Chemical Properties, Ruminal Fermentation, Gas Production and Digestibility of Silages Composed of Spineless Cactus and Tropical Forage Plants for Sheep Feeding.

The aim was to evaluate the chemical composition, carbohydrates, protein fractionation and in vitro gas production of silages composed of spineless cactus and tropical forages and their effect on sheep performance. Treatments consisted of silages: corn silage (CS), spineless cactus silage (SCS), spineless cactus + gliricidia (SCG), spineless cactus + buffel grass silage (SCBG) and spineless cactus + pornunça (SCP). Silos were opened 60 days after ensiling, and analyses were carried out. The digestibility test lasted for 36 days, with eight animals per treatment. A completely randomized design was adopted. Considering carbohydrate fractionation, CS, SCS and SCBG silages had higher total carbohydrate content (p = 0.001). The SCS silage presented a higher A + B1 fraction (p = 0.001). The SCBG and SCG silages showed a higher B2 fraction (p < 0.0001) compared to the CS and SCS silages. The SCBG and SCP silages presented a higher C fraction (p = 0.001). For protein fractionation, the SCP and SCG silages showed higher crude protein contents (p = 0.001). The CS and SCS silages showed a higher A fraction (p = 0.001). The SCBG silage presented a higher B1 + B2 fraction (p = 0.001). The SCG silage showed a higher B3 fraction (p = 0.006) compared to SCBG silage. The SCS and SCP silages showed a higher C fraction (p = 0.001). Exclusive SCS silage showed higher in vitro dry matter digestibility (p = 0.001), dry matter degradability (p = 0.001) and total gas production (p = 0.001). The use of the SCBG, SCP and SCG silages to feed sheep increased the dry matter intake (p < 0.001). Sheep fed the SCG silage showed greater dry matter and crude protein digestibility compared to the sheep fed the CS, SCS and SCP silages (p = 0.002). There was a higher water intake (p < 0.001) with the use of the SCS and SCG silages to feed the sheep. The SCP and SCG silages provided a greater intake (p < 0.001) and excretion (p < 0.001) of nitrogen by the animals. Although there were no differences between the treatments for daily gains, lambs that received the spineless cactus-based silage associated with tropical forages showed higher gains (160-190 g/day) than lambs that received CS silage (130 g/day). Thus, the use of spineless cactus associated with buffelgrass, pornunça and gliricidia to prepare mixed silages (60:40) to feed sheep has potential use to feed sheep, with positive effects on nutrient degradation and increases in dry matter intake. Under experimental conditions, we recommend the exclusive use of spineless cactus silage associated with buffel grass, pornunça and gliricidia in feeding sheep in semi-arid regions, as it provides nutrients, water and greater daily gains compared to corn silage.

Fermentation Profile, Aerobic Stability, and Chemical and Mineral Composition of Cactus Pear Silages with Different Inclusion Levels of Gliricidia Hay.

Cactus pear is used in large proportions in diets for small ruminants in semiarid regions. However, its exclusive use is not recommended due to the low fiber and crude protein content and the high water and mineral content, leading to metabolic disorders, low dry matter intake, and weight loss. The use of mixed cactus silage associated with protein and fibrous sources seeks to overcome the deficits in dry matter, fiber and crude protein, aiming to improve the nutritional quality of the diets that will be offered to ruminants. Thus, the use of gliricidia hay in cactus pear silages could represent an important alternative to improve the nutritional and fermentative characteristics of the ensiled material. Therefore, our aim was to evaluate the fermentation dynamics, nutritional characteristics, and aerobic stability of mixed silages of cactus pear combined with different levels of gliricidia hay. This was a completely randomized experimental design with five treatments and five repetitions. The treatments consisted of different levels of inclusion of gliricidia hay (0, 10, 20, 30, and 40% on a dry matter basis) in the composition of mixed cactus pear silages. The inclusion of gliricidia hay in the composition of mixed silages of cactus pear resulted in a quadratic effect for dry matter recovery, pH, NH3-N, buffering capacity, aerobic stability, ether extract, P, K, Na, and Zn (p < 0.05). There was a reduction in density, effluent losses, maximum pH, mineral matter, non-fiber carbohydrates, Ca, Mg, Fe, and Mn (p < 0.05), and an increase in the time to reach maximum pH as well as an upward trend in pH, dry matter, organic matter, crude protein, neutral detergent fiber, acid detergent fiber, and B (p < 0.05). Under experimental conditions, the inclusion of gliricidia hay between 20 and 30% in cactus pear-based silage provided an improvement to the chemical composition and fermentation parameters of the silages.

