RESUMO
Diante da carência de estudos sobre a frequência de dermatopatias que acometem cães por região geográfica no Brasil, o presente estudo objetivou conhecer a frequência das principais doenças cutâneas que afetam cães na região metropolitana de João Pessoa, Paraíba, Brasil. Os dados foram coletados de cães que passaram por atendimento dermatológico no período de setembro de 2014 a dezembro de 2016. Além dos exames clínicos e dermatológicos os cães foram submetidos a exames complementares (citológico, raspado de pele, parasitológico, tricograma, bacteriológico, micológico, histopatológico e molecular). No período do estudo, foram atendidos 1.083 cães, em que 18,65% (202/1.083) apresentavam algum tipo de dermatopatia não tumoral. Dos 202 cães acometidos, 51,49% (104/202) eram machos e 48,51% (98/202), fêmeas. Desses 202 cães, 13 tinham dois diagnósticos, totalizando 215 dermatopatias. Dos cães afetados, 62,87% (127/202) eram de raça definida e 37,13% (75/202), sem raça definida (SRD). As lesões observadas com mais frequência caracterizaram-se por áreas alopécicas, hipotricoicas, maculosas, erosivas e ulcerativas, placoides, eritematosas, assim como comedões, colaretes, seborreia. As dermatopatias parasitárias foram as mais frequentes (35,35%; 76/215), seguidas pelas dermatopatias bacterianas (24,19%; 52/215), dermatopatias alérgicas (20,00%; 43/215), dermatopatias fúngicas (17,21%; 37/215), dermatopatias por outras causas (2,32%; 5/215) e pelas dermatopatias autoimunes (0,93%; 2/215). Os exames físicos e dermatológicos, incluindo anamnese detalhada, histórico clínico apurado, associado a exames complementares, são ferramentas importantes para o diagnóstico das dermatopatias em cães. Presume-se que a frequência de dermatopatias em cães na região de estudo possa ser maior do que a observada.(AU)
Faced with the lack of studies on the frequency of dermatopathies that affect dogs by geographical region in Brazil, the present study aimed to evaluate the frequency of dermatopathies that affect the canine species in the metropolitan region of João Pessoa, Paraíba, Brazil. Data was collected from dogs that underwent dermatological care from September 2014 to December 2016. In addition to the clinical and dermatological examinations, dogs underwent complementary exams, such as cytological, skin scraping, parasitological skin examination, trichogram, bacteriological, mycological, histopathological and/or polymerase chain reaction. During the study period, 1,083 dogs were examined, in which 18.65% (202 /1,083) had some form of non-tumoral dermatopathy. Of the 202 dogs affected, 51.49% (104/202) were males and 48.51% (98/202) females. Of these 202 dogs, thirteen had two diagnoses, totaling 215 dermatopathies. 62.87% (127/202) of the affected dogs were purebred and 37.13% (75/202) were without a defined breed (WDB). The most frequently observed lesions were alopecia, hypotric, macular, erosive and ulcerative, placoid, erythematous areas, as well as comedones, collaretes and seborrhoea. The parasitic dermatopathies were the most frequent (35.35%; 76/215), followed by bacterial dermatopathies (24,19%; 52/215), allergic dermatopathies (20,00%; 43/215), dermatomycosis (17,21%; 37/215), dermatopathies for other causes (2,32%; 5/215) and autoimmune dermatopathies (0.93%; 2/215). Clinical and dermatological examination, including a detailed anamnesis, accurate clinical history and associated complementary exams are important tools for the diagnosis of dermatopathies in dogs. Available literature present some studies with canine dermatopathies frequencies superior to that obtained in the present study; however, the number of animals examined was smaller. In this survey, it was possible to establish the primary and secondary diagnoses in 100.0% of the non-tumoral dermatopathies in dogs, results higher than in previous studies. Probably, the frequency of canine dermatopathies in this region is higher than that observed, thus requiring additional studies with greater sampling.(AU)
Assuntos
Animais , Cães , Dermatopatias Parasitárias , Dermatopatias Bacterianas , Dermatite Seborreica , Dermatomicoses , Alopecia , Brasil , Reação em Cadeia da Polimerase/veterináriaRESUMO
