When size matters: changing opinion in the management of pleural space-the rise of small-bore pleural catheters

Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small to large bore ones. Indications for an appropriate selection remains yet matter of debate, especially regarding the use of small bore catheters. Through this paper, we aimed to retrace the improvements of drains through the years and to review the current clinical indications for chest drain placement in pleural/thoracic diseases, comparing the effectiveness of small-bore drains vs. large-bore ones

The prognostic impact of the international association for the study of lung cancer (IASLC) definitions on completeness of surgical resection for non-small cell lung cancer (NSCLC)

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Nature-Inspired Nanotechnology and Smart Magnetic Activation: Two Groundbreaking Approaches Toward a New Generation of Biomaterials for Hard Tissue Regeneration

Today, as the need of new regenerative solutions is steadily increasing, the demand for new bio-devices with smart functionality is pushing material scientists to develop new synthesis concepts. Indeed, the conventional approaches for biomaterials fail when it comes to generate nano-biocomposites with designed biomimetic composition and hierarchically organized architecture mimicking biologically relevant tissue features. In this respect, an emerging concept in material science is to draw inspiration from natural processes and products, which we may consider as the most advanced examples of smart nanotechnology. Natural processes of supramolecular assembly and mineralization of organic macromolecules, known as biomineralization, generate complex hybrid 3D constructs that are the basis of skeletons, exoskeletons, nacre and shells. On the other hand, natural structures such as woods and plants exhibit multi-scale hierarchic organization that is the source of smart and anisotropic mechanical properties associated with high porosity and lightness. The association of nature-inspired nano-technological products with smart functionalization can provide new advanced solutions to critical and still unmet clinical needs. In this respect, magnetic activation of biomaterials by the use of a recently developed biocompatible, resorbable magnetic apatite promises to represent a new safe and effective switching tool, enabling personalized applications in regenerative medicine and theranostics that so far were not feasible, due to the cytotoxicity of the currently used magnetic materials

Solitary Fibrous Tumours of the Pleura

Solitary fibrous tumours of the pleura (SFTP) are rare neoplasms originating from one of the components of the sub-mesothelial connective layer underlying the pleura. They are the most common non-mesothelial primary pleural neoplasms but still remain relatively rare. Their behaviour is mostly indolent; however, some may de-differentiate into malignant and aggressive tumours. Surgical resection is the mainstay treatment for SFTP, even more so in case of voluminous masses, due to compression onto lung, mediastinum and great vessels. In this chapter, we discuss the disease characteristics reported in the literature with respect to clinical presentation, diagnosis and treatment; also, we will discuss the results of patients treated for SFTP who underwent a surgical treatment in our unit of thoracic surgery

A pesquisa-ação como ferramenta para informação sobre agrotóxicos: o caso de trabalhadores rurais da Zona da Mata, Rondônia, Brasil

A região da Zona da Mata em Rondônia, Brasil, destaca-se pela grande produção de grãos e cereais, e também tem sido evidenciada pela utilização de grande quantidade e variedade de agrotóxicos por trabalhadores rurais locais. Considerando tal cenário, uma série de atividades foi planejada em municípios da Zona da Mata, no âmbito de uma pesquisa-ação, com o propósito de informar os trabalhadores rurais quanto aos riscos da má utilização de agrotóxicos e incentivar mudanças de rotina e a busca de informações técnicas. A pesquisa-ação foi desenvolvida em duas etapas. A primeira consistiu em eventos de integração entre trabalhadores rurais, órgãos públicos e o pesquisador; a segunda parte, realizada doze meses depois, consistiu da avaliação do impacto das atividades da primeira etapa na rotina de utilização de agrotóxicos.  Os achados revelaram que a maioria dos técnicos dos órgãos públicos (87,5%) e dos trabalhadores rurais (70,0%) entrevistados afirmou ter havido um aumento das consultas à assistência técnica. Quanto à utilização de agrotóxicos, 76,2% dos entrevistados relataram ter reduzido a quantidade utilizada ou ter processado a troca do agrotóxico utilizado por outros de menor toxicidade humana. É interessante observar que de acordo com 75,0% dos produtores rurais, houve um aumento na produtividade da lavoura. Dessa forma, atividades utilizando a pesquisa-ação podem constituir-se em ferramenta útil para promoção da saúde e divulgação de noções de segurança na utilização de agrotóxicos.

INK- JET PRINTING DEVICE

An ink-jet printing device (1) is described, said device comprising a first reservoir (4) designed to contain a first volume of printing fluid at a first height with respect to a reference plane, a supply system for forcing the printing fluid towards the first reservoir (4) and a second reservoir (5) designed to contain a second volume of printing fluid at a second height with respect to the reference plane. The second height is less than the first height. The device also comprises a conduit (2) designed to receive the printing fluid from the first reservoir (4) and conveys it towards the second reservoir (5) and an ejection plane in which ejector units (3) lie. The ejection plane is arranged in a position higher than the average of the first height and the second height, so as to generate a back pressure in the ejector units (3). The flow rate of the printing fluid is between about 5 and about 10 times the maximum flowrate which can be ejected from said ejector units. The printing fluid may be a ceramic ink

increased mean corpuscular volume of red blood cells predicts response to metronomic capecitabine and cyclophosphamide in combination with bevacizumab

Abstract Background There is an urgent need for the identification of commonly assessable predictive factors in the treatment of patients with metastatic breast cancer. Methods During the course of a treatment including low dose metronomic oral cyclophosphamide and capecitabine plus i.v. bevacizumab (plus erlotinib in one third of the patients) for metastatic breast cancer, we observed that a relevant number of patients developed repeatedly elevated levels of mean corpuscular volume (MCV) of red blood cells without a significant fall in hemoglobin levels. We conducted a retrospective analysis on these 69 patients to evaluate if the increase in MCV could be associated to tumor response. Results During the course of treatment 42 out of 69 patients (61%) developed macrocytosis. Using Cox proportional hazards modeling that incorporated macrocytosis (MCV≥100 fl) as a time-dependent covariate, macrocytosis resulted in a halved risk of disease progression (HR 0.45; 95% CI, 0.22–0.92, p-value 0.028). In a landmark analysis limited to patients with no sign of progression after 24 weeks of treatment, median time to progression was 72 weeks (48 weeks after landmark) in patients who had developed macrocytosis, and 43 weeks (19 weeks after landmark) in patients who had not (p = 0.023). Conclusion Macrocytosis inversely related to risk of disease progression in patients treated with metronomic capecitabine plus cyclophosphamide and bevacizumab for metastatic breast cancer. This finding may be explained through thymidylate synthase inhibition by capecitabine. Whether bevacizumab has a role in determining macrocytosis, similarly to what happens with sunitinib, has to be further investigated. If other studies will confirm our findings, macrocytosis might be used as an early marker of response during metronomic treatment with capecitabine and cyclophosphamide with or without bevacizumab