Chest wall perforator flaps for partial breast reconstruction after conservative surgery: Prospective analysis of safety and reliability.

INTRODUCTION: Breast-conserving surgery associated with adjuvant radiotherapy is the state of the art in the surgical treatment of breast cancer. Oncoplastic surgery through dermo-adipose flaps based in perforating arteries (muscle sparing flaps) for partial reconstruction is increasingly used as a good option for avoiding musculocutaneous flaps. In this study we evaluate the outcomes of the use of chest wall perforator flaps in the replacement of partial breast volume. METHODS: A prospective cohort study of female patients that underwent a conservative oncoplastic surgery procedure with partial breast reconstruction using a dermo-adipose flap of perforating arteries of the chest wall was conducted between November 2020 and March 2022 at our centre. Primary outcomes were surgical morbidity, positive margins and reoperation rates. Characteristics associated with the occurrence of complications were further identified. RESULTS: Forty-five patients underwent the procedure of interest during the study period. The mean age was 55 years. The median larger dimension of the tumor was 23 mm. Lateral intercostal artery perforator (LICAP), lateral thoracic artery perforator (LTAP), a combined flap and Anterior Intercostal Artery Perforator/Medial Intercostal Artery Perforator (AICAP)/(MICAP) were performed in 22, 16, 2 and 5 patients, respectively. The mean operative time was 126 min. A total of 9 (20.0%) patients required a reoperation after definitive diagnosis, 4 due to positive margins and 5 due to immediate/early surgical morbidity. CONCLUSIONS: Local perforator flaps in oncoplastic breast-conserving surgery are a good option for immediate reconstruction after conservative surgery, showing low morbidity and favourable outcomes.

Secondary production of Acartia tonsa Dana, 1849 and A. lilljeborgii Giesbrecht, 1889 in an Amazonian estuary (Brazil).

The dynamics of the copepods A. tonsa and A. lilljeborgii were described for the first time in the Taperaçu Estuary. The acartiids were collected using plankton nets (200 µm) in June 2012, March 2013 (rainy season) and September 2012 and 2013 (dry season). The oscillations in rainfall and the fluctuations in hydrological variables influenced the abundance, biomass, and production of both A. tonsa (17 ± 23 to 8501 ± 13,248 ind.m-3; 16,385.29 mg.C.m-3; 0.09 ± 0.21 to 355.17 ± 590.84 mg.C.m-3.d-1) and A. lilljeborgii (14 ± 11 to 1470 ± 1591 ind.m-3; 22,398.40 mg.C.m-3; 177.99 ± 263.13 mg.C.m-3.d-1) with clear monthly, seasonal, and spatial patterns. The high levels of production observed may be related to the presence of waters rich in particulate organic material derived from the adjacent mangrove forests. This material is consumed by a number of copepod species, in particular A. tonsa and A. lilljeborgii, favoring the development and reproduction of both species which are characterized by high rates of productivity in the study estuary. The present results indicate that the biomass and productivity in equatorial mangrove estuaries may be relatively high in comparison with the levels observed in other coastal systems around the world and that earlier stages of both species have a great relevance for biomass and production in Amazonian estuaries.

A comprehensive study on surveillance outcomes of a male population followed at a hereditary breast cancer high-risk consultation at a Portuguese tertiary hospital.

INTRODUCTION: Men born with pathogenic/likely pathogenic variants in genes associated with the Hereditary Breast and Ovarian Cancer Syndrome have a higher risk to develop breast cancer and other cancers (such as prostate cancer) and should undergo adequate surveillance protocols in highly specialized Centers. METHODS: A retrospective study was conducted to assess these genetic variants' epidemiological and phenotypical manifestations in male carriers, as well as the efficacy of the surveillance protocol and compliance toward it through a survey. During follow-up, a genetic panel for testing was implemented, the starting age for surveillance was delayed, and the six-month screening interval was extended to annual. RESULTS: A total of 104 men from a tertiary hospital's High-Risk Consultation were included, 102 with positive genetic testing for BRCA1 (n = 31), BRCA2 (n = 55), both BRCA2 and another gene (n = 5), CDH1 (n = 2), CHEK2 (n = 4), NF1 (n = 1), RAD51C (n = 4), and an additional two men with no actionable genetic variant identified. The follow-up period ranged from 1 to 13 years, and only one man developed cancer. Survey responses from 48 men in active surveillance showed that more than half recognizes their carrier status and consequent surveillance impact on their life, including the risk of transmission to offspring, fear of future cancer, meaningful distress, and feeling of injustice. Biannual surveillance was not actively detecting more cancer disease cases, confirming the adequacy of the currently implemented protocol CONCLUSION: With support of Genetics to fulfill the current gaps in high-risk management, the proposed redefinition of surveillance protocol would adapt it to the population needs and concerns.

