Changes in in vitro ruminal and post-ruminal degradation of tropical tannin-rich legumes due to varying levels of polyethylene glycol.

We evaluated the effects of tannins from Flemingia macrophylla (CIAT 17403) and Calliandra calothyrsus (San Ramón CIAT 22310 and Patulul CIAT 22316) on in vitro ruminal and post-ruminal dry matter and apparent protein degradation. For each tannin source (legumes), different dosages of polyethylene glycol (PEG) (8000 Da) in McDougall buffer were added to achieve ratios of 0:3, 1:3, 2:3 and 3:3 PEG:condensed tannin (CT). Ruminal fluid mixed with McDougall buffer (1:4) was added to tubes containing only legume foliage (control) or PEG-treated legume foliage. For both Calliandra varieties, a higher ruminal dry matter degradation was observed at a PEG:CT ratio of 3:3. For F. macrophylla, no differences were found between 2:3 and 3:3 ratios (p > 0.05), indicating that a PEG:CT ratio of 2:3 might be enough to bind tannins. Increasing PEG:CT ratios increased apparent ruminal degraded protein and ammonia concentration (p < 0.0001) differing among species (species × ratio: p < 0.0001). The degradation of bypass crude protein (dBCP) was influenced by both legume type and PEG:CT ratio (p < 0.0001). For Patulul, as PEG:CT ratio increased, dBCP increased, but after tannin ratio of 2:3, there was not a significant increase, and for San Ramón, dBCP degradation was higher as PEG:CT ratio increased up to 2:3. For Flemingia, dBCP was higher than PEG:CT ratio of 0:3 but not different among 1:3, 2:3 or 3:3. Low concentration of CT (116 mg/g DM) increased the proportion of protein digested in the abomasum, but higher levels of CT (252 mg/g) clearly reduced the proportion of digested CP. For Flemingia, PEG:CT ratio of 2:3 is enough to inactivate tannins, while PEG:CT ratio of 3:3 was needed for Calliandra and consequently increased ruminal degradation of dry mater (rdDM), and crude protein (rdCP), total degradation of dry matter (tdDM), crude protein (tdCP) and ammonia levels.

Efecto del recunnto de células somáticas sobre a aptitud quesera de la leche yy la calidad fisicoquímica y sensorial del queso campesino / Somaticcell counnt effect on cheese yield and quality of fresh cheese

Antecedentes: en Colombia, el alto recuento de células somáticas (RCS) en la leche es un problema para la industria lechera. Altos recuentos pueden afectar de manera considerable los rendimientos y calidad final del queso. Varios países han establecido límites máximos estandarizados para el RCS. Colombia no lo ha hecho de manera oficial y tan solo unas pocas industrias manejan sus propios límites. Objetivos: Determinar el efecto del RCS sobre parámetros de aptitud quesera de la leche y la calidad sensorial del queso campesino. Métodos: Se tomaron muestras de leche de seis tanques con altos y bajos RCS y se realizaron mezclas para obtener 30 baches con diferentes RCS (desde 150.000 hasta 1.200.000 cel/ml). Con estas mezclas se elaboraron 30 quesos tipo campesino a los cuales se les determinaron variables de aptitud quesera (tiempo de coagulación, rendimientos y pérdidas en suero) y la calidad organoléptica a través de una prueba sensorial descriptiva de puntajes con panel de seis jueces con experiencia previa y entrenados en queso campesino. Las variables de aptitud quesera fueron analizadas por regresión múltiple y los resultados de la evaluación sensorial con la prueba no paramétrica de Friedman. Resultados: La aptitud quesera disminuyó con RCS superiores a 200.000 cel/ml. El tiempo de coagulación (R² = 0.74; P< 0.001) y las pérdidas de proteína en el lactosuero (R² = 0.55; P<0,001) aumentaron, mientras que los rendimientos (R²=0.31; P<0.01) disminuyeron a medida que aumentó el RCS. La calificación de los panelistas respecto de la textura y la apariencia disminuyó con RCS mayores a 600.000 cel/ml (P<0.01) y el sabor y el aroma, a partir de 800.000 cel/ml (P<0,01). Conclusiones: Aumentos en el RCS en leche afectan negativamente parámetros de aptitud quesera y la calidad sensorial del queso campesino. Se sugiere que los impactos serán menores sobre el rendimiento cuanto menor sea el RCS, mientras que la calidad organoléptica mejorará cuando la leche tenga RCS por debajo de 600.000 cel/ml.

