In regard to Minniti et al.: "Current status and recent advances in resection cavity irradiation of brain metastases — roundup to cover all angles"

We read with great interest the recent review, entitled “Current status and recent advances in resection cavity irradiation of brain metastases”. It is a comprehensive summary of currently available techniques for treatment of post-resection cavity in patients with this diagnosis. We would like to complement this manuscript by including intraoperative techniques as other viable approaches in the management of these patients

Longitudinal Remote SBRT/SRS Training in Latin America: A Prospective Cohort Study

BACKGROUND: Continuing medical education in stereotactic technology are scarcely accessible in developing countries. We report the results of upscaling a longitudinal telehealth training course on stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS), after successfully developing a pilot course in Latin America. METHODS: Longitudinal training on SBRT and SRS was provided to radiation oncology practitioners in Peru and Colombia at no cost. The program included sixteen weekly 1-hour live conferencing sessions with interactive didactics and a cloud-based platform for case-based learning. Participant-reported confidence was measured in 16 SBRT/SRS practical domains, based on a 1-to-5 Likert scale. Pre- and post-curriculum exams were required for participation credit. Knowledge-baseline, pre- and post-curriculum surveys, overall and single professional-group confidence changes, and exam results were assessed. RESULTS: One hundred and seventy-three radiotherapy professionals participated. An average of 56 (SD ±18) attendees per session were registered. Fifty (29.7%) participants completed the pre- and post-curriculum surveys, of which 30% were radiation oncologists (RO), 26% radiation therapists (RTT), 20% residents, 18% medical physicists and 6% neurosurgeons. Significant improvements were found across all 16 domains with overall mean +0.55 (SD ±0.17, p\u3c0.001) Likert-scale points. Significant improvements in individual competences were most common among medical physicists, RTT and residents. Pre- and post-curriculum exams yielded a mean 16.15/30 (53.8 ± 20.3%) and 23.6/30 (78.7 ± 19.3%) correct answers (p\u3c0.001). CONCLUSION: Longitudinal telehealth training is an effective method for improving confidence and knowledge on SBRT/SRS amongst professionals. Remote continuing medical education should be widely adopted in lower-middle income countries

Caracterización del delito de explotación sexual comercial en niños, niñas y adolescentes en el municipio de Cartago

T 362.76 E41; 70 p.Se caracteriza y analiza el delito de explotación sexual en niños, niñas y adolescentes en el municipio de Cartago, Valle del Cauca, examinando el marco de protección legal que tiene el Sistema Penal Colombiano para este delito y la acción de las entidades de prevención.Universidad Libre de Pereir

Consideraciones éticas relacionadas al manejo de muestras de investigación en cáncer

Molecular analysis of human biological material allows the identification of future biomarkers to improve the management of patients with cancer. However, the handling of these samples requires particular ethical considerations. Different organizations such as the European Council and government agencies of the United States have generated different documents with definitions, mechanisms, and regulations to avoid putting at risk of harm or violating the rights of donors of biological samples. Finally, all these documents have evolved over time and have allowed research institutions to have standard committees and regulations in ethics. Thus, legal institutions can create precedents and generate coherent sentences.El análisis molecular de material biológico humano permite la identificación de futuros biomarcadores para mejorar el manejo de pacientes con cáncer. Sin embargo, el manejo de estas muestras requiere consideraciones éticas particulares. Distintas organizaciones como el Consejo Europeo y agencias de gobierno de Estados Unidos han generado distintos documentos con definiciones, mecanismos y reglamentos para evitar poner en riesgo de daño o vulnerar los derechos de los donantes de muestras biológicas. Finalmente, todos estos documentos han evolucionado en el tiempo y han permitido que las instituciones de investigación cuenten con comités y regulaciones en ética estándares. Así, las instituciones legales puedan crear precedentes y generar sentencias coherentes

Lung Cancer in Peru

Peru is a South American nation with a growing and aging population of 31 million people with a life expectancy at birth of 76.7 years. The country is divided into 25 regions, 79% of the population is urban, and Lima, the capital, concentrates more than a third of the population.1 Although Peru is an upper-middle-income country, health expenditure represents only 5.1% of the gross domestic product, which is lower than the average of Latin America and the Caribbean (LATAM) (8.56%).2 Out-of-pocket health expenditure is 30.9%.3 Peru has a comprehensive National Cancer Plan and two population-based cancer registries in Lima and Arequipa.Revisión por pare

Viabilidad y seguridad de la biopsia prostática transperineal en la era de fusión de imágenes por resonancia magnética cognitiva/ultrasonido en la detección del cáncer

Objetivo: Describir los resultados de la biopsia prostática transperineal por fusión de la resonancia magnética cognitiva y ultrasonido en la detección del cáncer.  Materiales y métodos: Estudio de serie de casos, retrospectivo, realizado en Clínica Delgado entre julio del 2019 y octubre del 2021. Se incluyó pacientes con examen digital de próstata y/o Antígeno Prostático Específico anormal e imágenes de Resonancia Magnética de próstata con lesiones categoría PI-RADS 4 o 5. Excluyendo a pacientes con trastorno de coagulación, lesiones rectales, imposibilidad para abducción, comorbilidades para anestesia. Registramos las características clínicas, demográficas, datos de antígeno prostático específico, volumen de la próstata, lesiones PI-RADS, tasas de cáncer, complicaciones. Resultados: Se evaluaron 18 pacientes, con edad media de 69,33 ± 7,67 años. La media del antígeno prostático específico de 14,94 ± 12,42 ng/mL. La media del volumen de próstata de 57,72 ± 28,68 cc. Al examen digital de la próstata 16/18 (88.88 %) pacientes tenían  sospecha de cáncer. Biopsias en pacientes con lesiones PI-RADS 4 en 6/18 (33,33%) y 5 en 12/18 (66,67%). Biopsia con 19 núcleos a 6/18 (33,33%) y 16 núcleos a 12/18 (66,67%) pacientes. Pacientes con cáncer 15/18 (83,33%), todos Adenocarcinoma Acinar, con Gleason 6 en 2/18 (11,11%) y Gleason ≥ 7 en 13/18 (72,22%) pacientes. Complicaciones leves como hematuria 1/18 (5,6%), disuria terminal 8/18 (44,4%) y molestia perineal 7/18 (38,8%) y ninguna infecciosa. Conclusiones: la biopsia prostática transperineal por fusión de imágenes de resonancia magnética cognitiva y ultrasonido es factible, segura, con tasas altas de positividad y sin infecciones