Foreign stingers: South American freshwater river stingrays Potamotrygon spp. established in Indonesia.

The pet trade is known to be one of the most important pathways of aquatic non-native species introduction and Indonesia is a significant trade partner. Popular ornamental South American river stingrays (Potamotrygon spp.) were introduced to Indonesia in the 1980s and the culture was established. Here we present a detailed Indonesian market and aquaculture survey, the volume of trade between January 2020 and June 2022, and the list of customer countries with the total amount of imported stingrays. Climate similarities between the native range of P. motoro and P. jabuti and Indonesia were analysed. A significant number of areas of Indonesian islands were identified as suitable for the establishment of this species. This was confirmed by the first record of probably established populations in the Brantas River (Java). In total 13 individuals including newborns were captured. The culture of potamotrygonid stingrays is unregulated in Indonesia, and the risk of the establishment of this predator and its potential spread is alarming for wildlife. Moreover, the first case of envenomation caused by Potamotrygon spp. in the wild outside of South America was recorded. The current condition is predicted as the 'tip of the iceberg' and continuous monitoring and mitigation of risks are strongly recommended.

Differences among a Portuguese cohort of BRCA pathogenic/likely pathogenic variants carriers choosing risk-reducing mastectomy or intensive breast surveillance.

PURPOSE: Women with BRCA1 and BRCA2 (BRCA1/2) pathogenic/likely pathogenic (P/LP) variants have a higher risk to develop breast and ovarian cancer. In structured high-risk clinics, risk-reducing measures are adopted. This study aimed at characterizing these women and identify factors that may have influenced their choice between risk reduction mastectomy (RRM) and intensive breast surveillance (IBS). METHODS: This study reviewed retrospectively 187 clinical records of affected and unaffected women with P/LP variants of the BRCA1/2 genes, from 2007 to 2022, of which 50 chose RRM, while 137 chose IBS. The research focused on personal and family history and tumor characteristics and their relation with the preventive option chosen. RESULTS: Among women with personal history of breast cancer, a higher proportion opted for RRM compared to those asymptomatic (34.2% vs 21.3%, p = 0.049), with younger age determining the option for RRM (38.5 years vs 44.0 years, p < 0.001). Among women with personal history of ovarian cancer, a higher proportion opted for RRM compared to those without that history (62.5% vs 25.1%, p = 0.033), with younger age determining the option for RRM (42.6 years vs 62.7 years, p = 0.009). Women who had bilateral salpingo-oophorectomy were more likely to choose RRM than those who did not (37.3% vs 18.3%, p = 0.003). Family history was not associated with preventive option (33.3% vs 25.3, p = 0.346). CONCLUSIONS: The decision for the preventive option is multifactorial. In our study, personal history of breast or ovarian cancer, younger age at diagnosis, and previous bilateral salpingo-oophorectomy were associated with the choice of RRM. Family history was not associated with the preventive option.

Impact of a 10-min typing task in the development of trapezius myalgia: a preliminary observational study.

Objectives. Computer use, as in typing, might contribute to trapezius myalgia (TM) development by increasing upper trapezius (UT) muscle fatigue. The purpose of this study is to investigate whether 10 min of performing a typing task by a population at risk would show significant changes in surface electromyography (sEMG) and pressure pain threshold (PPT) measurements. Supported and unsupported forearms postures are compared. Methods. Sixteen asymptomatic volunteers with minimum daily use of a computer of 5 h were randomized into two groups: fully supported forearms (n = 8) and unsupported forearms (n = 8). The protocol consisted of 10 min of a typing task, and the workstation was set according to the usual participant profile. sEMG and PPT readings were collected from both UT muscles. Results. PPT and sEMG readings were not significantly different among the two groups. Supported forearms had less reduction of PPT and a smaller increase in electrical activity. Conclusions. Ten minutes of typing seems insufficient to observe any significant changes that could lead to TM development.

