Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL).

BACKGROUND: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. PATIENTS AND METHODS: The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. RESULTS: With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. CONCLUSION: TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

Objetivo:Avaliar a capacidade de predição das formas precoce e tardia da pré-eclâmpsia pela dilatação fluxo-mediada da artéria braquial (FMD), marcador biofísico de disfunção endotelial.Materiais e Métodos:Um total de 91 pacientes de alto risco para desenvolvimento de pré-eclâmpsia foi submetido a FMD entre 24 e 28 semanas de gestação.Resultados:Das pacientes selecionadas, 19 desenvolveram pré-eclâmpsia, sendo 8 em sua forma precoce e 11 em sua forma tardia. Usando-se um valor de corte de 6,5%, a sensibilidade (S) da FMD para predição de pré-eclâmpsia precoce foi 75,0%, com especificidade (E) de 73,3%, valor preditivo positivo (VPP) de 32,4% e valor preditivo negativo (VPN) de 91,9%. Para predição de pré-eclâmpsia tardia, encontrou-se valor de S de 83,3%, E de 73,2%, VPP de 34,4% e VPN de 96,2%. Para a predição de todas as formas associadas de pré-eclâmpsia, encontrou-se valor de S de 84,2%, E de 73,6%, VPP de 45,7% e VPN de 94,6%.Conclusão:A FMD se mostrou uma ferramenta com boa capacidade de predição de pré-eclâmpsia, nas suas formas tardia e precoce, o que pode representar um impacto positivo no acompanhamento de gestantes de alto risco para desenvolvimento dessa síndrome.

Aplicação de um protocolo de espectroscopia por ressonância magnética das adrenais: experiência com mais de 100 casos

Objetivo: Avaliar um protocolo de espectroscopia por ressonância magnética (ERM) do próton de hidrogênio (1H) bidimensional (2D) disponível comercialmente (Siemens Medical Systems; Erlangen, Alemanha), aplicado para nódulos adrenais e diferenciação das massas (adenomas, feocromocitomas, carcinomas e metástases). Materiais e Métodos: Um total de 118 pacientes (36 homens e 82 mulheres), apresentando-se com 138 nódulos/massas adrenais, foi avaliado prospectivamente (média de idade: 57,3 ± 13,3 anos). Uma sequência de ERM-1H-PRESS-CSI (espectroscopia por resolução de ponto-imagem por desvio químico) multivoxel foi utilizada. Análise espectroscópica foi realizada da esquerda-direita, sentido crânio-caudal, usando três sequências sagitais, além de sequências axiais e coronais T2-HASTE. Os seguintes índices foram calculados: colina (Cho)/creatina (Cr), 4,0–4,3 ppm/Cr, lipídio (Lip)/Cr, Cho/Lip e lactato (Lac)/Cr. Resultados: ERM-1H-2D foi bem sucedida em 123 (89,13%) lesões. Os valores de sensibilidade e especificidade encontrados para as proporções e pontos de corte avaliados foram: Cho/Cr ≥ 1,2, sensibilidade de 100% e especificidade de 98,2% (diferenciação de adenomas e carcinomas de feocromocitomas e metástases); 4,0–4,3 ppm/Cr ≥ 1,5, 92,3% de sensibilidade, especificidade de 96,9% (diferenciação de carcinomas e feocromocitomas de adenomas e metástases); Lac/Cr ≤ –7,449, sensibilidade de 90,9% e especificidade de 77,8% (diferenciação de feocromocitomas contra carcinomas e adenomas). Conclusão: Os dados da ERM-1H-2D foram eficazes e permitiram a diferenciação entre massas adrenais e nódulos na maioria das lesões com diâmetro > 1,0 cm.

Radioterapia de intensidade modulada (IMRT) para pacientes do SUS: análise de 508 tratamentos em dois anos de instalação da técnica

Objetivo: A oferta de radioterapia de alta tecnologia para população atendida pelo Sistema Único de Saúde (SUS) é limitada, por não pertencer ao rol de procedimentos e, muitas vezes, pela capacidade instalada frente à demanda e dificuldade de retenção de recursos humanos especializados. Dessa forma, o acesso à radioterapia de intensidade modulada (IMRT) é restrito a poucos serviços no Brasil. Pretendemos apresentar as características dos primeiros 508 tratamentos de IMRT durante os primeiros anos de instalação da técnica em um hospital universitário. Materiais e Métodos: Foram analisados 508 tratamentos de IMRT, de maio de 2011 a setembro de 2013, que completaram a radioterapia. A técnica empregada foi multilâminas estático. Resultados: De um total de 4.233 pacientes tratados no período, 12,5% realizaram IMRT. As principais indicações foram para crânio, cabeça e pescoço, e próstata. Aproximadamente 30% das radioterapias de crânio e 50% das de próstata foram por IMRT. A toxicidade total foi 4%. Conclusão: Em razão das restrições de acesso à radioterapia e da não cobertura deste procedimento, as indicações de IMRT para pacientes do SUS devem ser apoiadas nos protocolos clínicos das instituições em acordo com sua realidade, com especial atenção à redução da toxicidade.

