Phase II study of paclitaxel combined with capecitabine as second-line treatment for advanced gastric carcinoma after failure of cisplatin-based regimens

Purpose To determine the safety and the efficacy of paclitaxel and capecitabine as second-line combination chemotherapy after failure of platinum regimens in advanced gastric cancer. Methods Patients with histologically proven gastric cancer and measurable metastatic disease received capecitabine 825 mg/m2 twice daily (1,650 mg/m2 per day) on days 1–14 and paclitaxel 175 mg/m2 by intravenous infusion on day 1 every 3 weeks until disease progression or unacceptable toxicities. Results Between June 2003 and October 2005, 26 patients, of median age 59 years (range 41–84 years) were included in the study and were treated by paclitaxel/capecitabine combination. Overall response rate was 34.6% (95%CI = 17.2–55.7%) with one complete response and 42.3% (95%CI = 17.2–55.7%) of patients achieved a stable disease. Median progression-free survival was 4.5 months (95%CI = 4–4.5 months). Median overall survival was 7.5 months (95%CI = 6–10 months). Cumulated overall survival including cisplatin regimens was 15.5 months (95%CI = 11–18 months). Grade 3/4 adverse events included alopecia (30.8%), neutropenia (11.5%), hand foot skin reaction (11.5%), neuropathy (11.5%), arthralgias (7.5%), and anemia (3.8%). Conclusions Paclitaxel and capecitabine combination was safe and effective in advanced gastric cancer after failure of cisplatin regimens. The cumulated overall survival of 15.5 months suggests a particular interest of taxanes in second-line treatment after failure of platinum salts

Existence and asymptotic behavior of solutions for neutral stochastic partial integrodifferential equations with infinite delays

In this work we study the existence, uniqueness and asymptotic behavior of mild solutions for neutral stochastic partial integrodifferential equations with infinite delays. To prove the results, we use the theory of resolvent operators as developed by R. Grimmer [12] R. Grimmer. Resolvent operators for integral equations in a banach space. Transactions of the American Mathematical Society, 273(1): 333-349, 1982, as well as a version of the fixed point principle. We establish sufficient conditions ensuring that the mild solutions are exponentially stable in pth-moment. An example is provided to illustrate the abstract results.Fondo Europeo de Desarrollo RegionalMinisterio de Economía y CompetitividadConsejería de Innovación, Ciencia y Empresa (Junta de Andalucía

Phase III study of pasireotide long-acting release in patients with metastatic neuroendocrine tumors and carcinoid symptoms refractory to available somatostatin analogues

In a randomized, double-blind, Phase III study, we compared pasireotide long-acting release (pasireotide LAR) with octreotide long-acting repeatable (octreotide LAR) in managing carcinoid symptoms refractory to first-generation somatostatin analogues. Adults with carcinoid tumors of the digestive tract were randomly assigned (1:1) to receive pasireotide LAR (60 mg) or octreotide LAR (40 mg) every 28 days. Primary outcome was symptom control based on frequency of bowel movements and flushing episodes. Objective tumor response was a secondary outcome. Progression-free survival (PFS) was calculated in a post hoc analysis. Adverse events were recorded. At the time of a planned interim analysis, the data monitoring committee recommended halting the study because of a low predictive probability of showing superiority of pasireotide over octreotide for symptom control (n=43 pasireotide LAR, 20.9%; n=45 octreotide LAR, 26.7%; odds ratio, 0.73; 95% confidence interval [CI], 0.27–1.97; P=0.53). Tumor control rate at month 6 was 62.7% with pasireotide and 46.2% with octreotide (odds ratio, 1.96; 95% CI, 0.89–4.32; P=0.09). Median (95% CI) PFS was 11.8 months (11.0 – not reached) with pasireotide versus 6.8 months (5.6 – not reached) with octreotide (hazard ratio, 0.46; 95% CI, 0.20–0.98; P=0.045). The most frequent drug-related adverse events (pasireotide vs octreotide) included hyperglycemia (28.3% vs 5.3%), fatigue (11.3% vs 3.5%), and nausea (9.4% vs 0%). We conclude that, among patients with carcinoid symptoms refractory to available somatostatin analogues, similar proportions of patients receiving pasireotide LAR or octreotide LAR achieved symptom control at month 6. Pasireotide LAR showed a trend toward higher tumor control rate at month 6, although it was statistically not significant, and was associated with a longer PFS than octreotide LAR