Diante da carência de estudos sobre a frequência de dermatopatias que acometem cães por região geográfica no Brasil, o presente estudo objetivou conhecer a frequência das principais doenças cutâneas que afetam cães na região metropolitana de João Pessoa, Paraíba, Brasil. Os dados foram coletados de cães que passaram por atendimento dermatológico no período de setembro de 2014 a dezembro de 2016. Além dos exames clínicos e dermatológicos os cães foram submetidos a exames complementares (citológico, raspado de pele, parasitológico, tricograma, bacteriológico, micológico, histopatológico e molecular). No período do estudo, foram atendidos 1.083 cães, em que 18,65% (202/1.083) apresentavam algum tipo de dermatopatia não tumoral. Dos 202 cães acometidos, 51,49% (104/202) eram machos e 48,51% (98/202), fêmeas. Desses 202 cães, 13 tinham dois diagnósticos, totalizando 215 dermatopatias. Dos cães afetados, 62,87% (127/202) eram de raça definida e 37,13% (75/202), sem raça definida (SRD). As lesões observadas com mais frequência caracterizaram-se por áreas alopécicas, hipotricoicas, maculosas, erosivas e ulcerativas, placoides, eritematosas, assim como comedões, colaretes, seborreia. As dermatopatias parasitárias foram as mais frequentes (35,35%; 76/215), seguidas pelas dermatopatias bacterianas (24,19%; 52/215), dermatopatias alérgicas (20,00%; 43/215), dermatopatias fúngicas (17,21%; 37/215), dermatopatias por outras causas (2,32%; 5/215) e pelas dermatopatias autoimunes (0,93%; 2/215). Os exames físicos e dermatológicos, incluindo anamnese detalhada, histórico clínico apurado, associado a exames complementares, são ferramentas importantes para o diagnóstico das dermatopatias em cães. Presume-se que a frequência de dermatopatias em cães na região de estudo possa ser maior do que a observada.(AU)
Faced with the lack of studies on the frequency of dermatopathies that affect dogs by geographical region in Brazil, the present study aimed to evaluate the frequency of dermatopathies that affect the canine species in the metropolitan region of João Pessoa, Paraíba, Brazil. Data was collected from dogs that underwent dermatological care from September 2014 to December 2016. In addition to the clinical and dermatological examinations, dogs underwent complementary exams, such as cytological, skin scraping, parasitological skin examination, trichogram, bacteriological, mycological, histopathological and/or polymerase chain reaction. During the study period, 1,083 dogs were examined, in which 18.65% (202 /1,083) had some form of non-tumoral dermatopathy. Of the 202 dogs affected, 51.49% (104/202) were males and 48.51% (98/202) females. Of these 202 dogs, thirteen had two diagnoses, totaling 215 dermatopathies. 62.87% (127/202) of the affected dogs were purebred and 37.13% (75/202) were without a defined breed (WDB). The most frequently observed lesions were alopecia, hypotric, macular, erosive and ulcerative, placoid, erythematous areas, as well as comedones, collaretes and seborrhoea. The parasitic dermatopathies were the most frequent (35.35%; 76/215), followed by bacterial dermatopathies (24,19%; 52/215), allergic dermatopathies (20,00%; 43/215), dermatomycosis (17,21%; 37/215), dermatopathies for other causes (2,32%; 5/215) and autoimmune dermatopathies (0.93%; 2/215). Clinical and dermatological examination, including a detailed anamnesis, accurate clinical history and associated complementary exams are important tools for the diagnosis of dermatopathies in dogs. Available literature present some studies with canine dermatopathies frequencies superior to that obtained in the present study; however, the number of animals examined was smaller. In this survey, it was possible to establish the primary and secondary diagnoses in 100.0% of the non-tumoral dermatopathies in dogs, results higher than in previous studies. Probably, the frequency of canine dermatopathies in this region is higher than that observed, thus requiring additional studies with greater sampling.(AU)
Assuntos
Animais , Cães , Dermatopatias Parasitárias , Dermatopatias Bacterianas , Dermatite Seborreica , Dermatomicoses , Alopecia , Brasil , Reação em Cadeia da Polimerase/veterináriaRESUMO
The surgical management of rectal cancer has evolved from a disease without any possibility of cure in the early 1700s where surgical management consisted of the palliative drainage of disease related abscesses to the present day where surgical cure is not only possible but also possible with sphincter or even organ preservation. Prof Habr-Gama's lecture describes the evolution of the surgical management of rectal cancer and the current focus on organ preservation.
