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Trotz der zunehmenden Finanzialisierung und Privatisierung von Stadtraum entstehen vielerorts Räume, die sich aus einer nicht-renditeorientierten Praxis heraus entwickeln. Auch aufgrund mangelnder kommunaler Absicherung findet in Berliner Nachbarschaften eine stadtpolitische Selbstermächtigung statt, indem Orte jenseits von Marktlogiken als für alle zugängliche und gemeinsame Räume offengehalten werden. Dieser zivilgesellschaftlichen Planungsarbeit, die auch die sozialen Gefüge am Ort erhält und weiter stärkt, wurde an drei Orten in Berlin nachgegangen: Im Nachbarschaftsraum neben dem Kotti-Shop im Neuen Zentrum Kreuzberg entsteht eine kollektive Spielplatzplanung; die station urbaner kulturen/ nGbK Hellersdorf hält für eine freiräumliche Allmende am «Place Internationale» eine Nutzungsvereinbarung, die Initiative Hermannplatz unterstützt die Nachbarschaft im Kampf gegen den Abriss des Karstadtgebäudes und die Verdrängung lokaler Gewerbetreibender. Studierende haben sich ein Semester lang als Kartograf:innen in eine Kooperation mit den Initiativen vor Ort begeben und drei grossformatige Zeichnungen erstellt, die die kooperativen Arbeitsweisen im jeweiligen Kontext modellhaft für eine gemeinwohlorientierte Stadtentwicklung aufzeigen. Sie veranschaulichen den Zusammenhang zwischen selbstverwalteter Planungsarbeit und nachbarschaftlicher Raumproduktion und befragen die Rolle von Politik und Verwaltung als – eigentlich – Gemeingut-sichernde Instanz. Als Handreichung und Debattenbeitrag dienen die Kartierungen der Etablierung kooperativer Designansätze im Widerstand gegen eine renditeorientierte Stadtentwicklung.

Objective. To the scarce information on dietary habits in fibromyalgia (FM), it is added that there are no comparative studies with other rheumatic diseases. The objective of this study was to characterise the dietary habits of patients with FM by comparing, for the first time, with healthy controls (HC) and rheumatoid arthritis (RA). Methods. This cross-sectional, observational study was based on data obtained from the Dietfibrom project for FM and from the IMID Consortium for RA and HC. All participants completed a food frequency questionnaire evaluating their weekly dietary intake of main food groups. The three cohorts were compared using a multiple logistic regression model adjusted for age, sex, and body mass index. Results. After quality control, n=287 FM, n=1,983 HC and n=1,942 RA patients were analysed. We found that FM had a profound impact in the diet compared to HC, reducing the consumption of dairy (OR=0.32, p

María Dueñas,1 Begoña Ojeda,2 Alejandro Salazar,2 Juan Antonio Mico,3 Inmaculada Failde,2 1Nursing Faculty “Salus Infirmorum”, The Observatory of Pain, Universityof Cádiz, Cádiz, Spain; 2Preventive Medicine and Public Health Area, The Observatory ofPain, University of Cádiz, Cádiz,Spain; 3Department of Neuroscience, Pharmacology, and Psychiatry, CIBERof Mental Health, CIBERSAM, Institute of Health CarlosIII, University of Cádiz, Cádiz,Spain Abstract: Chronic pain (CP) seriously affects the patient’s daily activities and quality of life, but few studies on CP have considered its effects on the patient’s social and family environment. In this work, through a review of the literature, we assessed several aspects of how CP influences the patient’s daily activities and quality of life, as well as its repercussions in the workplace, and on the family and social environment. Finally, the consequences of pain on the health care system are discussed. On the basis of the results, we concluded that in addition to the serious consequences on the patient’s life, CP has a severe detrimental effect on their social and family environment, as well as on health care services. Thus, we want to emphasize on the need to adopt a multidisciplinary approach to treatment so as to obtain more comprehensive improvements for patients in familial and social contexts. Accordingly, it would be beneficial to promote more social- and family-oriented research initiatives. Keywords: pain, everyday problems, social relationships, family environment, health services