Caractérisation des peuplements ligneux de la zone Cayor Baol (Thiès-Sénégal)

Cette étude se propose de déterminer la composition floristique et la structure des peuplements ligneux dans trois localités de la région de Thiès (Fandène, Mont Rolland et Sessène). Sur un transect orienté Nord/Sud, partant de Mont Rolland à Sessène, un inventaire floristique et des relevés dendrométriques ont été effectués en fonction des unités morphopédologiques. Le traitement statistique des données recueillies a montré que la flore ligneuse, dans ces 3 sites, est riche de 35 espèces réparties en 30 genres appartenant à 20 familles. La famille des  Mimosaceae est la mieux représentée, suivie des Caesalpiniaceae, des Combretaceae et des Anacardiaceae. La richesse floristique varie suivant les sites. La surface terrière est plus élevée au Mont Rolland, le  recouvrement et la densité sont plus importants à Fandène. La distribution du peuplement selon la circonférence est homogène à Fandène,  contrairement à Sessène et à Mont Rolland. Quant à la distribution selon la hauteur des individus, elle montre une prédominance de la strate arbustive dans les 3 sites. Les analyses de régression ont montré une corrélation entre la circonférence et la hauteur. La pression anthropiquesur la strate ligneuse est plus importante à Sessène, moyenne au Mont Rolland et faible à Fandène. L’AFC montre une forte hétérogénéité des peuplements ligneux. Elle a révélé l’existence de 3 groupements en  étroite relation avec les facteurs édaphologiques.© 2013 International Formulae Group. All rights reserved.Mot clés : Thiès, ligneux, flore, structure, groupement

Complex temporal climate signals drive the emergence of human water-borne disease

Predominantly occurring in developing parts of the world, Buruli ulcer is a severely disabling mycobacterium infection which often leads to extensive necrosis of the skin. While the exact route of transmission remains uncertain, like many tropical diseases, associations with climate have been previously observed and could help identify the causative agent's ecological niche. In this paper, links between changes in rainfall and outbreaks of Buruli ulcer in French Guiana, an ultraperipheral European territory in the northeast of South America, were identified using a combination of statistical tests based on singular spectrum analysis, empirical mode decomposition and cross-wavelet coherence analysis. From this, it was possible to postulate for the first time that outbreaks of Buruli ulcer can be triggered by combinations of rainfall patterns occurring on a long (i.e., several years) and short (i.e., seasonal) temporal scale, in addition to stochastic events driven by the El Nino-Southern Oscillation that may disrupt or interact with these patterns. Long-term forecasting of rainfall trends further suggests the possibility of an upcoming outbreak of Buruli ulcer in French Guiana

Identification of novel Coxiella burnetii genotypes from Ethiopian ticks

Background: Coxiella burnetii , the etiologic agent of Q fever, is a highly infectious zoonotic bacterium. Genetic information about the strains of this worldwide distributed agent circulating on the African continent is limited. The aim of the present study was the genetic characterization of C. burnetii DNA samples detected in ticks collected from Ethiopian cattle and their comparison with other genotypes found previously in other parts of the world. Methodology/Principal Findings: A total of 296 tick samples were screened by real-time PCR targeting the IS 1111 region of C. burnetii genome and from the 32 positive samples, 8 cases with sufficient C. burnetii DNA load ( Amblyomma cohaerens ,n 5 6; A. variegatum ,n 5 2) were characterized by multispacer sequence typing (MST) and multiple-locus variable-number tandem repeat analysis (MLVA). One novel sequence type (ST), the proposed ST52, was identified by MST. The MLVA-6 discriminated the proposed ST52 into two newly identified MLVA genotypes: type 24 or AH was detected in both Amblyomma species while type 26 or AI was found only in A. cohaerens . Conclusions/Significance: Both the MST and MLVA genotypes of the present work are closely related to previously described genotypes found primarily in cattle samples from different parts of the globe. This finding is congruent with the source hosts of the analyzed Ethiopian ticks, as these were also collected from cattle. The present study provides genotype information of C. burnetii from this seldom studied East-African region as well as further evidence for the presumed host-specific adaptation of this agent

