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1.
Sci Total Environ ; 802: 149847, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34525722

RESUMO

Burn severity influences on post-fire recovery of soil-hydraulic properties controlling runoff generation are poorly understood despite the importance for parameterizing infiltration models. We measured soil-hydraulic properties of field-saturated hydraulic conductivity (Kfs), sorptivity (S), and wetting front potential (ψf) for four years after the 2013 Black Forest Fire, Colorado, USA, at six sites across a gradient of initial remotely sensed burn severity using the change in the normalized burn ratio (dNBR). These measurements were correlated with soil-physical property measurements of bulk density (ρb), loss on ignition (LOI, a measure of soil organic matter), and ground cover composition to provide insight into causal factors for temporal changes in Kfs, S, and ψf. Modeled infiltration using the Smith-Parlange approach parameterized with measured Kfs, S, and ψf further discerned the role of precipitation intensity on runoff generation. Temporal trends of soil-physical properties and ground cover showed influences from initial burn severity. Trends in soil-hydraulic properties, surprisingly, were not strongly influenced by initial burn severity despite inferred effects of ρb, LOI, and ground cover on trends in Kfs and S. Calculations of dNBR at the time of sampling showed strong correlations with Kfs and S, demonstrating a new approach for estimating long-unburned Kfs and S values, infiltration model parameters after fire, and assessing the time of return to pre-fire values. Simulated infiltration-excess runoff, in contrast, did depend on initial burn severity. Time series of the ratio S2/Kfs ≈ ψf tended to converge between 1 and 10 mm four years after wildfire, potentially (i) defining a long-unburned forest domain of S2/Kfs and ψf from 1 to 10 mm with relatively high Kfs values, and (ii) providing a new post-fire soil-hydraulic property recovery metric (i.e. S2/Kfs ≈ ψf in the range of 1 to 10 mm) for sites in the Rocky Mountains of the USA.


Assuntos
Incêndios , Florestas , Incêndios Florestais , Colorado , Humanos , Solo
2.
Rev Sci Instrum ; 92(6): 063524, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34243576

RESUMO

A new tri-particle mono-energetic backlighter based on laser-driven implosions of DT3He gas-filled capsules has been implemented at the OMEGA laser. This platform, an extension of the original D3He backlighter platform, generates 9.5 MeV deuterons from the T3He reaction in addition to 14.7 and 3.0 MeV protons from the deuterium and helium-3 reactants. The monoenergetic 14.7 and 3.0 MeV protons have been used with success at OMEGA and the NIF for both radiography and stopping-power studies. There are several advantages of having a third particle to diagnose plasma conditions: an extra time-of-flight-separated radiograph and an improved ability to discern between electric and magnetic fields. In cases where the 3.0 MeV protons cannot penetrate an experiment, the benefit of the additional 9.5 MeV deuterons is magnified. This capability is well-suited for NIF experiments, where large fields and plasma densities often preclude useful 3.0 MeV proton data. The advantages are demonstrated with radiographs of OMEGA plasmas with magnetic and electric fields. Tests using backlighter-scale 420 µm diameter thin glass capsules validate the platform's extended backlighting capability. The performance characteristics of this backlighter, such as source size and timing, are discussed.

3.
Phys Rev E ; 103(3-1): 033201, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33862682

RESUMO

We report on the experimental investigation of magnetic field generation with a half-loop gold sheet coil driven by long-duration (10 ns) and high-power (0.5 TW) laser pulses. The amplitude of the magnetic field was characterized experimentally using proton deflectometry. The field rises rapidly in the first 1 ns of laser irradiation, and then increases slowly and continuously up to 10 ns during further laser irradiation. The transient dynamics of current shape were investigated with a two-dimensional (2D) numerical simulation that included Ohmic heating of the coil and the resultant change of electrical resistivity determined by the coil material temperature. The numerical simulations show rapid heating at the coil edges by current initially localized at the edges. This current density then diffuses to the central part of the sheet coil in a way that depends both on normal current diffusion as well as temporal changes of the coil resistance induced by the Ohmic heating. The measured temporal evolution of the magnetic field is compared with a model that determines a solution to the coil current and voltage that is consistent with a plasma diode model of the drive region and a 2D simulation of current diffusion and dynamic resistance due to Ohmic heating in the laser coil.

