A ESCRITA: UM INSTRUMENTO PEDAGÓGICO FUNDAMENTAL PARA O ENSINO DAS PRIMEIRAS SÉRIES.

Entender o mundo das letras, sobretudo nos centros urbanos, é para a criança, a possibilidade de começar a utilizar alguns códigos do mundo adulto, bem como a de dar significados consistentes às inúmeras grafias com as quais ela se defronta todos os dias. Sem dúvida é um processo muito rico para a criança e muito envolvente e desafiador para o professor

Venous thromboembolism in non-small cell lung cancer patients: retrospective analysis of cases treated at the Oncology Day Hospital of Novara, Italy

Venous thromboembolism (VTE) is the leading cause of mortality and morbidity in patients with cancer. The estimated risk of VTE in cancer patients is 0.5% per year and 0.04% per month. In small cell lung cancer and non-small cell lung cancer (NSCLC) the cumulative incidence is 3% per year and it seems to be associated with advanced stage and histotype. We performed a retrospective analysis on data from all NSCLC treated at the Oncology Day Hospital in Novara, Italy, northern Italy, to assess the incidence of thromboembolic events in patients undergoing systemic cancer treatments. All patients diagnosed with NSCLC who were treated at the Oncology Day Hospital in Novara from January 2008 to May 2011 have been assessed. Many variables related to VTE were analyzed: age, gender, different NSCLC histotype, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index, stage of disease, treatment and chemotherapy regimen, development of a VTE event and its temporal correlation with chemotherapy, central venous catheter presence, use of erythropoietin, use of low molecular weight heparin at baseline, use of acetyl salicylic acid. A total of 355 patients were evaluated, 307 of whom were considered to be eligible for analysis. Median age was 68 years. Histology was as follows: 7% not otherwise specified, 60% adenocarcinoma, 31% squamous cell carcinoma and 2% large cell carcinoma. Thirty-six cases of deep vein thrombosis (DVT) have been reported (incidence 12%). Thirty-one DVT were recorded in patients who were candidates for or undergoing chemotherapy: 14 during treatment, 7 at the end of chemotherapy, and 10 before treatment. The incidence was significantly higher for patients treated with cisplatin (CDDP), both during chemotherapy and after chemotherapy. A correlation with disease stage was documented: 26.5% of total VTE occurred in locally advanced and metastatic stages (IIIB and IV); 18.8% in stage IIIA (N2). A significant correlation between non-squamous histology was also highlighted (P=0.015) and ECOG 0-1 (P=0.010). According to the high incidence of VTE in patients with NSCLC, especially adenocarcinoma, and the correlation highlighted in this study with ECOG performance status 0-1 and CDDP-based treatment, we believe that outpatients undergoing chemotherapy for advanced stage (IIIB-IV) lung cancer should receive thromboembolic prophylaxis at least for the duration of chemotherapy. It is, therefore, essential to propose a thrombo-prophylaxis clinical trial that recruits only lung cancer patients to evaluate the benefit of prophylaxis in this population and to assess the real risk of bleeding during antithrombotic treatment

Frequency of O6-methylguanine-DNA methyltransferase promoter methylation in cytological samples from small cell lung cancer

BACKGROUND: In a phase II study for patients with relapsed small cell lung cancer (SCLC), the administration of Temozolomide, an alkylating agent used in gliomas and anaplastic astrocytoma, showed a effective activity when O(6) -methylguanine-DNA methyltransferase (MGMT) gene promoter was methylated. METHODS: We tested the feasibility of MGMT promoter status evaluation in small biopsies and cytological specimens routinely processed for diagnostic purposes. We tested samples from 56 patients with SCLC: 30 tissue biopsies, 17 fine-needle aspiration biopsy, 8 bronchial washing, and 1 was a sputum. Biopsies and fine-needle aspiration biopsy were fixed in formalin, bronchial washing and sputum in Dubosq Brazil. DNA was extracted after macrodissection of the areas containing the maximum number of cancer cells. MGMT promoter methylation status was assessed by methylation specific PCR. RESULTS: Methylation analysis was obtained in 54 samples (54/56) and failed in two bronchial wash. MGMT promoter was methylated in 35.2% of the cases without any significant difference between histological and cytological samples (37.9% vs. 32%). CONCLUSION: MGMT promoter methylation is present in SCLC and cytological samples are perfectly adequate for methylation analysis, even if they were taken during routine diagnostic procedures, using different fixative and with low number and percentage of cancer cells