First-line bevacizumab and capecitabine-oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study.

BACKGROUND: Subgroup analyses of clinical studies suggest that bevacizumab plus XELOX is effective and tolerable in elderly patients with metastatic colorectal cancer (mCRC). The prospective BECOX study examined the efficacy and safety of bevacizumab plus XELOX, followed by bevacizumab plus capecitabine in elderly patients with mCRC. METHODS: Patients aged ⩾70 years with Eastern Cooperative Oncology Group performance status 0 out of 1 and confirmed mCRC were included. Patients received bevacizumab 7.5 mg kg(-1) and oxaliplatin 130 mg m(-2) on day 1, plus capecitabine 1000 mg m(-2) bid orally on days 1-14 every 21 days; oxaliplatin was discontinued after 6 cycles. The primary end point was time to progression (TTP). RESULTS: The intent-to-treat population comprised 68 patients (65% male, median age 76 years). Median TTP was 11.1 months; median overall survival was 20.4 months; overall response rate was 46%. Grade 3 or 4 adverse events included diarrhoea (18%) and asthenia (16%). Grade 3 or 4 adverse events of special interest for bevacizumab included deep-vein thrombosis (6%) and pulmonary embolism (4%). CONCLUSIONS: Bevacizumab plus XELOX was effective and well tolerated in elderly patients in the BECOX study. The adverse-event profile was similar to previous reports; no new safety concerns were identified. Fit elderly patients with mCRC should be considered for treatment with bevacizumab plus XELOX.

Comparison and applicability of molecular classifications for gastric cancer.

Gastric Cancer (GC) is a complex and heterogeneous disease, which represents a global health concern. Despite advances in prevention, diagnosis, and therapy, GC is still a leading cause of cancer-related death. Over the last decade, several clinical trials have tested novel agents for advanced GC with mostly disappointing results. Heterogeneity, the absence of molecular selection in clinical trials and powerless predictive biomarkers may be potential explanations. Different molecular classification proposals for GC based on the genetic, epigenetic, and molecular signatures have been published. Molecular characterization of GC may offer new tools for more effective therapeutic strategies, such as the development of therapies for specifically well-defined sets of patients as well as the use of new clinical trial designs, which will ultimately lead to an improvement of medical management of this disease. However, the possibilities of implementation of GC molecular classifications on daily practice and their therapeutic implications remain challenging to date. In this review, we will describe and compare these GC molecular classifications, focusing on their main characteristics as the basis for their potential therapeutic implications and strategies for their clinical application. Key Message: A better understanding of gastric cancer molecular characteristics may lead to further improvements in treatment and outcomes for patients with the disease.

Optical absorption and fluorescence spectroscopy studies of ground state melanin-cationic porphyrins complexes.

Optical absorption and fluorescence spectroscopies were employed in the study of the interaction between synthetic L-dopa (dihydroxyphenylalanine) melanin and the cationic porphyrins tetrakis(4-N-methylpyridyl) porphyrin (TMPyP), tetrakis(4-N-benzylpyridyl)porphyrin (TBzPyP), zinc tetrakis(4-N-methylpyridyl)porphyrin (ZnTMPyP) and zinc tetrakis (4-N-benzylpyridyl)porphyrin (ZnTBzPyP). Optical absorption and fluorescence properties of the porphyrins were dependent on the symmetry of the central ring. No evidence was found for dimerization of the porphyrins in phosphate buffer, pH 7, in the concentration range between 4 x 10(-8) to 5 x 10(-5) M. Addition of L-dopa melanin red shifted the optical absorption spectra of porphyrins, concomitant to broadening and reduction in intensity of the bands. L-Dopa melanin also strongly quenched the fluorescence of the porphyrins. Time resolution of the fluorescence decay of porphyrins showed at least two lifetimes that were only slightly modified in the presence of melanin. The interaction between melanin and porphyrin resulted in the formation of non-fluorescent ground state complexes. It was found that there are two different classes of binding sites in melanin for complexation with cationic porphyrins and the values of dissociation constants are of the order of 10(-8) M. These values and the number of binding sites are dependent on the nature of the porphyrins. It was shown that the binding has electrostatic origin, but it is also affected by metal coordination and hydrophobic interaction.

[Alberprosenia malheiroi Serra, Atzingen & Serra, 1987 (Hemiptera, Reduviidae). Redescription and bionomics]. / Alberprosenia malheiroi Serra, Atzingen & Serra, 1987 (Hemiptera, Reduviidae). Redescrição e bionomia.

Alberprosenia malheiroi n. sp. first became known through an informal publication of a paper submitted a Congress, in 1980. The same diagnosis with a photograph was published in 1987, but no formal description has yet been made. The present authors describe adults and immature instars, establish a sintypical series and introduce bionomic data and data on the rearing of this species in insectary. The most evident differences between A. malheiroi n. sp. and A. goyovargasi, the former generic species, are the general colour pattern which is completely black; the interocular area, wider than an eye in dorsal view; the acute apex in collar tubercules and the significantly larger size, almost double that of the latter specie. The eggs are small attach themselves to the substratum in groups of either 3 or 4, are elipsoid with no lateral flattening, having a convex and prominent operculum, without conspicuous structures. Nymphs have the typical tribal and generic characteristics in each stage, the anteocular region being shorter than the postocular one. Pilosity appears in the second instar and becomes more evident with instar development. A. malheiroi n. sp. was captured in a forest, in wild (palm-tree) ecotopes associated with bats or birds, in the State of Para, Brazil. Trypanosoma cruzi was not found in any specimens. These triatomines were reared in +/- 25 degrees C and +/- 60% RH, the insects are quick and fly without difficulty. They fed well on pigeons and bats but not on rats, mice or hamsters. The eggs incubation period was thirteen days on average, and the evolution time of the nymphal period was a hundred and thirty two days on average.

