Program for Prostate Cancer Screening Using a Mobile Unit: Results From Brazil

OBJECTIVES To evaluate the initial results of a prostate cancer screening program using mobile units in Brazil. METHODS Since 2004, we have conducted a program of prostate cancer screening using mobile units across 231 municipalities from 6 Brazilian states. RESULTS A total of 17 571 men were evaluated by clinical history, digital rectal examination (DRE), and serum free and total prostate-specific antigen (PSA) levels. The recommendations for biopsy were a PSA level of >= 4.0 ng/mL, DRE findings suspicious for cancer, or a PSA level of 2.5-4.0 ng/mL with a percent-free PSA level <15%. The biopsy protocol included 12 biopsy cores from the peripheral zone, 2 from the transition zone, and additional sampling of suspicious areas. The cumulative cancer detection rate was 3.7%. The main indication for biopsy was a PSA level of >= 4.0 ng/mL (51.2%), with a positive predictive value (PPV) of 44.1%. Another 19.7% of biopsied men had suspicious DRE findings with a normal PSA level (PPV 23.5%). A percent-free PSA level of <15% in men with a PSA level of 2.5-4.0 ng/mL and normal DRE findings yielded a PPV of 31.1%. The PPV was greater (70.9%) for the 7.1% of men with both suspicious DRE findings and a PSA level of >4.0 ng/mL. Most cancers were Stage T1-T2 (93.4%), and the percentage of Gleason score of >= 7 was 32.5%. The proportion of insignificant cancers according to Epstein`s criteria was 13.5%. CONCLUSIONS A mobile prostate cancer screening unit enabled an underserved population to gain access to specialized care through the public healthcare system. The cancer detection rate in this population was similar to those from international studies. UROLOGY 76: 1052-1057, 2010. (C) 2010 Published by Elsevier Inc.

Adjuvant chemotherapy for stage II colod cancer

The use of adjuvant chemotherapy following resection for all patients with stage III colon cancer is now part of the standard of care around the world. Recent trials have led to changes in the standard regimens, which now include the use of oxaliplatin (Eloxatin) for most patients with stage III colon cancer. The addition of oxaliplatin has resulted in a 23% reduction in the risk of recurrence compared with fluorouracil/leucovorin alone, with a small but statistically significant survival benefit. Unfortunately, no adequately powered trial has determined whether adjuvant chemotherapy is beneficial for stage II patients, and its use is much more controversial. Most investigators agree that adjuvant chemotherapy has some activity against stage H disease. However, its impact on progression-free and overall survival remains highly controversial. Despite the lack of data, there is growing acceptance of an informal classification system, which stratifies stage II patients by risk on the basis of clinical data, as a guide for deciding whether to use adjuvant therapy. The only phase III clinical trial for stage H patients currently ongoing in the United States uses molecular classification as the basis for patient randomization.

CONGENITAL CLUBFOOT

The clubfoot is one of the most common congenital deformities affecting the lower limbs, it still presents controversial aspects regarding etiology and treatment. In spite of its relatively high frequency, the treatment is still challenging, since the long-term aim is achieving an everlasting flexible, plantigrade, pain-free and totally functional foot. The Ponseti method has gained attention and popularity because of its satisfactory results and surgery avoidance. Presently, surgical treatment is indicated only after failure of conservative methods, avoiding extensive soft-tissue release, but performing localized corrections of the deformities, a technique also know as ""a la carte"" release. The future perspective is based on the knowledge about long-term results and new understanding of the clubfoot etiology, especially in the genetic field, which may eventually be helpful for prognostic and treatment. Level of Evidence: Level II, systematic review.

Commensal microbiota is fundamental for the development of inflammatory pain

The ability of an individual to sense pain is fundamental for its capacity to adapt to its environment and to avoid damage. The sensation of pain can be enhanced by acute or chronic inflammation. In the present study, we have investigated whether inflammatory pain, as measured by hypernociceptive responses, was modified in the absence of the microbiota. To this end, we evaluated mechanical nociceptive responses induced by a range of inflammatory stimuli in germ-free and conventional mice. Our experiments show that inflammatory hypernociception induced by carrageenan, lipopolysaccharide, TNF-alpha, IL-1 beta, and the chemokine CXCL1 was reduced in germfree mice. In contrast, hypernociception induced by prostaglandins and dopamine was similar in germ-free or conventional mice. Reduction of hypernociception induced by carrageenan was associated with reduced tissue inflammation and could be reversed by reposition of the microbiota or systemic administration of lipopolysaccharide. Significantly, decreased hypernociception in germ-free mice was accompanied by enhanced IL-10 expression upon stimulation and could be reversed by treatment with an anti-IL-10 antibody. Therefore, these results show that contact with commensal microbiota is necessary for mice to develop inflammatory hypernociception. These findings implicate an important role of the interaction between the commensal microbiota and the host in favoring adaptation to environmental stresses, including those that cause pain.