Tamaño dental, desgaste oclusal y microestriación en primates Hominoidea

El patrón de microestriación dentaria depende no solo de la composición de los alimentos ingeridos, sino también de la presencia en ellos de polvo, cenizas u otras partículas abrasivas de origen externo, generalmente incorporadas al alimento durante su preparación. El presente estudio analiza cómo se ve afectado el patrón de microestriación de la superficie vestibular de los dientes por factores independientes a la estructura y composición alimentaria, como son el tamaño de la pieza dentaria y el desgaste oclusal de la misma. Se han analizado moldes dentarios obtenidos de ejemplares originales de colecciones osteológicas de molares de primates Hominoideos, en los que se ha medido el patrón de microestriación dentaria de todos los individuos, así como el tamaño dental (área oclusal total- AOT) y el desgaste oclusal (porcentaje de exposición de dentina- PED) mediante técnicas semiautomáticas de análisis cuantitativo. Los resultados obtenidos indican que el tamaño dentario y el grado de desgaste oclusal de los molares analizados no están correlacionados con el patrón de microdesgaste dental de sus superficies vestibulares. Ello sugiere que las actividades masticatorias asociadas con las superficies oclusales de los molares no están directamente relacionadas con la capacidad abrasiva del alimento, sino con utilización de la superficie occlusal de la dentición en actividades que no repercuten en el patrón de microestriación de las superficies vestibulares de los dientes.

Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging

AbstractObjective:To define the distal femur rotation pattern in a Brazilian population, correlating such pattern with the one suggested by the arthroplasty instruments, and analyzing the variability of each anatomic parameter.Materials and Methods:A series of 101 magnetic resonance imaging studies were evaluated in the period between April and June 2012. The epidemiological data collection was performed with the aid of the institution's computed imaging system, and the sample included 52 male and 49 female patients. The measurements were made in the axial plane, with subsequent correlation and triangulation with the other plans. The posterior condylar line was used as a reference for angle measurements. Subsequently, the anatomical and surgical transepicondylar axes and the anteroposterior trochlear line were specified. The angles between the reference line and the studied lines were calculated with the aid of the institution's software.Results:The mean angle between the anatomical transepicondylar axis and the posterior condylar line was found to be 6.89°, ranging from 0.25° to 12°. For the surgical transepicondylar axis, the mean value was 2.89°, ranging from –2.23° (internal rotation) to 7.86°, and for the axis perpendicular to the anteroposterior trochlear line, the mean value was 4.77°, ranging from –2.09° to 12.2°.Conclusion:The anatomical transepicondylar angle showed mean values corresponding to the measurement observed in the Caucasian population. The utilized instruments are appropriate, but no anatomical parameter proved to be steady enough to be used in isolation.

Total synthesis of (-)-isoavenaciolide

An enantioselective approach to (-)-isoavenaciolide was achieved starting from 1- undecyn-3-ol. The synthesis relied upon the preparation of a chiral 4-silyloxy-2-alkenylborane by hydroboration of a protected 2,3-allenol and subsequent stereoselective addition to 2- thiophenecarboxaldehyde

Total synthesis of entecavir

Entecavir (BMS-200475) was synthesized from 4-trimethylsilyl-3-butyn-2-one and acrolein. The key features of its preparation are: (i) a stereoselective boron-aldol reaction to afford the acyclic carbon skeleton of the methylenecylopentane moiety; (ii) its cyclization by a Cp2TiCl-catalyzed intramolecular radical addition of an epoxide to an alkyne; and (iii) the coupling with a purine derivative by a Mitsunobu reaction.

Impact of the Femoral Head Position on Moment Arms in Total Hip Arthroplasty: A Parametric Finite Element Study.

