Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy

In this update of our 2005 document, we used an evidence-based approach whenever possible to formulate recommendations, emphasizing the results of controlled trials concerning the best use of antiemetic agents for the prevention of emesis and nausea following anticancer chemotherapies of high emetic risk. A three-drug combination of a 5-hydroxytryptamine type 3 receptor (5-HT(3)) receptor antagonist, dexamethasone, and aprepitant beginning before chemotherapy and continuing for up to 4 days remains the standard of care. We address issues of dose, schedule, and route of administration of five selective 5-HT(3) receptor antagonists. We conclude that, for each of these five drugs, there is a plateau in therapeutic efficacy above which further dose escalation does not improve outcome. In trials designed to prove the equivalence of palonosetron to ondansetron and granisetron, palonosetron proved superior in emesis prevention, while adverse effects were comparable. Furthermore, for all classes of antiemetic agents, a single dose is as effective as multiple doses or a continuous infusion. The oral route is as efficacious as the intravenous route of administration

Unraveling the In Vitro Antitumor Activity of Vismia Baccifera Against HepG2: Role of Hydrogen Peroxide

Currently natural products derived from plants are receiving huge attention because of their antitumor activities. In previous work we reported that an aqueous leaf extract of Vismia baccifera induced toxicity in HepG2. The present study focuses on the mechanisms of the cytotoxic actions induced by the extract. Results showed that V. baccifera was innocuous in non-transformed human HH4 hepatocytes. In HepG2 it caused deregulation of antioxidant status (increasing superoxide dismutase expression and decreasing glutathione levels and glutathione peroxidase activity) and accumulation of reactive oxygen species, particularly hydrogen peroxide. The extract induced a) cell cycle arrest at G(2)/M phase, b) phosphorylation of ATM (protein kinase ataxia-telangiectasia mutated) and gamma H2AX (gamma-histone family 2A variant), c) caspase-3 activation, and e) deregulation of the Bax/Bcl family, increasing pro-apoptotic proteins. ATM did not seem to be involved in gamma H2AX activation. Co-incubation with catalase prevented the alterations elicited by V. baccifera in HepG2. Taking together, these results indicate that hydrogen peroxide mediates the HepG2 cytotoxic response and provide evidence for more in-depth studies of the signaling involved.This work was supported by the Basque Government (ref. IT687-13), and University of the Basque Country UPV/EHU (CLUMBER UFI11/20, and pre-doctoral and post-doctoral grants to J.T.)

Le patologie legate a difetti di allineamento dell’arto posteriore del cane

Le principali patologie dell’arto posteriore del cane sono state rivalutate negli ultimi decenni secondo una prospettiva nuova, che tende ad inglobarle in un complesso meccanismo di forze statiche e dinamiche che agiscono sull’intero arto pelvico durante la stazione e la deambulazione; alterazioni dell’allineamento di tali forze possono favorire l’insorgenza di patologie, come la lussazione rotulea. Lo scopo del lavoro è stato quello di mettere a confronto i principali metodi di misurazione e le proiezioni radiografiche (proiezione ventro-dorsale standard, proiezione postero-anteriore, proiezione antero-posteriore a “cane seduto”)riportati in letteratura per la valutazione dell’allineamento del femore, dal punto di vista della semplicità di esecuzione e dell’attendibilità dei valori ottenuti; i parametri analizzati sono stati l’angolo di deviazione anatomica, l’angolo di inclinazione e l’angolo di anteroversione. Alcuni casi di lussazione rotulea sono stati poi revisionati, al fine di individuare difetti di allineamento, che possano aver favorito la patologia ed influenzato l’esito del trattamento chirurgico. I risultati scaturiti sono stati successivamente utilizzati per rivedere, da un punto di vista critico, le cause di fallimento di alcuni interventi, e per valutare se e come la costante applicazione nella pratica clinica dei protocolli esaminati nel nostro studio possa migliorare le probabilità di successo della terapia chirurgica. Sulla base delle nostre osservazioni, possiamo affermare che nella patogenesi di molte patologie dell’arto posteriore del cane, soprattutto la lussazione rotulea, devono sempre essere considerati i possibili difetti di allineamento, come fattori predisponenti o anche di per sé determinanti; la loro valutazione è fondamentale per l’impostazione di una corretta procedura terapeutica. L’arto pelvico deve essere sottoposto a studio radiografico, composto da radiografie “perfette” di femore e tibia. Per quanto riguarda il femore, a nostro parere, la proiezione ventro-dorsale standard della pelvi per lo screening diagnostico della displasia d’anca si conferma essere la più idonea per semplicità di esecuzione e affidabilità; i parametri minimi per una adeguata valutazione morfologica sono: l’angolo di deviazione femorale, mediante l’impiego del metodo di Montavon per l’individuazione dell’asse anatomico; l’angolo di inclinazione, secondo il metodo Symax o il metodo di Montavon; l’angolo di anteroversione, calcolato utilizzando il metodo biplanare. La revisione della casistica clinica ha evidenziato che il trattamento di eventuali deformità ossee con tecniche di riallineamento morfo-funzionale che prevedono osteotomie correttive, seppur invasivo, è indispensabile per una definitiva risoluzione della patologia in atto. L’applicazione costante delle procedure diagnostiche e terapeutiche analizzate nelle diverse fasi del nostro lavoro ai casi di lussazione rotulea ha ridotto drasticamente la percentuale di recidive

