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Medical Sciences	75%

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DV-ICE, intensive induction and early transplantation for adult patients with acute lymphoblastic leukemia: a phase II study

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2009
Christine Dudler
Abstract Objectives:, Eighty percent of adult patients with acute lymphoblastic leukemia (ALL) achieve a complete remission (CR) but only 30,40% are long term survivors. Best treatment strategies remain to be defined. The role of induction intensity, first remission hematopoietic stem cell transplantation (HSCT) and maintenance chemotherapy continues to be discussed. We tested a strategy of high intensity treatment of short duration followed by HSCT. Patients and methods:, This prospective phase II study used induction with DV-ICE followed by immediate allogeneic or autologous HSCT (depending on donor availability) without additional consolidation or maintenance treatment. DV-ICE consisted of dexamethasone, vincristine, idarubicin, etoposide, and conventional dose cytosine arabinoside; HSCT was planned immediately if CR was achieved or after an additional course of intermediate high dose cytosine arabinoside and etoposide for patients with induction failure. A total of 42 consecutive patients between 17 and 67 yr of age (median 43 yr) were enrolled. Of the 42 patients, 57% were male, 76% had B-lineage ALL, 19% T-lineage ALL and two patients biphenotypic ALL. 29% were Ph+; 7% had 11q23 and 45% had a normal karyotype. CNS involvement was found in three patients. Results:, Thirty-three patients (79%) achieved a CR, 24 patients after induction I or II and nine patients after rescue HSCT. 31 patients received a HSCT (seven autologous and 24 allogeneic). 11 patients did not receive a HSCT because of early death in nine (treatment toxicity in five, refractory disease in four), one patient refused transplantation, one patient was not suitable. Disease-free survival (DFS) of the entire cohort was 46% (95% CI ±16%) at 1 yr and 16% (±13%) at 5 yr. Overall survival (OS) was 63% (±15%) at 1 yr and 23% (±15%) at 5 yr, with a median follow-up of surviving patients of 55 (4,136) months. Neither disease subtype, cytogenetic abnormalities nor patient age or gender was significantly associated with survival. Conclusions:, Intensive induction using DV-ICE followed by early transplantation without treatment beyond 4 months failed to improve outcome compared with standard treatment. [source]

A survey on undergraduate implant dentistry education in Europe

EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2009
H. De Bruyn
Abstract Introduction:, The aim of the survey was to assess the status of implant dentistry education and addressed various aspects related to competence level, practical implementation and barriers for further development in the field. Materials and methods:, An e-mail survey was performed amongst 73 opinion leaders from 18 European countries invited to the Association for Dental Education in Europe (ADEE) workshop on implant dentistry. Results:, Forty-nine surveys were returned (67%) and it was found that theoretical and pre-clinical courses to an average of 36 h are given to undergraduates; 70% reported that students assist or treat patients with prosthetics; 53% reported that students assist with surgery and only 5% is operating patients. In 23% of the schools optional undergraduate courses are available and 90% offer postgraduate training. Barriers for including prosthetics and surgery are lack of time, funding or staff. Partial restorations, including surgery, in the posterior regions may be provided by dentists after attendance at additional courses but complex treatments should be limited to specialists. Conclusion:, This survey confirms that implant dentistry is part of the undergraduate curriculum, albeit with a disparity in time. Whereas implant dentistry is an important part of clinical practice, coverage in the curriculum is limited and when compared with 10 years ago, even stagnating. Priorities within the curriculum should be evaluated depending on demands and treatment needs of the population. To optimise education, learning guidelines should be developed, based on the expected competencies for practicing dentists. Undergraduate education may start the process that must continue through all levels of education, including the postgraduate level. [source]

DOES TEACHER QUALITY AFFECT STUDENT PERFORMANCE?

BULLETIN OF ECONOMIC RESEARCH, Issue 4 2009
EVIDENCE FROM AN ITALIAN UNIVERSITY
H52; I2 ABSTRACT In this paper, we analyse whether the characteristics of university teaching staff matter with regard to students' performance and interest in the discipline. We use data on about 1000 students enrolled on the first-level degree course in business and economics at a medium-sized Italian university. Thanks to the random assignment of students to different teaching classes during their first year, we are able to analyse the effect that teachers with different characteristics, in terms of experience and research productivity, produce both on students' performance, measured in terms of the grades obtained at subsequent examinations, and on courses chosen. Our results suggest that teacher quality has statistically significant effects on students' grades in subsequent courses. These effects are also robust after controlling for unobserved individual characteristics. On the other hand, we find less clear evidence when relating teacher quality to student involvement with a subject. It emerges that research productivity does not produce a statistically significant effect on the probability of a student undertaking additional courses in a subject, while more experienced teachers have a negative impact. However, also this effect does not become statistically significant when we run separate regressions for different disciplines. [source]

Increase in daytime symptoms is a sensitive and specific criterion for predicting corticosteroid-treated exacerbations in a clinical asthma trial

CLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2005
S. M. Dennis
Summary Background To determine which diary card variables are the most predictive for administration of additional courses of corticosteroids using the TRUST (The Regular Use of Salbutamol Trial) data set. Methods Logistic regression models were used to identify the extent to which a change in diary card variable affected the odds ratio (OR) for administering a course of oral or increased inhaled corticosteroids. The complete TRUST diary card data were used with over 200 000 days of diary card observations from 983 mild to moderate asthmatic subjects. Results An increase in daytime symptoms of 1,5 U over baseline was associated with an increase in the OR for starting all types of corticosteroids from two- to 60-fold. Conclusions These results indicate that an increase in daytime symptoms of two or more over baseline strongly predicts the administration of additional corticosteroids. The results have significant implications for both clinical practice and design of clinical trials in asthma. [source]