Quality assurance in the 22991 EORTC ROG trial in localized prostate cancer: dummy run and individual case review.

INTRODUCTION: EORTC trial 22991 was designed to evaluate the addition of concomitant and adjuvant short-term hormonal treatments to curative radiotherapy in terms of disease-free survival for patients with intermediate risk localized prostate cancer. In order to assess the compliance to the 3D conformal radiotherapy protocol guidelines, all participating centres were requested to participate in a dummy run procedure. An individual case review was performed for the largest recruiting centres as well. MATERIALS AND METHODS: CT-data of an eligible prostate cancer patient were sent to 30 centres including a description of the clinical case. The investigator was requested to delineate the volumes of interest and to perform treatment planning according to the protocol. Thereafter, the investigators of the 12 most actively recruiting centres were requested to provide data on five randomly selected patients for an individual case review. RESULTS: Volume delineation varied significantly between investigators. Dose constraints for organs at risk (rectum, bladder, hips) were difficult to meet. In the individual case review, no major protocol deviations were observed, but a number of dose reporting problems were documented for centres using IMRT. CONCLUSIONS: Overall, results of this quality assurance program were satisfactory. The efficacy of the combination of a dummy run procedure with an individual case review is confirmed in this study, as none of the evaluated patient files harboured a major protocol deviation. Quality assurance remains a very important tool in radiotherapy to increase the reliability of the trial results. Special attention should be given when designing quality assurance programs for more complex irradiation techniques.

Profile of European radiotherapy departments contributing to the EORTC Radiation Oncology Group (ROG) in the 21st century.

PURPOSE: Since 1982, the Radiation Oncology Group of the EORTC (EORTC ROG) has pursued an extensive Quality Assurance (QA) program involving all centres actively participating in its clinical research. The first step is the evaluation of the structure and of the human, technical and organisational resources of the centres, to assess their ability to comply with the current requirements for high-tech radiotherapy (RT). MATERIALS AND METHODS: A facility questionnaire (FQ) was developed in 1989 and adapted over the years to match the evolution of RT techniques. We report on the contents of the current FQ that was completed online by 98 active EORTC ROG member institutions from 19 countries, between December 2005 and October 2007. RESULTS: Similar to the data collected previously, large variations in equipment, staffing and workload between centres remain. Currently only 15 centres still use a Cobalt unit. All centres perform 3D Conformal RT, 79% of them can perform IMRT and 54% are able to deliver stereotactic RT. An external reference dosimetry audit (ERDA) was performed in 88% of the centres for photons and in 73% for electrons, but it was recent (<2 years) in only 74% and 60%, respectively. CONCLUSION: The use of the FQ helps maintain the minimum quality requirements within the EORTC ROG network: recommendations are made on the basis of the analysis of its results. The present analysis shows that modern RT techniques are widely implemented in the clinic but also that ERDA should be performed more frequently. Repeated assessment using the FQ is warranted to document the future evolution of the EORTC ROG institutions.

EORTC-ROG expert opinion: radiotherapy volume and treatment guidelines for neoadjuvant radiation of adenocarcinomas of the gastroesophageal junction and the stomach.

PURPOSE: The Gastro-Intestinal Working Party of the EORTC Radiation Oncology Group (GIWP-ROG) developed guidelines for target volume definition in neoadjuvant radiation of adenocarcinomas of the gastroesophageal junction (GEJ) and the stomach. METHODS AND MATERIALS: Guidelines about the definition of the clinical target volume (CTV) are based on a systematic literature review of the location and frequency of local recurrences and lymph node involvement in adenocarcinomas of the GEJ and the stomach. Therefore, MEDLINE was searched up to August 2008. Guidelines concerning prescription, planning and treatment delivery are based on a consensus between the members of the GIWP-ROG. RESULTS: In order to support a curative resection of GEJ and gastric cancer, an individualized preoperative treatment volume based on tumour location has to include the primary tumour and the draining regional lymph nodes area. Therefore we recommend to use the 2nd English Edition of the Japanese Classification of Gastric Carcinoma of the Japanese Gastric Cancer Association which developed the concept of assigning tumours of the GEJ and the stomach to anatomically defined sub-sites corresponding respectively to a distinct lymphatic spread pattern. CONCLUSION: The GIWP-ROG defined guidelines for preoperative irradiation of adenocarcinomas of the GEJ and the stomach to reduce variability in the framework of future clinical trials.

