A simple direct-addition microtitre plate enzymeimmunoassay (EIA) for progesterone in whole milk is described. The assay used antiserum raised against 11 alpha-hydroxyprogesterone 11-hemisuccinate (progesterone 11-hemisuccinate) and a heterologous label prepared by conjugation of 11 alpha-hydroxyprogesterone 11-glucuronide (progesterone 11-glucuronide) with alkaline phosphatase using an active ester procedure. The sensitivity, analytical recovery, linearity of response and precision of the assay compared favourably with radioimmunoassay (RIA). Results from EIA of milk samples were compared with determinations made after isolation of progesterone by HPLC (r = 0.910). Milk samples (200) were assayed by RIA at both the Milk Marketing Board and the Cattle Breeding Centre and the results were correlated with EIA performed at the Cattle Breeding Centre (r = 0.890 and r = 0.833 respectively). Calving data were obtained from a further 110 cows for which the milk progesterone EIA had provided a pregnancy test 24 days after AI; 46 cows were correctly identified as non-pregnant and 58 as pregnant and there were 4 false positive and 2 inconclusive results.
BackgroundEuropean treatment guidelines recommend the use of hormonal therapy for the treatment of advanced prostate cancer, including castration-resistant prostate cancer (CRPC), but there is little understanding of how common practices in prostate cancer treatment compare across Europe. The aim of this analysis was to evaluate the management of CRPC patients across five European countries (France, Germany, Italy, Spain and the UK).MethodsData were drawn from the Adelphi Real World Prostate Cancer Disease Specific Programme (DSP), a cross-sectional survey of patients undertaken between December 2009 and May 2010. The study is based on physician interviews, physician-completed detailed patient record forms, and a patient-completed questionnaire.ResultsA total of 348 physicians (191 urologists and 157 oncologists) reported on 3477 patients with prostate cancer. Of the 3477 patients, 1405 (40%) were categorised as having CRPC, and 1119 of these had metastatic CRPC. Bone metastases were the most common (78%), followed by liver (37%) and lung (30%). The mean age of CRPC patients was 71 years, 35% were current or ex-smokers and 10% had a family history of prostate cancer. CRPC patients had a mean of 1.8 comorbidities; 66% had hypertension and 32% had diabetes. Most physicians estimated their patients would stop responding to initial hormone therapy after 19–24 months. Overall, addition of an anti-androgen to a luteinising-hormone-releasing hormone (LHRH) agonist was the most commonly prescribed therapy when patients failed initial LHRH agonist therapy, although there were considerable variations between countries. While 72% of physicians in Europe would choose chemotherapy as the next treatment option after diagnosis of CRPC, 31% of this group would initially prescribe this without an LHRH agonist.ConclusionsResults from this analysis highlight inconsistencies in common hormonal therapy treatment patterns for CRPC and hormonal therapy across the EU.
A new and rapid enzyme-amplified immunoassay (AELIA) has been developed for the measurement of progesterone in milk. The AELIA system is a non-isotopic method that gives results within 35 minutes. Milk progesterone concentrations measured in 10 cows sampled daily at various stages of the reproductive cycle were very similar to those recorded by a validated radioimmunoassay. The results show that the speed and sensitivity of the AELIA system would make it possible to diagnose pregnancy rapidly at about 24 days after insemination, to predict the onset of behavioural oestrus from decreasing progesterone values during the third week after a preceding oestrus, and to obtain a daily record of milk progesterone levels in animals treated for infertility of ovarian origin.
Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), a PRO instrument specifically designed to measure HRQoL of cancer patients. HRQoL was measured at screening, months 1, 3, 7, and at re-puncture. Meaningful deterioration was defined as a decrease in HRQoL scores of at least 5 points. Time to first meaningful deterioration was compared between catumaxomab (Nϭ160) and control (Nϭ85) groups using survival analysis techniques such as log-rank test and Cox models. RESULTS: Deterioration in HRQoL scores appeared more rapidly in the control group than the catumaxomab group (medians: 16-28 days vs. 45-49 days). The difference between the two groups in time to deterioration in HRQoL was statistically significant for all scores (pϽ0.01). Results were confirmed with Cox models (pϽ0.05). Hazard ratios ranged from 0.08 to 0.24. CONCLUSIONS: Treatment with catumaxomab delayed deterioration in HRQoL in patients with MA compared to paracentesis alone. The findings of this study indicate that the gain of puncture free survival due to catumaxomab treatment previously reported (Heiss et al. 2010) translates into a HRQoL benefit for the patients. OBJECTIVES:The majority of patients with prostate cancer progress to CRPC and frequently develop bone metastases. Treatment and management of bone metastases, as well as the underlying disease, influences the patient's quality of life. We evaluated the impact of bone metastases on utility (using EQ-5D) and quality of life (using FACT-P) in high-risk CRPC patients. METHODS: Data were extracted from the Adelphi Real World Prostate Cancer Disease-Specific Programme© (DSP), a cross-sectional survey of 348 urologists and oncologists and their prostate cancer patients that was conducted between and the UK. Physicians completed comprehensive record forms on 10 patients being actively treated for prostate cancer. Patients could also complete a questionnaire, which included the EQ-5D and FACT-P tools, however this was not compulsory. RESULTS: Of the 3,477 prostate cancer patients for which data were collected, 1,180 (34%) were categorised as having CRPC with a median time since diagnosis of 35.8 months. 146 patients with CRPC were identified as being at high risk for developing bone metastases (Gleason score Ն8, or a most recent PSA of Ն8ng/mL, or a PSA DT Յ10 months, or had received local therapy in addition to systemic medication). High-risk CRPC patients had an average EQ-5D index of 0.77 (nϭ36) and FACT-P of 99.54 (nϭ27). In contrast, patients with CRPC and bone metastases (nϭ680) had an average EQ-5D index of 0.59 (nϭ165) and FACT-P of 82.99 (nϭ147). Statistical differences were observed between the highrisk and bone metastases groups for both EQ-5D (pϭ0.0002) and FACT-P (pϭ0.0007). CONCLUSIONS: The development of bone metastases represents a significant additional burden for patients with CRPC highlighting the need for new treatments capable of preventing bone metastases in these patients.
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