Long-Term Recurrence of Nonmelanoma Skin Cancer after Topical Methylaminolevulinate Photodynamic Therapy in a Dermato-Oncology Department

BACKGROUND: Most available studies on the efficacy of topical photodynamic therapy focus on short-to medium-term results. Long-term data are scarce. OBJECTIVE: To evaluate the long-term efficacy of photodynamic therapy with topical methylaminolevulinate to treat Bowen's disease and basal cell carcinoma in the clinical practice setting of a dermato-oncology department. METHODS: The study included patients diagnosed with Bowen's disease or basal cell carcinoma, and who received photodynamic therapy from 2004 to 2008. Treatment protocol and clinical follow-up were standardized. The primary endpoint was clinically observed recurrence in a previous photodynamic therapy-treated area. Descriptive and survival analyses were performed. RESULTS: A total of 31 Bowen's disease lesions and 44 superficial basal cell carcinoma were treated, with a median follow-up of 43.5 months. Recurrence was observed in 14 Bowen's disease lesions (53.8%) and in 11 superficial basal cell carcinoma (33.3%). Significantly higher estimates for recurrence rates were found in patients with Bowen's disease (p=0.0036) or those aged under 58 years (p=0.039). The risk of recurrence was higher in patients with Bowen's disease than in those with superficial basal cell carcinoma and younger patients. CONCLUSIONS: Recurrence should be considered when choosing to treat non-melanoma skin cancer with photodynamic therapy. Younger age and Bowen's disease were independent predictors for long-term recurrence, suggesting the need to establish an extended period of follow-up for this subset of patients

Long-Term Evaluation of Recurrence after Photodynamic Therapy with Topical Methyl Aminolevulinate for Non-Melanoma Skin Cancer: a Hospital-Based Study

Introduction & Objectives: Several factors may influence the decision to pursue nonsurgical modalities for the treatment of non-melanoma skin cancer. Topical photodynamic therapy (PDT) is a non-invasive alternative treatment reported to have a high efficacy when using standardized protocols in Bowen’s disease (BD), superficial basal cell carcinoma (BCC) and in thin nodular BCC. However, long-term recurrence studies are lacking. The aim of this study was to evaluate the long-term efficacy of PDT with topical methylaminolevulinate (MAL) for the treatment of BD and BCC in a dermato-oncology department. Materials & Methods: All patients with the diagnosis of BD or BCC, treated with MAL-PDT from the years 2004 to 2008, were enrolled. Treatment protocol included two MAL-PDT sessions one week apart repeated at three months when incomplete response, using a red light dose of 37-40 J/cm2 and an exposure time of 8’20’’. Clinical records were retrospectively reviewed, and data regarding age, sex, tumour location, size, treatment outcomes and recurrence were registered. Descriptive analysis was performed using chi square tests, followed by survival analysis with the Kaplan-Meier and Cox regression models. Results: Sixty-eight patients (median age 71.0 years, P25;P75=30;92) with a total of 78 tumours (31 BD, 45 superficial BCC, 2 nodular BCC) and a median tumour size of 5 cm2 were treated. Overall, the median follow-up period was 43.5 months (P25;P75=0;100), and a total recurrence rate of 33.8% was observed (24.4 % for BCC vs. 45.2% for BD). Estimated recurrence rates for BCC and BD were 5.0% vs. 7.4% at 6 months, 23.4% vs. 27.9% at 12 months, and 30.0% vs. 72.4% at 60 months. Both age and diagnosis were independent prognostic factors for recurrence, with significantly higher estimated recurrence rates in patients with BD (p=0.0036) or younger than 58 years old (p=0.039). The risk of recurrence (hazard ratio) was 2.4 times higher in patients with BD compared to superficial BCC (95% CI:1.1-5.3; p=0.033), and 2.8 times higher in patients younger than 58 years old (95% CI:1.2-6.5; p=0.02). Conclusions: In the studied population, estimated recurrence rates are higher than those expected from available literature, possibly due to a longer follow-up period. To the authors’ knowledge there is only one other study with a similar follow-up period, regarding BCC solely. BD, as an in situ squamous cell carcinoma, has a higher tendency to recur than superficial BCC. Despite greater cosmesis, PDT might no be the best treatment option for young patients considering their higher risk of recurrence.Introduction & Objectives: Several factors may influence the decision to pursue nonsurgical modalities for the treatment of non-melanoma skin cancer. Topical photodynamic therapy (PDT) is a non-invasive alternative treatment reported to have a high efficacy when using standardized protocols in Bowen’s disease (BD), superficial basal cell carcinoma (BCC) and in thin nodular BCC. However, long-term recurrence studies are lacking. The aim of this study was to evaluate the long-term efficacy of PDT with topical methylaminolevulinate (MAL) for the treatment of BD and BCC in a dermato-oncology department. Materials & Methods: All patients with the diagnosis of BD or BCC, treated with MAL-PDT from the years 2004 to 2008, were enrolled. Treatment protocol included two MAL-PDT sessions one week apart repeated at three months when incomplete response, using a red light dose of 37-40 J/cm2 and an exposure time of 8’20’’. Clinical records were retrospectively reviewed, and data regarding age, sex, tumour location, size, treatment outcomes and recurrence were registered. Descriptive analysis was performed using chi square tests, followed by survival analysis with the Kaplan-Meier and Cox regression models. Results: Sixty-eight patients (median age 71.0 years, P25;P75=30;92) with a total of 78 tumours (31 BD, 45 superficial BCC, 2 nodular BCC) and a median tumour size of 5 cm2 were treated. Overall, the median follow-up period was 43.5 months (P25;P75=0;100), and a total recurrence rate of 33.8% was observed (24.4 % for BCC vs. 45.2% for BD). Estimated recurrence rates for BCC and BD were 5.0% vs. 7.4% at 6 months, 23.4% vs. 27.9% at 12 months, and 30.0% vs. 72.4% at 60 months. Both age and diagnosis were independent prognostic factors for recurrence, with significantly higher estimated recurrence rates in patients with BD (p=0.0036) or younger than 58 years old (p=0.039). The risk of recurrence (hazard ratio) was 2.4 times higher in patients with BD compared to superficial BCC (95% CI:1.1-5.3; p=0.033), and 2.8 times higher in patients younger than 58 years old (95% CI:1.2-6.5; p=0.02). Conclusions: In the studied population, estimated recurrence rates are higher than those expected from available literature, possibly due to a longer follow-up period. To the authors’ knowledge there is only one other study with a similar follow-up period, regarding BCC solely. BD, as an in situ squamous cell carcinoma, has a higher tendency to recur than superficial BCC. Despite greater cosmesis, PDT might no be the best treatment option for young patients considering their higher risk of recurrence

