Clinicopathological analysis of head and neck chondrosarcoma: three case reports and literature review

Chondrosarcoma (CHS) is a malignant neoplasm characterized by the formation of cartilaginous matrix by neoplastic cells, with a high propensity for local recurrences. Head and neck CHS is rare, accounting for less than 12% of all cases of CHS, usually affecting the maxilla. The majority of affected patients are in the fourth decade of life, with a slight predilection for male patients. A painless swelling is commonly the most frequent complaint. Surgery with wide en-bloc resection is the preferred treatment for CHS; radiotherapy and chemotherapy are usually palliative options. Owing to its rarity, there are few clinical series evaluating the biological behaviour of head and neck CHS. The aim of this study is to analyse the clinicopathological characteristics of head and neck CHS by reporting 3 new cases of this neoplasia affecting the jaw bones and reviewing the clinical series previously published in the English literature.

Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies

OBJECTIVETo determine the current status of the literature regarding the clinical efficacy and complication rates of cryoablation vs radiofrequency ablation in the treatment of small renal tumours.METHODSA review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: MEDLINE, EMBASE and LILACS.Inclusion criteria were (i) case series design with more than one case reported, (ii) use of cryoablation or radiofrequency ablation, (iii) patients with renal cell carcinoma and, (iv) outcome reported as clinical efficacy.When available, we also quantified the complication rates from each included study.Proportional meta-analysis was performed on both outcomes with a random-effects model. The 95% confidential intervals were also calculated.RESULTSThirty-one case series (20 cryoablation, 11 radiofrequency ablation) met all inclusion criteria.The pooled proportion of clinical efficacy was 89% in cryoablation therapy from a total of 457 cases. There was a statistically significant heterogeneity between these studies showing the inconsistency of clinical and methodological aspects.The pooled proportion of clinical efficacy was 90% in radiofrequency ablation therapy from a total of 426 cases. There was no statistically significant heterogeneity between these studies.There was no statistically significant difference regarding complications rate between cryoablation and radiofrequency ablation.CONCLUSIONSThis review shows that both ablation therapies have similar efficacy and complication rates.There is urgency for performing clinical trials with long-term data to establish which intervention is most suitable for the treatment of small renal masses.

Brachioradial pruritus - Descriptive analysis of Brazilian case series

Background The epidemiology and clinical features of brachioradial pruritus are variably described in the literature. We sought to analyze these features in a large group of Brazilian patients. Patients and Methods In a descriptive, observational study, we identified all patients with a final diagnosis of brachioradial pruritus seen over a one-year period and re-trospectively reviewed their records. The diagnosis was made after clinical-laboratory investigation had ruled out other causes of chronic pruritus. Demographic and clinical variables were collected along with pruritus characteristics, and analyzed using des-criptive statistics. Results Forty-three patients were identified; their mean age was 55.9 years, with predominance of women (81.4%) and Caucasians (86%). In 52%, the pruritus worsened with heat and sun exposure; 58.1% had intermittent complaints; the ice-pack sign was present only in 20.9%. The arms involving dermatomes C5-C6-C7-C8 (62.8%) were the most affected sites, while psychoactive drugs were the most frequently prescribed therapy. Conclusions Although uncommon, brachioradial pruritus should not be neglected in dermatological diagnosis. This case series analysis indicated that Brazilian patients from a tropical climate show characteristics similar to those described in other series from more temperate regions. © Blackwell Verlag GmbH, Berlin.

Enfoques para una política de la infancia y la juventud en el desarrollo económico: examen de cinco casos latinoamericanos = Approach to a children and youth policy in relation to economic development: analysis of five Latin American case studies

Incluye Bibliografía

An analysis of traffic accidents and children: the case of Uruguay

This issue of the FAL Bulletin deals with road safe ty and its impact on children by examining data collected on road safe ty in the Eastern Republic of Uruguay by the Gonzalo Rodríguez Foundation wi thin the framework of its EDU-CAR Road Safety Plan for Children.

Evaluation report of the training workshop on the use of the module to analyse growth of international commerce (Magic Plus) and the competitive analysis of nations (TRADECAN 2009) software

The aim of the workshop was to provide a functional overview of the software package, to enable participants to use the software in order to inform more evidence-based trade strategies, and build capacity for researchers and trade negotiators to provide more rigorous, analytical policy research to inform future trade negotiations. Participants came from the ministries of trade of the following CDCC member countries: Dominica, Grenada, Jamaica, Saint Lucia, Saint Kitts and Nevis, Saint Vincent and the Grenadines, and Trinidad and Tobago. Representatives of the following regional institutions were represented: the Caribbean Community/Caribbean Regional Negotiating Mechanism (CARICOM/CRNM); the Organisation of Eastern Caribbean States (OECS); the University of Guyana, University of Suriname and the University of the West Indies (UWI). It was hoped the workshop would be a stepping stone towards more advanced trade analysis training. The list of participants appears as Annex I.