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics.

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications.

Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users.

BACKGROUND: Computer use is a well-known source of chronic pain, leading to absenteeism and reduced productivity and well-being. This study evaluated the feasibility of conducting a full-scale randomised controlled trial. Several methodological variables defined trial feasibility. MATERIALS AND METHODS: Thirty adults, daily computer users reporting pain, were recruited. Data collection took place at LABIOMEP. Participants were randomised into 1 of 3 parallel groups and received either osteopathic, sham or no treatment. Only the volunteers were blind to group assignments. The primary objective was to study the feasibility and acceptability of the protocol. RESULTS: Of 77 participants interested, 30 were included and randomised into three groups of ten. All participants concluded the study, and all the data was analysed. The feasibility outcomes were deemed appropriate. No adverse events or severe side effects were reported or identified. CONCLUSION: Studying the efficacy of osteopathic consultation on computer users by conducting an RCT is feasible and safe. With adjustments, a full-scale study can be designed. TRIAL REGISTRATION: ClinicalTrials.gov with the identifier: NCT04501575. Date registered August 06, 2020.

Clinical Outcome of Patients Submitted to Liver Resection in the Context of Metastatic Breast Cancer: A Study of a Tertiary Hospital Center.

INTRODUCTION: Breast cancer is the most incident cancer in the world, accounting for 25% of new cancers per year in females. It is the most frequent malignancy in women, being the fifth cause of death from cancer worldwide. Approximately 5 to 10% of patients already present with metastases at diagnosis, and the liver is the site of metastases in half of these cases. Liver metastasis (LM) resection, performed after neoadjuvant systemic treatment, has been reported to increase median overall survival in this population. AIM: The aim of this analysis is to assess the outcomes of patients undergoing breast cancer liver metastasis surgical resection, including impact on survival, compared to patients where metastasectomy was not performed. METHODS: retrospective review of 55 female patients with breast cancer liver metastases, diagnosed and treated in a single tertiary university hospital from January 2011 to December 2016 was performed. RESULTS: In 32/55 patients (58.2%), multi-organ metastases were identified (the most common sites being bone, lungs, and lymph nodes). Of the remaining 23 patients, the liver was the unique metastatic site; thirteen patients had diffuse bilobar hepatic metastases. The remaining ten patients were proposed for surgical treatment; three of them had peritoneal carcinomatosis identified during surgery, and no hepatic metastasectomy was performed. As a result, only seven (12.7%) patients underwent liver metastasectomy. Overall survival was higher in patients who had LM surgery (65 months [Interquartile Range (IQR) 54-120]), in comparison to those diagnosed with diffuse bilobar hepatic metastases (17.5 months [IQR 11-41]), and with those showing concurrent liver and bone metastases (16.5 months [IQR 6-36]) (p = 0.012). In univariable analysis, the latter two groups showed worse overall survival outcomes (Hazard Ratio (HR) = 3.447, 95%CI: 1.218-9.756, p = 0.02 and HR = 3.855, 95% Confidence Interval (CI): 1.475-10.077, p = 0.006, respectively) when compared to patients with LM. CONCLUSION: In our series, patients submitted to metastasectomy had a median overall survival after diagnosis of LM three times greater than the non-operated patients with isolated LM, or concurrent LM and bone metastases (65 vs. 17.5 and 16.5 months, respectively). As is vastly known for colorectal cancer liver metastasis, resection of breast cancer liver metastasis may reduce tumor burden, and therefore may improve patient outcome.

The CDH1 c.1901C>T Variant: A Founder Variant in the Portuguese Population with Severe Impact in mRNA Splicing.

