Epidermal growth factor receptor and KRAS mutations in Brazilian lung cancer patients

OBJECTIVE: Epidermal growth factor receptor is involved in the pathogenesis of non-small cell lung cancer and has recently emerged as an important target for molecular therapeutics. The KRAS oncogene also plays an important role in the development of lung cancer. The aim of this study was to evaluate the frequency of epidermal growth factor receptor and KRAS mutations in a population of Brazilian patients with non-small cell lung cancer. METHODS: A total of 207 specimens from Brazilian patients with non-small cell lung cancer were analyzed for activating epidermal growth factor receptor and KRAS somatic mutations, and their associations with clinicopathological characteristics (including age, gender, ethnicity, smoking habits, and histological subtype) were examined. RESULTS: We identified 63 cases (30.4%) with epidermal growth factor receptor mutations and 30 cases (14.6%) with KRAS mutations. The most frequent epidermal growth factor receptor mutation we detected was a deletion in exon 19 (60.3%, 38 patients), followed by an L858R amino acid substitution in exon 21 (27%, 17 patients). The most common types of KRAS mutations were found in codon 12. There were no significant differences in epidermal growth factor receptor or KRAS mutations by gender or primary versus metastatic lung cancer. There was a higher prevalence of KRAS mutations in the non-Asian patients. Epidermal growth factor receptor mutations were more prevalent in adenocarcinomas than in non-adenocarcinoma histological types. Being a non-smoker was significantly associated with the prevalence of epidermal growth factor receptor mutations, but the prevalence of KRAS mutations was significantly associated with smoking. CONCLUSIONS: This study is the first to examine the prevalence of epidermal growth factor receptor and KRAS mutations in a Brazilian population sample with non-small cell lung cancer

Antibacterial Effect of Photodynamic Therapy on Root Canal Disinfection Combined with Different Irrigation Protocols

Introduction: Photodynamic therapy (PDT) is an emerging alternative therapy to conventional endodontic treatment to optimize bacterial elimination. The aim of this study was to evaluate the in vitro antibacterial effect of PDT combined with different irrigation protocols on root canals inoculated with Enterococcus (E.) faecalis. Methods and Materials: Ninety uni-radicular human premolars were prepared and contaminated with E. faecalis for 4 days. Teeth were randomly divided into six groups: positive control group (C+) consisted of conventional needle irrigation with 2.5% sodium hypochlorite (NaOCl); negative control group (C-) consisted of no treatment after contamination; PDT group as treated with 0.005% methylene blue and diode laser irradiation for 90 sec at wavelength of 660 nm, energy of 9 Joules, power of 100 mW; the fourth group consisted of  NaOCl+PDT, the fifth group were treated with passive ultrasonic irrigation (PUI) with NaOCl+PDT (PUI+PDT); and the final group were treated with XP Endo Finisher with NaOCl+PDT (XP Endo+PDT). The contents of the root canals were collected with sterile absorbent paper points at two times: before and 24 h after decontamination protocols. The number of colony-forming units (CFU) was determined for each root canal. ANOVA and the Tukey test were used, with significance set at 5% (P<0.05). Results: The inhibition percentage ranged from 10.72 (C-) to 100% (XP Endo+PDT), with CFU/mL counts differing among all protocols tested (P<0.05). The different protocols significantly influenced bacterial inhibition (P<0.05). However, the XP Endo+PDT protocol resulted in the highest inhibition percentage (100%), followed by NaOCl+PDT (65.85%). Conclusions: PDT combined with different final irrigation protocols was more effective in inhibiting E. faecalis growth than photodynamic therapy alone. XP Endo was the best irrigation protocol to eradicate this microorganism.Keywords: Biofilm; Endodontics; Enterococcus faecalis; Photodynamic Therap

