Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging

OBJECTIVES: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using 99mTc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. METHODS: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with 99mTc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. RESULTS: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for 99mTc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative predictive values of 67.7% and 91.2%, respectively. CONCLUSION: Single-photon emission computed tomography/computed tomography with 99mTc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma

Global and regional ecological boundaries explain abrupt spatial discontinuities in avian frugivory interactions

Species interactions can propagate disturbances across space via direct and indirect effects, potentially connecting species at a global scale. However, ecological and biogeographic boundaries may mitigate this spread by demarcating the limits of ecological networks. We tested whether large-scale ecological boundaries (ecoregions and biomes) and human disturbance gradients increase dissimilarity among plant-frugivore networks, while accounting for background spatial and elevational gradients and differences in network sampling. We assessed network dissimilarity patterns over a broad spatial scale, using 196 quantitative avian frugivory networks (encompassing 1496 plant and 1004 bird species) distributed across 67 ecoregions, 11 biomes, and 6 continents. We show that dissimilarities in species and interaction composition, but not network structure, are greater across ecoregion and biome boundaries and along different levels of human disturbance. Our findings indicate that biogeographic boundaries delineate the world’s biodiversity of interactions and likely contribute to mitigating the propagation of disturbances at large spatial scales.The authors acknowledge the following funding: University of Canterbury Doctoral Scholarship (L.P.M.); The Marsden Fund grant UOC1705 (J.M.T., L.P.M.); The São Paulo Research Foundation - FAPESP 2014/01986-0 (M.G., C.E.), 2015/15172-7 and 2016/18355-8 (C.E.), 2004/00810-3 and 2008/10154-7 (C.I.D., M.G., M.A.P.); Earthwatch Institute and Conservation International for financial support (C.I.D., M.G., M.A.P.); Carlos Chagas Filho Foundation for Supporting Research in the Rio de Janeiro State – FAPERJ grant E-26/200.610/2022 (C.E.); Brazilian Research Council grants 540481/01-7 and 304742/2019-8 (M.A.P.) and 300970/2015-3 (M.G.); Rufford Small Grants for Nature Conservation No. 22426–1 (J.C.M., I.M.), No. 9163-1 (G.B.J.) and No. 11042-1 (MCM); Universidade Estadual de Santa Cruz (Propp-UESC; No. 00220.1100.1644/10-2018) (J.C.M., I.M.); Fundação de Amparo à Pesquisa do Estado da Bahia - FAPESB (No. 0525/2016) (J.C.M., I.M.); European Research Council under the European Union’s Horizon 2020 research and innovation program (grant 787638) and The Swiss National Science Foundation (grant 173342), both awarded to C. Graham (D.M.D.); ARC SRIEAS grant SR200100005 Securing Antarctica’s Environmental Future (D.M.D.); German Science Foundation—Deutsche Forschungsgemeinschaft PAK 825/1 and FOR 2730 (K.B.G., E.L.N., M.Q., V.S., M.S.), FOR 1246 (K.B.G., M.S., M.G.R.V.) and HE2041/20-1 (F.S., M.S.); Portuguese Foundation for Science and Technology - FCT/MCTES contract CEECIND/00135/2017 and grant UID/BIA/04004/2020 (S.T.) and contract CEECIND/02064/2017 (L.P.S.); National Scientific and Technical Research Council, PIP 592 (P.G.B.); Instituto Venezolano de Investigaciones Científicas - Project 898 (V.S.D.)

Dinâmicas de (investig)ação em contextos de promoção da língua portuguesa: a presença do CIDTFF na rede Camões, I.P.

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Avaliação da abordagem palpebral subtarsal no tratamento cirúrgico das fraturas zigomático-orbitais

OBJETIVO: avaliar as complicações, vantagens e desvantagens da abordagem subtarsal quando utilizada para exposição da borda infra-orbital e do assoalho da órbita em fraturas zigomático-orbitais. MÉTODOS: Estudo retrospectivo de 41 incisões subtarsais empregadas em 39 pacientes com fraturas do complexo zigomático e/ou do assoalho da órbita do tipo blow-out, no período de janeiro de 2002 a dezembro de 2006. RESULTADOS: As complicações observadas foram conjuntivite, epífora e cicatriz aparente em seis (14,6%), cinco (12,2%) e dois (4,9%) dos casos, respectivamente. Não houve presença de ectrópio, entrópio ou esclera aparente nos pacientes reavaliados. CONCLUSÃO: As principais vantagens dessa abordagem são os resultados estéticos e funcionais associados aos benefícios trans-operatórios

Ficha de anamnese nas consultas médica e de enfermagem na prevenção do câncer do colo do útero em projeto extensionista

Introdução: O câncer do colo do útero é importante problema de saúde pública em todo mundo. Alterações celulares que podem evoluir para câncer podem ser descobertas no exame citopatológico. Este exame é coletado na consulta médica e de enfermagem, além de dados sobre o histórico de saúde  da paciente. Esses dados são registrados na ficha de anamnese que precisam ser corretamente preenchidas. Objetivos: comparar a ficha de anamnese utilizada durante a consulta ginecológica de enfermagem pelo SUS (Ficha Rosa) com a do Projetopap e verificar se as fichas do Projetopap foram preenchidas corretamente. Discutir sobre o impacto da falta de dados sobre o diagnóstico da paciente. Método: trata-se de estudo transversal, retrospectivo e descritivo, onde foram analisadas 955 fichas utilizadas na consulta de enfermagem do Projetopap entre 2011 e 2021. Resultados e discussão: Inicialmente foi realizado estudo comparativo entre a Ficha Rosa e a ficha do Projetopap. A análise dos dados revelou que 85,13% das fichas tabuladas apresentaram um ou mais campos incompletos. Conclusões: O alto percentual de fichas incompletas indica a necessidade de se avaliar as causas das falhas para que ações corretivas possam ser implementadas. Essas ações podem incluir adequação do modelo da ficha, além do treinamento da equipe responsável pelo seu preenchimento. O preenchimento correto da ficha de anamnese serve como registro de dados que estarão disponíveis para atendimentos futuros, além de permitir avaliação estatística epidemiológica que contribui para compreensão das causas que norteiam o desenvolvimento do câncer do colo do útero na população