Randomised, multicentre, phase III, open-label study of alectinib vs crizotinib in treatment-naïve anaplastic lymphoma kinase (ALK)-positive advanced NSCLC (ALEX study).

Background: In ∼5% of advanced NSCLC tumours, ALK tyrosine kinase is constitutively activated after translocation of ALK. ALK+ NSCLC was shown to be highly sensitive to the first approved ALK inhibitor, crizotinib. However, all pts eventually relapse on crizotinib mainly due to secondary ALK mutations/amplification or CNS metastases. Alectinib is a highly selective, potent, oral next-generation ALK inhibitor. Clinical phase II alectinib data in 46 crizotinib-naïve pts with ALK+ NSCLC reported an objective response rate (ORR) of 93.5% and a 1-year progression-free rate of 83% (95% CI: 68-92) (Inoue et al. J Thorac Oncol 2013). CNS activity was seen: of 14 pts with baseline brain metastasis, 11 had prior CNS radiation, 9 of these experienced CNS and systemic PFS of >12 months; of the 3 pts without prior CNS radiation, 2 were >15 months progression free. Trial design: Randomised, multicentre, phase III, open-label study in pts with treatment-naïve ALK+ advanced, recurrent, or metastatic NSCLC. All pts must provide pretreatment tumour tissue to confirm ALK rearrangement (by IHC). Pts (∼286 from ∼180 centres, ∼30 countries worldwide) will be randomised to alectinib (600mg oral bid, with food) or crizotinib (250mg oral bid, with/without food) until disease progression (PD), unacceptable toxicity, withdrawal of consent, or death. Stratification factors are: ECOG PS (0/1 vs 2), race (Asian vs non-Asian), baseline CNS metastases (yes vs no). Primary endpoint: PFS by investigators (RECIST v1.1). Secondary endpoints: PFS by Independent Review Committee (IRC); ORR; duration of response; OS; safety; pharmacokinetics; quality of life. Additionally, time to CNS progression will be evaluated (MRI) for the first time in a prospective randomised NSCLC trial as a secondary endpoint. Pts with isolated asymptomatic CNS progression will be allowed to continue treatment beyond documented progression until systemic PD and/or symptomatic CNS progression, according to investigator opinion. Time to CNS progression will be retrospectively assessed by the IRC using two separate criteria, RECIST and RANO. Further details: ClinicalTrials.gov (NCT02075840). Disclosure: T.S.K. Mok: Advisory boards: AZ, Roche, Eli Lilly, Merck Serono, Eisai, BMS, AVEO, Pfizer, Taiho, Boehringer Ingelheim, Novartis, GSK Biologicals, Clovis Oncology, Amgen, Janssen, BioMarin; board of directors: IASLC; corporate sponsored research: AZ; M. Perol: Advisory boards: Roche; S.I. Ou: Consulting: Pfizer, Chugai, Genentech Speaker Bureau: Pfizer, Genentech, Boehringer Ingelheim; I. Bara: Employee: F. Hoffmann-La Roche Ltd; V. Henschel: Employee and stock: F. Hoffmann-La Roche Ltd.; D.R. Camidge: Honoraria: Roche/Genentech. All other authors have declared no conflicts of interest.

Influência da dependência energética de dosímetros termoluminescentes na medida da dose na entrada da pele em procedimentos radiográficos

OBJETIVO: O objetivo do presente trabalho foi avaliar a influência da dependência energética de materiais termoluminescentes na determinação da dose na entrada da pele de pacientes submetidos a exames radiográficos (radiologia geral, mamografia e radiologia odontológica). MATERIAIS E MÉTODOS: Três diferentes materiais termoluminescentes foram utilizados: LiF:Mg,Ti, LiF:Mg,Cu,P e CaSO4:Dy. Estes materiais foram expostos a fontes padronizadas de radiação X e gama, e a feixes clínicos de raios X. RESULTADOS: As curvas de calibração e de dependência energética foram obtidas. Todos os materiais apresentaram resposta linear em função do kerma no ar. Com relação à dependência energética, as amostras de CaSO4:Dy e LiF:Mg,Ti mostraram maior variação da resposta termoluminescente em função da energia efetiva do feixe de radiação. CONCLUSÃO: Os materiais testados mostraram desempenho adequado para a detecção da radiação X em feixes padronizados e clínicos. Embora as amostras de CaSO4:Dy e LiF:Mg,Ti apresentem dependência energética significativa no intervalo de energia considerado, este materiais podem ser utilizados para medição da dose de entrada na pele se fatores de correção apropriados forem utilizados.