Composition of bottom sediments and their exchange with seawater in the Amur and Zolotoy Rog bays, Sea of Japan

Transition of Zn, Cu, Cd, and Pb into solution is studied for experimental suspensions of coastal marine sediments with different degrees of pollution from the Amur Bay (Sea of Japan) over 30-70 days. Concentrations of dissolved metals were measured by a voltammetry method. Transition of Zn and Cd into solution was shown to be linearly dependent on initial pollution of sediments with these metals. Cadmium mobilization is due to gradual degradation of organic matter from sediments. Under degradation processes Zn quickly goes into solution during sedimentation and from silts, while in case of polluted sediments it is slowly mobilized during oxidation of sulfides. Behavior of Cu is complex because of binding of mobilized metal by dissolved organic compounds. Transition of lead into solution is negligible. Calculation of potential transition of metals from sediments into water on the basis of experimental data and its comparison with downward sedimentary flux showed that in the studied area secondary pollution of water by aerobic degradation of sediments is possible only for Cd.

Diagnosis and treatment of extraction sockets in preparation for implant placement: report of three cases

This article addresses diagnostic parameters that should be assessed in the treatment of extraction sockets with dental implant placement by presenting three case reports that emphasize the relevance of the amount of remaining bone walls. Diagnosis was based on the analysis of clinical and radiographic parameters (e.g.: bone defect morphology, remaining bone volume, presence of infections on the receptor site). Case 1 presents a 5-wall defect in the maxillary right central incisor region with severe root resorption, which was treated with immediate implant placement. Cases 2 and 3 present, respectively, two- and three-wall bone defects that did not have indication for immediate implants. These cases were first submitted to a guided bone regeneration (GBR) procedure with bone graft biomaterial and membrane barriers, and the implants were installed in a second surgical procedure. The analysis of the preoperative periodontal condition of the adjacent teeth and bone defect morphology is extremely important because these factors determine the choice between immediate implant or GBR treatment followed by implant installation in a subsequent intervention.

Data Mart para apoio ?? capacita????o em gest??o de pol??ticas p??blicas voltado para uma Escola de Administra????o P??blica

Este trabalho consiste num estudo de caso que se destina ao desenvolvimento de um Data Mart que possibilite a Escola Nacional de Administra????o P??blica ??? ENAP conhecer o perfil e o panorama geral da situa????o funcional dos servidores p??blicos federais que se capacitaram na Escola nos ??ltimos 7 anos. O aplicativo foi desenvolvido cruzando o banco de dados do sistema gerenciador dos cursos ministrados pela ENAP, onde est??o armazenadas informa????es sobre os alunos capacitados, os cursos realizados, os resultados alcan??ados, o perfil dos docentes e demais informa????es relativas ??s atividades da Escola, com os dados gerados pelo Sistema Integrado de Administra????o de Recursos Humanos ??? SIAPE, cuja extra????o de dados foi direcionada para os registros sobre a situa????o funcional, cargos, carreiras, fun????es, ??rg??os e alguns dados pessoais dos alunos, servidores p??blicos federais que se encontram registrados no SIAPE