BACKGROUND: Although the importance of accurate femoral reconstruction to achieve a good functional outcome is well documented, quantitative data on the effects of a displacement of the femoral center of rotation on moment arms are scarce. The purpose of this study was to calculate moment arms after nonanatomical femoral reconstruction. METHODS: Finite element models of 15 patients including the pelvis, the femur, and the gluteal muscles were developed. Moment arms were calculated within the native anatomy and compared to distinct displacement of the femoral center of rotation (leg lengthening of 10 mm, loss of femoral offset of 20%, anteversion ±10°, and fixed anteversion at 15°). Calculations were performed within the range of motion observed during a normal gait cycle. RESULTS: Although with all evaluated displacements of the femoral center of rotation, the abductor moment arm remained positive, some fibers initially contributing to extension became antagonists (flexors) and vice versa. A loss of 20% of femoral offset led to an average decrease of 15% of abductor moment. Femoral lengthening and changes in femoral anteversion (±10°, fixed at 15°) led to minimal changes in abductor moment arms (maximum change of 5%). Native femoral anteversion correlated with the changes in moment arms induced by the 5 variations of reconstruction. CONCLUSION: Accurate reconstruction of offset is important to maintaining abductor moment arms, while changes of femoral rotation had minimal effects. Patients with larger native femoral anteversion appear to be more susceptible to femoral head displacements.

Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case-Controlled Analysis.

BACKGROUND: The use of a robotic surgical system is claimed to allow precise traction and counter-traction, especially in a narrow pelvis. Whether this translates to improvement of the quality of the resected specimen is not yet clear. The aim of the study was to compare the quality of the TME and the short-term oncological outcome between robotic and laparoscopic rectal cancer resections. METHODS: 20 consecutive robotic TME performed in a single institution for rectal cancer (Rob group) were matched 1:2 to 40 laparoscopic resections (Lap group) for gender, body mass index (BMI), and distance from anal verge on rigid proctoscopy. The quality of TME was assessed by 2 blinded and independent pathologists and reported according to international standardized guidelines. RESULTS: Both samples were well matched for gender, BMI (median 25.9 vs. 24.2 kg/m(2), p = 0.24), and level of the tumor (4.1 vs. 4.8 cm, p = 0.20). The quality of the TME was better in the Robotic group (complete TME: 95 vs. 55 %; p = 0.0003, nearly complete TME 5 vs. 37 %; p = 0.04, incomplete TME 0 vs. 8 %, p = 0.09). A trend for lower positive circumferential margin was observed in the Robotic group (10 vs. 25 %, p = 0.1). CONCLUSIONS: These results suggest that robotic-assisted surgery improves the quality of TME for rectal cancer. Whether this translates to better oncological outcome needs to be further investigated.

Estudo da Determinação dos Grupos Silanóis ( º Si-OH) em Sílica: Aplicação à Materiais de Recheio Utilizados em Cromatografia Gasosa

A simple chemical method has been developed to quantify the silanol groups (º Si-OH) in silica as well as in coated chromatographic supports for use in packed - column Gas Chromatography. After adsorption of 10 mg/mL methylene blue, centrifuging action and filtration, the absorbance of the solution was inversely proportional to the silanol quantity. The difference between the absorbance of the pure solution and that of the solid - free filtrate was related to the silica weight, yielding a quantitative analysis of these groups.

Comparação de dois tipos de amostragem de chuva: deposição total e deposição apenas úmida em àrea costeira tropical

In a tropical coastal area. During 6 months the composition of rain samples collected simultaneously over 24h with an open collector and with an automatic opened collector (KFA - J¸lich Type) at 500m of the Atlantic coastline of Salvador were compared. All average concentrations were higher for the "total" samples than for the "wet only" samples, except for hydrogen ions, nitrate and ammonium.

Química de materiais no Brasil: um olhar através das reuniões anuais da Sociedade Brasileira de Química

Several aspects of the Chemistry of Materials in Brazil will be focused using, as a data source, the activities of the Chemistry of Materials Division of the Brazilian Chemical Society. Evaluations, suggestions and prospectives are made on attempt to overcome challenges and difficulties of this emergent and important area of the chemical research.

Separação de espectros simulados e de luminescência total através do método generalizado de anulação do posto (GRAM)

A multivariate curve resolution method, "GENERALIZED RANK ANNIHILATION METHOD (GRAM)", is discussed and tested with simulated and experimental data. The analysis of simulated data provides general guidelines concerning the condition for uniqueness of a solution for a given problem. The second-order emission-excitation spectra of human and animal dental calculus deposits were used as an experimental data to estimate the performance of the above method. Three porphyrinic spectral profiles, for both human and cat, were obtained by the use of GRAM.