SIDERITE AS A WEIGHTING MATERIAL IN DRILLING MUD

Successful petroleum drilling largely depends on the type and quality of mud used in the process. There exist many types of muds, which differ in use and composition. Certain muds are composed of materials that can cause damage to the formation and the bottom-hole. This has resulted in the search for alternatives mud additives or addition of new materials to minimize the damage of the formation and enhance the stability of the wellbore. Several bodies of literature exist that research different sources of mud functions and additives, also their effect on the drilling process, the production zone and the environment. Density is one of the main properties of drilling mud because it is the responsible in controlling the formations pressure. So, many weighting agents exist to increase the density of drilling mud. Barite (BaSO4) has a specific gravity of 4.2–4.5 and hardness 2.5-3.5. It has been the most common weight material used in drilling fluids, it is preferred to other weighting materials because of its low cost and high purity but its main disadvantage that its composed of large amount of insoluble acid which damage the formation due to the invasion of the solids into the production zone. A new weighting agent that can be used instead of barite would be a new innovation in the oil field. Siderite (FeCO3) is a weighting material which has a specific gravity of 3.9 and a hardness of 3.5 and makes the mud weighted up to 20 lb/gal. It is specified by a high acid solubility which didn’t cause damage to the formation compared to barite. So, it can be used as an alternative weighting material in both oil and water muds due to its high specific gravity and high acid solubility

FACTORS AFFECTING PREGNANCY OUTCOME IN REFUGEE MOTHERS IN LEBANON

In recent years, Lebanon has been a destination for less privileged refugees who seek better living conditions and shelter from regional wars, conflicts and instabilities. Recently, it is estimated that more than 20% of residents in Lebanon are Syrian refugees who live under questionable conditions regarding quality of life. Pregnant women, among their population, are considered more vulnerable to the effect of such living conditions. This study aimed at assessment of pregnancy outcome (birth weight, infant complications…) in a sample of women in refugees areas who have recently given birth and relate this outcome to multiple factors including socioeconomic status of the family, psychological status of the mother, maternal vitamin supplementation, and previous high-risk pregnancies. This study was conducted by a field-based survey, using questionnaire. Sample taken was by convenient sampling of just delivered women, focusing on major areas in Lebanon with the highest population of refugees. Results of our study detected increased risk of having neonatal complications in women with previous high-risk pregnancies. There was statistically significant difference between Syrian and Lebanese women regarding birth outcome. Syrian women were had a higher percentage of complications and lower birth weight than Lebanese women. There were significantly more neonatal complications in families with low income, women with improper antenatal care, and those with a compromised psychosocial state during pregnancy. There was also a high percentage of refugees who did not know about supplementation during pregnancy. Conclusion: Less privileged women in refugee areas during pregnancy and after delivery are not receiving appropriate antenatal care. Poor living circumstances, low socioeconomic status, and compromised psychosocial status of Syrian mothers increase the risk of having neonatal complications and low birth weight of their newborn infants. It is recommended to encourage awareness programs for the Syrian refugees in Lebanon regarding pregnancy and neonatal health. It is advised to provide more strict antenatal care to women who had previous complications in delivery

Design and rationale for the non-interventional Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib (GIDEON) study

Hepatocellular carcinoma (HCC) is a complicated condition influenced by multiple confounding factors, making optimum patient management extremely challenging. Ethnicity, stage at diagnosis, comorbidities and tumour morphology affect outcomes and vary from region to region, and there is no common language to assess patient prognosis and make treatment recommendations. Despite recent efforts to reduce the incidence of HCC, most patients present with unresectable disease. Non-surgical treatments include ablation, transarterial chemoembolisation and the multikinase inhibitor, sorafenib, but their effects in all patient subgroups are not known and further information is needed to optimise the use of these treatments.The Global Investigation of Therapeutic DEcisions in Hepatocellular Carcinoma and Of its Treatment with SorafeNib (GIDEON) study (ClinicalTrials.gov identifier NCT00812175; http://clinicaltrials.gov/ ) is an ongoing global, prospective, non-interventional study of patients with unresectable HCC who are eligible for systemic therapy and for whom the decision has been taken to treat with sorafenib under real-life practice conditions. The aim of this study is to evaluate the safety and efficacy of sorafenib in different subgroups, especially Child-Pugh B where data are limited.This study will recruit 3000 patients from > 40 countries and follow them for approximately 5 years to compile a large and robust database of information that will be used to analyse local, regional and global differences in baseline characteristics, disease aetiology, treatment practice patterns and treatment outcomes, with a view to improve the knowledge base used to guide physician treatment decisions and to improve patient outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79194/1/j.1742-1241.2010.02414.x.pd

Safety and efficacy of cabozantinib for patients with advanced hepatocellular carcinoma who advanced to Child-Pugh B liver function at study week 8: a retrospective analysis of the CELESTIAL randomised controlled trial