Immune-Mediated Hemolytic Anemia in a Bitch Triggered by Drugs

Background: Immune-mediated hemolytic anemia (IMHA) is characterized by an autoimmune response with production of auto-antibodies and destruction of erythrocytes resulting in anemia. Primary IMHA is referred to a condition when the cause is unknown (idiopathic), whereas secondary IMHA involves changes in red blood cells caused by the action of drugs, neoplasms, or infectious diseases. The diagnosis can be made through changes in the blood count, usually of a regenerative character, Coombs test, and autoagglutination test. The present study aimed to report a case of drug-induced hemolytic anemia, with emphasis on the clinical signs, diagnostic methods, and treatment, in a female dog.Case: A 9-year-old mixed-breed bitch weighing 29.6 kg was referred to the Veterinary Medical Teaching Hospital (HCV-UFRGS) with a previous diagnosis of gallbladder mucocele that was unresponsive to clinical treatment. After laboratory tests, cholecystectomy was performed, and the procedure required conversion from laparoscopic to open cholecystectomy. Therapy included administration of amoxicillin, dipyrone, tramadol hydrochloride, and meloxicam. Three days after surgery, the dog presented with apathy, lethargy, hyporexia, and a pale and subicteric mucosa. The patient developed hypochromic macrocytic anemia with reticulocytosis, spherocytosis, anisocytosis, and leukocytosis with neutrophilia. The result of the autoagglutination test was positive, confirming the diagnosis. All medications were suspended, and immunosuppressive treatment with dexamethasone was included, with a subsequent switch to prednisolone. After 10 days of treatment, the patient experienced significant improvement, and therapy was discontinued.Discussion: Based on the patient's history, the cause of the IMHA was secondary to drug administration, and it is not possible to distinguish if it was due to one or a combination of drugs, as they were all started and stopped simultaneously. The patient had hypothyroidism, which may have contributed to the production of antibodies against TSH receptors, blocking the hormone's action, thereby causing tissue damage due to T cell-mediated cytotoxicity and the effect of cytokines. The pale and subicteric mucosa, apathy, weakness, lethargy, exercise intolerance, and dyspnea resulted from extravascular hemolysis and bilirubin released from erythrocyte rupture with a subsequent decrease in the number of red blood cells, leading to oxygen transport deficiency. The diagnosis is based on the blood count and results of autoagglutination supported by the response to immunosuppressive therapy. Anemia results in increased production and release of precursor cells from the bone marrow, accompanied by reticulocytosis and increased mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). The treatment of IMHA consists of supportive care and immunosuppressive therapy with corticosteroids to ensure suppression of the immune system, preventing response against erythrocytes. Initially, tramadol hydrochloride, dipyrone, and amoxicillin with potassium clavulanate were suspended to interrupt the cause of IMHA, and administration of dexamethasone in an immunosuppressive dose was started. Therefore, it is important to include drug-induced IMHA in the differential diagnosis of patients who present with anemia after using medications. Early diagnosis, initiation of therapy, and adequate care were important factors for the recovery of the animal.Título: Anemia hemolítica imunomediada medicamentosa em uma cadelaKeywords: dog, hypochromic macrocytic anemia, erythrocyte, hemoglobin, spherocyte.Descritores: cão, anemia macrocítica hipocrômica, eritrócito, hemoglobina, esferócito.

Neoplasias de glândulas salivares menores - estudo retrospectivo de 83 casos

Objetivo: Analisar os achados clínicos e histopatológicos de neoplasias de glândulas salivares menores arquivadas no Serviço de Ana- tomia Patológica da Disciplina de Patologia Oral do Departamento de Odontologia da Universidade Federal do Rio Grande do Norte. Métodos: Dados referentes à idade e gênero dos pacientes e localização anatômica das neoplasias de glândulas salivares menores, diagnosticadas no período de janeiro de 1970 a dezembro de 2007, foram obtidos em fichas de requisição de biópsia. Para o estudo histopatológico, cortes histológicos corados em hematoxilina e eosina foram avaliados sob microscopia de luz. Resultados: Foram identificados 83 casos. Destes, 69,9% acometeram o gênero feminino. Pacientes com neoplasias malignas apresenta- ram maior média de idade (47,6 anos) que pacientes com neoplasias benignas (40,7 anos). Os sítios anatômicos mais acometidos fo- ram: palato (43,4%), mucosa jugal (10,8%), lábio superior (10,8%) e rebordo alveolar (10,8%). Os três tipos histológicos mais frequentes foram: adenoma pleomórfico (38,6%), carcinoma mucoepidermóide (18,1%) e carcinoma adenóide cístico (13,3%). Conclusão: Neoplasias de glândulas salivares menores afetaram com maior frequência o gênero feminino. Pacientes com neoplasias ma- lignas apresentaram maior média de idade ao diagnóstico da condição. O subtipo histológico mais comum foi o adenoma pleomórfico, seguido do carcinoma mucoepidermóide e do carcinoma adenóide cístico. Em conjunto, estas três neoplasias perfizeram 70,0% de todos os tumores diagnosticados

