ABSTRACT
In June 2009, the World Health Organization (WHO) issued a pandemic alert concerning the spread of an influenza A (H1N1) virus that showed distinctive genetic characteristics vis-à-vis both seasonal influenza strains and vaccine strains. The main mutation occurred in the gene coding for hemagglutinin (HA). Mathematical models were developed to calculate the transmissibility of the virus; the results indicated a significant overlap with the transmissibility of previous pandemic strains and seasonal strains. The remarkable feature of A/(H1N1)pdm09, compared with seasonal strains, is its high fatality rate and its higher incidence among younger people. Data provided by the WHO on the number of deaths caused by A/(H1N1)pdm09 only include laboratory-confirmed cases. Some authors suggest that these data could underestimate the magnitude of the event, as laboratory confirmation is not obtained in all cases. It is important to bear in mind that the A/(H1N1)pdm09 virus is still circulating in the population. It is therefore essential to maintain its epidemiological and virological surveillance.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza Vaccines , Influenza, Human/epidemiology , Influenza, Human/virology , Pandemics/statistics & numerical data , Hemagglutinins, Viral/genetics , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human/transmission , Models, Theoretical , Mutation , Population SurveillanceABSTRACT
The aim of this phase II study was to determine the efficacy of high-dose ifosfamide with moderate dose etoposide in childhood osteosarcoma. From January 1992 to January 1995, 27 children (15 male, 12 female) with relapsed or refractory evaluable osteosarcoma were included in a phase II study of two courses of ifosfamide 3g/m2/day and etoposide 75 mg/m2/day for 4 days. Median age was 14 years (7-19 years). All but one had received high-dose methotrexate and doxorubicin as first-line treatment. 22 patients had previously received ifosfamide. This regimen was given as first-line in 1 patient, second-line in 23 and third-line in 3. Evaluable disease was lung metastases in 21 patients, local relapse in 5 and adenopathy in 1. There were six complete responses, seven partial responses, three minor responses, six stable disease and five progressive disease (including one mixed response). Response rate was 48% (95% confidence interval, 29-67%). Duration of response was not available (10 responding patients had other treatments). Response rate was equivalent in the subgroup of 22 patients who had previously received ifosfamide (4 CR, 6 PR). Among 3 patients who received the phase II regimen as third-line chemotherapy, there was 1 PR. All but 4 patients had a well tolerated grade 4 neutropenia. Transient mild confusion or seizures were each observed once. 5 patients are alive 15-31 months after the beginning of chemotherapy. This combination of drugs at this dosage has tolerable toxicity, is efficient and deserves evaluation in phase III studies.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/drug therapy , Osteosarcoma/drug therapy , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Child , Etoposide/administration & dosage , Etoposide/adverse effects , Female , Humans , Ifosfamide/administration & dosage , Ifosfamide/adverse effects , Male , Survival Rate , Treatment OutcomeABSTRACT
In a 39-year-old patient with tibial productive osteitis, Propionibacterium acnes was identified in a surgical specimen of the bone lesion. Similar cases have been reported by others. The possibility that P. acnes may play in a pathogenic role in the SAPHO syndrome by causing inflammatory or infectious changes is discussed.
Subject(s)
Gram-Positive Bacterial Infections/complications , Hyperostosis/etiology , Propionibacterium acnes , Tibia , Adult , Female , HumansSubject(s)
Clavicle , Digestive System Neoplasms/radiotherapy , Osteoradionecrosis/etiology , Radiation Injuries/etiology , Respiratory Tract Neoplasms/radiotherapy , Aged , Bone Neoplasms/diagnosis , Bone Neoplasms/secondary , Diagnosis, Differential , Digestive System Neoplasms/surgery , Humans , Male , Middle Aged , Osteitis/diagnosis , Osteoradionecrosis/diagnosis , Osteosarcoma/diagnosis , Respiratory Tract Neoplasms/surgeryABSTRACT
Bone localizations revealing Hodgkin's disease or non-Hodgkin's malignant lymphoma, are unusual. We are reporting 11 recent cases collected in rheumatology and haematology departments, including 4 where a comprehensive study of X-rays, scintigrams, axial tomograms and nuclear magnetic resonance imaging was performed. Review of the literature as well as our experience concerning the type of onset of the bone involvement, the clinical correlation, the imaging techniques, have led us to consider nuclear magnetic resonance as a decisive factor which should be offered at an early stage in the diagnostic approach.