Socio-demographic analysis of youth in the Caribbean- a three country case study

Many Caribbean youth are doing reasonably well. They live in loving and caring families, attend school and are involved in various social activities in their communities. The health and well-being of the children and youth1 in the Caribbean is, and has been, the centre of attention of many studies, meetings and policy directives set at the regional, subregional and national levels. Programmes have been put in place to address the basic needs of young children in the areas of health and education and to provide guidance and directives to youth and adolescents in the area of professional formation and transition to adulthood. Critical issues such as reproductive health and family planning combined with access to education and information on these topics have been promoted to some extent. And finally, the Caribbean is known for rather high school enrolment rates in primary education that hardly show any gender disparities. While the situation is still good for some, growing numbers of children and youth cannot cope anymore with the challenges experienced quite early in their lives. Absent parents, instable care-taking arrangements, violence and aggression subjected to at home, in schools and among their friends, lack of a perspective in schools and the labour-market, early sexual initiation and teenage pregnancies are some of those issues faced by a rising number of young persons in this part of the world. Emotional instability, psychological stress and increased violence are one of the key triggers for increased violence and involvement in crime exhibited by ever younger youth and children. Further, the region is grappling with rising drop-out rates in secondary education, declining quality schooling in the classrooms and increasing numbers of students who leave school without formal certification. Youth unemployment in the formal labour market is high and improving the quality of professional formation along with the provision of adequate employment opportunities would be critical to enable youth to complete consistently and effectively the transition into adulthood and to take advantage of the opportunities to develop and use their human capital in the process. On a rather general note, the region does not suffer from a shortage of policies and programmes to address the very specific needs of children and youth, but the prominent and severe lack of systematic analysis and monitoring of the situation of children, youth and young families in the Caribbean does not allow for targeted and efficient interventions that promise successful outcomes on the long term. In an effort to assist interested governments to fill this analytical gap, various initiatives are underway to enhance data collection and their systematic analysis2. Population and household censuses are conducted every decade and a variety of household surveys, such as surveys of living conditions, labour force surveys and special surveys focusing on particular sub-groups of the population are conducted, dependent on the resources available, to a varying degree in the countries of the region. One such example is the United Nations Children’s Fund (UNICEF)-funded Multi-Indicator Cluster Surveys (MICS) that assess the situation of children and youth in a country. Over the past years and at present, UNICEF has launched a series of surveys in a number of countries in the Caribbean3. But more needs to be done to ensure that the data available is analyzed to provide the empirical background information for evidence-based policy formulation and monitoring of the efficiency and effectiveness of the efforts undertaken.

Desenvolvimento de um sistema para análise da estabilidade transitória de sistemas de energia elétrica via redes neurais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise das aproximações RPP e RSP para meios isotrópicos

Neste trabalho são apresentadas aproximações lineares e quadráticas das equações de Zoeppritz para a obtenção dos coeficientes de reflexão e transmissão de eventos P-P e P-S em função dos ângulos de incidência e da média angular, bem como a análise de inversão linear de AVO, considerando os eventos de reflexão P-P e P-S dissociados e combinados. O uso das chamadas aproximações pseudo-quadráticas foi aplicado para obtenção de aproximações quadráticas apenas para eventos-PP, em torno dos contrastes médios das velocidades de ondas compressionais e cisalhantes e da razão Vs/Vp. Os resultados das aproximações desenvolvidas neste trabalho mostram que as aproximações quadráticas são mais precisas que as lineares, nas duas versões angulares. As comparações entre as aproximações em termos do ângulo de incidência e da média angular mostram que as aproximações quadráticas são equivalentes dentro do limite angular de [0º, 30º]. Por outro lado, as aproximações lineares em função do ângulo de incidência mostram-se mais precisas que as aproximações lineares em função da média angular. Na inversão linear, fez-se análises de sensibilidade e de ambigüidade e observou-se que, nos caso de eventos de reflexão P-P e P-S dissociados, apenas um parâmetro pode ser estimado e que a combinação destes eventos consegue estabilizar a inversão, permitindo a estimativa de dois dentre os parâmetros físicos dos meios (contrastes de impedância, de velocidade de onda P e de módulo de cisalhamento).

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS: We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS: As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS: Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research.