19 research outputs found
Ischemic stroke after chemotherapy with cisplatin, etoposide and bleomycin: case report
A 20-year-old man with a germ cell tumor who experienced an ischemic stroke as a complication of cisplatin/etoposide/bleomycin based chemotherapy is reported. The previously reported cases are reviewed as well as the different physiopathologic mechanisms associated with vascular toxicity of this regimen.Relatamos o caso de um homem de 20 anos, com diagnóstico de tumor de células germinativas, que apresentou acidente vascular cerebral isquêmico durante quimioterapia com cisplatina, etoposide e bleomicina. Os casos relatados na literatura foram revisados, bem como os diferentes mecanismos fisiopatológicos implicados na toxicidade vascular deste esquema quimioterápico.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL
Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities
Acidente vascular cerebral isquĂŞmico apĂłs quimioterapia com cisplatina, etoposide e bleomicina: relato de caso
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4
While the increasing availability of global databases on ecological communities has advanced our knowledge
of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In
the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of
Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus
crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced
environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian
Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by
2050. This means that unless we take immediate action, we will not be able to establish their current status,
much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost
Tempo de espera para a radioterapia como um fator prognóstico em pacientes com glioblastoma em um cenário de disparidades médicas
Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.Objetivo Avaliar o efeito do tempo de espera (TE) atĂ© radioterapia na sobrevida global de pacientes com glioblastoma como um fator prognĂłstico confiável. MĂ©todo Estudo retrospectivo de 115 pacientes com glioblastoma, que foram submetidos Ă radioterapia pĂłs-operatĂłria, em dois serviços diferentes no Brasil (um pĂşblico e outro privado). Resultados Mediana de TE para radioterapia foi de 6 semanas (variação, 1,3-17,6). A mediana de sobrevida para TE ≤ 6 semanas foi de 13,5 meses (IC95%, 9,1-17,9) e para TE > 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,770-1,762; p = 0,470). Na análise multivariada, as variáveis associadas Ă sobrevida foram perfomance status (p < 0,001), extensĂŁo da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). ConclusĂŁo NĂŁo se observou impacto prognĂłstico para TE atĂ© a radioterapia na sobrevida. Diante de outros fatores prognĂłsticos, Ă© possĂvel assegurar de que o espaço de tempo atĂ© a radioterapia nĂŁo parece influenciar o controle da doença
Clinical findings in Creutzfeldt-Jakob disease mimicking dementia with Lewy bodies Achados clĂnicos da doença de Creutzfeldt-Jakob mimetizando demĂŞncia com corpos de Lewy
Hospital e Maternidade Santa Helena Equipe de NeurologiaUniversidade Federal de SĂŁo Paulo (UNIFESP) Departamento de NeurologiaUniversidade Federal de SĂŁo Paulo (UNIFESP) Setor de DistĂşrbios do MovimentoUNIFESP, Depto. de NeurologiaUNIFESP, Setor de DistĂşrbios do MovimentoSciEL