Pilot evaluation of an interactive multimedia platform to provide nutrition education to Portuguese adolescents.

BACKGROUND: Obesity prevalence has been rising worldwide and currently is one of the most serious public health problems. Nutrition literacy is important to the development of healthier habits that could help prevent and stem obesity and overweight. The aim of this study was to evaluate the impact of using a multimedia web platform to provide nutrition education to Portuguese adolescents. METHODS: The intervention consisted in a two-week period in which students (n = 1291) had access to an interactive multimedia web platform with nutritional content, and designed for a self-paced learning experience. Students completed a knowledge questionnaire at baseline and immediately after the end of the intervention. RESULTS: The results obtained revealed that 85.8% of the students increased their nutrition knowledge. No gender differences were observed post-intervention. There were significant differences in the knowledge acquisition regarding age (P < 0.001). The baseline knowledge seemed to influence the learning process. CONCLUSIONS: Overall, the intervention had a positive impact. The preliminary results observed will be important for the improvement of the intervention, though they need to be confirmed by further research. Nevertheless, it is safe to say that technology-based assets can be important tools to incorporate and complement health-related interventions in schools.

Safety and efficacy of bosutinib in fourth-line therapy of chronic myeloid leukemia patients.

Bosutinib is a second-generation tyrosine kinase inhibitor (2GTKI) approved at 400 mg once daily (QD) as first-line therapy in patients with chronic myeloid leukemia (CML) patients and at 500 mg QD in patients who are resistant to or intolerant of prior therapy. In clinical practice, bosutinib is often given to patients who have failed imatinib, nilotinib, and dasatinib (i.e., as fourth-line treatment), despite the limited data on its clinical benefit in this setting. We have retrospectively evaluated the results of bosutinib in a series of 62 CML patients who have failed to prior treatment with all three, imatinib, nilotinib, and dasatinib. Median time on TKI treatment before bosutinib start was 105 (9-163) months, and median duration on bosutinib was 9 months (1-30). Overall, probabilities to achieve complete cytogenetic response (CCyR) and major molecular response (MMR) were 25% and 24% respectively. After a median follow-up period of 14 months, the event-free survival and progression-free survival were 68 and 85%, respectively. Sixty-four percent of patients in CCyR at the time of bosutinib start were able to achieve MMR. In contrast, patients without CCyR, probabilities to obtain CCyR and MMR were 25% and 14%. Bosutinib was well tolerated in this heavily pretreated patients' cohort. Pleural effusions and diarrhea were the most frequent grade II-IV side effects, leading to treatment discontinuation in 16% of patients. Bosutinib is an effective treatment option for patients who have failed previous 2GTKIs due to intolerance. However, efficacy seems to be related to the molecular response that the patient achieved prior to bosutinib.

Bosutinib shows low cross intolerance, in chronic myeloid leukemia patients treated in fourth line. Results of the Spanish compassionate use program.

The role of bosutinib as rescue treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) patients after failing three previous tyrosine kinase inhibitors (TKIs) is currently unknown. We report here the largest series (to our knowledge) of patients treated with bosutinib in fourth-line, after retrospectively reviewing 30 patients in chronic phase, and pretreated with imatinib, nilotinib, and dasatinib. With a median follow up of 11.1 months, the probability to either maintain or improve their CCyR response was 56.6% (17/30) and 11 patients (36.7%) achieved or maintained their baseline MMR. In patients not having baseline CCyR, the probabilities of obtaining CCyR, MMR, and MR4.5 were 13, 11, and 14%, respectively. The probabilities of obtaining MMR and deep molecular response MR4.5 in patients with baseline CCyR were 40.0% (6/15) and 20.0% (3/15). At 20 months, progression-free survival was 73%. Grade 3-4 hematological toxicities were more frequent in resistant than intolerant patients (45.4 vs. 0.0%). Nonhematological toxicities were also more frequent in resistant patients, being diarrhea the most conspicuous one. Bosutinib seems to be an appropriate treatment option for patients resistant or intolerant to three prior TKI's.