International guidelines for management of metastatic breast cancer: Can metastatic breast cancer be cured?

A distinctive subset of metastatic breast cancer (MBC) is oligometastatic disease, which is characterized by single or few detectable metastatic lesions. The existing treatment guidelines for patients with localized MBC include surgery, radiotherapy, and regional chemotherapy. The European School of Oncology-Metastatic Breast Cancer Task Force addressed the management of these patients in its first consensus recommendations published in 2007. The Task Force endorsed the possibility of a more aggressive and multidisciplinary approach for patients with oligometastatic disease, stressing also the need for clinical trials in this patient population. At the sixth European Breast Cancer Conference, held in Berlin in March 2008, the second public session on MBC guidelines addressed the controversial issue of whether MBC can be cured. In this commentary, we summarize the discussion and related recommendations regarding the available therapeutic options that are possibly associated with cure in these patients. In particular, data on local (surgery and radiotherapy) and chemotherapy options are discussed. Large retrospective series show an association between surgical removal of the primary tumor or of lung metastases and improved long-term outcome in patients with oligometastatic disease. In the absence of data from prospective randomized studies, removal of the primary tumor or isolated metastatic lesions may be an attractive therapeutic strategy in this subset of patients, offering rapid disease control and potential for survival benefit. Some improvement in outcome may also be achieved with optimization of systemic therapies, possibly in combination with optimal local treatment. © 2010. Published by Oxford University Press.

Liver-directed lentiviral gene therapy in a dog model of hemophilia B

We investigated the efficacy of liver-directed gene therapy using lentiviral vectors in a large animal model of hemophilia B and evaluated the risk of insertional mutagenesis in tumor-prone mouse models. We showed that gene therapy using lentiviral vectors targeting the expression of a canine factor IX transgene in hepatocytes was well tolerated and provided a stable long-term production of coagulation factor IX in dogs with hemophilia B. By exploiting three different mouse models designed to amplify the consequences of insertional mutagenesis, we showed that no genotoxicity was detected with these lentiviral vectors. Our findings suggest that lentiviral vectors may be an attractive candidate for gene therapy targeted to the liver and may be potentially useful for the treatment of hemophilia.

Doxifluridine and leucovorin: an oral treatment combination in advanced colorectal cancer

Purpose: This study was designed to test the activity and feasibility of an all-oral regimen of levo-leucovorin and doxifluridine (dFUR) in the treatment of advanced colorectal cancer and to establish whether the pharmacokinetics of dFUR and fluorouracil (FU) are affected by demographic and/or biologic parameters. Materials and Methods: One hundred eight patients with histologically proven colorectal cancer received orally administered levo-leucovorin 25 mg followed 2 hours later by dFUR 1,200 mg/m2 on days 1 to 5, with the cycle being repeated every 10 days. Results: Among 62 previously untreated patients, two complete responses (CRs) and 18 partial responses (PRs) were observed (overall response rate, 32%; 95% confidence interval, 21% to 45%). The median response duration was 4 months (range, 2 to 13) and the median survival time, 14 months. Among 46 pretreated patients, there were three CRs and three PRs (response rate, 13%; 95% confidence interval, 5% to 26%). In this group of patients, the median response duration was 4 months (range, 1 to 12) and the median survival time, 12 months. No toxic deaths were observed. The only World Health Organization (WHO) grade 3 to 4 side effect was diarrhea (32 patients). Conclusion: This regimen is active in previously untreated colorectal cancer patients and combines good compliance with safety. Limited but definite efficacy was also detected in the patients previously treated with FU, which suggests incomplete cross- resistance between the two drugs. The pharmacokinetic results suggest that the conversion rate of dFUR to FU increases between days 1 and 5, but that FU levels remain low in comparison to those measured after classical FU therapy. Under the experimental conditions used in this study, the interpatient variability of pharmacokinetic parameters remains largely unexplained by the tested variables.