Background: A high milk somatic cell count (SCC) is a problem for milk industry in Colombia. These high counts can affect considerably yield and final quality of cheese. Several countries have established maximum limits for SCC. In Colombia these limits have not been established officially, only a few industries have their own limits. Objectives: To determine the effect of somatic cell count (SCC) on milk potential for cheese making and sensorial quality of fresh cheese. Methods: Six milk samples with high and low SCC, were taken from bulk tanks and mixed to obtain 30 samples with SCC of 150.000 to 1.200.000 somatic cells/mL. Thirty fresh cheeses were prepared and clotting time, yield (protein, fat, dry matter) and whey losses were determined. Additionally, score descriptive sensorial quality test was performed by 6 trained judges. Protein, fat, dry matter in milk and cheese yields were analyzed by multiple regressions and information of sensorial test by Friedman method. Results: When milk SCC (somatic cells/ml) increased from 150.000 to 1.200.000, clotting time (R² = 0,74; P<0.001), and whey protein losses increased (R² = 0.55; P<0.001) and cheese yield decreased (R²=0.31, P<0.01). According to panelists, texture and appearance were affected negatively when SCC was higher than 600.000 cells per ml (P<0.01), flavor and aroma when they were higher than 800000 cells/ml. Conclusions: Increases in SCC have a negative effect on milk potential for cheese making and quality sensorial parameters on fresh cheese. It is suggested that minor impacts in fresh cheese yield would be obtained with a lower SCC and for good sensorial quality when the milk has SCC, lower than 600.000 cells per ml.

Dolor como factor predictor de depresión en el paciente oncológico: estudio de casos y controles. Estudio D-PRESS / Pain as predictor of depression in cancer patients: case-control study. Studio D-PRESS

Objetivos: Valorar la correlación entre dolor oncológico y depresión, determinar la prevalencia de depresión en los grupos de casos y controles, y conocer qué factores de la historia clínica del paciente podrían estar potencialmente asociados a la depresión. Métodos: Estudio observacional, retrospectivo, y multicéntrico. Se recogió información de la historia clínica de pacientes, de al menos 3 meses anteriores al inicio del estudio, de edad ≥ 18 años, que padecían dolor tras el diagnóstico oncológico (EVA ≥ 3) y que cumplimentaron el inventario de depresión de Beck (IDB). Los pacientes se clasificaron como casos y controles en base a la puntuación IDB (≥ 8 y ≤ 7, respectivamente). Resultados: Se incluyó un total de 248 pacientes con una media de edad de 59,0 ± 12,4 años. La media del IDB para el grupo de casos fue 13,1 ± 4,9, y para el grupo control 3,8 ± 2,1. El tiempo medio de supervivencia de los pacientes fue mayor en el grupo control (20,0 meses) en comparación con el grupo caso (12 meses; p = 0,0032). En líneas generales, la puntuación del IDB se correlacionó significativamente con la intensidad del dolor en las últimas 24 horas (0,215; p = 0,0007) y con el número de horas de dolor durante las últimas 24 horas (0,170; p = 0,0073). Presentar un estadio tumoral más avanzado fue uno de los factores que aumentó el riesgo de padecer depresión (p = 0,0113). El análisis multivariante demostró el carácter predictivo del cáncer digestivo (p = 0,0454) y del estadio tumoral T (T2 vs T4; p = 0,0039, y T3 vs T4; p = 0,0012) como factores de riesgo de padecer depresión. Conclusiones: De acuerdo a otros estudios previos, existe una clara correlación entre la intensidad de dolor y el estado psicológico del paciente. El potencial predictivo de ciertos factores clínicos (estadío tumoral y ciertos tipos tumorales) posibilita la identificación de pacientes oncológicos en riesgo de padecer depresión (AU)

