Lupus erítematoso sistêmico juvenil: comprometimento neurológico

With the purpose of analyzing the neurological involvement due to systemic lupus erythematosus (SLE), we evaluated 17 female patients who were seen regularly at the hospital and had been diagnosed as having SLE according to classification criteria proposed by the American College of Rheumatology revised in 1982, before the age of 16. Neurological involvement was detected in 12 patients (71%): headache (35%), extrapyramidal syndrome (35%), epileptic syndrome (24%) pyramidal syndrome (24%), peripheral neuropathy (12%) and optic neuritis (6%). The findings of CT scan (58%) and cerebrospinal fluid (50%) were most closely correlated to clinical neurological involvement.Com o objetivo de analisar o comprometimento neurológico secundário ao lupus eritematoso sistêmico (LES), avaliamos pacientes que estavam em acompanhamento ambulatorial. Foram selecionadas 17 pacientes do sexo feminino cujo diagnóstico do LES foi até a idade de 16 anos, e preencheu os critérios para a classificação propostos pelo Colégio Americano de Reumatologia revisados em 1982. O comprometimento neurológico foi observado em 12 pacientes (71%): cefaléia (35%), síndrome extrapiramidal (35%), síndrome epiléptica (24%), síndrome piramidal (24%), neuropatia periférica (12%) e neurite óptica (6%). Dos exames complementares a tomografia coputadorizada de crânio (58%) e o líquido cefalorraquidiano (50%) mostraram maior correlação com a presença de comprometimento neurológico.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Reumatologia PediátricaUNIFESP, EPM, Setor de Reumatologia PediátricaSciEL

On the anomalous large-scale flows in the Universe

Recent combined analyses of the CMB and galaxy cluster data reveal unexpectedly large and anisotropic peculiar velocity fields at large scales. We study cosmic models with included vorticity, acceleration and total angular momentum of the Universe in order to understand the phenomenon. The Zeldovich model is used to mimic the low redshift evolution of the angular momentum. Solving coupled evolution equations of the second kind for density-contrast in corrected Ellis-Bruni covariant and gauge-invariant formalism one can properly normalize and evaluate integrated Sachs-Wolfe effect and peculiar velocity field. The theoretical results compared to the observations favor a much larger matter content of the Universe than that of the concordance model. Large-scale flows appear anisotropic with dominant components placed in the plane perpendicular to the axis of vorticity(rotation). The integrated Sachs-Wolfe term has negative contribution to the CMB fluctuations for the negative cosmological constant and it can explain the observed small power of the CMB TT spectrum at large scales. The rate of the expansion of the Universe can be substantially affected by the angular momentum if its magnitude is large enough.Comment: 13 pages, 6 tables, 4 figures, 36 references; version to appear in Eur. Phys. J.

Qualidade fisiológica de sementes e desempenho de plantas de rúcula no campo

O estudo teve como objetivo avaliar a influência da qualidade fisiológica de diferentes lotes de sementes de rúcula (Eruca sativa L.) no desenvolvimento inicial e na produção comercial. Avaliou-se a qualidade fisiológica das sementes mediante testes de germinação, primeira contagem de germinação, índice de velocidade de germinação, comprimento da raiz primária e da parte aérea, massa fresca e seca de plântulas. Aos 10 dias após a semeadura em campo, avaliou-se a percentagem de emergência, comprimento de raiz e da parte aérea, massa fresca e seca das plântulas. Aos 35 dias após a semeadura, foram avaliados o número de folhas, número de folhas maiores que dez centímetros, massa fresca e seca das plantas. O delineamento experimental foi inteiramente casualizado utilizando-se quatro tratamentos (lotes) e quatro repetições. Quanto à qualidade fisiológica das sementes de rúcula, houve estratificação dos lotes, sendo que os mais vigorosos possibilitaram o maior desenvolvimento de raiz e da parte aérea aos 10 dias após a semeadura, entretanto a qualidade fisiológica das sementes não influenciou na produção comercial da cultura.The study had as objective evaluates the influence of different physiologic quality seeds of Eruca sativa L. in the initial development and in the commercial production. It was evaluated the physiological quality of seeds by tests of germination, first count, speed of germination-index, root length and shoot, fresh and dry weight of seedlings. At 10 days after sowing in the field, the percentage of emergence, root length and shoot, fresh and dry plants was estimated. After 35 days of sowing, the number of leaves, number of leaves greater than 10 cm, fresh and dry plants was evaluated. A randomized complete block design was used with four treatments (lots) and four replications. There was stratification of lots on the physiological quality of rocket seeds. The seeds vigorous possible the further development of root and shoot at ten days after the sowing, however the physiological quality of seeds didn't affect the commercial production of the culture