Assuntos
Tratamentos com Preservação do Órgão/métodos , Melhoria de Qualidade , Neoplasias Retais/terapia , Gerenciamento Clínico , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Tratamentos com Preservação do Órgão/história , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Análise de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) is one of the preferred initial treatment strategies for locally advanced rectal cancer. Responses are variable, and most patients still require surgery. The aim of this study was to identify molecular mechanisms determining poor response to CRT. METHODS: Global gene expression and pathway enrichment were assessed in pretreatment biopsies from patients with non-metastatic cT2-4 N0-2 rectal cancer within 7 cm of the anal verge. Downstream Akt activation was assessed in an independent set of pretreatment biopsies and in colorectal cancer cell lines using immunohistochemistry and western blot respectively. The radiosensitizing effects of the Akt inhibitor MK2206 were assessed using clonogenic assays and xenografts in immunodeficient mice. RESULTS: A total of 350 differentially expressed genes were identified, of which 123 were upregulated and 199 downregulated in tumours from poor responders. Mitochondrial oxidative phosphorylation (P < 0·001) and phosphatidylinositol signalling pathways (P < 0·050) were identified as significantly enriched pathways among the set of differentially expressed genes. Deregulation of both pathways is known to result in Akt activation, and high immunoexpression of phosphorylated Akt S473 was observed among patients with a poor histological response (tumour regression grade 0-2) to CRT (75 per cent versus 48 per cent in those with a good or complete response; P = 0·016). Akt activation was also confirmed in the radioresistant cell line SW480, and a 50 per cent improvement in sensitivity to CRT was observed in vitro and in vivo when SW480 cells were exposed to the Akt inhibitor MK2206 in combination with radiation and 5-fluorouracil. CONCLUSION: Akt activation is a key event in the response to CRT. Pharmacological inhibition of Akt activation may enhance the effects of CRT. Surgical relevance Organ preservation is an attractive alternative in rectal cancer management following neoadjuvant chemoradiotherapy (CRT) to avoid the morbidity of radical surgery. Molecular steps associated with tumour response to CRT may provide a useful tool for the identification of patients who are candidates for no immediate surgery. In this study, tumours resistant to CRT were more likely to have activation of specific genetic pathways that result in phosphorylated Akt (pAkt) activation. Pretreatment biopsy tissues with high immunoexpression of pAkt were more likely to exhibit a poor histological response to CRT. In addition, the introduction of a pAkt inhibitor to cancer cell lines in vitro and in vivo led to a significant improvement in sensitivity to CRT. Identification of pAkt-activated tumours may thus allow the identification of poor responders to CRT. In addition, the concomitant use of pAkt inhibitors to increase sensitivity to CRT in patients with rectal cancer may constitute an interesting strategy for increasing the chance of a complete response to treatment and organ preservation.
Assuntos
Quimiorradioterapia/métodos , Terapia Neoadjuvante/métodos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Neoplasias Retais/metabolismo , Idoso , Animais , Western Blotting , Linhagem Celular Tumoral , Ensaio de Unidades Formadoras de Colônias , Feminino , Compostos Heterocíclicos com 3 Anéis/farmacologia , Humanos , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Neoplasias Retais/terapia , Transdução de Sinais/efeitos dos fármacos , Resultado do TratamentoRESUMO
Syphilis is a systemic and sexually transmitted infection caused by Treponema pallidum ssp. pallidum. This spirochete causes different clinical and subclinical stages depending on the duration of infection and immune status of the host. Several tests have been developed for diagnosis, and are classified into direct and indirect methods. The first one includes dark field microscopy, direct fluorescent antibody test in fluids or tissue, and molecular biology techniques. In the indirect method (serologic), the routine tests are used, and are divided in two categories: non-treponemal and treponemal ones. The objective of this work was to identify T. pallidum ssp. pallidum in paraffin-embedded skin biopsies positive by immunohistochemistry, using conventional polymerase chain reaction (PCR) and quantitative real time PCR (qPCR). We included a sample of 17 paraffin-embedded biopsies. DNA was extracted and processed by conventional PCR and real-time PCR with a TaqMan® probe to identify the polA gene. Using PCR, 11 tested positive (64.7%) and 6 (35.3%) were negative. With qPCR and TaqMan® probe, 100% of samples tested positive. The minimum number of spirochetes detected in each sample was 2. With this work, we can conclude that qPCR is a fast and very accurate method for diagnosis of syphilis in tissue specimens.