Objectives: To evaluate the relationship between cancer pain and depression, to determine the prevalence of depression in both groups the cases and controls and also to evaluate which factors from the medical records can be potentially associated with depression. Methods: Observational, retrospective and multi-centre study. Patients were ≥18 years old, had medical data ≥ 3 months, experienced pain after cancer diagnosis (VAS ≥ 3) and completed the Beck Depression Inventory (BDI). Patients were classified as cases and controls based on the BDI score (≥ 8 y ≤ 7, respectively). Results: A total of 248 patients were included (mean age 59.0 ± 12.4 years). Mean BDI for the case group was 13.1 ± 4.9, and for the control group, 3.8 ± 2.1. Patients in the control group, had a longer survival time (20.0 months) in comparison with patients in the case group (12 months; p = 0.0032). For the overall population, BDI scoring was correlated with the intensity of pain during the last 24 hours (0.215; p = 0.0007) and the hours of pain during the last 24 hours (0.170; p = 0.0073). A more advanced disease stage was also among the factors that increased the risk of depression (p= 0.0113). The multivariate analysis revealed the predictive nature of digestive cancers (p = 0.0454) and T stage (T2 vs T4; p = 0.0039, and T3 vs T4; p = 0.0012) as risk factors for depression. Conclusions: According with previous studies, there is a clear relationship between pain intensity and patient's psychological status. The predictive potential of medical factors for depression (tumor stage and type of cancer) opens the possibility to target patients at risk (AU)

CALIDAD DE LA LECHE, DIGESTIBILIDAD IN VITRO DE LA MATERIA SECA Y PRODUCCIÓN EN VACAS ALIMENTADAS CON GRAMÍNEAS SOLAS O ASOCIADAS CON Lotus uliginosus / MILK CHEMICAL COMPOSITION, MATTER DRY IN VITRO DIGESTIBILITY AND PRODUCTION IN COWS FED ALONE GRASSES OR ASSOCIATED Lotus uliginosus

La presente investigación tuvo como objetivo evaluar el uso de la leguminosa Lotus uliginosus como alternativa de inclusión dentro de las praderas en dos ecorregiones estratégicas de la Sabana de Bogotá. En cada finca se evaluaron cuatro tratamientos: 1) kikuyo solo (P. clandestinum), 2) kikuyo asociado con trébol pata de pájaro (P. clandestinum + L. uliginosus), 3) festuca alta sola (F. arundinacea) y 4) Festuca alta asociada con trébol pata de pájaro (F. arundinacea + L. uliginosus). El número de bovinos varió de acuerdo a la capacidad de carga de cada finca. Se utilizaron animales que se encontraban en el segundo tercio de lactancia durante un período experimental de siete días. En cada tratamiento se determinó la producción (L/día) y calidad de leche (% de grasa, proteína y sólidos totales); en la pastura se evaluó la composición química (MS, FDN, FDA) y la digestibilidad in vitro de la materia seca (DIVMS). Se midió el consumo voluntario. En la finca Megaleche la producción de biomasa presentó diferencias significativas (P<0,05) entre los tratamientos destacándose el tratamiento del kikuyo solo; la calidad nutricional de las pasturas también presentó diferencias (P<0,04) destacándose el tratamiento de kikuyo + trébol pata de pájaro, asociación que también se destacó en consumo voluntario (P< 0.05) y producción de leche (P<0,05). En la finca Colega el contenido de proteína del forraje presentó diferencias cuando las gramíneas se asociaron con el trébol pata de pájaro (P<0,001). Se concluyó que la introducción del Lotus en las praderas mejoró la producción de leche y consumo de materia seca en los animales.

The present research aimed to evaluate the use of the legume Lotus uliginosus alternatively inclusion into the meadows on two strategic ecoregions savannah of Bogota. In each farm four treatments: 1) only kikuyu (P. clandestinum), 2) associated kikuyo Birdsfoot trefoil (P. clandestinum + L. uliginosus), 3) single tall fescue (F. arundinacea) and 4) tall fescue associated Birdsfoot trefoil (F. arundinacea + L. uliginosus). The number of cattle varied according the load capacity of each farm. Were used animals that were in the second third of lactation during a trial period of seven days, in each treatment was determined production (L/day) and milk quality (% of fat, protein and total solids). In the pasture it was evaluated chemical composition (DM, NDF, ADF) and in vitro digestibility of matter dry (IVDMD). Voluntary intake was measured. On the farm Megaleche biomass production showed significant differences (P˂0.05) between treatments kikuyu emphasizing treatment alone nutritional quality of pastures also showed significant differences (P˂0.04) emphasizing treating kikuyu + Birdsfoot trefoil an association that was also highlighted in the voluntary intake (P˂0.05) and milk production (P˂0.05). On the farm Colega protein content of forage grasses differed when associated with Birdsfoot trefoil (P˂0.001). It was concluded that the introduction of Lotus grassland improved milk production and dry matter intake in animals.

