Pacientes com carcinoma de células escamosas - relação do tratamento com o prognóstico

Background: Squamous cell carcinoma (SCC) is a malignant cutaneous neoplasm which occurs frequently in small animals. Histopathology or fine needle aspiration cytology is necessary to confirm diagnosis; macroscopic diagnosis is not possible since the lesions are very similar to others of distinct etiologies. Owing to the fact that it is a neoplasm, diagnosis and treatment are usually not well accepted by owners, especially since it can cause esthetic changes to the animal and adjunct treatments can cause unwanted side effects. The objective of this study was to report clinical cases of SCC with distinct tumor subtypes and relate the recommended treatment with prognosis of patients.Case: Two dogs and one cat with SCC that were subjected to physical and dermatological examination, and tested negative for sporotrichosis, cryptococcosis, and manges. Dog 1 (male, 9-year-old, yellow Labrador retriever) exhibited inspiratory dyspnea for three weeks owing to an ulcerative hemorrhagic lesion on the nose. In view of the site of the lesion, a radiographic exam was requested, and the bony portion of the septum was found to be compromised. Cat 2 (female, 10-year-old, bicolor, mixed-breed cat) exhibited a focal, punctate, ulcerated, hemorrhagic lesion on the nose. Dog 3 (female, 10-year-old, white Dogo Argentino) exhibited several ulcerative lesions, and papulae, plaques and comedones on the ventral region of the abdomen.Treatment for deep pyoderma and comedone syndrome were initially instituted; on follow-up, more ulcerative lesions were present, which prompted the inclusion of neoplasm as a differential diagnosis. In cases 1 and 3, histopathology was performed with diagnosis of undifferentiated and differentiated SCC, respectively. In both cases, surgical margins were compromised after resection of the lesion. In case 2, high malignancy SCC was diagnosed with cytology. Use of sunscreen was recommended in all cases, as well as avoidance of sun exposure during the hours not recommended by the National Cancer Institute. In case 1, a nosectomy with partial resection of the nasal septum was recommended as well as chemotherapy with intra-tumoral administration of carboplatin (1.5 mg/cm3 of lesion) and vincristine sulfate (0.05 mg/ kg/IV/week) every 15 days.However, the owner opted for the nosectomy alone with one month of chemotherapy with vincristine sulfate. In case 2, polychemotherapy was instituted using daunorubicin (4 mg/kg/IV/week) and vincristine sulfate (0.05 mg/kg/IV/week) every 15 days for four weeks, with maintenance for six weeks, with total remission of the lesion at the end of treatment. In case 3, eight intralesional chemotherapy sessions were performed (carboplatin – 1.5 mg/cm3 of lesion) every 15 days; maintenance was kept for two months with biweekly administration. The patient exhibited actinic lesions on the third month after the protocol was suspended, which was treated with isotretinoin (3 mg/kg/day PO) until remission; reduction of solar exposure was recommended. The animal in case 1 exhibited intense dyspnea three months after the end of treatment and the lesion was incompatible with preservation of quality of life and euthanasia was performed. In the other two cases, patients were followed-up annually and remained in remission throughout life.Discussion: Adherence to proposed treatment by the owner is directly related to a better prognosis. On the punctate and focal lesion in the cat, administrations of daunorubicin (4 mg/kg/IV/week) and vincristine sulfate (0.05 mg/kg/IV/week) in a total of 10 cycles resulted in an excellent prognosis. On the dog with multifocal lesions, partial resection and intralesional administration of carboplatin (1.5 mg/lesion/cm3) in a total of eight biweekly applications following maintenance for two months resulted in a good prognosis

Cianoacrilato na colagem de Bráquetes ortodônticos em resina acrílica: há maior adesão?

Pacientes em tratamento ortodôntico apresentam restaurações provisórias com frequência. No entanto, poucos estudos avaliam a influência dos adesivos na resistência ao cisalhamento dos bráquetes nessas superfícies. A resina acrílica é comumente indicada para colagem de bráquetes, porém o uso do cianoacrilato como adesivo ortodôntico é uma opção analisada. O objetivo do presente trabalho foi avaliar o desempenho do cianoacrilato associado aos materiais comumente utilizados para a fixação de bráquetes metálicos em restaurações provisórias de resina acrílica. Quarenta amostras em resina acrílica foram preparadas e as superfícies homogeinizadas com lixas de carboneto de silício (320 e 600). Em seguida, as amostras foram divididas aleatoriamente em quatro grupos (n=10) com base no tratamento de superfície e agente de união: G1 - bráquetes colados com resina acrílica; G2 - bráquetes colados com resina acrílica e aplicação de cianoacrilato; G3 - bráquetes colados com Transbond(tm) XT; G4 - bráquetes colados com Transbond(tm) XT e aplicação de cianoacrilato. Foram utilizados bráquetes ortodônticos de aço inoxidável, prescrição Roth, Kirium (3M/Abzil) para incisivos centrais superiores direitos, slot 022. Após colagem, as amostras foram submetidas ao teste de cisalhamento a uma velocidade de 0,5mm/min em uma máquina de ensaios universal (EMIC DL-1000). Os dados foram coletados e submetidos à análise estatística pelo teste ANOVA com nível de significância de 5%. A associação de resina acrílica ao cianoacrilato (G2) resultou na maior resistência ao cisalhamento (13,76 MPa), mas não significativa em comparação aos valores obtidos para a resina acrílica (G1= 7,76 MPa). O mesmo pôde ser observado para a associação Transbond(tm) XT e cianoacrilato (G4= 4,03 MPa) em relação a utilização da Transbond(tm) XT de forma isolada (G3= 3,87 MPa) e resina acrílica. O tratamento de superfície tem efeito significativo na resistência da união dos bráquetes colados aos materiais provisórios. A associação de cianoacrilato ao monômero de metilmetacrilato apresentou maior resistência ao cisalhamento, sendo mais indicada clinicamente

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research