European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment.

AIMS: To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. METHODS AND RESULTS: We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. CONCLUSION: We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes.

Formation and some factors influencing the activity of progesterone hydroxylases by Aspergillus niger.

The formation of progesterone hydroxylases by Aspergillus niger 173 was investigated. The constitution of the fermentation medium influenced both the yield and the type of enzymes catalyzing the transformation of progesterone. The enzyme yield also varied with the pH value at which induction was performed as well as with the buffer used. The transformation activity of progesterone was more pronounced with mycelia induced in citrate-phosphate than in phosphate buffer. The results demonstrated that induction of 6beta-hydroxylase was favoured at pH values near neutrality while that of 11alpha-hydroxylase in the presence of citrate ions. The transformation activity of progesterone was optimal at pH 5.0. The action of 11alpha-hydroxylase was also optimal at pH 5.0, but other hydroxylase showed pH optima between 2.2 and 4.0. Progesterone concentrations higher than 6 mg in 50 ml reaction mixture was a limiting factor for the rate of transformation activity.