Normative fitness performance scores of community-dwelling older adults in Spain.

A cross-sectional descriptive study was designed to obtain normative age-specific fitness scores for the general population of community-dwelling older adults in Spain. In total, 6,449 participants (5,610 women and 839 men) age 60-99 yr who lived in the region of Extremadura were recruited. Compared with the cohorts of similar studies in other countries, this cohort had more physically inactive elderly participants and participants with a higher body-fat percentage. All test results declined as age increased. Sex differences in the age-related decline in fat and body mass were observed. Women scored better in the flexibility tests, and men performed better in the other tests. These data may be highly useful for the age-specific assessment of the fitness performance of older adults and the design of programs that promote functional ability in older adults.

Residual disease after chemotherapy in aggressive malignant lymphoma: the role of radiotherapy.

Residual disease in patients with diffuse large B-cell lymphoma after intensive chemotherapy remains a problem. Radiotherapy has been used in some retrospective studies without definitive conclusions. We report the first controlled clinical trial to define the role of radiotherapy in this setting of patients. One hundred and sixty-six patients with diagnosis of diffuse large B-cell lymphoma, high- or high-intermediate clinical risk, with residual disease (defined as tumor mass < 5 cm) were randomly assigned to received radiotherapy at the involved field, with 30 Gy delivered in 20 sessions or no radiation (control group). Median follow-up was 135 mo; patients who received radiotherapy have an better outcome. Actuarial curves at 10 yr showed that progressive-free disease was 86% and overall survival was 89%; those were statistical significant when compared to patients who did no received radiotherapy: 32% and 58% respectively, (p < 0.001). Toxicity was mild and well tolerated. We concluded that presence of residual mass after chemotherapy in patients with aggressive malignant lymphoma has a worse prognosis, and salvage radiotherapy improves outcome with mild toxicity. We feel that radiotherapy will be considered as necessary treatment in this special group of patients.

Primary breast lymphoma: results of a controlled clinical trial.

OBJECTIVES: To assess the efficacy and toxicity of the most employed therapeutic approaches in the treatment of primary breast lymphoma (PBL). METHODS: Ninety-six patients with PBL in the early stage (I or II) were enrolled to receive radiotherapy (45 Gy); chemotherapy (six cycles of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP), every 21 days), or combined therapy. RESULTS: Complete response was achieved in 20 of 30 patients treated with radiotherapy, 19 of 32 who were treated with chemotherapy and 30 of 34 in the combined arm (p<0.01). Actuarial curves at 10 years showed that event-free survival was 50, 57 and 83%, respectively (p<0.01). Actuarial curves for overall survival were 50, 50 and 76% (p<0.01), respectively. The most common site of relapse was the central nervous system. Acute toxicity was mild. Until now, no second neoplasm or acute leukemia has been observed. CONCLUSIONS: In our study combined therapy is the best treatment in this special setting of patients; with improvement in event-free survival and overall survival without acute or severe late side effects. Prophylaxis to the central nervous system will be considered in the initial treatment to improve outcome.

Combined therapy in advanced stages (III and IV) of follicular lymphoma increases the possibility of cure: results of a large controlled clinical trial.

