Long term (five-year) survival following radical surgical treatment plus adjuvant chemotherapy (FAM) in advanced gastric cancer: a controlled study

Several drugs and their associations are being used for adjuvant or complementary chemotherapy with the aim of improving results of gastric cancer treatment. The objective of this study was to verify the impact of these drugs on nutrition and on survival rate after radical treatment of 53 patients with gastric cancer in stage III of the TNM classification. A control group including 28 patients who had only undergone radical resection was compared to a group of 25 patients who underwent the same operative technique followed by adjuvant polychemotherapy with FAM (5-fluorouracil, Adriamycin, and mitomycin C). In this latter group, chemotherapy toxicity in relation to hepatic, renal, cardiologic, neurological, hematologic, gastrointestinal, and dermatological functions was also studied. There was no significant difference on admission between both groups in relation to gender, race, macroscopic tumoral type of tumor according to the Borrmann classification, location of the tumor in the stomach, length of the gastric resection, or response to cutaneous tests on delayed sensitivity. Chemotherapy was started on average, 2.3 months following surgical treatment. Clinical and laboratory follow-up of all patients continued for 5 years. The following conclusions were reached: 1) The nutritional status and incidence of gastrointestinal manifestation were similar in both groups; 2) There was no occurrence of cardiac, renal, neurological, or hepatic toxicity or death due to the chemotherapeutic method per se; 3) Dermatological alterations and hematological toxicity occurred exclusively in patients who underwent polychemotherapy; 4) There was no significant difference between the rate and site of tumoral recurrence, the disease-free interval, or the survival rate of both study groups; 5) Therefore, we concluded, after a 5-year follow-up, chemotherapy with the FAM regimen did not increase the survival rate.

Assessment of Myocardial Infarction by Cardiac Magnetic Resonance Imaging and Long-Term Mortality

Background: Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. Objective: To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. Methods: A total of 1959 reports of “infarct size” were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors – left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named “MET-AMI”. The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. Results: The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003). Conclusion: The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long-term mortality, especially for ischemic heart disease death.

Long-term outcomes of school-based treatment for control of urinary schistosomiasis: a review of experience in Coast Province, Kenya

Urinary schistosomiasis remains a significant burden for Africa and the Middle East. The success of population-based control programs will depend on their impact, over many years, on Schistosoma haematobium reinfection and associated disease. In a multi-year (1984-1992) control program in Kenya, we examined risk for S. haematobium reinfection and late disease during and after annual school-based treatment. In this setting, long-term risk of new infection was independently associated with location, age, hematuria, and incomplete treatment, but not with sex or frequency of water contact. Thus, very local environmental features and age-related factors played an important role in S. haematobium transmission, such that population-based control programs should optimally tailor their efforts to local conditions on a village-by-village basis. In 2001-2002, the late benefits of earlier participation in school-based antischistosomal therapy were estimated in a cohort of formerly-treated adult residents compared to never-treated adults from the same villages. Among age-matched subjects, current infection prevalence was lower among those who had received remote therapy. In addition, prevalence of bladder abnormality was lower in the treated group, who were free of severe bladder disease. Treatment of affected adults resulted in rapid resolution of infection and any detectable bladder abnormalities. We conclude that continued treatment into adulthood, as well as efforts at long-term prevention of infection (transmission control) are necessary to achieve optimal morbidity control in affected communities.

Aeration condition of a clayey oxisol under long-term no-tillage

The hypothesis of this study was that the absence of soil tillage in long-term no-tillage (NT) systems can be detrimental to soil aeration. The objective was to assess the aeration condition of an Oxisol (Rhodic Ferrasol), very clayey texture (750 g kg-1 of clay; 200 g kg-1 of sand), after 30 years of cultivation under NT. The physical property soil air permeability (Ka) is sensitive to changes in the soil pore system. Aside from Ka, the air-filled porosity (ε a) and indices of pore continuity (K1 and N), derived from the relationship between Ka and εa, were used as indices of soil aeration. From the soil layers 0.0-0.1 and 0.1-0.2 m, 240 undisturbed samples were collected along a transect perpendicular to the crop rows, at three sampling positions: corn plant row (CR); center of the interrow (INT); and the equidistant point between CR and INT (PE). The properties Ka and εa were determined at soil matric potentials (Ψm) of -2, -4, -6, -10, -30, and -50 kPa. Soil bulk density (BD) was also determined. The results confirmed the hypothesis. In the 0.0-0.1 m layer, Ka, K1, N and Ψa were significantly greater and BD significantly lower in CR than at the other sampling positions. At a Ψm of -10 kPa, the Ka of CR was 6.9 and 8.4 times higher than in PE and INT, respectively, in the 0.0-0.1 m layer. The properties Ka, K1 and N were sensitive enough to detect changes in the pore system and their differences between the sampling positions demonstrated the importance of the spatial location for soil sampling. Tilling the crop rows provides better soil aeration under NT.