Recidiva de Cancro Cutâneo Não-Melanoma após Terapêutica Fotodinâmica num Serviço de Dermatologia

Introdução: São escassos os estudos de eficácia a longo prazo da terapêutica fotodinâmica(TFD) no tratamento da doença de Bowen (DB) e do carcinoma basocelular (CBC). Objectivos: Determinar a eficácia a longo prazo da TFD com metilaminolevulinato (MAL) no tratamento da DB e do CBC pela análise de recidiva. Material e método: Foram analisados retrospectivamente os processos clínicos de doentes com o diagnóstico de DB ou CBC tratados com TFD-MAL num serviço de Dermato- Oncologia entre 2004 e 2008. Foi efectuada a análise descritiva dos dados pelo teste do chiquadrado, seguida da análise de sobrevivência pelos métodos de Kaplan-Meier e regressão de Cox. Resultados: Foram tratados 68 doentes (mediana etária 71 anos, P25;P75=30;92) com um total de 78 tumores (31 DB, 45 CBC superficiais, 2 CBC nodulares finos). No período de seguimento efectuado (mediana 43,5 meses, P25;P75=0;100) observou-se uma taxa de recidiva de 25% no CBC e 45,2% na DB. As taxas de recidiva estimadas para os CBC e DB foram de 5,0% vs. 7,4% aos 6 meses, 23,4% vs. 27,9% aos 12 meses e de 30,0% vs. 72,4% aos 60 meses. Idade e diagnóstico constituíram factores independentes de prognóstico, com taxas de recidiva significativamente maiores nos doentes com DB (p=0,0036) ou com menos de 58 anos (p=0,039). De modo semelhante, o risco de recidiva foi 2,4 vezes superior nos doentes com DB face àqueles com CBC (p=0,033) e 2,8 vezes maior em doentes com menos de 58 anos (p=0,02). Conclusões: Na população estudada, a taxa de recidiva foi superior àquela encontrada na literatura. A TFD pode não ser a melhor opção para o tratamento do cancro cutâneo nãomelanoma em doentes mais jovens, em particular na doença de Bowen. Apesar do melhor resultado cosmético, o risco de recidiva deve ser equacionado e a escolha terapêutica deve ser ponderada caso a caso

Validação de protocolo para biometria de sementes de Jatoba do cerrado (Hymenae stignocarpa Mart. ex Hayne.) por análise digital.

