Correlation Between Tumor Extent In Radical Prostatectomies And Preoperative Psa, Histological Grade, Surgical Margins, And Extraprostatic Extension: Application Of A New Practical Method For Tumor Extent Evaluation.

To evaluate a new method designed for estimating the tumor extent in radical prostatectomy specimens. The tumor extent was correlated to preoperative PSA and to several pathologic findings in the surgical specimens as well. Tumor extent was estimated in 118 consecutive radical prostatectomies through a simple point-count method. Drawn on a sheet of paper, each quadrant of the whole mount sections contained 8 equidistant points. During the microscopic slides examination, the tumor area was drawn over the correspondent quadrant of the paper sheet. According to the extent, tumors were classified in 5 groups: 1) very limited: </= 10 positive points; 2) limited: 11-19 positive points; 3) moderately extensive: 20-35 positive points; 4) extensive: 36-39 positive points; 5) very extensive: 70 positive points. This classification was based on a previous analysis of tumor extent in 109 radical prostatectomies. The distribution was quite normal up to 69 positive points, but asymmetric above that number, including cases exceeding far above that value. We considered the quartiles of the normal distribution up to 69 positive points (groups 1 to 4), and above that value a fifth group was considered. There was a statistically significant and direct correlation between the tumor extent and all variables studied: preoperative PSA (p = 0.03), Gleason score (p < 0.0001), primary grade in high-grade tumors (p < 0.01), surgical margins (p < 0.0001), extraprostatic extension (pT3a) (p < 0.0001), and seminal vesicle invasion (pT3b) (p = 0.01). The method, which is simple and well correlated to other prognostic factors, is accessible to those pathologists working in routine pathology laboratories. Whether this method will be used by other urology centers is yet to be seen.29113-9; discussion 12

Sistema Municipal de Unidades Protegidas da Cidade do Recife, Pernambuco, Brasil

A paisagem urbana é síntese do processo de urbanização e, sobretudo, da relação do homem com a natureza e de todos os formatos de intervenções no ambiente natural e no próprio ambiente construído. As áreas verdes são elementos imprescindíveis dessa paisagem urbana e componentes do patrimônio, construído ou natural. Têm essa importância não só pela notória contribuição no aspecto físico que marca a morfologia da cidade, mas também pelo que elas representam para a qualidade de vida. A cidade do Recife, caracterizada pela imensa rede de água, associada ao sistema de áreas verdes, revela-se como unidade ambiental entre águas e cobertura vegetal, o que a torna emblemática e singular. Este estudo objetiva analisar o Sistema de Unidades Protegidas do Recife no que ele estabelece sobre as áreas verdes públicas. No estudo, recorreu-se à compilação dos dispositivos estabelecidos no Plano Diretor do Recife que originaram a sua instituição, do agrupamento de suas diretrizes e componentes e da sua classificação, em função das tipologias das áreas verdes que o compõe. Como resultado, observou-se que, com a instituição do Sistema, além de ter surgido um importante instrumento de planejamento, verifica-se que o mesmo ampliou e diversificou as categorias de áreas

Systematic Review And Meta-analysis Of Target Terapies For The Treatment Of Metastatic Renal Cancer.

At present there are several drugs for the treatment of advanced renal cell carcinoma (ARCC). The main objective of this work was to perform a systematic review (SR) and meta-analysis (MA) of clinical randomized studies that compared target cell therapies (TCT). SR identified clinical randomized trials that compared TCT versus interferon-alpha in the treatment of patients with ARCC. In order to analyze efficiency, it was evaluated free-survival progression (FSP), total survival (TS) and response rate (RR). In relation to first line treatment, seven studies of TCT were identified using sunitinib, sorafenib, bevacizumab and temsirolimus; and two studies with sorafenib and everolimus for second line treatment. Relative risk (RRi) of MA for FSP of first line therapies was: 0.83, CI = 0.78-0.87, I2 = 94% and p < 0.00001. Best results of RR of specific FSP among studies were: 0.38, sunitinib, CI = 0.25-0.58, bevacizumab, 0.62, CI = 0.47-0.83; and temsirolimus, 0.78, CI = 0.70-0.87. MA didn't show any benefit regarding TS of first line treatment of all analyzed drugs. As for RR significant results were: sunitinib, 3.83 CI = 2.86-5.12; bevacizumab, 2.52 CI = 1.78-3.57 and bevacizumab, 1.97 CI = 1.43-2.71. For first line treatment, sunitinib was the most effective TCT in relation to FPS; there was no alteration of TS and RR was small but significant for sunitinib and bevacizumab. Available studies could not conclude any results for second line treatments.39768-7

