Treatment Of Bone Pain Secondary To Metastases Using Samarium-153-edtmp.

More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. Retrospective. Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects.122208-1

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Tratamento da dor óssea secundária a metástases com EDTMP-153-samário

CONTEXT: More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. OBJECTIVE: To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. TYPE OF STUDY: Retrospective. SETTING: Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). METHODS: Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). RESULTS: All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. DISCUSSION: Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. CONCLUSION: Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects.CONTEXTO: Mais de 50% dos pacientes com câncer de próstata, mama ou pulmão desenvolverão dor óssea secundária a metástases. O tratamento da dor óssea metastática visa minimizar a dor, reduzir o uso de opióides e manter os movimentos. OBJETIVO: Avaliar o uso de EDTMP-153Sm para tratamento da dor óssea secundária a metástases refratária a tratamento com opióides. TIPO DE ESTUDO: Retrospectivo. LOCAL: Divisão de Medicina Nuclear, Universidade Estadual de Campinas (Unicamp). MÉTODOS: 58 pacientes foram estudados (34 homens), com média de idade de 62 anos. 31 pacientes com neoplasia de próstata, 20 com neoplasia de mama, três pacientes com câncer de pulmão, um com hemangioendotelioma de pulmão, um com adenocarcinoma de paratireóide, um com osteosarcoma e um paciente que apresentava um tumor primário desconhecido. Todos apresentavam múltiplas metástases ósseas à cintilografia óssea com MDP-99mTc e foram tratados com EDTMP-153Sm. A resposta ao tratamento foi graduada em boa (redução da dor em 50 - 100%), intermediária (25-49%) e má (0-24%). RESULTADOS: Todos os pacientes apresentavam boa captação de EDTMP-153Sm nas metástases ósseas. Dentre os doentes com câncer de próstata, resposta intermediária ou boa ocorreu em 80.6% (25 pacientes) e má resposta em 19.4% (6). Dentre os pacientes com câncer de mama, 85% (17) apresentaram resposta intermediária ou boa à terapia enquanto 15% (3) apresentaram má resposta. Todos os três pacientes com câncer de pulmão apresentaram resposta pobre ao tratamento. Os doentes com hemangioendotelioma de pulmão e com o tumor primário desconhecido apresentaram resposta intermediária ao tratamento; os pacientes com osteossarcoma e com o adenocarcinoma de paratireóide apresentaram boa resposta. Mielotoxicidade significativa não ocorreu. DISCUSSÃO: O controle da dor é importante para melhorar a qualidade de vida do doente com câncer avançado. O mecanismo de alívio da dor com radionuclídeos ainda não foi elucidado, mas o tratamento é de simples administração e baixo risco de mielotoxidade. CONCLUSÃO: Tratamento com EDTMP-153Sm pode controlar a dor secundária a metástases ósseas de forma efetiva na maioria dos pacientes com câncer de próstata e câncer de mama sem efeitos colaterais significativos.20821

Desenvolvimento de extrato de pimenta-biquinho como forma de conservação pós-colheita