Long-term changes in rice development in Southern Brazil, during the last ten decades

The objective of this work was to test long-term trends in the duration of rice development phases in Santa Maria, RS, Brazil. The duration from emergence to V3 (EM-V3), emergence to panicle differentiation (EM-R1), emergence to anthesis (EM-R4), and emergence to all grains with brown hull (EM-R9) was calculated using leaf appearance and developmental models for four rice cultivars (IRGA 421, IRGA 417, EPAGRI 109, and EEA 406), for the period from 1912 to 2011, considering three emergence dates (early, mid, and late). The trend of the time series was tested with the non-parametric Mann-Kendall test, and the magnitude of the trend was estimated with simple linear regression. Rice development has changed over the last ten decades in this location, leading to an anticipation of harvest time of 17 to 31 days, depending on the cultivar maturity group and emergence date, which is related to trends of temperature increase during the growing season. Warmer temperatures over the evaluated time period are responsible for changing rice phenology in this location, since minimum and maximum daily temperature drive the rice developmental models used.

No-till corn performance in response to P and fertilization modes

No-tillage systems provide soil changes that affect nutrient dynamics, hence, changing rates and forms of fertilizer application. This study aimed to evaluate the effect of phosphorus (P) and modes of nitrogen (N) and P application in corn under long-term no-tillage in a clayey Oxisol. Two experiments were carried out in the same experimental area and in the same year, in a randomized blocks design with four replications. In experiment I, the treatments consisted of five doses of phosphorus (0, 40, 80, 120 and 160 kg ha-1 of P2O5) applied in the sowing furrow. In experiment II, the treatments consisted of the N and P application modes (topdressing, in the sowing furrow and control - without N and P). Experiment I evaluated the root length, P uptake and grain yield and, the Experiment II, the firing height and yield. The P rates provided linear increases in root length in the 0-10 cm layer, P uptake and grain production. The different modes of application provided differences in the firing height and corn yield. The control treatment (0 kg ha-1 of N and P) provided the highest firing height, superior than those of topdressing and application in the furrow, which were not significantly different. The topdress application of N and P provided an increase in corn yield that exceeded 16 and 42% of the application in the furrow and the control, respectively. Thus, the results confirmed that increasing rates of P2O5, in soil with high initial P content, influence positively corn production factors, but with little significant responses, and the topdress application of N and P on soil with high P content, without water restriction, provided increased grain yield in relation to the application in the furrow.

Chemical treatment of papaya seeds aiming at long-term storage and control of damping off

Damping off is a nursery disease of great economic importance in papaya and seed treatment may be an effective measure to control. The aim of this work was to evaluate the quality of papaya seeds treated with fungicides and stored under two environmental and packaging conditions. Additionally, the efficiency of fungicide treatments in the control of damping-off caused by Rhizoctonia solani was evaluated. Papaya seeds were treated with the fungicides Captan, Tolylfluanid and the mixture Tolylfluanid + Captan (all commercial wettable powder formulations). Seeds of the control group were not treated. The seeds were stored for nine months in two conditions: packed in aluminum coated paper and kept at 7 ± 1ºC and in permeable kraft paper and kept in non-controlled environment. At the beginning of the storage and every three months the seed quality (germination and vigor tests), emergence rate index, height, dry mass and damping of plants in pre and post-emergence (in contaminated substrate and mycelia-free substrate) were analyzed. Both storage conditions as well as the fungicide treatments preserved the germination and seed vigor. In the infested substrate, seedling emergence was favored by fungicides, but in post-emergence, fungicides alone did not control the damping off caused by R. solani. Symptoms of damping off were not observed in the clean substrate. The results showed that the fungicide treatments may be used to pretreat papaya seed for long-term storage and commercialization.