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The air-flow dynamics in crops (cultures), when a crop is considered as porous media, is determined by factors depending of the phenological stage which define size and shape of the leaves. Leaves topology with respect to the wind direction determines the porosity of the media and in consequence the flow rate. This flow rate is a function of the porosity and permeability, which determines the dragging coefficient. The presence of crops in a greenhouse causes a consumption of momentum due to the resistance that the leaves offer for the friction force (drag forces). In this paper the greenhouse airflow dynamics is analyze for four different crops with different leaf configurations. Computational Fluid Dynamics (CFD) was used to model the airflow dynamic behavior considering a crop as porous media. The pressure reduction due to the effect of inertial force is represented by a Forcchaimer equation, which describe dragging forces (drag effect) depending on the crop density foliar area. The results indicate a reduction of 33 % in the wind speed along the cropped area; this causes a thermal gradient increase of 6 K in a length of 34 m.

The use of the Information and Communication Technologies (ICT) in Learning Environment allows achieving the maximum interaction between Teachers and Students.The Virtual Learning Environments are computer programs that benefit the learning facilitating the communication between users. Open Source software allow to create the own online modular learning environment with a fast placed in service. In the present paper the use of a Learning Management Systems (LMS) as continuous education tool is proposed.

This is the protocol for a review and there is no abstract. The objectives are as follows: We will assess the clinical effectiveness and safety of second-line chemotherapy for treating women with ovarian cancer sensitive or resistant to a previous course of platinum-based chemotherapy. © 2013 The Cochrane Collaboration.

El dolor crónico constituye un grave problema de salud pública, dada su elevada prevalencia y las consecuencias personales y sociales que produce. La presencia de dolor crónico se ha asociado con un deterioro cognitivo leve, sobre todo en los pacientes afectados por fibromialgia o dolor neuropático, habiéndose relacionado esto con la concurrencia en estos pacientes, de otros procesos, como la ansiedad, la depresión, los trastornos del sueño y el consumo de ciertos fármacos, todos ellos habituales en los pacientes con dolor crónico. En esta revisión, hacemos un repaso del complejo proceso de la cognición así como de los distintos elementos que lo integran. Asimismo, revisamos los mecanismos mediante los que el dolor crónico puede afectar el proceso de la cognición y el modo en el que este puede verse afectado por la concurrencia de otras patologías, o por los fármacos habitualmente utilizados para su tratamiento. Finalmente se plantea la necesidad de evaluar el deterioro cognitivo en los pacientes con dolor crónico, con el objetivo de evitar la progresión de la enfermedad cognitiva hacia un cuadro de deterioro más grave, así como de contribuir a mejorar la respuesta terapéutica al dolor y el aumento de la calidad de vida de los pacientes. Chronic pain constitutes a serious public health problem due to its high prevalence and the social and personal consequences. The presence of chronic pain has been associated with mild cognitive impairment, especially in patients with fibromyalgia and neuropathic pain, and it has been also related with other disease like anxiety, depression, sleep disorders and the use of certain drugs, usually taken on these patients. This document revises the complex issue of the cognitive process and the several elements that comprise it. Likewise, we review the different mechanisms by which pain affect cognitive process and the way it could be affected by other disease, or by drugs commonly used on treatment. It is necessary to assess mild cognitive impairment on chronic pain patients, in order to prevent the develop and the evolution of cognitive disease to a more severe impairment, as well as help to improve therapeutic response to pain and increase health related quality of life of patients.

Introduction: Bilateral salpingo-oophorectomy (BSO) is a common procedure for preventing breast and ovarian cancer in high-risk women. The goal of this study was to determine the incidence of subsequent breast cancer (BC) in a high-risk population and to identify clinical and epidemiological predictors of BC following BSO. Materials and methods: One hundred and thirty-three consecutive high-risk women, tested for BRCA1 and BRCA2 mutations due to family history, underwent preventive or therapeutic BSO at one of the study hospitals. One hundred and three patients had breast tissue at risk and were considered evaluable for the event-free survival analysis. Twenty-five women harbored a deleterious mutation in BRCA1 and 25 in BRCA2 genes. Results: Fifteen cases of invasive BC were diagnosed with a median interval of 49 months after BSO. Multivariate analysis showed that a prior BC after 50 years of age (p = 0.004), age over 50 years at the time of BSO (p = 0.005), and prior replacement or contraceptive hormonal treatment (p = 0.007) were significantly associated with a shorter event-free survival. Conclusion: In conclusion, age at prior diagnosis of cancer, age at BSO and prior hormonal treatment may be predictors of breast cancer after BSO. (C) 2010 Elsevier Ltd. All rights reserved.

