Magnesium monitoring practice in monoclonal anti-epidermal growth factor receptor antibodies therapy.

WHAT IS KNOWN AND OBJECTIVE: It is now estimated that about 5% of cetuximab-treated patients and about 3% of panitumumab-treated patients will develop grade 3-4 hypomagnesemia. The aim of this study was to assess the extent of magnesium monitoring in patients treated with epidermal growth factor receptor (EGFR)-targeting antibodies and to estimate the incidence of hypomagnesemia in these patients at our institution. METHODS: A 2-year retrospective study was carried out. At least four doses of weekly cetuximab or two doses of bi-weekly panitumumab were required for inclusion. Serum magnesium profiles were reviewed from 1 month before treatment until 3 months after treatment discontinuation, and patients with <2 determinations were excluded. RESULTS AND DISCUSSION: Two hundred and one patients received at least one dose of EGFR-targeting antibodies, but only 68 met the inclusion criteria. Seventy patients had <2 magnesium determinations. The overall hypomagnesemia was 58·82% (40 of 68 patients), with a 4·41% grade 3 hypomagnesemia (three of 68 patients). No grade 4 hypomagnesemia was detected. WHAT IS NEW AND CONCLUSION: There is a lack of magnesium monitoring in these patients. Serum magnesium determinations should be done every 4-8 weeks in patients treated with EGFR-targeting antibodies, as it is a useful surrogate marker for both toxicity and efficacy.

Medicamentos citostáticos identificados con código de barras: una necesidad indispensable para la seguridad del paciente / Cytostatic drug identification using bar codes: an essential need for patient safety

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Usefulness of human immunodeficiency virus post-test counseling by telephone for low-risk clients of an urban sexually transmitted diseases clinic.

BACKGROUND: Failure of clients to return for post-test counseling for human immunodeficiency virus (HIV) has been noted consistently as a problem with HIV counseling and testing in sexually transmitted disease clinics. GOALS: To assess trends in the rates of HIV post-test counseling in an urban sexually transmitted disease clinic. To determine the usefulness of providing post-test counseling by telephone to clients at low risk for HIV as a means of increasing post-test counseling rates and efficiency of clinic operations. STUDY DESIGN AND METHODS: Human immunodeficiency virus post-test counseling rates were evaluated among clients of a sexually transmitted disease clinic from January 1990 through May 1994. Low-risk clients (n = 1,304) from July 1994 through September 1994 were given the option of obtaining negative HIV test results by telephone. Rates of post-test counseling within 45 days were compared with historical controls from March 1994 through May 1994, during which time a return visit was required. RESULTS: The rate of post-test counseling increased significantly from 1990 to 1992 but remained stable thereafter. After the introduction of post-test counseling by telephone, 704 of 1,304 low-risk clients (54.0%) obtained post-test counseling compared with 476 of 1,187 (40.1%) clients during the control period (odds ratio = 1.75; 95% confidence interval = 1.50-2.06). Post-test counseling rates increased especially among clients younger than 20 years of age (30.6% versus 52.7%) and among those with multiple new sex partners in the last month (31.6% versus 56.1%). CONCLUSIONS: Telephone post-test counseling is an effective method of increasing access for low-risk clients attending sexually transmitted diseases clinics and may be especially useful for those who are otherwise unlikely to obtain post-test counseling.

Efficacy of an inactivated oil-adjuvanted rotavirus vaccine in the control of calf diarrhoea in beef herds in Argentina.

We have assessed the potency of an inactivated oil-adjuvanted rotavirus vaccine in beef herds in Argentina. Two different vaccine trials were conducted. In a small-scale experimental trial, involving 21 pregnant cows (13 vaccinated and eight unvaccinated controls), a significant increase in neutralizing antibody titres against different serotypes of bovine rotaviruses was found in both the colostrum and serum of vaccinated cows compared with that of unvaccinated controls. Seven days after birth, half of the calves born to vaccinated dams or to control cows were challenged with live virulent virus whereas the other half of both groups were left in contact with the infected calves in order to mimic a natural field challenge. Although no statistically significant differences in the rate of protection were observed among the different groups of animals, a larger number of vaccinated calves were protected in comparison with their controls, particularly where animals in contact with infected calves were concerned. Secondly, a large-scale field trial was carried out in 17 beef herds involving a total of 4066 vaccinated pregnant cows. In 11 farms morbidity and mortality in calves from vaccinated cows were compared with historical data from the previous 3 years at the same locations. In the other six herds, control groups were used to compare data of the same year: 1540 cows were vaccinated and 2700 were left as controls. Taking into account the previous and current incidence of diarrhoea, morbidity and mortality were significantly reduced in 16 of the 17 beef herds tested. Vaccine effectiveness was also evident in farms where other enteropathogens such as cryptosporidium and coronaviruses were present, together with rotavirus.