In cancer patients, malnutrition is associated with treatment toxicity, complications, reduced physical functioning, and decreased survival. The Prevalence of Malnutrition in Oncology (PreMiO) study ...identified malnutrition or its risk among cancer patients making their first medical oncology visit. Innovatively, oncologists, not nutritionists, evaluated the nutritional status of the patients in this study.
PreMiO was a prospective, observational study conducted at 22 medical oncology centers across Italy. For inclusion, adult patients (>18 years) had a solid tumor diagnosis, were treatment-naive, and had a life expectancy >3 months. Malnutrition was identified by the Mini Nutritional Assessment (MNA), appetite status with a visual analog scale (VAS), and appetite loss with a modified version of Anorexia-Cachexia Subscale (AC/S-12) of the Functional Assessment of Anorexia-Cachexia Therapy (FAACT).
Of patients enrolled (
1,952), 51% had nutritional impairment; 9% were overtly malnourished, and 43% were at risk for malnutrition. Severity of malnutrition was positively correlated with the stage of cancer. Over 40% of patients were experiencing anorexia, as reported in the VAS and FAACT questionnaire. During the prior six months, 64% of patients lost weight (1-10 kg).
Malnutrition, anorexia, and weight loss are common in cancer patients, even at their first visit to a medical oncology center.
The formation of ice on nacelle causes the reduction or loss of aerodynamic performance, fuel consumption increases, reduced thrust, and the ingestion of ice, which can damage the engine. The piccolo ...tube anti-icing employed as an active ice protection system has limitations in terms of performance losses and energy costs. Furthermore, according to the FAA regulation, it cannot be activated during takeoff and initial flight phases in order to avoid engine thrust reduction. This work reports on an icing wind tunnel test campaign performed at initial flight phases conditions on the M28 PZL nacelle before and after the application of a superhydrophobic coating in order to study the effect of wettability on ice accretion. Results highlighted that an ice thickness reduction of −49% has been recorded at −12 °C, matched to an increase in the impingement length of 0.5%. At 95 m/s and at 420 s of exposure time, the ice thickness was reduced by −27% and −14%, respectively, whereas the impingement length reductions were −9.6% and −7.6%. Finally, an ice thickness reduction of −8% was observed at a liquid water content of 1 g/m3, matched to an increase in the impingement length of 3.7% and to a reduction in length and number of the frozen rivulets.
The production of beneficial microorganisms is the first step to obtain a commercial-based product for application in agriculture. In this study, prickly pear (Opuntia ficus-indica) pruning waste was ...evaluated as a raw material for the production of large amounts of Plant Growth Promoting Microorganisms (PGPMs) reducing the number of generated wastes. Specifically, five PGPMs constituting a synthetic microbial consortium with complementing plant growth-promoting traits were grown on a laboratory scale and, subsequently, on a pilot scale using a 21-L bioreactor. Primarily, the physical-chemical characterization of the culture medium obtained from the juice of Opuntia cladodes was carried out, revealing the presence of sugars and organic acids with different molar ratios. Compared to conventional media, the waste medium did not show significant differences in bacterial growth efficiency. Instead, the survival rates of the bacteria grown in cladodes juice media, after air-drying on zeolite or freeze-drying, were significantly higher than those observed when they were grown in conventional media. The present work is the first conducted on a pilot-scale that maximizes the production of PGPMs in submerged fermentation using cladodes juice from Opuntia, reducing both economic and environmental impacts associated with the generation of wastes.
To determine the maximum-tolerated dose of gemcitabine when combined with a fixed dose of vinorelbine in the treatment of non-small-cell lung cancer (NSCLC) and to evaluate in a phase II trial the ...activity of this combination.
Sixty-eight patients with stage IIIB/IV NSCLC were treated with vinorelbine at fixed dose of 30 mg/m(2) intravenously and gemcitabine at increasing dose levels from 800 to 1,500 mg/m(2) intravenously on days 1 and 8 every 3 weeks.
In phase I, dose-limiting toxicity occurred at the dosage of 1,500 mg/m(2) gemcitabine, with three of five patients developing grade 4 thrombocytopenia. In phase II, with gemcitabine at 1,200 mg/m(2), 19 (36%) of 52 assessable patients responded. Objective response was observed in 11 (39%) of 28 patients with stage IIIB disease and in eight (33%) of 24 patients with stage IV. The median time to progression was 29 weeks (range, 2 to 41 weeks; 35 weeks and 16 weeks for stages IIIB and IV, respectively), and median survival was 54 weeks (range, 2 to 84+ weeks; 63 weeks and 42 weeks for stages IIIB and IV, respectively). One-year survival was 64% for patients with stage IIIB disease and 29% for those with stage IV. Clinical benefit response was observed in 29 (59%) of 49 assessable patients. Grade 4 leukopenia and thrombocytopenia were uncommon (6% and 8% of cases, respectively); however, grade 3/4 leukothrombocytopenia occurred more frequently in patients aged more than 70 years (52% and 24%, respectively).
The combination of vinorelbine and gemcitabine is effective and tolerable in the treatment of NSCLC, thus deserving randomized trials with cisplatin combination regimens.
Microalgae as Alternative Source Antonio Molino; Angela Iovine; Gian Paolo Leone ...
