Utilização conjunta do ABC e TOC para otimização dos resultados de empresas prestadoras de serviços : o caso de uma gráfica de jornais

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Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers

To investigate response, survival, and safety profile of the somatostatin-based radiopeptide (90)yttrium-labeled tetraazacyclododecane-tetraacetic acid modified Tyr-octreotide ([(90)Y-DOTA]-TOC) in neuroendocrine cancers.

Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers

Radiopeptide therapy is commonly performed with a single radioisotope. We aimed to compare the effectiveness of somatostatin-based radiopeptide therapy with a single versus a combination of radioisotopes.

Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours

PURPOSE Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides (90)Y or (177)Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. METHODS In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [(90)Y-DOTA]-TOC or [(177)Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. RESULTS Overall, 910 patients underwent 1,804 cycles of [(90)Y-DOTA]-TOC and 141 patients underwent 259 cycles of [(177)Lu-DOTA]-TOC. The median survival after [(177)Lu-DOTA]-TOC and after [(90)Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [(177)Lu-DOTA]-TOC over [(90)Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [(177)Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). CONCLUSION The present results revealed no difference in median overall survival after [(177)Lu-DOTA]-TOC and [(90)Y-DOTA]-TOC. Furthermore, [(177)Lu-DOTA]-TOC was less haematotoxic than [(90)Y-DOTA]-TOC.

Somatostatin-based radiotherapy with [90Y-DOTA]-TOC in neuroendocrine tumors: long-term outcome of a phase I dose escalation study

BACKGROUND We describe the long-term outcome after clinical introduction and dose escalation of somatostatin receptor targeted therapy with [90Y-DOTA]-TOC in patients with metastasized neuroendocrine tumors. METHODS In a clinical phase I dose escalation study we treated patients with increasing [90Y-DOTA]-TOC activities. Multivariable Cox regression and competing risk regression were used to compare efficacy and toxicities of the different dosage protocols. RESULTS Overall, 359 patients were recruited; 60 patients were enrolled for low dose (median: 2.4 GBq/cycle, range 0.9-7.8 GBq/cycle), 77 patients were enrolled for intermediate dose (median: 3.3 GBq/cycle, range: 2.0-7.4 GBq/cycle) and 222 patients were enrolled for high dose (median: 6.7 GBq/cycle, range: 3.7-8.1 GBq/cycle) [90Y-DOTA]-TOC treatment. The incidences of hematotoxicities grade 1-4 were 65.0%, 64.9% and 74.8%; the incidences of grade 4/5 kidney toxicities were 8.4%, 6.5% and 14.0%, and the median survival was 39 (range: 1-158) months, 34 (range: 1-118) months and 29 (range: 1-113) months. The high dose protocol was associated with an increased risk of kidney toxicity (Hazard Ratio: 3.12 (1.13-8.59) vs. intermediate dose, p = 0.03) and a shorter overall survival (Hazard Ratio: 2.50 (1.08-5.79) vs. low dose, p = 0.03). CONCLUSIONS Increasing [90Y-DOTA]-TOC activities may be associated with increasing hematological toxicities. The dose related hematotoxicity profile of [90Y-DOTA]-TOC could facilitate tailoring [90Y-DOTA]-TOC in patients with preexisting hematotoxicities. The results of the long-term outcome suggest that fractionated [90Y-DOTA]-TOC treatment might allow to reduce renal toxicity and to improve overall survival. (ClinicalTrials.gov number NCT00978211).

Chemostratigraphy (CaCO3, TOC, d13Corg) of Sinemurian black shales

The Shales-with-'Beef' and Black Ven Marls of the Charmouth Mudstone Formation (Sinemurian) exposed on the Dorset Coast in southern England (Wessex Basin) show stratigraphic variation in carbonate, organic carbon and organic-carbon isotopes. Little environmental significance is attached to the variation of carbonate except in the case of the tabular and nodular limestones interrupting the sequence that probably record stratigraphic condensation and/or sedimentary stillstands that, in an extreme case, were accompanied by sea-floor erosion to produce the bored and encrusted 'Coinstone'. Relatively high total organiccarbon (TOC) contents are present in the laminated mudstones of the lower turneri Zone (upper brooki and lower birch Subzones) and the obtusum Zone (obtusum and stellare Subzones). Basin stratification related to fresh-water influx was the most likely aid to deoxygenation and enhanced preservation of organic matter. The organic-carbon isotope curve (d13Corg), which shows positive excursions in the upper turneri Zone (upper birchi Subzone) and highest obtusum - raricostatum Zones (highest stellare Subzone, densinodulum and lower raricostatoides Subzones), does not correlate with the TOC stratigraphy and was clearly not controlled by local patterns of organic-matter burial. Long-term (hundreds-of-thousands of years) variations in the carbon-isotope (d13Corg) curve are interpreted as reflecting changing seawater isotopic composition and, in the case of the stratigraphically higher interval, may be related to marine organic-carbon burial on the margins of the proto-Atlantic, as exemplified by the Lusitanian Basin in Portugal. Correlation of the carbon-isotope profile with putative sea-level curves is problematic in detail, although significant local transgressive pulses in the turneri and late raricostatum Zones are approximately coincident with positive d13Corg excursions.

