Metástase ocular como apresentação inicial de carcinoma de células renais: relato de dois casos

Authors report the cases of 2 patients who had an ocular lesion as the first sign leading to diagnosis of renal cell carcinoma, an uncommon presentation of this neoplasm. The first patient was a 59-year-old man presented with a mass in the right eye. The histological and immunohistochemical profile of the biopsy showed a probable renal cell carcinoma. A CT scan showed a solid mass in the left kidney. The patient underwent radical nephrectomy and excision of the ocular lesion and had an uneventful evolution. The second patient was a 72-year-old man presenting with an ulcerated lesion on the right inferior tarsal conjunctiva. An excisional biopsy of the lesion showed histological and immunohistochemical patterns of a clear cell carcinoma. Abdominal tomography disclosed a right peripheral renal tumor. A right radical nephrectomy was performed. Renal cell carcinoma may present atypically with metastases to quite uncommon organs. Nephrectomy may be of value in selected cases; the ocular metastases are usually excised for aesthetic and functional reasons.Os autores apresentam dois casos de metástase ocular como o primeiro sinal que levou ao diagnóstico de carcinoma renal, uma apresentação incomum desta neoplasia. O primeiro paciente era um homem de 59 anos com uma massa no olho direito. O perfil histológico e imunohistoquimico demonstraram um provável carcinoma de células renais. A tomografia computadorizada revelou uma massa sólida no rim esquerdo, e o paciente foi submetido a nefrectomia radical esquerda, apresentando uma evolução sem complicações. O segundo paciente era um homem com 72 anos portador de uma lesão ulcerada na conjuntiva tarsal inferior direita. Uma biopsia excisional da lesão demonstrou um padrão histológico e imunohistoquimico de carcinoma de células renais. A tomografia de abdômen demonstrou um tumor periférico em rim direito, sendo o paciente submetido a nefrectomia radical. O carcinoma de células renais pode se apresentar atipicamente com metástases para órgãos incomuns. Nefrectomia pode ser útil em casos selecionados. As metástases oculares geralmente são excisadas por razoes estéticas e funcionais

Radionuclide Migration: A Numerical Study

Crystalline rock has been considered as a potentially suitable matrix for high-level radioactive waste (HLW) repository because it is found in very stable geological formations and may have very low permeability. A common problem encountered in this context is the modeling of migration of radio nuclides in a fractured medium. Generally, this consists of a large main fracture, which is surrounded by a rock matrix. Transport in the main fracture is usually assumed to obey an advection-dispersion relation, while molecular diffusion is the assumed dominant mechanism of transport in the porous rock. In this work, a numerical study of the governing partial differential equations is done, to describe radionuclide movement in the fracture and within the rock matrix. The adopted physical system consists of the rock matrix containing a single planar fracture situated in water saturated porous rock. The initial radionuclide concentrations are assumed to be zero in both fractured and rock matrices. As inlet boundary condition, a kinetic solubility-limited dissolution model is used, in order to calculate the radionuclide concentration in the fracture. The solution of the governing partial differential equations was obtained by finite difference methods, namely: fully explicit, fully implicit and Crank-Nicolson discretization schemes. Note that the influence of the advective term was considered in the partial differential equation in the fracture, in such discretization schemes. It was shown that all numerical schemes are consistent and that the explicit method, in all configurations of the advective term, and the implicit methods and Crank-Nicolson, for the forward discretization in the advective term, presented stability conditions to be considered

Modeling Grounding Systems for Electromagnetic Compatibility Analysis

In recent years, the development of smart grids for power distribution and the increasing usage of 5G communication networks have played a large impact on the resilience and reliability of grounding systems. Unexpected electromagnetic coupling between a communication tower and the one used for the electric power networks may pose a threat to the suitable performance of either system as one must assure that electromagnetic compatibility together with unexpected transient issues is within reasonable parameters. This requires wideband modeling of a grounding system, typically carried out using numerical approaches based on the Method of Moments. This modeling is implied in numerous segments to represent the conductors involved and the numerical solution of a double integral for each one of these segments. The modified nodal formulation used to obtain system voltages and branch currents is first solved in the frequency domain, leading to a heavy computational burden and a time-consuming simulation. This chapter briefly reviews the procedure used to model grounding grids and presents some results to illustrate the typical behavior. Afterward, a more complex system comprising a case of electromagnetic coupling is then analyzed to illustrate the impact of nearby grounding grids

New Materials to Solve Energy Issues through Photochemical and Photophysical Processes: The Kinetics Involved

Kinetic rates of energy production are extremely controlled by the competing processes that occur in systems capable of energy transfer. Besides organic and inorganic compounds already known as electronically actives, supramolecular systems can be thought to form energy transfer complexes to efficiently convert, for instance, light into electricity and the mechanisms for that can be of any kind. Photophysical and photochemical processes can simultaneously occur in such systems to provide energy conversion, by competing mechanisms or collaborative ones. Thus, to investigate the kinetic rates of each process and to understand the dynamics of the electronic excited states population and depopulation in strategically structured materials, can offer important tools to efficiently make use of this not always so evident power of supramolecular materials. In this chapter, we present the state-of-the-art of the use of photophysical processes and photochemical changes, presented by new materials and devices to provide a control of energy transfer processes and enable distinct applications, since energy conversion to sensing and imaging techniques to material characterization

Extracellular Matrix Proteome Remodeling in Human Glioblastoma and Medulloblastoma

Medulloblastomas (MBs) and glioblastomas (GBMs) are high-incidence central nervous system tumors. Different origin sites and changes in the tissue microenvironment have been associated with the onset and progression. Here, we describe differences between the extracellular matrix (ECM) signatures of these tumors. We compared the proteomic profiles of MB and GBM decellularized tumor samples between each other and their normal decellularized brain site counterparts. Our analysis revealed that 19, 28, and 11 ECM proteins were differentially expressed in MBs, GBMs, and in both MBs and GBMs, respectively. Next, we validated key findings by using a protein tissue array with 53 MB and 55 GBM cases and evaluated the clinical relevance of the identified differentially expressed proteins through their analysis on publicly available datasets, 763 MB samples from the GSE50161 and GSE85217 studies, and 115 GBM samples from RNAseq-TCGA. We report a shift toward a denser fibrillary ECM as well as a clear alteration in the glycoprotein signature, which influences the tumor pathophysiology. MS data have been submitted to the PRIDE repository, project accession: PXD023350

Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance

Background: This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods: This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results: 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions: HAI increased during COVID-19. The microorganisms’ susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use