Selective internal radiation therapy: review of the standard operating procedure for selective internal radiation therapy using SIR-Spheres microspheres labelled with Yttrium 90

Aim: Selective Internal Radiation Therapy (SIRT), also known as radioembolization, is a liver-directed therapy for inoperable primary and secondary liver tumours. The aim of this study is to review the Standard Operating Procedure (SOP) used in the Radiopharmacy Department of the Oxford University Hospital NHS Foundation Trust to prepare 90Y labelled SIR-Spheres microspheres, in order to improve the dispensing procedure for delivering the intended patient treatment doses. The specification is: the activity prescribed ±10%. Methods: Eleven tests were carried out according to the current SOP. Radioactivity was diluted in up to 3 or 5 ml of water for injection and inserted into a V-vial. Following this, the used syringes and needles were measured using a Capintec Radionuclide Calibrator to check for any remaining activity. Results: One of the doses dispensed (11th) was below the specification. This, is in, turn triggered the review of the SOP. The operator must dilute the dose up to 3 ml with water for injection and inject it in the V-vial. According to the new procedure, using the same syringe and needle the operator must draw up an additional 1 ml of water for injection and inject this volume again into the V-vial. This washes the syringe and needle and removes any remaining activity. Conclusions: The reviewed SOP to prepare 90Y labelled SIR-spheres microspheres has shown to improve the dispensing procedure in terms of dose delivered to the patient. The collected data has been accepted and the reviewed SOP implemented in the Radiopharmacy Department at Oxford University Hospitals NHS Foundation Trust

The call for sailing uncharted seas: motivations and expectations of recently graduated individuals

We explore the motivations and expectations that are impacting Portuguese recently graduated individuals in their decision of becoming international managers. Throughout a qualitative analysis over 20 interviews we construct a theoretical framework of recent graduates actual expectations and motivations regarding their international assignments. Accordingly, individuals are conducted by the desire of cultural-diversity experiences, social pressures and challenging environments. Expectations are not a result of a straightforward process; instead, they are dynamic and influenced by the challenges that international managers have to cope with during their international journey. Moreover, expectations and motivations are not mutually exclusive; they produce impact on each other, characterizing a dynamic process of international managers‟ lives

