Analysis of cardiac and pulmonary complication probabilities after radiation therapy for patients with early-stage breast cancer.
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OBJECTIVE: The purpose of this study was to evaluate the radiobiological implications of clinical use of respiratory-gated techniques for postoperative radiation therapy of early-stage left-sided breast cancer after breast-conserving surgery. MATERIAL AND METHODS: Radiation therapy treatment plans of 80 patients with early-stage breast cancer (stage I-II), receiving whole breast irradiation after breast-conserving therapy, were analyzed. The control group consisting of 47 patients received standard radiation therapy, and the respiratory-gated group consisting of 33 patients received deep inspiration-gated radiation therapy. Normal tissue complication probabilities (NTCP) for cardiac mortality and for clinical radiation-induced pneumonitis were calculated for all patients included in present study, using relative seriality model. NTCP data were analyzed for 113 radiation therapy plans, which included free breathing plans for the respiratory-gated groups. RESULTS: Pneumonitis probability was 0.6% (range 0.0-2.8%) and 0.3% (0.0-1.2%) for control and respiratory-gated group, respectively. Cardiac mortality was 1.3% (0.0-5.0%) and 0.2% (0.0-2.8%) for control and respiratory-gated group, respectively. Using respiratory-gated radiation therapy, NTCP was reduced in comparison with the control group by 83% (P<0.00001) and by 55% (P=0.01270) for cardiac mortality and for clinical radiation-induced pneumonitis, respectively. CONCLUSIONS: Use of respiratory-gated radiation therapy, for postoperative treatment of early-stage breast cancer, significantly reduces excessive cardiac mortality probability and pulmonary complication probability, as compared to standard radiation therapy techniques. This is especially important from heart complication probability point of view, as cardiac mortality remains one of the important issues of postoperative breast irradiation in patients with early stage breast cancer. (+info)
Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis.
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Repeated prevalence studies on antibiotic use in Latvia, 2003-2007.
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Antibiotic resistance and nosocomial infections have recently been recognised as a growing threat in Latvian hospitals. We used a modified point prevalence study design to gain accurate information on the antibiotic prescription pattern and the prevalence of nosocomial infections in different hospital departments. A given department was observed on a given day in a given month (May) five years in a row. All antibiotic treatments, dose and route of administration were recorded, in addition to demographic data. The most commonly used antibiotic groups were first generation cephalosporins (35.6-38.9%), broad-spectrum penicillins (17.5-23.0%), fluoroquinolones (8.4-14.5%) and aminoglycosides (7.7-12.6%). Cefazolin was the most commonly used antibiotic. Antibiotics were predominantly used intravenously. The proportion of oral administration varied from 15.1% to 21.8%. A large proportion (13.3%) of the antibiotics was administered without clear reason. The crude prevalence rate of infection treated with antibiotics was 19.3%. The average prevalence of nosocomial infections was found to be 3.6%. These prevalence studies provided an opportunity to compare hospitals and outline variations and problem areas. They indicated the main problems in antibiotic prescription: large interhospital variations in the choice of an antibiotic for the most common infections, frequent antibiotic use without clear reason, and predominant intravenous administration. (+info)
Analysis of content of phenolic acids in Lithuanian propolis using high-performance liquid chromatography technique.
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The aim of the study was to analyze phenolic acids in Lithuanian propolis and to compare it with the composition of propolis in neighboring countries (Latvia and Poland) according to the predominant flora in the collecting places. The study was also aimed at the evaluation of the effect of the layer thickness (mm) of the harvested propolis on the quality of the raw material in determining the amount of phenolic acids. MATERIALS AND METHODS: The object of the study was propolis collected in Lithuania, Poland, and Latvia in late July of 2006 and 2007. The qualitative and quantitative analysis of phenolic acids was performed using the high-performance liquid chromatography technique (HPLC). RESULTS: The results of the study showed that the quantitative and qualitative composition of phenolic acids in propolis depended on the plants from which the bees in the area collected substances for the raw material of propolis. The predominant phenolic acids were determined to be ferulic and coumaric acids, and they may be among the main indicators of quality in the standardization of the raw material and preparations of propolis. CONCLUSION: We created an HPLC-based analysis method for the identification and quantification of phenolic acids in propolis. The variety of phenolic acids in propolis depends on the vegetation predominating in the harvesting area. Studies have shown that the highest amount of phenolic acids is observed in propolis harvested in areas characterized by the predominance of deciduous trees and meadows. Results have also shown that ferulic and coumaric acids are the predominant phenolic acids in propolis. The thickness of the layer of the collected propolis in the hive also influences its chemical composition. (+info)
The increased risk of predation enhances cooperation.
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Randomized comparison of coronary bifurcation stenting with the crush versus the culotte technique using sirolimus eluting stents: the Nordic stent technique study.
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