Effectiveness,safety and quality of life of trifluridine/tipiracil in pretreated patients with metastatic colorectal cancer: Real-world data from the noninterventional TACTIC study in Germany

The prospective, multicenter, noninterventional TACTIC study assessed effectiveness and safety of trifluridine/tipiracil (FTD/TPI) in patients with metastatic colorectal cancer (mCRC) in a real-world setting in Germany, thus evaluating the external validity of the findings from the pivotal RECOURSE trial. Primary endpoint was overall survival (OS). Secondary objectives included progression-free survival (PFS), safety, and quality of life (QoL). Subgroups comprised patients with good (<3 metastatic sites at inclusion, ≥18 months from diagnosis of first metastasis to inclusion) or poor (remaining patients) prognostic characteristics (GPC/PPC). GPC without liver metastases was considered best prognostic characteristics (BPC). In total, 307 eligible patients (pretreated or not suitable for other available therapies) were treated with FTD/TPI. Overall, median [95%-CI] OS was 7.4 months [6.4-8.6], median PFS was 2.9 months [2.8-3.3]. In BPC (n = 65) and GPC (n = 176) compared to PPC (n = 124) subgroup, median OS (13.3 [9.1-17.6] vs 8.9 [7.6-9.8] vs 5.1 [4.4-7.0] months) and median PFS (4.0 [3.3-5.3] vs 3.4 [3.0-3.7] vs 2.6 [2.4-2.8] months) were longer. Patient-reported QoL, assessed by validated questionnaires (EQ-5D-5L, PRO-CTCAE), was stable throughout FTD/TPI treatment. Predominant FTD/TPI-related adverse events of grades 3 or 4 were neutropenia (13.0%), leukopenia (7.5%), and anemia (5.2%). Altogether, palliative FTD/TPI therapy in patients with pretreated mCRC was associated with prolonged survival, delayed progression, maintained health-related QoL, and manageable toxicity. Low metastatic burden and indolent disease were favorable prognostic factors for survival. TACTIC confirms the effectiveness and safety of FTD/TPI, highlighting its value in routine clinical practice.     

Sicherheit von Blut und Blutprodukten: Testmethoden zum Nachweis der Hepatitisviren B, C und E

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Infektionen mit den Hepatitisviren&nbsp;B,&nbsp;C und&nbsp;E (HBV, HCV, HEV) sind über das Blut übertragbar...     

Relationships that Heal: Beyond the Patient-Healer Dyad in Mayan Therapy

Biomedicine fosters particular styles of interaction and behaviors, with the therapeutic relationship seen as occurring between a doctor and patient. In contrast, where alternative modalities of healing are practiced, relationships go beyond a dyadic interaction and include wider social networks. In this article, we propose the existence of a ‘therapeutic unit’ in Maya healing practices in Guatemala that binds healer, wellness seeker, family, and community members, along with the spiritual and natural realms, into a coherent system requiring all of these elements to achieve success. Drawing on interviews with 67 Maya healers, we describe healers’ understanding of raxnaq’il nuk’aslemal (well-being), and show how these interactions activate wider networks that play crucial roles during treatments. We highlight how holism is expressed in relationships typical of indigenous healing systems, and how an appreciation of this is important for developing culturally appropriate health care provision systems.     

Cationic Polymerization of (3‐Aminopropyl)‐tris‐furfuryloxysilane Derivatives—a New Strategy for Complex Hybrid Material Synthesis

The trifunctional (3‐aminopropyl)‐tris‐furfuryloxysilane monomer ( 1 ) is able to undergo both twin polymerization and reaction with electrophilic compounds such as isocyanates. 1 can be readily synthesized from 3‐aminopropyptrimethoxysilane (APTMS) and furfuryl alcohol (FA). The reaction of 1 with three different aromatic isocyanates, namely phenyl isocyanate, diphenylmethane‐4,4′‐diisocyanate (MDI), and a prepolymer consisting of MDI end‐capped polytetramethylene ether glycole (PTMEG), to the corresponding substituted urea derivatives is presented. Three urea derivatives 1‐phenyl‐3‐(3‐tris‐furfuryloxysilyl)propylurea ( 2 ), diphenylmethan‐4,4′‐bis[3(tris‐furfuryloxysilyl)propyl]urea ( 3 ), bis[3(tris‐furfuryloxysilyl)‐propyl]urea‐capped PTMEG‐MDI‐prepolymer ( 4 ) as well as 1 were polymerized to multicomponent organic/inorganic hybrid materials in a one step procedure using methane sulfonic acid as catalyst. The simultaneous formations of poly furfuryl alcohol and polysiloxane networks within the hybrid material are proven by means of solid‐state NMR spectroscopic measurements. The homogeneous distribution of silicon within the solidified hybrid materials is analyzed by scanning electron microscopy, energy dispersive X‐ray spectroscopy, and high‐angle annular dark field‐scanning transmission electron microscopy (HAADF)‐STEM. Homogeneous nanostructured hybrid materials with silicon cluster sizes in the range of 2 nm have been obtained by polymerization of the urea derivatives 2 , 3, and 4 .