Pain in clinical oncology: patient satisfaction with management of cancer pain.

BACKGROUND: Despite effective analgesic therapy, inadequate pain control is frequently perceived by patients and caregivers. AIMS: To assess satisfaction with management of pain in cancer patients. METHODS: Between January and May 2007, a cross-sectional multicentre study was conducted in 64 Medical Oncology Departments throughout Spain. A total of 525 outpatients with oncological diseases completed a questionnaire with demographic data, characteristics and intensity of pain, and perceptions and attitudes towards pain management at the time of a routine clinical visit. Physicians also completed a questionnaire with tumour-related and treatment-related data. Cluster analysis was used to classify patients into three groups (satisfied, neither satisfied nor dissatisfied or neutral, dissatisfied) according to pain intensity and satisfaction with treatment. RESULTS: Patients satisfied with their analgesic treatment (33%) had lower pain intensities and, when regularly asked about their pain, considered their physicians to be more involved in their treatment. Neither satisfied nor dissatisfied patients (neutral) (44%) had higher mean pain intensities. Two-thirds of them achieved marked relief of their pain and also thought that physicians were aware of their situation. Dissatisfied patients (23%) had moderate to severe pain intensities, and said that they were asked less frequently about their pain, and thought that their physicians were less involved in their analgesic treatment. CONCLUSION: Physician-patient communication and information provided to patients are essential aspects of patient perceptions and attitudes towards control of cancer-related pain. Pain is seen as a condition that may be controlled but affects the capacity to lead a normal life.

In vitro evidence for the importance of cultivation conditions on the effects of Calliandra tannins on ruminal escape of soybean protein and its post-ruminal degradability.

Purified condensed tannins (CT) extracted from the legume Calliandra calothyrsus (var. San Ramón CIAT 22310), harvested in the dry and the rainy season and cultivated with low or high level of fertilization were added to soybean meal in a ratio of 600 mg/g of the incubated crude protein (CP). Effects on degradation either in ruminal fluid only, or in ruminal fluid followed by incubation in HCl/pepsin, were evaluated using a modified two-step in vitro method. Season was found to have larger effects on in vitro ruminal and post-ruminal CP degradation than fertilization. Condensed tannins from the rainy season harvest reduced ruminal CP degradation less than that from the dry season harvest. They had also less negative effects on the degradability of rumen escape protein and enhanced the proportion of post-ruminally degraded CP more than CT from the dry season harvest. An increase in level of fertilization reduced ruminal CP degradation in CT from the rainy season plants but this was not associated with effects on post-ruminal degradation. The study demonstrated the importance of environmental factors for the efficiency of CT in modifying ruminal and post-ruminal CP degradation.

Relación entre nutrición y salud en hatos lecheros: [revisión] / Relation between nutrition and health in dairy herds: [review]

La incidencia de problemas alimenticios, nutricionales y metabólicos es cada vez mayor en hatos lecheros, así como la aparición de problemas sanitarios, productivos y reproductivos asociados a los mismos. La detección oportuna y correcta de éstos permite reducir su incidencia y, por tanto, las pérdidas económicas de los hatos. El monitoreo nutricional periódico hace posible establecer el estado nutricional de una población animal, e identificar las posibles causas de desbalances nutricionales y errores en la alimentación, así como orientar en la toma de decisiones acerca de los correctivos que se deben establecer cuando se detectan problemas. El análisis de las posibles relaciones existentes entre la información aportada por cada uno de los aspectos evaluados en el monitoreo nutricional permite una evaluación más adecuada que su análisis independiente y aislado.

Incidence of health and production problems related to feeding, nutrition and/or metabolism have being growing in dairy herds. early diagnosis allows their reduction and consequently reduces economic losses. monitoring nutritional status periodically allows to identify possible causes of nutritional unbalances and/or mistakes in feeding practices and establish corrective measurements.