4.
Biophys J ; 118(5): 1003-1008, 2020 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-32032503

RESUMO

Advances in imaging methods such as electron microscopy, tomography, and other modalities are enabling high-resolution reconstructions of cellular and organelle geometries. Such advances pave the way for using these geometries for biophysical and mathematical modeling once these data can be represented as a geometric mesh, which, when carefully conditioned, enables the discretization and solution of partial differential equations. In this work, we outline the steps for a naïve user to approach the Geometry-preserving Adaptive MeshER software version 2, a mesh generation code written in C++ designed to convert structural data sets to realistic geometric meshes while preserving the underlying shapes. We present two example cases: 1) mesh generation at the subcellular scale as informed by electron tomography and 2) meshing a protein with a structure from x-ray crystallography. We further demonstrate that the meshes generated by the Geometry-preserving Adaptive MeshER software are suitable for use with numerical methods. Together, this collection of libraries and tools simplifies the process of constructing realistic geometric meshes from structural biology data.


Assuntos
Modelos Teóricos , Software , Algoritmos , Biofísica , Simulação por Computador
5.
ACM Trans Math Softw ; 45(3)2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474782

RESUMO

We introduce CASC: a new, modern, and header-only C++ library which provides a data structure to represent arbitrary dimension abstract simplicial complexes (ASC) with user-defined classes stored directly on the simplices at each dimension. This is accomplished by using the latest C++ language features including variadic template parameters introduced in C++11 and automatic function return type deduction from C++14. Effectively CASC decouples the representation of the topology from the interactions of user data. We present the innovations and design principles of the data structure and related algorithms. This includes a metadata aware decimation algorithm which is general for collapsing simplices of any dimension. We also present an example application of this library to represent an orientable surface mesh.

6.
Toxicon X ; 1: 100001, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32831344

RESUMO

Snakebite is predominantly an occupational disease affecting poor rural farmers in tropical regions and was recently added to the World Health Organisation list of Neglected Tropical Diseases (NTD). We document an overview of methodologies developed and deployed in the Myanmar Snakebite Project, a foreign aid project largely funded by the Australian Government, with the core aim to "improve outcomes for snakebite patients". A multidisciplinary team of experts was assembled that worked in a collaborative manner with colleagues in Myanmar, first to identify problems related to managing snakebite and then develop interventions aimed to improve selected problem areas. A broad approach was adopted, covering antivenom production, antivenom distribution and health system management of snakebite. Problems identified in antivenom production included poor snake husbandry resulting in poor survival of captive specimens, lack of geographical diversity; poor horse husbandry, resulting in high mortality, inadequate stock acquisition protocols and data collection, and inappropriate immunisation and bleeding techniques; and inadequate production capacity for freeze dried antivenoms and quality control systems. These problems were addressed in various ways, resulting in some substantial improvements. Antivenom distribution is being reorganised to achieve better availability and utilisation of stock. Health system management of snakebite was assessed across all levels within the area selected for the study, in Mandalay region. A comprehensive community survey indicated that hospital statistics substantially underestimated the snakebite burden, and that access to care by local villagers was delayed by transport and cost issues compounded by lack of antivenom at the most peripheral level of the health service. A health system survey confirmed under-resourcing at the local village level. Prospective case data collection initiated at tertiary hospitals indicated the extent of the snakebite burden on health resources. Interventions initiated or planned include training of health staff, development of a core of senior trainers who can "train the trainers" nationwide in a sustainable way, development and deployment of management guidelines and algorithms for snakebite and a distribution of solar powered fridges to remote health facilities to allow storage of antivenom and prompt treatment of snakebite cases before transfer to major hospitals, thereby reducing the "bite to needle" time.

