Alternative regimens for prostate cancer treatment using radiation therapy

Purpose/Objective: The purpose of this work was to determine biologically equivalent alternative regimens for the treatment of prostate cancer using External Beam Radiotherapy (EBRT) and Low Dose-Rate Brachytherapy (LDRBT) with 125I implants and to evaluate the sensitivity of these regimens to different sets of radiobiological parameters of the Linear-Quadratic (LQ) model

Um estudo sobre a execução de sons e criação de músicas no software GeoGebra

Apresenta-se nesse artigo um estudo no software GeoGebra sobre a execução de sons a partir de funções trigonométricas e a criação de músicas através de instrumentos e notas musicais pré-programadas, relacionando a Matemática, a Música e a Física do Som, cujo principal objetivo é o de utilizar o recurso de emissão de sons através de gráficos de funções trigonométricas e sons musicais presente no GeoGebra. Apresentam-se dois objetos de aprendizagem, bem como, o passo a passo de suas construções, evidenciando as relações existentes entre a Matemática e a Música e contextualizando este estudo com as ondas sonoras, em uma proposta interdisciplinar, utilizando-se de tecnologias

RESOLUTIVIDADE DOS CUIDADOS À SAÚDE EM REGIÃO DE FRONTEIRA PARA BRASILEIROS NÃO RESIDENTES

Objetivo: Identificar a resolutividade do cuidado na atenção primária à saúde de brasileiros não residentes na região da tríplice fronteira. Metodologia: Pesquisa qualitativa, exploratória, do tipo estudo de caso, utilizando-se o referencial do materialismo histórico. A coleta de dados foi realizada por meio de entrevistas semiestruturadas com treze usuários do serviço de atenção primária no município de Foz do Iguaçu e em Puerto Iguazu, na Argentina e a análise dos dados foi temática. Resultados: Foi identificado que os usuários têm trilhado caminhos longos para buscar saúde para si ou para seus familiares e com pouca resolutividade em muitos casos, satisfatória ou sem resolutividade em outros. Considerações: Novas e diferentes intervenções relacionadas à gestão do cuidado e ao processo de trabalho precisam ser realizadas com vistas a uma atenção primária a saúde mais resolutiva

Pleurodese experimental induzida por antibióticos (macrolídeos e quinolonas)

PURPOSE: Chemical pleurodesis is a therapeutic tool for the treatment of recurrent pleural effusions, mainly those of neoplastic etiology. In the past, tetracycline was the sclerosant agent of choice in clinical practice, but presently, there is no consensus about an ideal agent. The aim of this study was to evaluate the effectiveness of macrolides (azithromycin and clarithromycin) or quinolones (levofloxacin and gatifloxacin) in inducing experimental pleurodesis in rabbits. METHOD: Forty New Zealand rabbits randomized into groups of 10 received (at a total volume of 2 mL for each animal) 1 of the 4 drugs by intrapleural injection. After 28 days, the animals were euthanized and the pleural cavity was evaluated macroscopically and microscopically. RESULTS: The intensity of the macroscopic adhesions was mild in all groups. On microscopic analysis, minimal pleural fibrosis and inflammation were observed in all animals. CONCLUSION: The macrolides (azithromycin or clarithromycin) and the quinolones (levofloxacin or gatifloxacin) when injected into the normal pleural space of rabbits are not effective in promoting pleurodesis. Additional research is required to identify sclerosing agents capable of inducing pleurodesis.OBJETIVO: A pleurodese química representa uma ferramenta terapêutica utilizada no tratamento dos processos pleurais recidivantes, principalmente nos derrames neoplásicos. A escolha do melhor esclerosante pleural é ainda motivo de controvérsia, não havendo consenso com relação ao agente considerado ideal. O objetivo deste estudo é avaliar a efetividade dos macrolídeos (azitromicina e claritromicina) e das quinolonas (levofloxacina e gatifloxacina) na indução de pleurodese experimental em coelhos. MÉTODOS: Quarenta animais randomizados em grupos de 10, receberam, em volume total de 2 mL, estas drogas através de injeção intrapleural. RESULTADOS: Após 28 dias, os animais foram sacrificados sendo avaliada a cavidade pleural. A intensidade das aderências macroscópicas assim como da fibrose e da inflamação observadas à microscopia foi discreta tanto no grupo que recebeu macrolídeos quanto naquele que recebeu quinolonas. CONCLUSÃO: Azitromicina, Claritromicina, Levofloxacina e Gatifloxacina quando injetados na cavidade pleural de coelhos, não são eficazes na indução de pleurodese. Novas pesquisas devem ser realizadas com o intuito de identificar agentes esclerosantes capazes de produzir sínfise pleural

