Towards optimal use of antithrombotic therapy of people with cancer at the end of life: a research protocol for the development and implementation of the SERENITY shared decision support tool Thrombosis Research

Background: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. Methods: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.Results: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. Conclusions: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. There-fore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atri-al fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies pub-lished in English reporting MRPs of DOACs in adult patients with AF were in-cluded. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice

Espécies de Cyperaceae do Centro de Pesquisa e Conservação da Natureza Pró-Mata, município de São Francisco de Paula, RS, Brasil Cyperaceae species of the Centro de Proteção e Conservação da Natureza Pró-Mata, São Francisco de Paula municipality, Rio Grande do Sul State, Brazil

Foi realizado o levantamento florístico das espécies de Cyperaceae do Centro de Pesquisa e Conservação da Natureza PróMata (CPCN Pró-Mata), Rio Grande do Sul. O local de estudo está situado no município de São Francisco de Paula, na região fisiográfica dos Campos de Cima da Serra. Foram efetuadas cinco expedições de coleta e encontradas 42 espécies, distribuídas em oito gêneros. São apresentadas a lista das espécies, chaves de identificação nos níveis genérico e específico e fotomicrografias em Microscopia Eletrônica de Varredura dos aquênios de cada espécie.<br>A floristic survey of Cyperaceae species at the Centro de Proteção e Conservação da Natureza Pró-Mata (CPCN Pró-Mata), Rio Grande do Sul was performed. The study area is located in São Francisco de Paula municipality, in the physiographic region of the Campos de Cima da Serra. In five collecting expeditions, 42 species were found at the study site, distributed on eight genera. A list of the species, analytical keys for genera and species, as well as scanning photomicrographs of the achenes are presented

Atividades de coleta e origem floral do pólen armazenado em colônias de Plebeia saiqui (Holmberg) (Hymenoptera, Apidae, Meliponinae) no sul do Brasil Collection activities and floral origin of the stored pollcn in colonies of Plebeia saiqui (Holmberg) (Hymenoptera, Apidae, Meliponinae) in south Brazil

<abstract language="eng">Four colonies of Plebeia saiqui (Holmberg, 1903), of São Francisco de Paula, were studied during the period from October/1998 to October/1999. The counting of the bees was proceeded monthly, differentiated workers that came back with and without pollen in the corbicula. Grains of pollen of pots previously marked were collected monthly and identified. The percentage of the pollen types of the samples was estimated: 20% of Asteraceae, 17% Myrtaceae, 15% type Meliaceae and 10% Euphorbiaceae. The remaining corresponds to other pollen types of small representation, besides those the were no identified. The climatic influence on the pollen collection was analyzed being used simple and multiple regressions. It was verified that in the spring and in the summer the temperature, the solar irradiation and relative humidity were significant for the pollen foraging. During autumn and winter the relative humidity had smaller influence in the pollen collection