Transarterial Chemoembolization to the treatment of Hepatocellular Carcinoma – preparation procedures

Poster Presentations Background:  Allergic rhinitis to house dust mites is characterized by a chronic inflammation of nasal mucosa. H1 antihistamines from second generation reduce the rhinitis’ symptoms, but may also have anti-inflammatory properties. This study aims to evaluate some proinflammatory cytokines in patients with allergic rhinitis to house dust mite and their evolution under treatment with H1 antihistamines. Material and Methods:  Fifty-eight patients with persistent allergic rhinitis to house dust mite were included in the study. They were clinically evaluated before and after 4 week-treatment with 2nd generation H1 antihistamines, Levocetirizine 5 mg/day or Desloratadine 5 mg/day. The clinical evaluation includes: symptoms scores and total symptoms score (TSS), type of sensitization. Plasmatic levels of IL-6 and TNF-α  were determined before and after treatment. Results:  A total of 20.7% of the patients were sensitized only to house dust mite, while 79.3% were polisensitized (house dust mites and pollen). Most of the patients with moderate severe forms of allergic rhinitis were polisensitized (9.8% vs 90.2%, P =  0.003). The total symptoms score was significantly higher in patients with polisensitization (P =  0.045), Plasmatic level of TNF-α  was significantly higher in patients with allergic rhinitis (1.92 vs 1.206, P =  0.003), while IL-6 was similar to healthy volunteers. Both Levocetirizine and Desloratadine improved the rhinitis’ symptoms and significantly reduced total symptoms score (8.62 ± 3.47 vs 2.18 ± 2.3, P =  0.000) after 4 weeks of treatment. Levocetirizine improves better the nasal congestion (P =  0.048) than Desloratadine. Both H1 antihistamines significantly reduced plasmatic level of IL-6 and TNF-α  after 4 weeks of treatment. Levocetirizine reduced more significant the value of IL-6 compared to Desloratadine (P =  0.05). Conclusions:  There were observed high plasmatic values of TNF-α  in patients with persistent allergic rhinitis to house dust mites. H1 antihistamines reduce the severity of symptoms and the level of some pro-inflammatory mediator.

Transarterial Chemoembolization to the treatment of Hepatocellular Carcinoma – preparation procedures D. Ferreira1; T Pires1,2; and N. Machado2 Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Farmácia, Coimbra, Portugal; and 2Centro Hospitalar e Universitário de Coimbra,EPE Coimbra, Coimbra, Portugal Background: The liver is a vital organ to our organism and an hepatocellular cancer brings several complications and problems in patient’s life quality. Nowadays, hepatocellular carcinoma is one of the most diagnosed in the world and the third cause of death related to oncologic disease. Its treatment is mostly based in cytotoxic therapeutics. One of the drugs is doxorubicin, an antitumor drug belonging to anthracyclines that acts by intercalating into DNA of tumor cells. Transarterial chemoembolization (TACE) is a method that takes advantage of arterial and hepatic vascularization, which exists near the hepatic tumors. Recently, conventional TACE has suffered some developments, using beads that transport the drug – transarterial chemoembolization with drug-eluting bead. The objective of this review was to understand the different steps of the preparation procedure of the transarterial chemoembolization with drug-eluting beads, specifically, to doxorubicin in hepatic cancer treatment, and its administration path. Material and Methods:  Was conducted a research of articles published, in PubMed and Google Scholar, in English and Portuguese, using key words like chemoembolization, hepatocellular carcinoma, doxorubicin and TACE-DEB. Results:  This method uses microspheres (TACE-DEB), which are loaded with the drug in question and subsequently dropped by 1

August 2015

catheter to the tumor site. This procedure is made in aseptic conditions, with all necessary precautions due to the nature of the drug. Conclusions:  TACE-DEB with doxorubicin brings higher results and favorable improvements in evolution of hepatocellular carcinoma. There are many studies ongoing to discover more things about this important thematic.

An acenocoumarol dose algorithm in a Romanian Population A.D. Buzoianu; Ş.C. Vesa; A.P. Trifa; and S. Crişan “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania Background or Introduction:  A stable therapeutic dosing of vitamin K antagonist such as acenocoumarol or warfarin is a difficult task due to a high inter- and intra-individual variability. This variability is determined by several genetic and environmental factors. Our study aimed to develop an algorithm for stable acenocoumarol therapeutic dose prediction in Romanian patients. Material and Methods:  We recruited 301 patients who necessitated treatment with acenocoumarol for one or two concomitant diseases: acute deep vein thrombosis, permanent atrial fibrillation or valvular prostheses. The patients were selected from those admitted within the Municipal Hospital of Cluj-Napoca and the Heart Institute “Niculae Stănciou” in Cluj-Napoca, Romania, between 2009 and 2011. Clinical and demographic data that could influence the acenocoumarol stable dose were recorded for each patient. Genetic analysis included the genotyping the CYP2C9 gene and the -1693 G> A polymorphism of the VKORC1 (vitamin K epoxide reductase) gene. The patients were randomly divided into two groups: 200 patients (66.4%) formed the main group designed to develop clinical and genetic algorithms for acenocoumarol dose prediction, and 101 patients (33.6%) formed the validation group. Results:  Age and body mass index explained 18.8% (R2) of the acenocoumarol weekly dose variability in patients from the main group. When we added the genetic data to the algorithm, CYP2C9 mutations account for 4.7% of acenocoumarol dose variability and VKORC1 -1693 G> A polymorphism explained 19.6% of dose variation. In the validation group, clinical parameters explained 22.2% of the weekly acenocoumarol dose variability. Genetic variants increased the R2 coefficient to 32.8%. Conclusion:  We created and validated an accurate algorithm for prediction of stable therapeutic dose of acenocoumarol.

Vancomycin Therapeutic Drug monitoring in clinical practise H. Suchánková; and M. Machačová Faculty of Medicine and Dentistry, Palacký University in Olomouc, Czech Republic Introduction:  Vancomycin has a particular importance in treatment of Gram-positive bacterial infections. Recent TDM guidelines recommend monitoring of only through concentrations for dosage adjustment with target Cmin between 15mg/l and 20mg/l in patients with invasive infections (or) where less sensitive pathogen is involved, and between 10mg/l and 15 mg/l in other infections. This study evaluated the practice of vancomycin TDM in University Hospital in Olomouc and the influence of new recommendations on dosing strategies. Patients and Methods: A retrospective analysis of vancomycin plasma levels determined in patients treated with i.v. vancomycin was performed. Values with uncertain sample timing and haemodialysed patients were excluded. Each trough value was compared with the

e107