Multicenter randomized trial of dacarbazine alone or in combination with two different doses and schedules of interferon alfa-2a in the treatment of advanced melanoma

Purpose: Some phase II studies have suggested that the combination of interferons (IFNs) with dacarbazine (DTIC) in the treatment of malignant melanoma (MM) increases the antitumor activity of DTIC alone. In an attempt to confirm this hypothesis, a randomized study was performed with the further intent of observing whether low doses of recombinant interferon alfa-2a (rIFNα2a) could be as effective as intermediate doses. Patients and Methods: Two hundred sixty-six patients were randomized onto three different treatment arms: DTIC 800 mg/m 2 intravenously (IV) days 1 and 21; DTIC plus rIFNα2a 9 mIU intramuscularly (IM) daily; and DTIC plus rIFNα2a 3 mIU IM three times per week. Major prognostic factors were well balanced among the three arms. Chemotherapy was administered for a maximum of eight cycles. After 6 months of therapy, rIFNα2a was continued until disease progression at 3 mIU three times per week in responding patients who had received the combined treatment. Results: The percentage of objective responses did not differ among the three groups (20%, 28%, and 23%, respectively), although a significant prolongation of response duration was observed when rIFNα2a was added to DTIC (2.6 v 8.4 v 5.5 months, respectively). However, this improvement in response duration did not translate into an amelioration of overall survival. The addition of rIFNα2a led to the onset of flu-like syndrome, but in no case was it necessary to withdraw the treatment program and no toxic deaths or life-threatening toxicities were reported. Conclusion: In this study, rIFNα2a significantly prolonged response duration, whereas no effects on response rate and survival were observed; rIFNα2a 3 mIU appeared to be equally effective and better tolerated than 9 mIU.

A dose-finding study of lanreotide (a somatostatin analog) in patients with colorectal carcinoma

BACKGROUND. Laboratory data suggest that insulin-like growth factor-1 (IGE-1) may stimulate the growth of different human tumors. At least in acromegalic patients, somatostatin (SMS) analogs, such as lanreotide, suppress the serum levels of growth hormone (GH) and IGE-1. METHODS. To evaluate the tolerability and biologic activity of different doses of lanreotide in patients with advanced colorectal carcinoma, consecutive groups of 3 patients each were subcutaneous treated with lanreotide at doses of 1, 2, 3, 4, 5, or 6 mg three times a day for 2 months. In the event of Grade 3 side effects, 3 additional patients were treated with the same dose before the next dose escalation. Serum samples were obtained on Days 0, 15, 30, and 60 for serum GH, IGF-1, and lanreotide assessment. RESULTS. Twenty-four patients were enrolled and all were evaluable. Except for the 3 and 6 mg doses, for which the observation of a Grade 3 side effect required that an additional three patients be treated, it was sufficient to treat 3 patients at each dose. The overall incidence of side effects was as follows: changes in bowel habits, 83%; abdominal cramps, 79%; diarrhea, 17%; vomiting, 17%; nausea, 21%; steatorrhea, 78%; hyperglycemia, 35%; laboratory hypothyroidism, 39%; gallstones, 13%; and weight loss, 17%. No evidence of an increase in the incidence, intensity, or duration of side effects was observed with dose escalation. Serum IGF-1 levels were as follows: Day 13: 63%, 60%, and 67% of the baseline values for the low (12 mg), intermediate (3-4 mg), and high (5- 6 mg) dose groups, respectively; Day 30: 63%, 59%, and 51%, respectively; and Day 60: 73%, 69%, and 47%, respectively. Serum lanreotide levels declined during treatment in all of the dose groups (90 ng/mL on Day 15, and 35 ng/mL on Day 60 for the 5-6 mg group; 10 ng/mL on Day 15, and 1.5 ng/mL on Day 60 for the 1-2 mg group). No antitumor activity or tumor marker reduction was observed. CONCLUSIONS. No increase in toxicity was observed when subcutaneous lanreotide doses were escalated to 6 mg three times a day for 2 months. The highest doses seemed to maintain reduced serum IGF-1 levels; with the lowest doses, a 'rebound' in serum IGF-1 levels was observed during treatment. Nevertheless, intermittent subcutaneous injections do not ensure constant serum drug concentrations over time.

