Association of Drowning Mortality with Preventive Interventions: A Quarter of a Million Deaths Evaluation in Brazil

In 2015, drowning in Brazil was responsible for 6,043 deaths and was the second leading cause of death in children. Although several prevention strategies have been promoted to reduce drowning, most are still based on low levels of evidence. This study evaluated the effectiveness of prevention and water safety interventions in reducing drowning mortality. Data obtained from the National Mortality System for 36 years were split in two time periods to allow the comparison of drowning mortality numbers before and after implementation of SOBRASA’s drowning prevention and water safety programs and to check for any positive effects attributable to such programs. To assess differences between the two periods, a “drowning water safety score” (DSS) was estimated and compared to mortality/100,000 of population. There were 258,834 drowning deaths over 36 years. A significant decrease of 27% in drowning rates (5.2 to 3.8/100,000;

A systematic review on the effectiveness of anti-choking suction devices and identification of research gaps

Aim: Despite an obstructed airway (choking) being a relatively preventable injury, it has a considerable mortality burden globally, with increasing incidence. Given new technologies in choking management, this systematic review aimed to assess current literature on the effectiveness of anti-choking suction devices at relieving obstructions. Methods: Ovid MEDLINE, Embase, PubMed, The Cochrane Library, SCOPUS, Web of Science, CINAHL Plus and the English websites of the devices were searched on September 23, 2019. Studies were included if they reported the anti-choking devices’ dislodgment success rate (primary outcome) or associated adverse events (secondary outcome). Articles, conference abstracts or technical reports were included if peer reviewed. Certainty of evidence was assessed in accordance with GRADE. Results: Five studies satisfied the inclusion criteria for this review. Two studies (40%) reported findings of a single centre mannequin trial, one (20%) of a single centre cadaveric trial, and two (40%) were case series. Cohen's Kappa for the first and second round of screening was 0.904 and 0.674 respectively. Although several devices have been manufactured worldwide, the LifeVac© has been most extensively studied, with a combined dislodgement success rate of 94.3% on first attempt. However, certainty of evidence for the primary outcome was evaluated as very low. Conclusions: There are many weaknesses in the available data and few unbiased trials that test the effectiveness of anti-choking suction devices resulting in insufficient evidence to support or discourage their use. Practitioners should continue to adhere to guidelines authored by local resuscitation authorities which align with ILCOR recommendations

Epidermal growth factor receptor and KRAS mutations in Brazilian lung cancer patients

OBJECTIVE: Epidermal growth factor receptor is involved in the pathogenesis of non-small cell lung cancer and has recently emerged as an important target for molecular therapeutics. The KRAS oncogene also plays an important role in the development of lung cancer. The aim of this study was to evaluate the frequency of epidermal growth factor receptor and KRAS mutations in a population of Brazilian patients with non-small cell lung cancer. METHODS: A total of 207 specimens from Brazilian patients with non-small cell lung cancer were analyzed for activating epidermal growth factor receptor and KRAS somatic mutations, and their associations with clinicopathological characteristics (including age, gender, ethnicity, smoking habits, and histological subtype) were examined. RESULTS: We identified 63 cases (30.4%) with epidermal growth factor receptor mutations and 30 cases (14.6%) with KRAS mutations. The most frequent epidermal growth factor receptor mutation we detected was a deletion in exon 19 (60.3%, 38 patients), followed by an L858R amino acid substitution in exon 21 (27%, 17 patients). The most common types of KRAS mutations were found in codon 12. There were no significant differences in epidermal growth factor receptor or KRAS mutations by gender or primary versus metastatic lung cancer. There was a higher prevalence of KRAS mutations in the non-Asian patients. Epidermal growth factor receptor mutations were more prevalent in adenocarcinomas than in non-adenocarcinoma histological types. Being a non-smoker was significantly associated with the prevalence of epidermal growth factor receptor mutations, but the prevalence of KRAS mutations was significantly associated with smoking. CONCLUSIONS: This study is the first to examine the prevalence of epidermal growth factor receptor and KRAS mutations in a Brazilian population sample with non-small cell lung cancer

Pemetrexed na segunda linha de tratamento do carcinoma do pulmão de não pequenas células – A experiência portuguesa

AbstractUntil 2004, docetaxel in monotherapy was the standard for second-line treatment of non-small cell lung cancer (NSCLC). Pemetrexed (P) has shown similar activity in this setting with a better adverse event profile. In Portugal, it was introduced in October of 2004.We have carried out a retrospective analysis of patients (pts) who received P for second-line NSCLC in Portugal from October 2004 to December 2006. Data were collected from the records of pts with locally advanced or metastatic NSCLC and failed first-line chemotherapy enrolled in centers participating in the Portuguese Lung Cancer Study Group (GECP). Objective response (OR; complete [CR] or partial [PR] response) was evaluated using RECIST and safety was assessed using serious or non-serious adverse events (SAEs/AEs).By December 2006, 19 GECP centers had enrolled 244 pts who had received P for ≥1cycle, and were considered evaluable for both objective response and safety. Demography: male/female, 175/69; median age, 57.0years (range 20-81); smoking status, y/ex/n, 116/57/71; adenocarcinoma / squamous-cell carcinoma/other histology, 141/72/31; mean time to progression (TTP) 8.07months. Disease control in 209 evaluable pts was observed in 116 (55.5%): 2 CR, 45 PR and 69 SD; mean TTP 4.70months. The majority of AEs were grade 3 anemia (15 pts) and neutropenia (18 pts). The mean overall survival was 17.27months.Our retrospective analysis has observed a similar disease control rate with P in 2nd line (55.5%), and TTP (4.7months) in our current unselected population to that published in the literature. P is an option for second-line NSCLC with a good tolerability.Rev Port Pneumol 2008; XIV (Sup.2): S9-S2

Avaliação do hemograma e das funções hepática e renal de cabras leiteiras alimentadas com farelo de mamona destoxificado.

