Carlos Lopes

SELDI-TOF biomarker signatures for cystic fibrosis, asthma and chronic obstructive pulmonary disease

OBJECTIVES The aim of this work was to establish protein profiles in serum and nasal epithelial cells of cystic fibrosis individuals in comparison with controls, asthma and chronic obstructive pulmonary disease patients for specific biomarker signatures identification. DESIGN AND METHODS Protein extracts were analyzed by Surface Enhanced Laser Desorption/Ionization Time-Of-Flight Mass-Spectrometry (SELDI-TOF-MS). RESULTS The mass spectra revealed a set of peaks with differential expression in serum and nasal cells among the different groups studied, resulting into peak signatures representative/specific of each pathology. Logistic regressions were applied to those peaks; sensitivity, specificity, Youdens indexes and area under the curve (AUC) of the respective receiver operating characteristic (ROC) curves were compared. DISCUSSION Multivariate analysis demonstrated that combination of peaks has a better predictive value than the individual ones. These protein signatures may serve as diagnostic/prognostic markers for the studied diseases with common clinical features, or as follow-up assessment markers of therapeutic interventions.

Profiling the erythrocyte membrane proteome isolated from patients diagnosed with chronic obstructive pulmonary disease

Structural and metabolic alterations in erythrocytes play an important role in the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD). Whether these dysfunctions are related to the modulation of erythrocyte membrane proteins in patients diagnosed with COPD remains to be determined. Herein, a comparative proteomic profiling of the erythrocyte membrane fraction isolated from peripheral blood of smokers diagnosed with COPD and smokers with no COPD was performed using differential (16)O/(18)O stable isotope labeling. A total of 219 proteins were quantified as being significantly differentially expressed within the erythrocyte membrane proteomes of smokers with COPD and healthy smokers. Functional pathway analysis showed that the most enriched biofunctions were related to cell-to-cell signaling and interaction, hematological system development, immune response, oxidative stress and cytoskeleton. Chorein (VPS13A), a cytoskeleton related protein whose defects had been associated with the presence of cell membrane deformation of circulating erythrocytes was found to be down-regulated in the membrane fraction of erythrocytes obtained from COPD patients. Methemoglobin reductase (CYB5R3) was also found to be underexpressed in these cells, suggesting that COPD patients may be at higher risk for developing methemoglobinemia. This article is part of a Special Issue entitled: Integrated omics.

Water and Heat Fluxes in Mediterranean Vineyards: Indicators and Relevance for Management

Abstract Improved monitoring of water and heat fluxes in the vineyard can help to support more efficient soil and crop management (e.g., irrigation). Row crops such as grapevines are more vulnerable to drought/heat stress due to increased exposition to radiative soil fluxes. Such soil effect can be particularly negative for canopy and cluster microclimates and conditions under Mediterranean dry and warm climate conditions. Our aim is to better understand diurnal and seasonal variation in water and heat fluxes in the vineyard and to assess how agronomic practices (e.g., irrigation, soil management) influence those fluxes in Mediterranean irrigated viticulture. We also address the use of thermography as a tool to assess vines water status and visualize heat patterns/fluxes in a vineyard, to support canopy/soil management and feed models that can predict crop growth and irrigation needs.

PS-047 Implementing a pharmacovigilance programme in oncology

This abstract was published in error and withdrawn at the author’s request.

PS-099 Drug-drug interactions in fluoropyrimidines-based regimens used in colorectal cancer treatment

Background Drug interactions in oncology are of particular importance due to the narrow therapeutic range and inherent toxicity. The incidence of interactions increases when patients are polymedicated, which is very common in cancer patients as they often have other co-morbidities. Purpose To identify potential drug–drug interactions in patients with colorectal cancer treated with fluoropyrimidines-based regimens and concomitant treatment. Material and methods Retrospective study to evaluate drug interactions in patients with colorectal cancer who started chemotherapy between January and March 2014, in a central hospital, and who were also prescribed other drugs. Interactions were screened using the Lexi-Interact database between chemotherapy regimens including FOLFOX4, mFOLFOX6, FOLFIRI, capecitabine and fluorouracil continuous infusion, supportive treatment for prevention of emesis (dexamethasone, ondansetron) and other prescribed treatment. Results Of the patients who started fluoropyrimidines-based chemotherapy, 29 were also prescribed other drugs, the majority cardiovascular and Central Nervous System drugs. Of the 108 drugs prescribed, 20 interacted with the chemotherapeutic regimen, and accounted for 34 interactions, with an average of 1.2 interactions per prescription. According to the Lexi-Interact database 10 had risk rating C and required monitoring of side effects; 23 had risk rating D and were recommended for treatment modification or aggressive monitoring; 1 had risk rating X which required avoidance of the combination. The drugs included in the chemotherapy regimens with the highest number of interactions were dexamethasone (n = 20) and fluorouracil (n = 8). Conclusion The screening of drugs for the treatment of co-morbidities was based on electronic medical records hence OTC drugs and dietary supplements were not included in this study. The identification of these drug interactions enables their inclusion in the prescription program, allowing alerts to be issued at the time of prescription. Reference Crul M, Yap KD, Terpstra WE. Frequent interactions between chemotherapy and community-dispensed drugs in a continuous screening programme. Eur J Hosp Pharm 2012;19:171 No conflict of interest.

CP-019 Hospital pharmacists’ interventions in a central hospital

Background Several studies have demonstrated the positive impact of clinical pharmacy services in the hospital setting. Interventions by clinical pharmacists have been shown to reduce the frequency of drug-related problems. Pharmacist interventions (PIs) are defined as a professional activity performed by pharmacists, directed towards improving the quality use of medicines and resulting in a recommendation for a change in the patient’s drug treatment. Purpose To characterise all PIs recorded in the electronic medical record and quantify their acceptance by the medical team. Materials and methods An observational, retrospective study was carried out in a 350-bed central hospital, between January and June 2013. All the PIs recorded in the electronic medical record during the study period were eligible for inclusion; verbal PIs and related to clinical pharmacokinetics were excluded. Results 1449 PIs were performed during the study period. The majority of these PIs involved the following therapeutic classes: antibacterial (25%), CNS (24%), cardiovascular (18%) and blood (9%). 147 drugs were targeted in an intervention; acetaminophen (18%) was the subject of the largest number of pharmacist interventions, followed by enoxaparin (13%) and amoxicillin/clavulanic acid (10%). When we looked at the type of intervention we found that most corresponded to dose adjustment for renal failure (29%), change of administration route (24%) or other dose adjustment (9%). Discharge, transfer between clinical services and drug discontinuation led to it only being possible to assess 69% of interventions performed. The acceptance rate was 48%. Conclusions Our results, in particular those referring to dose-dependent problems, confirm the need for pharmacotherapy follow-up. From this study it can be concluded that a high percentage of PIs are focused on a limited number of drugs, suggesting the need to make specific recommendations in order to improve drug use. The ultimate goal of PI is to improve health outcomes for each patient by promoting the rational use of medicines. No conflict of interest.