Chemical engineering transactions,
04/2020, Volume:
79
Journal Article
Peer reviewed
Open access
Microalgae represent one of the most interesting biological source, since they are relatively simple microorganisms containing high-value compounds with potential applications in numerous industrial ...sectors. The global nutraceutical market is well developed and with an enormous potential for growth: suffice to say that it has shown considerable growth with a value in 2016 between 168 and 174 billion euros, with a growth forecast that will allow it to reach between 285 and 313 billion euros in 2024. In accordance with the National Center for Biotechnology Information, by 2050, microalgae will constitute ~18% of protein source among the more diverse market. Healthy properties and excellent nutritional values have been conferred to microalgae, with particular regard to the high content of carbohydrates, vitamins, carotenoids and polyunsaturated fatty acids (PUFAs). The omega-3 PUFAs are extremely important throughout life and are a dietary need found predominantly in Nannochloropsis gaditana oleaginous microalga. In fact, although fish contain long-chain omega-3, they acquire PUFAs mainly from their microalgal diet. Additionally, considering depleting fish supplies, the use of microalgae as alternative raw material might be considered of increasing importance in the near future. Herein we report the assessment of the economic feasibility of an integrated process which allows to extract PUFAs from Nannochloropsis gaditana, by taking into account the main operational parameters able to influence the final products yield.
Although advances in imaging techniques have allowed earlier diagnosis of renal cell carcinoma (RCC) in recent decades, one-third of patients who have undergone radical resection of organ-confined ...disease will eventually develop metastases. The treatment of metastatic RCC was revolutionized by the advent of targeted therapy with tyrosine kinase inhibitors. We have followed seven patients with metastatic RCC who were treated with first-line pazopanib at our center. The case of one of these patients is described here in detail. The patient was first diagnosed with RCC in 1999 and metastases were detected in 2006 and 2012. Treatment with pazopanib at the standard dose of 800 mg/day for 29 months led to a partial response that persisted over time. Side effects (hypertension and painful mucositis) were successfully managed with supportive care at our oral therapy clinic. Early management of adverse events using a multidisciplinary approach is paramount to the favorable outcome of treatment with pazopanib and other targeted agents.
Introduction
Green oncology is a new conceptual and operational paradigm of oncology, which compared to the traditional biomedical model focused on the interest of a single patient and on its ...exclusive relationship with the doctor, represents a complex evolutionary step towards clinical activities that have to be eco-responsible of the potential current and future impact on the human, professional, structural, technological, and organizational environment, where they arise, as well as on the biosphere.
Definition
Green oncology works through ethical and managerial choices that incorporate, besides the traditional criteria of efficiency and effectiveness, the criterion of cultural, economic, environmental, and social sustainability as they are fair, livable, and possible to be realized.
Introduction
Stomatitis is a common and potentially dose-limiting adverse event of the mammalian target of rapamycin (mTOR) inhibitor therapy. To minimize dose reductions or treatment delays that may ...affect therapeutic outcomes, management includes patient education, pain management strategies, and drug treatment. The aim of this study was to evaluate the effectiveness of a topically-applied galenical preparation to minimize the impact of everolimus-associated oral mucositis in patients with advanced cancer.
Methods
Patients receiving everolimus plus exemestane for advanced breast cancer or everolimus alone for advanced renal cancer were eligible for inclusion. All patients were advised on procedures to maintain good oral hygiene and directed to use a dexamethasone-containing galenical preparation at the first signs of mucositis. Questionnaires were administered at baseline, and after cycles one, two, and three to evaluate the presence, duration, and intensity of oral mucositis.
Results
Of the 19 patients included in the study (mean age 66 years; 16% male), mucositis developed in 10.5%, 47.4%, and 52.6% of patients after the first, second, and third cycles of everolimus, respectively. The median time to development of mucositis was 18.0 days, and the median time to mucositis resolution was 30.0 days. After the first, second, and third cycles of therapy, 5.3%, 10.5%, and 10.5% of patients required interruption of everolimus therapy; however, no dosage reductions for mucositis were necessary.
Conclusions
Patient education and the provision of an effective galenical preparation can minimize the effect of mTOR inhibitor-related mucositis.
For decades Western medicine has followed a biomedical model based on linear thinking and an individualized, disease-oriented doctor-patient relationship. Today this framework must be replaced by a ...biopsychosocial model based on complexity theory and a person-oriented medical team-patient relationship, taking into account the psychological and social determinants of health and disease. However, the new model is already proving no longer adequate or appropriate, and current events are urging us to develop an ecological model in which the medical team takes into account both individual illness and population health as a whole, since we are all part of the biosphere. In recent years, the rising costs of cancer treatment have raised a serious issue of economic sustainability. As the population of our planet, we now need to rapidly address this issue, and everyone of us must try to reduce their ecological footprint, measured as CO2 production. Medical oncologists need to reduce the ecological footprint of their professional activity by lowering the consumption of economic resources and avoiding environmental damage as much as possible. This new paradigm is endorsed by the Italian College of Hospital Medical Oncology Directors (CIPOMO). A working group of this organization has drafted the "Green Oncology Position Paper": a proposal of Italian medical oncology (in accordance with international guidelines) that oncologists, while aiming for the same end results, make a commitment toward the more appropriate management of health care and the careful use of resources in order to protect the environment and the ecosphere during the daily exercise of their professional activities.
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