Pharmacotherapy of intermittent claudication

Intermittent claudication (IC) is leg muscle pain, cramping and fatigue brought on by exercise and is the primary symptom of peripheral arterial disease. The goals of pharmacotherapy for IC are to increase the walking capacity/quality of life and to decrease rates of amputation. In 1988, pentoxifylline was the only drug that had reasonable supportive clinical trial evidence for being beneficial in IC. Since then a number of drugs have shown benefit or potential in IC. Cilostazol, a specific inhibitor of phosphodiesterase 3 and activator of lipoprotein lipase, clearly increases pain-free and absolute walking distances in claudicants. However, cilostazol does cause minor side effects including headache, diarrhoea, loose stools and flatulence. Naftidrofuryl, a serotonin (5-HT2) receptor antagonist and antiplatelet drug, is beneficial in claudicants. Inhibitors of platelet aggregation (including nitric oxide from L-arginine or glyceryl trinitrate) and anticoagulants (low molecular weight heparin, defibrotide) probably have both short and long-term benefits in IC. In addition, intravenous infusions of prostaglandins (PGs) PGE1 and PGI2 have an established role in severe peripheral arterial disease and the recent introduction of longer lasting and/or oral forms of the PGs makes them more likely to be useful in the IC associated with less severe forms of the disease. There are some exciting new approaches to the treatment of IC, including propionyl-L-carnitine and basic fibroblast growth factor (bFGF).

Lições de Direito dos Contratos

1 – Importância e actualidade do instituto. 2 – Noção de contrato. Sua disciplina no Código Civil. 3 – Relações contratuais de facto. 4 – Princípios fundamentais do regime dos contratos. 5 – Princípio da liberdade contratual. 6 – Princípio do consensualismo. 7 – Princípio da boa fé. A responsabilidade pré-contratual. 8 – Princípio da força vinculativa. 9 – Contratos unilaterais ou não sinalagmáticos e bilaterais ou sinalagmáticos. Contratos gratuitos e onerosos. Contratos cumulativos e aleatórios. 10 – Contratos mistos. União de contratos ou coligação de contratos. 11 – Contrato-promessa. 12 – Pacto de preferência. 13 - Alguns problemas e “contratos em especial”, a título enunciativo, relacionados com as actividades de Gestão, Banca e Seguros: “aspectos contratuais” de direito civil e de direito comercial. § 1 - Importance and actuality of the institute. 2 - Contract notion. Its disciplines in the portuguese Civil Code. 3 – Contractual relations of fact. 4 - Basic principles of the regimen of contracts. 5 - Principle of the contractual freedom. 6 - Principle of “consensualism”. 7 - Principle of the "good faith". The pre-contractual liability. 8 - Principle of the obligatory force (binding). 9 - Unilateral or not bilateral contracts. Free and onerous contracts. Cumulative and random contracts.

Direito (Penal) Tributário deve manter-se Penal a Bem do Estado de Direito

Enquanto existir Estado-de-Direito, Social, democrático, livre e verdadeiro, o Direito Penal, incluindo o Económico e de Gestão como também é o Tributário, será sempre um problema dos penalistas, do Direito Penal e das Ciências Jurídico-Criminais. Abstract: As long as state-of-law, social, democratic, free and true, Criminal Law, including the Economic and Management as is the Tax will always be a problem of criminalists, the Criminal Law and the Legal and Criminal Sciences.

E já agora, a extinção do Tribunal Constitucional: porque não?

Um Estado de Direito Social democrático, livre e verdadeiro, não existe sem um Tribunal Constitucional. Abstract: A democratic rule of social law, free and true, does not exist without a Constitutional Court.

Ó sistema capitalista, quanto do teu Portugal são lavagens de capital?

Ouvimos também muitos a falar em branqueamento de capitais, crimes financeiros, abuso de informação, manipulação do mercado, etc.. Salvo o devido respeito, contudo, poucos sabem o quão difícil é a prova destes crimes! Sabiam que p.e. até meados de 2008, crimes como o abuso de informação ou a manipulação do mercado eram insusceptíveis de interferência nas comunicações?! Sabiam que até hoje, o Código dos Valores Mobiliários não prevê a criminalização das pessoas colectivas e, portanto, dos próprios bancos?! Abstract: We hear too many to talk about money laundering, financial crimes, insider trading, market manipulation, etc .. Unless all due respect, however, few know how hard it is to prove that the crimes! Standing knew that by mid-2008, crimes such as dealing or market manipulation were incapable of interference in communications ?! They knew that to date, the Securities Code does not provide for the criminalization of legal persons and therefore the banks themselves ?!

25 de Abril para sempre? "Fascismo" nunca mais?

