Mortality from severe TBI is high in Latin American LMIC, although the rate of favorable recovery is similar to that of high-income countries. Demographic factors such as race and study site played an outsized role in predicting outcome; further research is required to understand these associations.

Objectives: To assess the efficacy and tolerability of gemcitabine and paclitaxel as first-line treatment in advanced breast cancer. Methods: Patients with histologically confirmed metastatic or metastatic plus locally advanced breast cancer received gemcitabine 1,200 mg/m² on days 1 and 8 and paclitaxel 175 mg/m² on day 1 every 21 days for 8 cycles. Results: From December 1999 to August 2001, 45 patients, with a median age of 53.5 years (range, 22–77), received a total of 260 cycles. All were assessable for response and toxicity. Twenty-seven patients had prior adjuvant therapy. Hormonal receptor status was positive in 31.1% and negative in 40.0% of patients. Main metastatic sites included soft tissue (62.2%) and lung (53.3%). The objective response rate was 66.7%; complete response, 22.2%; partial response, 44.4%; stable disease, 15.6%; progressive disease, 17.8%. Median duration of response was 18 months and median time to tumor progression was 11 months. Grade 3/4 leukopenia, neutropenia, and thrombocytopenia developed in 13.3% of patients, and 15.5% developed grade 3/4 mucositis. No treatment-related deaths occurred. Median overall survival was 19 months. Conclusion: Gemcitabine plus paclitaxel is an active combination with a favorable toxicity profile as first-line treatment for patients with advanced breast cancer.

Purpose -The purpose of this paper is to present an integrated design approach for rapid product development (RpD) of a broken product. Design/methodology/approach -Reverse engineering (RE), re-engineering (ReE) and RpD systems have been incorporated to infuse agile characteristics in the proposed design and development process. A case study involving a broken clutch shoe was selected to demonstrate the efficacy of the proposed integrated approach. Findings -Integration of RE, ReE and RpD presented an unconventional approach towards achieving reduced lead times for design and development of products. Agile characteristics have been manifested for the broken clutch shoe by retrieval of a digitized parametric computer aided design (CAD) model. Moreover, development and selection of an enhanced feasible design (M 3 ) as well as delivery of the corresponding prototype was accomplished just in one week. Originality/value -The proposed integrated approach for RpD can provide solutions to similar industrial situations wherein agility in the product design and development process can be infused so that the developed part can be delivered quickly to the customer at the reduced time and costs.

No abstract

No abstract