Cytoreductive Surgery With or Without HIPEC After Neoadjuvant Chemotherapy in Ovarian Cancer: A Phase 3 Clinical Trial.

BACKGROUND: Cytoreductive surgery (CRS) and administration of hyperthermic intraperitoneal chemotherapy (HIPEC) have shown their efficacy in multiple malignancies and also could offer a prognostic benefit for patients with advanced ovarian cancer. METHODS: A prospective, single-center, parallel-group, randomized phase 3 clinical trial analyzed patients with a diagnosis of carcinomatosis from ovarian cancer treated with neoadjuvant systemic chemotherapy (NACT). In this trial, 71 patients were randomized to receive CRS alone (36 patients) or CRS with HIPEC (35 patients) using cisplatin (75 mg/m2 for 60 min at 42 °C). The primary end point was disease-free survival (DFS). Overall survival (OS), morbidity, and quality of life (QoL) were the secondary end points. RESULTS: During a median follow-up period of 32 months, the median DFS was 12 months in the control group (CRS) and 18 months in the experimental group (CRS and HIPEC). The findings showed HIPEC to be an independent protective factor against the development of recurrence (hazard ratio [HR], 0.12, 95 % confidence interval [CI], 0.02-0.89; p = 0.038). The median OS was 45 months in the control group and 52 months in the experimental group. The respective morbidity rates for any grade (1 to 5) were respectively 58.3 % and 45.7 % (p > 0.05), with a mortality rates of 2.8 % and 2.9 % (p > 0.05). In the dimensions evaluated, CRS with or without HIPEC had no impact on QoL. CONCLUSIONS: For patients who had advanced ovarian cancer treated with NACT, CRS and HIPEC was associated with better DFS and OS, but without a difference in postoperative morbidity, mortality, or in the QoL evaluation.

Validation of a peritoneal surface disease severity score in stage IIIC-IV ovarian cancer treated with cytoreduction and hyperthermic intraperitoneal chemotherapy.

BACKGROUND: The aim of the present study is to evaluate and validate the PSDSS score as a prognostic tool in patients with stage IIIC-IV epithelial ovarian cancer (EOC) who are treated with a first cytoreduction with peritonectomy procedures and HIPEC, and to discuss the usefulness and applicability of this approach in decision making in clinical practice. PATIENTS AND METHODS: We analyzed a consecutive series of patients with stage IIIC-IV epithelial ovarian cancer treated by cytoreductive surgery and HIPEC between January 2012 and December 2016. RESULTS: A total of 115 consecutive patients diagnosed of stage IIIC-IV EOC were included. After the multivariate analyses, the impossibility of performing a complete cytoreduction (CC-score = 1, HR: 4.56, p = 0.012), the PSDSSov (III-IV, HR: 3.59, p = 0.024), a high (>20) PCI (HR: 3.16, p = 0.032), and the histological type of the tumor (G3, HR: 2.28, 95% CI: 1.14-8.14, p = 0.033) were factors that were independently related with lower DFS. Other variables included in PSDSSov such as pathological lymphadenopathy and the clinical symptoms were not independently related to lower DFS in our series. CONCLUSIONS: PSDSSov is a useful tool in the prognostic stratification of patients with advanced ovarian cancer with peritoneal dissemination (IIIB/IIIC).

Uso de la spirulina en gestante con betatalasemia menor heterocigótica. A propósito de un caso / Use of spirulin in pregnant woman with heterozygous minor beta-thalassemia. A case report

Introducción: la hemoglobina es una proteína tetramérica responsable del transporte de oxígeno a las células y tejidos del cuerpo, formada por cuatro subunidades: dos subunidades α-globina y dos subunidades β-globina (α2, β2), la mayoría de individuos heterocigotos (β+/β ó βo/β) son portadores silenciosos que no manifiestan síntomas (β-talasemia menor); a veces, pueden presentar episodios leves de anemia. Objetivo: presentar un caso de gestante con betatalasemia menor heterocigótica, destacando la eficacia del suplemento Spirel. Presentación del caso: gestanteresidente en Provincia Mayabeque, con antecedentes de betatalasemia menor heterocigota con tratamiento de ácido fólico; en embarazo anterior recibió 13 transfusiones manteniendo hemoglobina de 3 a 4 g/l), a las 23,5 semanas. Una vez recibida la primera terapia transfusional se aplican 3 tabletas 30 minutos después de desayuno, almuerzo y comida del suplemento Spirel que contiene Spirulina Platensis (Sp), proteínas, vitaminas, y otros compuestos con 16 g de hierro broquelado. Conclusiones: la evolución de este caso destaca la eficacia del suplemento Spirel en el incremento de la hemoglobina, peso materno, altura uterina y el peso del neonato en las gestantes con betatalasemia(AU)

Introduction: The hemoglobin is a protein tetrameric carrier of oxygen to the cells and tissues of the body, composed by four subunits: two α-Globin sub units and two of β-Globin (α-2, β-2), most of individuals heterozygote β+/β or βo/β) They are silent carries that do not manifest symptoms (β thalassemia minor) sometimes, can present mild anemia episode. Objective: Present a case of pregnant with heterozygoteβ thalassemia minor enhancing the efficiency of the supplement Spirel.Case presentation: A Pregnant woman resident in Mayabeque Province, with antecedents of heterozygote β thalassemia minor with treatment of folic acid , in a previous pregnancy received 13 transfusions keeping hemoglobin of 3 to 4 g/l). To the 23,5 weeks. Once received the first therapy transfusion are given 3 pills 30 minutes after breakfast, lunch and dinner of Spirel containing Spirulin Platensis (Sp), proteins, vitamins, and other compounds with 16 g of chelate iron. Conclusions: The presentation of this case remarks the efficacy of the Spirel supplement according to hemoglobin, maternal weight, uterine height, and the newborn weight, in pregnant with a diagnosis of β thalassemia minor(AU)

Assessment of the Factors Contributing to the Growth or Spoilage of Meyerozyma guilliermondii in Organic Yogurt: Comparison of Methods for Strain Differentiation.

In this work we analyze the spoiling potential of Meyerozyma guilliermondii in yogurt. The analysis was based on contaminated samples sent to us by an industrial laboratory over two years. All the plain and fruit yogurt packages were heavily contaminated by yeasts, but only the last ones, containing fermentable sugars besides lactose, were spoiled by gas swelling. These strains were unable to grow and ferment lactose (as the type strain); they did grow on lactate plus galactose, fermented glucose and sucrose, and galactose (weakly), but did not compete with lactic acid bacteria for lactose. This enables them to grow in any yogurt, although only those with added jam were spoiled due to the fermentation of the fruit sugars. Fermentation, but not growth, was strongly inhibited at 8 °C. In consequence, in plain yogurt as well as in any yogurt maintained at low temperature, yeast contamination would not be detected by the consumer. The risk could be enhanced because the species has been proposed for biological control of fungal infections in organic agriculture. The combination of the IGS PCR-RFLP (amplification of the intergenic spacer region of rDNA followed by restriction fragment length polymorphism analysis) method and mitochondrial DNA-RFLP makes a good tool to trace and control the contamination by M. guilliermondii.