Stereotactic ablative radiotherapy in castration-resistant prostate cancer patients with oligoprogression during androgen receptor-targeted therapy

Objectives To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). Patients and methods Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan–Meier method, univariate and multivariate analysis (MVA) were performed. Results Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. Conclusion Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed (AU)

Elaphostrongylus cervi in a population of red deer (Cervus elaphus) and evidence of cerebrospinal nematodiasis in small ruminants in the province of Varese, Italy.

Thirty-one faecal samples were collected from red deer in the northern area of Varese, in the Italian region of Lombardy, between August and October 2008. The animals had either been hunted or accidently killed. Examination for internal parasites showed a prevalence of 45.2% for Elaphostrongylus cervi larvae and species identification was confirmed by polymerase chain reaction (PCR). Ninety-seven faecal samples were also collected from two goat flocks grazing in the same area between December 2007 and May 2008. These showed a prevalence of 74.7% for lungworms. Furthermore, the central nervous systems from five goats and one sheep from this area with a history of neurologically related lameness were examined. Histopathology confirmed E. cervi cerebro-spinal nematodiasis in five cases out of six. This study demonstrates E. cervi transmission from wild to domestic ruminants when the animals graze in the same area, and the possible occurrence of clinical disease in infected goats and sheep associated with high prevalence in deer.

Synthesis and biological evaluation of 2-methoxy- and 2-methylthio-6-[2'-alkylamino)ethyl]-4(3H)-pyrimidinones with anti-rubella virus activity.

The synthesis of a new family of antiviral compounds, 2-methoxy-, and 2-methylthio-6-[(2'-alkylamino)ethyl]-4(3H)-pyrimidinones, has been accomplished. The activity of these agents against positive strand (rubella virus and sindbis virus) and negative strand (vesicular stomatitis virus) RNA viruses is reported. Some of these compounds are efficient and selective inhibitors of rubella virus.

Analgesic activity of tramadol and pentazocine in postoperative pain.

This controlled, completely randomized trial was designed to compare the efficacy and safety of tramadol and pentazocine in the treatment of postoperative pain. A total of 50 adults were admitted (31 males, 19 females, mean age 48 years) to undergo hemorrhoidectomy or traumatological or abdominal surgery. Following a randomization list, each patient was given one ampul of tramadol (100 mg/2 mL) or pentazocine (30 mg/mL) by intramuscular injection at 8-h intervals for 3 days. Efficacy was assessed on both the basis of severity of pain (rated using a visual analog scale in the 6th h after the first injection and during the 3 days of treatment), and quality of sleep (rated using a five-point scale). Local reactions at the injection site (pain, skin reactions) were also assessed, as were systemic reactions (vital parameters, blood and biochemistry tests), and any untoward events were reported. Both drugs had good antalgic activity, significantly relieving pain in the 3 days of treatment (p < 0.01 from baseline). The first dose of tramadol was significantly more effective than pentazocine after the 1st h and throughout the subsequent 5 h. Final judgments on efficacy and acceptability were in favor of tramadol (p < 0.01 from pentazocine). Local and systemic safety were good, with no reactions at the injection site and no changes in vital parameters or laboratory findings. No patient reported any adverse reactions.

Successful treatment of biliary colic with intravenous ketoprofen or lysine acetylsalicylate.

In a double-blind trial, 60 patients with biliary colic were allocated at random to receive 200 mg ketoprofen, 1.8 g lysine acetylsalicylate or placebo by intravenous bolus. The patients were asked to rate their pain at intervals within 3 hours of injection and to indicate their overall pain experience on a visual analogue scale. Both ketoprofen and lysine acetylsalicylate proved significantly more effective than placebo in relieving pain, with no significant difference between them. A good analgesic response, reflected by complete or almost complete relief of pain within 30 minutes of injection, was recorded in 4, 17, and 16 patients, respectively, in the placebo, ketoprofen, and lysine acetylsalicylate treatment groups. All drugs were well tolerated. It is concluded that the results provide further evidence for a useful therapeutic role of prostaglandin inhibitors in the treatment of biliary colic.

Intravenous ketoprofen in renal colic: a placebo-controlled pilot study.

In a double-blind trial 30 patients with renal colic were allocated at random to receive 200 mg of ketoprofen, 1 gm of lysine acetylsalicylate, or placebo by intravenous bolus injection. The patients were asked to rate their pain at intervals within three hours of injection and to indicate on a visual analogue scale the overall pain relief obtained. Both ketoprofen and lysine acetylsalicylate proved significantly more effective than placebo, with no apparent difference between them. Complete relief of pain was obtained in seven of ten patients in each of the active treatment groups compared with only one of ten patients given placebo. No untoward events were observed in any patient.