Hypofractionation as a solution to radiotherapy access in latin america: expert perspective

Background: Limited radiation therapy resources have resulted in an interest in developing time and cost-saving innovations to expand access to cancer treatment, in Latin America. Therefore, hypofractionated radiotherapy (HRT) is a possible solution, as this modality delivers radiation over a shorter period of time. Materials and methods: A selected panel of Latin American (LA) experts in fields related to HRT were provided with a series of relevant questions to address, prior to the multi-day conference. Within this meeting, each narrative was discussed and edited, through numerous rounds of discussion, until agreement was achieved. Results: The challenges identified in increasing the adoption of HRT in LA include a lack of national and regional clinical practice guidelines and cancer registries; a lack of qualified human resources and personnel education; high up-front costs of equipment; disparate resource distribution and scarce HRT research. An analysis for these overarching challenges was developed and answered with recommendations. Conclusion: Extending the adoption of HRT in LA can provide a path forward to increase access to radiotherapy and overcome the shortage of equipment. HRT has the potential to improve population health outcomes and patient centered care, while offering comparable local control, toxicity, palliation, and late effects for multiple indications, when compared to conventional RT. Concerted efforts from all involved stakeholders are needed to overcome the barriers in adopting this strategy in LA countries. The recommendations presented in this article can serve as a plan of action for HRT adoption in other countries in a similar situation

Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases.

Postsurgical radiotherapy (RT) has been early proven to prevent local tumor recurrence, initially performed with whole brain RT (WBRT). Subsequent to disadvantageous cognitive sequalae for the patient and the broad distribution of modern linear accelerators, focal irradiation of the tumor has omitted WBRT in most cases. In many studies, the effectiveness of local RT of the resection cavity, either as single-fraction stereotactic radiosurgery (SRS) or hypo-fractionated stereotactic RT (hFSRT), has been demonstrated to be effective and safe. However, whereas prospective high-level incidence is still lacking on which dose and fractionation scheme is the best choice for the patient, further ablative techniques have come into play. Neoadjuvant SRS (N-SRS) prior to resection combines straightforward target delineation with an accelerated post-surgical phase, allowing an earlier start of systemic treatment or rehabilitation as indicated. In addition, low-energy intraoperative RT (IORT) on the surgical bed has been introduced as another alternative to external beam RT, offering sterilization of the cavity surface with steep dose gradients towards the healthy brain. This consensus paper summarizes current local treatment strategies for resectable brain metastases regarding available data and patient-centered decision-making

Acylsucrose-Producing Tomato Plants Forces Bemisia tabaci to Shift Its Preferred Settling and Feeding Site

[Background] The whitefly Bemisia tabaci (Genn.) causes dramatic damage to plants by transmitting yield-limiting virus diseases. Previous studies proved that the tomato breeding line ABL 14-8 was resistant to B. tabaci, the vector of tomato yellow leaf curl disease (TYLCD). This resistance is based on the presence of type IV glandular trichomes and acylsucrose production. These trichomes deter settling and probing of B. tabaci in ABL 14-8, which reduces primary and secondary spread of TYLCD.[Methodology/Principal Findings] Whitefly settlement preference was evaluated on the adaxial and abaxial leaf surfaces of nearly-isogenic tomato lines with and without B. tabaci-resistance traits, 'ABL 14-8 and Moneymaker' respectively, under non-choice and free-choice conditions. In addition, the Electrical Penetration Graph technique was used to study probing and feeding activities of B. tabaci on the adaxial and abaxial leaf surfaces of the same genotypes. B. tabaci preferred to settle on the abaxial than on the adaxial surface of 'Moneymaker' leaves, whereas no such preference was observed on ABL 14-8 tomato plants at the ten-leaf growth stage. Furthermore, B. tabaci preferred to feed on the abaxial than on the adaxial leaf surface of 'Moneymarker' susceptible tomato plants as shown by a higher number of sustained phloem feeding ingestion events and a shorter time to reach the phloem. However, B. tabaci standard probing and feeding behavior patterns were altered in ABL 14-8 plants and whiteflies were unable to feed from the phloem and spent more time in non-probing activities when exposed to the abaxial leaf surface.[Conclusions/Significance] The distorted behavior of B. tabaci on ABL 14-8 protects tomato plants from the transmission of phloem-restricted viruses such as Tomato yellow leaf curl virus (TYLCV), and forces whiteflies to feed on the adaxial side of leaves where they feed less efficiently and become more vulnerable to natural enemies. © 2012 Rodriguez-Lopez et al.Ministerio de Ciencia e Innovación Spain (co-financed by FEDER) projects: AGL2007-66760-C02-02/AGR, AGL2007-66399-CO3-02/AGR, and AGL2010-22287-C02-01/AGR, AGL2010-22287-C02-01/AGR Consejería de Innovación y Ciencia, Junta de Andalucía, Spain (co-financed by FEDER-FSE) projects: AGR-214 and AGR-129Peer Reviewe