Impact of changes in perinatal care on bronchopulmonary dysplasia: an overview of the last two decades

Objective: To compare the clinical approach and outcomes of bronchopulmonary dysplasia (BPD) patients in the last two decades (1996-2005 vs 2006-2015) in a neonatal intensive care unit. Methods: Out of 1,196 admissions of very low birth weight and/or less than 32 weeks of gestational age infants, 96 had BPD and were dichotomized into two groups according to the year of birth (1996-2005 and 2006-2015). Their clinical data were studied and conclusions were drawn about their morbidity and mortality. Results: There was a decrease in mortality (23.3% vs. 14.4%, p < 0.001) and in BPD prevalence (9.7% vs 6.1%, p = 0.023); in the delivery room, early nasal continuous positive airways pressure (nCPAP) was used in 41.2% vs 1.6%, p < 0.001 and tracheal intubation in 70.6% vs 96.8%, p < 0.001. We observed an increase on the duration of non-invasive ventilation (nCPAP, 22.5 vs 45.5 days, p < 0.001) and a decrease of invasive ventilation (39.5 vs 20 days, p = 0.013) from the first to the second period. Conclusions: Improvement in perinatal and neonatal intensive care practices, namely the use of non-invasive methods of mechanical ventilation implemented in the last years, probably contributed to the better evolution of preterm infants with BPD.This study was funded by: FEDER through the Operational Programme “Competitiveness and Internationalization” and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), under the Unidade de Investigação em Epidemiologia – Instituto de Saúde Públicada Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013); the PhD Grant SFRH/BD/111794/2015 (Carina Rodrigues), co-funded by the FCT and the POPH/FSE Program

Practical Based Learning (PBL) for Academic, Technological and Scientific Education in Engineering Courses - Case Study

The increase in the number of students evaded has alerted different segments of society and the public sector to the need to update the guidelines of engineering courses as well as innovation in teaching engineering. In this sense, the objective is to report on the challenges of engineering education in Brazil and the methodological strategies that have been adopted for the modernization of the curricula of engineering courses and consequent reduction of the indicators of avoidance and withdrawal. In addition, involving the use of the 43 academic academics of the University of Cruz Alta (Unicruz) who studied the discipline of Research Methodology in the second semester of 2017 through the Problem Based Learning (PBL) strategy as an innovative strategy education. Finally, in addition to the production of a technical material produced throughout the course, it was observed that there were only 2 students in 1 failed exam, demonstrating that teaching by PBL has high effectiveness for academic achievement in the discipline of research methodology

Lack of microsatellite instability in gastrointestinal stromal tumors

The microsatellite instability (MSI) phenotype may constitute an important biomarker for patient response to immunotherapy, particularly to anti-programmed death-1 inhibitors. MSI is a type of genomic instability caused by a defect in DNA mismatch repair (MMR) proteins, which is present mainly in colorectal cancer and its hereditary form, hereditary nonpolyposis colorectal cancer. Gastrointestinal stromal tumor (GIST) development is associated with activating mutations of KIT proto-oncogene receptor tyrosine kinase (KIT) or platelet-derived growth factor receptor alpha (PDGFRA), which are oncogenes that predict the response to imatinib mesylate. In addition to KIT/PDGFRA mutations, other molecular alterations are important in GIST development. In GISTs, the characterization of the MSI phenotype is scarce and the results are not consensual. The present study aimed to assess MSI in a series of 79 GISTs. The evaluation of MSI was performed by pentaplex polymerase chain reaction comprising five markers, followed by capillary electrophoresis. The expression of MMR proteins was evaluated by immunohistochemistry. Regarding the KIT/PDGFRA/B-Raf proto-oncogene, serine/threonine kinase molecular profile of the 79 GISTs, 83.6% of the tumors possessed KIT mutations, 10.1% had PDGFRA mutations and 6.3% were triple wild-type. The mutated-PDGFRA cases were associated with gastric location and a lower mitotic index compared with KIT-mutated and wild-types, and these patients were more likely to be alive and without cancer. MSI analysis identified 4 cases with instability in one marker, however, additional evaluation of normal tissue and immunohistochemical staining of MMR proteins confirmed their microsatellite-stable nature. The results of the present study indicated that MSI is not involved in GIST tumorigenesis and, therefore, cannot serve as a biomarker to immunotherapy response in GIST.The present study was supported by The Brazilian National Council for Scientific and Technological Development (grant no. 476192/2013-7) and the São Paulo Research Foundation Doctoral Fellowship (grant no. 2013/25787-3).info:eu-repo/semantics/publishedVersio