Assuntos
Genes pol/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Pele/microbiologia , Sífilis Cutânea/diagnóstico , Treponema pallidum/genética , Treponema pallidum/isolamento & purificação , Biópsia , DNA Bacteriano/análise , DNA Bacteriano/genética , Humanos , Imuno-Histoquímica , Inclusão em Parafina , Pele/patologia , Sorodiagnóstico da Sífilis , Sífilis Cutânea/imunologia , Taq Polimerase , Treponema pallidum/imunologiaRESUMO
AIM: Full-thickness local excision after neoadjuvant chemoradiotherapy (CRT) for patients with rectal cancer and incomplete clinical response has been a treatment strategy for organ preservation. Follow-up of these patients is challenging since anatomic distortion and postoperative changes may be clinically indistinguishable from tumour recurrence. MRI may have a role in detecting recurrence. The aim of this study was to describe the MRI findings during follow-up in patients having local excision following CRT with and without local recurrence. METHOD: The data were collected retrospectively from a single centre. Fifty-three patients with rectal cancer who had full-thickness local excision after neoadjuvant CRT and near-complete response were eligible for the study. Patients with local recurrence were treated by radical salvage surgery. The main outcome was local MRI assessment findings during follow-up. RESULTS: Fifteen patients (five who developed local recurrence and 10 with no evidence of local recurrence) had MR images available for review and were included in the study. High signal intensity and thickening of the rectal wall were present in all patients with recurrent disease within the rectal wall. Overall, 80% of the patients with recurrence showed diffusion restriction. MRI mesorectal fascia status and circumferential resection margin showed agreement in all cases. A low signal intensity scar was seen in all patients without recurrent disease. CONCLUSION: MRI shows high signal intensity and thickening of the rectal wall in recurrent disease in comparison to a low signal intensity fibrotic scar in non-recurrent disease. These findings may be useful in surveillance of these patients.
Assuntos
Quimiorradioterapia Adjuvante/métodos , Imageamento por Ressonância Magnética , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Retais/diagnóstico por imagem , Microcirurgia Endoscópica Transanal/métodos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Período Pós-Operatório , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Reto/diagnóstico por imagem , Reto/cirurgia , Estudos Retrospectivos , Terapia de Salvação , Resultado do TratamentoRESUMO
This study aimed to model the habitat suitability for an invasive clam Corbicula fluminea in a coastal shallow lagoon in the southern Neotropical region (30.22, 50.55). The lagoon (19km2, maximum deep 2.5m) was sampled with an Ekman dredge in an orthogonal matrix comprising 84 points. At each sampling point, were obtained environmental descriptors as depth, organic matter content (OMC), average granulometry (Avgran), and the percentage of sand (Pcsand). Prediction performance of Generalized Linear Models (GLM), Generalized Additive Models (GAM) and Boosted Regression Tree (BRT) were compared. Also, niche overlapping with other native clam species (Castalia martensi, Neocorbicula limosa and Anodontites trapesialis) was examined. A BRT model with 1400 trees was selected as the best model, with cross-validated correlation of 0.82. The relative contributions of predictors were Pcsand-42.6%, OMC-35.8%, Avgran-10.9% and Depth-10.8%. Were identified that C. fluminea occur mainly in sandy sediments with few organic matter, in shallow areas nor by the shore. The PCA showed a wide niche overlap with the native clam species C. martensi, N. limosa and A. trapesialis.(AU)
O objetivo de deste estudo foi modelar a adequabilidade de habitat do bivalve invasor Corbicula fluminea em uma lagoa costeira na região Neotropical (30.22, 50.55). A lagoa (19km2, 2,5 m de profundidade máxima) foi amostrada com uma draga Ekman em uma matriz ortogonal compreendendo 84 pontos. Em cada ponto de amostragem foram obtidos descritores ambientais como a profundidade, teor de matéria orgânica (OMC), granulometria média (Avgran), e a percentagem de areia (Pcsand). O poder preditivo dos métodos Modelos Lineares Generalizados (GLM), Modelos Aditivos Generalizados (GAM) e Boosted Regression Trees (BRT) foram comparados. Além disso, a sobreposição de nicho com espécies de moluscos nativos (Castalia martensi, Neocorbicula limosa e Anodontites trapesialis) foi examinada. Um modelo BRT com 1.400 árvores foi selecionado como o melhor modelo, com correlação da validação cruzada de 0,82. As contribuições relativas dos preditores foram Pcsand-42,6%, OMC-35,8%, Avgran-10,9% e profundidade-10,8%. Foi demonstrado que C. fluminea está associada a sedimentos arenosos com pouca matéria orgânica, em áreas rasas próximo às margens. A PCA mostrou uma ampla sobreposição de nicho com as espécies de moluscos nativos C. martensi, N. limosa e A. trapesialis.(AU)
