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Objectives: The aim of this study is to provide relevant and accurate information on prevalence and treatment patterns of anaemia in Belgian cancer patients.Methods: The Anaemia Day 2008 survey was a single visit, multi-centre, non-interventional study in adult cancer patients under systemic therapy (chemotherapy, hormonal, immunological and/or targeted therapy) and/or radiotherapy. Efforts were made to enroll the maximum number of patients seen in each centre that day. Patients signed an informed consent and relevant data were collected from their files, i.e. disease and disease stage, cancer therapy and anti-anaemic treatment, including transfusions and the use of erythropoietin stimulating agents (ESA). A blood count of each included patient was performed. Haemoglobin (Hb) values (grams per decilitre) were classified into four categories to assess the severity of anaemia, as defined by WHO: no anaemia: Hb ≥ 12 g/dL; mild 10 ≤ Hb ≤ 11.9 g/dL; moderate 8 ≤ Hb ≤ 9.9 g/dL; severe Hb < 8 g/dL. Univariate and multivariate analyses were carried out with anaemia as the dependent variable.Results: A total of 1,403 eligible patients aged 63 ± 13 years (mean age ± SD) were enrolled in 106 oncology or haematology centres. The mean Hb level (± SD) was 11.6 g/dL (± 1.8 g/dL) and the prevalence of anaemia (Hb < 12 g/dL) was 55.7% (95% CI, 53.1-58.3%), respectively, 35.9% mild, 17.8% moderate and 2.1% severe anaemia. Anaemia was more frequent in females than in males, and in patients with haematological malignancies (73.4%) than in those with solid tumours (51.4%; p < 0.001). Anaemia prevalence was higher in hospitalised patients (75.5%) compared to those seen in one-day-clinic (54.3%) or in consultation (33.9%; p < 0.001), and in patients treated with chemotherapy (61.3%) compared to those receiving radiotherapy (34.4%) or hormonal therapy (19.5%; p < 0.001). There was a clear correlation between severity of anaemia and WHO performance status (p < 0.001). Among anaemic patients, 53.1% received no treatment (mean Hb 10.8 ± 0.9 g/dL). Among the anaemic patients who received therapy for their anaemia (mean Hb 9.7 ± 1.1 g/dL), the most frequent treatments were RBC transfusions (42%), ESA (34.6%), transfusions + ESA (12%), ESA + iron (7.9%) and iron alone (3.5%). Comparison to the ECAS survey shows that there has been no major change in attitude towards anaemia management in the last decade.Conclusion: This survey shows that cancer-related anaemia is still frequently observed in cancer patients. Even if in our study ESA were used more frequently than about 10 years ago, still a large amount of anaemic patients who could be treated for anaemia according to EORTC guidelines, were not. [ABSTRACT FROM AUTHOR]

The binding of gitoxin, digitoxin and digoxin to human plasma proteins was measured by ultracentrifugation and equilibrium dialysis. At concentrations in the range of therapeutic plasma levels, protein binding amounted, respectively, to 85, 92 and 20%, the last two values being consistent with data reported in the literature. The affinity of purified human albumin was not significantly different for the three cardiac glycosides tested. No other protein than albumin was found to bind gitoxin in human plasma. [ABSTRACT FROM AUTHOR]

The influence of R(-) apomorphine, S(+) apomorphine and deopamine on the oxidation kinetics of two polyunsaturated fatty acids (PUFA) (cholesteryl linoleate (CL) and Trilinolein (TL) was investigated The oxidation was initiated by free radicals generated through thermal decomposition of 2,2'-Azobis(2-methy-propionitrile) (AMPN) in phosphate buffer (pH 7.4) thermostated at 50°C. The hydroperoxides formed were determined by iodine titration using a diode array spectrophotometer at 290 nm. Both enantiomers of apomorphine as well as dopamine exerted an inhibitory effect. Tocopherol (α-tocopherol) and ascorbic acid were used as controls. The former inhibited while ascorbic acid facilitated the oxidation reaction. These results are discussed i relation with the possible role of oxidative injury in parkinsonism and the usefulness of apomorphine in elevating 'on-off' episodes. On this basis, the non-dopaminergic enantiomer of apomorphine (S(+)-isomer) is put foward to test the importance of its radical scavenging properties in parkinsonism which could eventually lead to a therapeutic alternative with less side effects. [ABSTRACT FROM AUTHOR]

Blood levels of racemic chloroquine and its main metabolites desethylchloroquine and bisdesethylchloroquine were measured in 29 patients treated chronically for rheumatoid arthritis. In six patients, the concentrations were followed during a one day dosage interval. There was considerable intersubject variability in the steady state blood concentrations of chloroquine (range 36.6 to 3895 ng·ml) and its two main biotransformation products; the latter represented, respectively, 47.7% and 12.9% of the concentration of chloroquine. This finding shows the need for further studies in view of the known toxic effects of chloroquine and the inevitable accumulation due to the exceptionally long residence time of the compound and its metabolites. The main requirement, which has not yet been met, for adding chloroquine to the list of drugs for which therapeutic drug monitoring is useful, is the lack of information about its mechanism of action, and consequently the dose-effect relationships of its therapeutic and toxic actions. Regular ophthalmic examination, in particular, is strongly recommended. The relatively high concentrations of desethylchloroquine and bisdesethylchloroquine found during chronic treatment show the need for more information about the therapeutic value and adverse effects of the metabolites. [ABSTRACT FROM AUTHOR]

We report a case of a woman hospitalized after chloroquine overdose whose whole blood concentration on admission was 7.87 Μg/ml. High blood concentrations of chloroquine induce cardiotoxicity and have been associated with death when they exceed 3.0 Μg/ml. Early administration of massive doses of diazepam has been described to reduce the mortality due to chloroquine toxicity, but the protective mechanism has remained unknown. This patient was treated with diazepam (2.0 mg/kg over 30 min followed by a dosage of 1.0 to 2.0 mg/kg over 24 h), yet she remained awake despite the high plasma concentrations of diazepam and nordiazepam which would normally be associated with sedation. This suggests an antagonistic effect of chloroquine on the benzodiazepine-induced sedation due to an interaction between these drugs at their site of action. [ABSTRACT FROM AUTHOR]