OBJECTIVES: We evaluate the long-term results of a randomized clinical trial in patients with advanced stages (III and IV) of follicular lymphoma using chemotherapy or combined therapy (chemotherapy following by adjuvant radiotherapy in patients with nodal bulky disease). MATERIAL AND METHODS: Between 1981 and 1995, patients with follicular lymphoma were treated with combined chemotherapy, mostly anthracycline-based regimens; patients who achieved complete response were randomly assigned either to receive adjuvant radiotherapy to sites or to nodal bulky disease or not (control group). RESULTS: Four hundred and sixty-nine patients were randomized; in an intent-to-treat analysis all were evaluable for efficacy and toxicity. Actuarial curves at 20yr showed that event-free survival (EFS) and overall survival (OS) in the control group were 41% [95% confidence interval (CI) 36-56%) and 71% (95% CI 65-78%), respectively; these were statistically different from results for the patients who received adjuvant radiotherapy: 68% (95% CI 62-72%) and 89% (95% CI 79-96%), respectively (P<0.01). Acute and late toxicity were minimal; only four patients (<1%) developed myelodysplastic syndrome/acute leukemia. Cardiac toxicity was 2%, but one case was lethal. Thirty-six patients (8%) died secondary to unrelated causes, in complete remission. CONCLUSIONS: The use of adjuvant radiotherapy in patients with poor-prognosis follicular lymphoma increases EFS and OS with minimal toxicity. We feel that follicular lymphoma should be treated curatively because <80% of patients will be in first complete response at <20yr. The use of adjuvant radiotherapy will be considered in the first line of treatment in this set of patients.

Malignancy: Adjuvant Radiotherapy to Initial Bulky Disease in Patients with Advanced Stage Hodgkin's Disease.

To determine if the use of adjuvant radiotherapy to sites of initial bulky disease and adequate modern chemotherapy in patients with advanced stages (IIIB and IV) Hodgkin's disease could improve duration of remission and overall survival. Patients previously untreated with pathologically documented advanced stages Hodgkin's disease were randomly assigned to received chemotherapy alone with EBVD regimen (epirubicin, bleomycin, vinblastine and dacarbazine): 56 patients or combined therapy: The same chemotherapy regimen following by adjuvant radiotherapy (35 Gy) to sites of initial bulky disease (tumor mass >7 cm diamenter): 54 patients. Five year overall survival rates were 88% (48 patients) and 60% (34 patients) from combined therapy compared to chemotherapy alone respectively (p < 01) (95% confidence interval (CI): for the difference 18% to 39%). Five-year failure free survival were 83% and 50% respectively (p < 01) (95% CI for difference: 22% to 35%). Toxicity was moderate and well tolerate. No death-related treatment were observed. After a median follow-up of 66 months, no second solid neoplasmas or acute leukemia has been observed. The use of adjuvant radiotherapy to sites of initial bulky disease following the use of modern chemotherapy in patients with advanced stages Hodgkin's disease improve outcome with increase in failure free survival and overall survival, with moderate toxicity. More randomized clinical trials are warranted to define this therapeutic approach.

Caracterización el virus el Distemper (moquillo canino) en cultivos celulares, aislado de animales clínicamente enfermos / Caracterization of Distemper Virus in cell culture

Se estudió el comportamiento del virus del Distemper Canino (VDC) en cultivos celulares primarios y de líneas. Se emplearon diversos VDC, aislados de encéfalos provenientes de perros que murieron mostrando una sintomatología nerviosa; histológicamente, dichos encéfalos presentaron cuerpos de inclusión y reacción positiva por inmunofluorescencia (IF) al emplear un conjugado anti-DVC. Cada muestra se inoculó en células VERO y Cultivo Primario de Riñón de perro (CRP) para evaluar la capacidad de: a) producir efectos citopáticos (ECP),b) reaccionar frente a un conjugado fluorescente anti-DVC, c) hemoaglutinar glóbulos rojos de diversas especies en diferentes condiciones y d) hemoadsorber glóbulos rojos. Los resultados mostraron que: a) no hubo diferencia alguna entre emplear células VERO y CRP, observándose cambios citopáticos que permitieron diferenciar un cultivo infectado de uno no infectado con virus vacunal, b) el 88 por ciento de las muestras conservó su antigenisidad, pues resultó positivo en la prueba de IF, observándose la mayor intensidad de fluorescencia específica a las 48 horas postinfección, c) el 58 por ciento de las muestras mostró hemoadsorción y d) ninguna muestra, incluyendo los testigos, fue capaz de hemoaglutinar. No fue posible, con base en los resultados, establecer diferencias entre los virus "de campo" y los vacunales.