Assuntos
Animais , Ecossistema , Corbicula , Características de ResidênciaRESUMO
Abstract This study aimed to model the habitat suitability for an invasive clam Corbicula fluminea in a coastal shallow lagoon in the southern Neotropical region (–30.22, –50.55). The lagoon (19km2, maximum deep 2.5m) was sampled with an Ekman dredge in an orthogonal matrix comprising 84 points. At each sampling point, were obtained environmental descriptors as depth, organic matter content (OMC), average granulometry (Avgran), and the percentage of sand (Pcsand). Prediction performance of Generalized Linear Models (GLM), Generalized Additive Models (GAM) and Boosted Regression Tree (BRT) were compared. Also, niche overlapping with other native clam species (Castalia martensi, Neocorbicula limosa and Anodontites trapesialis) was examined. A BRT model with 1400 trees was selected as the best model, with cross-validated correlation of 0.82. The relative contributions of predictors were Pcsand-42.6%, OMC-35.8%, Avgran-10.9% and Depth-10.8%. Were identified that C. fluminea occur mainly in sandy sediments with few organic matter, in shallow areas nor by the shore. The PCA showed a wide niche overlap with the native clam species C. martensi, N. limosa and A. trapesialis.
Resumo O objetivo de deste estudo foi modelar a adequabilidade de habitat do bivalve invasor Corbicula fluminea em uma lagoa costeira na região Neotropical (–30.22, –50.55). A lagoa (19km2, 2,5 m de profundidade máxima) foi amostrada com uma draga Ekman em uma matriz ortogonal compreendendo 84 pontos. Em cada ponto de amostragem foram obtidos descritores ambientais como a profundidade, teor de matéria orgânica (OMC), granulometria média (Avgran), e a percentagem de areia (Pcsand). O poder preditivo dos métodos Modelos Lineares Generalizados (GLM), Modelos Aditivos Generalizados (GAM) e Boosted Regression Trees (BRT) foram comparados. Além disso, a sobreposição de nicho com espécies de moluscos nativos (Castalia martensi, Neocorbicula limosa e Anodontites trapesialis) foi examinada. Um modelo BRT com 1.400 árvores foi selecionado como o melhor modelo, com correlação da validação cruzada de 0,82. As contribuições relativas dos preditores foram Pcsand-42,6%, OMC-35,8%, Avgran-10,9% e profundidade-10,8%. Foi demonstrado que C. fluminea está associada a sedimentos arenosos com pouca matéria orgânica, em áreas rasas próximo às margens. A PCA mostrou uma ampla sobreposição de nicho com as espécies de moluscos nativos C. martensi, N. limosa e A. trapesialis.
Assuntos
Animais , Ecossistema , Corbicula , Espécies Introduzidas/estatística & dados numéricos , Brasil , Dinâmica Populacional , Monitoramento Ambiental , Densidade Demográfica , Modelos TeóricosRESUMO
This study aimed to model the habitat suitability for an invasive clam Corbicula fluminea in a coastal shallow lagoon in the southern Neotropical region (-30.22, -50.55). The lagoon (19km2, maximum deep 2.5m) was sampled with an Ekman dredge in an orthogonal matrix comprising 84 points. At each sampling point, were obtained environmental descriptors as depth, organic matter content (OMC), average granulometry (Avgran), and the percentage of sand (Pcsand). Prediction performance of Generalized Linear Models (GLM), Generalized Additive Models (GAM) and Boosted Regression Tree (BRT) were compared. Also, niche overlapping with other native clam species (Castalia martensi, Neocorbicula limosa and Anodontites trapesialis) was examined. A BRT model with 1400 trees was selected as the best model, with cross-validated correlation of 0.82. The relative contributions of predictors were Pcsand-42.6%, OMC-35.8%, Avgran-10.9% and Depth-10.8%. Were identified that C. fluminea occur mainly in sandy sediments with few organic matter, in shallow areas nor by the shore. The PCA showed a wide niche overlap with the native clam species C. martensi, N. limosa and A. trapesialis.