Case report and review of the literature

Adenomyoepithelioma is a biphasic neoplastic proliferation of luminal and myoepithelial cells. Patients are 22 to 92 years old, normally asymptomatic. It is either diagnosed as a palpable mass or as an occasional mammographic finding(1). Fine-needle aspiration cytology is the investigation of choice to diagnose(2) and immunohistochemistry is very useful in confirming the diagnosis(3). Adenomyoepithelioma is usually benign, although it may recur locally(4). Tubular variants and some lobular tumors with high mitotic activity or cytological atypia are particularly prone to local recurrence. Its treatment is complete local excision(5-7) and, in case of recurrence, a wider excision(5). Case Report: 47-year-old female with a breast mass on the external upper quadrant of the left breast. Ultrasound revealed an 8 millimeter homogeneous, well delimitated nodule with regular borders and medio-lateral mammography showed a well defined opaque mass with irregular borders. The anatomo-pathological and immunohistochemisty of the specimen from the needle core biopsy was inconclusive so an excisional biopsy was performed diagnosing a tubular adenomyoepithelioma. No additional treatment was performed with a follow-up of 20 months without recurrence. Review of published cases: 159 cases of adenomyoepithelioma almost all women mostly older than 45 years old. Adenomyoepithelioma is presented as a mass of on average 30 millimeters in either breast of lobular pattern most of the times. Adenomyoepithelioma demonstrated a borderline malignancy especially in women from 15 to 40 years of age or older than 80 years. Lobular pattern proved to be the most benign, while spindle pattern the most malignant variant and tubular pattern is the commonest one to recur. Low mitotic rates are associated with less recurrence or malignancy and high mitotic rates accompany adenomyoepitheliomas with great potential to metastasize. Conclusions: Adenomyoepithelioma affects women aged between 16 and 92 years in either breast. It may display a heterogeneous pattern and a borderline malignancy. Ultrasonographic images may play an important role as a first approach and fine-needle aspiration cytology combined with immunohistochemistry should define the diagnosis. Potential malignant adenomyoepitheliomas are associated with high mitotic activity, cytologic atypia(6), necrosis and infiltrative borders(4). Metastases have only been documented in tumors 20 millimeter in diameter or larger(8) and distant metastases locations include lung, brain, jaw, soft tissues, thyroid, lymph nodes (mediastinal and axillary) and liver(6, 9-13). Mitotic rate appears to be a good parameter for prognosis and to predict the tumor behavior.O adenomioepitelioma da mama é uma proliferação neoplásica bifásica de células luminais e mioepiteliais. É normalmente assintomático, sendo diagnosticado como massa palpável ou achado imagiológico ocasional(1). A punção aspirativa por agulha fina é o melhor método de diagnóstico(2) e a imuno-histoquímica é muito útil na sua confirmação(3) Os adenomioepiteliomas são geralmente benignos embora possam recorrer localmente(4) sendo a variante tubular, os tumores lobulares com alta atividade mitótica ou os tumores com atipia citológica particularmente propensos à recorrência local. O tratamento é a excisão local completa(5-7) e em caso de reincidência a excisão ampla(5). Caso clínico: Paciente de 47 anos com uma massa no quadrante superior-externo da mama esquerda. A ecografia revelou um nódulo com 8 milímetros de maior eixo, homogéneo, bem delimitado, de contornos regulares e a mamografia mostrou uma massa opaca, bem definida, com bordos irregulares. Os estudos anátomo-patológico e imunohistoquímico da amostra da microbiópsia foram inconclusivos pelo que foi realizada uma tumorectomia cuja análise anatomo-patologica revelou um adenomioepitelioma tubular. Não foi realizado tratamento adicional e o follow-up ao fim de 20 meses não teve recorrência. Avaliação dos casos publicados: dos 159 casos de adenomioepitelioma descritos, 158 são em mulheres e maioritariamente acima dos 45 anos de idade. Apresenta-se como uma massa, em média com 30 milímetros de diâmetro, sendo o padrão lobular o mais frequente. Demonstrou malignidade limítrofe especialmente em mulheres entre 15 a 40 anos ou com mais de 80 anos. O padrão lobular parece ser o mais benigno enquanto o padrão spindle o mais maligno e o padrão tubular é o que mais apresenta recorrências locais. Taxas mitóticas baixas estão associadas a menos recorrências e as altas a grande potencial de metastização. Conclusões: O adenomioepitelioma afeta predominantemente mulheres entre os 16 e os 92 anos de idade, sem predomínio mamário. Pode exibir um padrão heterogéneo e uma malignidade limítrofe. A ecografia é importante como uma primeira abordagem e a punção aspirativa por agulha fina combinada com a imunohistoquímica definem o diagnóstico. Adenomioepiteliomas com potencial maligno estão associados a alta atividade mitótica, atipia citológica(6), necrose e limites imprecisos(4). As metástases foram documentadas em tumores de 20 milímetros de diâmetro ou maiores(8) e os locais de metástases distantes incluem pulmão, cérebro, mandíbula, tecidos moles, tiroide, gânglios linfáticos (mediastino e axilar) e fígado(6, 9-13). O Índice mitótico parece ser um ótimo parâmetro para o prognóstico e para prever o comportamento do tumor

Efeito da acumulação de metais pesados na motilidade do esperma e no índice ARN/ADN de populações de duas espécies de equinodermes

