Management of ibrutinib treatment in patients with B-cell malignancies: clinical practice in Portugal and multidisciplinary recommendations

Objectives: Ibrutinib, a potent inhibitor of the Bruton tyrosine kinase, has revolutionized the treatment of many B-cell malignancies. Ibrutinib has an established favorable toxicity profile with up to 8 years of experience in clinical trials; however, despite ibrutinib’s favorable toxicity profile, dose reductions and treatment discontinuations are becoming more evident in clinical practice, particularly in the setting of specific clinical contexts and patient characteristics. This manuscript is set to provide practical recommendations on the management of patients treated with this agent in daily practice. Methods: A group of multidisciplinary experts from Portugal met to discuss and highlight practical recommendations, supported on both literature and clinical insights, for the management of the treatment with ibrutinib. Results/discussion: Handling of both toxicities and drug–drug interactions during ibrutinib treatment poses several challenges to healthcare providers and can benefit from a multidisciplinary approach. The involvement of specialties, such as cardiology, infectiology and pharmacology, can bring an added value to patient care, not only in anticipating/managing safety issues and dose adjustments but also in enhancing adherence to treatment, ultimately improving the risk/benefit balance. Conclusion: By involving a multidisciplinary group of experts, this work provides a set of key recommendations to optimize care and outcomes for ibrutinib-treated patients. Despite not being a fully comprehensive review on the topic, it is intended as a framework to hematologists and other healthcare professionals who manage these patients in their daily clinical practice.The project received financial support from Janssen for logistics of expert meetings and editorial support. The sponsor had no influence on the opinions expressed here, which are those of the authors

Electrochemical methods to characterize nanomaterial-based transducers for the development of noninvasive glucose sensors

Electrochemical biosensors consist of electrodes modified with nanomaterials that contain immobilized biomolecules for analyte recognition and utilize electrochemical transduction; a glucose meter is an example of such a biosensor. Innovation in glucose monitoring includes non-invasive sensing, where alternative body fluids such as saliva can be used in place of blood, eliminating finger-pricking. However, the concentration of glucose in saliva is twofold lower than in blood, demanding a more sensitive transducer. For a decade, research focused on enhancing the transduction layer by modifying electrodes with nanomaterials that can increase electron transfer, enabling detection of glucose at much lower concentrations. The contribution of these nanomaterials towards enhancement of electron transfer can be understood via electrochemical characterization techniques such as cyclic voltammetry (CV), linear sweep voltammetry (LSV), and electrical impedance spectroscopy (EIS). This chapter provides the basis of the voltammetry techniques and EIS with example graphs from our current research. The aforementioned techniques were performed on screen-printed glassy carbon electrodes modified with reduced graphene–conductive polymer composites, with voltammetry measurements providing CV and LSV and EIS measurements, with EIS resulting in Bode and Nyquist plots and Randles equivalent circuit. Results from our study show a reversible electrode reaction that is diffusion controlled

Impact of Fishmeal Replacement in Diets for Gilthead Sea Bream (Sparus aurata) on the Gastrointestinal Microbiota Determined by Pyrosequencing the 16S rRNA Gene

Recent studies have demonstrated the impact of diet on microbiota composition, but the essential need for the optimization of production rates and costs forces farms and aquaculture production to carry out continuous dietary tests. In order to understand the effect of total fishmeal replacement by vegetable-based feed in the sea bream (Sparus aurata), the microbial composition of the stomach, foregut, midgut and hindgut was analysed using high-throughput 16S rDNA sequencing, also considering parameters of growth, survival and nutrient utilisation indices.A total of 91,539 16S rRNA filtered-sequences were analysed, with an average number of 3661.56 taxonomically assigned, high-quality sequences per sample. The dominant phyla throughout the whole gastrointestinal tract were Actinobacteria, Protebacteria and Firmicutes. A lower diversity in the stomach in comparison to the other intestinal sections was observed. The microbial composition of the Recirculating Aquaculture System was totally different to that of the sea bream gastrointestinal tract. Total fishmeal replacement had an important impact on microbial profiles but not on diversity. Streptococcus (p-value: 0.043) and Photobacterium (p-value: 0.025) were highly represented in fish fed with fishmeal and vegetable-meal diets, respectively. In the stomach samples with the vegetable diet, reads of chloroplasts and mitochondria from vegetable dietary ingredients were rather abundant. Principal Coordinate Analysis showed a clear differentiation between diets in the microbiota present in the gut, supporting the presence of specific bacterial consortia associated with the diet.Although differences in growth and nutritive parameters were not observed, a negative effect of the vegetable diet on the survival rate was determined. Further studies are required to shed more light on the relationship between the immune system and sea bream gastrointestinal tract microbiota and should consider the modulation of the microbiota to improve the survival rate and nutritive efficacy when using plant-based diets