Blood Transfusion Requirements for Patients With Sarcomas Undergoing Combined Radio- and Chemotherapy

Patients with bony and soft tissue sarcomas may require intensive treatment with chemotherapy and radiotherapy, which often leads to a fall in haemoglobin levels, requiring blood transfusion. There may be advantages in predicting which patients will require transfusion, partly because anaemia and hypoxia may worsen the response of tumours to chemotherapy and radiotherapy. Between 1997 and 2003, a total of 26 patients who received intensive treatment with curative intent were identified. Transfusions were given to maintain the haemoglobin at 10g/dl or above during chemotherapy, and at 12 g/dl or above during radiotherapy. Eighteen (69%) required a transfusion, the majority as a result of both the chemotherapy and RT criteria. There were 78 transfusion episodes, and 181 units of blood given. In the 18 patients who required transfusion, the average number of units was 10.1, but seven patients required more blood than this. The most significant factor influencing blood transfusion was choice of intensive chemotherapy. Intensive chemotherapy and presenting Hb less than 11.6 g/dl identified 13 out of 18 patients who needed transfusion. Adding a drop in haemoglobin of greater than 1.7 g/dl after one cycle of chemotherapy identified 16 out of 18 patients who required transfusion. The seven patients who had heavy transfusion requirements were identified by age 32 or less, intensive chemotherapy and a presenting Hb of 12 g/dl or less. Erythropoietin might be a useful alternative to transfusion in selected patient groups, especially those with heavy transfusion requirements

Citizen science for observing and understanding the Earth

Citizen Science, or the participation of non-professional scientists in a scientific project, has a long history—in many ways, the modern scientific revolution is thanks to the effort of citizen scientists. Like science itself, citizen science is influenced by technological and societal advances, such as the rapid increase in levels of education during the latter part of the twentieth century, or the very recent growth of the bidirectional social web (Web 2.0), cloud services and smartphones. These transitions have ushered in, over the past decade, a rapid growth in the involvement of many millions of people in data collection and analysis of information as part of scientific projects. This chapter provides an overview of the field of citizen science and its contribution to the observation of the Earth, often not through remote sensing but a much closer relationship with the local environment. The chapter suggests that, together with remote Earth Observations, citizen science can play a critical role in understanding and addressing local and global challenges

Polineuropatia devida ao óxido de etileno registro de caso com estudo clínico, eletrofisiológico e histopatológico

Os autores referem-se a caso de um jovem que, trabalhando em fábrica de esterilização de artigos médicos e em contato diário com o óxido de etileno, desenvolveu leve polineuropatia sensitivo-motora. Os estudos eletrofisiológicos evidenciaram neuropatia por degeneração axonal. A biópsia do nervo sural mostrou discreta perda de fibras mielínicas e sinais de degeneração e regeneração axonal. Este é o primeiro caso desta afecção descrita em nosso meio