O objetivo deste estudo foi avaliar a eficácia in vivo do processo de destoxificação do farelo de mamona através da avaliação do hemograma e das funções hepática e renal de cabras leiteiras. Foram utilizadas 28 cabras da raça Anglo-Nubiana e Saanen, alojadas em baias individuais e distribuídas em um delineamento inteiramente casualizado com quatro níveis de substituição (0%, 33,3%, 66,6% e 100%) do farelo de soja pelo farelo de mamona destoxificado e sete repetições. O período experimental foi composto por 30 dias de adaptação à dieta e 5 dias para a coleta dos dados. O exame hematológico consistiu na determinação do volume globular, hemáceas, hemoglobina, volume globular médio, concentração hemoglobínica globular média, hemoglobina globular média, contagem total de leucócitos e contagem diferencial de leucócitos. A determinação da atividade enzimática da aspartato aminotransferase e a quantificação da uréia, creatinina e glicose no sangue foram realizadas através do método colorimétrico. Os dados foram analisados por meio de análise de variância e teste de comparação de médias. O farelo de mamona destoxificado não desencadeou nenhum tipo de alteração patológica nos animais experimentais, já que não foi detectada diferença estatística significativa entre o grupo controle e os outros grupos testados, em nenhum parâmetro avaliado, com exceção dos valores de monócitos. Este último achado não possui significado clínico, já que os valores destas células encontram-se dentro dos parâmetros de normalidade para a espécie. Considerando os dados obtidos neste estudo, conclui-se que o processo de destoxificação do farelo de mamona foi eficaz na inativação de substâncias tóxicas nocivas ao organismo animal

Adubação verde como forma de melhorar a oferta de recursos florais para abelhas-sem-ferrão em sistemas agroflorestais.

Resumo: Este estudo teve o objetivo de avaliar a densidade de plantas estabelecidas e o período de florescimento de adubos verdes em cultivos solteiros e consorciados como estratégia de manejo adotada para aumentar a oferta de recursos florais e melhorar a integração entre sistemas agroflorestais e a criação de abelhas-sem-ferrão. O experimento foi realizado no Sítio Oliveira, situado no Assentamento Vergel, município de Mogi Mirim, SP. O delineamento experimental foi de blocos casualizados, com três blocos e quatro tratamentos: girassol solteiro; trigo mourisco solteiro; girassol e trigo mourisco; e girassol e crotalárias. Foram realizadas avaliações de densidades de girassol e trigo mourisco em cultivos solteiros e consorciados. As densidades de girassol e trigo mourisco solteiros e consorciados não apresentaram diferenças significativas e apresentaram médias de densidade de 155.555 plantas/ha e 83.999 plantas/ha, respectivamente. O início do florescimento do girassol ocorreu aos 40 dias após a semeadura e teve uma duração de cerca de 40 dias. O trigo mourisco iniciou o período de florescimento aos 25 dias após a semeadura, 15 dias antes do girassol. As plantas de trigo mourisco sofreram danos severos de formigas cortadeiras aos 50 dias após a semeadura, o que inviabilizou a avaliação do seu período de florescimento. Os cultivos consorciados de girassol com trigo mourisco não influenciaram a densidade de plantasestabelecidas dessas duas espécies, ampliou o período e diversificou a oferta de recursos florais para abelhas-sem-ferrão. -- Abstract: The present work evaluated the density of established plants and the flowering of green manures in single and intercropped crops as a management strategy that aims to increase the supply of floral resources, keep the soil covered, recycle nutrients and make organic matter available, in processes that integrate agroforestry systems and the creation of stingless bees. The experiment was carried out at Sítio Oliveira, located in the Vergel Settlement, in the municipality of Mogi Mirim, SP. The experimental design was randomized blocks, with three blocks and four treatments: single sunflower; single buckwheat; sunflower and buckwheat; and sunflower and crotalaria. Evaluations of sunflower and buckwheat densities were carried out in single and intercropping. Single and intercropped sunflower and buckwheat densities did not show significant differences and presented mean densities of 155,555 plants/ha and 83,999 plants/ha, respectively. The beginning of sunflower flowering occurred 40 days after sowing and lasted for about 40 days. Buckwheat started the flowering period at 25 days after sowing, 15 days before sunflower. The buckwheat plants suffered severe damage from leaf-cutting ants 50 days after sowing, which made it impossible to assess their flowering period. Intercropping sunflower with buckwheat did not influence the density of established plants of these two species, extended the period and diversified the supply of floral resources for stingless bees.CIIC 2023. Nº 23407