Engineering Services: A Business Plan

[ABSTRACT ONLY; NO FULL TEXT] The following MBA thesis was selected based on our cumulative group interest in engineering services. Our client reached out to CSUN as a Masters in Mechanical Engineering alumni seeking business counsel for his startup engineering company. Based on mutual interest between the group and our client, a situational analysis was conducted, concluding that the project's scope would include finding a profitable niche and business strategy in the engineering services environment. Research commenced through the use of tools such as Porter's Five Forces and PEST Analysis for the external environment, in addition to SWOT analysis for the internal environment of engineering services. The purpose of these analyses was to identify resources and capabilities of the firm and determine how they fit into its competitive environment. Next, a feasibility analysis was conducted to determine the viability of the firm's offerings, given the capabilities and constraints whichconstraints that it possesses. This included a thorough analysis of technical specifications, risks, management team, marketing, and management team considerations. The methods used to conduct our research included research from literary websites and databases in addition to customer and competitor surveys. Based on the group's research, recommendations were offered to fulfill the firm's goals by focusing the firm's resources on a specific area or niche of the engineering market. The tactics to achieve this include capital investments, sales and marketing strategy, management plans, and financial leverage techniques. My contributions to the project included thorough literary research, interviewing potential customers and incumbent competitors of the industry, and strategy recommendations. I took the lead on key areas of the project such as Porter's Five Forces analysis and , marketing feasibility, while managing and supporting my teammates. In addition, I designed the marketing survey and maintained a key role in editing the group's documentation throughout the project. Furthermore, I was able to leverage some of my networking abilities to attain critical information from targeted cold-calling and established contacts within the engineering industry. The thesis was largely considered a success due to the hard work of the engineering services team, the support of our graduate counselor, Dr. Ali Behnezhad, and the willingness of our client to embrace change.California State University, Northridge. Department of Business Administration

A Performer's Guide: Suite Paysanne Hongroise for Flute and Piano by Béla Bartók/Arranged Paul Arma

Recognized today principally as a composer, B&eacute;la Bart&oacute;k devoted much of his life to the collection, analysis and categorization of folk music in his native Hungary as well as Romania and Slovakia. Along with his colleague Zoltan Kodaly,&nbsp;Bart&oacute;k's work as an ethnomusicologist is credited for the resurgence of interest in the preservation of folk music traditions in Hungary.</p

Ecogenetics of mercury: From genetic polymorphisms and epigenetics to risk assessment and decision‐making

The risk assessment of mercury (Hg), in both humans and wildlife, is made challenging by great variability in exposure and health effects. Although disease risk arises following complex interactions between genetic (“nature”) and environmental (“nurture”) factors, most Hg studies thus far have focused solely on environmental factors. In recent years, ecogenetic‐based studies have emerged and have started to document genetic and epigenetic factors that may indeed influence the toxicokinetics or toxicodynamics of Hg. The present study reviews these studies and discusses their utility in terms of Hg risk assessment, management, and policy and offers perspectives on fruitful areas for future research. In brief, epidemiological studies on populations exposed to inorganic Hg (e.g., dentists and miners) or methylmercury (e.g., fish consumers) are showing that polymorphisms in a number of environmentally responsive genes can explain variations in Hg biomarker values and health outcomes. Studies on mammals (wildlife, humans, rodents) are showing Hg exposures to be related to epigenetic marks such as DNA methylation. Such findings are beginning to increase understanding of the mechanisms of action of Hg, and in doing so they may help identify candidate biomarkers and pinpoint susceptible groups or life stages. Furthermore, they may help refine uncertainty factors and thus lead to more accurate risk assessments and improved decision‐making. Environ Toxicol Chem 2014;33:1248–1258. © 2013 SETACPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106903/1/etc2375.pd