The use of chemotherapy regimens carrying a moderate or high risk of febrile neutropenia and the corresponding management of febrile neutropenia: an expert survey in breast cancer and non-Hodgkin's lymphoma

The use of chemotherapy regimens with moderate or high risk of febrile neutropenia (defined as having a FN incidence of 10% or more) and the respective incidence and clinical management of FN in breast cancer and NHL has not been studied in Belgium. The existence of a medical need for G-CSF primary and secondary prophylaxis with these regimens was investigated in a real-life setting.Journal ArticleMulticenter StudyResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Experience with fertilizer expert systems for balanced fertilizer recommendations

To evaluate soil fertility and to calculate fertilizer recommendations for different soil types and crop rotations, two expert systems were developed and are being used in Belgium and the Northern part of France. The BEMEX expert system (BEMEX, coming from BEMEstingsEXpertsysteem, Dutch for fertilization expert system) calculates field specific fertilizer recommendations for macronutrients and liming recommendations for crop rotations with arable crops and vegetable crops and for grasslands. The N-INDEX method is a field specific advice-system for N-fertilizer recommendation for most arable and vegetable crops. The knowledge base of BEMEX as well as of N-INDEX contains empirical and theoretical knowledge, The required information to run the expert systems consists of measurements of the chemical soil fertility on soil samples on the one hand and of information concerning the parcel and the crop on the other hand. The final output of the expert system is a two-to-five page bulletin, with the results of soil analysis and the fertilizer and liming recommendations. This bulletin is sent to the farmer. Additionally, an impressive database with soil fertility data is gathered annually. As a consequence presentation models such as choroplets, pie charts, etc. are useful tools to describe soil fertility on the basis of numerous soil analyses. Both the personalized advice bulletins and the general presentation models are the interface between the expert and the user of the expert system, which is commonly the farmer himself or extension staff members. BEMEX and N-INDEX are useful tools for operational decision support on the subject of liming and fertilization.status: publishe

Preservation of in situ reef framework in regions of low hurricane frequency: Pleistocene of Curaçao and Bonaire, southern Caribbean

Luxuriant fringing reefs along the southwestern shores of the Caribbean islands of Curaçao and Bonaire (12°N), located outside the most frequent hurricane tracks, are rarely affected by major storms. Consequently, reef growth and long‐term preservation are potentially optimal and distinct from reefs experiencing greater hurricane frequency. Hurricane Lenny (November 1999) took an unusual west‐to‐east track, bisecting the Caribbean Basin north of these islands, but generated heavy waves (3‐6 m) that severely damaged reefs along the normally leeward shores. Massive coral colonies \u3e100 years old were toppled, but even at the most severely damaged sites, 82–85% of colonies remained in growth position. Late Pleistocene (125 ka) elevated reefs in the Lower Terrace of Curaçao record even higher proportions of corals in growth position (93%), possibly reflecting a low hurricane frequency during the Pleistocene highstand. In comparison, coeval Pleistocene reefs in regions that today experience a high hurricane frequency (Great Inagua Island and San Salvador, Bahamas) have lower proportions of corals preserved in growth position (79% and 38%, respectively). These results are consistent with the hypothesis that reefs in regions experiencing very low hurricane frequency, like the southern Caribbean, are more likely to be preserved with corals in primary growth position in comparison to regions with higher hurricane frequency

Application of humic substances results in consistent increases in crop yield and nutrient uptake

The effect of humic substances on yield and nutrient uptake of grass, maize, potato and spinach was investigated in six field experiments and two pot experiments in a high input cropping system. The humic substances originating from leonardite formations in Canada were applied as liquid solution to the soil (Humifirst liquid) or as a solid incorporated in mineral fertilizers (Humifirst incorporated). Formal meta-analysis of the results of all executed experiments showed that the application of humic substances had an overall positive effect on dry matter yield of the crops and this effect was statistically significant for Humifirst incorporated. In the case of permanent grassland, humic substances promoted mainly the production of the first grass cut, which has the highest grass quality among all cuts during the growing season. Tuber production on the potato field trial showed a high response on the application of humic substances. Total potato yield increased with 13 and 17% for Humifirst liquid and Humifirst incorporated, respectively. The effect of humic substances on maize yield was limited, probably due to the rather high nutrient status of both soils. Finally, the formal meta-analysis showed a consequent increase in nitrogen and phosphorus uptake of all studied crops as well. The effect on potassium and magnesium uptake was also mainly positive, while sodium and calcium uptake were not affected in most of the experiments

High prevalence of anaemia and limited use of therapy in cancer patients : a Belgian survey (Anaemia Day 2008)

Objectives: The aim of this study is to provide relevant and accurate information on prevalence and treatment patterns of anaemia in Belgian cancer patients. Methods The Anaemia Day 2008 survey was a single visit, multi-centre, non-interventional study in adult cancer patients under systemic therapy (chemotherapy, hormonal, immunological and/or targeted therapy) and/or radiotherapy. Efforts were made to enrol the maximum number of patients seen in each centre that day. Patients signed an informed consent and relevant data were collected from their files, i.e. disease and disease stage, cancer therapy and anti-anaemic treatment, including transfusions and the use of erythropoietin stimulating agents (ESA). A blood count of each included patient was performed. Haemoglobin (Hb) values (grams per decilitre) were classified into four categories to assess the severity of anaemia, as defined byWHO: no anaemia: Hb≥12 g/dL; mild 10≤Hb≤11.9 g/dL; moderate 8≤Hb≤9.9 g/dL; severe Hb< 8 g/dL. Univariate and multivariate analyses were carried out with anaemia as the dependent variable. Results A total of 1,403 eligible patients aged 63±13 years (mean age±SD) were enrolled in 106 oncology or haematology centres. The mean Hb level (±SD) was 11.6 g/dL (±1.8 g/dL) and the prevalence of anaemia (Hb<12 g/dL) was 55.7% (95% CI, 53.1–58.3%), respectively, 35.9% mild, 17.8% moderate and 2.1% severe anaemia. Anaemia was more frequent in females than in males, and in patients with haematological malignancies (73.4%) than in those with solid tumours (51.4%; p<0.001). Anaemia prevalence was higher in hospitalised patients (75.5%) compared to those seen in one-day-clinic (54.3%) or in consultation (33.9%; p<0.001), and in patients treated with chemotherapy (61.3%) compared to those receiving radiotherapy (34.4%) or hormonal therapy (19.5%; p<0.001). There was a clear correlation between severity of anaemia and WHO performance status (p< 0.001). Among anaemic patients, 53.1% received no treatment (mean Hb 10.8±0.9 g/dL). Among the anaemic patients who received therapy for their anaemia (mean Hb 9.7±1.1 g/dL), the most frequent treatments were RBC transfusions (42%), ESA (34.6%), transfusions+ESA (12%), ESA+iron (7.9%) and iron alone (3.5%). Comparison to the ECAS survey shows that there has been no major change in attitude towards anaemia management in the last decade. Conclusion This survey shows that cancer-related anaemia is still frequently observed in cancer patients. Even if in our study ESA were used more frequently than about 10 years ago, still a large amount of anaemic patients who could be treated for anaemia according to EORTC guidelines, were not