Search

•Geriatric assessments can aid in identifying patients with less physical resilience who are at increased risk of grade ≥3 adverse events.•Fixed-duration Ven-O improves HRQoL in patients with CLL with and without geriatric impairments.

The effect of present-day and future NOx emissions from aircraft on the NOx and ozone concentrations in the atmosphere and the corresponding radiative forcing were studied using a three-dimensional chemistry transport model (CTM) and a radiative model. The effects of the aircraft emissions were compared with the effects of the three most important anthropogenic NOx surface sources: road traffic, electricity generation and industrial combustion. From the model results, NOx emissions from aircraft are seen to cause an increase in the NOx and ozone concentrations in the upper troposphere and lower stratosphere, and a positive radiative forcing. For the reference year 1990, the aircraft emissions result in an increase in the NOx concentration at 250 hPa of about 20 ppt in January and 50 ppt in July over the eastern USA, the North Atlantic Flight Corridor and Western Europe, corresponding to a relative increase of about 50%. The maximum increase in the ozone concentrations due to the aircraft emissions is about 3-4 ppb in July over the northern mid-latitudes, corresponding to a relative increase of about 3-4%. The aircraft-induced ozone changes cause a global average radiative forcing of 0.025 W/m2 in July. According to the ANCAT projection for the year 2015, the aircraft NOx emissions in that year will be 90% higher than in the year 1990. As a consequence of this, the calculated NOx perturbation by aircraft emissions increases by about 90% between 1990 and 2015, and the ozone perturbation by about 50-70%. The global average radiative forcing due to the aircraft-induced ozone changes increases by about 50% between 1990 and 2015. In the year 2015, the effects of the aircraft emissions on the ozone burden and radiative forcing are clearly larger than the individual effects of the NOx surface sources. Taking chemical conversion in the aircraft plume into account in the CTM explicitly, by means of modified aircraft NOx emissions, a significant reduction of the aircraft-induced NOx and ozone perturbations is realised. The NOx perturbation decreases by about 40% and the ozone perturbation by about 30% in July over Western Europe, the eastern USA and the North Atlantic Flight Corridor.

Summary A patient with an extramedullary plasmacytoma of the omentum and ovaries is described. In spite of the presence of a very high concentration of paraprotein (103.5 g/l IgG k), bone marrow involvement was not demonstrated either at presentation or during the course of the disease. After debulking surgery, chemotherapy (vincristine, prednisone, and cyclophosphamide) was initiated. Although this resulted in considerable improvement, the paraproteinemia persisted. After ten courses of chemotherapy there was recurrence of the tumor with involvement of the lymph nodes in the right axilla. Chemotherapy was changed to a CHOP regimen (cyclophosphamide, adriamycin, vincristine, and prednisone), followed by autologous bone marrow transplantation with the BEAM regimen (BCNU, etoposide, cytarabine, melphalan) as conditioning therapy. The patient was still in complete remission 1 year after transplantation. This case demonstrates that an extramedullary plasmacytoma may become manifest as extensive but localized disease with high levels of paraprotein, and that autologous bone marrow transplantation as a therapeutic modality can lead to prolonged complete remission of the disease.

A three-dimensional off-line tracer transport model coupled to the ECMWF analyses has been used to study the transport of trace gases in the atmosphere. The model gives a reasonable description of their general transport in the atmosphere. The simulation of the transport of aircraft emissions (as NOx) has been studied as well as the transport of passive tracers injected at different altitudes in the North Atlantic flight corridor. A large zonal variation in the NOx concentrations as well as large seasonal and yearly variations was found. The altitude of the flight corridor influences the amount of tracers transported into the troposphere and stratosphere to a great extent.