Budget impact from the incorporation of positron emission tomography – computed tomography for staging lung cancers

OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.RESULTS The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively.CONCLUSIONS The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

Effects of light and temperature on isoprene emission at different leaf developmental stages of eschweilera coriacea in central Amazon

Isoprene emission from plants accounts for about one third of annual global volatile organic compound emissions. The largest source of isoprene for the global atmosphere is the Amazon Basin. This study aimed to identify and quantify the isoprene emission and photosynthesis at different levels of light intensity and leaf temperature, in three phenological phases (young mature leaf, old mature leaf and senescent leaf) of Eschweilera coriacea (Matamatá verdadeira), the species with the widest distribution in the central Amazon. In situ photosynthesis and isoprene emission measurements showed that young mature leaf had the highest rates at all light intensities and leaf temperatures. Additionally, it was observed that isoprene emission capacity (Es) changed considerably over different leaf ages. This suggests that aging leads to a reduction of both leaf photosynthetic activity and isoprene production and emission. The algorithm of Guenther et al. (1999) provided good fits to the data when incident light was varied, however differences among E S of all leaf ages influenced on quantic yield predicted by model. When leaf temperature was varied, algorithm prediction was not satisfactory for temperature higher than ~40 °C; this could be because our data did not show isoprene temperature optimum up to 45 °C. Our results are consistent with the hypothesis of the isoprene functional role in protecting plants from high temperatures and highlight the need to include leaf phenology effects in isoprene emission models.

Analysis of the effects of the continuous electrode paste band on precordial leads of the electrocardiogram

OBJECTIVE - To determine if the application of a continuous electrode paste band on precordial leads results in alteration of the electrocardiographic tracing as compared with an adequate amount of electrode paste, and if the former condition does not cause uniform morphologies from V1 to V6. METHODS - The amplitude and morphology of the electrocardiographic waves on the precordial leads in electrocardiographic tracings, which were performed with standard (control group) or excessive (continuous band) application of the electrode paste, were compared. RESULTS - None of the 106 patients studied showed uniformity of the QRS morphology from V1 to V6. The eletrocardiographic alterations identified in the tracings performed with a continuous electrode paste band that showed statistical significance in relation to the control group were the following: inversion of the P wave in V1; inversion of the T wave in V1, V2, and V3; appearance of R' waves in V1 and V2; disappearance of S waves in V1; appearance of S waves in V5 and V6; alterations in the amplitude of almost all waves, in all leads. CONCLUSION - Application of a continuous electrode paste band in the precordial leads may cause significant alterations in the electrocardiographic tracing obtained.

Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery

OBJECTIVE: To assess the prognostic value of Technetium-99m-labeled single-photon emission computerized tomography (SPECT) in the follow-up of patients who had undergone their first myocardial revascularization. METHODS: We carried out a retrospective study of 280 revascularized patients undergoing myocardial scintigraphy under stress (exercise or pharmacological stress with dipyridamole) and at rest according to a 2-day protocol. A set of clinical, stress electrocardiographic and scintigraphic variables was assessed. Cardiac events were classified as "major" (death, infarction, unstable angina) and "any" (major event or coronary angioplasty or new myocardial revascularization surgery). RESULTS: Thirty-six major events occurred as follows: 3 deaths, 11 infarctions, and 22 unstable anginas. In regard to any event, 22 angioplasties and 7 new surgeries occurred in addition to major events, resulting a total of 65 events. The sensitivity of scintigraphy in prognosticating a major event or any event was, respectively, 55% and 58%, showing a negative predictive value of 90% and 83%, respectively. Diabetes mellitus, inconclusive stress electrocardiography, and a scintigraphic visualization of left ventricular enlargement were significant variables for the occurrence of a major event. On multivariate analysis, abnormal myocardial scintigraphy was a predictor of any event. CONCLUSION: Myocardial perfusion tomography with Technetium-99m may be used to identify high-risk patients after their first myocardial revascularization surgery.

Protein-DNA associations in a gender-specific gene of Schistosoma mansoni: characterization by UV cross-linking, DNase I footprinting and band shift assays

Protein extracts obtained from male and female shistosomes were incubated with a gender-specific gene, F-10, transcribed only in adult females and encoding a major egg-shell protein. The protein/DNA interaction was measured using the band shift, DNase-I-footprinting and UV cross-linking techniques. The results showed a clear band shift when a 302 bp restriction fragment containing the 3'end of the gene was incubated with either female or male proteins. This fragment also contained a putative steroid hormone regulatory element (HRE). In contrast, only the male proteins produced a shift with the 495 bp fragment corresponding to the middle region of the gene. DNase I footprinting showed that proteins from males and females interacted with the F-10 gene by binding to multiple adjacent sites along the DNA, thus generatingrelatively long protected fragments of approximately 100 bp. This result suggested that the adjacent binding of several moles of proteins occured at the 5'end of the gene. UV cross-linking between schistosome proteins and a 21 bp synthetic oligonucleotide the F-10 HRE, evidence proteins having MWS of 30,45 and 65 kDNA. These proteins are presumably involved in the regulation of transcription of the F-10 gene.