O consumo de pimenta-biquinho (Capsicum chinense) na forma in natura ou processada tem aumentado nos últimos anos. Entretanto, um dos grandes entraves em sua cadeia produtiva é a ocorrência de perdas consideráveis dos frutos após a colheita, indicando a necessidade de alternativas para sua conservação pós-colheita. Assim, objetivou-se desenvolver um extrato de pimenta-biquinho para ser utilizado como forma de conservação dessa hortaliça. Para o preparo do extrato, as pimentas foram lavadas, sanitizadas, branqueadas (80 o C/3min), trituradas e concentradas até o teor de sólidos solúveis de 12 o Brix. Avaliou-se durante os 90 dias de armazenamento: o rendimento, extrato seco, umidade, pH, acidez titulável, o teor de sólidos solúveis , cor (L*, a*, b*), índices chroma e hue, teor de vitamina C, carotenóides, contagem de fungos filamentosos e leveduras, mesófilos aeróbios, bactérias láticas, coliformes totais e termotolerantes, e pesquisa de Salmonella sp. Não houve variação de umidade, extrato seco, teor de sólidos solúveis e acidez titulável, porém observou-se variação do pH. Os valores de L* indicaram baixa luminosidade e os valores de a* e b* indicaram a tendência do extrato para coloração vermelha e amarela. A concentração de vitamina C e de carotenóides foi estável. A contagem de fungos filamentosos e leveduras variou de 2,0 a 4,1 Log UFC/g e de mesófilos aeróbios de <1,0 a 4,3 Log UFC/g. Por outro lado, a contagem de bactérias láticas foi <1,0 Log UFC/g, de coliformes totais e termotolerantes foi < 3 NMP/g e constatou-se ausência de Salmonella sp. em 25 g do extrato. Considerando seu rendimento e sua estabilidade físico-química e microbiológica, o extrato de pimenta-biquinho é uma excelente alternativa para o processamento dessa hortaliça em períodos de entressafra e para prevenção de perda de matéria-prima pela agroindústria que utilizam pimenta nas formulações de seus produtos derivados.The consumption of biquinho pepper (Capsicum chinense) has been increased in recent years as in natura form or processed. However, one of the main problems in its production chain is the occurrence of considerable losses of fruits after harvest, which indicates the need to develop alternative ways to post- harvest conservation. Thus, the aim of this study was to develop an extract of biquinho pepper in order to conservate this vegetable. In order to prepare the extract, the peppers were washed, sanitized, bleached (80 °C/3min), crushed and concentrated until 12 o Brix. The yield, dry extract, moisture, pH, titratable acidity, °Brix, color (L *, a *, b *), chroma and hue indexes, vitamin C and carotenoid content, besides counts of molds and yeast, aerobic mesophilic microorganisms, lactic acid bacteria, total and fecal coliforms, and Salmonella sp. were evaluated during the 90 days of storage. There was not variation of moisture, dry extract, o Brix and acidity. However, it was observed variation of pH. The values of L* indicated low luminosity and the values of a* and b* indicated tendency of the extract to red yellow coloring. The concentration of vitamin C and carotenoids were stable. The count of molds and yeasts ranged from 2.0 to 4.1 log CFU/g, and of aerobic mesophilic microorganisms from <1.0 to 4.3 log CFU/g. On the other hand, the count of lactic acid bacteria were <1.0 log CFU/g, and of total and fecal coliforms <3,0 MPN/g. Besides, Salmonella sp. was absent in 25 g of extract. Considering yield and physicochemical and microbiological stability, the biquinho pepper extract is an excellent alternative for processing this vegetable in off-season periods and to prevent loss of raw materials for agro-industries that use pepper in the formulations of their derived products

Treatment of bone pain secondary to metastases using samarium-153-EDTMP

CONTEXT: More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. OBJECTIVE: To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. TYPE OF STUDY: Retrospective. SETTING: Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). METHODS: Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). RESULTS: All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. DISCUSSION: Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. CONCLUSION: Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects

Detection of CD5 in B-cell chronic lymphoproliferative diseases by flow cytometry: a strong expression in B-cell chronic lymphocytic leukemia Detecção do CD5 em doenças linfoproliferativas crônicas de células B por citometria de fluxo: uma importante expressão em leucemia linfocítica crônica

PURPOSE: CD5 is a T cell marker, aberrantly express in B cell chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL). Other chronic B cell malignancies including hairy cell leukemia (HCL) and B cell prolymphocytic leukemia (B-PLL) are CD5 negative or express this antigen in a weak way. In this study, CD5 expression was investigated in leukemic cells from 42 patients with chronic B cell lymphoproliferative disease. METHODS: We studied the CD5 expression in leukemic cells from 42 patients with chronic B-cell malignancies by flow cytometry. Demographic features such as age, sex and clinical date were also analyzed. RESULTS: There were 22 males and 20 females. The immunophenotyping showed that 35 cases were B-CLL, 3 B-PLL and HCL and one patient was MCL. CD5 expression was present in all B-CLL and MCL. Low expression of CD5 was observed in one patient with B-PLL and negative in all cases of HCL. CONCLUSION: Our date demonstrated that CD5 expression can help distinguish among B-CLL from HCL and B-PLL, but is similar expressed in MCL.<br>OBJETIVOS: CD5 é um marcador normalmente expresso nas células T e de forma aberrante nas células B da leucemia linfocítica crônica (LLC) e no linfoma de células do manto (LCM). Outras doenças linfoproliferativas crônicas como a hairy cell leukemia (HCL) e leukemia prolinfocítica de células B (LPL-B), são geralmente CD5 negativas ou expressam fracamente este antígeno. Neste trabalho investigou-se o padrão de expressão do CD5 em 42 pacientes com doenças linfoproliferativas crônicas de células B (DLC-B). METODOS: Investigamos a expressão de CD5 em células leucêmicas de 42 pacientes com DLC-B através da citometria de fluxo. Dados demográficos, tais como idade e sexo, bem como dados clínicos e laboratoriais também foram analisados. RESULTADOS: A imunofenotipagem mostrou que 35 casos foram LLC, 3 LPL-B, 3 HCL e um caso de LMC. O CD5 mostrou-se fortemente expresso em todos os casos de LLC e LMC. Baixa expressão desse antígeno foi observada em um caso de LPL-B, mostrando-se negativamente expresso em todos os casos de HCL. CONCLUSÃO: Nossos resultados demonstram que o padrão de expressão do CD5 pode auxiliar na distinção entre LLC da HCL e LPL-B, sendo no entanto similares na HCL e LCM

