Association Of Lipophilic Opioids And Hyperbaric Bupivacaine In Spinal Anesthesia For Elective Cesarean Section. Randomized Controlled Study

PURPOSE: To evaluate the efficacy and side-effects of fentanyl and sufentanil combined with hyperbaric spinal bupivacaine in elective cesarean section.METHODS: A prospective, randomized, double-blind study with 64 term parturients, distributed into 2 groups according to the opioid combined with hyperbaric bupivacaine 0.5% (10mg): GF - fentanyl (25μg) and GS - sufentanil (5.0μg). The latency and maximum sensory block level; degree and duration of motor block; duration and quality of analgesia; maternal-fetal repercussions were evaluated. This was an intention-to-treat analysis with a 5% significance level.RESULTS: The latency period, maximum sensory block level, motor block degree and perioperative analgesia were similar in both groups. Motor block and analgesia had a longer duration in the sufentanil group. Maternal adverse effects and neonatal repercussions were similar. The incidence of hypotension was higher in the fentanyl group. In both groups, there was a predominance of patients who were awake and either calm or sleepy.CONCLUSIONS: The addition of fentanyl and sufentanil to hyperbaric subarachnoid bupivacaine was shown to be effective for the performance of cesarean section, and safe for the mother and fetus. Analgesia was more prolonged with sufentanil.2911752758Dahlgren, G., Hultstrand, C., Jakobsson, J., Norman, M., Eriksson, E.W., Martin, H., Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section (1997) Anesth Analg, 85 (6), pp. 1288-1293. , Dec, PMID: 9390596Dyer, R.A., Joubert, I.A., Low-dose spinal anaesthesia for Caesarean section (2004) Curr Opin Anaesthesiol, 17 (4), pp. 301-308. , 2004 Aug, PMID: 17021569Arzola, C., Wieczorek, P.M., Efficacy of low-dose bupivacaine in spinal anaesthesia for Caesarean delivery: Systematic review and meta-analysis (2011) Br J Anaesth, 107 (3), pp. 308-318. , Sep, Epub 2011 Jul 14Braga Ade, F., Frias, J.A., Braga, F.S., Pereira, R.I., Titotto, S.M., Spinal anesthesia for elective ceasarean section: Use of different doses of hyperbaric bupivacaine associated with morphine and clonidine (2013) Acta Cir Bras, 28 (1), pp. 26-32. , Jan, PMID: 23338110Braga Ade, F., Braga, F.S., Potério, G.M., Pereira, R.I., Reis, E., Cremonesi, E., Sufentanil added to hyperbaric bupivacaine for subarachnoid block in Caesarean section (2003) Eur J Anaesthesiol, 20 (8), pp. 631-635. , Aug, PMID: 12932064Braga Ade, F., Frias, J.A., Braga, F.S., Pinto, D.R., Spinal block with 10 mg of hyperbaric bupivacaine associated with 5 microg of sufentanil for cesarean section. 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Breast cancer in very young women—a multicenter 10-year experience

Background: Breast cancer (BC) is the most prevalent cancer in adult young women in Europe. Although rare, it is one of the leading causes of death in this age group. The aim of this study is to characterize a cohort of young women regarding tumor stage, biology, treatment and survival. Patients and methods: We present a multicenter retrospective analysis of women <35 years of age, diagnosed with BC between 2008 and 2017. A total of 207 patients from five Portuguese centers were included, from whom 172 were eligible for analysis. Data were analyzed using IBM SPPSS statistics. Results: Median age at diagnosis was 31 years. Fifty-one percent of tumors were hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative, 20% HR-positive/HER2-positive, 8% HR-negative/HER2-positive and 20% triple-negative BC. Twenty-two percent of patients were diagnosed in stage I, 26% stage II, 45% stage III and 6% had de novo metastatic cancer. Thirty-nine percent of patients were treated with neoadjuvant chemotherapy. Mean follow-up time was 64.9 months and overall survival at 5 years, of the entire cohort and metastatic patients, was 86.5% and 26%, respectively. Conclusions: In our study we found similar population characteristics to other cohorts <35 years of age. To our knowledge, this is one of the largest cohorts in very young women. BC in young women is an important issue and further studies are needed to provide better care and survivorship to patients.info:eu-repo/semantics/publishedVersio

Comparação de métodos de seleção de genitores e populações segregantes aplicados ao melhoramento de trigo

Os métodos utilizados para seleção de cruzamentos em uma cultura não necessariamente são apropriados para outras. O presente trabalho teve como objetivo avaliar a aplicação da análise dialélica, da diversidade genética, da média parental e do método de Jinks e Pooni na seleção de genitores e populações segregantes superiores para o caráter rendimento de grãos em trigo. Para isso, foram conduzidos dois experimentos. Os tratamentos foram dispostos em látice (experimento I) e em blocos casualizados com informação de indivíduo dentro da parcela (experimento II). Avaliaram-se 12 genitores e as 36 populações segregantes na geração F3 resultantes do cruzamento desses genitores em esquema de dialelo parcial. A aplicação das metodologias avaliadas produziu resultados distintos. A média parental e a diversidade genética isoladamente não constituem método de predição eficiente. A aplicação da metodologia de Jinks e Pooni apresenta limitação de ordem prática, não se adequando ao sistema de cultivo do trigo. Dentre as metodologias avaliadas, a análise dialélica constitui o método mais promissor para identificação de genitores e populações segregantes superiores