Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,770-1,762; p = 0,470). Na análise multivariada, as variáveis associadas à sobrevida foram perfomance status (p < 0,001), extensão da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). Conclusão Não se observou impacto prognóstico para TE até a radioterapia na sobrevida. Diante de outros fatores prognósticos, é possível assegurar de que o espaço de tempo até a radioterapia não parece influenciar o controle da doença.Hospital Israelita Albert EinsteinUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaHospital do Coração Departamento de OncologiaUniversidade de São Paulo Faculdade de MedicinaUNIFESP, EPMSciEL

Ovarian cancer

Ovarian cancer is not a single disease and can be subdivided into at least five different histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at a late stage and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents and poly(ADP-ribose) polymerase inhibitors are used, and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and at diagnosis is typically very responsive to platinum-based chemotherapy. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy. Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Substantial progress has been made in identifying genes that are associated with a high risk of ovarian cancer (such as BRCA1 and BRCA2), as well as a precursor lesion of HGSC called serous tubal intraepithelial carcinoma, which holds promise for identifying individuals at high risk of developing the disease and for developing prevention strategies

Tongue forces and handgrip strength in normal individuals: association with swallowing

OBJECTIVES: To describe and correlate tongue force and grip strength measures and to verify the association of these measures with water swallowing in different age groups. METHOD: Tongue force was evaluated using the Iowa Oral Performance Instrument and grip strength using the Hand Grip in 90 normal individuals, who were divided into three groups: young (18-39 years old), adult (40-59 years old) and elderly (above 60 years old) individuals. The time and number of swallows required for the continuous ingestion of 200 ml of water were also measured. RESULTS: A reduction in tongue force and grip strength, as well as an increase in the time required to drink 200 ml of water, were observed with increasing participant age. There was no difference in the number of swallows among the three groups. A correlation was observed between reductions in tongue force and grip strength in the groups of young and elderly individuals. CONCLUSION: There were differences in the measures of tongue force in young, adult and elderly individuals. Greater variations within these differences were observed when repeated movements were performed; in addition, a decrease in strength was associated with an increase in age. The decrease in tongue force among the elderly was offset by the increase in time needed to swallow the liquid. There was an association between the measures of tongue force and grip strength in the different age groups. The results of this study can be applied clinically and may act as a basis for guidelines in healthy or vulnerable elderly populations

Frequências do fornecimento da dieta sobre as características da carcaça bovina em confinamento

Objetivou-se avaliar a influência de diferentes freqüências do fornecimento do volumoso e con- centrado sobre as características da carcaça nas categorias vaca e novilha, terminadas em confinamento. Foram utilizadas 16 novilhas e 16 vacas, com idade média de 20 e 66 meses e peso médio inicial de 338 e 432 kg, respectivamente, provenientes de gerações avançadas do cruzamento rotativo contínuo entre as raças Charolês e Nelore. Os tratamentos representados pelas freqüências do fornecimento do volumoso (V) e do concentrado (C), foram: 2 V/C (V e C duas vezes ao dia); 1 V/C (V e C uma vez ao dia); 1 V/ 2 C (V uma vez e o C duas vezes ao dia); 1 V/3 C (V uma vez e o C três vezes ao dia). Cada fornecimento alimentar foi ofertado às categorias vaca e novilha. A dieta fornecida foi composta de 60 % de silagem de milho e 40 % de concentrado com base na matéria seca. O abate foi realizado em frigorífico comercial, seguindo as normas do estabelecimento. O delineamento experimental utilizado foi inteiramente casualizado em arranjo fatorial 4 x 2 (fornecimento x categoria). Os dados foram submetidos à análise de variância e as médias comparadas pelo teste t. Não houve interação significativa entre freqüência de fornecimento e categoria animal. A freqüência de fornecimento não promoveu alterações nas ca- racterísticas da carcaça avaliadas (p>0,05). As vacas apresentaram maior peso de abate e de carcaça quente e fria em relação às novilhas (525,5; 291,0; 281,7 kg vs. 424,7; 236,1; 227,5 kg, respectivamente). Entretanto, as carcaças das novilhas apresentaram maior porcentagem de traseiro do que as vacas.The influence of different frequencies of supply of roughage and supplement on carcass characteristics of feedlot cows and heifers was studied. Sixteen heifers and sixteen cows, with average age of 20 and 66 months and initial weight of 338 and 432 kg, respectively, from advanced generations of Charolais and Nellore continuous rotational crossbreeding were used. The treatments, representing the frequencies of the supply of roughage (V) and concentrate (C), were: 2 V/C (V and C twice a day); 1 V/C (V and C once a day); 1 V/2 C (V once a day and C twice a day); 1 V/3 C (V once a day and C three times a day). Each treatment was offered to cows and heifers. The supplied diet was composed by 60 % of corn silage and 40 % of concentrate, on dry matter basis. The slaughter was carried out in commercial refrigerated slaugher house, following the rules of the establishment. The complete randomized experimental design was used, with a factorial arrangement of 4 x 2 (frequency of supply x category). Data were submitted to a variance analysis and the means were compared by t test. No significant interaction was observed between frequency of supply and animal category. The frequency of supply did not change the eva- luated carcass characteristics (p>0.05). The cows presented higher slaughter weight and hot and cold carcass weights when compared to heifers (525.5, 291.0, 281.7 kg vs. 424.7, 236.1, 227.5 kg, respectively). However, the carcasses of heifers showeda higher percentage of rear cows

