Effect of fatigue on landing performance assessed with the landing error scoring system (less) in patients after ACL reconstruction. A pilot study.

BACKGROUND: Fatigue has been shown to affect performance of hop tests in patients after anterior cruciate ligament reconstruction (ACLR) compared to uninjured controls (CTRL). This may render the hop test less sensitive in detecting landing errors. The primary purpose of this study was to investigate the effect of lower extremity fatigue on landing performance assessed with the Landing Error Scoring System (LESS) in patients after ACLR compared to a CTRL group. It is plausible that fatigue would have an effect on confidence and risk appraisal in the ACLR group. The secondary purpose was to determine the relationship between psychological responses and LESS scores after fatigue. METHODS: Twelve patients following ACLR (6 males, 6 females) who were tested at 10 ± 2.4 months after surgery participated in the current study and were compared to 10 subjects in the control group (5 males, 5 females). Subjects performed a jump-landing task and the landing was assessed using the Landing Error Scoring System (LESS) both before and after fatigue. Digital video camcorders recorded frontal and sagittal plane views of the subject performing the task. The LESS was scored using video replay. Psychological responses in the ACLR group were assessed with the ACL-RSI questionnaire. RESULTS: Patients after ACLR had a median LESS of 6.5 which reflects a poor result (LESS >6) in the pre-fatigue condition compared to controls who had a LESS of 2.5 which is considered excellent (≤4). In the post-fatigue condition, median LESS in patients after ACLR increased to 7.0 whereas in the control group the LESS increased to 6.0 both of which reflect a poor result. The median increase in LESS was larger in the control (2.0) group compared to patients after ACLR (1.0) but the difference was not significant (p=0.165). CONCLUSIONS: Patients after ACLR have higher LESS scores at baseline compared to a control group. Fatigue resulted in an increase in scores on the LESS in both groups. LEVEL OF EVIDENCE: 3b.

First-line gemcitabine with cisplatin or epirubicin in advanced non-small-cell lung cancer: a phase III trial.

The purpose of our study was to compare progression-free survival and quality of life (QOL) after cisplatin-gemcitabine (CG) or epirubicin-gemcitabine (EG) in chemotherapy-naive patients with unresectable non-small-cell lung cancer. Patients (n=240) were randomised to receive gemcitabine 1125 mg x m(-2) (days 1 and 8) plus either cisplatin 80 mg x m(-2) (day 2) or epirubicin 100 mg x m(-2) (day 1) every 3 weeks for a maximum of five cycles. Eligible patients had normal organ functions and Eastern Cooperative Oncology Group performance status

Activity of high-dose epirubicin combined with gemcitabine in advanced non-small-cell lung cancer: a multicenter phase I and II study.

The aim of the study was to evaluate efficacy and tolerance of epirubicin and gemcitabine as first-line chemotherapy in patients with advanced non-small-cell lung cancer. A phase I study was performed with the combination of escalating doses of epirubicin intravenously on day 1 and a fixed dose of gemcitabine on days 1 and 8 of a 21 -day cycle. Eighteen patients were included in the phase I part of the study before the maximum tolerated dose was found. Dose-limiting toxicity was febrile neutropenia. The phase II part of the study was continued with epirubicin 100 mg m(-2) on day 1 and gemcitabine 1125 mg m(-2) on days 1 and 8 of a 21-day cycle. Forty-three chemotherapy-naive patients were included. The median age of the patients was 60 years (range 26-75). Most patients (74%) were in stage IV. Granulocytopenia CTC grade 4 occurred in 32.5% and thrombocytopenia grade 4 in 11.6% of cycles. Febrile neutropenia occurred in six patients. Non-haematological toxicity was mainly mucositis CTC grade 2 and 3 in 35% of patients. The tumour response rate was 49% (95% confidence interval (CI) 35-63%). The median survival time for the patients was 42 weeks (95% CI 13-69).

Benign endobronchial tumours treated by neodymium-YAG laser.

We present two patients with benign endobronchial tumours: polypi and a chondroma. Both were treated by Neodymium-YAG laser photoresection. There have been no signs of recurrence in the four years since treatment. Endobronchial resection by Neodymium-YAG laser is an effective treatment for benign endobronchial tumours.