Estimation of surface roughness in a semiarid region from C-band ERS-1 synthetic aperture radar data

In this study, we investigated the feasibility of using the C-band European Remote Sensing Satellite (ERS-1) synthetic aperture radar (SAR) data to estimate surface soil roughness in a semiarid rangeland. Radar backscattering coefficients were extracted from a dry and a wet season SAR image and were compared with 47 in situ soil roughness measurements obtained in the rocky soils of the Walnut Gulch Experimental Watershed, southeastern Arizona, USA. Both the dry and the wet season SAR data showed exponential relationships with root mean square (RMS) height measurements. The dry C-band ERS-1 SAR data were strongly correlated (R² = 0.80), while the wet season SAR data have somewhat higher secondary variation (R² = 0.59). This lower correlation was probably provoked by the stronger influence of soil moisture, which may not be negligible in the wet season SAR data. We concluded that the single configuration C-band SAR data is useful to estimate surface roughness of rocky soils in a semiarid rangeland.

The combined use of reflectance, emissivity and elevation Aster/Terra data for tropical soil studies

Reflectance, emissivity and elevation data of the sensor ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer)/Terra were used to characterize soil composition variations according to the toposequence position. Normalized data of SWIR (shortwave infrared) reflectance and TIR (thermal infrared) emissivity, coupled to a soil-fraction image from a spectral mixture model, were evaluated to separate bare soils from nonphotosynthetic vegetation. Regression relationships of some soil properties with reflectance and emissivity data were then applied on the exposed soil pixels. The resulting estimated values were plotted on the ASTER-derived digital elevation model. Results showed that the SWIR bands 5 and 6 and the TIR bands 10 and 14 measured the clay mineral absorption band and the quartz emissivity feature, respectively. These bands improved also the discrimination between nonphotosynthetic vegetation and soils. Despite the differences in pixel size and field sampling size, some soil properties were correlated with reflectance (R² of 0.65 for Al2O3 in band 6; 0.61 for Fe2O3 in band 3) and emissivity (R² of 0.65 for total sand fraction in the 10/14 band ratio). The combined use of reflectance, emissivity and elevation data revealed variations in soil composition with topography in specific parts of the landscape. From higher to lower slope positions, a general decrease in Al2O3 and increase in total sand fraction was observed, due to the prevalence of Rhodic Acrustox at the top and its gradual transition to Typic Acrustox at the bottom.

Emission of nitrous oxide and carbon dioxide from semi-arid tropical soils in Chiapas México

The semi-arid region of Chiapas is dominated by N2 -fixing shrubs, e.g., Acacia angustissima. Urea-fertilized soil samples under maize were collected from areas covered and uncovered by A. angustissima in different seasons and N2O and CO2 emissions were monitored. The objective of this study was to determine the effects of urea and of the rainy and dry season on gas emissions from semi-arid soil under laboratory conditions. Urea and soil use had no effect on CO2 production. Nitrons oxide emission from soil was three times higher in the dry than in the rainy season, while urea fertilization doubled emissions. Emissions were twice as high from soil sampled under A. angustissima canopy than from arable land, but 1.2 lower than from soil sampled outside the canopy, and five times higher from soil incubated at 40 % of the water-holding capacity (WHC) than at soil moisture content, but 15 times lower than from soil incubated at 100 WHC. It was found that the soil sampling time and water content had a significant effect on N2O emissions, while N fertilizer and sampling location were less influent.

EFFECT OF RICE STRAW AND NITRATE LEVELS IN SOIL SOLUTION ON NITROUS OXIDE EMISSION

Among the greenhouse gases, nitrous oxide (N2O) is considered important, in view of a global warming potential 296 times greater than that of carbon dioxide (CO2) and its dynamics strongly depend on the availability of C and mineral N in the soil. The understanding of the factors that define emissions is essential to develop mitigation strategies. This study evaluated the dynamics of N2O emissions after the application of different rice straw amounts and nitrate levels in soil solution. Pots containing soil treated with sodium nitrate rates (0, 50 and 100 g kg-1 of NO−3-N) and rice straw levels (0, 5 and 10 Mg ha-1), i.e., nine treatments, were subjected to anaerobic conditions. The results showed that N2O emissions were increased by the addition of greater NO−3 amounts and reduced by large straw quantities applied to the soil. On the 1st day after flooding (DAF), significantly different N2O emissions were observed between the treatments with and without NO−3 addition, when straw had no significant influence on N2O levels. Emissions peaked on the 4th DAF in the treatments with highest NO−3-N addition. At this moment, straw application negatively affected N2O emissions, probably due to NO−3 immobilization. There were also alterations in other soil electrochemical characteristics, e.g., higher straw levels raised the Fe, Mn and dissolved C contents. These results indicate that a lowering of NO−3 concentration in the soil and the increase of straw incorporation can decrease N2O emissions.

