Inter-fractional monitoring of [Formula: see text]C ions treatments: results from a clinical trial at the CNAO facility.

The high dose conformity and healthy tissue sparing achievable in Particle Therapy when using C ions calls for safety factors in treatment planning, to prevent the tumor under-dosage related to the possible occurrence of inter-fractional morphological changes during a treatment. This limitation could be overcome by a range monitor, still missing in clinical routine, capable of providing on-line feedback. The Dose Profiler (DP) is a detector developed within the INnovative Solution for In-beam Dosimetry in hadronthErapy (INSIDE) collaboration for the monitoring of carbon ion treatments at the CNAO facility (Centro Nazionale di Adroterapia Oncologica) exploiting the detection of charged secondary fragments that escape from the patient. The DP capability to detect inter-fractional changes is demonstrated by comparing the obtained fragment emission maps in different fractions of the treatments enrolled in the first ever clinical trial of such a monitoring system, performed at CNAO. The case of a CNAO patient that underwent a significant morphological change is presented in detail, focusing on the implications that can be drawn for the achievable inter-fractional monitoring DP sensitivity in real clinical conditions. The results have been cross-checked against a simulation study.

Farinha da casca do fruto de Passiflora edulis f. flavicarpa Deg (maracujá-amarelo): do potencial terapêutico aos efeitos adversos / Peel flour of the Passiflora edulis f. flavicarpa Deg (yellow passion fruit): From therapeutic potentials to side effects.

RESUMO O maracujá-amarelo (Passiflora edulis f. flavicarpa Deg) é considerado um alimento funcional, visto que, além de funções nutricionais, desempenha ações em vias metabólicas específicas. A farinha da casca do maracujá-amarelo (Passiflora edulis f. flavicarpa Deg) é rica em pectina. Esta fibra reduz a absorção de glicídios e lipídios, influenciando no metabolismo destes nutrientes. Portadores de patologias associadas às alterações no metabolismo glicêmico e lipidêmico têm utilizado este recurso de forma indiscriminada. Porém, substâncias designadas glicosídeos cianogênicos, presentes na casca do fruto são tóxicas ao organismo e prejudiciais à saúde. Ademais, o uso exacerbado de agrotóxicos na produção do maracujá é preocupante e a ingestão destes compostos também pode acarretar complicações à saúde. Portanto, o objetivo do presente trabalho foi sintetizar o conhecimento disponível referente aos efeitos terapêuticos e colaterais da suplementação com a farinha da casca do maracujá-amarelo (Passiflora edulis f. flavicarpa Deg). Foi realizada uma revisão bibliográfica nas bases de dados indexadas SCIELO, LILACS e PUBMED, sem limitação quanto ao período de publicação. Os estudos inclusos no trabalho, de forma unânime, apresentam eficácia da suplementação com a farinha da casca do maracujá-amarelo. A trituração da casca do fruto, realizada no processo de obtenção da farinha, é incapaz de promover redução de glicosídeos cianogênicos e agrotóxicos, permitindo que os indivíduos submetidos à suplementação estejam susceptíveis aos efeitos tóxicos destes compostos. Dessa forma, o desenvolvimento de estudos que avaliem a toxicidade da suplementação por períodos crônicos é de suma importância. Referente ao uso de agrotóxicos, a produção da farinha com frutos orgânicos pode ser uma alternativa para atenuar a toxicidade, sendo necessária a elucidação desta hipótese através de estudos.

ABSTRACT The yellow passion fruit (Passiflora edulis f. flavicarpa Deg) is considered a functional food, because, in addition to nutritional functions, it performs actions in specific metabolic pathways. The yellow passion fruit peel flour (Passiflora edulis f. flavicarpa Deg) is rich in pectin. This fiber reduces the absorption of carbohydrates and lipids, influencing the metabolism of these nutrients. Individuals affected by pathologies associated with alterations in the metabolism of lipids and carbohydrates have used this resource indiscriminately, however, substances called cyanogenic glycosides, present in the fruit peel, are toxic to the body and harmful to health. In addition, the overuse of pesticides in passion fruit production is becoming worrisome and the ingestion of these compounds can also cause negative health implications. Therefore, the aim of this study was to synthesize the available knowledge regarding the therapeutic effects and side effects of supplementation with the yellow passion fruit peel flour (Passiflora edulis f. flavicarpa Deg). A literature review was conducted from the indexed databases SCIELO, LILACS and PUBMED, without limitation to the publication period. The studies included in the work, unanimously, have effectiveness of supplementation with yellow passion fruit peel flour (Passiflora edulis f. flavicarpa Deg). The crushing of the fruit peel, performed in the process of obtaining flour, is unable to promote a reduction of cyanogenic glycosides and pesticides, causing individuals undergoing supplementation to be susceptible to the toxic effects of these compounds. Thus, this study’s development to evaluate the toxicity of supplementation for chronic periods is very important. With reference to the use of pesticides, flour production with organic fruits can be an alternative to attenuate toxicity and it is necessary to elucidate this hypothesis through this study.

Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency.

BACKGROUND: Obesity and insulin resistance predispose individuals to the development of both metabolic syndrome and non-toxic nodular thyroid diseases. AIM: The aim of this observational, cross-sectional study is to evaluate the relationship between metabolic syndrome and multinodular nontoxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. SUBJECTS AND METHODS: We examined 1422 Caucasian euthyroid inpatients. Thyroid volume was determined by ultrasound of the neck. A fine-needle aspiration biopsy was performed to evaluate single thyroid nodules and dominant nodules ≥15 mm in euthyroid multinodular goiter. The diagnosis of metabolic syndrome was made according to the criteria of the American Heart Association/ National Heart, Lung, and Blood Institute. RESULTS: Of the sample, 277 patients had clinical evidence of multinodular nontoxic goiter, 461 met the criteria for the diagnosis of metabolic syndrome, and 132 were found to have both conditions. After adjusting for age, gender, body mass index, nicotinism, parity, alcohol intake, thyroid function, and metabolic syndrome- related pharmacological treatment, metabolic syndrome was found to be an independent risk factor for the occurrence of multinodular non-toxic goiter. The relationship between metabolic syndrome and multi nodular non-toxic goiter was apparent in both men and women. CONCLUSIONS: In this study of euthyroid inpatients, we demonstrate that metabolic syndrome is an independent risk factor for the occurrence of multinodular non-toxic goiter in a geographic area with moderate iodine deficiency. We propose that patients meeting the criteria for metabolic syndrome should be screened for the presence of multinodular non-toxic goiter.

[Adverse drug reactions in childhood. A drug surveillance study in Sicily]. / Reazioni avverse da farmaci in età pediatrica. Studio di farmacovigilanza in Sicilia.

The aim of the present study was to investigate the spontaneous reports of suspected adverse drug reactions, observed in paediatric patients in Sicily during the period between the 1st January 1995 and the 31st August 1997. The ADRs were classified according to the "WHO Programme for International Monitoring of Adverse Reactions to Drugs". On 1020 reports, the paediatric suspected ADRs were 130 (12.7%); 23% of these was serious, and 29.2% involved children aged 3 years or less. The antimicrobial and the musculoskeletal drugs were responsible of 74.6% of the whole suspected paediatric ADRs. Cutaneous and gastrointestinal apparatus were involved in 70% of reports and were the most frequently targets of ADRs. On 57 different molecules ceftriaxone and co-amoxiclav were the most common drugs causing ADRs with a percentage of 13%. In 45.4% of ADRs the suspension of the treatment occurred, in 34.6% therapy was needed besides the suspension of the drug, whilst in 11.5% patients needed an hospital visit. In 59.2% spontaneous reports were sent by hospitals, in 32.3% by primary health care and the remaining percentage by other sources. Our investigation should stimulate physicians to better evaluate the potential side effects of drugs and the cost/effectiveness profile of paediatric therapies.

Tumor microcirculation and its significance in therapy: possible role of omega-3 fatty acids as rheological modifiers.

Despite the great efforts to find new drugs or devices to suppress cancer cells, attempts to modify microcirculation and therefore the state of tumor cells and their surrounding normal tissues have not been given the attention they deserve. Solid tumors are composed of highly heterogeneous populations of malignant, stromal and inflammatory cells in a continuously adapting extracellular matrix. All of the above components interact and regulate each other to produce distinct microenvironments within the tumor mass. Abnormal microcirculation plays a particular role in the maintenance of this anomalous condition and favors the formation of metastasis, but on the other hand provides the therapist with an important site for intervention. In this brief overview we attempt to outline three aspects: (a) how the anomalous tumor blood flow provokes the nonuniform distribution of oxygen and nutrients within the tumor mass, thus determining different responses to the various cancer therapies; (b) how hemorheology is the clinical parameter most easily modified and (c) how omega-3 essential fatty acids are natural drugs that could be used in this sense beyond their antitumoral properties.