Modelo experimental de doença pleural maligna induzida por células LLC (Lewis Lung Carcinoma)

Derrame pleural maligno (DPM) é um fator de mau prognóstico em pacientes com câncer de pulmão avançado. Sua patogênese ainda é pouco compreendida e as opções terapêuticas são limitadas. Modelos animais de DPM podem demonstrar novos aspectos fisiopatológicos desta doença. Stathopoulos et al. em 2006 (Am J Respir Cell Mol Biol. 2006;34:142-50) descreveram um modelo de DPM com 1,5 x105 células de LLC injetadas diretamente no espaço pleural de camundongos. Os autores relataram carcinomatose com derrame pleural, tumores pleurais e 100% de mortalidade após 17 dias. [...

Treatment of winery wastewater by combined almond skin coagulant and sulfate radicals: assessment of HSO5− activators

The large production of wine and almonds leads to the generation of sub-products, such as winery wastewater (WW) and almond skin. WW is characterized by its high content of recalcitrant organic matter (biodegradability index < 0.30). Therefore, the aim of this work was to (1) apply the coagulation–flocculation–decantation (CFD) process with an organic coagulant based on almond skin extract (ASE), (2) treat the organic recalcitrant matter through sulfate radical advanced oxidation processes (SR-AOPs) and (3) evaluate the efficiency of combined CFD with UV-A, UV-C and ultrasound (US) reactors. The CFD process was applied with variation in the ASE concentration vs. pH, with results showing a chemical oxygen demand (COD) removal of 61.2% (0.5 g/L ASE, pH = 3.0). After CFD, the germination index (GI) of cucumber and corn seeds was ≥80%; thus, the sludge can be recycled as fertilizer. The SR-AOP initial conditions were achieved by the application of a Box–Behnken response surface methodology, which described the relationship between three independent variables (peroxymonosulfate (PMS) concentration, cobalt (Co2+) concentration and UV-A radiation intensity). Afterwards, the SR-AOPs were optimized by varying the pH, temperature, catalyst type and reagent addition manner. With the application of CFD as a pre-treatment followed by SR-AOP under optimal conditions (pH = 6.0, [PMS] = 5.88 mM, [Co2+] = 5 mM, T = 343 K, reaction time 240 min), the COD removal increased to 85.9, 82.6 and 80.2%, respectively, for UV-A, UV-C and US reactors. All treated wastewater met the Portuguese legislation for discharge in a municipal sewage network (COD ≤ 1000 mg O2/L). As a final remark, the combination of CFD with SR-AOPs is a sustainable, safe and clean strategy for WW treatment and subproduct valorization.Fundação para a Ciência e a Tecnologia | Ref. UIDB/00616/2020Fundação para a Ciência e a Tecnologia | Ref. UI/BD/150847/2020CCRN - Comissão de Coordenação da Região Norte | Ref. NORTE-01- 0145-FEDER-00004

Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status

OBJECTIVES: To evaluate the effectiveness and safety of pleurodesis carried out entirely on an outpatient basis in patients with recurrent malignant pleural effusions and Karnofsky Performance Status scores <70. METHODS: This study was a prospective trial comprising patients with symptomatic recurrent malignant pleural effusion and Karnofsky Performance Status scores <70 but &gt;30. All selected patients underwent pleural catheter placement (14 Fr) in an outpatient facility. When chest radiography revealed post-drainage lung expansion of &gt;90%, pleurodesis (3 g of talc) was performed. Catheters were maintained until the daily output was ,100 mL/day. The patients were evaluated in the first month and every three months thereafter for fluid recurrence, the need for additional procedures, and complications. RESULTS: During the study period (January 2005 to July 2007), 64 patients (24 men, 40 women), with an average age of 61.4 years, underwent elective chest tube drainage. Primary sites of the underlying malignancy were breast (27), lung (22), and others (15). Sixty-six pleural catheters were placed (bilaterally in 2 patients), and 52 talc pleurodesis procedures were performed. Fourteen patients had a trapped lung and were excluded from the trial. No complications were observed during catheter placement or pleurodesis. Post-pleurodesis complications included catheter obstruction (4 patients) and empyema (1). The average drainage time was 9.9 days. The recurrence rate observed in patients that were alive 30 days after pleurodesis was 13.9% (5/36 patients). Six patients required additional procedures after the pleurodesis. The average survival time was 101 days. CONCLUSION: In this study, talc pleurodesis was safely performed in an outpatient setting with good efficacy and a reasonable complication rate, thereby avoiding hospital admission

