Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer

A fluoropyrimidine plus irinotecan or oxaliplatin, combined with bevacizumab (a monoclonal antibody against vascular endothelial growth factor), is standard first-line treatment for metastatic colorectal cancer. Before the introduction of bevacizumab, chemotherapy with fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) showed superior efficacy as compared with fluorouracil, leucovorin, and irinotecan (FOLFIRI). In a phase 2 study, FOLFOXIRI plus bevacizumab showed promising activity and an acceptable rate of adverse effects

Obstetric and perinatal outcomes of teenage pregnant women: a retrospective study

<p><strong>Background:</strong> teenage pregnancy is a worldwide social problem. The aim of this study is to provide more data for a better understanding of the possible maternal and foetal risks associated with teenage pregnancies.</p><p><strong>Methods:</strong> the hospital records of all pregnant women, aged between 14 and 19, from the obstetric registers of the Policlinico Umberto I Hospital in Rome, between 2000 and 2010, have been completely reviewed (n=184). For each pregnant woman socio-demographic characteristics, obstetric history, pregnancy and birth outcomes were also determined. Our results were compared with a control group composed of 150 primigravida adult women aged 20-29 years who delivered at the Policlinico Umberto I Hospital in Rome in the same period.</p><p><strong>Results:</strong> the mean age ± SD of the study group was 17.9 ± 1.2, while that of the control group was 25.4 ± 2.4. The control group had a significantly lower risk of preterm delivery (p=0.000). The rate of low birth weight babies born to the young mothers was significantly higher than that of babies born to the adult mothers (p=0.036). The study group had a lower risk of instrumental delivery and a higher proportion of spontaneous delivery (p=0.000). Finally, we observed a statistically significant difference of the APGAR score at the fifth minute between the two groups (p=0.004).</p><p><strong>Conclusions:</strong> our results seemed to confirm the outcomes of previous studies for adolescent pregnant women, mainly regarding the increased risks of preterm deliveries and low birth weight babies, the higher incidence of spontaneous vaginal delivery and the lower incidence of instrumental delivery.</p

Obstetric and perinatal outcomes of teenage pregnant women: a retrospective study

Background: teenage pregnancy is a worldwide social problem. The aim of this study is to provide more data for a better understanding of the possible maternal and foetal risks associated with teenage pregnancies. Methods: the hospital records of all pregnant women, aged between 14 and 19, from the obstetric registers of the Policlinico Umberto I Hospital in Rome, between 2000 and 2010, have been completely reviewed (n=184). For each pregnant woman socio-demographic characteristics, obstetric history, pregnancy and birth outcomes were also determined. Our results were compared with a control group composed of 150 primigravida adult women aged 20-29 years who delivered at the Policlinico Umberto I Hospital in Rome in the same period. Results: the mean age ± SD of the study group was 17.9 ± 1.2, while that of the control group was 25.4 ± 2.4. The control group had a significantly lower risk of preterm delivery (p=0.000). The rate of low birth weight babies born to the young mothers was significantly higher than that of babies born to the adult mothers (p=0.036). The study group had a lower risk of instrumental delivery and a higher proportion of spontaneous delivery (p=0.000). Finally, we observed a statistically significant difference of the APGAR score at the fifth minute between the two groups (p=0.004). Conclusions: our results seemed to confirm the outcomes of previous studies for adolescent pregnant women, mainly regarding the increased risks of preterm deliveries and low birth weight babies, the higher incidence of spontaneous vaginal delivery and the lower incidence of instrumental delivery

Preventing Adolescent Maltreatment: A Focus on Child Welfare, Juvenile Justice, and Sexual Exploitation

Compared to young children, fewer resources have been devoted to examining the etiology and circumstances related to maltreatment experienced by adolescents. This is unfortunate given adolescents have been found to experience similar, and sometimes higher, rates of maltreatment. This chapter discusses the prevalence of adolescent maltreatment, explores the need to develop interventions and prevention strategies for adolescent maltreatment within alternative contexts, and identifies emerging strategies and necessary next steps for improving the collective response to adolescent maltreatment prevention. The authors focus specifically on how practices and policies within the child welfare, foster care, and juvenile justice systems, and the response to sexually exploited youth present opportunities for targeting and improving treatment and prevention efforts among adolescents

Integrating Validity Evidence to Revise a Child Abuse Knowledge Test for Early Childhood Education Providers: A Mixed Methods Approach

Knowledge tests used to evaluate child protection training program effectiveness for early childhood education providers may suffer from threats to construct validity given the contextual variability inherent within state-specific regulations around mandated reporting requirements. Unfortunately, guidance on instrument revision that accounts for such state-specific mandated reporting requirements is lacking across research on evaluation practices. This study, therefore, explored how collection and integration of validity evidence using a mixed methods framework can guide the instrument revision process to arrive at a more valid program outcome measure. </jats:p

Mineralogy and Zn Chemical Speciation in a Soil-Plant System from a Metal-Extreme Environment: A Study on Helichrysum microphyllum subsp. tyrrhenicum (Campo Pisano Mine, SW Sardinia, Italy)