Is the pollination efficiency of long-lived orchid flowers affected by age?

The long-lived flowers of orchids increase the chances of pollination and thus the reproductive success of the species. However, a question arises: does the efficiency of pollination, expressed by fruit set, vary with the flower age? The objective of this study was to verify whether the flower age of Corymborkis flava(Sw.) Kuntze affects pollination efficiency. The following hypotheses were tested: 1) the fruit set of older flowers is lower than that of younger ones; 2) morphological observations (perianth and stigmatic area), stigma receptivity test by using a solution of hydrogen peroxide and hand-pollination tests are equally effective in defining the period of stigmatic receptivity. Flowers were found to be receptive from the first to the fourth day of anthesis. Fruit set of older flowers (third and fourth day) was lower than that of younger flowers. Morphological observations, the stigma receptivity test and hand-pollinations were equally effective in defining the period of stigmatic receptivity. However, to evaluate the maximum degree of stigma receptivity of orchid species with long-lived flowers, we recommend hand-pollinations, beyond the period of receptivity.

Studies on mosquitoes (Diptera: Culicidae) and anthropic environment: 2 - Immature stages research at a rice irrigation system location in South-Eastern Brazil

A relation between a rice irrigation system and mosquito breeding was established in a study undertaken at the Ribeira Valley Experimental Station, from January through December 1992. Flooding favoured Anopheles (Nyssorhynchus) and Culex (Melanoconion) species, while empty paddies condition were propitious to Aedes scapularis and Culex (Culex) species. Compared with a more primitive area of the same region, several species showed high a degree of adaptation to the anthropic environment. Among them, Anopheles albitarsis, a potential malaria vector that breeds in the irrigation system, has shown immature stage production thirteen times higher than at the natural breeding sites. In addition, Ae. scapularis, An. oswaldoi, Cx. bastagarius, and Cx. chidesteri presented high levels of synanthropy.

Autonomy of long-stay psychiatric inpatients

OBJECTIVE: To assess personal autonomy of long-stay psychiatric inpatients, to identify those patients who could be discharged and to evaluate the impact of sociodemographic variables, social functioning, and physical disabilities on their autonomy was also assessed. METHODS: A total of 584 long-stay individuals of a psychiatric hospital (96% of the hospital population) in Southern Brazil was assessed between July and August 2002. The following instruments, adapted to the Brazilian reality, were used: independent living skills survey, social behavioral schedule, and questionnaire for assessing physical disability. RESULTS: Patients showed severe impairment of their personal autonomy, especially concerning money management, work-related skills and leisure, food preparation, and use of transportation. Autonomy deterioration was associated with length of stay (OR=1.02), greater physical disability (OR=1.54; p=0.01), and male gender (OR=3.11; p<0.001). The risk estimate of autonomy deterioration was 23 times greater among those individuals with severe impairment of social functioning (95% CI: 10.67-49.24). CONCLUSIONS: In-patients studied showed serious impairment of autonomy. While planning these patients' discharge their deficits should be taken into consideration. Assessment of patients' ability to function and to be autonomous helps in identifying their needs for care and to evaluate their actual possibilities of social reinsertion.

Long-stay patients in a psychiatric hospital in Southern Brazil

OBJECTIVE: To describe the demographic profile, social functioning, and quality of life of a population of long-stay care patients in a psychiatric hospital. METHODS: A study was carried out in Porto Alegre, Southern Brazil, in 2002. A total of 584 (96%) long-stay patients were assessed by means of the following instruments: the World Health Organization Quality of Life, the Social Behavior Schedule, the Independent Living Skills Survey, the Brief Psychiatric Rating Scale and another instrument for assessing disability (Questionnaire for Assessing Physical Disability). RESULTS: The average hospital stay was 26 years (SD: 15.8) and 46.6% of inpatients had no physical disability. Patients had their social functioning skills and autonomy largely impaired. Few of them (27.7%) answered the instrument for assessing quality of life, and showed significant impairments in all domains. The Brief Psychiatric Rating Scale evidenced a low prevalence of positive symptoms in this population. CONCLUSIONS: The institutionalized population studied presented significantly impaired social functioning, autonomy, and quality of life. These aspects need to be taken into consideration while planning for their deinstitutionalization.