Cost-effective primary care-based strategies to improve smoking cessation: more value for money.

Background: Evidence from cost-effective smoking cessation programs is scarce. This study determined the cost-effectiveness of 3 smoking cessation strategies as provided by general practitioners (GPs) in Germany.

Methods: In a cluster-randomized smoking cessation trial, rates and intervention costs for 577 smoking patients of 82 GPs were followed up for 12 months.

3-{1-[(2,4-Dinitrophenyl)hydrazino]-ethyl-idene}-5-(1-methylpropyl)pyrrolidine-2,4-dione.

In the title compound, C(16)H(19)N(5)O(6), two intramolecular N-H⋯O hydrogen bonds help to establish the conformation. In the crystal, intermolecular N-H⋯O links result in chains propagating in [010].

Standardized surgery for colonic cancer: complete mesocolic excision and central ligation--technical notes and outcome.

Objective: Total mesorectal excision (TME) as proposed by R.J. Heald more than 20 years ago, is nowadays accepted worldwide for optimal rectal cancer surgery.

p16INK4a is a beta-catenin target gene and indicates low survival in human colorectal tumors.

Background & Aims: Human colorectal carcinomas display an infiltrative front of invasion where tumor cells undergo an epithelomesenchymal transition associated with low survival. Epithelomesenchymal transition is regulated by a nuclear beta-catenin accumulation, and subsequently, activation of beta-catenin/TCF4 target genes similar to CYCLIN D(1). Unexpectedly, these tumor cells are characterized by low proliferation, which correlates with the expression of the cell cycle inhibitor p16(INK4A).

Angiostatic immune reaction in colorectal carcinoma: Impact on survival and perspectives for antiangiogenic therapy.

Angiogenesis and inflammation are the 2 major stroma reactions in colorectal carcinoma (CRC). Guanylate binding protein-1 (GBP-1) is a key mediator of angiostatic effects of inflammation. Therefore, we hypothesized that GBP-1 may be a biomarker of intrinsic angiostasis associated with an improved outcome in CRC patients.

Umbilical cord blood regulatory T-cell expansion and functional effects of tumor necrosis factor receptor family members OX40 and 4-1BB expressed on artificial antigen-presenting cells.

Previously, we showed that human umbilical cord blood (UCB) regulatory T cells (Tregs) could be expanded approximately 100-fold using anti-CD3/28 monoclonal antibody (mAb)-coated beads to provide T-cell receptor and costimulatory signals. Because Treg numbers from a single UCB unit are limited, we explored the use of cell-based artificial antigen-presenting cells (aAPCs) preloaded with anti-CD3/28 mAbs to achieve higher levels of Treg expansion. Compared with beads, aAPCs had similar expansion properties while significantly increasing transforming growth factor beta (TGF-beta) secretion and the potency of Treg suppressor function.

[Diagnosis and treatment of colorectal liver metastases - workflow].

In this review, standards of diagnosis and treatment of colorectal liver metastases are described on the basis of a workshop discussion. Algorithms of care for patients with synchronous / metachronous colorectal liver metastases or locoregional recurrent tumour are presented. Surgical resection is the procedure of choice in the curative treatment of liver metastases.

Adenocarcinoma of the esophagogastric junction: the pattern of metastatic lymph node dissemination as a rationale for elective lymphatic target volume definition.

Purpose: Regional nodal metastasis after neoadjuvant chemoradiation of adenocarcinoma of the esophagogastric junction (AEG) predicts survival. We aimed to clarify the lymph node (LN) distribution of AEG according to location of the tumor mass and invasion of neighboring areas for the selection of radiotherapy planning target volume (PTV) margins.

Methods And Materials: Patterns of regional spread were analyzed in pathology reports of 326 patients patients with AEG who had undergone primary resection, with > or = 15 lymph nodes examined.

Preoperative chemoradiation in adenocarcinoma of the pancreas. A single centre experience advocating a new treatment strategy.

Aims: To evaluate a single centre's experience with pancreatic carcinoma focused on preoperative chemoradiation therapy (CRT) for treatment of locally advanced pancreatic carcinoma. The aim of the present analysis was to evaluate the median overall survival time (OS) after preoperative CRT and to compare it with OS after primary resection of pancreatic carcinoma. In conclusion a new treatment strategy was developed using multimodality treatment for pancreatic carcinoma deemed to be resectable by CT-scan.

Clinical and electrical performance of expanded polytetrafluoroethylene-covered defibrillator leads in comparison to traditional leads.

Background: In the event of infection, erosion, or failure, fibrosis of a defibrillation lead can make extraction difficult. In the ENDOTAK RELIANCE G defibrillation lead, coils are covered with expanded polytetrafluoroethylene (ePTFE) to prevent tissue ingrowth.

Objective: The objective of the REFLEx Study was to evaluate if RELIANCE G defibrillation leads with ePTFE-covered coils are as good as comparative defibrillation leads with respect to electrical performance and termination of spontaneous tachyarrhythmias.

A comparison of the clinical utility of pain assessment tools for children with cognitive impairment.

Background: Difficulty assessing pain has been cited as one of the primary reasons for infrequent and inadequate assessment and analgesia for children with cognitive impairment (CI). Several behavioral observational pain tools have been shown to have good psychometric properties for pain assessment in this population; however, routine clinical use may depend largely on their pragmatic qualities. We designed this study to evaluate pragmatic attributes or clinical utility properties of three recently developed pain assessment tools for children with CI.

High-pressure creep of serpentine, interseismic deformation, and initiation of subduction.