8.
Support Care Cancer ; 23(9): 2643-8, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25663509

RESUMO

PURPOSE: Preventive care, referring to medical interventions with anticipated long-term benefits, is often inappropriately continued near the end of life. We examined the use of statin medications in patients with brain metastases receiving whole brain radiation therapy to determine the effect of short life expectancy and regular interaction with oncology providers on statin discontinuation. We propose reasons for the unnecessary continuation of preventive care and suggest that it is a frequently missed communication opportunity to discuss prognosis in a concrete manner. METHODS: This is a retrospective study examining statin use in patients receiving whole brain radiotherapy for brain metastases. A total of 206 patients at two cancer centers were studied, and information on statin use and clinical characteristics was obtained from review of the medical record. RESULTS: Of the 206 patients, 53 (26 %) were on a statin at their initial radiation oncology consultation. Of these patients, 13 (25 %) had their statin discontinued by the time of their last follow-up visit, but 40 patients (75 %) were continued on their statin despite their limited life expectancy and low likelihood of benefit. CONCLUSIONS: The majority of patients who were on statins prior to starting palliative whole brain radiation therapy remained on a statin after completing treatment despite an estimated survival of months and regular visits with an oncologist. This represents a missed opportunity for doctors and patients to discuss the appropriateness of continuing preventive care as part of an important conversation about prognosis.


Assuntos
Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Comunicação , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Assistência Terminal/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Prognóstico , Estudos Retrospectivos
9.
Am J Clin Oncol ; 37(5): 473-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23428947

RESUMO

OBJECTIVE: Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period. METHODS: To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor, and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012. RESULTS: The cohort included 81 patients diagnosed at ages 19 to 90 years (median, 67 y). Fifty-five (68%) patients presented with localized disease, whereas 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%), and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size > 5 cm, tumor necrosis, and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival. CONCLUSIONS: Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management, and highlights the need for novel therapies particularly in patients who present with metastatic disease.


Assuntos
Hemangiossarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hemangiossarcoma/mortalidade , Hemangiossarcoma/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/terapia , Taxa de Sobrevida , Wisconsin , Adulto Jovem
11.
Int J Radiat Oncol Biol Phys ; 83(2): e197-204, 2012 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-22401916

RESUMO

PURPOSE: This study examines the management and outcomes of muscle-invasive bladder cancer in the United States. METHODS AND MATERIALS: Patients with muscle-invasive bladder cancer diagnosed between 1988 and 2006 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified according to three mutually exclusive treatment categories based on the primary initial treatment: no local management, radiotherapy, or surgery. Overall survival was assessed with Kaplan-Meier analysis and Cox models based on multiple factors including treatment utilization patterns. RESULTS: The study population consisted of 26,851 patients. Age, sex, race, tumor grade, histology, and geographic location were associated with differences in treatment (all p < 0.01). Patients receiving definitive radiotherapy tended to be older and have less differentiated tumors than patients undergoing surgery (RT, median age 78 years old and 90.6% grade 3/4 tumors; surgery, median age 71 years old and 77.1% grade 3/4 tumors). No large shifts in treatment were seen over time, with most patients managed with surgical resection (86.3% for overall study population). Significant survival differences were observed according to initial treatment: median survival, 14 months with no definitive local treatment; 17 months with radiotherapy; and 43 months for surgery. On multivariate analysis, differences in local utilization rates of definitive radiotherapy did not demonstrate a significant effect on overall survival (hazard ratio, 1.002; 95% confidence interval, 0.999-1.005). CONCLUSIONS: Multiple factors influence the initial treatment strategy for muscle-invasive bladder cancer, but definitive radiotherapy continues to be used infrequently. Although patients who undergo surgery fare better, a multivariable model that accounted for patient and tumor characteristics found no survival detriment to the utilization of definitive radiotherapy. These results support continued research into bladder preservation strategies and suggest that definitive radiotherapy represents a viable initial treatment strategy for those who wish to attempt to preserve their native bladder.