Patients' perception of cancer-related fatigue: results of a survey to assess the impact on their everyday life

PURPOSE: Fatigue is a cancer-related symptom with great impact on patients' daily lives, but often not discussed with their oncologists. This survey explored functional and psychological fatigue impact among different cancer symptoms according to patient's perception (pp). METHODS: A cross-sectional, self-administered survey was conducted in 10 oncologist services throughout Spain. Demographical data and tumour diagnoses were collected. Fatigue impact on functional and social activities (Likert scale) and on emotional well-being (visual analogue scale) was measured. The pp of oncologist's response to fatigue report was recorded. RESULTS: 505 surveyed cancer patients were analysed (55.2% women, aged 58.8 years +/-11.7), 97.8% remembered experiencing fatigue during treatment. 27.1% did not discuss their fatigue with their oncologist. Fatigue affected patient's daily routine (> or = 50% of times) included self-care (58.26%), entertainment activities (69.8%), and relationships (71.4%). Fatigue was the most bothersome symptom of cancer. CONCLUSIONS: Cancer patients perceive fatigue as the symptom with highest impact on their daily living and that substantially affects their emotional and social areas (AU)

No disponible

Effects of Sapindus saponaria fruits on ruminal fermentation and duodenal nitrogen flow of sheep fed a tropical grass diet with and without legume.

Six adult African-type hair sheep (BW = 40.3 +/- 6.3 kg) fitted with ruminal and duodenal cannulas were subjected to four treatments. Sheep were offered basal diets at a rate of 80 g of DM/kg of metabolic BW (equivalent to ad libitum access) consisting either of a low-quality grass hay (Brachiaria dictyoneura, 3.7% CP, DM basis) alone or in combination with a forage legume (Cratylia argentea, 18.6% CP, DM basis) in a 3:1 ratio (DM basis). In addition, 0 or 8 g of DM of Sapindus saponaria fruits (12.0% crude saponins, DM basis) per kilogram of metabolic BW was administered intraruminally. Supplementation of C. argentea increased intakes of OM (+21%; P < 0.01) and CP (+130%; P < 0.001), as well as ruminal fluid ammonia N concentrations (from 2.40 to 8.43 mg/dL; P < 0.001). Apparent OM and N digestibilities were not affected by legume addition, but ADF digestibility decreased by 10% (P < 0.01). Total ruminal VFA concentration was unchanged, but acetate:propionate was lower (P < 0.01) and isobutyrate proportion was greater (P < 0.001) with the legume addition. Legume supplementation increased duodenal flows of total N (+56%; P < 0.001), nonammonia N (+52%; P < 0.001), ruminal escape N (+80%; P < 0.001), and microbial N (+28%; P < 0.05). Microbial efficiency was not affected by legume addition. Supplementation of S. saponaria increased (P < 0.05) dietary OM intake by 14%, but had no effect on CP intake and ruminal fluid ammonia concentration or on OM and N digestion. Digestibility of ADF was decreased (P < 0.01) by 10% with S. saponaria as was acetate:propionate (P < 0.001) and the isobutyrate proportion (P < 0.001). Ruminal protozoa counts increased (P < 0.01) by 67% with S. saponaria. Duodenal N flows were not significantly affected by S. saponaria supplementation, except for microbial N flow (+34%; P < 0.01). Microbial efficiency was greater (P < 0.05) by 63% with the addition of S. saponaria. Few interactions between legume and S. saponaria supplementation were observed. The NDF digestibility was decreased with S. saponaria in the grass-alone diet, but not in the legume-supplemented diet (interaction; P < 0.05). Interactions were absent in ruminal fermentation measures and duodenal N flow, indicating that effects were additive. Results suggest that, even when not decreasing ruminal protozoa count, supplementation of S. saponaria fruits is a beneficial way to improve ruminal VFA profile, microbial efficiency, and duodenal flow of microbial protein in sheep fed tropical grass-alone or grass-legume diets.

[Study of cancer-associated asthenia: foundation of the ASTHENOS group]. / Estudio de la astenia tumoral: constitución del grupo ASTHENOS.