O Jatobá do cerrado (Hymenaea stigonocarpa) apresenta frutos com polpa farinácea, que por sua vez são apreciadas por moradores regionais e viajantes na forma in natura ou processada. Além disso, a espécie é um condicionante inicial para processos de recuperação de áreas degradadas, estabelecendo assim condições para desenvolvimento da fauna e flora local. O presente estudo teve por objetivo estimar o comprimento e largura de sementes utilizando o paquímetro digital e o software ImageJ®, e validar as mensurações através de análises estatísticas. Foram avaliadas 50 sementes de jatobá do cerrado utilizando: plataforma de fenotipagem, câmera fotográfica Sony Hd Avchd progressive, software ImajeJ® Software SigmaPlot®, régua de 20 cm e paquímetro digital. Com o paquímetro obteve-se estimativas de comprimento e largura das 50 sementes da espécie, e posteriormente se repetiu as análises via software. A metodologia digital se mostra eficaz e acurada na obtenção das estimativas para análise biométrica de sementes, sendo possível o pesquisador realizar leituras de forma objetiva, minimizando os erros

Propagação vegetativa de Pau de Balsa com diferentes concentrações de AIB.

Objetivo: Avaliar o efeito do Ácido Indol Butírico (AIB) na propagação vegetativa do pau de balsa por meio de estaquia. Métodos: Para o desenvolvimento da pesquisa foram realizados dois experimentos: No experimento 1 (E1) o material vegetativo foi coletado no município de Guarantã do Norte ? MT. Já o experimento 2 (E2), o qual foi a replicação do experimento 1, as amostras foram retiradas em Alta Floresta ? MT. Foram coletadas estacas provenientes de 10 matrizes, formando um mix amostral de 240 estacas para compor os tratamentos. O E2 foi realizado 90 dias após a finalização do E1. Tais estacas foram submetidas ao tratamento com cinco concentrações de AIB (2000, 4000, 6000, 8000 e 10 000 mg L-1 de AIB) e a testemunha (0 mg L-1 de AIB). As estacas foram avaliadas após 60 dias quanto as variáveis: sobrevivência, formação de calosidade e formação de raízes. Resultados: Aos 60 dias após o estabelecimento do E1, foi possível identificar uma quantidade de indivíduos vivos de 38,75 % em relação ao número total. Os indivíduos sobreviventes, 47,5 % foram estabelecidos pelo tratamento com 8.000 mg L-1 de AIB, seguidos pelos 45 % obtidos com 2.000 mg. L-1 de AIB, e 40 % com o tratamento sem a presença de AIB. Ao analisar a porcentagem de indivíduos vivos com presença de calos, se percebe uma baixa nos valores, porém os mesmos mantêm um perfil próximo aos apresentados para a sobrevivência. Embora tenha ocorrido a presença de calosidade em alguns indivíduos, e que outros ainda tenham se mantidos vivos durante os 60 dias, não foram o suficiente para estabelecer o desenvolvimento de raízes nas estacas. Conclusão: Não há efeito do AIB na propagação vegetativa do pau de balsa por meio de estaquia

Selection and phenotypic divergence in pau de balsa of different origins.

Abstract: Pau de balsa is a forest species that is native to the Amazon and stands out for its rapid growth, being an option for a productive and profitable activity. The objective of this study was to select phenotypically superior pau de balsa trees and verify the dissimilarity between them and their respective origins in order to identify individuals for wood production. Three distinct populations trees in plantations of pau de balsa implanted in January 2011 in the municipality of Guarantã do Norte, Mato Grosso, Brazil, were evaluated as to their characteristics of commercial importance. Among the trees evaluated, highlight the genotype A09 as a candidate for the matrix in breeding programs of the species due to its superiority in the characteristics of diameter at breast height and total height. Genotypes A09 and IF03 are the most genetically distant and S02 and S09 the most similar. The principal component analysis explained 81.24% of all the variance of the characteristics analyzed in the first two variables. With the results obtained, it was possible to identify the superior characteristics of the Ecuadorian genotypes A01, A09 and A14; the first two present good characteristics for wood production, and the third presents the lowest basic density of wood. | Resumo: O pau de balsa é uma espécie florestal nativa da Amazônia, e destaca-se pelo rápido crescimento e, portanto, considerada como uma opção de atividade produtiva e rentável. Objetivou-se neste estudo selecionar árvores de pau de balsa superiores fenotipicamente e verificar a dissimilaridade entre elas e suas respectivas origens, afim de identificar indivíduos para a produção de madeira. Foram avaliadas as árvores de plantios de pau de balsa implantado em janeiro de 2011 no município de Guarantã do Norte, Mato Grosso, Brasil, em três populações distintas e avaliadas características de importância comercial. Entre as árvores avaliadas podemos destacar o genótipo A09 como um candidato à matriz em programas de melhoramento da espécie, devido à superioridade nas características de diâmetro à altura do peito e altura total. Os genótipos A09 e IF03 são os mais distantes geneticamente e S02 e S09 os mais similares. A análise de componentes principais explicou 81,24% de toda a variância das características analisadas logo nas duas primeiras variáveis. Com os resultados obtidos foi possível selecionar os genótipos equatorianos A01, A09 e A14, os dois primeiros por apresentar boas características para a produção de madeira, e o terceiro por apresentar a menor densidade básica da madeira