Hereditary diffuse gastric cancer (HDGC) caused by CDH1 variants predisposes to early-onset diffuse gastric (DGC) and lobular breast cancer (LBC). In Northern Portugal, the unusually high number of HDGC cases in unrelated families carrying the c.1901C>T variant (formerly known as p.A634V) suggested this as a CDH1-founder variant. We aimed to demonstrate that c.1901C>T is a bona fide truncating variant inducing cryptic splicing, to calculate the timing of a potential founder effect, and to characterize tumour spectrum and age of onset in carrying families. The impact in splicing was proven by using carriers' RNA for PCR-cloning sequencing and allelic expression imbalance analysis with SNaPshot. Carriers and noncarriers were haplotyped for 12 polymorphic markers, and the decay of haplotype sharing (DHS) method was used to estimate the time to the most common ancestor of c.1901C>T. Clinical information from 58 carriers was collected and analysed. We validated the cryptic splice site within CDH1-exon 12, which was preferred over the canonical one in 100% of sequenced clones. Cryptic splicing induced an out-of-frame 37bp deletion in exon 12, premature truncation (p.Ala634ProfsTer7), and consequently RNA mediated decay. The haplotypes carrying the c.1901C>T variant were found to share a common ancestral estimated at 490 years (95% Confidence Interval 445-10,900). Among 58 carriers (27 males (M)-31 females (F); 13-83 years), DGC occurred in 11 (18.9%; 4M-7F; average age 33 ± 12) and LBC in 6 females (19.4%; average age 50 ± 8). Herein, we demonstrated that the c.1901C>T variant is a loss-of-function splice-site variant that underlies the first CDH1-founder effect in Portugal. Knowledge on this founder effect will drive genetic testing of this specific variant in HDGC families in this geographical region and allow intrafamilial penetrance analysis and better estimation of variant-associated tumour risks, disease age of onset, and spectrum.

Large-scale Degradation of the Tocantins-Araguaia River Basin.

The Tocantins-Araguaia Basin is one of the largest river systems in South America, located entirely within Brazilian territory. In the last decades, capital-concentrating activities such as agribusiness, mining, and hydropower promoted extensive changes in land cover, hydrology, and environmental conditions. These changes are jeopardizing the basin's biodiversity and ecosystem services. Threats are escalating as poor environmental policies continue to be formulated, such as environmentally unsustainable hydropower plants, large-scale agriculture for commodity production, and aquaculture with non-native fish. If the current model persists, it will deepen the environmental crisis in the basin, compromising broad conservation goals and social development in the long term. Better policies will require thought and planning to minimize growing threats and ensure the basin's sustainability for future generations.

Dwarf versus tall elephant grass in sheep feed: which one is the most recommended for cut-and-carry?

Tall- and dwarf-sized elephant grass cultivars have been developed for cut-and-carry system. Dwarf clones have better digestibility; on the other hand, tall-sized cultivars are more productive. The aim was to verify which grass would be most recommended for cut-and-carry: tall-sized (Elephant B and IRI-381) or dwarf (Taiwan A-146 2.37 and Mott) elephant grass cultivars to feed 24 male sheep, aged between 4 and 5 months, uncastrated, weighing approximately 24.08 ± 1.76 kg body weight which were sampled on intake, digestibility, performance, ingestive behavior, nitrogen balance, microbial protein synthesis, metabolic parameters, and ruminal degradability. This research was divided into two experiments: experiment 1 lasted 38 days, seven for adaptation and 31 for data collection. Elephant grass cultivars were supplied with a mineral mixture. Data collected were intake, digestibility, ingestive behavior, metabolic parameters, microbial protein synthesis, and performance submitted to a completely randomized design. For experiment 2, three rumen fistulae animals were sampled, lasting 20 days. In this case, a randomized block in split-plot design was applied. Both designs were with P < 0.05 and analyzed through SAS statistical software. Mott and Taiwan A-146 2.37 cultivars provided greater intake, digestibility, weight gain, feeding time, nitrogen retention, production and efficiency of microbial protein synthesis, dry matter (DM) and neutral detergent fiber (NDF) degradability, and DM, crude protein, and NDF, but shorter rumination time rather than Elephant B and IRI-381. There was also a significant difference for glucose, triglycerides, plasma urea, total serum protein, urinary urea (mg/L), and urea excretion in urine (mg/day). Dwarf elephant grass cultivars as Mott and Taiwan A-146 2.37 have greater nutritional value than tall-sized Elephant B and IRI-381. Dwarf elephant grass is recommended for cut-and-carry system.

