentially increasing the risk of the allogeneic procedure.

Do we have markers to select patients for adjuvant therapies of non-small-cell lung cancer?

Adjuvant platinum-based chemotherapy represents the standard of care in fit stage II and IIIA non-small-cell lung cancer patients after surgical resection. This review discusses current knowledge on molecular prognostic and predictive tumor features for benefit from adjuvant therapies with emphasis on ongoing clinical trials that prospectively assess the biomarker utility. Until the results of these trials are available, use of these markers is not recommended in routine clinical care.

The feasibility study on continuous 7-day-a-week external beam irradiation in locally advanced cervical cancer: a report on acute toxicity.

PURPOSE: To evaluate the feasibility and toxicity of continuous 7-day-a-week pelvic irradiation with no breaks between external beam irradiation and intracavitary applications. MATERIAL AND METHODS: Between November 1998 and December 1999, 30 patients with FIGO Stage IIB or IIIB cervical cancer were treated with continuous 7-day-a-week pelvic irradiation, to the total Manchester point B dose of 40.0-57.6 Gy. The first 13 patients (group A) were applied a daily tumor dose of 1.6 Gy and the remaining 17 patients (group B)-10.8 Gy. One or two immediate brachytherapy applications (point A dose 10-20 Gy, each) were performed in 28 cases. RESULTS: Two patients did not complete the irradiation due to apparent early progression of disease during the irradiation. Of the remaining 28 evaluable patients 11 (39%) completed treatment within the prescribed overall treatment time and 17 had unplanned treatment breaks. For the latter group overall treatment time ranged from 103 to 122% (mean 114%) and from 103 to 197% (mean 138%) of the planned treatment time for group A and B, respectively. The majority of patients experienced acute toxicity. Severe toxicity (EORTC/RTOG grade 3 and 4), predominantly gastrointestinal, occurred in 5 of the 13 patients in group A, and in 7 of 17 patients in group B. CONCLUSION: The studied regimen was accompanied by considerable toxicity, hindering delivery of irradiation within planned treatment time.

Serum p53 antibodies in small cell lung cancer: the lack of prognostic relevance.

Prognostic relevance of serum p53 antibodies was assessed in 96 patients with microscopically proven small cell lung cancer (SCLC). The study group included 67 males and 29 females; mean age 58 years; range 35--86 years; 60 with limited disease (LD), and 36 with extensive disease (ED). The control group consisted of 41 patients with non-malignant diseases. The presence of p53 antibodies was assayed by the immunoenzymatic method (P53 ELISA kit, PharmaCell, France). Antibodies were present in 26 SCLC cases (27%); 15 (25%) in LD and 11 (31%) in ED. Antibodies were also found in one out of 41 control subjects (2%). There was no correlation between the level of antibodies and clinical characteristics of SCLC patients including age, gender and extent of disease. The median follow-up for the entire group was 30 months (range: 11--39 months). By the time of analysis, 78 patients (82%) had deceased. Median survival in SCLC patients with and without antibodies was 42 and 39 weeks, respectively (log rank, P=0.81). These results indicate the lack of clinical relevance of serum p53 antibodies in SCLC.

The prevalence of cigarette smoking among school pupils staying at summer camps.

SETTING: The prevalence of cigarette smoking in Poland is one of the highest in Europe. OBJECTIVE: To compare the frequency of smoking among Polish pupils during a school year and the summer holidays. DESIGN: A questionnaire including personal and demographic data and information on smoking behaviour was distributed among 598 school pupils: 357 girls and 241 boys aged 8-19 years, with a mean age of 14.4. RESULTS: Among the entire group of school pupils, 18.6% were cigarette smokers. Half of the smokers smoked occasionally and the remainder smoked every day; of these, 9.9% smoked more than 10 cigarettes daily. The frequency of smoking among these teenagers increased with age. The average age of smoking initiation was 13 years for boys and 15 years for girls. The majority smoked more during the summer holidays than during the school year. The most frequently reported reasons for increasing cigarette smoking during the summer holidays were: feeling more free, having more money to spend, the influence of new friends, and smoking to pass the time when they felt bored. CONCLUSION: Young people in this study still started smoking early, most frequently between the ages of 13 and 15. High rates of daily smokers among teenagers were observed. In some groups of teenagers the summer holidays may be a time of increased cigarette smoking.

p53 codon 72 polymorphism in cervical cancer patients and healthy women from Poland.

A polymorphism at codon 72 of gene p53 results in the presence of either arginine or proline at this position. We investigated the distribution of p53 codon 72 polymorphism in cervical cancer patients and a control group of healthy women from Poland. Our results do not confirm the hypothesis that the p53 codon polymorphism could play a role as a factor for squamous carcinoma of the cervix.

[Analysis of motivation for cigarette smoking by teenagers based on a questionnaire distributed among school pupils staying in summer camps]. / Analiza motywacji palenia papierosów przez mlodziez szkolna na podstawie ankiety przeprowadzonej wsród uczestników kolonii i obozów letnich.

Cigarette smoking by teenagers is conditioned by many factors with psychosocial ones among them. The aim of our study was to define the reasons for cigarette smoking by juveniles in Poland nowadays. The analysis was performed on the basis of questionnaire given to 598 school pupils resting in the summer camps in the Tricity of three neighbouring towns of Gdansk, Sopot and Gdynia. The study group included 357 females and 241 males, with an age of 8-19 years, on average 14.4. Out of the hole group 111 (18.6%) were smokers. This subgroup, 58 boys and 53 girls (age: 12-19 yrs.; on average 15.4), answered to several questions concerning cigarette smoking. Among remaining 487 non-smokers the prevalence of cigarette smoking among their parents was only assessed. As the main reason for smoking the majority (69.4%) of smokers reported the stress reduction. Pleasure was another frequently reported (29.7%) reason for cigarette smoking. Peers smoking was an important reason for cigarette smoking for 28.8% of school pupils. We found that the example of smoking parents significantly influenced the prevalence of smoking cigarettes among teenagers. The majority (73.9%) of smoking pupils knew the cigarette were harmful. Obtained results show the multiplicity of reasons for cigarette smoking by juveniles resulting mainly from psychosocial factors. There is a great necessity of antismoking programs for school pupils adjusted to specificity of psychology of adolescence as well as the exemplary role of adults creating a life style without cigarette.