Controle dos estoques p??blicos de gr??os

O Sistema de Controle Interno do Poder Executivo sofreu recente reformula????o que culminou na cria????o da Secretaria Federal de Controle (SFC), ??rg??o respons??vel pela avalia????o da gest??o p??blica e acompanhamento dos programas de governo. A Secretaria de Controle Interno (Ciset) no Minist??rio da Agricultura, unidade seccional da SFC, desenvolveu trabalho na ??rea de estoques governamentais de gr??os, geridos pela Companhia Nacional de Abastecimento (Conab), afetos ao Programa de Garantia de Pre??os M??nimos (PGPM). Para operacionalizar o PGPM, o governo adquire estoques de gr??os no per??odo da safra, quando os pre??os est??o rebaixados pelo excesso de oferta e administra esses estoques at?? o per??odo de entressafra, quando os mesmos retornam ao mercado consumidor, por meio de leil??es de venda. Foram cobradas in??meras d??vidas atrasadas de empresas armazenadoras, com o retorno de recursos aos cofres p??blicos, aliviando, assim, a carga de processos em cobran??a administrativa e judicial. Foi cobrado o ressarcimento de preju??zos causados por desvio, perda e sinistro de estoques, bem como foi determinada a cobran??a de preju??zos por desvios perda e sinistro que se encontravam pendentes de solu????o. Desenvolveu-se a????o preventiva, evitando preju??zos relativos a safras antigas mal armazenadas e com riscos de perda de qualidade. Procedeu-se ?? redu????o do quantitativo de estoques p??blicos de safras antigas, reduzindo-se os riscos de deprecia????es e perdas. Realizou-se o saneamento de inconsist??ncias e falhas no sistema de controle do cadastro de armaz??ns e dos contratos de dep??sito de estoques p??blicos por empresas armazenadoras privadas. Iniciou-se efetivamente a aferi????o da qualidade dos estoques p??blicos, de acordo com a classifica????o oficial do Maara, quando das opera????es de aquisi????es indiretas (transforma????o de estoques de empr??stimos do governo federal ??? EFG ??? em Aquisi????es do Governo Federal ??? AFG) e das vendas em leil??es p??blicos (via bolsas de mercadorias). O sucesso da iniciativa levou ?? cria????o de um grupo de trabalho interministerial envolvendo os Minist??rios da Fazenda e da Agricultura, destinados a analisar e a oferecer alternativas de solu????o para os problemas operacionais do PGPM

M??dulo 1 - contextualiza????o e planejamento das contrata????es de TI: curso sele????o de fornecedores de TI (SFTI)

Esse documento trata de: solu????es de Tecnologia da Informa????o nos ??rg??os p??blicos; fundamentos legais da sele????o de fornecedores de TI na APF; rela????o entre as ??reas de neg??cio, administrativa e de tecnologia da informa????o; conex??es com o PDTI e PCTI; vis??o geral do processo; gest??o or??ament??ria; c??rculo or??ament??rio; etapas da despesa or??ament??ria;despesas com TI

M??dulo 2 - conceitos, princ??pios e boas pr??ticas da licita????o p??blica aplicadas ?? SFTI: curso sele????o de fornecedores de TI (SFTI)

Esse documento trata de: conceito de licita????o p??blica e princ??pios; finalidades; princ??pios b??sicos; modalidades de licita????o; tipos de Licita????o; preg??o; bens e servi??os comuns; sistema de registro de pre??os; ades??o ao registro de pre??o (O Carona); inten????o ao registro de pre??o - Decreto N?? 7892/13; contrata????o direta; fases da licita????o; or??amento estimado; pre??o m??ximo; consulta ou audi??ncia p??blica; comiss??o de licita????o e pregoeiro; questionamentos, impugna????es e controle social; proibi????o de Participar; boas pr??ticas de licita????o; projeto b??sico e Termo de Refer??ncia; edital e Termo de Refer??ncia; prazos do ato convocat??rio; impugna????es ao edital; boas pr??ticas de licita????o

M??dulo 3: divulga????o do instrumento convocat??rio, habilita????o dos licitantes, propostas, encerramento: cautelas e boas pr??ticas: curso sele????o de fornecedores de TI (SFTI)

Esse documento trata de: habilita????o; processamento da licita????o; qualifica????o t??cnica (art. 30 da Lei 8.666/93; dilig??ncias; recursos administrativos; posicionamento da ??rea de TI; coer??ncia Estrita com o Edital; modelo de sele????o de Fornecedores; crit??rios de julgamento; capacidade t??cnico-operacional; capacidade t??cnico-profissional; parecer t??cnico para subsidiar o pregoeiro ou a comiss??o; an??lise de pre??o; amostra ou prot??tipo; adjudica????o e homologa????o

Sele????o de fornecedores de TI (SFTI)

Esse documento trata de: contextualiza????o e planejamento das contrata????es de TI; conceitos, princ??pios e boas pr??ticas da licita????o p??blica aplicadas ?? SFTI; divulga????o do instrumento convocat??rio, habilita????o dos licitantes, propostas, encerramento: cautelas e boas pr??ticas