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Of 14 patients with stage IV measurable disease who received VI, 11 (79%) achieved CR (n = 1) or PR (n = 10) after 2 cycles. Doses of doxorubicin, cyclophosphamide, and etoposide were reduced midstudy because of nonhematologic toxicity. Four patients (6%) died as a result of toxicity. Four-year event-free survival, relapse-free survival, and overall survival rates were 67.7% (95% CI, 55.9% to 79.4%), 72.9% (95% CI, 61.5% to 84.4%), and 73.7% (95% CI, 62.7% to 84.8%), respectively, compared with 57.5% (95% CI, 47.6% to 67.4%; P = .26), 57.5% (95% CI, 47.6% to 67.4%; P = .048), and 59.2% (95% CI, 49.4% to 69.0%; P = .08), respectively, in NWTS-5. CONCLUSION VI produced a high response rate in patients with metastatic DAWT. AREN0321 treatment seemed to improve outcomes for patients with stage II to IV DAWT compared with NWTS-5, but with increased toxicity. The UH2 regimen warrants further investigation with modifications to reduce toxicity.PURPOSE Presence of teratoma in patients with metastatic testicular germ cell tumor (GCT) is of unknown prognostic significance. We report survival outcomes of patients with or without teratoma in primary tumor and postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) specimen and assess impact on prognosis. https://www.selleckchem.com/products/fx11.html PATIENTS AND METHODS Patients with metastatic nonseminomatous GCT (NSGCT) who were evaluated at Indiana University between 1990 and 2016 and had primary testicular tumor specimen from orchiectomy (ORCH) were included. All patients were treated with cisplatin-based combination chemotherapy. The cohort was divided into 2 groups according to presence or absence of teratoma in ORCH specimen. Survival data were correlated with histopathologic findings. Differences in progression-free (PFS) and overall survival (OS) were evaluated using log-rank tests and Cox proportional hazards models to adjust for known adverse prognostic factors. RESULTS We identified 1,224 consecutive patients evaluated at Indiana University between 1990 and 2016 who met inclusion criteria. Median age was 27 years (range, 13-71 years); 689 patients had teratoma in ORCH specimen, and 535 did not. With median follow-up of 2.3 years, 5-year PFS was 61.9% (95% CI, 57.1% to 66.2%) for those with teratoma versus 63.1% (95% CI, 58.0% to 67.8%) for those without (P = .66); 5-year OS was 82.2% (95% CI, 77.9% to 85.8%) versus 81.4% (95% CI, 76.5% to 85.3%; P = .91), respectively. A total of 473 patients underwent PC-RPLND; 5-year PFS for patients with pure teratoma in PC-RPLND specimen versus necrosis only was 65.9% versus 79.1% (P = .06), and 5-year OS was 90.3% versus 93.4% (P = .21), respectively. CONCLUSION Presence of teratoma in ORCH and PC-RPLND specimens was not a prognostic factor in this large retrospective study of patients with NSGCT.BACKGROUND Musculoskeletal injuries are a primary source of disability. Understanding how risk factors predict injury is necessary to individualize and enhance injury reduction programs. HYPOTHESIS Because of the multifactorial nature of musculoskeletal injuries, multiple risk factors will provide a useful method of categorizing warrior athletes based on injury risk. STUDY DESIGN Prospective observational cohort study. LEVEL OF EVIDENCE Level 2. METHODS Baseline data were collected on 922 US Army soldiers/warrior athletes (mean age, 24.7 ± 5.2 years; mean body mass index, 26.8 ± 3.4 kg/m2) using surveys and physical measures. Injury occurrence and health care utilization were collected for 1 year. Variables were compared in healthy versus injured participants using independent t tests or chi-square analysis. Significantly different factors between each group were entered into a logistic regression equation. Receiver operating characteristic curve and accuracy statistics were calculated for regression variableo reduce medical costs and time lost.A new risk/treatment needs protocol for assessing "juveniles with sex offenses" operationalized in the Treatment Needs and Progress Scale (TNPS) was recently introduced, prompting quick embrace before any serious examination. This article critiques the proposed protocol and TNPS. Highlighted are misleading statements, substantial omissions related to review of research, and significant margins of TNPS underpinnings that cause considerable pause. Target population, essential to adopting and implementing TNPS, is not clearly stated. Multiple basic rudimentary steps are missing in the research protocol for two age groups. The "new" protocol appears to be a re-installment of the old one, applying templates from adult tools and empirical findings on adults to adolescents, thus treating youth like adults, an outdated stance in contemporary research and clinical practice related to risk assessment of sexually abusive youth..Red Lake Diatomaceous Earth (DE) is a naturally occurring blend of diatomaceous earth and calcium bentonite that can be used as an anti-caking agent in animal feed and contains naturally occurring dioxins. A quantitative risk assessment was conducted to assess potential human health risk associated with consumption of edible tissues from livestock exposed to dioxins via feed containing Red Lake DE. Empirical data characterising the transfer of dioxins to eggs and other tissues in chickens demonstrate that resulting concentrations in eggs are lower than those found in the general food supply. These data also provided product-specific input for a risk assessment conducted both with default parameters and with media-specific input from the feed study. Results demonstrate that exposure to dioxins in edible tissue from livestock that consumed Red Lake DE in feed would not be associated with an increased risk to humans. Findings from this assessment highlight the utility and importance of accounting for bioavailability as part of health-based risk assessment and provide information critical to risk managers in determining the safe use of Red Lake DE as an anticaking agent in livestock and pet feed.Purpose There is an unclear relationship between ocular blood flow (OBF) and the structural characteristics of the optic nerve head (ONH) in glaucoma, a multifactorial disease. This study used laser speckle flowgraphy (LSFG) to identify low-OBF glaucoma patients and investigated the ONH in these patients.Materials and Methods In 533 eyes with glaucoma, we determined confounding factors for LSFG-measured OBF (tissue-area mean blur rate MT) and corrected MT with a linear mixed-effects model (LMM). Structural ONH data (from fundus stereo photography), OCT data, and clinical characteristics were then compared in patients with corrected MT in the upper and lower quartiles using the LMM.Results Single regression showed significant correlations between MT and age, spherical equivalent (SE), central corneal thickness (CCT), and a weighted count of retinal ganglion cells (wRGC), but not axial length or systemic blood pressure. Gender also significantly influenced MT; MT was corrected for these correlated factors and also glaucoma type with the LMM.
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