The supposed low viscosity of serpentine may strongly influence subduction-zone dynamics at all time scales, but until now its role could not be quantified because measurements relevant to intermediate-depth settings were lacking. Deformation experiments on the serpentine antigorite at high pressures and temperatures (1 to 4 gigapascals, 200 degrees to 500 degrees C) showed that the viscosity of serpentine is much lower than that of the major mantle-forming minerals. Regardless of the temperature, low-viscosity serpentinized mantle at the slab surface can localize deformation, impede stress buildup, and limit the downdip propagation of large earthquakes at subduction zones.

Quantum control of the hyperfine spin of a Cs atom ensemble.

We demonstrate quantum control of a large spin angular momentum associated with the F=3 hyperfine ground state of 133Cs. Time-dependent magnetic fields and a static tensor light shift are used to implement near-optimal controls and map a fiducial state to a broad range of target states, with yields in the range 0.8-0.

Resectability of pancreatic adenocarcinoma: assessment using multidetector-row computed tomography with multiplanar reformations.

The purpose was to assess capabilities of the multidetector-row computed tomography (MDCT) with multiplanar reformations (MPR) for predicting of pancreatic adenocarcinoma resectability. Forty-eight patients deemed to have resectable pancreatic adenocarcinoma after assessment using biphasic MDCT with MPRs underwent surgery for potential tumor resection. Imaging findings were retrospectively evaluated for tumor resectability and correlated with surgical and pathological results.

Renal cell carcinoma in transplant recipients with acquired cystic kidney disease.

Background: Acquired cystic kidney disease (ACKD) is a widely known renal cell carcinoma risk factor.

Design, Setting, Participants, And Measurements: An ultrasound screening of the native kidneys in all renal transplant patients of a renal outpatient clinic who received a transplant between 1970 and 1998 and presented between 1997 and 2003 (n = 916) was initiated prospectively. A total of 561 patients were screened.

TGF-beta receptor 2 downregulation in tumour-associated stroma worsens prognosis and high-grade tumours show more tumour-associated macrophages and lower TGF-beta1 expression in colon carcinoma: a retrospective study.

Background: Histological phenotype and clinical behaviour of malignant tumours are not only dependent on alterations in the epithelial cell compartment, but are affected by their interaction with inflammatory cells and tumour-associated stroma. Studies in animal models have shown influence of tumour-associated macrophages (TAM) on histological grade of differentiation in colon carcinoma. Disruption of transforming growth factor beta (TGF-beta) signalling in tumour cells is related to more aggressive clinical behaviour.

Deformation of (Mg,Fe)SiO3 post-perovskite and D'' anisotropy.

Polycrystalline (Mg(0.9),Fe(0.1))SiO3 post-perovskite was plastically deformed in the diamond anvil cell between 145 and 157 gigapascals.

[Report on the workshop "workflow rectal cancer II" in Burghausen].

The task force "workflow rectal cancer II" defined operative techniques in lower rectal cancer, especially the total mesorectal excision and an improved technique of abdominalperineal resection. New aspects for treatment of rectal cancer with primary distant metastases are described. Due to newer publications a concept of bidirectional procedure with surgery and radiochemotherapy is recommended, where the operation must not be inevitably the first step.

[Quality indicators for diagnostic and therapy of rectal carcinoma].

Diagnostic and treatment of rectal cancer need a continuous quality assessment. Indicators of quality were compiled as indicator profile for a summarizing evaluation. The indicators selected should potentially show an appreciable variation of the quality target and in addition should be decisive for the outcome.

Authorized and Unauthorized ("PCA by Proxy") Dosing of Analgesic Infusion Pumps: position statement with clinical practice recommendations.

The American Society for Pain Management Nursing (ASPMN), in order to address sentinel alerts issued by JCAHO in 2004 and ISMP in 2005 concerning "PCA by Proxy", has developed a position statement and clinical practice recommendations on Authorized and Unauthorized (PCA by Proxy) Dosing of Analgesic Infusion Pumps, approved by the Board of Directors in June of 2006. In short, ASPMN does not support the use of "PCA by Proxy". ASPMN does, however, support the practice of Authorized Agent Controlled Analgesia in a variety of patient care settings when the agency has in place clear guidelines outlining the conditions under which this practice shall be implemented and outlining monitoring procedures that will insure safe use of the therapy.

[Lymphadenectomy with tumors of the lower gastrointestinal tract].

For advanced adenocarcinomas, which are the most frequent tumours of the lower GI tract, the concept of radical lymphnode dissection is well accepted. The quality of lymphadenectomy for these malignancies has a strong effect on cancer-related survival. Based upon a strict quality control program with outcome evaluated according to internal results, the technique and extent of lymph node dissection have been continuously developed over the last three decades.

[Urgent surgery in colon carcinoma].

Introduction: About 10% of all operations in colon carcinoma are performed in emergency situations because of severe preoperative complications.

Patients And Method: The prospectively collected data of 1496 patients with colon carcinoma treated from 1987 to 2002 at the Department of Surgery of the University of Erlangen were analysed with special interest on postoperative morbidity and long-term prognosis after elective and urgent surgery.

Results: The rate of urgent surgery was 11%.

[Expenditures for members of a health insurance company suffering from alcoholism - a payer's view].

Aim: In this study, expenditures of a health insurance company for alcoholics are calculated and analysed.

Method: Data are derived from the company's records. To participate in this study, subjects had to have a clearly alcohol-related diagnosis during a stay in hospital or a time-off work in 2001 (index-year).

Decreased renal transplant function after parathyroidectomy.

Background: Persistent secondary hyperparathyroidism after renal transplantation may require parathyroidectomy (PTX). Clinical experience suggests that these patients commonly develop decreased renal function thereafter.

Methods: To test this notion, we evaluated 76 transplant patients who underwent pararhyroidectomy between 1997 and 2003.