Cervical and Vulvar Intraepithelial Neoplasia after Treatment with Oral Isotretinoin for Severe Acne Vulgaris

Oral isotretinoin is the drug of choice for severe acne vulgaris, but its use is still controversial in preventing, treating or stopping the progression of the cervical intraepithelial neoplasia [6, 7, 8]. It induces cell differentiation, inhibits cell proliferation, stimulates host immune reaction, inhibits the oncogene expression, augments cell-mediated cytotoxicity, and induces apoptosis [5]. The isotretinoin has many side effects including teratogenicity. There is no previous report of developing cervical intraepithelial neoplasia (CIN) or vulvar intraepithelial neoplasia (VIN) after introducing oral isotretinoin to a patient. We are reporting a 37-year-old female with no risk factors for cervical cancer who had developed CIN-I and VIN-I during a 6-month treatment period of oral isotretinoin for her severe acne vulgaris. Interestingly, the patient had complete spontaneous pathologic-proven remission after stopping the isotretinoin. Further case reports are warranted to support this incidence

Successful Treatment of Primary Vaginal Papillary Serous Adenocarcinoma Using Chemoradiation Followed by Brachytherapy

Advances in treatment have not recently been reported in rare primary vaginal adenocarcinomas. A 56-year-old woman with a chronic vaginal cyst and possible in utero diethylstilbestrol exposure presented with postmenopausal bleeding. Biopsy of the vagina revealed high-grade papillary serous adenocarcinoma. MRI showed a 6-cm vaginal tumor and 3-cm left inguinal lymph node with metastasis. The patient initially received concurrent cisplatin and radiation. She then received high-dose-rate brachytherapy for further local control. Brachytherapy following external beam radiation with concurrent cisplatin led to clinically undetectable cancer at 24 months with minimal side effects

Extramammary Perianal Paget's Disease

Perianal Paget's disease is a rare malignancy. It is rarely isolated and often associated with an underlying adenocarcinoma. It usually presents with anal itchiness and discomfort and can be misdiagnosed as hemorrhoids. Once the diagnosis of perianal Paget's disease is granted, extensive work-up to find an underlying primary malignancy is crucial. Surgery is the standard modality of treatment of extramammary Paget's disease (EMPD) with recurrence rates of 44–60%. Other different treatment modalities including radiotherapy, laser therapy, topical and systemic chemotherapy and the new emerging, promising photodynamic therapy are in the field of study. A 76-year-old man was referred to our hospital with a one-year history of anal itchiness and intermittent rectal bleeding. Skin shave and punch biopsies from the perianal area were reported back as perianal Paget's disease with no underlying adenocarcinoma. The immunohistochemical stains were positive for cytokeratin 7 but also positive for cytokeratin 20 and CEA which indicated the essentiality of extensive investigations to find a primary malignancy. Skin exam showed no primary source. The investigations were unable to find the primary malignancy. Given the results of immunohistochemical stains we recommended local perianal Paget's disease resection. The intraoperative frozen section showed adenocarcinoma around the anal sphincter. Ten days later the patient underwent an abdominoperineal resection and the final pathology report showed extensive adenocarcinoma in three quadrants of the perianal area with focal involvement of the rectal mucosa. We recommended an adjuvant chemotherapy with FOLFOX following surgery given the bulkiness of the disease. We conclude that once perianal Paget's disease is diagnosed, an extensive work-up should be done to find the underlying primary malignancy. Immunohistochemical stains are helpful in raising the suspicion of underlying primary malignancy. Finding an underlying primary malignancy in patients with EMPD is prompt to choose the treatment modality and estimate the prognosis

