Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: a retrospective analysis of 21 patients

Because of low incidence, mixed study populations and paucity of clinical and histological data, the management of adult brainstem gliomas (BSGs) remains non-standardized. We here describe characteristics, treatment and outcome of patients with exclusively histologically confirmed adult BSGs. A retrospective chart review of adults (age >18 years) was conducted. BSG was defined as a glial tumor located in the midbrain, pons or medulla. Characteristics, management and outcome were analyzed. Twenty one patients (17 males; median age 41 years) were diagnosed between 2004 and 2012 by biopsy (n = 15), partial (n = 4) or complete resection (n = 2). Diagnoses were glioblastoma (WHO grade IV, n = 6), anaplastic astrocytoma (WHO grade III, n = 7), diffuse astrocytoma (WHO grade II, n = 6) and pilocytic astrocytoma (WHO grade I, n = 2). Diffuse gliomas were mainly located in the pons and frequently showed MRI contrast enhancement. Endophytic growth was common (16 vs. 5). Postoperative therapy in low-grade (WHO grade I/II) and high-grade gliomas (WHO grade III/IV) consisted of radiotherapy alone (three in each group), radiochemotherapy (2 vs. 6), chemotherapy alone (0 vs. 2) or no postoperative therapy (3 vs. 1). Median PFS (24.1 vs. 5.8 months; log-rank, p = 0.009) and mOS (30.5 vs. 11.5 months; log-rank, p = 0.028) was significantly better in WHO grade II than in WHO grade III/IV tumors. Second-line therapy considerably varied. Histologically verification of adult BSGs is feasible and has an impact on postoperative treatment. Low-grade gliomas can simple be followed or treated with radiotherapy alone. Radiochemotherapy with temozolomide can safely be prescribed for high-grade gliomas without additional CNS toxicities

Qualidade de aplicação de herbicida em lavoura de trigo Herbicide spraying quality in wheat crop

O objetivo deste trabalho foi analisar a operação de aplicação de herbicida em lavoura de trigo utilizando ferramentas estatísticas da qualidade e tecnologia de sistema de informação geográfica, sendo os dados coletados em propriedade agrícola situada no Paraná. Foram considerados dois indicadores: percentagem de cobertura de gotas e densidade de gotas. Foram utilizadas, para avaliação dos resultados, técnicas da estatística descritiva, de controle de qualidade e do sistema de informação geográfica. Os resultados mostram que o processo de aplicação de defensivo avaliado apresenta irregularidade e grande variabilidade, necessitando de melhorias. Entretanto, tendo em vista a característica dos produtos utilizados (sistêmicos), pode-se considerar como razoável a qualidade da operação. A associação de técnicas de análises, como os da carta de controle, histograma de freqüência e da tecnologia SIG, permite boa caracterização do processo de pulverização empregado.<br>This work aimed to evaluate the pesticide spraying in no tillage system using statistical quality and GIS tools. The data were collected in a farm Paraná State, Brazil. Two indicators were considered: drop coverage percentage and drop density. Tools from descriptive statistics, quality control and GIS were used in the results evaluation. The spraying process presented irregularity and high variability, demanding improvement. However, considering the characteristics of the applied pesticides (systemics), the operation could be considered as reasonable. The association of the control chart, histogram and GIS is a tool which allowed the process characterization to be done