A careful monitoring of cardiac function is needed due to potential trastuzumab cardiotoxicity (Tcardiotox). To date, the incidence, timing, and phenotype of patients with Tcardiotox in clinical practice are not well known.
Methods and Results: A total of 499 consecutive HER2-positive women (mean age 55 +/- 11 years) with EBC treated with trastuzumab between January 2008 and June 2009 at 10 Italian institutions were followed for 1 year. We evaluated incidence, time of occurrence, and clinical features associated with
Tcardiotox. Left ventricular ejection fraction (LVEF) was evaluated by echocardiography at baseline and at 3, 6, 9, and 12 months during trastuzumab therapy. Tcardiotox was recognized in 133 patients (27%): 102 (20%) showed asymptomatic reduction
in LVEF of > 10% but <= 20% (grade 1 Tcardiotox); 15 (3%) had asymptomatic decline of LVEF of >20% or <50% (grade 2); and 16 (3%) had FDA-approved Drug Library clinical trial symptomatic heart failure (grade 3). Trastuzumab was discontinued due to cardiotoxicity in 24 patients (5%) and restarted in 13 after LVEF recovery. Forty-one percent of Tcardiotox cases occurred within the first 3 months of follow-up, most selleck chemicals llc prevalently in older patients with higher creatinine levels and in patients pretreated with doxorubicin and radiotherapy.
Conclusions: In clinical practice ,Tcardiotox is frequent in HER2-positive women with EBC and occurs in the first 3 months of therapy. Cardiac dysfunction is mild and asymptomatic in the majority of patients. The interruption of treatment is a rare event which occurs, however, in a significantly higher percentage than reported in randomized clinical trials. (J Cardiac Fail 2012;18:113-119)”
“The thermal conductivity and viscosity of various shapes of alumina nanoparticles MK-0518 research buy in a fluid consisting of equal volumes of ethylene glycol and water were investigated. Experimental data were analyzed and accompanied by theoretical modeling. Enhancements in the effective thermal conductivities due to particle shape effects expected from Hamilton-Crosser
equation are strongly diminished by interfacial effects proportional to the total surface area of nanoparticles. On the other hand, the presence of nanoparticles and small volume fractions of agglomerates with high aspect ratios strongly increases viscosity of suspensions due to structural constrains. Nanoparticle surface charge also plays an important role in viscosity. It is demonstrated that by adjusting pH of nanofluid, it is possible to reduce viscosity of alumina nanofluid without significantly affecting thermal conductivity. Efficiency of nanofluids (ratio of thermal conductivity and viscosity increase) for real-life cooling applications is evaluated in both the laminar and turbulent flow regimes using the experimental values of thermal conductivity and viscosity.