Small cell carcinoma of the ovary-hypercalcemic type (SCCOHT): A review of 47 cases*

Objective. Small cell carcinoma of the ovary-hypercalcemic type (SCCOHT) is a rare disease with a poor prognosis. SCCOHT has recently been shown to be associated with SMARCA4 gene mutations as well as molecular and genetic similarities to malignant rhabdoid tumors (MRT). The objective of our study is to describe the clinical characteristics, treatment modalities and outcomes of 47 patients with SCCOHT. Methods. We performed a retrospective analysis of 47 patients with SCCOHT evaluated at MD Anderson Cancer Center between 1990 and 2014. Medical records were reviewed for demographic information, pathologic findings, treatment regimens and outcomes. Results. Median age at diagnosis was 30 years (range 5-46). All patients underwent surgery with unilateral salpingo-oophorectomy (USO) performed in 26 patients (55%), and hysterectomy with bilateral salping000phorectomy (BSO) in 21 patients (45%). Sixteen patients (34.0%) had stage I disease, six (12.8%) stage II, 23 (48.9%) stage III, and two patients (4.3%) had stage IV disease. Information on adjuvant treatment was available for 43 patients: 83.3% received chemotherapy alone, 9.5% chemotherapy followed by radiotherapy, 2.4% chemoradiation, and 4.8% did not receive any adjuvant therapy. Median follow-up was 13.2 months (range, 0.1 to 210.7) with a median overall survival of 14.9 months. Multi-agent chemotherapy and radiotherapy were associated with a better prognosis. Conclusion. Our findings suggest that aggressive therapy including multi-agent chemotherapy and possibly radiotherapy may extend survival. Further study is needed to improve outcomes in these patients including the adoption of systemic therapies used in MRT as well as the development of novel agents targeting specific mutations. (c) 2015 Elsevier Inc. All rights reserved.National Institutes of Health through MD Anderson's Cancer Center Support Grant [CA016672]Hosp Israelita Albert Einstein, Dept Med Oncol, Sao Paulo, BrazilUniv Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USAUniv Fed Sao Paulo, Div Gynecol Oncol, Sao Paulo, BrazilDivision of Gynecologic Oncology, Universidade Federal de São Paulo, São Paulo, BrazilNational Institutes of Health through MD Anderson's Cancer Center Support Grant CA016672.Web of Scienc

Frequências do fornecimento do alimento no desempenho de vacas e novilhas em confinamento

Objetivou-se avaliar a frequência do fornecimento do volumoso (V) e concentrado (C) no desempenho de vacas e novilhas em confinamento. Os tratamentos foram: 2 V/C= V e C 2 vezes ao dia; 1 V/C= V e C 1 vez ao dia; 1 V/ 2C= V 1 vez e C 2 vezes ao dia; 1 V/3C= V 1 vez e C 3 vezes ao dia para vacas ou novilhas. O delineamento experimental utilizado foi o inteiramente casualizado em arranjo fatorial 4 x 2, com 4 repetições. Não houve interação significa- tiva entre frequência de fornecimento e categorias animal. O consumo de matéria seca (CMS) foi superior para os animais alimentados 1 V/2C e 1 V/3C ao dia em relação ao fornecimento de 2 V/C e 1 V/C, apresentando valores de 11,7; 11,4; 10,6 e 10,7 kg, respectivamente. O ganho de peso diário não foi influenciado pelas frequências de fornecimentos. O CMS foi superior para as vacas (12,6 kg) em relação às novilhas (9,57 kg), não havendo diferença para o ganho de peso. O aumento nas frequências do fornecimento do concentrado para 2 ou 3 vezes proporcionou maior consumo, não influenciando o ganho de peso.The effect of frequency of supply of forage(V) and concentrate (C) on the performance of cows and heifers in feedlot was studied. The treatments were the following frequencies in the supply: 2 V/C= V and C twice daily; 1 V/C= V and C once daily; 1 V/2C= once V and C twice daily, 1 V/3C= once V and C three times a day, for the cows or heifers. The experimental design was completely randomized in factorial arrangement 4 x 2, with four replications. There was no significant interaction between frequency of supplying and category animal. The dry matter intake (DMI) was superior for the animals fed 1 V/2C or 1 V/3C a day in relation with the supply of 2 V/C and 1 V/C, presenting values of 11.7; 11.4; 10.6 and 10.7 kg, respectively. The average daily gain (ADG) was not influenced by the frequency of supplying. The DMI was higher in cows (12.6 kg) than heifers (9.57 kg), having no difference in the weight gain. Increasing frequency of feeding the concentrate to two or three times a day, provided greater consumption, not influencing the weight gain of cows and heifers confined