La plataforma continental somera (PSC, profundidades < 10m) del Departamento de Córdoba se ubica entre los 8º 52´ 58” N, 76º 24´ 53” O y los 9º 20’ 42”N, 75º 47’ 55” O, inmediatamente al sur del Golfo de Morrosquillo, Costa Caribe colombiana. La información aportada por 140 transectos batimétricos y geofísicos de alta resolución (12/200 kHz, trayectorias perpendiculares y paralelas a la costa) permitió determinar la morfología general y algunas de las características geométricas y anomalías principales de sus fondos y subfondos marinos. En términos generales, la morfología de los sectores central y sur de la PSC de Córdoba (Arboletes- Delta de Tinajones) es la de una superficie amplia, caracterizada por fondos cóncavos depositacionales a partir de la isóbata de -8m (pendientes mínimas del 0.01494 %) y por superficies cóncavas de erosión bien definidas a profundidades menores (pendientes máximas del 1.88 %); a lo largo de los 124 km de línea de costa, las condiciones transgresivas recientes y actuales se evidencian por la abundancia de plataformas de abrasión por oleaje (wave cut platforms) y por el carácter fuertemente erosional de las playas y sectores acantilados. La morfología del sector este de la PSC (delta del Sinú-Bahía de Cispatá-Punta Bolívar) es altamente variada, caracterizada al oeste por dos lóbulos progradantes y por la presencia de superficies aterrazadas, relieves positivos (¿paleoarrecifes?, ¿volcanes de lodo?) y escarpes (-4m, -6m, -10m de profundidad) de alta inclinación que representan probablemente posiciones antiguas de la línea de costa. Los registros de alta resolución (12 kHz) de la PSC evidencian ambientes dinámicos e inestables, afectados en el Holoceno tardío por la actividad de diapiros y volcanes de lodo, fallamientos y eventos depositacionales recientes que incluyen la formación de depósitos sedimentarios (espesores hasta 5m) de rellenos de cubetas y paleocanales. The inner (less than 10 m depth) continental shelf in front of Department of Córdoba extends from 8º 52´58” N, 76º 24´53” O to 9º 20’42” N, 75º 47’ 55” O, just south of Gulf of Morrosquillo, Colombian Caribbean Coast. In order to get a general picture of the morphology and subbottom geometry of the area, a set of 140 bathymetrical and geophysical (200 and 12 kHz) transects were collected both perpendicular and parallel to the shoreline. The morphology of the area in the southern and central zones (from Arboletes to Tinajones delta) resembles that of an extended surface of marine erosion with a rather uniform topography, characterized by concave-upward depositional surfaces down to the -8m isobath, (minimum slopes in the order of 0.01494 %) and a well defined, concave, erosional surface at shallower depths (maximum slopes of the order of 1.88 %) on which recent and present transgressive conditions are well evidenced by numerous wave-cut platforms and by the strongly erosional character of beaches and cliffs along most of the 124 km-long coastline. The morphology of the eastern inner shelf (from the Sinú delta-Cispatá Bay-Punta Bolívar) is highly variable and characterized to the west by two prograding prisms (Tinajones and Los Venados deltas), terraced surfaces, other positive reliefs (¿paleoreefs?, ¿mud volcanoes?) and a series of steep scarps (at depths of -4m, -6m, and -10m) suggesting ancient submerged shorelines. High resolution records (12 kHz) of the area show highly dynamical and unstable environments affected during the late Holocene by mud diapirism, active faulting and depositional events (up to 5m thick) that filled ancient channels and small basins.

