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- Acute myeloid leukemia (1)
- All-trans retinoic acid (1)
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- Isoscalar giant resonances (1)
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The aim of this clinical trial was to evaluate the impact of all-trans retinoic acid (ATRA) in combination with chemotherapy and to assess the NPM1 status as biomarker for ATRA therapy in younger adult patients (18-60 years) with acute myeloid leukemia (AML). Patients were randomized for intensive chemotherapy with or without open-label ATRA (45 mg/m2, days 6-8; 15 mg/m2, days 9-21). Two cycles of induction therapy were followed by risk-adapted consolidation with high-dose cytarabine or allogeneic hematopoietic cell transplantation. Due to the open label character of the study, analysis was performed on an intention-to-treat (ITT) and a per-protocol (PP) basis. One thousand one hundred patients were randomized (556, STANDARD; 544, ATRA) with 38 patients treated vice versa. Median follow-up for survival was 5.2 years. ITT analyses revealed no difference between ATRA and STANDARD for the total cohort and for the subset of NPM1-mutated AML with respect to event-free (EFS; p = 0.93, p = 0.17) and overall survival (OS; p = 0.24 and p = 0.32, respectively). Pre-specified PP analyses revealed better EFS in NPM1-mutated AML (p = 0.05) and better OS in the total cohort (p = 0.03). Explorative subgroup analyses on an ITT basis revealed better OS (p = 0.05) in ATRA for genetic low-risk patients according to ELN recommendations. The clinical trial is registered at clinicaltrialsregister.eu (EudraCT Number: 2004-004321-95).
Die stetig wachsende Menge an digital verfügbarem, zeitgenössischem wie historischem Textmaterial bietet für die begriffsgeschichtliche Forschung Chancen und Herausforderungen: Während die fortschreitende Digitalisierung die Verfügbarkeit erforschbaren Materials deutlich erhöht, resultiert aus der verbesserten Auffindbarkeit potentieller Quellen eine schwindende Übersicht dessen, was für begriffsgeschichtliche Studien überhaupt in Betracht zu ziehen ist. Am Beispiel der Begriffe Netz, Netzwerk und Vernetzung erproben wir quantitative, semi-automatische Ansätze für eine digitale Begriffsgeschichte. Dafür identifizieren wir zunächst die Beschränkungen des Tools Google Ngrams, das weder für die Analyse von Wortbedeutungen noch für die Bestimmung der Kontexte von Wortverwendungen geeignet ist. Demgegenüber erörtern wir die Vorzüge einer hier erstmals im Kontext begriffsgeschichtlicher Forschung vorgestellten Methode der vorwissensfreien Bedeutungsinduktion, die semantische Aspekte gesuchter Begriffsworte automatisch ermittelt, deren typische und untypische Verwendungskontexte aggregiert, Wortfelder kartiert und durch einen geeigneten Index die Möglichkeit bietet, Belegstellen zu betrachten sowie die Veränderung von Wortbedeutungen im Laufe eines gegebenen Zeitraums zu analysieren. Mittels dieser interaktiven, semi-automatischen Methode lässt sich für den deutschen Sprachraum nachweisen, dass sich zu Beginn des 21. Jahrhunderts ein Problemdiskurs über Netzwerke entwickelt, mit dem sich ein Wandel der Semantik des Begriffswortes erklären lässt. Mit dem vorgestellten Verfahren lässt sich auch die Bedeutung komplexer metaphorischer Prozesse für den zu erklärenden Begriffswandel erschließen.
A new technique developed for measuring nuclear reactions at low momentum transfer with stored beams in inverse kinematics was successfully used to study isoscalar giant resonances. The experiment was carried out at the experimental heavy-ion storage ring (ESR) at the GSI facility using a stored 58Ni beam at 100 MeV/u and an internal helium gas-jet target. In these measurements, inelastically scattered α-recoils at very forward center-of-mass angles (θcm ≤ 1.5°) were detected with a dedicated setup, including ultra-high vacuum compatible detectors. Experimental results indicate a dominant contribution of the isoscalar giant monopole resonance at this very forward angular range. It was found that the monopole contribution exhausts 79+12−11% of the energy-weighted sum rule (EWSR), which agrees with measurements performed in normal kinematics. This opens up the opportunity to investigate the giant resonances in a large domain of unstable and exotic nuclei in the near future. It is a fundamental milestone towards new nuclear reaction studies with stored ion beams.
Influence of antibiotic-regimens on intensive-care unit-mortality and liver-cirrhosis as risk factor
(2016)
AIM: To assess the rate of infection, appropriateness of antimicrobial-therapy and mortality on intensive care unit (ICU). Special focus was drawn on patients with liver cirrhosis.
METHODS: The study was approved by the local ethical committee. All patients admitted to the Internal Medicine-ICU between April 1, 2007 and December 31, 2009 were included. Data were extracted retrospectively from all patients using patient charts and electronic documentations on infection, microbiological laboratory reports, diagnosis and therapy. Due to the large hepatology department and liver transplantation center, special interest was on the subgroup of patients with liver cirrhosis. The primary statistical-endpoint was the evaluation of the influence of appropriate versus inappropriate antimicrobial-therapy on in-hospital-mortality.
RESULTS: Charts of 1979 patients were available. The overall infection-rate was 53%. Multiresistant-bacteria were present in 23% of patients with infection and were associated with increased mortality (P < 0.000001). Patients with infection had significantly increased in-hospital-mortality (34% vs 17%, P < 0.000001). Only 9% of patients with infection received inappropriate initial antimicrobial-therapy, no influence on mortality was observed. Independent risk-factors for in-hospital-mortality were the presence of septic-shock, prior chemotherapy for malignoma and infection with Pseudomonas spp. Infection and mortality-rate among 175 patients with liver-cirrhosis was significantly higher than in patients without liver-cirrhosis. Infection increased mortality 2.24-fold in patients with cirrhosis. Patients with liver cirrhosis were at an increased risk to receive inappropriate initial antimicrobial therapy.
CONCLUSION: The results of the present study report the successful implementation of early-goal-directed therapy. Liver cirrhosis patients are at increased risk of infection, mortality and to receive inappropriate therapy. Increasing burden are multiresistant-bacteria.