Gestão de áreas verdes públicas na cidade do Recife, Pernambuco, Brasil

Green areas are crucial elements in the urban landscape and heritage components, built or natural. They have such importance not only for the notorious contribution the physical aspect that characterize the morphology of the city, but are, as well, influential elements of socio- economic aspects, which makes possible to understand the appropriation levels by the society on these areas. In this scenario the agenda of the management of green areas should be one of the conditions for the characterization in its transformation process they went through. This should permeate both its diagnosis and the proposals to change the current scenario in perspective of welfare, of environmental quality and of path in the pursuit of sustainability.. In this study were analyzed public green areas of the city of Recife from the point of view of management, taking as a premise the benefits they generate from their various functions, whether ecological, landscape, social, psychological, etc. and, above all, from the fundamental role in the balance of urban life. This approach allowed to elucidate the importance of these areas in the context of urban space in the city not only by physical factors, but also the historical and cultural values that constitute the process of the city formation. The relevance of green areas in this context, considering the role they play in the quality of life, is in quantitative point of view, reporting and analyzing their distribution in the territory of the city of Recife, its formats, occurrences and classification, from the qualitative point of view, where their influences were identified, either from an objective or subjective point of view in the urban and environmental quality, and consider the opinion of the community, is where is based the objective of this project. For the development of this study, it was adopted a methodological model that required some steps – literature review, data collection and analysis and systematic interpretation of the data. From the discussion and analysis can be inferred, regarding to the management tools, advances upon insertion of urban green in the Master Plan and the establishment of the Municipal System of Protected Areas, for example, in addition, we can identify various projects and innovative actions as the expansion of arboreal covering and the use of environmental compensation mechanisms to improve the green areas. However, it is possible to realizes that the administrative structure is still fragile from the point of view of technology and an adequate number of specialized technicians, in addition to being notorious the disarticulation and overlapping responsibilities among agencies. It was also possible to perceive an identity of the people involved in the management and among users regarding to the opinions about the scenario of public green areas, especially in the perception of the main problems – lack of security; restricted accessibility and lighting and poor maintenance . There was the identification of the attributes of green areas from conceptual approaches concerning its various functions be they ecological, economic, aesthetic, contemplation or leisure, defined in the pilot area (Region Administrative Policy 3 - RPA3) considering, of course, the whole collection institutional units related to protected beyond the resident and user community auscultation, which supported recommendations called Guidelines for the Management of Public Areas Green Recife, becoming an important tool for the sustainable management of municipal green areas.As áreas verdes são elementos imprescindíveis na paisagem urbana e componentes do patrimônio, construído ou natural. Têm essa importância pela notória contribuição aos aspectos físicos que marcam a morfologia da cidade e por serem elementos influenciadores dos aspectos socioeconômicos, o que faz entender os diversos níveis de apropriação dessas áreas pela sociedade. Neste cenário, a pauta de gestão das áreas verdes é uma das condições para caracterização das cidades em todo o processo de transformação por que passaram. Deve permear tanto o diagnóstico como as proposições para mudar o quadro atual na perspectiva do bem-estar, da qualidade ambiental e do caminho para a sustentabilidade. Neste estudo foram analisadas as áreas verdes públicas da cidade do Recife sob o ponto de vista de sua gestão, tomando como pressuposto os benefícios por elas gerados a partir das suas diversas funções, quer sejam ecológicas, paisagísticas, sociais ou psicológicas e, sobretudo, a partir do papel fundamental no equilíbrio da vida urbana. A abordagem permitiu elucidar a importância dessas áreas no contexto do espaço urbano da cidade através das suas características físicas e pelos seus valores históricos e culturais que configuram o processo de formação da cidade. É sobre essa relevância que as áreas verdes possuem no contexto da cidade que se fundamenta este trabalho, que tem como objetivo, a análise dos aspectos que permeiam a sua gestão no âmbito da cidade do Recife. A análise da gestão das áreas verdes públicas do Recife se deu através da descrição dos seus instrumentos e da sua governança, da identificação dos principais elementos da estrutura administrativa, da configuração da sua distribuição no território, além da análise da percepção dos usuários. Para o desenvolvimento desta pesquisa, foi adotado um modelo metodológico que exigiu algumas etapas – revisão bibliográfica, coleta de dados e análise e interpretação sistemática dos dados. Da discussão e análise pôde-se depreender, quanto aos instrumentos de gestão, avanços quando da inserção do verde urbano no Plano Diretor e da instituição do Sistema Municipal de Unidades Protegidas, por exemplo. Além disso, puderam-se identificar vários projetos e ações inovadoras, como a ampliação da cobertura arbórea e utilização de mecanismos de compensação ambiental para melhoria das áreas verdes. No entanto, percebe-se que a estrutura administrativa ainda é frágil do ponto de vista do uso de tecnologias e de um número inadequado de técnicos especializados, além de ser notória a desarticulação e a sobreposição de atribuições entre os órgãos. Foi possível também perceber uma uniformidade de opinião das pessoas envolvidas na gestão e entre os usuários acerca do cenário das áreas verdes públicas, sobretudo, quanto à percepção dos principais problemas apontados – falta de segurança; acessibilidade restrita e iluminação e manutenção deficientes. Houve a identificação dos atributos das áreas verdes a partir de abordagens conceituais acerca de suas diferentes funções, sejam elas ecológicas, econômicas, estéticas, de contemplação ou de lazer, delimitadas na área piloto (Região Política Administrativa 3 – RPA3) considerando, evidentemente, todo acervo institucional relacionado às unidades protegidas, além da ausculta da comunidade residente e usuária que subsidiou recomendações denominadas de Diretrizes para a Gestão das Áreas Verdes Públicas do Recife, configurando-se, portanto, em uma importante ferramenta para a gestão sustentável das áreas verdes públicas municipais

