The lagged effect of cold temperature and wind chill on cardiorespiratory mortality in Scotland.
(9/19)
AIMS: To investigate the lagged effects of cold temperature on cardiorespiratory mortality and to determine whether "wind chill" is a better predictor of these effects than "dry bulb" temperature. METHODS: Generalised linear Poisson regression models were used to investigate the relation between mortality and "dry bulb" and "wind chill" temperatures in the three largest Scottish cities (Glasgow, Edinburgh, and Aberdeen) between January 1981 and December 2001. Effects of temperature on mortality (lags up to one month) were quantified. Analyses were conducted for the whole year and by season (cool and warm seasons). MAIN RESULTS: Temperature was a significant predictor of mortality with the strongest association observed between temperature and respiratory mortality. There was a non-linear association between mortality and temperature. Mortality increased as temperatures fell throughout the range, but the rate of increase was steeper at temperatures below 11 degrees C. The association between temperature and mortality persisted at lag periods beyond two weeks but the effect size generally decreased with increasing lag. For temperatures below 11 degrees C, a 1 degrees C drop in the daytime mean temperature on any one day was associated with an increase in mortality of 2.9% (95% CI 2.5 to 3.4), 3.4% (95% CI 2.6 to 4.1), 4.8% (95% CI 3.5 to 6.2) and 1.7% (95% CI 1.0 to 2.4) over the following month for all cause, cardiovascular, respiratory, and "other" cause mortality respectively. The effect of temperature on mortality was not observed to be significantly modified by season. There was little indication that "wind chill" temperature was a better predictor of mortality than "dry bulb" temperature. CONCLUSIONS: Exposure to cold temperature is an important public health problem in Scotland, particularly for those dying from respiratory disease. (+info)
A phase 1 clinical study of intravenous administration of PV701, an oncolytic virus, using two-step desensitization.
(10/19)
PURPOSE: In a previous phase 1 study, adverse events, especially flu-like symptoms, were observed mainly following the first i.v. bolus dose of PV701, an oncolytic Newcastle disease virus. Desensitization to adverse events of subsequent doses occurred, allowing a 10-fold increase in the maximum tolerated dose for these doses. Although one-step desensitization (a single desensitizing dose with higher subsequent doses) addressed the tolerability of high repeat doses, additional testing was required to further improve tolerability of the initial dose. This study tested the hypothesis that two-step desensitization, using two dose increments before high repeat doses, would be well tolerated. EXPERIMENTAL DESIGN: Sixteen adults with incurable solid tumors were enrolled. Cycles consisted of six PV701 doses over 2 weeks followed by a 1-week rest. Doses 1 to 2 were 1 and 12 x 10(9) plaque-forming units (pfu)/m(2), respectively, whereas doses 3 to 6 were escalated by cohort from 24 to 120 x 10(9) pfu/m(2). RESULTS: No dose-limiting toxicities were observed, permitting dose escalation through cohort 4 (1, 12, 120, 120, 120, 120 x 10(9) pfu/m(2)). Mild flu-like symptoms were common following the first infusion, diminished with repeated dosing, and were less pronounced than those seen previously. Tumor regression was observed in a patient with anal carcinoma who enrolled with stable disease following palliative radiotherapy. Four patients with clearly progressing cancer before enrollment had disease stabilization of >/=6 months. CONCLUSIONS: This novel two-step desensitization improved patient tolerability compared with the previous regimen. Toxicities were predictable and manageable. PV701, the first oncolytic virus to enter phase 1 i.v. testing, continues to show single-agent activity, warranting planned phase 2 trials. (+info)
Atypical histopathology in bowel-associated dermatosis-arthritis syndrome: A case report.
(11/19)
Bowel-associated dermatosis-arthritis syndrome (BADAS) is characterized by a prodrome of fever, chills, and flu-like symptoms with subsequent skin eruptions, myalgias, and polyarthralgias. The syndrome was initially described following jejunoileal bypass surgery for weight loss. Histopathology of the skin lesions present in BADAS is described in the literature as identical to that of Sweet syndrome. We present a patient whose clinical history and physical exam were consistent with the diagnosis of BADAS. Dermatopathology in this case demonstrated a large subcorneal pustule without a significant dermal neutrophilic infiltrate. The histologic differential included subcorneal pustular dermatosis, bullous impetigo, or IgA pemphigus. The histology in BADAS may not necessarily be identical to Sweet syndrome, and the clinical picture alone plays an important role in diagnosis. The correct diagnosis of BADAS prevents a myriad of laboratory tests and allows for more effective symptom management in this chronic condition. (+info)
Adverse events following infusion of T cells for adoptive immunotherapy: a 10-year experience.
(12/19)