Calibration of the Pilodyn instrument for the indirect in situ determination of the basic wood density of balsa

Abstract: Balsa wood is used widely in the nautical, aeronautical and wind-energy industries because of its low-density and high-resistance. In the Brazilian state of Mato Grosso, speculative producers with little knowledge of the culture have established balsa plantations using non-standardized and non-selected seedlings. In this sense, research is needed to improve balsa cultivation under Brazilian conditions to better explore the resource. The present study evaluated the efficiency of the Pilodyn instrument for the indirect determination of the basic wood density (BWD) of balsa. Twenty 12-year old balsa trees cultivated in Alta Floresta, Mato Grosso, were probed with the Pilodyn instrument on both north and south faces of the trunk at the base and at 1.30 and 3.10 m from the ground. Wood discs were subsequently collected from the probed sites and BWD determined according to the water-immersion method. Data were submitted to the Shapiro-Wilk normality test followed by analysis of variance and Pearson?s correlation analysis with α=0.05. The BWD of balsa decreased in the direction from the base to the top of the tree. The penetration depth of the Pilodyn probe was inversely proportional to BWD with a correlation that was strong (R2=0.72) at heights of 1.30 and 3.10 m but considered weak (R2=0.46) at the base of the trunk. The reliability of the Pilodyn method was sufficient to allow the development of a linear equation that could be applied for the indirect determination of the BWD of balsa based on the penetration depth of the Pilodyn probe assessed at 1.30 m from the ground. | Resumo: O pau-de-balsa é amplamente utilizado nas indústrias náutica, aeronáutica e de energia eólica devido à sua baixa densidade. No estado de Mato Grosso, produtores especulativos de balsa têm estabelecido plantios sem conhecimento sólido da cultura usando mudas não padronizadas e não selecionadas. Pesquisas são necessárias para melhorar o cultivo de balsa sob condições brasileiras para melhor explorar este recurso. O presente estudo teve como objetivo avaliar a eficiência do instrumento Pilodyn para a determinação indireta da densidade básica da madeira (DBM) de balsa. Vinte árvores de 12 anos de idade cultivadas em Alta Floresta, Mato Grosso, foram avaliadas com o instrumento Pilodyn nas faces norte e sul do tronco, na base e a 1,30 e 3,10 m do solo. Discos de madeira foram posteriormente coletados dos locais sondados e o DBM determinado de acordo com o método de imersão em água. Os dados foram submetidos ao teste de normalidade Shapiro-Wilk seguido de análise de variância e análise de correlação de Pearson com α=0,05. Os valores de DBM da balsa diminuiu da base em direção ao topo da árvore, enquanto a profundidade de penetração do Pilodyn foi inversamente proporcional. A correlação entre a profundidade de penetração do Pilodyn e o DBM foi fraca na base do tronco (R2=0,46), mas forte (R2=0,72) nos pontos de 1,30 e 3,10 m. O método Pilodyn foi suficientemente confiável que permitiu o desenvolvimento de uma equação para a determinação indireta do DBM do pau-de-balsa considerando o valor da profundidade de penetração a 1,30 m como uma das variáveis

Allergic contact dermatitis in children. A multicenter study of the Portuguese Contact Dermatitis Group (GPEDC)

The authors report a study of allergic contact dermatitis in 329 Portuguese children of 14 years or younger. 170 children (64 male and 106 female) reacted to 1 or more allergens. Most of these were in the 11-14 years group. The main allergens were nickel, thimerosal, cobalt, mercury, fragrance-mix and potassium dichromate. Nickel reactivity predominated in females over the whole group, but a greater number of males younger than 5 years reacted to nickel. The number of positive reactions increased with age, but this was not accompained by an increase in the % of relevant tests. 12 children, all of them 13 or 14 years-old, had an occupational allergic contact dermatitis