Background: Patients with hepatocellular carcinoma (HCC) and Child–Pugh B liver cirrhosis have poor prognosis and are underrepresented in clinical trials. The CELESTIAL trial, in which cabozantinib improved overall survival (OS) and progression-free survival (PFS) versus placebo in patients with HCC and Child–Pugh A liver cirrhosis at baseline, was evaluated for outcomes in patients who had Child–Pugh B cirrhosis at Week 8. Methods: This was a retrospective analysis of adult patients with previously treated advanced HCC. Child–Pugh B status was assessed by the investigator. Patients were randomised 2:1 to cabozantinib (60 mg once daily) or placebo. Results: Fifty-one patients receiving cabozantinib and 22 receiving placebo had Child–Pugh B cirrhosis at Week 8. Safety and tolerability of cabozantinib for the Child–Pugh B subgroup were consistent with the overall population. For cabozantinib- versus placebo-treated patients, median OS from randomisation was 8.5 versus 3.8 months (HR 0.32, 95% CI 0.18–0.58), median PFS was 3.7 versus 1.9 months (HR 0.44, 95% CI 0.25–0.76), and best response was stable disease in 57% versus 23% of patients. Conclusions: These encouraging results with cabozantinib support the initiation of prospective studies in patients with advanced HCC and Child–Pugh B liver function. Clinical Trial Registration: NCT01908426

An Open-Label, Multicenter, Phase I, Dose Escalation Study with Phase II Expansion Cohort to Determine the Safety, Pharmacokinetics, and Preliminary Antitumor Activity of Intravenous TKM-080301 in Subjects with Advanced Hepatocellular Carcinoma.

Lessons learnedTKM-080301 showed a favorable toxicity profile at the studied dose.TKM-080301 targeting PLK1 through small interfering RNA mechanism did not demonstrate improved overall survival in patients with advanced hepatocellular carcinoma compared with historical control. Preliminary antitumor activity as shown in this early-phase study does not support further evaluation as a single agent.BackgroundPolo-like kinase 1 (PLK1) is overexpressed in hepatocellular carcinoma (HCC). Knockdown of PLK1 expression by PLK1 small interfering RNA (siRNA) in an HCC cell line showed reduced expression in RNA-induced silencing complex and a reduction in cell proliferation.MethodsA 3 + 3 dose escalation plus expansion cohort at the maximum tolerated dose (MTD) was implemented. Patients with HCC, Eastern Cooperative Oncology Group (ECOG) performance status ≤2, and Child-Pugh score A received TKM-080301 as an intravenous infusion once every week for 3 consecutive weeks, repeated every 28 days.ResultsThe study enrolled 43 patients. The starting dose of TKM-080301 was 0.3 mg/kg, and MTD was declared at 0.75 mg/kg. Following the development of grade 4 thrombocytopenia in two subjects on the expansion cohort, the MTD was redefined at 0.6 mg/kg. Four patients did not have any evaluable postbaseline scan. Of the other 39 subjects who had received at least 0.3 mg/kg, 18 subjects (46.2%) had stable disease (SD) by independent RECIST 1.1 criteria. By Choi criteria, eight subjects (23.1%) had a partial response (PR). For 37 assessable subjects, with 2 subjects censored, median progression-free survival (PFS) was 2.04 months. Median survival for the whole study population was 7.5 months.ConclusionTKM-080301 was generally well tolerated. In this early-phase study, antitumor effect for TKM 080301 was limited. Further evaluation as a single agent in large randomized trials is not warranted

Quality of life assessment of cabozantinib in patients with advanced hepatocellular carcinoma in the CELESTIAL trial

BACKGROUND: The CELESTIAL trial (NCT01908426) demonstrated overall survival benefit for cabozantinib versus placebo in patients with advanced hepatocellular carcinoma (aHCC) who had received prior sorafenib treatment. This analysis of CELESTIAL compared the impact of cabozantinib versus placebo on health-related quality of life (HRQoL). MATERIALS AND METHODS: Health status was assessed using the EuroQol five-dimension five-level (EQ-5D-5L) questionnaire over the 800-day follow-up period. EQ-5D-5L health states were mapped to health utility scores using reference values for the UK population. Quality-adjusted life years (QALYs) were calculated for each treatment group as the area under the curve for the plot of health utility score over time. The between-treatment group difference in restricted mean QALYs was calculated by generalized linear models and adjusted for baseline differences. A difference of 0.08 in health utility score (or in QALY) was deemed a minimally important difference and to be clinically significant. RESULTS: At week 5, the difference in mean health utility score between cabozantinib and placebo was -0.097 (95% confidence interval [95% CI]: -0.126, -0.067; p ≤ 0.001). Between-group differences in health utility scores diminished over time and were generally non-significant. The cabozantinib group accrued more QALYs than the placebo group over follow-up. Differences in mean QALYs (cabozantinib minus placebo) were statistically and clinically significant, ranging from +0.092 (95% CI: 0.016, 0.169) to +0.185 (95% CI: 0.126, 0.243) in favour of cabozantinib, depending on the reference value set used. CONCLUSIONS: These HRQoL findings support a positive benefit-risk profile for cabozantinib in previously treated patients with aHCC

Efficacy, safety, and pharmacokinetics of the anti-programmed cell death receptor-1 (PD-1) monoclonal antibody, tislelizumab (BGB-A317) in a phase 2, open-label, multicenter study to investigate in patients with unresectable hepatocellular carcinoma - Trial in progress.

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assessment of disease burden in the phase iii celestial trial of cabozantinib c versus placebo p in advanced hepatocellular carcinoma hcc

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