Magnetic Resonance Image in the diagnosis and evaluation of extra-prostatic extension and involvement of seminal vesicles of prostate cancer: a systematic review of literature and meta-analysis

Objective Systematic review of literature and meta-analysis to evaluate the results of magnetic resonance image 1.5T with endorectal coil in the diagnosis and evaluation of extra-prostatic extension and involvement of seminal vesicles of prostate cancer, compared to the histopathological results of the radical prostatectomy specimen. Materials and Methods It was conducted a systematic review of literature and meta-analyses of all studies data published after 2008. In those studies, the patients with prostate cancer with indication to radical prostatectomy were submitted to magnetic resonance image (MRI) at pre-operatory period and the results were compared to those of histopathological studies after the surgery. The selected terms for research included prostate cancer, magnetic resonance, radical prostatectomy, and prostate cancer diagnosis, in the databases EMBASE, LILACS, PUBMED/MEDLINE and Cochrane Library. The data were collected using a specific qualitative instrument and the meta-analysis data were presented in the forest plot graphics, homogeneity test and sROC curves and funnel plot. Results A total of seven studies were included, with a total of 603 patients. Among these studies, six evaluated the value of MRI for the detection of prostate cancer, and the median sensitivity of meta-analysis was 0.6 and specificity 0.58, but with heterogeneity among the studies. Three studies evaluated extra-prostatic extension with a median sensitivity of 0.49, specificity 0.82 and heterogeneity only for sensitivity. Three studies evaluated invasion of seminal vesicles, with median sensitivity of 0.45 and specificity 0.96, with heterogeneity in both analysis. Conclusion Magnetic resonance of 1.5T with endocoil showed low values of sensitivity and specificity for the diagnosis and staging of prostate cancer. The reviewed studies showed a significant heterogeneity among them. The best observed result was MRI specificity for invasion of seminal vesicles. More studies are necessary to evaluate new techniques and parameters before recommending the routine use of MRI in clinical practice.15516