Assuntos
Tratamentos com Preservação do Órgão/métodos , Neoplasias da Bexiga Urinária/radioterapia , Bexiga Urinária , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células de Transição/mortalidade , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/radioterapia , Carcinoma de Células de Transição/cirurgia , Terapia Combinada/métodos , Terapia Combinada/mortalidade , Cistectomia/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Tratamentos com Preservação do Órgão/mortalidade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Programa de SEER , Análise de Sobrevida , Resultado do Tratamento , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Adulto Jovem
12.
Neoplasia ; 14(2): 131-40, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22431921

RESUMO

Angiosarcomas are malignant endothelial cell tumors with few effective systemic treatments. Despite a unique endothelial origin, molecular candidates for targeted therapeutic intervention have been elusive. In this study, we explored the tunica internal endothelial cell kinase 2 (Tie2) receptor as a potential therapeutic target in angiosarcoma. Human angiosarcomas from diverse sites were shown to be universally immunoreactive for Tie2. Tie2 and vascular endothelial growth factor receptor (VEGFR) antagonists inhibited SVR and MS1-VEGF angiosarcoma cell survival in vitro. In the high-grade SVR cell line, Tie2 and VEGF antagonists inhibited cell survival synergistically, whereas effects were largely additive in the low-grade MS1-VEGF cell line. Xenograft modeling using these cell lines closely recapitulated the human disease. In vivo, Tie2 and VEGFR inhibition resulted in significant angiosarcoma growth delay. The combination proved more effective than either agent alone. Tie2 inhibition seemed to elicit tumor growth delay through increased tumor cell apoptosis, whereas VEGFR inhibition reduced tumor growth by lowering tumor cell proliferation. These data identify Tie2 antagonism as a potential novel, targeted therapy for angiosarcomas and provide a foundation for further investigation of Tie2 inhibition, alone and in combinations, in the management of this disease.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hemangiossarcoma/tratamento farmacológico , Receptor TIE-2/antagonistas & inibidores , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Apoptose , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Feminino , Hemangiossarcoma/metabolismo , Hemangiossarcoma/patologia , Humanos , Imidazóis/administração & dosagem , Indóis/administração & dosagem , Camundongos , Camundongos Nus , Piridinas/administração & dosagem , Pirróis/administração & dosagem , Receptor TIE-2/metabolismo , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo , Sunitinibe , Ensaios Antitumorais Modelo de Xenoenxerto
13.
Int J Radiat Biol ; 87(4): 385-99, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21219111

RESUMO

PURPOSE: To compare the development of intestinal adenomas following neutron and X-ray exposure of Apc(Min/+) mice (Apc - adenomatous polyposis coli; Min - multiple intestinal neoplasia). MATERIALS AND METHODS: Adult mice were exposed to acute doses of X-rays or fission neutrons. Tumour counting was undertaken 200 days later and samples were taken for Loss of Heterozygosity (LOH) analysis. RESULTS: Tumour numbers (adenomas and microadenomas) increased by 1.4-fold, 1.7-fold, 2.7-fold and 9-fold, after 0.5, 1, 2 and 5 Gy X-rays, respectively, and by 2.4-fold and 5.7-fold, after 0.5 and 1 Gy fission neutrons, respectively. LOH analysis of tumours from neutron-exposed mice showed that 63% had lost Apc and 90% (cf. 53% in controls) had lost D18mit84, a marker for Epb4.1l4a/NBL4 (erythrocyte protein band 4.1-like 4a/novel band 4.1-like 4), known to be involved in the Wnt (wingless-related mouse mammary tumour virus integration site) pathway. Some tumours from neutron-exposed mice appeared to have homozygous loss of some chromosomal markers. CONCLUSIONS: X-ray or fission neutron irradiation results in strongly enhanced tumour multiplicities. Comparison of tumour yields indicated a low Relative Biological Effectiveness of around 2-8 for fission neutrons compared with X-rays. LOH in intestinal tumours from neutron-exposed mice appeared to be more complex than previously reported for tumours from X-irradiated mice.