Asthenia in cancer patients is a highly controversial subject. A distinct definition of asthenia in medical literature is lacking as well as its prevalence and incidence. Also, no simple tools for its diagnosis are available. Moreover its etiopathogenesis is complex and multifactorial, thereby making therapeutic approaches difficult. Recently, a Spanish group has been set up for the study and treatment of asthenia in cancer patients. This paper reports on its establishment, objectives and first conclusions.

Estudio de la astenia tumoral: constitución del grupo ASTHENOS / Study of cancer-associated asthenia: foundation of the ASTHENOS group

La astenia del paciente con cáncer es un tema de enorme controversia. No disponemos en la literatura médica de una definición clara de la astenia ni de su prevalencia e incidencia. Tampoco disponemos de instrumentos sencillos para su diagnóstico. Además, su etiopatogenia es compleja y multicausal, lo que dificulta las aproximaciones terapéuticas. Recientemente ha empezado a formarse un grupo español para el estudio y tratamiento de la astenia del paciente con cáncer, cuya constitución, objetivos y primeras conclusiones se exponen en este artículo (AU)

Cyclophosphamide, methotrexate, and chronic oral tegafur modulated by folinic acid in the treatment of patients with advanced breast carcinoma.

BACKGROUND: Chronic oral tegafur (a 5-fluorouracil prodrug) modulated by folinic acid has antitumor activity in patients with metastatic breast carcinoma resistant to 5-fluorouracil or doxorubicin-based regimens. In this study, bolus 5-fluorouracil was substituted with chronic oral tegafur and folinic acid in a cyclophosphamide, methotrexate, and 5-fluorouracil-based regimen to study the activity of this novel regimen in patients with advanced breast carcinoma. METHODS: This study was comprised of patients with advanced breast carcinoma and measurable or evaluable disease. Patients with prior chemotherapy were eligible. The regimen was comprised of cyclophosphamide, 600 mg/m2, and methotrexate, 40 mg/m2, both given intravenously on Day 1, and tegafur, 750 mg/m2, with folinic acid, 45 mg/day, both given orally in 3 daily fractions on Days 2-14, every 3 weeks. RESULTS: Forty-seven patients were included, 44 of whom were fully assessable. Three patients (7%) achieved a complete remission and 17 (38.6%) achieved a partial remission, for an objective response rate of 45.5% (95% confidence interval, 29-59%). The median duration of response was 11 months. In previously untreated patients the response rate was 54.5%. In patients previously treated with anthracycline or 5-fluorouracil-based regimens the response rates were 41% and 39%, respectively. Sixteen patients (36.4%) had disease stabilization. The median overall time to progression was 10 months. Toxicities usually were mild and were comprised of leukocytopenia, mucositis, emesis, and diarrhea. CONCLUSIONS: Chronic oral tegafur and folinic acid combined with intravenous cyclophosphamide and methotrexate at the dose and schedule used in the current study has significant antitumor activity both as first-line chemotherapy as well as in other patients with advanced breast carcinoma who had prior chemotherapy. This regimen is well tolerated, with gastrointestinal toxicity being the most frequent and dose-limiting toxicity.

Early results of the value of p53 in predicting survival in a homogeneous cohort of patients with invasive bladder cancer treated with a neoadjuvant carboplatin-based regimen (M-CAVI).