Este estudo teve como objetivo verificar o efeito da acumulação de metais pesados na motilidade do esperma e na razão ARN/ADN em indivíduos de duas populações de equinodermes: Asterias rubens e Echinus acutus. Estas espécies ocorrem naturalmente ao longo de um gradiente de contaminação de cádmio, cobre, chumbo e zinco, num fiorde norueguês (Sørfjord). A motilidade do esperma foi quantificada com o auxílio de um sistema informático especializado (CASA). A razão ARN/ADN foi determinada através de ensaios utilizando brometo de etídio como corante fluorescente. Embora se tenha verificado acumulação de metais pesados nos tecidos dos indivíduos, não se registaram diferenças significativas na motilidade do esperma e na razão ARN/ADN do tegumento em função do grau de contaminação do ambiente. Apenas os valores da razão ARN/ADN do ceco pilórico de A. rubens foram significativamente maiores na estação mais contaminada. Estas populações parecem então tolerar os níveis de contaminantes existentes no Sørfjord. /ABSTRACT - Effects of field metal contamination on sperm motility and RNA/DNA ratio in two echinoderm species this study aimed to assess the effects of field metal contamination on sperm motility and RNA/DNA ratio in two populations of echinoderms: Asterias Rubens and Echinus acutus. These species occur naturally along a contamination gradient of cadmium, copper, lead and zinc, in a Norwegian fjord (Sørfjord). Sperm motility was quantified with the help of a computer assisted sperm analysis system (CASA). The RNA/DNA ratios were assessed based on a 1-dye, (Ethidium bromide)/1-enzyme (RNase) 96-well microplate fluorometric assay. Although both species appeared to readily accumulate metals, neither sperm motility parameters in A. Rubens nor RNA/DNA in the body wall of both species were affected. The RNA/DNA ratios in A. Rubens pyloric caeca were significantly higher in the most contaminated station. Even though this fjord is considered a highly contaminated place, these populations seem to tolerate these metal contamination levels

Social tagging and Dublin Core : a preliminary proposal for an application profile fo DC social tagging

The Web 2.0 maximizes the Internet concept of encouraging its users to cooperate effectively for the offer of virtual services and content organization. Among the various potentialities of the Web 2.0, folksonomy appears as a result of the free assignment of tags to the Web’s resources by their users/ readers. Despite tags describe the Web’s resources, generally they are not integrated in the metadata. In order for them to be intelligible by machines and therefore used in the Semantic Web context, they have to be automatically allocated to specific metadata elements. There are many metadata formats. The focus of this investigation will be the Dublin Core Metadata Terms (DCTerms) that is a widely used set of properties for the description of electronic resources. A subset of DCTerms, the Dublin Core Metadata Element Set (DCMES), has been adopted by the majority of Institutional Repositories’ platforms as a way to promote interoperability. We propose a research that intends to identify elements of the metadata originated from folksonomies and propose an application profile for DC Social Tagging. That will allow tags to be conveniently processed by interoperability protocols, particularly the Open Archives Initiative – Protocol for Metadata Harvesting (OAI-PMH). This paper will present the results of the pilot study developed in the beginning of the research as well as the metadata elements preliminarily defined.Capes/MEC - Brasil.Fundação para a Ciência e Tecnologia (FCT)

Adequação Nutricional em Crianças Subnutridas dos 6 aos 59 Meses, em Cantagalo (São Tomé e Príncipe)

OBJETIVOS: Conhecer as diferenças entre o aporte energético e de macronutrientes e as recomendações nutricionais em crianças subnutridas dos 6 aos 59 meses, no distrito de Cantagalo, em São Tomé e Príncipe. Estudar a relação entre a adequação da ingestão e o tipo e grau de subnutrição, idade, amamentação e dificuldade de acesso a comida suficiente reportada pelo cuidador da criança. METODOLOGIA: Neste estudo descritivo inquiriram-se cuidadores de 118 crianças entre os 6 e os 59 meses. Foram recolhidos dados antropométricos e sociodemográficos e foi feito um inquérito às 24 horas anteriores para avaliar o aporte energético e de macronutrientes. Determinou-se a adequação nutricional pela comparação com as Dietary Reference Intake (crianças não amamentadas) e com as recomendações definidas por Dewey e Brown (para as amamentadas).RESULTADOS: Da amostra de crianças subnutridas, 72,9%, 59,3% e 74,6% apresentou aportes inferiores às recomendações em termos de energia, hidratos de carbono e lípidos, respetivamente. Apenas 14,4% apresentou aporte proteico inferior ao de referência. As crianças mais velhas e as não amamentadas tenderam a apresentar-se mais afastadas das recomendações. As crianças com subnutrição crónica moderada, comparativamente às que tinham subnutrição crónica severa, apresentaram maior prevalência de aporte energético inferior às recomendações, mas não se verificaram diferenças relativamente aos macronutrientes. CONCLUSÕES: A maioria das crianças subnutridas avaliadas não atinge as recomendações energéticas e de macronutrientes, à exceção das proteínas. Esta situação é mais grave em crianças mais velhas e crianças não amamentadasINTRODUCTION: Undernutrition in children is considered a public health issue, especially in developing countries, and its relation to an inadequate dietary intake is highly recognized. The lack of data concerning to São Tomé e Príncipe in this area makes it imperious to evaluate these childrens nutritional adequacy and to do more similar studies.OBJECTIVES: To know the differences between energetic and macronutrient intake and nutritional recommendations in undernourished children from 6 to 59 months of age in Cantagalo, São Tomé e Príncipe. To assess the relationship between nutritional adequacy and undernutrition type and severity, age, breastfeeding and reported difficulties in access to enough food.METHODOLOGY: In this descriptive study, a survey was applied to 118 caregivers of children from 6 to 59 months of age. Anthropometric and sociodemographic data were collected and a 24 hour recall was applied to assess childrens energy and macronutrient intake. Nutritional adequacy was determined by comparison with the DRI (non-breastfed children) and Dewey and Browns recommendations (for breastfed children).RESULTS: From the sample of undernourished children, 72.9%, 59.3% and 74.6% presented values below the recommendations for energy, carbohydrates and lipids, respectively. For protein, only 14.4% were below the reference values. Older and non-breastfed children tended to be out of the recommendation. Children with moderate chronic undernutrition, comparatively to those with severe chronic undernutrition, showed a higher prevalence of energetic intake inferior to recommendations, but no significant differences were found in terms of macronutrients. CONCLUSIONS: Most of the evaluated undernourished children do not reach energetic and macronutrient recommendations, with protein being an exception. This is worse for older and non-breastfed children