Assuntos
Corbicula , Ecossistema , Espécies Introduzidas/estatística & dados numéricos , Animais , Brasil , Monitoramento Ambiental , Modelos Teóricos , Densidade Demográfica , Dinâmica PopulacionalRESUMO
Abstract This study aimed to model the habitat suitability for an invasive clam Corbicula fluminea in a coastal shallow lagoon in the southern Neotropical region (30.22, 50.55). The lagoon (19km2, maximum deep 2.5m) was sampled with an Ekman dredge in an orthogonal matrix comprising 84 points. At each sampling point, were obtained environmental descriptors as depth, organic matter content (OMC), average granulometry (Avgran), and the percentage of sand (Pcsand). Prediction performance of Generalized Linear Models (GLM), Generalized Additive Models (GAM) and Boosted Regression Tree (BRT) were compared. Also, niche overlapping with other native clam species (Castalia martensi, Neocorbicula limosa and Anodontites trapesialis) was examined. A BRT model with 1400 trees was selected as the best model, with cross-validated correlation of 0.82. The relative contributions of predictors were Pcsand-42.6%, OMC-35.8%, Avgran-10.9% and Depth-10.8%. Were identified that C. fluminea occur mainly in sandy sediments with few organic matter, in shallow areas nor by the shore. The PCA showed a wide niche overlap with the native clam species C. martensi, N. limosa and A. trapesialis.
Resumo O objetivo de deste estudo foi modelar a adequabilidade de habitat do bivalve invasor Corbicula fluminea em uma lagoa costeira na região Neotropical (30.22, 50.55). A lagoa (19km2, 2,5 m de profundidade máxima) foi amostrada com uma draga Ekman em uma matriz ortogonal compreendendo 84 pontos. Em cada ponto de amostragem foram obtidos descritores ambientais como a profundidade, teor de matéria orgânica (OMC), granulometria média (Avgran), e a percentagem de areia (Pcsand). O poder preditivo dos métodos Modelos Lineares Generalizados (GLM), Modelos Aditivos Generalizados (GAM) e Boosted Regression Trees (BRT) foram comparados. Além disso, a sobreposição de nicho com espécies de moluscos nativos (Castalia martensi, Neocorbicula limosa e Anodontites trapesialis) foi examinada. Um modelo BRT com 1.400 árvores foi selecionado como o melhor modelo, com correlação da validação cruzada de 0,82. As contribuições relativas dos preditores foram Pcsand-42,6%, OMC-35,8%, Avgran-10,9% e profundidade-10,8%. Foi demonstrado que C. fluminea está associada a sedimentos arenosos com pouca matéria orgânica, em áreas rasas próximo às margens. A PCA mostrou uma ampla sobreposição de nicho com as espécies de moluscos nativos C. martensi, N. limosa e A. trapesialis.
RESUMO
AIM: Inguinal nodes may be a possible route for lymphatic spread in patients with distal rectal cancer. The outcome was examined for patients with distal rectal cancer undergoing neoadjuvant chemoradiation (CRT) and having 2-fluorine-18-fluoro-2-deoxy-d-glucose (FDG)-avid inguinal nodes using positron emission tomography/computed tomography (PET/CT) imaging. METHOD: Ninety-nine consecutive patients with cT2-4N0-2M0 distal rectal adenocarcinoma were enrolled in a clinical trial (NCT00254683) and underwent baseline PET/CT followed by 54 Gy and 5-fluorouracil-based CRT. After CRT, patients underwent 6- and 12-week PET/CT. Patients with positive inguinal node uptake were compared with patients with negative uptake. The inguinal region was not included in the field of radiation therapy. RESULTS: Seventeen (17%) patients had baseline positive inguinal node FDG uptake. They were more likely to have the tumour closer to the anal verge (2.0 vs 4.2 cm; P = 0.001). Of these, eight (47%) demonstrated a positive inguinal uptake at PET/CT after 12 weeks from CRT. Patients with inguinal node FDG uptake after CRT (positive PET at baseline and 12 weeks) had a significantly worse 3-year overall and disease-free survival (P = 0.02 and P = 0.03). After a median follow-up period of 22 months, none of these patients had developed inguinal recurrence. CONCLUSION: Uptake of inguinal nodes at PET/CT may be present in up to 17% of patients with distal rectal cancer, particularly with ultra-low tumours. Nearly half of these nodes no longer show uptake after CRT despite the groin area not being included in the radiation field. Persistence of inguinal node uptake 12 weeks after CRT completion may be a marker for worse oncological outcome.