[Prurigo strophulus (concept, interpretation, therapeutic approach, prevention and clinical studies)]. / Prurigo estrófulo (estudo clínico, conceituação, interpretação, conduta terapêutica e profilaxia).

The authors in this work analyse the Prurigo Strophulus in detail, starting with its clinical study up to its therapy and prophylaxis, emphasizing two main points. It is a hypersensitivity syndrome to insects appearing in genetically predisposed individuals, partly belonging to the hyperreactive group. As to etiology, they believe it to be a sensitization to insect bites, chiefly due to diptera such as blood-sucking mosquitoes, flies and sometimes ticks and bugs.

Use of a balloon and N-butyl-2-cyanoacrylate for treatment of arteriovenous fistula.

We report a patient who developed a large arteriovenous fistula in right lower extremity after gunshot injury. Because other endovascular methods failed, the patient was successfully treated with concomitant use of detachable latex balloon and N-butyl-2-cyanoacrylate (NBCA). The combination of detachable balloon and NBCA can be effectively used for endovascular treatment of peripheral arteriovenous fistulas in selected cases when effective embolization could not be achieved with other embolizing agents or their various combinations.

Semen quality in a population of volunteers from the province of Barcelona.

A prospective study was carried out on 1005 male volunteers residing in the province of Barcelona. Participants were asked to complete a questionnaire concerning their health status and lifestyle, and provided a semen sample for analysis. Sperm concentration and percentages of motile, and normal forms were evaluated. The effect of smoking, alcohol consumption, stress and previous disease on semen parameters was also evaluated. Normal parameters were found in 22% of volunteers and sperm counts and/or percentage motility below normal threshold values were found in 78%. Asthenozoospermia detected in 62% and oligozoospermia in 17% of volunteers. No statistically significant association was found between semen quality and age, with the exception of a decrease in semen volume (P = 0.04) and progressive motility (P = 0.01). No statistically significant differences in semen parameters were found between smokers and non-smokers or between males who consumed alcohol versus those that did not. However, stress had a negative effect on sperm concentration. In conclusion, the prevalence of normal semen parameters in the study population evaluated was markedly lower than that reported for the general population (60-70%). Since sperm concentration did not appear to decrease with age, the decrease observed in the last decades may be related to exposure to environmental toxicants during the fetal period, as previously suggested.

Intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm: superselective arteriographic embolization via the collateral route.

We present a patient with intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm despite bilateral hypogastric artery ligation who was successfully treated by an endovascular approach via the collateral route. Although there is a good argument for postponing surgery until transcatheter embolization has been attempted, this case shows that embolization can still be successful even if the iliac vessels have been ligated.

Delivery of a healthy baby following the transfer of embryos cryopreserved for 13 years.

Although embryos can theoretically be frozen for an unlimited period of time, there is still uncertainty about how long embryos can be cryopreserved without compromising pregnancy outcome. Following transfer of fresh embryos obtained after IVF, surplus embryos are usually frozen for personal use in later treatments. A 40-year-old woman was admitted to the centre's embryo adoption programme. She had a 7-year-old son, was diagnosed with ovarian factor infertility and her husband had secretory azoospermia. They underwent two cycles of IVF with donor spermatozoa and one cycle of donor intrauterine insemination that ended in spontaneous abortion. At this point, the couple was admitted to the embryo adoption programme. Six frozen embryos, obtained from a couple that had had a pregnancy through IVF at the centre and that had abandoned their surplus frozen embryos, were assigned to this patient. All six embryos were cryopreserved for 13 years. Of these, three were transferred and the patient became pregnant and delivered a healthy boy. Thanks to the embryo adoption programme, these embryos, rather than being left frozen for an indefinite period of time, were transferred to a couple that was willing to adopt them, resulting in the birth of a healthy newborn.

Análisis de la gestión integral de residuos sólidos en la zona sur del Área Metropolitana del valle del Aburrá (2004) / Analysis of the integrated management of solid residues in the south zone of Medellín Metropolitan Area in 2004

Objetivo: analizar la gestión integral de residuos sólidos en la zona sur del área metropolitana del valle del Aburrá durante el año 2004. Metodología: se realizó un estudio descriptivo en que se observaron las condiciones socioeconómicas, técnicas, ambientales e institucionales relacionadas con el manejo de los residuos sólidos municipales en sus diferentes etapas. Resultados: al examinar la información se evidenció que la prestación del servicio público de aseo se ha orientado principalmente hacia la recolección y transporte hasta el sitio de disposición final, restándole importancia a las demás fases previstas dentro de la gestión integral de residuos. Por medio de un diagnóstico se hallaron las deficiencias y necesidades que sirvieron de base para el estudio de las alternativas de solución y elaboración de estrategias, lo que facilitó la propuesta de programas y proyectos encaminados al mejoramiento de la administración de los residuos desde la generación hasta la disposición final. Conclusión: se pudo verificar la prioridad de implementar campañas permanentes de sensibilización y educación para el logro de un cambio de actitud de los actores que intervienen en el manejo de los residuos municipales; además, se proponen estrategias de solución, con el fin de que se apropien de la problemática local y de que participen en el mejoramiento continuo de dicha gestión.