37 research outputs found
Role-Play Preceded by Fieldwork in the Teaching of Pharmacology: from “Raw Sap” to “Elaborated Sap”
Patients’ perceptions of palliative care quality in hospice inpatient care, hospice day care, palliative units in nursing homes, and home care: a cross-sectional study
Effect of increasing rate of insecticides on its selectivity for Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae).
TĂtulo em portuguĂŞs: Efeito do aumento de dose de inseticidas sobre sua seletividade para Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae)
Efficacy and safety of FOLFIRI/Aflibercept (FA) in an elderly population with metastatic colorectal cancer (mCRC) after the failure of an oxaliplatin-based regimen
Introduction: Aflibercept (ziv-aflibercept) significantly improves progression-free (PFS) and overall survival (OS) when added to FOLFIRI, compared with FOLFIRI alone, in the overall population of patients pretreated with oxaliplatin-based therapy. A subset analysis of elderly patients included in the registration VELOUR trial suggested that elderly (> 65 years) patients have a consistent, albeit small benefit in OS in PFS and a higher percentage of grade 3-4 toxicity. Our hypothesis was that selected patients with good PS could benefit from FOLFIRI-aflibercept (FA), provided they underwent careful monitoring of toxicity, and rapid intervention.
Methods: We conducted a retrospective, multicentre, observational study of elderly patients (> 70 years) with mCRC treated with FOLFIRI-aflibercept after progression on an oxaliplatin-based regimen as part of routine clinical practice at seven hospitals from the Galician Research Group on Digestive Tumours (GITuD).
Results: Of 315 patients treated with FA between June 2013 to November 2018, 71 elderly patients were recorded in this study. Median age was 72.7 years (range 70-84 years) and 33.4% were over 75 years (compared with only 14% in the VELOUR study subanalysis), 66.2 % were male, 83.1 % ECOG PS0-1, 43.7 % left-sided location, 76.1 % low grade, 63.4% RASmt and 2.8% BRAFmt, 66.2 % synchronous presentation and 77.5 % primary tumor resection. Prior therapy included bevacizumab (57.7%) and anti-EGFR agents (22.5%). Median of FA cycles was 9 (range 1-35 cycles). Overall Response Rate (ORR) and disease control rate (DCR) were 31.0 % and 63.4 %, respectively. With a median follow up of 27.1 months, median PFS was 6.6 months (95% CI, 5.0-8.3 months) and median OS was 15.1 months (95% CI, 12.1-18.1 months). The most common grade 3-4 toxicities were asthenia (18.3%), neutropenia (15.5%), diarrhoea (11.3%) and mucositis (9.9%). Aflibercept most common grade 3-4 related toxicities were hypertension (5.6%), dysphonia (5.6%), proteinuria (2.8%). Two patients experienced grade 5 toxicity (1 cerebrovascular event and 1 bowel perforation). This toxicity was managed with dose reduction of aflibercept in 39.4 % of cases, dose reduction of FOLFIRI on 57.7% and led to the discontinuation of aflibercept in 39.4%.
Conclusion: Older patients with mCRC are underrepresented in clinical trials. The VELOUR study included only 6.4% patients over 65 years of age and only 14% of those over 65 were 75 years or older. Elderly patients treated with FA in the VELOUR trial experienced a higher rate of G3-4 adverse events (89.3% versus 80.5%) but this increase in toxicity was even more evident in the control arm (67.4% versus 59.4%). Our series confirms that with careful dose adjustment based on toxicity, including dose interruption if necessary elderly patients can be treated with FA with a 49.3% of grade 3-4 toxicity a PFS of 6.6 months and OS of 15.1 months, results that are comparable to those of younger patients
Habituation to the test cage influences amphetamine-induced locomotion and Fos expression and increases FosB/ΔFosB-like immunoreactivity in mice
MC-1 (pyridoxal 5′-phosphate): novel therapeutic applications to reduce ischaemic injury
Veredas do triângulo mineiro: solos, água e uso Veredas of Minas Gerais Triangle: soils, water and use
Sendo as veredas importantes reguladores do equilĂbrio dos cursos d'água da regiĂŁo dos cerrados, objetivou-se caracterizar e comparar solo, água e tipo de uso destes ambientes nas superfĂcies geomĂłrficas Chapadas e Arenito Bauru. Foram coletadas amostras dos solos e da água, das veredas. O uso foi analisado por observações de campo e entrevistas com proprietários rurais. As veredas apresentam solos hidromĂłrficos em toda a sua extensĂŁo, havendo maior homogeneidade no Bauru. Do terço superior em direção ao terço inferior, a drenagem piora, e sĂŁo maiores os teores de argila, matĂ©ria orgânica e fertilidade natural. As veredas do Bauru apresentam melhor drenagem, maior fertilidade, menores teores de matĂ©ria orgânica de argila. A água enquadrou-se na classe 4, principalmente em função da cor, acompanhando variações do teor de matĂ©ria orgânica do solo. Nas veredas da Chapada, o uso da água na agricultura gera risco de contaminação ambiental, enquanto no Bauru, Ă© comum seu represamento para dessedentação do gado. Os solos das veredas do Bauru sĂŁo utilizados com freqĂĽĂŞncia para pastagem nativa, os da Chapada, sĂŁo mantidos sem uso. A cor preta ou cinzenta dos solos Ă© um atributo de fácil identificação no campo para delimitar tais ambientes.<br>Being the veredas (swampy plains between hills and rivers) important regulators of water courses equilibrium at the cerrado region, we aimed to characterize and to compare soils, water and use type of these environments in Chapada and Arenito Bauru geomorphic surfaces. Soil and water samples were collected from the veredas. The use was analysed through field observations and interviews with farmers. The veredas present hydromorphic soils in all their extension, occurring higher homogeneity in Bauru. From the superior to the inferior part, the drainage gets worse, and the clay contents, organic matter and natural fertility increase. The Bauru veredas present better drainage, higher natural fertility, smaller amounts of organic matter and clay.The water was classified as class 4, mainly as a function of color, following variations in the soil organic matter content. At Chapada veredas, the water use in agriculture generates environmental contamination risk, while at the Bauru ones, it is common the water damming up for cattle supplying. The soils of Bauru veredas are frequently used for native pasture, while the Chapada ones are maintained without use. The black or grayish color of the veredas soils is an easily-identifiable field attribute for delimitation of such environments