The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Fraturas vertebrais em grandes animais: estudo retrospectivo de 39 casos (1987-2002)

Realizou-se estudo retrospectivo (1987-2002) dos aspectos clínicos das fraturas vertebrais em eqüinos, bovinos, ovinos, caprinos e suínos atendidos no hospital veterinário da FMVZ-Unesp de Botucatu. Todos os casos tiveram confirmação radiográfica ou post-mortem. Segundo a espécie, a ordem de acometimento foi: bovina, eqüina, ovina, caprina e suína. As lesões ocorreram desde os 12 dias de idade até os 10 anos, com maior freqüência até os 12 meses. O segmento torácico foi o mais comprometido seguido dos segmentos lombar, cervical e sacral. As fraturas vertebrais devem fazer parte da lista de diagnósticos diferenciais de animais em decúbito, independente da espécie, sexo ou idade.It was performed a retrospective study (1987-2002) of clinical features of spinal fractures in the equine, bovine, ovine, caprine and swine referred to the Veterinary Hospital - FMVZ-Unesp in Botucatu, SP, Brazil. All the cases were confirmed by necropsy or radiographic evaluation. Bovines were the most affected species, followed by horses, sheep, goats and swines, and lesions occurred from 12 days to 10 years of age, being more frequent up to 12 months of age. Thoracic vertebrae were the most affected, followed by lumbar, cervical and sacral segments. Vertebral fractures should be included for differential diagnosis of recumbent animals, independently on species, sex or age

Anti-Sarcocystis neurona immunostaining associated with equine protozoal myeloencephalitis in Brazil Imunomarcação de Sarcocystis neurona associada com um caso de mieloencefalite protozoária eqüina no Brasil

A retrospective study (1942 to 2005) of histopathological lesions included samples of central nervous system (SNC) from 203 animals in the Equidae family. A total of 42.4% of these samples had significant pathological changes, which were classified as inflammatory (62.8%), degenerative (25.6%), circulatory (10.5%), and neoplasic (1.1%) lesions. Immunohistochemistry anti-Sarcocystis neurona antigens was performed in all the cases with inflammatory changes (54), of which one of the case of encephalitis resulted positive to immunostaining. Although evidence of EPM (Equine Protozoal Myeloencephalitis) has been previously reported in Brazil, to the best of our knowledge, this is the first report in which characteristic EPM lesion was associated with anti-S. neurona immunostaining in Brazil.<br>Em um estudo retrospectivo (de 1942 a 2005), amostras do sistema nervoso central de 203 eqüídeos foram avaliadas para a presença de alterações histológicas. Dessas amostras, 42,4% apresentaram alguma lesão histopatológica significativa, das quais foram classificadas como alterações inflamatórias (62,8%), degenerativas (25,6%), circulatórias (10,5%) e neoplásicas (1,1%). Fragmentos de SNC dos 54 animais com alterações inflamatórias foram avaliados para detecção de antígenos de Sarocystis neurona pela técnica de imunoistoquímica, que foi positiva em um caso de encefalite em eqüino. Embora haja registros de MPE no Brasil, este é o primeiro caso confirmado imunoistoquimicamente

Water stress before harvest of pepper-rosmarin

The objective of this work was to assess the effect of different periods of water stress before harvest of pepper-rosmarin (Lippia sidoides) on the contents of essential oil and flavonoids. The experiment was carried out during 270 days of cultivation, with drainage lysimeters, in a completely randomized block design with five treatments: 0, 2, 4, 6, and 8 days of water suppression before harvest, with four replicates. Fresh and dry matter yield, essential oil content, total flavonoids content, and water potential and temperature of leaves were determined. There was a decrease of approximately 50% in oil content and of 60% in total flavonoid content with the reduction of leaf water potential in 0.3 MPa. Essential oil is more sensitive to water stress than total flavonoids