Assuntos
Neoplasias Intestinais/etiologia , Neoplasias Induzidas por Radiação/etiologia , Animais , Relação Dose-Resposta à Radiação , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Nêutrons , Doses de Radiação , Eficiência Biológica Relativa , Raios X
14.
Ann Thorac Surg ; 90(1): 176-81, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20609770

RESUMO

BACKGROUND: The presentation, management, and outcome of patients with primary cardiac sarcomas are not well defined. Furthermore, the role of adjuvant therapy has not been delineated in the management of primary cardiac sarcomas. METHODS: Patients with primary cardiac sarcoma and noncardiac sarcoma, diagnosed between 1988 and 2005, were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics and outcomes of primary cardiac sarcoma were defined and compared with the characteristics of noncardiac sarcomas. Univariate and multivariate methods were used to identify factors associated with primary cardiac sarcoma survival. RESULTS: Compared with noncardiac sarcomas, primary cardiac sarcomas were found to occur in a younger age group and were more likely to present with advanced disease. Primary cardiac sarcomas were ten times more likely to be vessel-derived (eg, angiosarcoma), comprising almost half of all cases. Median overall survival for cardiac sarcoma patients was 6 months whereas that for noncardiac sarcoma patients was significantly longer at 93 months (p < 0.001). Furthermore, cardiac sarcoma patients who underwent surgery had a median survival of 12 months whereas those who did not undergo surgery had a median survival of 1 month (p < 0.001). CONCLUSIONS: Cardiac sarcomas are a distinct, rare subset of soft tissue sarcomas with a poor prognosis. Surgery continues to be the central component of successful management. Future clinical efforts should be directed at developing approaches to permit safe radical excision and, potentially, developing effective adjuvant therapy.


Assuntos
Neoplasias Cardíacas/epidemiologia , Sarcoma/epidemiologia , Adulto , Idoso , Feminino , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Programa de SEER , Sarcoma/diagnóstico , Sarcoma/terapia , Análise de Sobrevida , Estados Unidos/epidemiologia , Adulto Jovem
15.
Am J Clin Oncol ; 33(6): 629-32, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20216302

RESUMO

OBJECTIVES: Despite evidence that radiation therapy (RT) improves outcome in multiple malignancies, some patients with strong clinical indications still refuse RT. Data on factors associated with RT refusal are limited. Furthermore, the effect of RT refusal on outcome has not been clearly defined. METHODS: Patients with nonmetastatic cancer, diagnosed between 1988 and 2005, were identified in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate methods were used to identify factors associated with RT refusal and the impact of refusal on outcomes. RESULTS: On univariate analysis, age, sex, marital status, tumor site, and tumor stage were associated with RT refusal (P < 0.001). On multivariate analysis, sex and tumor stage were not found to be associated with RT refusal. In contrast, age, race, marital status, and tumor location were significantly associated with RT refusal. The median survival of compliant patients was 171 months compared with just 96 months among patients who refused RT. CONCLUSIONS: A significant percentage of patients continue to refuse RT despite medical advice and evidence. Subgroups at particular risk of RT refusal include elderly, black and widowed patients. RT refusal is associated with markedly worse clinical outcomes.


Assuntos
Neoplasias/mortalidade , Neoplasias/radioterapia , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Neoplasias/patologia , Modelos de Riscos Proporcionais , Radioterapia Adjuvante , Programa de SEER , Fatores Sexuais , Estatísticas não Paramétricas , Sobrevida , Análise de Sobrevida
16.
Int J Radiat Oncol Biol Phys ; 76(5): 1420-4, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19619959