In Chile, flour is fortified with folic acid since 2000, and the incidence of neural tube defects has decreased. Cranio-encephalic congenital defects (CECD) have a wider clinical scope, includind classical neural tube defects (NTD) such as anencephalia and acrania, but also incorporating other defects. Therefore, the effects of folic acid fortification on the incidence of CECD could be different.To study the effect of folic acid fortification on the incidence of CECD.All prenatal diagnoses of CECD and cases registered locally in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) were reviewed. The obtained data were crossed with all death certificates of newborns or stillborns of more than 500 g in the Sixth Region, in Central Chile. All cases were classified again in four subtypes, according to their phenotype. The incidences of all subtypes prior (1996-2000) and after folic acid supplementation (2001-2004), were compared.Between 1996 and 2004, there were 64 cases of CEDC among 109,176 infants born alive. The global rate was 8.86 per 10,000 born alive in the period prior to fortification and 3.03 per 10,000 born alive after fortification. Comparing both periods, there was a 66% reduction in all CECD and a 77 and 100% reduction in subtypes A and B of CECD, respectively (p0.05). No significant reductions in type C and D CECD, were observed.After the start of flour folic acid fortification, there was a global reduction in the incidence of CECD. However, only types A and B CECD, supposedly more responsive to folic acid, were reduced.

Background: In Chile, flour is fortified with folic acid since 2000, and the incidence of neural tube defects has decreased. Cranio-encephalic congenital defects (CECD) have a wider clinical scope, includind classical neural tube defects (NTD) such as anencephalia and acrania, but also incorporating other defects. Therefore, the effects of folic acid fortification on the incidence of CECD could be different. Aim: To study the effect of folic acid fortification on the incidence of CECD. Material and methods: All prenatal diagnoses of CECD and cases registered locally in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) were reviewed. The obtained data were crossed with all death certificates of newborns or stillborns of more than 500 g in the Sixth Region, in Central Chile. All cases were classified again in four subtypes, according to their phenotype. The incidences of all subtypes prior (1996-2000) and after folic acid supplementation (2001-2004), were compared. Results: Between 1996 and 2004, there were 64 cases of CEDC among 109,176 infants born alive. The global rate was 8.86 per 10,000 born alive in the period prior to fortification and 3.03 per 10,000 born alive after fortification. Comparing both periods, there was a 66% reduction in all CECD and a 77 and 100% reduction in subtypes A and B of CECD, respectively (p

Background: In Chile, flour is fortified with folic acid since 2000, and the incidence of neural tube defects has decreased. Cranio-encephalic congenital defects (CECD) have a wider clinical scope, includind classical neural tube defects (NTD) such as anencephalia and acrania, but also incorporating other defects. Therefore, the effects of folic acid fortification on the incidence of CECD could be different. Aim: To study the effect of folic acid fortification on the incidence of CECD. Material and methods: All prenatal diagnoses of CECD and cases registered locally in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) were reviewed. The obtained data were crossed with all death certificates of newborns or stillborns of more than 500 g in the Sixth Region, in Central Chile. All cases were classified again in four subtypes, according to their phenotype. The incidences of all subtypes prior (1996-2000) and after folic acid supplementation (2001-2004), were compared. Results: Between 1996 and 2004, there were 64 cases of CEDC among 109,176 infants born alive. The global rate was 8.86 per 10,000 born alive in the period prior to fortification and 3.03 per 10,000 born alive after fortification. Comparing both periods, there was a 66% reduction in all CECD and a 77 and 100% reduction in subtypes A and B of CECD, respectively (p

Background: The Latin American Collaborative Study for Congenital Malformations (ECLAMC) has detected a higher incidence of Down syndrome in a zone of central Chile than in the rest of the country. Aim: To analyze the incidence rates of Down syndrome between 1997 and 2003 at the Regional Hospital of Rancagua, located 90 km south of Santiago, Chile. Material and methods: The information obtained by ECLAMC was used. This program, using a case control methodology, registers all newborns with congenital malformations and assigns, as a control, the next normal newborn of the same sex. Results: During the study period, 106 newborns with Down syndrome were registered, with a mean rate of 29.61 per 10,000 live births, twice higher than expected. The rate variations along the years of study suggest a cyclic change, with a hemicycle of six years. Conclusions: In this hospital, mothers under 35 years of age, have twice the risk of having a child with Down syndrome, than in the rest of the country