SOD2 immunoexpression predicts lymph node metastasis in penile cancer

BACKGROUND: Superoxide dismutase-2 (SOD2) is considered one of the most important antioxidant enzymes that regulate cellular redox state in normal and tumorigenic cells. Overexpression of this enzyme in lung, gastric, colorectal, breast cancer and cervical cancer malignant tumors has been observed. Its relationship with inguinal lymph node metastasis in penile cancer is unknown. METHODS: SOD2 protein expression levels were determined by immunohistochemistry in 125 usual type squamous cell carcinomas of the penis from a Brazilian cancer center. The casuistic has been characterized by means of descriptive statistics. An exploratory logistic regression has been proposed to evaluate the independent predictive factors of lymph node metastasis. RESULTS: SOD2 expression in more than 50% of cells was observed in 44.8% of primary penile carcinomas of the usual type. This expression pattern was associated with lymph node metastasis both in the uni and multivariate analysis. CONCLUSIONS: Our results indicate that SOD2 expression predicts regional lymph node metastasis. The potential clinical implication of this observation warrants further studies.Dr. Lara Termini (FAPESP 2005/57274-9); Dr. Luisa Lina Villa (FAPESP 2008/57889-1 and CNPq 573799/2008-3)

On the use of VISIR under different course implementations

This paper addresses different course integrations of VISIR. The didactic approaches are summarized and the analysis done provides explanations to some of the problems encountered, plus some guidelines for future implementations. A number of strengths and weaknesses are highlighted, leading to suggestions on how to enhance some strategic approaches to motivate teachers and students to the potential of using VISIR in teaching and learning processes. Proper references to previously published work also help to understand the research background and the lessons derived from a more intensive usage of VISIR.N/

Cloudina-Corumbella-Namacalathus association from the Itapucumi Group, Paraguay: Increasing ecosystem complexity and tiering at the end of the Ediacaran

The intriguing Ediacaran fossil Namacalathus is described from limestones of the Tagatiya Guazú Formation, Itapucumi Group, Paraguay. This is the fifth occurrence of the genus in the Ediacaran geological record. The Paraguayan Namacalathus specimens are preserved as partially complete spheroidal cups with an opening at the top and thin walled stems. The remains of this soft-calcified globe-shaped organism occur as sparse disarticulated parautochthonous fragments within bioclastic deposits dominated by Cloudina shells with subordinate Corumbella fragments. The co-occurrence of these three skeletal metazoan species in the same environmental context attests that the diversity of the Paraguayan accumulations is ecologically comparable to the typical skeletal assemblage of the Nama Group. The discovery of new samples of Namacalathus in the Itapucumi Group also indicates that this genus presented a broader paleobiogeographic distribution than previously thought and, in the same way as Cloudina, it represents a low latitude, shallow water metazoan of the Ediacaran Gondwana.Centro de Investigaciones Geológica

Whole brain radiotherapy for brain metastases from breast cancer: estimation of survival using two stratification systems

BACKGROUND: Brain metastases (BM) are the most common form of intracranial cancer. The incidence of BM seems to have increased over the past decade. Recursive partitioning analysis (RPA) of data from three Radiation Therapy Oncology Group (RTOG) trials (1200 patients) has allowed three prognostic groups to be identified. More recently a simplified stratification system that uses the evaluation of three main prognostics factors for radiosurgery in BM was developed. METHODS: To analyze the overall survival rate (OS), prognostic factors affecting outcomes and to estimate the potential improvement in OS for patients with BM from breast cancer, stratified by RPA class and brain metastases score (BS-BM). From January 1996 to December 2004, 174 medical records of patients with diagnosis of BM from breast cancer, who received WBRT were analyzed. The surgery followed by WBRT was used in 15.5% of patients and 84.5% of others patients were submitted at WBRT alone; 108 patients (62.1%) received the fractionation schedule of 30 Gy in 10 fractions. Solitary BM was present in 37.9 % of patients. The prognostic factors evaluated for OS were: age, Karnofsky Performance Status (KPS), number of lesions, localization of lesions, neurosurgery, chemotherapy, absence extracranial disease, RPA class, BS-BM and radiation doses and fractionation. RESULTS: The OS in 1, 2 and 3 years was 33.4 %, 16.7%, and 8.8 %, respectively. The RPA class analysis showed strong relation with OS (p < 0.0001). The median survival time by RPA class in months was: class I 11.7, class II 6.2 and class III 3.0. The significant prognostic factors associated with better OS were: higher KPS (p < 0.0001), neurosurgery (P < 0.0001), single metastases (p = 0.003), BS-BM (p < 0.0001), control primary tumor (p = 0.002) and absence of extracranial metastases (p = 0.001). In multivariate analysis, the factors associated positively with OS were: neurosurgery (p < 0.0001), absence of extracranial metastases (p <0.0001) and RPA class I (p < 0.0001). CONCLUSION: Our data suggests that patients with BM from breast cancer classified as RPA class I may be effectively treated with local resection followed by WBRT, mainly in those patients with single BM, higher KPS and cranial extra disease controlled. RPA class was shown to be the most reliable indicators of survival