Síndrome do túnel do carpo: estudo comparativo entre a medição ultrassonográfica e cirúrgica do nervo mediano nos casos moderados e severos da doença

OBJETIVO: Comparar os perímetros ultrassonográfico e cirúrgico do nervo mediano, avaliar o diagnóstico da síndrome do túnel do carpo pela área seccional do nervo mediano, verificar associação entre área seccional do nervo mediano e gravidade da síndrome do túnel do carpo. MATERIAIS E MÉTODOS: Estudo de 30 pacientes com síndrome do túnel do carpo. Mediram-se a área seccional e o perímetro ultrassonográfico do nervo mediano. Avaliaram-se correlação clínica-ultrassonográfica e associação com a gravidade da doença. Compararam-se os perímetros ultrassonográfico e cirúrgico. Compararam-se classificação clínica com perímetro cirúrgico, área seccional e perímetro ultrassonográfico. RESULTADOS: Cinco perdas, 25 pacientes estudados; 60% dos pacientes com doença moderada, 60% de casos graves ultrassonográficos (área seccional > 0,15 cm²). Distribuição não normal de perímetro cirúrgico (p = 0,5), distribuição normal de perímetro ultrassonográfico (p = 0). Diferença significativa entre perímetros (teste-t de amostras pareadas; p < 0,0001; intervalo de confiança = 95%). Pearson 0,3913. Pelo diagrama de Bland-Altman, observaram-se maiores perímetros cirúrgicos. Encontrou-se área seccional do nervo mediano > 0,09 cm² em todos os pacientes. CONCLUSÃO: Não houve associação entre perímetro ultrassonográfico e perímetro cirúrgico do nervo mediano. Área seccional do nervo mediano > 0,09 cm² foi válida para o diagnóstico. Não houve associação entre área seccional e gravidade da doença.

Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

Abstract Objective: To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality. Materials and Methods: We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m2 to 41.8 kg/m2. Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement. Results: The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis. Conclusion: Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations.

Análise das isotermas de adsorção de Cu(II), Cd(II), Ni(II) e Zn(II) pela N-(3,4-dihidroxibenzil) quitosana empregando o método da regressão não linear

Adsorption of Cu(II), Ni(II), Pb(II) and Zn(II) ions from aqueous solutions by N-(3,4-dihydroxybenzyl) chitosan have been carried out. The Langmuir (L), Freundlich (F), Langmuir - Freundlich (LF), Redlich-Peterson (RP) and Tóth (T) adsorption isotherms models have been applied to fit the experimental data. Nonlinear regression computational program "Enzefitte", which is a library of the more commonly used adsorption isotherm equations for obtaining tabular outuput suitable for plotting theoretical of fitted isotherms, has been used to estimate the adsorption parameters. These parameters were used to calculate the amount adsorbed q calc., a function of concentration (C).

Estudo da dissolução oxidativa microbiológica de uma complexa amostra mineral contendo pirita (FeS2), Pirrotita (Fe1-xS) e Molibdenita (MoS2)

This work aims to study the oxidation of a complex molybdenite mineral which contains pyrite and pyrrotite, by Acidithiobacillus ferrooxidans. This study was performed by respirometric essays and bioleaching in shake flasks. Respirometric essays yielded the kinetics of mineral oxidation. The findings showed that sulfide oxidation followed classical Michaelis-Menten kinetics. Bioleaching in shake flasks allowed evaluation of chemical and mineralogical changes resulting from sulfide oxidation. The results demonstrated that pyrrotite and pyrite were completely oxidized in A. ferrooxidans cultures whereas molybdenite was not consumed. These data indicated that molybdenite was the most recalcitrant sulfide in the sample.

Estudo da oxidação dos sulfetos sintéticos molibdenita (MoS2) e covelita (CuS) por Acidithiobacillus ferrooxidans via respirometria celular

This paper analyses the oxidation of covellite and molybdenite by Acidithiobacillus ferrooxidans strain LR using respirometric experiments. The results showed that both sulfides were oxidized by A. ferrooxidans, however, the covellite oxidation was much higher than molybdenite. Regarding the kinetic oxidation, the findings revealed that just molybdenite oxidation followed the classical Michaelis-Menten kinetic. It is probably associated with the pathway which these sulfides react to chemistry-bacterial attack, what is influenced by its electronic structures. Besides, experiments conducted in the presence of Fe3+ did not indicate alterations in molybdenite oxidation. Thus, ferric ions seem not to be essential to the sulfide oxidations.

Optimization of the use of carbon paste electrodes (CPE) for electrochemical study of the chalcopyrite

The use of carbon paste electrodes (CPE) of mineral sulfides can be useful for electrochemical studies to overcome problems by using massive ones. Using CPE-chalcopyrite some variables were electrochemically evaluated. These variables were: (i) the atmosphere of preparation (air or argon) of CPE and elapsed time till its use; (ii) scan rate for voltammetric measurements and (iii) chalcopyrite concentration in the CPE. Based on cyclic voltammetry, open-circuit potential and electrochemical impedance results the recommendations are: oxygen-free atmosphere to prepare and kept the CPE until around two ours, scan rates from 10 to 40 mV s-1, and chalcopyrite concentrations > 20%.