Biotic differentiation in headwater creeks after the massive introduction of non-native freshwater aquarium fish in the Paraíba do Sul River basin, Brazil

This study evaluated fish beta diversity in six headwater creeks located in the area affected by the largest ornamental aquaculture center implemented in the Minas Gerais State, southeastern Brazil. We sampled fish assemblages in 2017 and 2018 to investigate changes in assemblage structure (species richness and beta diversity), comparing these data with the historic species pool. We recorded 60 fish species, of which 16 were native and 44 non-native with 19 translocated, and 25 exotic. The exotics Poecilia reticulata, Xiphophorus maculatus, X. variatus, Danio rerio, and Misgurnus anguillicaudatus were the most widely distributed in the headwater creeks. The Contamination Index showed that most creeks had high proportional contamination by exotic species (above 60%). Beta diversity increased from historical to contemporary periods in all creeks due to the introduction and differential colonization pressure of several non-native translocated and exotic species, indicating biotic differentiation. Temperature and number of ponds were the main preditors of change in beta diversity in the headwater creeks during the contemporary period. In summary, we observed that invaders have induced substantial changes to fish communities under influence of environmental filters. Our results support the hipothesis that aquaculture is a main driver of fish non-native fish introduction and native biodiversity loss in the Neotropics.(AU)

Este estudo avaliou a diversidade beta de peixes em seis riachos de cabeceira localizados em uma área afetada pelo maior centro de aqüicultura ornamental do Brasil, localizado em Minas Gerais. Amostramos assembleias de peixes em 2017 e 2018 para investigar mudanças na estrutura (riqueza de espécies e diversidade beta), comparando esses dados com tendências históricas de composição de comunidades. Registramos 60 espécies de peixes, sendo 16 nativos e 44 não nativos: 19 translocados e 25 exóticos. Os exóticos Poecilia reticulata, Xiphophorus maculatus, X. variatus, Danio rerio e Misgurnus anguillicaudatus foram os mais distribuídos nos riachos. O Índice de Contaminação mostrou que a maioria dos riachos apresentou alta contaminação proporcional por espécies exóticas (acima de 60%). A diversidade beta aumentou do período histórico para o contemporâneo em todos os riachos devido à introdução e pressão de colonização de várias espécies não-nativas translocadas e exóticas, indicando diferenciação biótica. Temperatura da água e número de tanques de piscicultura foram os principais fatores de mudança na diversidade beta dos riachos no período contemporâneo. Os não-nativos induziram mudanças em nível de comunidades e sob influência de variáveis ambientais. Os resultados mostram que a aquicultura é um dos principais vetores da introdução de peixes não-nativos e perda de biodiversidade nativa nos Neotrópicos.(AU)

Superiority of the triple combination of bortezomib, cyclophosphamide and dexamethasone versus cyclophosphamide, thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma, eligible for transplantation

ABSTRACT Background: The treatment of multiple myeloma (MM) has evolved significantly in the past decade, and new drug combinations have improved the response rates and prolonged survival. Studies comparing different induction chemotherapy regimens have shown that triple combinations have better results than double combinations. However, comparisons among different triple combinations are rare in the literature. Methods: We retrospectively compared two triple combinations comprising bortezomib, cyclophosphamide and dexamethasone (VCD) versus thalidomide, cyclophosphamide and dexamethasone (CTD), and aimed at identifying which of the two combinations would yield better response rates following four induction cycles prior to hematopoietic cell transplantation in patients with untreated multiple myeloma. Results: We retrospectively reviewed the medical records of 311 patients from 24 different centers.The VCD regimen was used as induction therapy by 117 (37.6%) patients, whereas 194 (62.4%) patients received the CTD regimen. After four cycles of induction on an intention-to-treat basis, 54% of the patients in the VCD group achieved at least very good partial response versus 42.8% in the CTD group (p = 0.05). We observed no difference in neuropathy or thrombotic events rates among the two regimens. Conclusion: Our results corroborate the superiority of the triple combination regimes containing bortezomib over the triple combination with thalidomide as pre ASCT induction therapy in MM.

Sentinel node total tumour load as a predictive factor for non-sentinel node status in early breast cancer patients - The porttle study.

