Introduction: This retrospective study evaluates the efficacy of palliative chemotherapy with a modified docetaxel, cisplatin, 5-fluorouracil (5-FU; “TPF” regimen) regimen (mTPF; reduced doses of docetaxel, cisplatin, and 5-FU with reduction of intravenous 5-FU from 4 days to 2 days) in Asian patients with recurrent and metastatic squamous cell carcinoma of head and neck (HNSCC) after surgery and adjuvant chemoradiation. Methods: The mTPF regimen was used in this study. Fifty-five patients (from January 2007 to October 2009) received docetaxel on day 1, followed by cisplatin and 5-FU administered continuous infusion on day 2 for another 48 hours every 3 weeks for three to six cycles. Results: The disease control rate was 81%. The overall response rate was 56%. Five patients achieved complete remission; 26 patients had partial remission; 14 patients had stable disease. Ten patients had disease progression. The metastatic sites that responded well to mTPF regimen (either complete or partial remission) were: neck lymph node, lung, liver, and skin. The median follow-up was 15 months (range 1-28 months). The median overall survival was 10 months (range 2-28 months). The common nonhematological toxicity was alopecia and the most common hematological adverse event was neutropenia. Thirty-one patients (56%) had grade 3-4 neutropenia. Conclusion: The mTPF chemotherapy regimen is efficacious for the palliative treatment of recurrent and metastatic HNSCC in Asian patients.

Introduction: Data regarding the prevalence of immune thrombocytopenia (ITP) is limited, and is derived from North American population-based analyses. Therefore, the authors conducted the first study outside the United States (US) using the United Kingdom (UK) General Practice Research Database (GPRD) to estimate the adult prevalence of ITP in the UK. Methods: This study estimated the diagnosed prevalence of ITP in the adult population in UK using the GPRD from January 1, 1992 to December 31, 2009. Results: The unadjusted, overall 18-year period prevalence was 50.29/100,000 (95% CI: 48.51, 52.06). The age- and gender-adjusted, overall 18-year period prevalence was 50.00/100,000 (95% CI: 49.20, 50.90). ITP prevalence was lower in adults aged 18-49 years of age (30.09/100,000, 95% CI: 28.27, 31.90) than in older adults aged 50-64 years of age (58.22/100,000, 95% CI: 53.88, 62.57) or ≥65 years of age (93.80/100,000, 95% CI: 88.76, 98.85). Prevalence was higher among females (59.32/100,000, 95% CI: 56.63, 62.01) than in males (40.66/100,000, 95% CI: 38.36, 42.96). Prevalence in the GPRD increased over time (1992 [16.33/100,000, 95% CI: 13.70, 19.00], 2000 [36.93/100,000, 95% CI: 34.50, 39.30], and 2009 [58.49/100,000, 95% CI: 55.80, 61.20]). Conclusion: This new analysis of general practice in the UK provides robust prevalence estimates of diagnosed ITP among adults in Europe. ITP prevalence is higher in women and increases with age and over time.

Introduction: The authors investigated whether a new ginkgo biloba (ginkgo) fresh plant extract had a positive effect on microcirculation in the skin and liver of elderly individuals, and whether the extract had antioxidative properties in vivo. Methods: In a monocentric, controlled clinical trial with 32 elderly patients, 16 patients received three 90 mg ginkgo extract tablets twice daily for 30 days, and 16 patients acted as untreated controls. On days 0, 10, 20, and 30, microcirculatory parameters were measured using intravital microscopy in combination with reflection spectrometry, and the amount of reduced glutathione in the liver. Results: This new ginkgo fresh plant extract significantly increased the number of blood cell-perfused nodal points, the venular streaming flow, and the local hematocrit in treated participants compared to control participants and compared to values on day 0. The ginkgo preparation also increased microcirculation in the liver, and possessed antioxidative properties that resulted in significant increases in the amount of the radical scavenger glutathione in treated participants. Conclusion: The new ginkgo fresh plant extract increased the microcirculation significantly, and at the same time improved the radical scavenging capacity in elderly patients and was very well tolerated. This extract is an interesting adjuvant treatment option for patients suffering from impaired microcirculation and improves mechanisms which inhibit an accelerated expression of atherosclerosis.