Published by Elsevier Ltd.”
“Objective: Controversy remains over the routine use of mediastinoscopy or positron emission tomography in T1 non-small cell lung cancer without lymph node enlargement on computed tomography because the risk of N2 involvement is comparatively low. We aimed to develop a prediction model for N2
disease in cT1N0 non-small cell lung cancer to aid AZD6244 chemical structure in the decision-making process.
Methods: We reviewed the records of 530 patients with computed tomography-defined T1N0 non-small cell lung cancer who underwent surgical resection with systematic lymph node dissection. Correlations between N2 involvement and clinicopathologic parameters were assessed using univariate analysis and binary logistic regression analysis. A JNJ-64619178 supplier prediction model was built on the basis of logistic regression analysis and was internally validated using bootstrapping.
Results: The incidence of N2 disease was 16.8%. Four independent predictors were identified in
multivariate logistic regression analysis and included in the prediction model: younger age at diagnosis (odds ratio, 0.974; 95% confidence interval, 0.952-0.997), larger tumor size (odds ratio, 2.769; 95% confidence interval, 1.818-4.217), central tumor location (odds ratio, 3.204; 95% confidence interval, 1.512-6.790), and invasive adenocarcinoma histology (odds ratio, 3.537; 95% confidence interval, 1.740-7.191). This model shows good calibration (Hosmer-Lemeshow test: P = .784), reasonable discrimination (area under the receiver operating characteristic curve, 0.726; 95% confidence interval, 0.669-0.784), and minimal overfitting demonstrated by bootstrapping.
Conclusions: We developed a 4-predictor model that can estimate the probability of N2 disease in computed tomography-defined T1N0 non-small cell lung cancer. This prediction model can help to determine the cost-effective use of mediastinal staging procedures. (J Thorac Cardiovasc Surg 2012; 144:1360-4)”
“Transcranial magnetic stimulation (TMS) is a non-invasive
brain stimulation technique that activates neurons via generation of brief pulses of high-intensity magnetic field. If these pulses are applied Bumetanide in a repetitive fashion (rTMS), persistent modulation of neural excitability can be achieved. The technique has proved beneficial in the treatment of a number of neurological and psychiatric conditions. However, the effect of rTMS on excitability and the other performance indicators shows a considerable degree of variability across different sessions and subjects.
The frequency of stimulation has always been considered as the main determinant of the direction of excitability modulation. However, interactions exist between frequency and several other stimulation parameters that also influence the degree of modulation.