Sonography of the iliotibial band: spectrum of findings

Iliotibial band lesions constitute a potential source of discomfort and are frequently confounded with other conditions which cause pain on the lateral aspect of the hip, thigh and knee. Ultrasonography is usually regarded as a first-line imaging modality in the assessment of such conditions because of its excellent diagnostic accuracy, low cost and wide availability. The correct identification of the structure involved in the production of symptoms leads to an appropriate management and to a higher probability of resolution of the clinical complaint. The present article is aimed at reviewing the different sonographic presentations of iliotibial band syndromes.

Ambient radiation levels in positron emission tomography/computed tomography (PET/CT) imaging center

Objective: To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods: Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results: In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion: In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed.

Coordenação local do Eu(III) em híbridos orgânicos/inorgânicos emissores de luz branca

Eu3+ luminescence and EXAFS (Extended X-ray Absorption Fine Structure) results are presented for organic-inorganic hybrid gel hosts composed of a siliceous network to which small chains of oxyethylene units are covalently grafted by means of urea bridges. Coordination numbers for Eu3+ ions range from 12.8 to 9.7 with increasing Eu3+ concentration while the Eu3+-first neighbours mean distance is found to be constant at 2.48-2.49 Å in the same concentration range. Emission spectra display a broad band in the green/blue spectral region superposed to narrow lines appearing in the yellow/red region in such a way that for the eyes emission appears white. The broad band is assigned to intrinsic NH groups emission and also to electron-hole recombination in the nanosised siliceous domains. The narrow lines are assigned to intra-4f6, 5D0->7F0-4 Eu3+ transitions and from the energy position of the 7F0-4 levels a mean distance could be calculated for the Eu3+-first neighbours. The calculated results are in good agreement with the experimental ones obtained from EXAFS analysis.

Ultra-trace monitoring of copper in environmental and biological samples by inductively coupled plasma atomic emission spectrometry after separation and preconcentration by using octadecyl silica membrane disks modified by a new schiff's base

Ultra-trace amounts of Cu(II) were separated and preconcentrated by solid phase extraction on octadecyl-bonded silica membrane disks modified with a new Schiff,s base (Bis- (2-Hydroxyacetophenone) -2,2-dimethyl-1,3-propanediimine) (SBTD) followed by elution and inductively coupled plasma atomic emission spectrometric detection. The method was applied as a separation and detection method for copper(II) in environmental and biological samples. Extraction efficiency and the influence of sample matrix, flow rate, pH, and type and minimum amount of stripping acid were investigated. The concentration factor and detection limit of the proposed method are 500 and 12.5 pg mL-1, respectively.

A novel method for fast enrichment and monitoring of hexavalent and trivalent chromium at the ppt level with modified silica MCM-41 and its determination by inductively coupled plasma optical emission spectrometry

Chromium(III) at the ng L-1 level was extracted using partially silylated MCM-41 modified by a tetraazamacrocyclic compound (TAMC) and determined by inductively coupled plasma optical emision spectrometry (ICP OES). The extraction time and efficiency, pH and flow rate, type and minimum amount of stripping acid, and break- through volume were investigated. The method's enrichment factor and detection limit are 300 and 45.5 pg mL-1, respectively. The maximum capacity of the 10 mg of modified silylated MCM-41 was found to be 400.5±4.7 µg for Cr(III). The method was applied to the determination of Cr(III) and Cr(VI) in the wastewater of the chromium electroplating industry and in environmental and biological samples (black tea, hot and black pepper).

TREATMENT OF WASTE FROM ATOMIC EMISSION SPECTROMETRIC TECHNIQUES AND REUSE IN UNDERGRADUATE LAB CLASSES FOR QUALITATIVE ANALYSIS

Flame atomic absorption spectrometry (FAAS) and inductively coupled plasma optical emission spectrometry (ICP OES) are widely used in academic institutions and laboratories for quality control to analyze inorganic elements in samples. However, these techniques have been observed to underperform in sample nebulization processes. Most of the samples processed through nebulization system are discarded, producing large volumes of waste. This study reports the treatment and reuse of the waste produced from ICP OES technique in a laboratory of analytical research at the Universidade Federal do Ceará, Brazil. The treatment of the waste was performed by the precipitation of elements using (NH4)2CO3. Subsequently, the supernatant solution can be discarded in accordance with CONAMA 430/2011. The precipitate produced from the treatment of residues can be reused as a potential sample in undergraduate qualitative analytical chemistry lab classes, providing students the opportunity to test a real sample.