Uretrostomia pré-púbica vídeo-assistida : modelo experimental em coelhos

The purpose of this study was to develop a laparoscopic-assisted prepubic urethorstomy (PPU) technique using rabbits as an experimental model. Six male New Zealand rabbits (Oryctolagus cuniculus) over six months old and weighing between 3 and 4kg (3.5kg ± 0.4) were used in this study. The animals underwent laparoscopic dissection of the pelvic urethra, which was then exposed for the laparoscopicassisted urethrostomy procedure. The proposed model for training of laparoscopic-assisted PPU in rabbits was considered effective and feasible. It proved to be a simple technique even for surgeons under basic endosurgery skills training, with possibilities of employing the technique for the treatment of cats with loss of function of the distal urethra.Este estudo objetivou o desenvolvimento de uma técnica de uretrostomia pré-púbica (UPP) vídeo-assistida, utilizando coelhos como modelo experimental. Foram utilizados seis coelhos Nova Zelândia (Oryctolagus cuniculus), machos, com peso médio de 3.5kg (± 0.4), com idade acima de seis meses. Os animais foram submetidos à dissecação laparoscópica da uretra pélvica e posterior exposição desta para a realização de uretrostomia vídeo-assistida. O modelo proposto para treinamento de UPP vídeo-assistida em coelho foi considerado eficaz e factível, mostrando-se uma técnica exequível mesmo por videocirurgiões iniciantes, havendo possibilidade de seu emprego no tratamento de gatos com perda na função da uretra distal

Elective Laparoscopic Ovariectomy in Domestic Swine (Sus scrofa domesticus)

Background:In the last years the number of exotic company animals has been increased, and the demand for neutering services for these animals has become greater. By the author’s knowledge, there are no records of elective ovariectomy in domestic swine (Sus scrofa domesticus). The current paper reports a case of elective laparoscopic ovariectomy in a domestic swine (Sus scrofa domesticus).Case:A 4-month-old domestic swine (Sus scrofa domesticus), weighing 45 kg was referred to elective video-laparoscopic ovariectomy at the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (HCV - UFRGS). Physical examination and laboratory tests, including hemogram and biochemistry (alanine aminotransferase - ALT, serum albumin and creatinine), were within normal range for the species. Ketamine hydrochloride (Cetamin®) 10 mg.kg-1, xylazine hydrochloride (Xilazin®) 2 mg.kg-1, and midazolam (Midazolam®) 0.5 mg.kg-1 were administered intramuscularly (IM) as pre-anesthetic medication. The anesthetic induction was performed with intravenous (IV) propofol (Propovan®) and anesthesia was maintained with isoflurane (Isoforine®) diluted in O2 by a universal vaporizer with a partial gas rebreathing anesthetic system. Throughout the procedure, were monitoring constantly the invasive blood pressure (IBP), electrocardiogram (ECG) in lead II, peripheral arterial saturation with O2 (SpO2), end-tidal carbon dioxide concentration (ETCO2), and esophageal temperature. The abdominal cavity was accessed through the insertion of three portals (one of 10 mm of diameter and other two of 5 mm of diameter). The cavity was inflated with medicinal CO2 until the pressure of 10 mmHg was achieved. The uterine body and ovaries were identified. The right ovary was suspended and, by a bipolar clamp, the ovarian vessels were occluded through electrocoagulation in three distinct locations with approximately 0,5 cm between themselves, and cut off. The right ovary was removed from the cavity. An identic maneuver was used for the realization of the surgical steps and removal of the left ovary. By the end, the cavity was deflated and the cannulas were removed. The abdominal wall was sutured with Sultan pattern with 3-0 polyglycolic acid thread, and the skin was sutured with simple interrupted suture with 3-0 nylon monofilament. The post-operative evaluations were subjective and fitting with the patient's behavior. The patient didn't show any clinical signs of pain, discomfort and returned to its usual eating habits on the second day after the procedure. No signs of infection, dehiscence, cicatrization retard or other complications were observed in the surgical wound. The stitches were removed after seven days.Discussion: This case report shows the applicability of the video-laparoscopic ovariectomy technique by three portals in other species than dogs and cats, and serves as bibliographic support to the veterinary endosurgery field. Based on previous studies, it has been concluded that minimally invasive procedures represent the most beneficial sterilization methods to the patient due to its diagnostical and surgical capacity, as well as minor surgical trauma and shorter recovery time. The most common indication for the video-laparoscopic technique in veterinary routine is the elective sterilization. Pyometra, urinary incontinence and weight gain are complications that are not diagnosed more frequently after ovariectomy when compared to ovariohysterectomy. The laparoscopic ovariectomy is a viable technique to be applied to the swine, with the most difficult aspect being the anatomical peculiarities of the animal

