Impact of cranial radiotherapy on central nervous system prophylaxis in children and adolescents with central nervous system-negative stage III or IV lymphoblastic lymphoma.

Purpose: In the Non-Hodgkin's Lymphoma-Berlin-Frankfurt-Munster (NHL-BFM) 95 trial, we tested, against the historical control of the combined trials NHL-BFM90 and NHL-BFM86, whether prophylactic cranial radiotherapy (PCRT) can be omitted for CNS-negative patients with stage III or IV lymphoblastic lymphoma (LBL) with sufficient early response.

Patients And Methods: Apart from the removal of PCRT in NHL-BFM95, the chemotherapy of the three trials was identical except for the amount of l-asparaginase and daunorubicin during induction. The therapy in NHL-BFM95 was accepted to be noninferior when compared with trials NHL-BFM90/86 if the lower limit of the one-sided 95% CI for the difference in the 2-year probability of event-free-survival (pEFS) between target patients of NHL-BFM95 and the historical controls of NHL-BFM90/86 did not exceed -14%.

Acute hemodynamic effects of beta-blockers in patients with severe congestive heart failure: comparison of celiprolol and esmolol.

The present study was designed to investigate, in patients with severe heart failure, the dose-dependent acute hemodynamic effects of celiprolol versus those of esmolol. Celiprolol is a beta 1 -receptor blocker with vasodilating properties, whereas esmolol is an ultra-short-acting beta 1 -blocker. Included were 14 patients with decompensated chronic heart failure (NYHA class IV) due to coronary heart disease (n = 8) or to dilated cardiomyopathy (n = 6).

Severe prosthetic valve-related endocarditis following dental scaling: a case report.

There is a well-known correlation between surgical dental procedures and the risk of bacterial endocarditis in patients with prosthetic cardiac valves. A 43-year-old patient with prosthetic aortic and mitral valves, which already have been removed twice because of endocarditis, suffered from a prosthetic valve-related endocarditis following dental scaling, which was performed without any antibiotic prophylaxis. Invasive medical procedures in patients with prosthetic heart valves may lead to endocarditis.

Superior vena cava syndrome. From the bronchus to the vessel.

This paper addresses the diagnosis and management of superior vena cava syndrome (SVCS) due to malignant intrathoracic tumours. Diagnosis of SVCS is usually established by bedside examination. Chest X-ray and computed tomography may be helpful, but the cavography remains the "gold-standard".