Posts Tagged ‘cwr’

CWRUmedicine and UH develops New Drugs to improve oxygen delivery to tissues

April 8, 2010

Case Western Reserve University and University Hospitals are pleased to announce the awarding of a $4.7 million contract from the Defense Advanced Research Projects Agency (DARPA) to Dr. Jonathan Stamler, Director of the Institute for Transformative Molecular Medicine (ITMM).

The grant will fund development of a new class of drugs that selectively vasodilate under hypoxia and thereby enhance performance at high altitude (e.g. soldiers on mountains in Afganistan).

It is also anticipated that the grant will generate new physiologic information on high-altitude adaptation and new therapeutic interventions to treat patients suffering from conditions where oxygen delivery is impaired, including heart failure, ischemic heart disease, stroke, sickle cell disease and diabetes.

Studies will involve a transdisciplinary approach, including the Department of Anesthesia (James Reynolds) the division of Pulmonary Medicine (Kingman Stroh), and the Harrington-McLaughlin Cardiovascular Institute (Sahil Parikh).

Learn more at CWRUmedicine.org

New Research Published on Antibiotic resistance determinants in Acinetobacter spp

March 31, 2010

We explored the association of antibiotic-resistant phenotypes and genotypes in Acinetobacter spp with clinical outcomes and characteristics in 75 patients from a major military treatment facility. Amikacin resistance was associated with nosocomial acquisition of A baumannii, and carbapenem resistance and bla(OXA-23) were associated with the need for mechanical ventilation. The presence of bla(OXA-23) also correlated with longer hospital and ICU stay. Associations between bla(OXA-23) and complexity, duration, and changes made to antibiotic regimens also existed. Copyright 2010.

Learn more at CWRUmedicine.org

Read why Cushing’s syndrome: Why is diagnosis so difficult?

March 31, 2010

Practicing and perfecting the art of medicine demands recognition that uncertainty permeates all clinical decisions. When delivering clinical care, clinicians face a multiplicity of potential diagnoses, limitations in diagnostic capacity, and “sub-clinical” disease identified by tests rather than by clinical manifestations. In addition, clinicians must recognize the rapid changes in scientific knowledge needed to guide decisions. Cushing’s syndrome is one of several disorders in which there may be considerable difficulty and delay in diagnosis. This article describes a current model of clinical reasoning, some of its challenges, and the application of the principles of clinical epidemiology to meet some of those challenges.

Learn more at CWRUmedicine.org

New Research on Older Patients with Acute Myeloid Leukemia in their first complete remission

March 31, 2010

“Effect of Age on Outcome of Reduced-Intensity Hematopoietic Cell Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission or With Myelodysplastic Syndrome”

McClune BL, Weisdorf DJ, Pedersen TL, da Silva GT, Tallman MS, Sierra J, Dipersio J, Keating A, Gale RP, George B, Gupta V, Hahn T, Isola L, Jagasia M, Lazarus H, Marks D, Maziarz R, Waller EK, Bredeson C, Giralt S.
J Clin Oncol. 2010 Mar 8

PURPOSE:
Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) primarily afflict older individuals. Hematopoietic cell transplantation (HCT) is generally not offered because of concerns of excess morbidity and mortality. Reduced-intensity conditioning (RIC) regimens allow increased use of allogeneic HCT for older patients. To define prognostic factors impacting long-term outcomes of RIC regimens in patients older than age 40 years with AML in first complete remission or MDS and to determine the impact of age, we analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR).

PATIENTS AND METHODS:
We reviewed data reported to the CIBMTR (1995 to 2005) on 1,080 patients undergoing RIC HCT. Outcomes analyzed included neutrophil recovery, incidence of acute or chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, disease-free survival (DFS), and overall survival (OS).

RESULTS:
Univariate analyses demonstrated no age group differences in NRM, grade 2 to 4 acute GVHD, chronic GVHD, or relapse. Patients age 40 to 54, 55 to 59, 60 to 64, and >/= 65 years had 2-year survival rates as follows: 44% (95% CI, 37% to 52%), 50% (95% CI, 41% to 59%), 34% (95% CI, 25% to 43%), and 36% (95% CI, 24% to 49%), respectively, for patients with AML (P = .06); and 42% (95% CI, 35% to 49%), 35% (95% CI, 27% to 43%), 45% (95% CI, 36% to 54%), and 38% (95% CI, 25% to 51%), respectively, for patients with MDS (P = .37). Multivariate analysis revealed no significant impact of age on NRM, relapse, DFS, or OS (all P > .3). Greater HLA disparity adversely affected 2-year NRM, DFS, and OS. Unfavorable cytogenetics adversely impacted relapse, DFS, and OS. Better pre-HCT performance status predicted improved 2-year OS. CONCLUSION: With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT.