Survival rates

Prosta.te Ca.ncer, Estrogen has an inhibitory effect on the prostate in addition to its suppression of gonadotropin secretion by the pituitary. The three- and five-year survival rates in prostate cancer patients with metastatic disease improved when treated with DES (7) alone or along with castration. However, DES does not improve the survival rates in patients whose carcinoma is confined to the prostate. Small doses of DES (1 mg/d) appear to retard prostate cancer growth and could reduce the cardiovascular complications associated with larger doses (5 mg/d) (135) (see... 

The use of oxygen in pediatric incubators is an important factor in increasing the survival rate of premature infants who develop cyanosis. However, the use of oxygen is associated with risk of developing the visual defect known as retrolental fibroplasia (38). A careflil monitoring of arterial blood oxygen partial pressure is important. 

Chinese Herbal Medicines. Many traditional Chinese medicines have been screened for radioprotective activity in experimental animals. In one study of more than a thousand Chinese herbs, a number of agents increased the survival rate of dogs exposed to a lethal dose of y-rays by 30—40%, and some symptoms of radiation injury were ameHorated. These effects are potentially related to stimulation of the hemopoietic and immune systems (130). Extracts of five Chinese dmg plants, as weU as aspirin, effectively protected mice exposed to 7.5—8.0 Gy (750—800 rad) of y-radiation, and increased survival rates by 8—50% (131). Several Chinese traditional medicines, adininistered ip before or after irradiation, protected against Hpid peroxidation in a variety of mouse tissues, including BM, Hver, and spleen, as weU as in mouse Hver microsomal suspensions irradiated in vitro (132). 

Not only is TCDO a potent therapeutic agent in acute radiation syndrome, but treatment using TCDO from days 4—11 after TBI increases the survival rate in rats for up to one year, protects against the development of late GI ulcers, and also reduces the development of y-ray-induced leukemias and malignant epitheHal tumors, but not sarcomas (202). The anticarcinogenic effect of TCDO maybe related to the inhibition of PGs, which promote carcinogenesis, or to immunostimulation, which may result in a more effective elimination of malignant cells. 

Decreased production of yolk protein resulting from inhibition of either ovarian or liver function presents the fish with a similar choice to that resulting from decreased food availability. It can produce the same number of smaller eggs, or a smaller number of eggs of normal size, but the mechanism by which that choice is made is unclear. Since the decreased nutrient content of small eggs will result in smaller larvae with a decreased survival rate, the net result in both cases may be a... 

ACE inhibitors are approved for the treatment of hypertension and cardiac failure [5]. For cardiac failure, many studies have demonstrated increased survival rates independently of the initial degree of failure. They effectively decrease work load of the heart as well as cardiac hypertrophy and relieve the patients symptoms. In contrast to previous assumptions, ACE inhibitors do not inhibit aldosterone production on a long-term scale sufficiently. Correspondingly, additional inhibition of aldosterone effects significantly reduces cardiac failure and increases survival even further in patients already receiving diuretics and ACE inhibitors. This can be achieved by coadministration of spironolactone, which inhibits binding of aldosterone to its receptor. 

In the treatment of hypertension, ACE inhibitors are as effective as diuretics, (3-adrenoceptor antagonists, or calcium channel blockers in lowering blood pressure. However, increased survival rates have only been demonstrated for diuretics and (3-adrenoceptor antagonists. ACE inhibitors are approved for monotherapy as well as for combinational regimes. ACE inhibitors are the dtugs of choice for the treatment of hypertension with renal diseases, particularly diabetic nephropathy, because they prevent the progression of renal failure and improve proteinuria more efficiently than the other diugs. 

In breast cancer patients, total PR status is measured for hormonal treatment. The presence of PR is associated with increased survival rates and hormonal responsiveness of mammary tumors. PR agonists are widely used in contraception, HRT, breast cancer, and endometrial hyperplasia. Antiprogestins such as RU486 are used for blocking ovulation and preventing implantation, and in addition they are in clinical testing for the induction of labor and to control various neoplastic transformations. 

Nevertheless, SDM showed a maximum decrease in the cell survival rate of approximately 12% and 27% at the lowest and highest concentrations of microparticles, respectively (Figure 14). The massive cytotoxicity induced by CLM may be explained by the presence of remaining molecules of terephthaloyl chloride, which plays the role of cross-linking agent during the formation of CLM and is well known as a toxic substance. 