To test the hypothesis of an association between HER2 and chemotherapy resistance, we performed a prospective assessment of the predictive value of the circulating HER2 extracellular domain (ECD) in patients with advanced breast carcinoma in the setting of a multicenter Phase II trial using paclitaxel and doxorubicin. Serum samples were collected from 58 patients with metastatic breast carcinoma before first-line chemotherapy for advanced disease, and the levels of circulating HER2 ECD were measured using an enzyme immunoassay. Immunohistochemistry with anti-HER2 monoclonal antibody CB11 was used to assess the overexpression of HER2 in the primary tumors. When 450 fmol/ml was used as a cutoff, 24 cases (41%) had elevated HER2 ECD levels. Elevated levels of circulating HER2 ECD were associated with the expression of HER2 in the primary tumor tissue and with the metastatic tumor burden (evaluated with the marker CA 15-3; P = 0.032 and P = 0.002, respectively) but not with variables such as menopausal status, stage at diagnosis, previous adjuvant therapy, or the number of metastatic sites. The levels of circulating HER2 ECD correlated inversely with the response to treatment. The probability of obtaining a complete response to chemotherapy was significantly lower (P = 0.021) in patients with elevated HER2 ECD levels (0%; 95% confidence interval, 0-13%) compared with patients with nonelevated HER2 (26%; 95% confidence interval, 12-45%). In addition, the duration of clinical response was significantly shorter in patients with elevated HER2 ECD, compared with the cases with nonelevated HER2 (7.5 versus 11 months; P = 0.035). In conclusion, elevated levels of circulating HER2 ECD in patients with metastatic breast cancer correlate with reduced efficacy of a paclitaxel-doxorubicin chemotherapy combination. We suggest that the poor response rate associated with HER2 expression in advanced breast cancer may not be reversed by aggressive chemotherapy alone.

Background: Chronic pesticide exposure is a recognized risk for human health. The frequency of congenital malformations in exposed people, can be used for epidemiological studies assessing reproductive risk secondary to toxic exposure. Aim: To study the association between the incidence of congenital malformations and parent’s exposure to pesticides. Material and methods: A prospective study of cases and controls. The exposure could be caused by occupational activities or residence around fumigated crops. The records of cases and controls from the surveillance carried out in the Hospital Regional de Rancagua were analyzed. This hospital is active member of a collaborative study of congenital malformations in Latin America. Results: In two years there was a total of 453 newborns (18 stillborn) with congenital malformations, with an incidence of 41.24 ‰. Considering only children born alive, the paired analysis of cases and controls showed an association of congenital malformations with a history of maternal exposure, with an attributable fraction of 54.4%. Conclusions: These results, showing an association between pesticide exposure and congenital malformations, should be analyzed in the future by a logistic regression test. (Rev Méd Chile 2000; 128: 399-404)

La presente investigación es requisito parcial para optar al título de Magister Scientiae en Ambiental. El propósito es la determinación del contenido de plomo en las muestras de material en forma de partículas, obtenidas en las trece estaciones que conforman la Red-Bogotá.