The importance of histopathologic review of biopsies in patients with prostate cancer referred to a tertiary uro - oncology center

In view of the detailed histologic evaluation of prostate cancer (PC), it is usually advisable to provide a "second opinion" to confirm diagnosis. This study aimed to compare the Gleason score (GS) of initial diagnosis versus that of histopathologic review of patients with PC. The secondary objective was to compare initial GS versus histopathologic review versus post - surgical histopathology. Material and methods: Retrospective study based on chart review of patients with PC that attended the Uro - oncology Department of Hospital das Clinicas - UNICAMP - Campinas, Brazil, from April, 2002, to April, 2012. Data were divided in groups: patients with biopsies performed elsewhere, biopsies after pathological review and histopathological results following retropubic radical prostatectomy (RRP). These were evaluated in relation to GS difference using Fleis's Kappa concordance coefficient. Results: 402 PC patients, with a median age of 66 years, were evaluated. Reviewed GS showed worsening, with accuracy of 61.2%, and Kappa concordance value = 0.466. Among 143 patients submitted to surgery, GS varied widely, regarding initial evaluation, review and post - surgical RRP. Joint concordance of evaluations was weak (Kappa = 0.216), mainly due to almost no existence concordance between initial evaluation and following RRP (Kappa = 0.041). Conclusion: There is a great histopathological variation of initial GS versus reviewed GS. There is also a better correlation of reviewed GS and post - surgical GS than with initial GS. The second opinion by an uropathologist improves diagnosis and should be advised for better therapeutic decision451323

Agronegócio: pandemia Covid-19 e os impactos no comércio entre o Brasil e a China

From the perspective of Sino-Brazilian trade relations, this article aims to analyze the impacts caused by the COVID-19 pandemic on exports of agricultural products between Brazil and China in 2020, when the pandemic began, as well as the possible Chinese changes in their food security strategies and geographic diversification of import of agricultural products, accelerated due to the global health crisis and that will require special attention from the national sector. In this context, this article, conducted by a qualitative approach and bibliographic and documentary review, found that the pandemic caused by the SARS-CoV-2 coronavirus caused enormous degradation of the economic environment and employment levels and, above all, the purchasing power of the Brazilian population. Nevertheless, agribusiness, the country's economic sector that exports the most and generates a trade surplus, was not affected by the global pandemic in 2020 and continues in 2021 with favorable prospects, mainly: a) due to the high Chinese demand for commodities; b) conflicts in Sino-American relations; and c) exchange devaluation, notably of the Brazilian currency against the US dollar and the Euro.Sob a perspectiva das relações comerciais sino-brasileiras, o presente artigo tem o objetivo de analisar os impactos provocados pela pandemia da COVID-19 nas exportações de produtos agropecuários entre o Brasil e a China no ano de 2020, em que se deu o início da pandemia, bem como as possíveis mudanças chinesas em suas estratégias de segurança alimentar e de diversificação geográfica de importação de produtos agropecuários, aceleradas por conta da crise sanitária mundial e que exigirá especial atenção por parte do setor nacional. Nesse contexto, este artigo, conduzido por uma abordagem qualitativa e de revisão bibliográfica e documental, constatou que a pandemia provocada pelo Coronavírus, SARS-CoV-2, causou enorme degradação do ambiente econômico e dos níveis de emprego e, sobretudo, do poder de compra da população brasileira. Não obstante, o agronegócio, setor econômico do País que mais exporta e gera superavit comercial, não foi afetado pela pandemia mundial em 2020 e continua em 2021 com perspectivas favoráveis, principalmente: a) em razão da alta demanda chinesa por commodities; b) dos conflitos nas relações sino-americanas; e c) da desvalorização cambial, notadamente da moeda brasileira frente ao Dólar Americano e ao Euro