Contraindications are the same as for immunotherapy for inhalant allergy, but are relative in nature because of the life-saving potential of venom immunotherapy. Elderly patients, especially with preexisting cardiovascular disease, are at a high risk to develop severe or even fatal anaphylaxis [26]. Therefore, venom immunotherapy is often recommended in patients over 50-60 years of age. Since (3-blocker treatment is associated with a significantly increased survival rate in patients with coronary heart... 

Lindsberg and Mattle ° recently analyzed published case series reporting on the outcome of basilar artery occlusion (BAO) after lAT or IV thrombolysis. In 420 BAO patients treated with IV thrombolysis (76) and lAT (344), death or dependency was equally common 78% (59 of 76) and 76% (260 of 344). Recanalization was achieved more frequently with lAT (225 of 344 65%) than with IV thrombolysis (40 of 76 53% p = 0.05), but survival rates after IV thrombolysis (38 of 76 50%) and lAT (154 of 344 45%) were equal (p = 0.48). A total of 24% of patients treated with lAT and 22% treated with IV thrombolysis reached good outcomes (p = 0.82). Without recanalization, the likelihood of achieving a good outcome was close to nil (2%). The authors conclude that recanalization occurs in more than half of BAO patients treated with lAT or IV thrombolysis, and 45-55% of survivors regain functional independence. They advised that hospitals not equipped for lAT should consider setting up IV thrombolysis protocols for BAO since the effect of IVT did not appear to be much different from the effect of lAT. 

More recent reports conclude that early CEA after a nondisabling ischemic stroke can be performed with perioperative mortality and stroke rates comparable to those of delayed CEA. In a subgroup analysis by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators, 42 patients who underwent early CEA (<30 days after stroke) were compared with 58 patients who underwent delayed CEA (>30 days), and no overall difference was demonstrated in the perioperative stroke rate (4.8% vs. 5.2%). Another recent prospective randomized study of 86 patients showed no difference in either perioperative stroke (2% in both groups) or survival rates (mean 23 months follow-up) between patients randomized to early or delayed CEA. ... 

Lacunar stroke is characterized by occlusion of a small penetrating artery creating a small deep infarct. Lacunar strokes have the lowest early recurrence risk and best survival rates, but may still cause significant functional morbidity. Although subgroup analyses are available from secondary prevention trials in lacunar stroke, few clinical trial data are available regarding nonthrombolytic antithrombotic therapy for lacunar stroke in the acute setting. 

Fig. 17.8 The acquisition pipeline. The bars indicate, as a percentage of total available compounds, the survival rate at each step. If,...

Another area of active research is the development of stable low molecular weight metal complexes, which could serve as SOD mimics. Fridovich has described a complex of mangsmese (III) with desferral, which can catalyse the dismutation of superoxide anion in vitro and can protect green algae against paraquat toxicity (Beyer and Fridovich, 1989). This manganese-desferral complex was evaluated in models of circulatory shock and also found to improve survival rate (de Garavilla etal., 1992). 

Fungal endocarditis is quite uncommon but has significant mortality, typically affecting patients who have had cardiovascular surgery, received a prolonged course of broad-spectrum antibiotics, have long-term catheter placement, are immunocompromised, or are IVDUs.8,35 Survival rates have remained... 

Surgical resection of the tumor is the mainstay of treatment in early-stage non-small cell lung cancer and produces the longest survival rates. 

Small cell lung cancer typically presents as extensive disease (approximately 60% to 70% of new cases) and progresses very quickly. Small cell carcinomas are very responsive to chemotherapy and radiation. Radiotherapy became the standard in 1969, when a randomized trial showed that it offered the potential for cure, whereas surgery did not.20 For the vast majority of patients, chemotherapy with or without radiotherapy is the treatment of choice. Even after a complete response to therapy, the cancer usually recurs within 6 to 8 months, and survival time following recurrence is typically short ( 4 months). This yields a typical survival rate of 14 to 20 months for limited disease and 8 to 13 months for extensive disease.33 Table 87-6 illustrates the general treatment path of SCLC. 

The 5-year event-free survival rate for ALL is nearly 80% in children and approximately 40% for adults.1 The success rate for children with ALL is attributed to risk-directed therapy and enrollment in clinical trials. For patients with AML younger than 20 years of age, the 5-year survival is 50%.6 Patients with AML older than age 60 generally have a poorer prognosis of less than 20%. 

With increased success in pediatric clinical trials, the overall survival rate for pediatric cancers has increased significantly over the last 35 years. For certain disease states, the overall survival rate for specific pediatric malignancies is now up to 80%. Unfortunately, the consequences of success are that approximately two-thirds of childhood cancer survivors have at least one chronic or late-occurring complication of treatment. Long-term follow-up of survivors treated decades ago also has revealed very late sequelae.24... 

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