Systemic Treatment of Metastatic Conjunctival Melanoma

Conjunctival melanoma (CM) is an exceptionally rare tumor, with a propensity for local and distant recurrence, with the lungs, skin, liver, and brain being the most common sites of metastasis. Recent progress in systemic treatments, with checkpoint inhibitors and targeted therapies blocking BRAF and MEK, has redefined the standard of care of advanced unresectable and metastatic melanoma. Although most trials did not include patients with conjunctival melanoma, its close molecular and genetic relationship to cutaneous melanoma might suggest a similar response to these novel agents. The authors describe two uncommon cases of metastatic conjunctival melanomas with distinct genetic profiles and, as such, submitted to different systemic treatments.info:eu-repo/semantics/publishedVersio

Smoking in acute coronary syndromes--the "smoker's paradox" revisited

INTRODUCTION: Although a well-known risk factor for coronary disease, smoking has long been associated with lower short-term mortality in acute coronary syndromes (ACS). There are few recent works on Portuguese populations examining all aspects of smoking in ACS, particularly the interaction between smoking and other risk factors, and the management and prognosis of patients according to smoking status. OBJECTIVE: We sought to examine clinical characteristics, presentation, in-hospital treatment, angiographic features and prognosis of patients with and without smoking history admitted with ACS. METHODS: A total of 1228 patients consecutively admitted with ACS from January 2004 to March 2007 were analyzed. Patients were classified into two groups, those with present or past smoking habits (n=450) making up Group I and those without smoking habits (n=778), Group II. The main outcome analyzed was overall mortality during hospital stay and at 6 months. RESULTS: Smokers and former smokers were younger and more frequently male (odds ratio [OR] = 22.46; 95% confidence interval [CI]: 12.94-38.96), and less often had diabetes (OR = 0.41; 95% CI: 0.30-0.54), hypertension (OR = 0.31; 95% CI: 0.24-0.39) and renal insufficiency (OR = 0.26; 95% CI: 0.18-0.36). Patients with smoking habits more frequently presented with ST elevation (OR = 1.32; 95% CI: 1.04-1.67), more often received evidence-based medical therapy, namely beta blockers (during hospital stay, OR = 2.42; 95% CI: 1.63-3.56 and at discharge, OR = 1.45; 95% CI: 1.03-2.1) and statins (at discharge, OR = 2.48; 95% CI: 1.2-6.1), and more frequently underwent coronary angiography (OR = 2.15; 95% CI: 1.63-2.84). Although smokers and former smokers had lower in-hospital mortality on univariate analysis (OR = 0.54; 95% CI: 0.31-0.96), this association was not confirmed on multivariate analysis, with adjustment for known short-term mortality predictors (OR = 1.25; 95% CI: 0.61-2.54). Similarly, multivariate analysis failed to confirm lower 6-month mortality for smokers and former smokers (OR = 2.0; 95% CI: 1.17-3.41). CONCLUSIONS: Clinical characteristics and management options differed between ACS patients with and without smoking habits. These differences explained the lower shortterm mortality initially observed between the two groups. In our population of patients admitted with ACS, we did not find a real "smoker's paradox"

Detecção de Cryptosporidium sp. em fezes não diarréicas de crianças, em uma escola de educação infantil de São Paulo, Brasil

O protozoário Cryptosporidium sp. tem sido detectado com freqüência em fezes de crianças com diarréia persistente. Este trabalho teve como objetivo investigar um surto de criptosporidiose, em uma escola de educação infantil, que atende crianças de classe média alta, de 0 a seis anos de idade. O surto foi detectado a partir de amostras fecais não diarréicas encaminhadas ao Instituto Adolfo Lutz através da rede de saúde pública. Das 64 crianças 13 (20,3%) apresentaram oocistos de Cryptosporidium nas fezes, examinadas pelo método de Kinyoun, sendo sete crianças com um ano de idade, três com dois anos de idade e três, com três anos de idade. Dos 23 adultos examinados, apenas uma mulher de 22 anos, com possível imunocomprometimento, foi positiva. Aspectos epidemiológicos e clínicos foram investigados por meio de questionários, ressaltando-se que o surto ocorreu em período muito seco.The protozoan Cryptosporidium sp. has been frequently detected in faeces from children with persistent diarrhoea. This work achieved to investigate an outbreak of cryptosporidiosis, in a day care center, attending children of high socio-economic level, between 0 and six years old. The outbreak was detected through the network of public health, when stool samples, not diarrhoeic, were examined at the Parasitology Service of the Adolfo Lutz Institute. Among the 64 examined children, 13 (20.3%) showed oocysts of Cryptosporidium sp. in the faeces examined by Kinyoun technique: seven children one year old, three, two years old and three, three years old. Among the 23 examined adults, only a 22 years old woman, possibly having an immunocomprometiment, was positive. Clinical and epidemiological aspects were investigated by questionnaires, highlighting the occurrence of the outbreak in a very dry period

Influencia da posicao de semeadura na germinacao de sementes de umbu (Spondias tuberosa Arruda) - Anacardiaceae.