Assuntos
Adenocarcinoma/terapia , Antimetabólitos Antineoplásicos/uso terapêutico , Quimiorradioterapia Adjuvante/métodos , Fluoruracila/uso terapêutico , Linfonodos/diagnóstico por imagem , Neoplasias Retais/terapia , Adenocarcinoma/diagnóstico por imagem , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Fluordesoxiglucose F18 , Humanos , Canal Inguinal , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Terapia Neoadjuvante/métodos , Tomografia por Emissão de Pósitrons , Prognóstico , Compostos Radiofarmacêuticos , Neoplasias Retais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
There are currently no reports on the isolation and molecular examination of Toxoplasma gondii from bats. Here, we report the isolation and genotypic characterisation of two T. gondii isolates from bats. A total of 369 bats from different municipalities in São Paulo state, southeastern Brazil, were captured and euthanised, and collected tissues (heart and pectoral muscle) were processed for each bat or in pools of two or three bats and bioassayed in mice (a total of 283 bioassays). Eleven PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) markers were used to genotype positive samples: SAG1, SAG2 (5'-3'SAG2 and alt. SAG2), SAG3, BTUB, GRA6, L358, c22-8, c29-2, PK1, CS3 and Apico. The parasite was isolated from two bats from São Paulo city: an insectivorous bat, the velvety free-tailed bat Molossus molossus, and a hematophagous bat, the common vampire bat Desmodus rotundus. Isolates were designated TgBatBr1 and TgBatBr2, respectively. The genotype of the isolate from M. molossus (TgBatBr1) has been previously described in an isolate from a capybara from São Paulo state, and the genotype from the D. rotundus isolate (TgBatBr2) has already been identified in isolates from cats, chickens, capybaras, sheep, a rodent and a common rabbit from different Brazilian states, suggesting that this may be a common T. gondii lineage circulating in some Brazilian regions. Isolation of T. gondii from a hematophagous species is striking. This study reveals that bats can share the same isolates that are found in domesticated and wild terrestrial animals. This is the first report of the isolation and genotyping of T. gondii in chiropterans.
Assuntos
Quirópteros/parasitologia , Genótipo , Toxoplasma/genética , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Animais , Brasil/epidemiologia , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , Polimorfismo de Fragmento de Restrição , Toxoplasmose Animal/epidemiologiaRESUMO
BACKGROUND: In recent decades several groups of researchers have been interested in describing and understanding vocal morbidity in teachers in order to explain the large number of teachers diagnosed with dysphonia and account for the absenteeism attributed to vocal disability. AIMS: To determine the proportion of teachers who reported a diagnosis of dysphonia and measure associations between individual and contextual factors and the event of interest. METHODS: Teachers were recruited from the city of Belo Horizonte and invited to complete a web-based institutional intranet questionnaire. RESULTS: In total, 649 teachers responded; 32% (CI 28.5-35.5) reported that they had received a physician diagnosis of dysphonia. This prevalence was significantly higher among female teachers (prevalence ratio (PR) 2.33; CI 1.41-3.85), and groups who reported limited technical resources and equipment (PR 1.56; CI 1.14-2.15), a diagnosis of gastritis (PR 1.59; CI 1.28-1.98), not being summoned for an annual physician examination (PR 0.47; CI 0.32-0.68), or absenteeism (PR 1.39; CI 1.06-1.81). CONCLUSIONS: The high prevalence of dysphonia in teachers was not associated with any individual variables, except for sex and comorbidity (diagnosis of gastritis). Limited technical resources and equipment were associated with dysphonia and suggests policy change is important in preventing dysphonia.