Uso de equações lineares na determinação dos parâmetros de Michaelis-Menten

The Michaelis-Menten equation is used in many biochemical and bioinorganic kinetic studies involving homogeneous catalysis. Otherwise, it is known that determination of Michaelis-Menten parameters K M, Vmax, and k cat by the well-known Lineweaver-Burk double reciprocal linear equation does not produce the best values for these parameters. In this paper we present a discussion on different linear equations which can be used to calculate these parameters and we compare their results with the values obtained by the more reliable nonlinear least-square fit.

Uso da FTIR na obtenção de resinas e na síntese de peptídeos em fase sólida

Despite the increase in peptide chain aggregation, which decreases the rate of coupling reactions, the synthesis and use of very highly substituted resins still remains as a controversial point in the SPPS, due to its clear economical advantages (lesser solvent consumption and higher amount of peptide per synthesis). In order to better investigate the synthesis and the use of very highly substituted resins, the FTIR, NMR and EPR were compared. By FTIR techniques it was possible to follow all the steps of resin synthesis and the factors affecting the aggregation of the chains inside the peptidil-BHAR and MBHAR.

Xylitol from rice husks by acid hydrolysis and Candida yeast fermentation

An investigation was conducted into the production of xylose by acid hydrolysis of rice husks and its subsequent bioconversion to xylitol. The parameters were optimised using the response surface methodology. The fermentation stage took place with the aid of the yeast species Candida guilliermondii and Candida tropicalis. An evaluation of the influence of several biomass pre-treatments was also performed. The effects of the acid concentration and hydrolysate pH on xylitol global yield were also assessed, and the highest yield of xylitol was 64.0% (w/w). The main products, xylose and xylitol, were identified and quantified by means of liquid chromatography.

Volatile constituents of Aristolochia trilobata L. (Aristolochiaceae): a rich source of sulcatyl acetate

Analysis of the volatile fraction of Aristolochia trilobata stem led to the identification of 6-methyl-5-hepten-2-yl acetate (23.31 ± 0.28%), limonene (15.43 ± 0.030%), linalool (8.70 ± 0.29%), p-cymene (7.81 ± 0.12%), bicyclogermacrene (4.21 ± 0.11%), and spathulenol (4.17 ± 0.14%) as the major constituents of the essential oil. Linalool (29.51 ± 0.49%), 6-methyl-5-hepten-2-ol (19.54 ± 0.82%), 6-methyl-5-hepten-2-yl acetate (8.92 ± 0.16%), and a-terpineol (4.62 ± 0.05%) were identified as major constituents of the hydrolate. The compound 6-methyl-5-hepten-2-yl acetate was isolated for the first time from this plant and was identified as the major component of the volatile fraction.

Modelos de ponto crítico para estimar danos causados pela ferrugem da folha da aveia branca

Em experimentos conduzidos no campo, nas safras agrícolas de 1995 e 1996, gerou-se o gradiente da intensidade da ferrugem da folha da aveia branca, cultivar UPF 13, pela aplicação nos órgãos aéreos de doses crescentes do fungicida triadimenol. As equações das funções de dano foram obtidas pela correlação entre o rendimento de grãos e a incidência da doença em diferentes estádios fenológicos da cultura. Na safra de 1995 as equações obtidas foram R= 2.103,5 - 17,983I e R= 2.404,6 - 12,832I, respectivamente para alongamento e emborrachamento, e em 1996, R= 3.889,2 - 27,871I e R= 5.366,4 - 20,999I, respectivamente para emborrachamento e floração (R= rendimento de grãos e I= incidência foliar). Estas equações, contendo o coeficiente de dano, permitem calcular o limiar de dano econômico (LDE) tomado como critério indicador do momento para o início do controle químico da ferrugem da folha da aveia. As reduções no rendimento de grãos, no peso do hectolitro e no peso de mil sementes, atingiram, respectivamente 57,13%, 16,64% e 21,49% na safra 1995 e 19,79%, 13,39% e 16,33%, na safra 1996.

População caiçara, Mata Atlântica e situação atual do palmito-juçara (Euterpe edulis Mart.) na região do Rio Una da Aldeia (Iguape-SP), entorno da Estação Ecológica Jureia-Itatins

Neste trabalho foram desenvolvidos estudos na região do Rio Una da Aldeia, afluente do ribeira de Iguape, no entorno da Estação Ecológica Jureia-Itatins, Município de Iguape, São Paulo. Esses estudos consistiram de levantamento em campo das populações de Euterpe edulis Mart. (palmito-juçara) e também de estudos preliminares etnobotânicos, através da aplicação de questionários semiestruturados e realização de seminário para diagnóstico do uso atual da área, sensibilização e percepção da sustentabilidade ambiental pelos comunitários. O trabalho teve como objetivos avaliar o estado de conservação das populações do palmito-juçara e também estudar relações que as comunidades caiçaras da região mantinham com o ambiente natural. Os resultados indicaram a urgente necessidade de elaboração de um plano para enriquecimento e manejo de Euterpe edulis Mart. Foi constatada também a imensa potencialidade de uso econômico da floresta, bem como o desejo das populações tradicionais em manejar sustentavelmente os recursos naturais.