Foi conduzido um experimento na EMBRAPA-CPATSA, Petrolina- PE, com o objetivo de estudar o efeito da posicao de semeadura de sementes de umbu no numero de sementes germinadas e indice de velocidade de emergencia. As sementes, obtidas de matrizes do CPATSA, foram lavadas em agua corrente, expostas em ambiente sombreado e ventilado para secagem e armazenadas sob condicoes ambientais por tres meses. Apos este periodo, a dormencia foi superada por meio de escarificacao mecanica ate o rompimento do endocarpo. Adotou-se o delineamento em blocos casualizados com quatro repeticoes. Os tratamentos constaram de tres posicoes de semeadura: deitada, que serviu como testemunha; com embriao para baixo e com o embriao para cima, sendo as medias dos tratamentos comparadas peloteste de Duncan a 5%. Os resultados mostram que as sementes colocadas com o embriao para baixo apresentam uma germinacao significativamente mais elevada do que as sementes colocadas deitadas (testemunha) e semelhante aquelas semeadas com o embriao voltado para cima. Contudo, nao houve diferencas no indice de velocidade de emergencia para os tratamentos testados. Com os resultados obtidos pode-se concluir que a semeadura com o embriao voltado para baixo permite a germinacao de um maior numero de sementes de umbu

Efeitos de diferentes substratos e de gradientes de luminosidade na germinacao de sementes de umbu (Spondias tuberosa Arruda) - Anacardiaceae.

Com o objetivo de determinar o melhor substrato e gradiente de luminosidade para a germinacao de sementes de umbu (Spondias tuberosa) foram conduzidos testes de germinacao com sementes colhidas de plantas matrizes no ano de 1994 na EMBRAPA-CPATSA, Petrolina- PE. As sementes foram escarificadas e posteriormente semeadas em caixa de zinco, com dimensoes 8,5 x 27 x 32,5cm preenchidas com os seguintes substratos: terra; areia lavada; esterco de caprinos; esterco de caprinos+terra (1:1); areia lavada+terra (1:1); areia lavada+terra (1:2), nas condicoes de ceu aberto, 25% e 50% de sombreamento. Foi utilizado o delineamento blocos ao acaso em esquema fatorial 6x3 com tres repeticoes. As medias foram comparadas pelo teste de Duncan a 5%. Os resultados referentes ao numero de sementes germinadas mostraram nao haver diferencas significativas devidas aos substratos e ao gradiente de luminosidade. O indice de velocidade de germinacao apresentou diferenca significativa quando foi utilizado o substrato areia lavada colocada a ceu aberto. Os demais substratos e respectivas interacoes com os gradientes de luminosidade nao foram significativos

Neurobiological Effects of Transcranial Direct Current Stimulation: A Review

Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that is affordable and easy to operate compared to other neuromodulation techniques. Anodal stimulation increases cortical excitability, while the cathodal stimulation decreases it. Although tDCS is a promising treatment approach for chronic pain as well as for neuropsychiatric diseases and other neurological disorders, several complex neurobiological mechanisms that are not well understood are involved in its effect. The purpose of this systematic review is to summarize the current knowledge regarding the neurobiological mechanisms involved in the effects of tDCS. The initial search resulted in 171 articles. After applying inclusion and exclusion criteria, we screened 32 full-text articles to extract findings about the neurobiology of tDCS effects including investigation of cortical excitability parameters. Overall, these findings show that tDCS involves a cascade of events at the cellular and molecular levels. Moreover, tDCS is associated with glutamatergic, GABAergic, dopaminergic, serotonergic, and cholinergic activity modulation. Though these studies provide important advancements toward the understanding of mechanisms underlying tDCS effects, further studies are needed to integrate these mechanisms as to optimize clinical development of tDCS

Great human resources management practices : case study of a retailer company certified by GPTW.

O artigo objetivou levantar as pr?ticas de gest?o de pessoas adotadas por uma organiza??o do segmento varejista brasileiro certificada pelo GPTW como uma das melhores para se trabalhar. Realizou-se uma pesquisa descritiva, com abordagem qualitativa, e o m?todo utilizado foi o estudo de caso. As t?cnicas utilizadas para coleta de evid?ncias foram an?lise documental, entrevistas em profundidade e observa??o in loco. O objeto de estudo foi uma empresa de grande porte que atua no segmento varejista e possui mais de 500 filiais e cerca de 7 mil funcion?rios em todo o territ?rio brasileiro. A partir dos resultados obtidos, constatou-se que a empresa estudada trabalha com diversas pol?ticas e pr?ticas de gest?o de pessoas, permitindo que os empregados se desenvolvam e sejam recompensados adequadamente pelas contribui??es que fornecem, o que impacta positivamente na percep??o que eles t?m acerca da organiza??o.The article aimed to set up the people management practices adopted by an organization certified by GPTW as one of the best to work in the Brazilian retail segment. A descriptive research was carried out, using a qualitative approach, and the method used was the study-case. The techniques used to collect evidence were documentary analysis, in-depth interviews and in loco observation. The object of study was a large company that operates in the retail segment and has more than 500 branches and about seven thousand employees in the entire Brazilian territory. Based on the results obtained, it was verified that the studied company works with several policies and practices of people management, allowing employees to develop and be rewarded appropriately for their contributions, which positively impacts the perception they have about the organization

Women’s perception of separation/divorce in Portugal: A sociodemographic profile

This article focuses on the personal experiences of Portuguese women regarding separation and divorce. The sample included 96 women, with at least 1 child, who responded to an inventory that addressed conflict, dysfunctional conjugality, emotional experiences, social support, and adaptation to divorce. Higher levels of conflict and marital dysfunction in litigious divorces were found, as well as more conflict when different lawyers were employed. Those women who were satisfied with alimony and visiting rights reported less conflict, fewer negative emotional experiences, and greater social support. Level of education and duration of separation influenced women’s perceptions. Implications for intervention are addressed.(undefined