Nem está garantido que o “25 de Abril seja para sempre”. O mais certo é que não esteja. Nem está assegurado, qual verdade ontológica, que não haverá mais “fascismo” ou um outro “Estado Novo de inspiração fascista”, como alguns preferem descrever o período histórico vivido em Portugal entre 1933 (com raízes em 1928 após eleição de Óscar Carmona) e o 25 de Abril de 1974. O mais certo é que surjam novos tipos de “fascismo”. § Abstract: Neither is guaranteed that the "April 25th is forever." Most likely it is not. Neither is assured, what ontological truth, there will be no more "fascism" or another "New State of fascist inspiration," as some prefer to describe the historical period lived in Portugal between 1933 (with roots in 1928 after Óscar Carmona Election) and April 25, 1974. most likely there are new types of "fascism."

Tribunal Constitucional Internacional – auto de ciência

Resumo: a criação dum Tribunal Constitucional Internacional, no nosso entender, é uma exigência da própria Declaração Universal dos Direitos do Homem de 1948. Neste texto são apresentados uma série de argumentos velhos e novos para a importância da existência do Tribunal Constitucional Internacional a nível mundial. Trata-se dum Tribunal que é indispensável à defesa dos Direitos do Homem, contra qualquer tipo de ditadura ou fanatismo económico, social, político, cultural ou mental. § Abstract: the creation of an International Constitutional Court, in our view, is a requirement of own Universal Declaration of Human Rights of 1948. In this paper are given a lot of old and new arguments for the importance of the existence of the International Constitutional Court worldwide. It is of a Court that is indispensable to the defense of human rights, against all forms of dictatorship or economic fanaticism, social, political, cultural or mental.

Palavras para os presos e desprezados

Lembremo-nos de vez em quando dos presos, que não se podem manifestar, nem têm sindicato relevante em termos de Estado de Direito social, democrático, livre e verdadeiro. Presos pelas mais diversas razões: desde o crime de roubo sem feridos nem mortos, até aos crimes mais bárbaros. Agora que se fala em perdão por outras razões das quais não queremos falar hoje aqui, logo nos lembramos que o perdão não tem sentido se não houver arrependimento. E logo nos lembramos dos presos também. Somente em Portugal, são milhares. E estão presos neste momento em que escrevemos. Certo que também não nos podemos esquecer das vítimas. Sempre tivemos uma preocupação profunda por estas. § Let us remember from time to time the prisoners, who can not speak or have a relevant union in terms of rule of law social, democratic, free and true. Arrested for various reasons: from the wounded without theft crime or dead, even the most barbaric crimes. Now we talk about forgiveness for other reasons which do not want to speak here today, then we remember that forgiveness is meaningless if there is no repentance. And then we remember the prisoners as well. Only in Portugal, thousands. And we're stuck in this time of writing. Also certain that we can not forget the victims. I have always had a deep concern for these.

Production of hydroxamic acids by immobilized Pseudomonas aeruginosa cells Kinetic analysis in reverse micelles

Intact cells from Pseudomonas aeruginosa strain L10 containing amidase were used as biocatalysts both free and immobilized in a reverse micellar system. The apparent kinetic constants for the transamidation reaction in hydroxamic acids synthesis, were determined using substrates such as aliphatic, amino acid and aromatic amides and esters, in both media. In reverse micelles, K-m values decreased 2-7 fold relatively to the free biocatalyst using as substrates acetamide, acrylamide, propionamide and glycinamide ethyl ester. We have concluded that overall the affinity of the biocatalyst to each substrate increases when reactions are performed in the reversed micellar system as opposed to the buffer system. The immobilized biocatalyst in general, exhibits higher stability and faster rates of reactions at lower substrates concentration relatively to the free form, which is advantageous. Additionally, the immobilization revealed to be suitable for obtaining the highest yields of hydroxamic acids derivatives, in some cases higher than 80%. (C) 2013 Elsevier B.V. All rights reserved.

Estudo da transferência das cloraminas da água para o ar duma piscina coberta

Mestrado em Engenharia Química

An Efficient Long Distance Echo Canceller

This paper describes an implementation of a long distance echo canceller, operating on full-duplex with hands-free and in real-time with a single Digital Signal Processor (DSP). The proposed solution is based on short length adaptive filters centered on the positions of the most significant echoes, which are tracked by time delay estimators, for which we use a new approach. To deal with double talking situations a speech detector is employed. The floating-point DSP TMS320C6713 from Texas Instruments is used with software written in C++, with compiler optimizations for fast execution. The resulting algorithm enables long distance echo cancellation with low computational requirements, suited for embbeded systems. It reaches greater echo return loss enhancement and shows faster convergence speed when compared to the conventional approach. The experimental results approach the CCITT G.165 recommendation levels.