Agronegócio: pandemia Covid-19 e os impactos no comércio entre o Brasil e a China

From the perspective of Sino-Brazilian trade relations, this article aims to analyze the impacts caused by the COVID-19 pandemic on exports of agricultural products between Brazil and China in 2020, when the pandemic began, as well as the possible Chinese changes in their food security strategies and geographic diversification of import of agricultural products, accelerated due to the global health crisis and that will require special attention from the national sector. In this context, this article, conducted by a qualitative approach and bibliographic and documentary review, found that the pandemic caused by the SARS-CoV-2 coronavirus caused enormous degradation of the economic environment and employment levels and, above all, the purchasing power of the Brazilian population. Nevertheless, agribusiness, the country's economic sector that exports the most and generates a trade surplus, was not affected by the global pandemic in 2020 and continues in 2021 with favorable prospects, mainly: a) due to the high Chinese demand for commodities; b) conflicts in Sino-American relations; and c) exchange devaluation, notably of the Brazilian currency against the US dollar and the Euro.Sob a perspectiva das relações comerciais sino-brasileiras, o presente artigo tem o objetivo de analisar os impactos provocados pela pandemia da COVID-19 nas exportações de produtos agropecuários entre o Brasil e a China no ano de 2020, em que se deu o início da pandemia, bem como as possíveis mudanças chinesas em suas estratégias de segurança alimentar e de diversificação geográfica de importação de produtos agropecuários, aceleradas por conta da crise sanitária mundial e que exigirá especial atenção por parte do setor nacional. Nesse contexto, este artigo, conduzido por uma abordagem qualitativa e de revisão bibliográfica e documental, constatou que a pandemia provocada pelo Coronavírus, SARS-CoV-2, causou enorme degradação do ambiente econômico e dos níveis de emprego e, sobretudo, do poder de compra da população brasileira. Não obstante, o agronegócio, setor econômico do País que mais exporta e gera superavit comercial, não foi afetado pela pandemia mundial em 2020 e continua em 2021 com perspectivas favoráveis, principalmente: a) em razão da alta demanda chinesa por commodities; b) dos conflitos nas relações sino-americanas; e c) da desvalorização cambial, notadamente da moeda brasileira frente ao Dólar Americano e ao Euro

Estimating uniaxial compressive strength, density and porosity of rocks from the p-wave velocity measurements in-situ and in the laboratory

Knowledge of the physical properties of rock masses is fundamental for the economics and safety of mining projects. The determination of these properties in rock samples in the laboratory requires time, expensive equipment and qualified personnel, which considerably increases the information's cost. Indirect methods were developed to obtain properties related to rock masses, which have been shown to be a viable alternative to traditional procedures. The determination of the compressional mechanical wave velocity (Vp) and subsequent correlation with lithological mechanical properties are indirectly obtained. This study’s objective was to obtain correlations between Vp and the resistance to uniaxial compression, UCS (Unconfined Compressive Strength), as well as the density and porosity of the siltstone and sandstone lithologies present in the coalfield of Candiota, located in the southern region of Rio Grande do Sul, Brazil. The Vp records were obtained in laboratory samples, using ultrasonic velocity sensors, and in-situ by geophysical well logging (directly in boreholes). The results indicate the possibility of using Vp to determine the physical parameters of the investigated lithologies. In the specific case of the correlations between Vp and Unconfined Compressive Strength, determination coefficients R2 above 0.70 were obtained, indicating sufficiently high reliability for using this information (e.g. in roof support projects). The correlation between Vp and density was also high