OSNA is a molecular assay for the detection of sentinel node metastasis. TTL emerged as a concept that seems to accurately predict the status of the NSN. Authors tried to confirm this motion. This is a retrospective and multicentric study that analyzed 2164 patients, 579 of whom had positive SN and completion AD. Logistic regression models were performed in order to identify a suitable cutoff to identify patients who benefit from AD. Univariate and multivariate regression analysis showed a relationship between TTL>30000 and the presence of NSN metastasis (OR 2.84, CI 1.99-4.08, p < 0.001). Logistic regression indicated that the cutoff of 30000 copies/µL better discriminates patients with NSN positivity and allows wide use of these criteria. This cutoff value may safely assist clinicians and patients to decide to proceed or not with an AD.

Superiority of the triple combination of bortezomib, cyclophosphamide and dexamethasone versus cyclophosphamide, thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma, eligible for transplantation.

BACKGROUND: The treatment of multiple myeloma (MM) has evolved significantly in the past decade, and new drug combinations have improved the response rates and prolonged survival. Studies comparing different induction chemotherapy regimens have shown that triple combinations have better results than double combinations. However, comparisons among different triple combinations are rare in the literature. METHODS: We retrospectively compared two triple combinations comprising bortezomib, cyclophosphamide and dexamethasone (VCD) versus thalidomide, cyclophosphamide and dexamethasone (CTD), and aimed at identifying which of the two combinations would yield better response rates following four induction cycles prior to hematopoietic cell transplantation in patients with untreated multiple myeloma. RESULTS: We retrospectively reviewed the medical records of 311 patients from 24 different centers.The VCD regimen was used as induction therapy by 117 (37.6%) patients, whereas 194 (62.4%) patients received the CTD regimen. After four cycles of induction on an intention-to-treat basis, 54% of the patients in the VCD group achieved at least very good partial response versus 42.8% in the CTD group (p=0.05). We observed no difference in neuropathy or thrombotic events rates among the two regimens. CONCLUSION: Our results corroborate the superiority of the triple combination regimes containing bortezomib over the triple combination with thalidomide as pre ASCT induction therapy in MM.

Effect of association of fresh cassava root with corn silage in replacement for cactus cladodes on dairy cow performance.

The aim of this study was to investigate the replacement effect of cactus cladodes with cassava root and corn silage (CRCS) (0, 25, 50, 75, and 100%, dry matter basis) in diets of lactating dairy cows on nutrients intake and digestibility, microbial protein synthesis, nitrogen balance, and milk yield. Ten Holstein cows with an average milk yield of 16 kg/day, an initial body weight (BW) of 670 ± 35 kg, and an average of 17 weeks in milking were assigned to an experiment using a double 5 × 5 Latin square design. The ratio of forage/concentrate was 82:18, and the ingredients used were cactus cladodes, cassava root, corn silage, soybean meal, wheat meal, urea, and mineral premix. The intake of dry matter, organic matter, and total digestible nutrients were not influenced by the replacement levels. On the other hand, the intake of crude protein and neutral detergent fiber increased while the intake of non-fiber carbohydrates decreased with addition of CRCS. The digestibility of the nutrients was not changed as the milk yield as fat-corrected milk production and milk content of fat, protein, lactose, and total solids. The microbial protein synthesis, microbial protein efficiency, nitrogen balance, and efficiency of N in milk were not changed. Therefore, we recommend the complete replacement of cactus cladodes by cassava root and corn silage in the diets of lactating cows with an average milk yield of 16 kg/day.

Physicochemical parameters, fatty acid profile, and sensory attributes of meat from lambs fed with cassava dregs in replacement of corn.

The objective of this study was to evaluate the effect of the replacement of corn by cassava dregs (0, 33, 66, and 100%) in the diet of lamb on physicochemical parameters, fatty acid profile, and sensory attributes of meat. Forty male non-castrated Santa Inês crossbred lambs with an initial average weight of 20 ± 1.87 kg were slaughtered after 70 days. The physicochemical parameters and chemical composition of meat were not affected by the diets. Eicosenoic (C20:1n-9) and linolenic (C18:3n-3) acids increased linearly and there was a linear decreasing effect for the flavor score with increasing cassava dregs in the diets. The replacement of corn by cassava dregs did not influence omega-6:omega-3 ration or the total desirable fatty acids, as well as the color, aroma, tenderness, juiciness, or overall evaluation scores. Cassava dregs may be added in the diets of lambs, without negative effects on physicochemical characteristics, chemical composition, and fatty acid indexes, with positive effects on unsaturated fatty acid content. However, the total replacement of corn altered the sensory attributes and decreased purchase intent of the meat.