Motivações para a violência no contexto escolar sob a óptica do adolescente

Objective: to understand the motivations that lead to the practice of violence in the school context from the perspective of adolescents. Method: we used the qualitative method, and data collected through interviews. The data were evaluated using content analysis. Results: for adolescents, the reasons for school violence were issues related to affective relations between partners, disregard for the physical and social characteristics of the subjects, resistance to the imposition of rules, influence of family structure and drug use. Conclusion: the research shows that the source of violence is multifactorial roots. We stress the need to integrate actions from various sectors in the context of everyday practices of the school, the prospect of building a network capable of providing better care and achieve greater compliance of adolescents, guiding actions to empower them on their access rights services of health promotionObjetivos: entender las motivaciones que llevan a la práctica de la violencia en el ámbito escolar desde la perspectiva de los adolescentes. Metodología: se utilizó el método cualitativo, y los datos recogidos a través de entrevistas fueron evaluados mediante análisis de contenido. Resultados: para los adolescentes, las razones de la violencia escolar fueron las relaciones afectivas, desconocimiento de las características físicas y sociales de los sujetos, resistencia a la imposición de normas, influencia de la estructura familiar y consumo de drogas. Conclusión: la investigación muestra que el origen de violencia es multifactorial raíces. Destaca la necesidad de integrar acciones de varios sectores en el contexto de las prácticas cotidianas de la escuela, la perspectiva de construir una red capaz de ofrecer mejor atención y lograr un mayor cumplimiento de los adolescentes, para orientar las acciones para fortalecerlas en sus derechos de acceso servicios de promoción de la salud.Objetivos: Compreender as motivações que levam à prática de violência no contexto escolar, sob a óptica dos adolescentes. Método: Utilizou-se o método qualitativo, sendo os dados colhidos por meio de entrevista. Os dados foram avaliados por meio da análise de conteúdo. Resultados: Para os adolescentes, as motivações para a violência escolar foram: questões relacionadas a relações entre parceiros afetivos, desrespeito às características físicas e sociais dos sujeitos, resistência à imposição de regras, influência da estrutura familiar e uso de drogas. Considerações finais: A pesquisa mostra que a origem da violência tem raízes multifatoriais. Ressalta-se a necessidade de integrar ações de diversos setores ao contexto das práticas no cotidiano da escola, na perspectiva de construção de uma rede que permita prestar melhor assistência e conseguir maior adesão dos adolescentes, direcionando ações para empoderá-los sobre seus direitos de acesso aos serviços de promoção da saúde

Architectural Anatomy in the work of Eileen Gray. A Comparative Analysis Identifying the Authorship Behind the Design of the E.1027

La escasa producción arquitectónica de Eileen Gray y su aprendizaje autodidacta, ajeno al ámbito académico, han contribuido a cuestionar su protagonismo en el proyecto de la vivienda E.1027, realizado junto a Jean Badovici, arquitecto y director de la revista L’Architecture Vivante. Esta investigación compara su lenguaje arquitectónico con el de otros de sus proyectos desarrollados en solitario. Se abordan paralelismos e influencias de su obra con aquella modernidad temprana que ella reinterpretaba siempre con una mirada crítica. Dichas comparaciones permiten identificar las cualidades más relevantes de su arquitectura, además de demostrar su protagonismo en el diseño de la E.1027 y relegar a Badovici al papel de consultor técnico, mentor y asesor crítico. La compleja densidad espacial y las relaciones entre lugar, arquitectura y equipamiento se muestran como huellas objetivas para confirmar esta hipótesis y valorar la importancia de su talento como pionera de la modernidad.Eileen Gray’s limited architectural production and her non-academic architectural self-training in architecture have contributed to questioning her role in the authorship of the E.1027, a house designed collaboratively with Jean Badovici, architect and director of the journal L’Architecture Vivante. This article compares the architectural language of the E.1027 house with other projects and works carried out by Eileen Gray alone. Analogies and influences in her work are analysed; an architectural avant-garde at the onset of modernity that she reinterpreted under her attentive critical eye. This methodology has allowed us to identify the most relevant features of her architecture in addition to proof her leading role in the design of the E.1027, thus relegating Badovici’s role to that of a technical consultant, a mentor and a critical advisor. The complex spatial density, her particular understanding of the relationships between place, architecture and equipment, confirm our hypothesis supported by objective traces that may avoid the recurring questioning of her authorship accentuating her talent as a pioneer of modernity