Síndrome da dilatação volvo gástrica em cães Gastric volvulus dilatation syndrome in dogs

A síndrome da dilatação volvo gástrica (DVG) é uma condição grave, de caráter agudo, que confere alto índice de óbito em pequenos animais. A etiologia não está completamente estabelecida e, em contrapartida, diversas possibilidades de tratamento são descritas. A DVG causa grave redução na perfusão tecidual, afetando vários órgãos, incluindo os sistemas respiratório e cardiovascular. Este estudo tem como objetivo realizar uma revisão de literatura sobre a patogenia desta síndrome e seu tratamento.<br>The syndrome of gastric dilatation volvulus (GDV) is a severe condition of acute character, which gives a high rate of death in small animals. The etiology is not fully established, however, several treatment options have been described. The DVG causes severe reduction in tissue perfusion, affecting many organs, including the respiratory and cardiovascular systems. This study aims to conduct a comprehensive literature review of the pathogenesis of this syndrome as well as its treatment

Overall survival in the OlympiA phase Ill trial of adjuvant olaparib in patients with germime pathogenic variants in BRCA1/2 and high-risk, early breast cancer

Background: The randomized, double-blind OlympiA trial compared 1 year of the oral poly(adenosine diphosphate-ribose) polymerase inhibitor, olaparib, to matching placebo as adjuvant therapy for patients with pathogenic or likely pathogenic variants in germline BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative, early breast cancer (EBC). The first pre-specified interim analysis (IA) previously demonstrated statistically significant improvement in invasive disease-free survival (IDFS) and distant disease-free survival (DDFS). The olaparib group had fewer deaths than the placebo group, but the difference did not reach statistical significance for overall survival (OS). We now report the pre-specified second IA of OS with updates of IDFS, DDFS, and safety.Patients and methods: One thousand eight hundred and thirty-six patients were randomly assigned to olaparib or placebo following (neo)adjuvant chemotherapy, surgery, and radiation therapy if indicated. Endocrine therapy was given concurrently with study medication for hormone receptor-positive cancers. Statistical significance for OS at this IA required P < 0.015.Results: With a median follow-up of 3.5 years, the second IA of OS demonstrated significant improvement in the olaparib group relative to the placebo group [hazard ratio 0.68; 98.5% confidence interval (CI) 0.47-0.97; P = 0.009]. Four-year OS was 89.8% in the olaparib group and 86.4% in the placebo group (Delta 3.4%, 95% CI -0.1% to 6.8%). Four-year IDFS for the olaparib group versus placebo group was 82.7% versus 75.4% (Delta 7.3%, 95% CI 3.0% to 11.5%) and 4-year DDFS was 86.5% versus 79.1% (Delta 7.4%, 95% CI 3.6% to 11.3%), respectively. Subset analyses for OS, IDFS, and DDFS demonstrated benefit across major subgroups. No new safety signals were identified including no new cases of acute myeloid leukemia or myelodysplastic syndrome.Conclusion: With 35 years of median follow-up, OlympiA demonstrates statistically significant improvement in OS with adjuvant olaparib compared with placebo for gBRCA1/2pv-associated EBC and maintained improvements in the previously reported, statistically significant endpoints of IDES and DDFS with no new safety signals

Plant physiological ecology and the global changes Ecofisiologia vegetal e as mudanças globais

The global changes are marked by alteration on the normal patterns of important biochemical and biophysical processes of the Earth. However, the real effects as well as the feedbacks of the global changes over vegetation are still unclear. Part of this uncertainty can be attributed to the inattention of stakeholders and scientists towards vegetation and its complex interrelations with the environment, which drive plant physiological processes in different space-time scales. Notwithstanding, some key subjects of the global changes could be better elucidated with a more plant physiological ecology approach. We discuss some issues related to this topic, going through some limitations of approaching vegetation as a static component of the biosphere as the other sub-systems of the Earth-system change. With this perspective, this review is an initial reflection towards the assessment of the role and place of vegetation structure and function in the global changes context. We reviewed the Earth-system and global changes terminology; attempted to illustrate key plant physiological ecology researches themes in the global changes context; consider approaching plants as complex systems in order to adequately quantify systems characteristics as sensibility, homeostasis, and vulnerability. Moreover, we propose insights that would allow vegetation studies and scaling procedures in the context of the Earth-system. We hope this review will assist researchers on their strategy to identify, understand and anticipate the potential effects of global changes over the most vulnerable vegetation processes from the leaf to the global levels.<br>As mudanças globais englobam importantes alterações nos padrões normais de processos bioquímicos e biofísicos da Terra. Os reais efeitos e retroalimentações das mudanças globais sobre a vegetação ainda são incertos. Parte das incertezas pode ser atribuída à falta de atenção de cientistas e políticos para a vegetação, enquanto componente do sistema terrestre. Entretanto, algumas questões sobre as mudanças globais poderiam ser mais bem esclarecidas por abordagens mais voltadas à ecofisiologia vegetal. Nesse artigo, alguns pontos relacionados e esses problemas, como as limitações em se abordar a vegetação como um componente estático da atmosfera enquanto outros subsistemas do sistema terrestre são dinâmicos, são discutidos. Dentro dessa perspectiva, essa revisão traz uma reflexão inicial do papel da vegetação, em termos de estrutura e funcionamento, no contexto das mudanças globais. Para isso, foi feita uma revisão das terminologias relacionadas às mudanças globais e ao sistema terrestre, buscou-se ilustrar alguns dos principais temas de pesquisa da ecofisiologia vegetal no contexto das mudanças globais. Foram feitas considerações em relação ao tratamento de plantas como sistemas complexos, o que é importante para o estudo de aspectos relacionados à sensibilidade, estabilidade e vulnerabilidade a variações ambientais. Finalmente, são discutidas alternativas que podem ser utilizadas para incorporar aspectos do funcionamento da vegetação, de forma dinâmica, em estudos de mudanças globais, considerando o desafio de mudança de escalas. Espera-se que essa revisão possa auxiliar pesquisadores subsidiando suas estratégias de identificação e compreensão dos efeitos potenciais das mudanças globais sobre os processos mais vulneráveis da vegetação, da folha ao globo