Radium-223 in combination with paclitaxel in cancer patients with bone metastases : safety results from an open-label, multicenter phase Ib study

Purpose Concomitant treatment with radium-223 and paclitaxel is a potential option for cancer patients with bone metastases; however, myelosuppression risk during coadministration is unknown. This phase Ib study in cancer patients with bone metastases evaluated the safety of radium-223 and paclitaxel. Methods Eligible patients had solid tumor malignancies with >= 2 bone metastases and were candidates for paclitaxel. Treatment included seven paclitaxel cycles (90 mg/m(2) per week intravenously per local standard of care; 3 weeks on/1 week off) plus six radium-223 cycles (55 kBq/kg intravenously; one injection every 4 weeks, starting at paclitaxel cycle 2). The primary end point was percentage of patients with grade 3/4 neutropenia or thrombocytopenia during coadministration of radium-223 and paclitaxel (cycles 2, 3) versus paclitaxel alone (cycle 1). Results Of 22 enrolled patients, 15 were treated (safety population), with 7 completing all six radium-223 cycles. Treated patients had primary cancers of breast (n = 7), prostate (n = 4), bladder (n = 1), non-small cell lung (n = 1), myxofibrosarcoma (n = 1), and neuroendocrine (n = 1). No patients discontinued treatment from toxicity of the combination. In the 13 patients who completed cycle 3, the rates of grade 3 neutropenia in cycles 2 and 3 were 31% and 8%, respectively, versus 23% in cycle 1; there were no cases of grade 4 neutropenia or grade 3/4 thrombocytopenia. Breast cancer subgroup safety results were similar to the overall safety population. Conclusion Radium-223 was tolerated when combined with weekly paclitaxel, with no clinically relevant additive toxicities. This combination should be explored further in patients with bone metastases.Peer reviewe

Communication: Transient Anion States Of Phenol…(h₂o)n (n = 1, 2) Complexes: Search For Microsolvation Signatures.

We report on the shape resonance spectra of phenol-water clusters, as obtained from elastic electron scattering calculations. Our results, along with virtual orbital analysis, indicate that the well-known indirect mechanism for hydrogen elimination in the gas phase is significantly impacted on by microsolvation, due to the competition between vibronic couplings on the solute and solvent molecules. This fact suggests how relevant the solvation effects could be for the electron-driven damage of biomolecules and the biomass delignification [E. M. de Oliveira et al., Phys. Rev. A 86, 020701(R) (2012)]. We also discuss microsolvation signatures in the differential cross sections that could help to identify the solvated complexes and access the composition of gaseous admixtures of these species.14105110

Relato do acompanhamento farmacoterapêutico de um paciente Hipertenso, Diabético e Lipêmico atendido em um centro de saúde / Report of the pharmacotherapeutic monitoring of a hypertensive, diabetic and lipemic patient attended at a health center

A Hipertensão Arterial e o Diabetes Mellitus são responsáveis pela elevação na taxa de morbimortalidade da população mundial. O Ministério da Saúde estabeleceu diretrizes que priorizam a vinculação do paciente às unidades de saúde para tratamento e monitoramento dessas doenças através do Acompanhamento Farmacoterapêutico, em que propõem-se garantir a adesão a terapia farmacológica de forma efetiva e segura. O presente estudo de caso clínico teve como objetivo realizar o acompanhamento farmacoterapêutico de um paciente hipertenso, diabético e lipêmico em um centro de saúde.  Para execução da pesquisa o indivíduo assinou o TCLE e foi submetido ao procedimento para coleta de dados através de uma entrevista organizada pelos autores do estudo. Dessa forma foi possível avaliar o caso clínico do paciente, estabelecer intervenções farmacêuticas através da elaboração de um plano posológico, fornecer instruções quanto ao estado de saúde e encaminhá-lo ao endocrinologista. Assim, foi obtido uma redução nos valores pressóricos e glicêmicos do indivíduo para 115/75 mmHg e 105 mg/dL, respectivamente. Portanto, o Acompanhamento Farmacoterapêutico permitiu a realização de educação em saúde, resolução de problemas relacionados à farmacoterapia e o alcance dos objetivos terapêuticos, trazendo benefícios diretos à qualidade de vida do paciente

Prevalence of cardiovascular risk factors among truck drivers in the South of Brazil

Abstract\ud \ud Background\ud Truck drivers work under conditions that predispose them to a high prevalence of risk factors for the development of cardiovascular disease (CVD); however, these factors have not been fully evaluated and are not usually considered to be within the scope of health or labor services.\ud \ud \ud Methods\ud An observational cross-sectional study was conducted on 250 long-distance truck drivers; the drivers were all male and were aged 18-60 years. The clinical evaluation consisted of an assessment of social habits and demographic data and an evaluation of risk factors for CVD at 3 time points separated by a one-week interval. To assess the associations with risk factors were used univariate and multivariate analysis. The suitability of the final model fit was assessed via the Hosmer-Lemeshow test. The significance level was set at 5%.\ud \ud \ud Results\ud Among all of the subjects, the prevalence of physical inactivity was 72.8%; consumption of alcoholic beverages, 66.8%; routine use of some type of stimulant during work activities, 19.2%; and smoking, 29%. Only 20.8% had a healthy weight, and 58.2% had an abdominal circumference greater than 102 cm. A diagnosis of arterial hypertension was confirmed in 45.2%, and abnormal glucose levels were detected in 16.4%. Although some of the truck drivers were aware of these conditions, most were not taking specific medications. The logistic regression analysis shows that the odds of hypertension and abnormal glucose levels were increased in truck drivers with abdominal obesity. Age and the family history of premature CVD also increased the chances of hypertension and the abnormal blood glucose levels were related to II or III grade obesity.\ud \ud \ud Conclusion\ud Long-distance truck drivers showed a high prevalence of a cluster of cardiovascular risk factors; these risk factors make the drivers highly susceptible to the development of CVD. The associated risk factors, low compliance with drug treatment, and unique features of this profession suggest that traditional precautions are not sufficient to change this scenario.We acknowledge FAPESP and CNPq for providing grants to Fernanda M\ud Consolim-Colombo. We also thank the Agraria Cooperative by providing\ud room for evaluation of truck drivers