El trabajo se realizó en el zoocriadero "Bellavista", Cali-Colombia. Se incluyeron los eventos correspondientes a 120 partos de 54 hembras que se aparearon con 22 machos durante un período de tres años. Los animales presentaron promedios de 94,277 y 407 g, para nacimiento (231 crías), destete (204) y saca (170), respectivamente. Las distribuciones del peso corporal son del tipo "normaloide", con ligera asimetría positiva. Los coeficientes de correlación entre pesos corporales disminuyen con el transcurso del tiempo. Los promedios de peso se diferencian en cada etapa de vida del animal, según el sexo y el tamaño de camada; para compensar los efectos, los datos se ajustaron en forma multiplicativa y se corrigieron linealmente por edad. Para la selección de reproductores se ensayaron tres criterios: grupo de mejor comportamiento, padres que no difieren significativamente del mejor reproductor y padres con hijo, homogéneamente más pesados. La estimación de heredabilidad para el incremento post-destete por el método de Hermanos Medios Paternos, arrojó un valor de 0.298 y mediante el ajuste multiplicativo, se incrementó en un 72% con la combinación de los tres factores. Con base en los datos ajustados se definió como criterio de selección de crías, las características peso a 90 días e incremento post destete, exigiendo en forma simultánea el requisito de estar por encima de la media general más 0.5 veces la desviación estándar.The accomplishment of this work took place in zoobreeeding "Bellavista", Cali-Colombia. Events this refers to 120 births of 54 females mated to 22 males, were included in this study, data gathered in a period of 3 years. These animals present weight averages of 94,227 and 407 g, per birth (231 breedings), weaning (204) and end of foIIow-up (170) respectively. A distribution of weight is of "normaloide” type, with a slight positive asimetry. Coefficients of correlation between body weight, are decreasing as time pass. In each stage of life, the average weight of animals, showed remarkable difference, in accordance with the sex and the size of the brood or litter. To compensate the effects, all data was adjusted in a multiplication way and correction was made in a lineal way, according to age. ln selection of breeder, three critetions were taken in mind: group of best behaviour, fathers with slight difference from the best one, and fathers with childs with more weight homogenously. Estimation of heredability for increments post-weaning by the method of Paternal Brothers, to throw a value of 0.298 and by means of the multiplication adjustment, was incremented in a 72% in combination of the three factorso Based on adjustment of data, was defined as criterion of selection of breeds, the combinations of features as body weight at 90 days and increase post-weaning, with exigence of requirement to be over the genera I media plus 0.5 times the standart desviation.

El trabajo se realizó en el zoocriadero "Bellavista", Cali-Colombia. Se incluyeron los eventos correspondientes a 120 partos de 54 hembras que se aparearon con 22 machos durante un período de tres años. Los animales presentaron promedios de 94,277 y 407 g, para nacimiento (231 crías), destete (204) y saca (170), respectivamente. Las distribuciones del peso corporal son del tipo "normaloide", con ligera asimetría positiva. Los coeficientes de correlación entre pesos corporales disminuyen con el transcurso del tiempo. Los promedios de peso se diferencian en cada etapa de vida del animal, según el sexo y el tamaño de camada; para compensar los efectos, los datos se ajustaron en forma multiplicativa y se corrigieron linealmente por edad. Para la selección de reproductores se ensayaron tres criterios: grupo de mejor comportamiento, padres que no difieren significativamente del mejor reproductor y padres con hijo, homogéneamente más pesados. La estimación de heredabilidad para el incremento post-destete por el método de Hermanos Medios Paternos, arrojó un valor de 0.298 y mediante el ajuste multiplicativo, se incrementó en un 72% con la combinación de los tres factores. Con base en los datos ajustados se definió como criterio de selección de crías, las características peso a 90 días e incremento post destete, exigiendo en forma simultánea el requisito de estar por encima de la media general más 0.5 veces la desviación estándar. The accomplishment of this work took place in zoobreeeding "Bellavista", Cali-Colombia. Events this refers to 120 births of 54 females mated to 22 males, were included in this study, data gathered in a period of 3 years. These animals present weight averages of 94,227 and 407 g, per birth (231 breedings), weaning (204) and end of foIIow-up (170) respectively. A distribution of weight is of "normaloide” type, with a slight positive asimetry. Coefficients of correlation between body weight, are decreasing as time pass. In each stage of life, the average weight of animals, showed remarkable difference, in accordance with the sex and the size of the brood or litter. To compensate the effects, all data was adjusted in a multiplication way and correction was made in a lineal way, according to age. ln selection of breeder, three critetions were taken in mind: group of best behaviour, fathers with slight difference from the best one, and fathers with childs with more weight homogenously. Estimation of heredability for increments post-weaning by the method of Paternal Brothers, to throw a value of 0.298 and by means of the multiplication adjustment, was incremented in a 72% in combination of the three factorso Based on adjustment of data, was defined as criterion of selection of breeds, the combinations of features as body weight at 90 days and increase post-weaning, with exigence of requirement to be over the genera I media plus 0.5 times the standart desviation.