Nanoknife And Hepatic Embolization For Colorectal Cancer Liver Metastases

Effective techniques for local management of unresectable colorectal liver metastases are important tools for a substantial number of patients. Novel approaches and technical improvement of older techniques have been developed to target liver lesions, both in the combined-modality and salvage settings. Irreversible electroporation is a non-thermal technique and can be safely delivered to lesions in the margins of blood vessels, with low risk of vascular disruption. Hepatic embolization consists of selectively treating a hepatic tumor, via its nutrient arterial supply, with one of the following technical variations: bland embolization, chemoembolization, or radioembolization. These techniques have achieved locoregional disease control activity that ultimately may translate into survival gains. Both modalities should be considered as an option for selected patients with colorectal cancer liver metastases. © 2014 Springer Science+Business Media.1017683Siegel, R., Naishadham, D., Jemal, A., Cancer statistics, 2013 (2013) CA: Cancer J Clin., 63, pp. 11-30Alberts, S.R., Poston, G.J., Treatment advances in liver-limited metastatic colorectal cancer (2011) Clin Colorectal Cancer, 10, pp. 258-265McLoughlin, J.M., Jensen, E.H., Malafa, M., Resection of colorectal liver metastases: Current perspectives (2006) Cancer Control, 13 (1), pp. 32-41. , http://www.moffitt.usf.edu/pubs/ccj/v13n1/pdf/32.pdfHeinrich, S., Lang, H., Liver metastases from colorectal cancer: Technique of liver resection (2013) J Surg Oncol, 107, pp. 579-584Albert, M., Kiefer, M.V., Sun, W., Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol (2011) Cancer, 117, pp. 343-352. , This paper shows the difference of outcomes, with increased survival rates with introduction of TACE after first or second lines of systemic therapy when compared with salvage therapyBecker, D., Hansler, J.M., Strobel, D., Hahn, E.G., Percutaneous ethanol injection and radio-frequency ablation for the treatment of nonresectable colorectal liver metastases-techniques and results (1999) Langenbeck's Arch Surg / Deutsche Gesellschaft fur Chirurgie, 384, pp. 339-343Van Tilborg, A.A., Meijerink, M.R., Sietses, C., Long-term results of radiofrequency ablation for unresectable colorectal liver metastases: A potentially curative intervention (2011) Br J Radiol, 84, pp. 556-565Kennedy, T.J., Cassera, M.A., Khajanchee, Y.S., Laparoscopic radiofrequency ablation for the management of colorectal liver metastases: 10-year experience (2013) J Surg Oncol, 107, pp. 324-328Donckier, V., Van Laethem, J.-L., Ickx, B., Van Gansbeke, D., Goldman, S., Gelin, M., Local ablative treatments for liver metastases: The current situation (2003) Acta Chirurgica Belgica, 103 (5), pp. 452-457Fong, Z.V., Palazzo, F., Needleman, L., Combined hepatic arterial embolization and hepatic ablation for unresectable colorectal metastases to the liver (2012) Am Surg, 78, pp. 1243-1248Ahmed, M., Brace, C.L., Lee Jr., F.T., Goldberg, S.N., Principles of and advances in percutaneous ablation (2011) Radiology, 258, pp. 351-369Al-Sakere, B., Andre, F., Bernat, C., Tumor ablation with irreversible electroporation (2007) PLoS One, 2, pp. e1135Bertacchini, C., Margotti, P.M., Bergamini, E., Lodi, A., Ronchetti, M., Cadossi, R., Design of an irreversible electroporation system for clinical use (2007) Technology in Cancer Research and Treatment, 6 (4), pp. 313-320Golberg, A., Yarmush, M.L., Nonthermal irreversible electroporation: Fundamentals, applications, and challenges (2013) IEEE Trans Biomed Eng, 60, pp. 707-714Edd, J.F., Horowitz, L., Davalos, R.V., Mir, L.M., Rubinsky, B., In vivo results of a new focal tissue ablation technique: Irreversible electroporation (2006) IEEE Transactions on Biomedical Engineering, 53 (7), pp. 1409-1415. , DOI 10.1109/TBME.2006.873745, 1643410Lee, E.W., Chen, C., Prieto, V.E., Advanced hepatic ablation technique for creating complete cell death: Irreversible electroporation (2010) Radiology, 255, pp. 426-433Kim, G.B., Sung, G.K., Baik, G.Y., Changes of apoptosis in tumor tissues with time after irreversible electroporation (2013) Biochem Biophys Res Commun, 435, pp. 651-656Charpentier, K.P., Irreversible electroporation for the ablation of liver tumors: Are we there yet? (2012) Arch Surg, 147, pp. 1053-1061Kingham, T.P., Karkar, A.M., D'Angelica, M.I., Ablation of perivascular hepatic malignant tumors with irreversible electroporation (2012) J Am Coll Surg, 