Technology Roadmapping for Renewable Fuels: Case of Biobutanol in Brazil

Technology roadmapping has been used to define long term strategies and research agenda for the development of biofuels. The present work proposes the use of technology roadmapping as a technique for long term strategic planning of the biobutanol development, aligning long term goals with the resources, funding, and priorities to fulfill the needs in the development process in Brazil.Interviews have been used in the roadmapping process as an alternative to the workshops on market, product and technology. It allows the participation of companies in a highly competitive environment. The use of interviews allows the information to be collected individually, contributing to the elaboration of a roadmap.The results show that sugar cane has the potential to be used as a feedstock in the biobutanol production process, enabling Brazil to become a key exporter to supply other countries. For the short future, biobutanol has the potential to be produced in Brazil to replace petro-butanol as a solvent in industrial applications and to build the export platform for the fuels market

Geotecnologias nos estudos geológicos e geotécnicos para suporte à gestão ambiental no litoral norte do RS (Brasil): um panorama de duas décadas.

O objetivo deste trabalho foi comparar os dados disponíveis, bem como as técnicas e os softwares utilizados há duas décadas frente ao que hoje está disponível para produzir mapas temáticos, empregando dados vetoriais e de imagens e integrando os mesmos num sistema de informações geográficas (SIG)

The Level of Europium-154 Contaminating Samarium-153-EDTMP Activates the Radiation Alarm System at the US Homeland Security Checkpoints

153Sm-EDTMP is a radiopharmaceutical composed of EDTMP (ethylenediamine-tetramethylenephosphonate) and Samarium-153 [1]. 153Sm-EDTMP has an affinity for skeletal tissue and concentrates in areas with increased bone turnover; thus, it is successfully used in relieving pain related to diffuse bone metastases [1]. The manufacturing process of 153Sm-EDTMP leads to contamination with 154Eu (Europium-154) [2]. A previous study only alluded to the retention of 154Eu in the bones after receiving treatment with 153Sm-EDTMP [2]. Activation of the alarm at security checkpoints after 153Sm-EDTMP therapy has not been previously reported. Two out of 15 patients who received 153Sm-EDTMP at Roger Maris Cancer Center (Fargo, N. Dak., USA) activated the radiation activity sensors while passing through checkpoints; one at a US airport and the other while crossing the American-Canadian border. We assume that the 154Eu which remained in the patients’ bones activated the sensors

Identificación de unidades de paisaje en la planicie costera de Rio Grande do Sul, Brasil, a través de técnicas de teledetección

El objetivo de este trabajo es identificar las unidades de paisaje que permitan comprender los procesos dominantes de la paleogeografía en la zona costera de Rio Grande. Se utilizaron dos imágenes LANDSAT 8, usando el sensor Operational Land Image (OLI). Se realizó la fusión de la banda pancromática (banda 8) con las bandas 3, 4 y 5, generándose una imagen de 15 metros de resolución espacial. Fue posible identificar y mapear las unidades de paisaje en la zona de Rio Grande. En el área de sedimentos marinos del Holoceno, se identificó la presencia de crestas de playa regresivas intercaladas con depósitos eólicos. Las áreas de bancos de arena son paleo-orientaciones de la costa durante el Holoceno. El proceso de fusión de imágenes (sensor OLI) que permite la generación de una imagen de 15 metros de resolución espacial fue esencial en los resultados y como una propuesta metodológica de trabajo, ya que facilita la interpretación de las unidades de paisaje

New Configuration of the Brazilian State: Liberty and Development in the Evolution of Government in Brazil

The recent events in the global economy have revitalized the debate about the size and functions of the State. The neoliberal discourse was put in check, reopening the discussions concerning Market Liberty and the importance of the State. Since the proclamation of the Republic, the Brazilian government has undergone numerous reforms, sometimes assuming a liberal, external market dependent orientation, while at other times assuming an authoritarian, developmental state-driven orientation. The aim of this article is to develop insights into the evolution of the governmental organization and reflect on the assumptions that lie behind the various reforms that have taken place since the beginning of the Republic. The theoretical framework is divided into three parts: Development and Liberty based on the perspectives of Friedrich Hayek and Amartya Sen; the role of the State and its impact on the economy and; the formats assumed by the Brazilian State throughout the history of the Republic. The latter part of the work returns to the theoretical framework, summarizing all that has been discussed in order to fulfil the aims of the study