RESUMO

PURPOSE: Despite its common and well characterized use in other gastrointestinal malignancies, little is known about radiotherapy (RT) use in nonmetastatic colon cancer in the United States. To address the paucity of data regarding RT use in colon cancer management, we examined the RT patterns of care in this patient population. METHODS AND MATERIALS: Patients with nonmetastatic colon cancer, diagnosed between 1988 and 2005, were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate methods were used to identify factors associated with RT use. RESULTS: On univariate analysis, tumor location, age, sex, race, T stage, N stage, and geographic location were each associated with differences in RT use (all p < 0.01). In general, younger patients, male patients, and patients with more advanced disease were more likely to receive RT. On multivariate analysis, tumor location, age, gender, T and N stage, time of diagnosis and geographic location were significantly associated with RT use (all p < 0.001). Race, however, was not associated with RT use. On multivariate analysis, patients diagnosed in 1988 were 2.5 times more likely to receive RT than those diagnosed in 2005 (p = 0.001). Temporal changes in RT use reflect a responsiveness to evolving evidence related to the therapeutic benefits of adjuvant RT. CONCLUSIONS: External beam RT is infrequently used for colon cancer, and its use varies according to patient and tumor characteristics. RT use has declined markedly since the late 1980s; however, it continues to be used for nonmetastatic disease in a highly individualized manner.


Assuntos
Neoplasias do Colo/radioterapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Neoplasias do Colo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia Adjuvante/estatística & dados numéricos , Programa de SEER , Fatores Sexuais , Adulto Jovem
17.
Neuro Oncol ; 11(6): 833-41, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19332771

RESUMO

Giant cell glioblastoma (GC) is an uncommon subtype of glioblastoma multiforme (GBM). Consequently, the epidemiology, natural history, and factors associated with outcome are not well defined. Patients diagnosed with GC from 1988 through 2004 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Outcomes were examined with Kaplan-Meier survival analysis and Cox models. For comparison, similar analyses were conducted for patients diagnosed with GBM. GC was identified in 1% of 16,430 patients diagnosed with either GC or GBM. Compared with GBM, GC showed similar gender and racial distributions. Likewise, tumor size and location were not significantly different between the two histologies. GC tended to occur in younger patients with a median age at diagnosis of 51 years, compared with 62 years for GBM. Additionally, patients with GC were more likely to undergo complete resection compared with patients with GBM. For both histologies, young age, tumor size, extent of resection, and the use of adjuvant radiation therapy (RT) were associated with improved survival. Cox modeling suggests the prognosis for GC is significantly superior to that for GBM (hazard ratio = 0.76; 95% confidence interval, 0.59-0.97) even after adjustment for factors affecting survival. GC is an uncommon GBM subtype that tends to occur in younger patients. Prospective data defining optimal treatment for GC are unavailable; however, these retrospective findings suggest that resection, as opposed to biopsy only, and adjuvant RT may improve survival. The prognosis of GC is superior to that of GBM, and long-term survival is possible, suggesting aggressive therapy is warranted.


Assuntos
Neoplasias Encefálicas/epidemiologia , Glioblastoma/epidemiologia , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Glioblastoma/patologia , Glioblastoma/terapia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Radioterapia Adjuvante , Programa de SEER , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
18.
Aquat Toxicol ; 92(3): 187-94, 2009 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-19249111

RESUMO

With the current expansion of offshore oil activities in Arctic regions, there is an urgent need to establish the potential effects of oil-related compounds on Arctic organisms. As susceptibility to growth, disease and survival is determined partly by the condition of an organism's immune system, measurement of endpoints linked to the latter system provide important early warning signals of the sub-lethal effects of exposure to contaminants. This study assessed the impact of dispersed oil exposure on immune endpoints in the Arctic Scallop Chlamys islandica, using a combination of cellular and humoral biological responses. Laboratory exposures of C. islandica to sub-lethal dispersed oil concentrations (0.06 and 0.25 mg l(-1)) were conducted over 15 days, followed by a 7-day recovery period in clean, filtered seawater. Cellular endpoints were significantly altered following dispersed oil exposure: haemocyte counts (P<0.01) and protein levels (P<0.01) were significantly elevated, whilst cell membrane stability (P<0.001) and phagocytosis (P<0.01) demonstrated a significant reduction. Whilst these results indicate alteration in the immune endpoints measured, this appears to be reversible upon removal of the contaminant stress. However, the impact of long-term continuous exposure and high-level acute exposure to oil is still unknown, and may have consequences for disease resistance and hence survival.