TOC, TN, d15N isotopes and alkenone concentration in equatorial Pacific sediments

The largest increase in export production in the eastern Pacific of the last 5.3 Myr (million years) occurred between 2.2 and 1.6 Myr, a time of major climatic and oceanographic reorganization in the region. Here, we investigate the causes of this event using reconstructions of export production, nutrient supply and oceanic conditions across the Pliocene-Pleistocene in the eastern equatorial Pacific (EEP) for the last 3.2 Myr. Our results indicate that the export production peak corresponds to a cold interval marked by high nutrient supply relative to consumption, as revealed by the low bulk sedimentary 15N/14N (d15N) and alkenone-derived sea surface temperature (SST) values. This ?0.6 million year long episode of enhanced delivery of nutrients to the surface of the EEP was predominantly initiated through the upwelling of nutrient-enriched water sourced in high latitudes. In addition, this phenomenon was likely promoted by the regional intensification of upwelling in response to the development of intense Walker and Hadley atmospheric circulations. Increased nutrient consumption in the polar oceans and enhanced denitrification in the equatorial regions restrained nutrient supply and availability and terminated the high export production event.

TOC and TIC concentration in sediments from Peru margin and eastern equatorial Pacific ODP sites

Organic matter deposited and buried under the seafloor is one of the major carbon sources for microbial life in the deep subsurface of the ocean. In this report, we present a compilation of all available total organic carbon (TOC) and total inorganic carbon (TIC) data for the sites drilled during Ocean Drilling Program (ODP) Leg 201. We include the TOC and TIC data from sites of Deep Sea Drilling (DSDP) Leg 34 and ODP Legs 112 and 138 (Yeats, Hart, et al., 1976, doi:10.2973/dsdp.proc.34.1976; Suess, von Huene, et al., 1988, doi:10.2973/odp.proc.ir.112.1988; Mayer, Pisias, Janecek, et al., 1992, doi:10.2973/odp.proc.ir.138.1992), which were reoccupied during ODP Leg 201. Additional data from Leg 201 shore-based analyses are also included in the compilation.

Elemental analyses (XRF), total organic carbon (TOC), grain size analyses, lamination index of sediment core SO130-289KL

The Dansgaard-Oeschger oscillations and Heinrich events described in North Atlantic sediments and Greenland ice are expressed in the climate of the tropics, for example, as documented in Arabian Sea sediments. Given the strength of this teleconnection, we seek to reconstruct its range of environmental impacts. We present geochemical and sedimentological data from core SO130-289KL from the Indus submarine slope spanning the last ~ 80 kyr. Elemental and grain size analyses consistently indicate that interstadials are characterized by an increased contribution of fluvial suspension from the Indus River. In contrast, stadials are characterized by an increased contribution of aeolian dust from the Arabian Peninsula. Decadal-scale shifts at climate transitions, such as onsets of interstadials, were coeval with changes in productivity-related proxies. Heinrich events stand out as especially dry and dusty events, indicating a dramatically weakened Indian summer monsoon, potentially increased winter monsoon circulation, and increased aridity on the Arabian Peninsula. This finding is consistent with other paleoclimate evidence for continental aridity in the northern tropics during these events. Our results strengthen the evidence that circum-North Atlantic temperature variations translate to hydrological shifts in the tropics, with major impacts on regional environmental conditions such as rainfall, river discharge, aeolian dust transport, and ocean margin anoxia.

TOC, carbonate, opal composition and trace element concentration from ODP Holes 175-1082A and 175-1084A

Distinctive light-dark color cycles in sediment beneath the Benguela Current Upwelling System indicate repetitive alternations in sediment delivery and deposition. Geochemical proxies for paleoproductivity and for depositional conditions were employed to investigate the paleoceanographic processes involved in creating these cycles in three mid-Pleistocene intervals from ODP Sites 1082 and 1084. Concentrations of total organic carbon (TOC) vary between 3.5 and 17.1%. Concentrations of CaCO3 vary inversely to TOC and Al, which suggests that both carbonate dissolution and terrigenous dilution contribute to the light-dark cycles. Opal concentrations are independent of both TOC and CaCO3, therefore eliminating diatom production and lateral transport of shelf material as causes of the light-dark cycles. d13Corg and d15Ntot values do not vary across light-dark sediment intervals, implying that the extent of relative nutrient utilization did not change. The stable d15Ntot values represent a balanced change in nitrate supply and export production and therefore indicate that productivity was elevated during deposition of the TOC-rich layers. Parallel changes in concentrations of indicator trace elements and TOC imply that changes in organic matter delivery influenced geochemical processes on the seafloor by controlling consumption of pore water oxygen. Cu, Ni, and Zn are enriched in the darker sediment as a consequence of greater organic matter delivery. Redox-sensitive metals vary due to loss (Mn and Ba) or enrichment (Mo) under reducing conditions created by TOC oxidation. Organic matter delivery impacts subsequent geochemical changes such as carbonate dissolution, sulfate reduction and the concentration of metals. Thus, export production is considered ultimately responsible for the generation of the color cycles.