215, pp. 379-387Kosiek, O., Strach, K., Ricke, J., Pech, M., Irreversible electroporation - A new kid on the block? (2012) Radiologe, 52, pp. 38-43Ryan, E.R., Sofocleous, C.T., Schoder, H., Split-dose technique for FDG PET/CT-guided percutaneous ablation: A method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness (2013) Radiology, 268, pp. 288-295Thomson, K.R., Cheung, W., Ellis, S.J., Investigation of the safety of irreversible electroporation in humans (2011) J Vasc Interv Radiol, 22, pp. 611-621Loaiza-Bonilla, A., Barbery, K.J., Perez-Rojas, E., Percutaneous irreversible electroporation (IRE) in the treatment of hepatocellular carcinoma (HCC) and metastatic colorectal cancer (mCRC) to the liver: A retrospective analysis of the University of Miami experience (2012) 2012 Gastrointestinal Cancers Symposium. 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To date, this is the only published randomized controlled trial in this settingRichardson, A.J., Laurence, J.M., Lam, V.W., Transarterial chemoembolization with irinotecan beads in the treatment of colorectal liver metastases: Systematic review (2013) J Vasc Interv Radiol: JVIR, 24, pp. 1209-1217Ceelen, W., Praet, M., Villeirs, G., Defreyne, L., Pattijn, P., Hesse, U., De Hemptinne, B., Initial experience with the use of preoperative transarterial chemoembolization in the treatment of liver metastasis (1996) Acta Chirurgica Belgica, (1), pp. 37-40Hong, K., McBride, J.D., Georgiades, C.S., Salvage therapy for liver-dominant colorectal metastatic adenocarcinoma: Comparison between transcatheter arterial chemoembolization versus yttrium- 90 radioembolization (2009) J Vasc Interv Radiol, 20, pp. 360-367Memon, K., Lewandowski, R.J., Kulik, L., Radioembolization for primary and metastatic liver cancer (2011) Semin Radiat Oncol, 21, pp. 294-302(2011) SIR-Spheres (Yttrium-90) Microspheres [Package Insert], , Woburn, MA: Sirtex Medical IncGray, B., Van Hazel, G., Hope, M., Randomised trial of SIRSpheres plus chemotherapy vs. Chemotherapy alone for treating patients with liver metastases from primary large bowel cancer (2001) Ann Oncol: Off J Eur Soc Med Oncol / ESMO, 12, pp. 1711-1720Hendlisz, A., Van Den Eynde, M., Peeters, M., Phase III trial comparing protracted intravenous fluorouracil infusion alone or with yttrium-90 resin microspheres radioembolization for liver-limited metastatic colorectal cancer refractory to standard chemotherapy (2010) J Clin Oncol: Off J AmSoc Clin Oncol, 28, pp. 3687-3694. , A phase III trial of combined modalities with improved benefits in the combination group reinforcing that using both systemic and locoreginal approaches in selected patients results in disease control and survival gainsSeidensticker, R., Denecke, T., Kraus, P., Matched-pair comparison of radioembolization plus best supportive care versus best supportive care alone for chemotherapy refractory liver-dominant colorectal metastases (2012) Cardiovasc Interv Radiol, 35, pp. 1066-1073Benson III, A.B., Geschwind, J.F., Mulcahy, M.F., Radioembolisation for liver metastases: Results from a prospective 151 patient multi-institutional phase II study (2013) Eur J Cancer, 49, pp. 3122-3130Sharma, R.A., Wasan, H.S., Love, S.B., FOXFIRE: A phase III clinical trial of chemo-radio-embolisation as first-line treatment of liver metastases in patients with colorectal cancer (2008) Clin Oncol (R Coll Radiol), 20, pp. 261-263Martin, R.C., Howard, J., Tomalty, D., Toxicity of irinotecaneluting beads in the treatment of hepatic malignancies: Results of a multi-institutional registry (2010) Cardiovasc Intervent Radiol, 33, pp. 960-966Borner, M., Castiglione, M., Triller, J., Considerable side effects of chemoembolization for colorectal carcinoma metastatic to the liver (1992) Ann Oncol, 3, pp. 113-115Martinelli, D.J., Wadler, S., Bakal, C.W., Cynamon, J., Rozenblit, A., Haynes, H., Kaleya, R., Wiernik, P.H., Utility of embolization or chemoembolization as second-line treatment in patients with advanced or recurrent colorectal carcinoma (1994) Cancer, 74 (6), pp. 1706-1712. , DOI 10.1002/1097-0142(19940915)74:6<1706::AID-CNCRLeichman, C.G., Jacobson, J.R., Modiano, M., Daniels, J.R., Zalupski, M.M., Doroshow, J.H., Fletcher, W.S., Macdonald, J.S., Hepatic chemoembolization combined with systemic infusion of 5- fluorouracil and bolus leucovorin for patients with metastatic colorectal carcinoma: A southwest oncology group pilot trial (1999) Cancer, 86 (5), pp. 775-781. , DOI 10.1002/(SICI)1097-0142(19990901)86:5<775::AI