Assuntos
Pectinidae/efeitos dos fármacos , Pectinidae/imunologia , Petróleo/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Hemócitos/efeitos dos fármacos , Pectinidae/química , Petróleo/análise , Fagocitose/efeitos dos fármacos , Água do Mar/análise , Poluentes Químicos da Água/análise
19.
J Gastroenterol ; 44(1): 84-91, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19159077

RESUMO

BACKGROUND: The role of adjuvant radiotherapy (RT) for pancreatic cancer remains controversial despite the completion of three multi-institutional randomized trials. This study examines the survival impact of postoperative RT in a large population-based database. METHODS: Patients with pancreatic cancer diagnosed from 1988 to 2003 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. The cohort was limited to patients who underwent resection of nonmetastatic disease to yield a population of 3252 patients. The primary end point was overall survival. Survival analyses were conducted using corrections for perioperative mortality as well as a propensity score analysis to account for baseline differences in patient characteristics. RESULTS: Multiple independent factors were associated with RT use, including patient age and disease stage (P < 0.0001). In general, younger patients and those with more advanced disease were more likely to receive RT. Disease stage significantly affected survival (P < 0.0001). For patients who survived at least 6 months, adjuvant RT was associated with increased survival [hazard ratio (HR), 0.87; 95% confidence interval (CI), 0.80-0.96]. On subgroup analysis, only stage IIB (T1-3N1) patients enjoyed a statistically significant benefit associated with RT (HR, 0.70; 95% CI, 0.62-0.79). CONCLUSIONS: Adjuvant RT is frequently given to patients in the United States after resection of their pancreatic cancer. Although RT is associated with a survival benefit for nonmetastatic patients as a whole, this trend appears to predominantly derive from a survival benefit in patients with stage IIB disease.


Assuntos
Pancreatectomia , Neoplasias Pancreáticas/radioterapia , Adulto , Fatores Etários , Idoso , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Modelos de Riscos Proporcionais , Radioterapia Adjuvante/métodos , Programa de SEER , Análise de Sobrevida , Taxa de Sobrevida , Fatores de Tempo , Estados Unidos/epidemiologia
20.
Neuro Oncol ; 11(2): 183-91, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18780813

RESUMO

The epidemiology and natural history of adult gliosarcomas (GSMs), as well as patient and treatment factors associated with outcome, are ill defined. Patients over 20 years of age with GSM diagnosed from 1988 to 2004 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival analysis and Cox models were used to examine outcomes. Similar analyses were conducted for patients diagnosed with glioblastoma (GBM) over the same time period. GSM represented 2.2% of the 16,388 patients identified with either GSM or GBM. No significant differences between GSM and GBM were identified with respect to age, gender, race, tumor size, or use of adjuvant radiation therapy (RT). Patients with GSM were more likely to have temporal lobe involvement and undergo some form of tumor resection. The most important analyzed factors influencing GSM overall survival were age, extent of resection, and use of adjuvant RT. After adjusting for factors impacting overall survival, the prognosis for GSM appears slightly worse than for GBM (HR = 1.17, 95% CI, 1.05-1.31). GSM is a rare malignancy that presents very similarly to GBM with a slightly greater propensity for temporal lobe involvement. Optimal treatment remains to be defined. However, these retrospective findings suggest tumor excision, as opposed to biopsy only, and adjuvant RT may improve outcome. Despite therapy, prognosis remains dismal and outcomes may be inferior to those seen in GBM patients.


Assuntos
Neoplasias Encefálicas/epidemiologia , Gliossarcoma/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/radioterapia , Feminino , Gliossarcoma/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Radioterapia Adjuvante , Programa de SEER , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
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