Phase II trial of neoadjuvant temozolomide in resectable melanoma patients.

BACKGROUND: We treated melanoma patients with temozolomide (TMZ) in the neoadjuvant setting and collected cryopreserved tumor samples before and after treatment. The primary objective was to determine whether the response proportion was higher than previously reported in widely metastatic patients. A secondary objective was to test the feasibility of obtaining adequate tissue before and after treatment for genetic testing. MATERIALS AND METHODS: Chemotherapy-naive melanoma patients who were candidates for surgical resection were eligible. TMZ was administered orally at 75 mg/m(2)/day for 6 weeks of every 8-week cycle. Cycles were repeated until complete response (CR), progression, or stable disease (SD) for two cycles. RESULTS: Of 19 assessable patients, 2 had CRs and 1 had partial response. Four patients had SD; 12 progressed. Tumor O-6-methylguanine-DNA methyltransferase (MGMT) promoter was unmethylated in all nine patients analyzed including from the two CR patients. Pretreatment tumor microarray results were obtained in 16 of 19 patients. CONCLUSIONS: The response proportion to TMZ in the neoadjuvant setting was 16%, not different than in the metastatic setting. Responses were seen even in tumors with a methylated MGMT promoter. Pretreatment cryopreserved tumor adequate for microarray analysis could be obtained in most, but not all, patients. Post-treatment tumor was unavailable in complete responders.

Bitemporal epileptiform discharges induced by bupropion: a case report.

We report the case of a 44-year-old right-handed woman who experienced her first convulsion while taking bupropion. Electroencephalography showed frequent bilateral independent temporal lobe epileptiform discharges that resolved when bupropion was discontinued. This is the first well-documented case of epileptiform discharges induced by bupropion in humans.

A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study.

AIM: To compare the development of posterior capsule opacification (PCO) between eyes with and without diabetes mellitus after single-piece hydrophobic acrylic intraocular lens implantation 4 years postoperatively. METHODS: In this prospective, observational case-control study carried out at Iladevi Cataract and IOL Research Centre, Ahmedabad, India, 75 consecutive eyes with diabetes mellitus (cases) were compared with 75 age-matched eyes with age-related cataract (controls). A detailed, preoperative and posterior segment evaluation was carried out in eyes with diabetes mellitus to detect the presence or absence of diabetic retinopathy (DR). The Mann-Whitney U-test was applied to compare the differences in the development of PCO between the two groups. RESULTS: There was no difference in median PCO between cases and controls at 1 month (2.0 vs 1.50, P<0.068), but cases had a higher median PCO at 12 months (2.95 vs 1.30, P<0.001). At 4 years, there was no significant difference in median PCO between cases and controls (3.75 vs 2.25, P=0.273). The duration of diabetes increased the incidence of PCO at 4 years (P=0.02). Severity of DR had no influence on the progress of PCO at 4 years (P=0.69). CONCLUSION: Diabetes mellitus did not increase the incidence of PCO at 4 years. The duration of diabetes increased the risk of PCO. The severity of retinopathy did not influence the development of PCO.

A study to explore the risk factors for the early onset of cataract in India.

PURPOSE: The aim of this study was to identify risk factors for the development of cataract in young patients. SETTINGS: The study was undertaken at Iladevi Cataract and IOL Research Centre, Ahmedabad, Gujarat, India. METHODS: In a clinic-based observational study, 340 consecutive patients in the age group of 30-45 years presenting with nuclear, cortical, posterior subcapsular (PSC), mixed, and posterior polar cataract were prospectively studied. A detailed history regarding sunlight exposure, atopy, diabetes, steroid intake, myopia, glaucoma, and uveitis was elicited. RESULTS: The mean age of the patients was 40.2+/-4.6 years; there were 202 men. The major risk factors were atopy (25.6%), idiopathic (19.1%), high myopia (12.4%), atopy with steroid intake (10.9%), steroid usage (7.4%), sunlight exposure (3.8%), and diabetes mellitus (3.2%). PSC was observed in 53.5% eyes. Multinomial logistic regression revealed that atopy (P=0.016), steroid usage (P=0.100), and diabetes mellitus (P=0.076) documented higher odds for PSC. High myopia (P<0.001) and sunlight exposure (P=0.003) documented higher odds for nuclear cataract. CONCLUSION: Atopy was found to be the most common risk factor associated with the development of cataract in young individuals. PSC was the predominant type of cataract prevalent in young patients.

Impact of anterior capsule polishing on anterior capsule opacification after cataract surgery: a randomized clinical trial.

AIMS: To evaluate the effect of anterior capsule polishing on the development of anterior capsule opacification (ACO) in patients undergoing cataract surgery. METHODS: This prospective randomized observational double-masked clinical trial comprised 120 eyes of 60 consecutive patients with bilateral age-related cataract who underwent phacoemulsification. The patients were randomly assigned to one of the two groups: One eye received a 360 degree anterior capsule polishing (group 1 (cases)) and the fellow eye was without anterior capsule polishing (group 2 (controls)) The primary observation was to observe the development of ACO between the 2 groups, whereas the secondary observation was to measure uveal inflammation. ACO was evaluated at 1 week, 1 month, and 6 months. RESULTS: At the 1-week follow-up, there was no significant difference in the development of ACO between the two groups. At 1 month, 54 (90%) eyes developed ACO in controls and 26 (43.3%) eyes in cases (P<0.001). However, at 6 months, there was no significant difference in the development of ACO between controls and cases (P=0.500). The odds of having cells and flare were significantly more in cases compared with controls at first postoperative day (cells: OR, 39.27; 95% CI, 13.49-114.26 and flare: OR, 48.0; 95% CI, 15.57-147.97). CONCLUSIONS: ACO was significantly lower at 1 month in cases compared with controls. However, the difference in ACO between the two groups was insignificant at 6 months. A significant difference in anterior segment inflammation was documented in cases on the first postoperative day. There was no detectable benefit of performing scraping on the anterior capsule to avoid opacification after phacoemulsification.E