Relating folksonomies with Dublin Core

This article presents a research carried out to continue the project Kinds of Tags, which intends to identify elements required for metadata originating from folksonomies. It will provide information that may be used by intelligent applications to assign tags to metadata elements. Despite the unquestionably high value of DC and DC Terms, the pilot study revealed a significant number of tags for which no corresponding properties yet existed. A need for new properties was determined. This article presents the problem, motivation and methodology of the underlying research. It further presents and discusses the findings from the pilot study.(undefined

Relating folksonomies with Dublin Core

Folksonomy is the result of describing Web resources with tags created by Web users. Although it has become a rich basis for the description of resources, in general terms it is not being conveniently integrated in metadata. However, if the appropriate metadata elements are identified, then further work may be done in order to automatically assign tags to these elements (RDF properties) and use them in Semantic Web applications. This article presents research carried out to continue the project Kinds of Tags, which intends to identify elements required for metadata originating from folksonomies and to propose an application profile for DC Social Tagging. It will provide information that may be used by software applications to assign tags to metadata elements and, therefore, means for tags to be conveniently gathered by metadata interoperability tools. Despite the unquestionably high value of DC and the significance of the already existing properties in DC Terms, the pilot study show revealed a significant number of tags for which no corresponding properties yet existed. A need for new properties, such as Action, Depth, Rate, and Utility was determined. Those potential new properties will have to be validated in a later stage by the DC Social Tagging Community.(undefined

Therapeutic nursing education in promoting self-management of adolescents with type 1 diabetes mellitus: integrative literature review

Diabetes Mellitus Type I (DM1) is an autoimmune disease, characterized by the total destruction of the beta (β) cells of the islets of Langerhans in the pancreas. This disease can strike people at any age, but it usually develops in children or young adults. Because of the high prevalence of DM1 in the young population, as well as all the difficulties in effective self-management in this population, with very specific characteristics, it is essential to develop therapeutic education interventions, with the aim of acquiring self-management skills. Thus, the main objective of this study is to identify the benefits of therapeutic nursing education interventions in promoting self-management of adolescents with DM1. For this, an Integrative Literature Review was carried out, using the EBSCOhost, PubMed, Scopus and Web of Science platforms. Six articles were eligible. In terms of results, benefits were identified in the health of adolescents, with the use of therapeutic education interventions by nurses, including the control of capillary glycemia, better acceptance of the pathology, improvement in body mass index, increased adherence to the therapeutic regime, a reduction in hospitalizations and complications, contribution to bio-psycho-social well-being and improvement quality of life.info:eu-repo/semantics/publishedVersio