Complete internal audit of a mammography service in a reference institution for breast imaging

Objective Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS®, in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature. Materials and Methods Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. Results The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%. Conclusion The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.

Use of new silica fillers as additives for polymers used in packaging of fruit

The objective of this work was to synthesize nanosilicas with different degree of hydrophobicity by the sol-gel method, using tetraethyl orthosilicate as a precursor. For this purpose, 3-aminopropyl triethoxysilane (APS) and 1,1,1,3,3,3 - hexamethyldisilazane (HMDS), were added during synthesis as modifiers. A commercial biopolymer (Hexamoll Dinch, BASF) intended for packaging of apples, was added to the new nanosilicas. The materials obtained were characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, potentiometric titration, porosity, specific surface area and hydrophobicity/hydrophilicity by wetting test. Colorimetry was used to evaluate change in apple pulp color after contact with the different silicas.

‘Sweet grape’ tomato post harvest packaging

ABSTRACT This paper aims at evaluating the shelf life of mini tomatoes (Lycopersicum esculentum Mill.) cultivar ‘Sweet Grape’, grown in hydroponics, and stored under environmental and refrigerated conditions inside different packages. We adopted a completely randomized design, in which treatments were combinations of storage conditions: environment (e) and refrigerated (r) with packaging: polyvinyl chloride film (PVC); low-density polyethylene (LDPE); biofilm of tomato fruit of Solanum lycocarpum A.St.-Hil (lobeira) (TFB); cassava starch biofilm (CSB); carnauba wax (Copernicia prunifera) (CW), and without packaging - control (C). Physicochemical and sensory tests were carried out at the beginning (day zero), and at 8, 19, and 33 days of storage (DS). Fruit stored inside PVCr, LDPEe, LDPEr, and CWr had an acceptable shelf life of 33 days. The use of cassava and tomato starches were not effective in controlling fruit fresh weight loss. ‘Sweet Grape’ tomato postharvest conservation was enhanced under refrigerated conditions. The sensory evaluation results revealed that CWr treatment most pleased appraisers, while PCV had the highest rejection rate.

Evolution in the profile of thyroid cancer cases treated in an oncology reference service: what changed in the last 20 years

Objective: To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010.Methods: we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications.Results: Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication.Conclusion: The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections.

Aplication of videothoracoscopy in trauma - experience of a service

Objective: To evaluate patients with chest trauma submitted to videothoracoscopy during hospitalization. In 2007, the Trauma Surgery Group was created in the General Surgery Department of the Hospital Municipal Lourenço Jorge of Rio de Janeiro-RJ, and started following all trauma victims who were admitted to the Hospital. Methods : We conducted a retrospective analysis of patients submitted to thoracoscopy from July 2007 to May 2015, based on a database started at the beginning of this period and on data collection from patients who underwent thoracoscopy. We evaluated the following parameters: procedure effectiveness, indication of the procedure, conversion rate, complications and mortality. We included patients who presented post-traumatic pleural collections, such as retained hemothorax and pleural empyema, and penetrating injury in the thoracoabdominal transition. All patients were hemodynamic stable and signed an informed consent. Results: In the analyzed period 53 patients were submitted to videothoracoscopy; 24 had penetrating trauma (45.3%) and 29, blunt (54.7%), with a predominance of males (75.5%). The procedure was performed in 26 cases of retained hemothorax (49%), 14 cases of empyema (26.5%) and in 13 patients for evaluation of injury in the thoracoabdominal transition (24.5%). The thoracoscopy was effective in resolution of 36 cases (80%), without need for further procedure. There was a conversion rate of 15.5% and 3 procedure complications related (6.6%). Mortality was nil. Conclusion: In this series, videothoracoscopy proved that this diagnostic and therapeutic procedure is safe and effective, if performed by a surgeon with appropriate training, especially when it is indicated in cases of retained hemothorax and evaluation of penetrating thoracoabdominal trauma.