Effectiveness of silver nitrate compared to talc slurry as pleural sclerosing agent in rabbits. Influence of concomitant intrapleural lidocaine

Não está ainda definido, qual o agente ideal para a produção de uma pleurodese efetiva. O talco é o agente mais freqüentemente utilizado apesar de suas manifestações colaterais. Outra possibilidade é o nitrato de prata, largamente usado no passado. OBJETIVOS: Determinar a influência da injeção intrapleural de lidocaina na produção de pleurodese com nitrato de prata, definir o efeito da lidocaina na maturação das fibras colágenas e confirmar que a pleurodese produzida pelo nitrato de prata é mais potente que a conseqüente à injeção intrapleural de talco. MÉTODOS: Foram estudados três grupos de 8 coelhos. Dois receberam nitrato de prata a 0,5%; em um deles, foi injetado previamente 0,5 ml de lidocaina a 2%. O terceiro grupo recebeu 2 ml de talco (400 mg/kg). Os animais foram sacrificados após 28 dias da injeção intrapleural e as cavidades pleurais examinadas macroscopicamente, analisando-se a presença de fusão entre os folhetos pleurais e microscopicamente avaliando-se a inflamação e a fibrose. Quantificou-se o total de colágeno na pleura e a distribuição de fibras finas e grossas, utilizando-se a coloração de pricrosirius. RESULTADOS: Nos dois grupos em que se injetou nitrato de prata (s/ lidocaina: 3.5 + 0.3 e com lidocaina: 3.2 + 0.3), a pleurodese macroscópica (scala 0 - 4) foi significantemente (p = 0.001) melhor do que a pleurodese resultante do talco (1.6 + 0.2). A média da fibrose pleural induzida pelo nitrato de prata (3.5 + 0.2) foi significantemente (p = 0.004) mais acentuada do que a produzida por talco (1.9 + 0.1). A instilação prévia de lidocaina determinou tendência a diminuir a quantidade de fibrose (3.1 + 0.4). A média (10³mm²) do colágeno pleural foi significantemente (p = 0.009) maior nos coelhos que receberam nitrato de prata (116.9 + 22.7) do que naqueles que receberam talco (10.7 + 3.4). A injeção de lidocaina reduziu discretamente o colágeno (80.1 + 30.3). A distribuição das fibras colágenas não foi diferente entre os grupos estudados. CONCLUSÃO: Este modelo animal confirma que, o nitrato de prata injetado no espaço pleural mais efetivo do que o talco na produção de pleurodese. A injeção intrapleural de lidocaina determina uma tendência a reduzir a quantidade de colágeno, mas não muda a efetividade da sínfise pleural ou modifica a maturação do colágeno.The ideal agent for producing pleurodesis has not been identified. Talc, the most commonly used, poses several problems. Another possibility is silver nitrate, which was widely used in the past. PURPOSE: To determine the influence of the intrapleural instillation of lidocaine in producing a pleurodesis with silver nitrate, to define the effect of lidocaine in the maturation of the collagen fibers, and to confirm that the pleurodesis after silver nitrate is stronger than after talc. METHODS: We studied three groups of 8 rabbits. Two groups received 0.5% silver nitrate; in one we had previously injected 0.5 ml of 2% lidocaine. The third group received 400 mg/kg talc (2 ml). The animals were sacrificed 28 days after the injection, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation and fibrosis. The total amount of pleural collagen and the distribution of thick and thin collagen fibers were quantified. Collagen was identified using picrosirius red stain. RESULTS: In the two groups that received silver nitrate (without lidocaine: 3.5 + 03 and with lidocaine: 3.2 + 0.3), the macroscopic pleurodesis (scale 0 -- 4) was significantly (p = 0.001) better than that resulting from talc (1.6 + 0.2). The mean degree of pleural fibrosis induced by silver nitrate (3.5 + 0.2) was significantly (p = 0.004) higher than that induced by talc (1.9 + 0.1). The previous instillation of lidocaine resulted in a tendency for decreased amounts of fibrosis (3.1 + 0.4). The mean amount (10³mm²) of pleural collagen was significantly (p = 0.009) greater in the rabbits that received silver nitrate (116.9 + 22.7) than in those that received talc (10.7 + 3.4). The injection of lidocaine slightly reduced the collagen (80.1 + 30.3). The distribution of collagen fibers did not differ among the groups. CONCLUSION: This rabbit model clearly confirms that intrapleural silver nitrate is more effective than talc for producing pleurodesis. The previous intrapleural instillation of lidocaine results in a decreasing trend in the amount of collagen, but does not change the effectiveness of the pleural fusion or modify the process of collagen maturation