¿Es el agua un espejismo? algunas reflexiones desde la perspectiva de la educación matemática crítica

Teniendo en cuenta que la educación tradicional es vista como un modelo pedagógico que entre otras: i) se enfoca en desarrollar en los estudiantes conocimientos algorítmicos, ii) hace un énfasis en la ejercitación de procedimientos, iii) no tiene en cuenta el desarrollo social del individuo dentro de una comunidad y tampoco se enfoca en el proceso que tiene un estudiante al desarrollar una actividad con determinado objeto matemático; hoy en día se propende por buscar perspectivas que le permitan a los estudiantes encontrarle sentido a las actividades que el profesor lleva al aula. A la luz de lo anterior, en Colombia han surgido diversas tendencias que han buscado la renovación pedagógica, didáctica y conceptual en la educación escolar, enmarcadas –la mayoría de estas propuestas– dentro de la idea de que los estudiantes se relacionen directamente con el conocimiento, mientras que el profesor toma una postura de orientador del proceso de aprendizaje del estudiante. Teniendo en cuenta lo anterior, muchos profesores han buscado cambiar sus prácticas tradicionales de enseñanza, un ejemplo de ello lo encontramos en el colectivo de profesores de la Institución Educativa Distrital Colegio Paulo Freire de la localidad de Usme (Bogotá, Colombia); donde los profesores –en concordancia con las ideas del pedagogo Paulo Freire– comparten, como parte de su proyecto educativo, el hecho de ver a la enseñanza como un proceso que debe generar en los estudiantes una comprensión crítica de la realidad social, política y económica en la que él está inmerso.

La construcción del significado de la asociación mediante actividades de análisis de datos: reflexiones sobre el papel del ordenador en la enseñanza de la estadística

Durante los cursos 1992 a 1998 hemos trabajado en un proyecto de investigación dirigido al estudio de las concepciones iniciales que tienen los alumnos sobre la asociación estadística y su evolución después de diversos experimentos de enseñanza usando ordenadores. En este trabajo, describimos brevemente los resultados de este proyecto, y los utilizamos como base para la reflexión sobre el papel del ordenador como recurso didáctico y como instrumento en la resolución de problemas, extendiendo las conclusiones presentadas en Batanero y cols. (1998).

Eating secret [at Whitstable Biennale Satellite]

Research around ingesting /public perceptions of ‘secret’ and exploring other narratives around our perceptions of food and eating.

Magnetic damping of levitated liquid droplets in AC and DC field

The intense AC magnetic field required to produce levitation in terrestrial conditions, along with the buoyancy and thermo-capillary forces, results in turbulent convective flow within the droplet. The use of a homogenous DC magnetic field allows the convective flow to be damped. However the turbulence properties are affected at the same time, leading to a possibility that the effective turbulent damping is considerably reduced. The MHD modified K-Omega turbulence model allows the investigation of the effect of magnetic field on the turbulence. The model incorporates free surface deformation, the temperature dependent surface tension, turbulent momentum transport, electromagnetic and gravity forces. The model is adapted to incorporate a periodic laser heating at the top of the droplet, which have been used to measure the thermal conductivity of the material by calculating the phase lag between the frequency of the laser heating and the temperature response at the bottom. The numerical simulations show that with the gradual increase of the DC field the fluid flow within the droplet is initially increasing in intensity. Only after a certain threshold magnitude of the field the flow intensity starts to decrease. In order to achieve the flow conditions close to the ‘laminar’ a D.C. magnetic field >4 Tesla is required to measure the thermal conductivity accurately. The reduction in the AC field driven flow in the main body of the drop leads to a noticeable thermo-capillary convection at the edge of the droplet. The uniform vertical DC magnetic field does not stop a translational oscillation of the droplet along the field, which is caused by the variation in total levitation force due to the time-dependent surface deformation.