AIMS AND BACKGROUND: Several reports on prognostic factors for infiltrating-bladder cancer have given controversial results. We assessed the prognostic value of p53 nuclear overexpression together with known prognostic factors for survival in patients with invasive T2-4 N0 M0 bladder cancer treated with neoadjuvant chemotherapy. STUDY DESIGN: Thirty-five paraffinized tumor samples from initial transurethral resection of patients with bladder cancer were analyzed immunohistochemically to detect overexpression of p53 protein. Patients were treated with 3 to 4 cycles of neoadjuvant methotrexate, carboplatin, and vinblastine (M-CAVI) and then underwent radical cystectomy. Prechemotherapy, treatment, and postchemotherapy factors were analyzed for correlation with survival by univariate and multivariate analysis. Fifty-seven percent of tumors were positive for p53 protein, 71.5% had grade III-IV tumors, and 72% had organ-confined disease. The median follow-up was 20 months (range 5-71+). RESULTS: By univariate analysis, the significant pretreatment factors were initial tumor (T) stage (P < 0.0001) and the male sex (P = 0.03). Five postchemotherapy variables were found significant: surgery performed according to protocol (P = 0.003), overall clinical (P = 0.004), and overall pathologic (P = 0.02) response to therapy, postchemotherapy pathologic stage (P = 0.0002), and tumor status after surgery (P = 0.0006). By multivariate analysis, the initial prechemotherapy T stage was the only factor that demonstrated independent significance. CONCLUSIONS: Although the median follow-up of the study is still too short, in this group of patients treated with a neoadjuvant carboplatin-based regimen, a classical variable (prechemotherapy T stage) rather than p53 nuclear overexpression was an independent prognostic factor for survival. Further follow-up will be required to assess the value of p53 overexpression as a prognostic factor in invasive bladder cancer patients treated with neoadjuvant carboplatin-based chemotherapy.

M-CAVI, a neoadjuvant carboplatin-based regimen for the treatment of T2-4N0M0 carcinoma of the bladder.

Carboplatin, methotrexate, and vinblastine (M-CAVI) is an active and well-tolerated regimen for bladder cancer patients ineligible for cisplatin-based regimens. We treated 47 T2-4 N0 M0 bladder cancer patients with M-CAVI in a neoadjuvant phase II trial. These 47 patients are evaluable for clinical response and toxicity. Clinical overall response rate was 34%, for a 95% confidence interval (CI95%) of 21-49%. Pathological response was seen in 40% of the patients (CI95%, 26-56%) with a 26.5% rate of pathological complete response (CI95%, 15-42%). Factors associated with the achievement of a response to therapy were the initial TNM stage (pT3a or lower, greater than pT3a, p = 0.001) and a Karnofsky score greater or equal than 90%, which was marginally significant (p = 0.08). With a median follow-up of 14 months, the disease-specific actuarial survival at 2 years is 42%. No patient has relapsed beyond 21 months of follow-up in a disease-free status. Toxic effects have been moderate. In conclusion, M-CAVI is an active and well-tolerated regimen that should be compared in terms of response rate and survival with a cisplatin-based regimen for invasive bladder cancer.

Five-day course of granulocyte colony-stimulating factor in patients with prolonged neutropenia after adjuvant chemotherapy for breast cancer is a safe and cost-effective schedule to maintain dose-intensity.

PURPOSE: To analyze the safety and efficacy of a short course of granulocyte colony-stimulating factor (G-CSF) to maintain dose-intensity of subsequent cycles of chemotherapy after a prior episode of prolonged neutropenia, without febrile complications, in patients receiving adjuvant treatment for breast cancer. PATIENTS AND METHODS: Thirty-two patients undergoing adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) or doxorubicin-CMF for stages I to II breast cancer were included after having chemotherapy delays due to neutropenia (absolute neutrophil count [ANC] < 1.5 x 10(9)/L) on day 22. G-CSF was administered subcutaneously on days 15 to 19 of each subsequent cycle. RESULTS: None of the patients included in this study had to be admitted to the hospital for fever and neutropenia. The median percentage of the projected dose-intensity for CMF or doxorubicin-CMF on an intent-to-treat basis was 0.994, which was significantly higher than the delivered dose-intensity before the start of G-CSF treatment (P < .0001). Patients who received concomitant G-CSF and radiotherapy achieved a similar dose-intensity as patients who did not undergo radiotherapy. Seven patients discontinued G-CSF treatment due to musculoskeletal pain. These patients had more subsequent cycle delays because of day 22 neutropenia than the 25 patients who followed the G-CSF schedule (P = .0028). CONCLUSION: A 5-day course of G-CSF in patients with prior chemotherapy delays due to prolonged neutropenia seems to be a safe and cost-effective schedule to maintain CMF or doxorubicin-CMF dose-intensity in the adjuvant treatment of breast cancer.

Node-negative breast cancers with p53(-)/HER2-neu(-) status may identify women with very good prognosis.

