Effect of prophylactic CPAP in very low birth weight infants in South America.

OBJECTIVE: The objective of this study was to examine the effect of prophylactic continuous positive airway pressure (CPAP) on infants born in 25 South American neonatal intensive care units affiliated with the Neocosur Neonatal Network using novel multivariate matching methods. STUDY DESIGN: A prospective cohort was constructed of infants with a birth weight 500 to 1500 g born between 2005 and 2011 who clinically were eligible for prophylactic CPAP. Patients who received prophylactic CPAP were matched to those who did not on 23 clinical and sociodemographic variables (N=1268). Outcomes were analyzed using the McNemar's test. RESULTS: Infants not receiving prophylactic CPAP had higher mortality rates (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.17, 2.46), need for any mechanical ventilation (OR=1.68, 95% CI 1.33, 2.14) and death or bronchopulmonary dysplasia (BPD) (OR=1.47, 95% CI 1.09, 1.98). The benefit of prophylactic CPAP varied by birth weight and gender. CONCLUSIONS: The implementation of this process was associated with a significant improvement in survival and survival free of BPD.

Predictors of Tumor Response to Cetuximab and Panitumumab in 116 Patients and a Review of Approaches to Managing Skin Toxicity.

INTRODUCTION AND OBJECTIVES: Cetuximab and panitumumab are monoclonal antibodies that target the epidermal growth factor receptor (EGFR) in the treatment of metastatic colorectal cancer. Most patients develop a papulopustular rash, which may predict tumor response. We studied whether the other adverse cutaneous effects associated with these monoclonal antibodies are also clinical predictors of response. We also reviewed publications describing approaches to treating the papulopustular rash since no evidence-based guidelines have yet been published. MATERIAL AND METHODS: We performed a retrospective study of 116 patients with metastatic colorectal cancer receiving anti-EGRF therapy with cetuximab or panitumumab at Hospital Universitario Donostia. RESULTS: In total, 81.9% of the patients developed a papulopustular rash. Patients who received the most cycles of treatment with the EGFR inhibitor were at the highest risk of developing the rash, and these patients also had the most severe rash reactions (P=.03). All of the patients who exhibited a complete tumor response had the rash, and the incidence of rash was lower in patients with poor tumor response (P=.03). We also observed an association between tumor response and xerosis (53.4% of the patients who developed xerosis also exhibited tumor response, P=.002). The papulopustular rash was managed according to an algorithm developed by our department. CONCLUSIONS: Severe papulopustular rash and xerosis may be clinical predictors of good response to anti-EGFR therapy. Patients who develop a papulopustular rash should be treated promptly because suboptimal treatment of this and other adverse effects can lead to delays in taking the prescribed anti-EGFR dose or to interruption of therapy.

[The effect of peroperative transfusion on survival in resected lung carcinomas]. / Influencia de la transfusión perioperatoria en la supervivencia de los carcinomas de pulmón resecados.

This paper analyzes the influence of perioperative transfusion on survival after lung cancer surgery. Between January 1991 and December 1995, we enrolled 405 patients, 196 of whom received transfusions and 209 of whom did not. Follow-up extended to December 1997. Excluded were patients undergoing exploratory thoracotomy (n = 92), those who died during the postoperative period (n = 19) and those lost to follow-up (n = 13). The final number of patients in the study was 281 (136 who received transfusions and 145 who did not). We analyzed age, sex, general clinical status measured on the Eastern Cooperative Oncology Group (ECOG) scale, histological type and TNM staging. Single and multiple variable analyses were performed. At the end of the study 158 patients were alive and 123 had died. Transfusions were used more often in pneumonectomies (p < 0.001) and in patients with an ECOG score of 2 (p < 0.01). Survival at 36 and 60 months, calculated using the Kaplan-Meier method was 52% and 30%, respectively, for those who had received transfusions, and 53% and 49%, respectively, for those who had not. The differences were not statistically significant (p > 0.1). Multivariant analysis failed to demonstrate an influence of transfusion on survival (relative risk of 1.08; 95% confidence interval 0.72-1.61; p > 0.1). We conclude that there is no negative prognostic effect of perioperative transfusion.

Vasoactive intestinal polypeptide (VIP)-like immunoreactivity in intraprostatic neurons and major pelvic ganglia in the rat.

VIP-like immunoreactive neurons have been found within the prostate and major pelvic ganglia of the male rats; they are of two different sizes. Moreover many VIP-like nerve fibers were found around the perikarya. On the basis of present data it is suggested that VIP-like prostatic nerves arise from both pelvic ganglia and intraprostatic neurons.

[Microscopic innervation of the spermatic ducts and testis. II. Ductus epididymis]. / Inervación microscópica de las vías espermáticas y testículo. II. Ductus epididymis.

The microscopic innervation of the ductus epididymis in the rat has been studied both in light and electron microscope. The nerve fibres form perivascular, intramuscular and subepithelial plexuses. Occasionally sensory formations were observed in the adventitia of the cauda epididymis. The innervation is more abundant in the cauda epididymis than in the other segments (caput and corpus). The varicosities and endings of nerve fibres have synaptic vesicles of different sizes and electron characteristics. Some of the varicosities were close to the muscle cells and without glial sheath. The epithelial cells were not directly innervated.

[Familial eosinophilic fascitis induced by toxic oil]. / Fascitis eosinofílica familiar inducida por aceite tóxico.

Three of four family members in husband, wife and one of two daughters developed in a short time interval (eleven months) eosinophilic fasciitis. The clinical, analytical and histopathological changes were characteristic of this disease. Familial cases of eosinophilic fasciitis have not been previously published. The process of these patients was probably caused by the ingestion of denatured oil (toxic oil syndrome), although the clinical picture begun two and a half years after the epidemic phase of the toxic oil syndrome declined.

[Bowenoid papulosis in a patient with AIDS]. / Papulosis bowenoide en paciente de SIDA.

A patient with a acquired immunodeficiency syndrome (AIDS) and Kaposi's angiosarcoma developed bowenoid papulosis of the genitalia (BP). The clinical and histopathological criteria were both characteristic of BP. With vinblastine treatment a moderate improvement of Kaposi's lesions was observed, but no significant changes of the BP lesions were noted during this treatment.