2017年05月03日

Chemotherapy plus radiotherapy

…reduced the risk for death at 1 year (relative risk, 0.88 [95% Cl, 0.80 to 0.96]), 2 years (relative risk, 0.87 [Cl, 0.81 to 0.94]), and 3 years (relative risk, 0.83 [Cl, 0.77 to 0.90]).

Chemotherapy plus radiotherapy compared with radiotherapy alone in the treatment of locally advanced, unresectable, non-small-cell lung cancer. A meta-analysis.
https://www.ncbi.nlm.nih.gov/pubmed/8929005


…Trials comparing radical radiotherapy with radical radiotherapy plus chemotherapy gave a hazard ratio of 0.87 (13% reduction in the risk of death; absolute benefit of 4% at two years)

Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small Cell Lung Cancer Collaborative Group.
https://www.ncbi.nlm.nih.gov/pubmed/7580546


…For the cisplatin-based group, the estimated pooled odds ratio of death at 1 and 2 years was 0.76 (0.6-0.9 CI) and 0.70 (0.5-0.9 CI), with a reduction in mortality of 24% and 30%, respectively. For the noncisplatin-based group, the estimated pooled odds ratio at 1 and 2 years was 1.05 (0.7-1.5 CI) and 0.82 (0.5-1.3 CI), with a reduction in mortality of 5% and 18%, respectively. However, no significant differences were found between the percentage of survival and the CI at 3 and 5 years using the point estimates.

Randomized trials of radiotherapy alone versus combined chemotherapy and radiotherapy in stages IIIa and IIIb nonsmall cell lung cancer. A meta-analysis.
https://www.ncbi.nlm.nih.gov/pubmed/8625152
posted by salinejapan at 19:59 | Comment(0) | 医学・医療 | このブログの読者になる | 更新情報をチェックする

2017年05月01日

Pleural fluid adenosine deaminaseの診断意義

胸水中のADAが、40-50UI/L以上の時、結核性胸膜炎の可能性が高いと考えられます。胸水細胞が好中球優位でADAが上昇しているときは、膿胸あるいは細菌性胸膜炎に随伴した胸膜炎を考えることに注意しましょう。胸水のADAは結核性胸膜炎の除外としても用いることができ、リンパ球優位の胸水でADAが40IU/L未満であれば、結核性胸膜炎は否定的と考えられています。

胸水中のADA高値が結核性胸膜炎を示唆するのは、胸水細胞がリンパ球優位の時である。
http://www.kameda.com/pr/pulmonary_medicine/ada.html


Pleural fluid cytology and pleural biopsy can give definite diagnosis. Pleural fluid ADA ≥ 70 u/l is almost diagnostic of tuberculosis, where pleural biopsy is not recommended.

Role of pleural biopsy in etiological diagnosis of pleural effusion
http://www.lungindia.com/article.asp?issn=0970-2113;year=2010;volume=27;issue=4;spage=202;epage=204;aulast=Pandit


At a cutoff value of 5.62, ADA/S-CRP ratio had a sensitivity of 89 %, specificity of 88 %, positive likelihood ratio of 7.29, and negative likelihood ratio of 0.13 for identifying TPE. Additionally, more than half of TPE patients had a ratio above 15.82, while none of PPE patients showed such findings.

Pleural fluid adenosine deaminase/serum C-reactive protein ratio for the differentiation of tuberculous and parapneumonic effusions with neutrophilic predominance and high adenosine deaminase levels.
https://www.ncbi.nlm.nih.gov/pubmed/27488820


The cut-off level for serum LDH: pleural fluid ADA ratio of >20 is highly predictive of malignancy in patients with exudative pleural effusion (whether lymphocytic or neutrophilic) with high sensitivity and specificity.

The cut-off level for serum LDH: pleural fluid ADA ratio of >20 is highly predictive of malignancy in patients with exudative pleural effusion (whether lymphocytic or neutrophilic) with high sensitivity and specificity.

Identifying Malignant Pleural Effusion by A Cancer Ratio (Serum LDH: Pleural Fluid ADA Ratio)
https://link.springer.com/article/10.1007%2Fs00408-015-9831-6


Three patients did not undergo biopsy. Abrams' biopsy correctly diagnosed malignancy in eight of 17 patients (sensitivity 47%, specificity 100%, negative predictive value 44%, positive predictive value 100%). CT-guided biopsy correctly diagnosed malignancy in 13 of 15 (sensitivity 87%, specificity 100%, negative predictive value 80%, positive predictive value 100%

Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial
http://thelancet.com/journals/lancet/article/PIIS0140-6736(03)13079-6/fulltext


If only PLBX procedures yielding more than six tissue specimens (n=18) or more than two pleural specimens (n=12) were analyzed, then the diagnostic sensitivity of PLBX for pleural tuberculosis was 100%. There seemed to be a direct relationship between the sensitivity of PLBX and the number of specimens submitted.

The optimal number of pleural biopsy specimens for a diagnosis of tuberculous pleurisy.
https://www.ncbi.nlm.nih.gov/pubmed?term=9315802
posted by salinejapan at 23:08 | Comment(0) | 医学・医療 | このブログの読者になる | 更新情報をチェックする

2017年04月15日

トワイライト



200911122033241b5.jpg

posted by salinejapan at 15:52 | Comment(0) | 音楽・映画 | このブログの読者になる | 更新情報をチェックする

2017年04月09日

夢追人



本来は校歌として制作されたものではなく、飯尾が取材を通じて交流のあった女子レスリングの伊調姉妹(伊調千春・伊調馨)と吉田沙保里が、2004年のアテネオリンピックでメダルを獲得したことを祝して制作されたものだった:Wikipedia

23714_main.jpg
posted by salinejapan at 22:25 | Comment(0) | 音楽・映画 | このブログの読者になる | 更新情報をチェックする

赤いタンバリン



skTUD.jpg
posted by salinejapan at 21:49 | Comment(0) | 音楽・映画 | このブログの読者になる | 更新情報をチェックする