Prooxidant action of knipholone anthrone: Copper dependent reactive oxygen species generation and DNA damage

Knipholone (KP) and knipholone anthrone (KA) are natural 4-phenylanthraquinone structural analogues with established differential biological activities including in vitro antioxidant and cytotoxic properties. By using DNA damage as an experimental model, the comparative Cu(II)-dependent prooxidant action of these two compounds were studied. In the presence of Cu(II) ions, the antioxidant KA (3.1-200 [mu]M) but not KP (6-384 [mu]M) caused a concentration-dependent pBR322 plasmid DNA strand scission. The DNA damage induced by KA could be abolished by reactive oxygen species scavengers, glutathione and catalase as well as EDTA and a specific Cu(I) chelator bathocuproine disulfonic acid. In addition to Cu(II) chelating activity, KA readily reduces Cu(II) to Cu(I). Copper-dependent generation of reactive oxygen species and the subsequent macromolecular damage may be involved in the antimicrobial and cytotoxic activity of KA.

In-situ non-destructive ultrasonic rheology technique for monitoring different lead-free solder pastes for surface mount applications

This paper investigates the application of a non-destructive ultrasonic technique for characterising the rheological properties of solder paste through the use of through-mode microsecond ultrasonic pulses for evaluation of viscoelastic properties of lead-free solder paste containing different types of flux. Ultrasonic techniques offer a robust and reliable form of non-destructive testing of materials where access to the sample is restricted or when sample handling can interfere with the monitoring or analysis process due to externally incorporated changes to the material’s physical state or accidental contamination during the removal or testing process. Ultrasonic based techniques are increasingly used for quality control and production monitoring functions which requires evaluation of changes in material properties for a wide range of industrial applications such as cement paste quality, plastic/polymer extrusion process, dough and even sugar content in beverage drinks. In addition, ultrasound techniques are of great interest for their capability to take rapid measurements in systems which are optically opaque. The conventional industry approach for characterising the rheological properties of suspensions during processing/packaging stage is mainly through the use of viscometer and some through the use of rheometer. One of the potential limitations of viscometer and rheometer based measurements is that the collection and preparation of the solder paste samples can irreversibly alter the structure and flow behaviour of the sample. Hence the measurement may not represent the actual quality of the whole production batch. Secondly, rheological measurements and the interpretation of rheological data is a very technical and time consuming process, which requires professionally trained R&D personnel. The ultrasound technique being proposed provides simple, yet accurate and easy to use solution for the in-situ rheological characterisation of solder pastes which will benefit the materials suppliers (who formulate and produce solder pastes) and solder paste consumers (especially, contract electronics manufacturers). The results from the work show that the technique can be used by R&D personnel involved in paste formulation and manufacture to monitor the batch-to-batch quality and consistency.

Detection of Emerging and Re-Emerging Pathogens in Surface Waters Close to an Urban Area

Current knowledge about the spread of pathogens in aquatic environments is scarce probably because bacteria, viruses, algae and their toxins tend to occur at low concentrations in water, making them very difficult to measure directly. The purpose of this study was the development and validation of tools to detect pathogens in freshwater systems close to an urban area. In order to evaluate anthropogenic impacts on water microbiological quality, a phylogenetic microarray was developed in the context of the EU project µAQUA to detect simultaneously numerous pathogens and applied to samples from two different locations close to an urban area located upstream and downstream of Rome in the Tiber River. Furthermore, human enteric viruses were also detected. Fifty liters of water were collected and concentrated using a hollow-fiber ultrafiltration approach. The resultant concentrate was further size-fractionated through a series of decreasing pore size filters. RNA was extracted from pooled filters and hybridized to the newly designed microarray to detect pathogenic bacteria, protozoa and toxic cyanobacteria. Diatoms as indicators of the water quality status, were also included in the microarray to evaluate water quality. The microarray results gave positive signals for bacteria, diatoms, cyanobacteria and protozoa. Cross validation of the microarray was performed using standard microbiological methods for the bacteria. The presence of oral-fecal transmitted human enteric-viruses were detected using q-PCR. Significant concentrations of Salmonella, Clostridium, Campylobacter and Staphylococcus as well as Hepatitis E Virus (HEV), noroviruses GI (NoGGI) and GII (NoGII) and human adenovirus 41 (ADV 41) were found in the Mezzocammino site, whereas lower concentrations of other bacteria and only the ADV41 virus was recovered at the Castel Giubileo site. This study revealed that the pollution level in the Tiber River was considerably higher downstream rather than upstream of Rome and the downstream location was contaminated by emerging and re-emerging pathogens.