Genetic factors associated with intestinal metaplasia in a high risk Singapore-Chinese population: a cohort study

BMC Gastroenterology97

Efficacy and safety of pemetrexed and nedaplatin followed by pemetrexed maintenance therapy in advanced lung adenocarcinoma

Zhong Lin,1,* Wei-Ze Lv,1,* Si-Yang Wang,2 Jin-Lin Zou,3 Yun-Yan Con,1 Zhi-Hui Wang,1 Mei Xiao,1 Pei-Jian Peng1 1Department of Medical Oncology, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhuhai, Guangdong, People’s Republic of China; 2Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhuhai, Guangdong, People’s Republic of China; 3Department of Surgical Oncology, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhuhai, Guangdong, People’s Republic of China *These authors contributed equally to this work Objective: To evaluate the efficacy and safety of pemetrexed and nedaplatin followed by pemetrexed maintenance therapy in advanced lung adenocarcinoma.Methods: A total of 53 advanced lung adenocarcinoma patients hospitalized between July 2013 and June 2016 with a performance status ≤2 were enrolled in this study. All patients received 4–6 cycles of combination chemotherapy comprising pemetrexed (500 mg/m2 dL) and nedaplatin (80 mg/m2 dL). Each chemotherapy cycle consisted of 21 days. After the efficacy of the combination chemotherapy was assessed, patients with stable disease, partial remission, or complete remission received pemetrexed maintenance therapy (500 mg/m2 dL) until disease progression or intolerable side effects occurred. Each pemetrexed maintenance therapy cycle was 28 days.Results: After completion of the pemetrexed and nedaplatin combination chemotherapy, 26 (49.1%), 15 (28.3%), and 12 (22.6%) patients exhibited partial remission, stable disease, and progressive disease, respectively. Complete remission was not achieved in any patient. Therefore, the response and disease control percentages were 49.1% and 77.4%, respectively. A total of 38 patients were further administered pemetrexed maintenance chemotherapy for an average of 9.8 cycles. The median progression-free survival and overall survival of the 38 patients receiving the pemetrexed maintenance therapy were 9.3 (95% confidence interval: 8.6–10) months and 16.3 (95% confidence interval: 14.5–18.2) months, respectively. The major adverse effects included bone marrow suppression and gastrointestinal reactions, which were well tolerated.Conclusions: Combination chemotherapy based on pemetrexed and nedaplatin is effective for the treatment of advanced lung adenocarcinoma with a high tolerance by patients. In addition, pemetrexed maintenance therapy of advanced lung adenocarcinoma is safe and effective for the treatment of advanced lung adenocarcinoma following pemetrexed and nedaplatin combination chemotherapy. Keywords: lung adenocarcinoma, pemetrexed, nedaplatin, maintenance therap

Vitimização por violência urbana em uma cidade de médio porte do sul do Brasil Urban violence victimization in a medium size town in south Brazil

A violência urbana afeta a vida dos indivíduos, tornando-se um problema complexo de saúde e segurança pública. Buscando avaliar a situação de violência em uma cidade de médio porte, realizou-se um estudo transversal, de base populacional, investigando a prevalência de vitimização por violência urbana para furtos, roubos, agressões e furto/roubo à residência nos últimos cinco anos e 12 meses; e o perfil das vítimas e a prevalência de notificação à polícia. Foi construído um escore a fim de medir a vitimização por pelo menos um dos tipos de violência em cada período. Na análise bruta, a associação entre a vitimização por cada tipo de violência e as variáveis independentes foi investigada através do teste de Wald para heterogeneidade e para tendência linear, quando aplicável. A Regressão de Poisson foi utilizada na análise multivariável. Foram entrevistados 2.912 indivíduos (idade > 20 anos), sendo que 16,6% destes sofreram violência no último ano e 28% nos últimos cinco anos. As maiores prevalências de vitimização foram de furto/roubo à residência (9,7%) e furto (6,0%). As principais vítimas de violência urbana foram homens e jovens. Mais da metade dos vitimizados não notificou a ocorrência por não confiar na polícia. Os achados confirmam a importância de pesquisas de vitimização além das metrópoles. As discussões sobre o tema mostram a necessidade de incrementar, executar ou criar políticas públicas de segurança e saúde em distintos contextos nacionais, sem desconsiderar cidades do interior.<br>Urban violence affects individuals' lives, and therefore it is a complex problem of public health and security. To evaluate the occurrence of violence in a medium size city, a population-based cross-sectional study was carried out to investigate: prevalence of urban violence victimization (theft, robbery, aggression, and burglary) in the period of five years and twelve months before the interview; victims' profile and prevalence of crime reporting. A score was constructed to measure global urban violence victimization, which means at least one type of violence in each period. The Wald test for heterogeneity and linear trend was used in crude analysis, to measure violence victimization and independent variables. Poisson Regression was used in multivariate analysis. The sample included 2.912 individuals (> 20 years of age) and 16.6% of them had experienced urban violence in the past year and 28.0% in the past five years. Prevalence of burglary was 9.7% and theft 6.0% in the past year. Most urban violence victims were men and youth. More than half of the victims had not reported the crime, and the reason for that was distrust in the police. These findings sustain the importance of victimization surveys in smaller cities. The debate about urban violence should include the need to develop, execute or create health and security policies in different contexts, without comprising countryside

Regenerating the Socio-Ecological Quality of Urban Streams : The Potential of a Social Learning Approach

The degradation of urban streams is a pressing problem in many cities around the world. Particularly in the so-called Global South, this degradation is associated with factors such as poverty, unplanned settlements, social exclusion, lack of basic sanitation infrastructure, poor management of water resources and inefficiencies in environmental governance systems. Responses to this urban challenge involve the participation of diverse stakeholders in a complex process of dialogue and learning that must deal with the multifaceted ecological and social issues affecting urban water systems and populations inhabiting their surroundings. In this context, social learning is considered a relevant approach to inform collective action towards the sustainability of these socio-ecological systems. The goal of this chapter is to identify potentialities and challenges in utilising a social learning approach to facilitate dialogue between a range of stakeholders involved in the restoration of an urban stream in a context of socio-ecological vulnerability. Our analysis is built on a representative case from urban Brazil: the Taquara Stream, in the city of Porto Alegre. This case involves a community-based initiative enacted by a group of citizens who are collectively seeking solutions to regenerate the socio-ecological quality of this local stream and watershed