This ongoing phase II trial was designed to determine the antitumor activity and cardiotoxicity of a combination of doxorubicin (50 mg/m2) and paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (175 to 225 mg/m2 over 3 hours) as first-line chemotherapy for metastatic breast cancer. Of 76 patients entered so far, 57 who had received at least three courses of chemotherapy are assessable for efficacy and cardiac toxicity. A slight majority (57%) of the patients entered had prior adjuvant chemotherapy, including 33% with anthracycline-containing combinations. An objective response was achieved by 70% of patients, with 18% complete responders. The main noncardiac toxicities were alopecia, neutropenia, mucositis, and peripheral neuropathy. Overall, after a median cumulative doxorubicin dose of 350 mg/m2, the evolution of left ventricular ejection fraction (LVEF) values did not significantly decrease from baseline to the sixth course of therapy. However, LVEF values decreased significantly in eight patients (14%). The LVEF decreased by more than 14% over basal values in three patients, although the final determination was still above the lower limits of normal. The remaining five patients had LVEF decreases that fell below the lower limits of normal (33% to 48%). None of the patients developed clinically evident heart failure. Our results indicate that the combination of doxorubicin (50 mg/m2) plus paclitaxel (175 to 225 mg/m2) is effective and does not induce a clinically relevant cardiotoxicity.

The purpose of this study was to evaluate the toxicity and efficacy of paclitaxel/gemcitabine administered every 2 weeks in the first-line treatment of advanced breast cancer. Forty-three chemonaive patients with histologically confirmed metastatic breast carcinoma were enrolled. Patients received paclitaxel 150 mg/m2 followed by gemcitabine 2,500 mg/m2, both on day I of a 14-day cycle, for a maximum of eight cycles. Thirty-four patients were evaluable for toxicity; 38 were evaluable for efficacy. The median age at the time of diagnosis was 54 years, the median performance status was 90, and the median number of lesions was three. Most patients (71%) had received prior adjuvant therapy. Grade 3 and 4 toxicity was limited to leukocytes (14% and 18%, respectively). Grade 3 toxicities (5% each) were thrombocytopenia, nausea and vomiting, elevation of aspartate transaminase, neurosensory, and constipation. One patient had neutropenia and fever. The objective response rate was 68% (21% complete response and 47% partial response); 18% had stable disease and 13% had partial disease. The preliminary evaluation of paclitaxel/gemcitabine given as a 2-week schedule to patients with untreated advanced breast carcinoma shows encouraging activity and a favorable toxicity profile.

Advanced ovarian neoplasm has bad prognosis. There is little knowledge as to the effect of surgical and chemotherapy treatments on long-term survival.Seventy-two patients with advanced epithelial ovary carcinoma (53 stage III and 19 stage IV) were treated according to a treatment regimen with reduction surgery, five cycles of chemotherapy with cyclophosphamide, adriamycin and cisplatin (CAP) followed by second revision laparotomy.The rate of response for the CAP schedule was 80%, of which 16 patients (23%) showed complete response (CR), 7 (10%) partial microscopic response (PMiR) and 33 (47%) partial macroscopic response (PMR). Complete resection of residual masses was performed on the second laparotomy in 14 of the 33 patients with parital response. The median survival for all the group was 36 months with overall actuarial survival of 27% at 10 years. The survival of the group of patients with CR was significantly longer than that of PMiR and other groups. Significant differences favorable for the group of partial response with second attempt radical surgery were found versus the group in which te second surgical resection was not radical. FIGO III stage and prechemotherapy tumor size less than 5 cm were found to have favorable effect in the rate of response and survival.The use of CAP chemotherapy achieved complete response in 23% of the patients studied. This group of patients showed to have a greater probability of longer survival. Second attempt surgery on the second laparotomy offers therapeutic benefits when radical.