BACKGROUND: The contribution of p53 and HER-2/neu to the management of node-negative breast cancer (NNBC) could be improved by combining their results. MATERIAL AND METHODS: We studied paraffin-embedded primary tumors for p53 (BP-53-12-1) (n=57) and HER2/neu (pAB1) (n=63) from NNBC patients. The results were grouped in a negative (p53(-)/neu(-)) versus a positive group (one or both overexpressed). The association between both groups (negative and positive) and clinicopathologic parameters, S-phase fraction and DNA ploidy, and patients' outcome, was analyzed. RESULTS: In 28% of the tumors p53 was overexpressed, and HER2/neu in 11%. Sixty-five percent (37 out of 57) were p53(-)/neu(-), and 35% overexpressed one (31.5%) or both (3.5%) oncoproteins. Significant correlations were found between p53(-)/neu(-) tumors and age greater than 50 (p=0.003), S-phase fraction lower than 7 (p=0.03), and positive estrogen receptor contents (p=0.049). Actuarial 5-year disease-free and overall survival for p53(-)/neu(-) tumors were 88% and 97%, respectively, versus 50% and 66%, for tumors overexpressing one or both oncoproteins (p=0.004).

Feeding wet corn gluten feed to reduce subacute acidosis in cattle.

Two experiments were conducted to evaluate the effects of feeding wet corn gluten feed (WCGF) on subacute acidosis in cattle. In Exp. 1, 60 individually fed yearling steers (270 +/- 22 kg BW) were used in a 5 x 2 factorial arrangement of treatments. Steers were assigned to one of five dietary treatments: 1) dry-rolled corn (DRC), 2) 35% WCGF fed d 1 to 132, 3) 86.5% WCGF fed d 1 reduced to 35% WCGF by d 19 and increasing the proportion of DRC, 4) 86.5% WCGF fed d 1 to 132, or 5) 94.5% WCGF fed d 1 to 132. Final diets for Treatments 1 through 4 contained 92% concentrate and 8% alfalfa hay (DM basis). Treatment 5 was a 100% concentrate diet. All diets were fed with or without the addition of escape protein. During d 19 to 24, steers fed WCGF had less (P < .05) DMI variation than steers fed the control diet. Steers fed 86.5 and 94.5% WCGF had lower (P < .05) DMI and ADG than steers fed TReatments 1 through 3, although gain/feed was mot different (P > .10) In Exp. 2, three ruminally fistulated steers (615 +/- 36 kg BW) were used in a repeated 3 x 3 Latin square design. On d 14 of each period, 7.9 kg (DM) of 100% DRC, 50% DRC:50% WCGF, of 100% WCGF was intraruminally dosed as an acidosis challenge. Area within the curve below ruminal pH 6.0 was greater (P < .05) over a 24-h period for steers dosed with 100% DRC than for steers dosed with 50% DRC: 50% WCGF or 100% WCGF. In addition, more (P < .05) ruminal VFA accumulated over 24 h for steers dosed with 100% DRC. These data suggest that feeding WCGF does nor eliminate ruminal acidosis but may reduce the length of time cattle are exposed to the insult.

Phase II trial of an all-oral regimen of tegafur and folinic acid in patients with previously treated metastatic breast cancer.

BACKGROUND: Tegafur is an antimetabolite slowly metabolized to 5-fluorouracil in vivo. Protracted administration of oral tegafur is active in metastatic breast cancer, with reported response rates ranging from 29 to 44%. The addition of folinic acid could improve the efficacy of tegafur by means of biochemical modulation. METHODS: A prospective Phase II trial in patients with pretreated metastatic breast cancer was performed. The regimen consisted of oral tegafur (750 mg/m2/day) and oral folinic acid (45 mg/day) for 21 days, recycling at day 28. RESULTS: Twenty-five patients were included. Eight partial responses were observed for an objective response rate of 32% (95% confidence intervals for response, 23-41%). The median duration of response was 7 months. According to WHO criteria, 24% of patients experienced grade 3 mucositis and 12% grade 3 diarrhea, but no other significant toxicities were observed. Twenty-eight percent of patients required dose reductions for toxicity. CONCLUSIONS: A significant response rate with oral tegafur and folinic acid in patients with heavily pretreated breast cancer was found. This all-oral regimen, which could be safely administered on an outpatient basis, deserves further evaluation to define the role of folinic acid on the activity of tegafur in metastatic breast cancer.