Management of radiation dermatitis in patients receiving cetuximab and radiotherapy for locally advanced squamous cell carcinoma of the head and neck: proposals for a revised grading system and consensus management guidelines

Background: Radiation dermatitis developing in patients receiving cetuximab concomitantly with radiotherapy for locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) is now recognized to have different pathophysiological and clinical characteristics to the radiation dermatitis associated with radiotherapy or concomitant chemotherapy and radiotherapy. Current grading tools were not designed to grade this type of radiation dermatitis; their use may lead to misclassification of reactions and inappropriate management strategies, potentially compromising cancer treatment. Patients and methods: An advisory board of seven leading European specialists (three medical oncologists, three radiation oncologists and a dermatologist) with extensive experience of the use of cetuximab plus radiotherapy produced consensus guidelines for the grading and management of radiation dermatitis in patients receiving cetuximab plus radiotherapy. Results: Modifications to the current, commonly used National Cancer Institute—Common Terminology Criteria for Adverse Events version 4.3 for grading radiation dermatitis were proposed. Updated management guidelines, building on previously published guidelines from 2008, were also proposed. Conclusions: The proposed revisions to the grading system and updated management guidelines described here represent important developments toward the more appropriate grading and effective management of radiation dermatitis in patients receiving cetuximab plus radiotherapy for LA SCCH

BÚSQUEDA DE PRINCIPIOS ACTIVOS ANTIPARASITARIOS EN PLANTAS DE USO TRADICIONAL DE LA AMAZONIA PERUANA. ESPECIAL ENFASIS EN ALCALOIDES INDOLICOS

A fin de evaluar el potencial antimalárico de remedios tradicionales utilizadas en el Perú por las poblaciones indígenas y mestizas del río Nanay en Loreto, fueron entrevistados sobre el uso medicina tradicional para el tratamiento de la malaria. La encuesta se llevó a cabo en seis pueblos y llevaron a la recolección de 59 plantas. 35 extracciones hidro-alcohólico se realizaron en las 21 plantas más citadas. A continuación se ensayaron los extractos para la actividad antiplasmodial in vitro sobre cepa resistente a la cloroquina de Plasmodium falciparum (FCR-3), y también se realizó la prueba de inhibición de ferriprotoporfirina con el fin de asumir propiedades farmacológicas. Los extractos de 9 plantas, en veintiún evaluados, mostraron una actividad antiplasmodial interesante (IC50 <10 µg/ml) y 16 extractos resultaron activos en la prueba de inhibición de la ferriprotoporfirina. Cinco alcaloides oxindólicos y dos alcaloides de tipo plumerano subtipo haplophitina, fueron aislados de plantas medicinales: Aspidosperma rigidum y A. schultesii. Uno de estos compuestos se identificó como un confórmero rotámero transoide de la 18-Oxo-O-metilaspidoalbina que no se describió anteriormente, también fueron determinada la actividad antiparasitaria de los compuestos contra Trypanosoma cruzi y Leishmania infantum

Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 2)

Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists have to deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers a number of specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved.Also, special thanks to Ainhoa Torres and the Merck Health Foundation for funding and promoting the project and development of the Article.Peer Reviewe

Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1)

Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved.Merck Health Foundatio

A Functional Assessment Tool to Distinguish Controls From Alzheimer’s Disease in Lima, Peru

Background The Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale is a versatile functional assessment tool for patients with Alzheimer's disease (AD). We evaluated its performance in controls, Peruvians with MCI or AD. Methods A cross-sectional study of older adults attending a neurology institute in Lima (Peru) with mild cognitive impairment (MCI), ad or cognitively healthy. Test-retest reliability (intraclass correlation coefficient, ICC; internal consistency, Cronbach's alpha) and validity were assessed. Results We enrolled 276 individuals (AD: 113, MCI: 68, controls: 95) with no age, sex, educational level, and depressive symptom differences. Reliability was ideal (ICC: .996), and Cronbach's alpha was adequate (.937). The ADCS-ADL could not differentiate MCI from controls but did differentiate AD severity. The ADCS-ADL correlated highly with nearly all tools. Conclusions The ADCS-ADL scale is reliable in a population with AD in Lima, Peru. Future work may validate a tool for Peruvians with lower educational levels

Bioactive compounds of the genus Senecio from Peruvian Andes

Trabajo presentado en el Congrès International Natural Products and Biocontrol celebrado en Perpignan (Francia) del 24 al 26 de septiembre de 2014.The genus Senecio, is widely distributed throughout the world and consists of approximately 1500 species. This genus is characterized by the presence of pyrrolizidine alkaloids (PAs), sesquiterpenes and diterpenoids. Furthermore, PAs are sequestered by specialist insects for their defense abd chemical communication and are also considered plant defenses against generalist herbivore insects. About 239 species of this genus are present in the Peruvian flora, and several are frequently used in traditional medicine for treatment of diverse diseases.Peer Reviewe