Evolução e desempenho da aplicação dos recursos do Programa Nacional de Alimentação Escolar (PNAE) no estado do Pará no período de 2011 a 2019

A Lei nº 11. 947/09, que estabelece o Programa Nacional de Alimentação Escolar (PNAE), trouxe importantes avanços, sobretudo no que se refere ao estímulo da produção familiar com o estabelecimento da exigência de no mínimo de 30% para aquisições de alimentos da agricultura familiar com recursos do programa. O estado do Pará tem uma significativa participação da agricultura familiar na produção do estado, representando 38,6% do valor da produção agropecuária e 85% dos estabelecimentos, segundo o Censo Agropecuário IBGE de 2017. O artigo tem como objetivo analisar o desempenho da aplicação dos recursos do PNAE nas mesorregiões paraenses no período de 2011 a 2019. Foi utilizada a abordagem qualitativa, com a utilização de método descritivo, e quantitativa, com o emprego de estatística descritiva e regressão simples para análise do número de alunos e escolas atendidos e os valores repassados por mesorregião e destinados para aquisição da agricultura familiar, a partir de informações obtidas do Fundo Nacional de Desenvolvimento da Educação (FNDE), do Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep) e do Instituto Brasileiro de Geografia e Estatística (IBGE). Os resultados mostraram que houve redução do número de escolas e matrículas de escolas públicas, bem como estagnação dos valores repassados no período. As mesorregiões com maior PIB não necessariamente foram as que mais aplicaram os recursos do PNAE nas aquisições da agricultura familiar. Um resultado positivo foi o aumento dessas aquisições, levando ao alcance do percentual de 30% por todas as mesorregiões paraenses no último ano analisado

In Vitro Studies of the Activity of Dithiocarbamate Organoruthenium Complexes against Clinically Relevant Fungal Pathogens

The in vitro antifungal activity of nine dirutheniumpentadithiocarbamate complexes C1–C9 was investigated and assessed for its activity against four different fungal species with clinical interest and related to invasive fungal infections (IFIs), such as Candida spp. [C. albicans (two clinical isolates), C. glabrata, C. krusei, C. parapsolisis, C. tropicalis, C.dubliniensis (six clinical isolates)], Paracoccidioides brasiliensis (seven clinical isolates), Cryptococcus neoformans and Sporothrix schenckii. All synthesized complexes C1–C9 and also the free ligands L1–L9 were submitted to in vitro tests against those fungi and the results are very promising, since some of the obtained MIC (minimal inhibitory concentration) values were very low (from 10−6 mol mL−1 to 10−8 mol mL−1) against all investigated clinically relevant fungal pathogens, except for C. glabrata, that the MIC values are close to the ones obtained for fluconazole, the standard antifungal agent tested. Preliminary structure-activity relations (SAR) might be suggested and a strong influence from steric and lipophilic parameters in the antifungal activity can be noticed. Cytotoxicity assays (IC50) showed that the complexes are not as toxic (IC50 values are much higher—30 to 200 fold—than MIC values). These ruthenium complexes are very promising lead compounds for novel antifungal drug development, especially in IFIs, one of most harmful emerging infection diseases (EIDs)

Território e sociedade

O livro Território e sociedade: as múltiplas faces da Brasília metropolitana vem integrar a Coleção Brasília da Editora UnB, que, desde a década de 1980, tem reunido pesquisadores de diferentes áreas do conhecimento, sob a liderança do professor emérito da Universidade de Brasília Aldo Paviani, para debater e proporcionar olhares complementares sobre esse território singular que abriga a capital federal. Na intenção de analisar e refletir sobre essas questões, os textos apresentados nesta obra abrangem desde temas mais amplos até aspectos mais específicos da integração/desintegração da Área Metropolitana de Brasília. As discussões passam por questões sobre desenvolvimento, economia, governança, política, patrimônio, cultura, vulnerabilidades e impactos dos marcadores de desigualdades ao longo do curso de vida dos grupos populacionais da cidade. O livro é organizado em quatro unidades: 1) desenvolvimento e integração metropolitana; 2) metropolização e governança; 3) patrimônio, cultura e território; e 4) o curso da vida e as desigualdades na metrópole