Understanding Similarities and Differences in CKD and Dialysis Care in Children and Adults

In lower-income settings there is often a dearth of resources and nephrologists, especially pediatric nephrologists, and individual physicians often find themselves caring for patients with chronic kidney diseases and end-stage kidney failure across the age spectrum. The management of such patients in high-income settings is relatively protocolized and permits high-volume services to run efficiently. The basic principles of managing chronic kidney disease and providing dialysis are similar for adults and children, however, given the differences in body size, causes of kidney failure, nutrition, and growth between children and adults with kidney diseases, nephrologists must understand the relevance of these differences, and have an approach to providing quality and safe dialysis to each group. Prevention, early diagnosis, and early intervention with simple therapeutic and lifestyle interventions are achievable goals to manage symptoms, complications, and reduce progression, or avoid kidney failure in children and adults. These strategies currently are easier to implement in higher-resource settings with robust health systems. In many low-resource settings, kidney diseases are only first diagnosed at end stage, and resources to pay out of pocket for appropriate care are lacking. Many barriers therefore exist in these settings, where specialist nephrology personnel may be least accessible. To improve management of patients at all ages, we highlight differences and similarities, and provide practical guidance on the management of children and adults with chronic kidney disease and kidney failure. It is important that children are managed with a view to optimizing growth and well-being and maximizing future options (eg, maintaining vein health and optimizing cardiovascular risk), and that adults are managed with attention paid to quality of life and optimization of physical health

Cryptic species in a well-known habitat: applying taxonomics to the amphipod genus Epimeria (Crustacea, Peracarida)

Taxonomy plays a central role in biological sciences. It provides a communication system for scientists as it aims to enable correct identification of the studied organisms. As a consequence, species descriptions should seek to include as much available information as possible at species level to follow an integrative concept of ‘taxonomics’. Here, we describe the cryptic species Epimeria frankei sp. nov. from the North Sea, and also redescribe its sister species, Epimeria cornigera. The morphological information obtained is substantiated by DNA barcodes and complete nuclear 18S rRNA gene sequences. In addition, we provide, for the first time, full mitochondrial genome data as part of a metazoan species description for a holotype, as well as the neotype. This study represents the first successful implementation of the recently proposed concept of taxonomics, using data from highthroughput technologies for integrative taxonomic studies, allowing the highest level of confidence for both biodiversity and ecological research

Mechanical and structural properties of termite soil as a partial replacement to cement for different applications

This paper presents the results of the experimental and theoretical study of the mechanical and structural properties of termite soil as a partial replacement to cement for different applications, especially in the building/construction industry. Different volume fractions of termite soil are mixed with Portland cement and their compressive and flexural strengths as well as fracture toughness values are determined. The mechanical properties of the composites are also elucidated after curing the samples for 7 days, 14 days and 28 days. The study shows that the 28 days Compressive strength decreases with increasing volume percentage of termite soil for volume percentages up to 60%. The 28 day strength was also greater than the requirement of (NIS 87: 2000) for non-bearing load walls (δmin=2.8N/mm²› 2.5 N/mm²). The flexural strength for 20% replacement (at all curing days) was greater than 7 N/mm². The fracture toughness was also observed to decrease with increasing volume percentage of termite soil up to 20 vol. %. This resulted in a maximum fracture toughness of 4.24  for the materials with 20 vol. % of termite soil stabilization. The samples are then characterized via X-ray Diffraction (XRD) and Energy Dispersive Spectroscopy (EDX). The implications of the results are discussed for the development of sustainable termite-stabilized building materials