Environmental contamination due to human activities is a worldwide problem that has led to the development of different remediation techniques, including biotechnological approaches such as phytoextraction and phytostabilization. These techniques take advantage of pioneer plants that naturally develop tolerance mechanisms to survive in extreme environments. A multi-technique and multi-disciplinary approach was applied for the investigation of Helichrysum microphyllum subsp. tyrrhenicum samples, bulk soil, and rhizospheres collected from a metal-extreme environment (Zn-Pb mine of Campo Pisano, SW Sardinia, Italy). Zinc, Pb, and Cd are the most abundant metals, with Zn attaining 3 w/w% in the rhizosphere solid materials, inducing oxidative stress in the roots as revealed by infrared microspectroscopy (IR). X-ray diffraction (XRD), scanning electron microscopy (SEM), and chemical analysis coupled with synchrotron radiation-based (SR) techniques demonstrate that quartz, dolomite, and weddellite biominerals precipitate in roots, stems, and leaves, likely as a response to environmental stress. In the rhizosphere, Zn chemical speciation is mainly related to the Zn ore minerals (smithsonite and hydrozincite) whereas, in plant tissues, Zn is primarily bound to organic compounds such as malate, cysteine, and histidine molecules that act as metal binders and, eventually, detoxification agents for the Zn excess. These findings suggest that H. microphyllum subsp. tyrrhenicum has developed its own adaptation strategy to survive in polluted substrates, making it a potential candidate for phytostabilization aimed at mitigating the dispersion of metals in the surrounding areas.</jats:p

Mineralogy and Zn chemical speciation in a soil-plant system from a metal-extreme environment: a study on Helichrysum microphyllum subsp. tyrrhenicum (Campo Pisano Mine, SW Sardinia, Italy)

Environmental contamination due to human activities is a worldwide problem that has led to the development of different remediation techniques, including biotechnological approaches such as phytoextraction and phytostabilization. These techniques take advantage of pioneer plants that naturally develop tolerance mechanisms to survive in extreme environments. A multi-technique and multi-disciplinary approach was applied for the investigation of Helichrysum microphyllum subsp. tyrrhenicum samples, bulk soil, and rhizospheres collected from a metal-extreme environment (Zn-Pb mine of Campo Pisano, SW Sardinia, Italy). Zinc, Pb, and Cd are the most abundant metals, with Zn attaining 3 w/w% in the rhizosphere solid materials, inducing oxidative stress in the roots as revealed by infrared microspectroscopy (IR). X-ray diffraction (XRD), scanning electron microscopy (SEM), and chemical analysis coupled with synchrotron radiation-based (SR) techniques demonstrate that quartz, dolomite, and weddellite biominerals precipitate in roots, stems, and leaves, likely as a response to environmental stress. In the rhizosphere, Zn chemical speciation is mainly related to the Zn ore minerals (smithsonite and hydrozincite) whereas, in plant tissues, Zn is primarily bound to organic compounds such as malate, cysteine, and histidine molecules that act as metal binders and, eventually, detoxification agents for the Zn excess. These findings suggest that H. microphyllum subsp. tyrrhenicum has developed its own adaptation strategy to survive in polluted substrates, making it a potential candidate for phytostabilization aimed at mitigating the dispersion of metals in the surrounding areas

FOLFOXIRI/bevacizumab (bev) versus FOLFIRI/bev as first-line treatment in unresectable metastatic colorectal cancer (mCRC) patients (pts): Results of the phase III TRIBE trial by GONO group.

Background: Doublets plus bev are a standard option for the first-line treatment of mCRC. First-line FOLFOXIRI demonstrated superior RR, PFS and OS compared to FOLFIRI. A phase II study of FOLFOXIRI/bev showed promising activity and manageable toxicities. The objective of the TRIBE trial was to confirm the superiority of FOLFOXIRI vs FOLFIRI when bev is added to chemotherapy (CT). Methods: Eligibility criteria included: measurable and unresectable mCRC, age 18-75 years, no prior CT for advanced disease. Pts were randomized to either FOLFIRI/bev (arm A) or FOLFOXIRI/bev (arm B). Both treatments were administered for a maximum of 12 cycles followed by 5FU/bev until progression. Primary endpoint was PFS. Results: Between July 2008 and May 2011 508 pts were randomized. Pts characteristics were (arm A/arm B): median age 60/61, ECOG PS 1-2 11%/10%, synchronous metastases 81%/79%, multiple sites of disease 74%/70%, liver-only disease 18%/23%, prior adjuvant (adj) 12%/12%. At a median follow-up of 26.6 mos 424 pts progressed and 244 died. Median PFS and OS in the intention to treat (ITT) population were 10.9 and 30.9 mos. FOLFOXIRI/bev significantly increased PFS (median 9.7 vs 12.2 mos, HR 0.73 [0.60-0.88] p=0.0012). Subgroup analyses based on stratification factors (PS, prior adj) and baseline characteristics (site of primary, liver only disease, resection of primary, Kohne score) did not evidence significant interactions between treatment and analyzed factors. A trend toward a more consistent effect of FOLFOXIRI/bev was reported in no prior adj (HR 0.68 [0.55-0.83]) compared to prior adj group (HR 1.18 [0.67-2.08], p for interaction=0.071). Response rate (RECIST) was also significantly improved (53% vs 65% p=0.006). FOLFOXIRI/bev did not increase the R0 secondary resection rate in the ITT population (12% vs 15%, p=0.327), or in the liver-only subgroup (28% vs 32%, p=0.823). Conclusions: FOLFOXIRI/bev compared to FOLFIRI/bev, significantly increases PFS and response rate. Subgroup analysis suggests a possible interaction between prior adj CT and PFS benefit. Secondary resection rate does not differ between treatment arms. Clinical trial information: NCT00719797