Assuntos
Disfonia/epidemiologia , Disfonia/etiologia , Docentes , Gastrite/epidemiologia , Doenças Profissionais/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/epidemiologia , Absenteísmo , Adulto , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Disfonia/prevenção & controle , Feminino , Gastrite/complicações , Gastrite/prevenção & controle , Humanos , Internet , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Prevalência , Fatores de Risco , Distribuição por Sexo , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/prevenção & controle , Inquéritos e QuestionáriosRESUMO
AIM: The study aimed to determine the value of postchemoradiation biopsies, performed after significant tumour downsizing following neoadjuvant therapy, in predicting complete tumour regression in patients with distal rectal cancer. METHOD: A retrospective comparative study was performed in patients with rectal cancer who achieved an incomplete clinical response after neoadjuvant chemoradiotherapy. Patients with significant tumour downsizing (> 30% of the initial tumour size) were compared with controls (< 30% reduction of the initial tumour size). During flexible proctoscopy carried out postchemoradiation, biopsies were performed using 3-mm biopsy forceps. The biopsy results were compared with the histopathological findings of the resected specimen. UICC (Union for International Cancer Control) ypTNM classification, tumour differentiation and regression grade were evaluated. The main outcome measures were sensitivity and specificity, negative and positive predictive values, and accuracy of a simple forceps biopsy for predicting pathological response after neoadjuvant chemoradiotherapy. RESULTS: Of the 172 patients, 112 were considered to have had an incomplete clinical response and were included in the study. Thirty-nine patients achieved significant tumour downsizing and underwent postchemoradiation biopsies. Overall, 53 biopsies were carried out. Of the 39 patients who achieved significant tumour downsizing, the biopsy result was positive in 25 and negative in 14. Only three of the patients with a negative biopsy result were found to have had a complete pathological response (giving a negative predictive value of 21%). Considering all biopsies performed, only three of 28 negative biopsies were true negatives, giving a negative predictive value of 11%. CONCLUSION: In patients with distal rectal cancer undergoing neoadjuvant chemoradiation, post-treatment biopsies are of limited clinical value in ruling out persisting cancer. A negative biopsy result after a near-complete clinical response should not be considered sufficient for avoiding a radical resection.
Assuntos
Adenocarcinoma/patologia , Adenocarcinoma/terapia , Quimiorradioterapia Adjuvante , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Adulto , Idoso , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Neoplasia Residual , Valor Preditivo dos Testes , Proctoscopia , Estudos Retrospectivos , Carga TumoralRESUMO
BACKGROUND: Management of rectal cancer has become increasingly complex and a multidisciplinary approach is considered of key importance for improving outcomes. A national survey among specialists involved in this multidisciplinary setting was performed. METHODS: A web-based survey containing 11 questions regarding rectal cancer management was sent to surgeons and medical oncologists registered by their corresponding societies as members. Statistical analysis was performed using the chi-square and Fisher's exact tests for all categorical variables according to response to individual questions. Multivariate analysis was performed using Cox's logistic regression. RESULTS: Overall, 418 email recipients responded the survey. Local staging was performed without either magnetic resonance imaging or endorectal ultrasound by 64% of responders. Seventy-two percent considered that final management decision should be made after neoadjuvant chemoradiation therapy. Additionally, 46% considered that an alternative procedure (local excision or observation) was appropriate in a patient with a complete clinical response. Colorectal surgeons were more frequently in favor of longer intervals after completion of chemoradiation therapy (P = 0.001) and of alternative management procedures after a complete clinical response (P = 0.02). After multivariate analysis, the choice of a watch and wait approach after a complete clinical response following neoadjuvant chemoradiation therapy was significantly more frequent among surgeons (OR 3.5, 95% CI 1.8-7.1). CONCLUSIONS: Surgeons seem to be more in favor of tailoring management of rectal cancer according to tumor response after neoadjuvant chemoradiation therapy, with longer intervals after chemoradiation therapy, decisions about treatment strategy being made after chemoradiation therapy instead of before, and the use of alternative surgical procedures after a complete clinical response following neoadjuvant therapy.