RESUMO
The contribution of Image-guided Radiotherapy (IGRT) to modern radiotherapy is undeniable, being the way to bring into daily practice the dosimetric benefits of Intensity-Modulated Radiotherapy (IMRT). Organ and target motion is constant and unpredictable at the pelvis, thus posing a challenge to the safe execution of IMRT. There are potential benefits of IMRT in the radical treatment of cervical cancer patients, both in terms of dose escalation and decrease of toxicity. But it is essential to find IGRT solutions to control the aspects that can lead to geographic miss targeting or organs at risk (OAR) overdose. This review seeks to describe the problems and possible solutions in the clinical implementation of IMRT/IGRT protocols to treat intact cervical cancer patients.
RESUMO
OBJECTIVE: To compare preoperative, intraoperative, and postoperative variables at 1, 6, and 12 months after laparoscopic simple prostatectomy (LSP), robotic simple prostatectomy (RSP), and intrafascial robotic simple prostatectomy (IF-RSP). PATIENTS AND METHODS: From January 2003 to November 2014, 315 simple prostatectomies were performed using three techniques, LSP, RSP, and IF-RSP; of the patients who underwent these procedures, 236 met the inclusion criteria for this study. RESULTS: No statistically significant difference (SSD) was found in preoperative or perioperative variables. Of the postoperative variables that were analyzed, an SSD (p > 0.01) in prostate-specific antigen levels was found, with levels of 0.07 ± 1.1 ng/mL following IF-RSP, and the detection rate of prostate adenocarcinoma (26%) and high-grade prostatic intraepithelial neoplasia (HG-PIN; 12%) was higher for IF-RSP. We also found that lower International Prostate Symptom Scores (IPSS) were associated with LSP, at 4.8 ± 3.2. Erectile function was reduced in IF-RSP patients in the first 6 months after surgery but was similar in all patient groups at 12 months after surgery; continence and other measured parameters were also similar at 12 months for all three techniques. CONCLUSION: The IF-RSP technique is safe and effective, with results at 1-year follow-up for continence, IPSS, and Sexual Health Inventory for Men scores similar to those for the LSP and RSP techniques. IF-RSP also offers the advantages that it does not require postoperative irrigation, has an increased ability to detect prostate cancer (CA) and HG-PIN, and avoids the risk of future cancer and subsequent reintervention for possible new prostate growth.
Assuntos
Adenocarcinoma/epidemiologia , Disfunção Erétil/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Neoplasias da Próstata/epidemiologia , Adenocarcinoma/sangue , Adenocarcinoma/diagnóstico , Idoso , Comorbidade , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Ereção Peniana , Estudos Prospectivos , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/sangue , Hiperplasia Prostática/epidemiologia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Resultado do TratamentoRESUMO
Impact of two artificial reefs on diurnal artisanal fishing at gulf of Morrosquillo, Colombian Caribbean. Fishing activity in two artificial reefs (ARs) was monitored between August 2001 and August 2002 in the gulf of Morrosquillo, to investigate their possible impact on the fishery dynamics. We determined catch per unit effort (CPUE) and catch composition, and found 19 species in Punta de Piedra and 36 in Tolú (16 species common to both). In Punta de Piedra, CPUE was 0.40 kg/hour/fisherman and estimated annual catch was 1 830 kg (Tolú values: 0.42 kg/hour/fisherman and 4 820 kg). No significant differences in CPUE were found between ARs and no seasonal pattern was evident. The differences in total composition and extracted biomass between ARs were mainly a consequence of greater effort exerted in Tolú, whereas the absence of trends and correlation with environmental factors of CPUE and species caught suggests that the ARs are near their carrying capacity. As expected, the ARs supported and improved CPUE and fishing success in comparison with reported values of natural habitats, traditional fishing grounds and some artificial habitats in the zone, owing to their greater volume, structural complexity and vertical profile. However, this increase could also be the result of biomass aggregation, not production. The potential negative impacts of ARs on the environment require experimental research. The deployment of non-extractive ARs and the controlled usage for fishery purposes could be a useful tool for resource enhancement and management in the area. Rev. Biol. Trop. 57 (4): 993-1007. Epub 2009 December 01.
Entre los meses de agosto de 2001 y agosto de 2002 se hizo el seguimiento de la actividad pesquera en dos arrecifes artificiales (AAs) instalados en el Golfo de Morrosquillo, con el fin de evaluar sus posibles impactos en la dinámica pesquera del área. Se determinó la captura por unidad de esfuerzo (CPUE) y su composición, registrando un total de 19 especies en Punta de Piedra y 36 en Tolú con 16 especies en común. La CPUE fue de 0.40kg/hora/ pescador en Punta de Piedra y de 0.42kg/hora/pescador en Tolú, y la biomasa extraída total estimada fue de 1 830kg y 4 820kg en Punta de Piedra y Tolú respectivamente, para pescadores que trabajaron con línea de mano en horas diurnas. No se encontraron diferencias significativas de CPUE entre los AAs y no fue evidente ningún patrón estacional. Las diferencias en composición y biomasa extraída total entre los AAs fueron principalmente consecuencia del mayor esfuerzo ejercido en Tolú, mientras que la ausencia de tendencias y correlaciones de los factores abióticos con la CPUE y las especies capturadas, sugiere que los AAs están cerca de su capacidad de carga. Como era de esperarse, los AAs mantuvieron y mejoraron la CPUE en comparación con valores reportados en hábitats naturales, caladeros tradicionales de pesca y algunos hábitats artificiales del sector, debido a su mayor volumen, complejidad estructural y perfil vertical. Sin embargo, este incremento puede ser el resultado de la agregación de biomasa más que la producción en los AAs, lo cual tiene impactos negativos potenciales sobre el ambiente que necesitan ser evaluados con el desarrollo de investigaciones experimentales. La disposición de AAs no-extractivos y el uso controlado para propuestas pesqueras, puede ser una herramienta útil para el enriquecimiento y manejo de los recursos en el área.
Assuntos
Animais , Biomassa , Pesqueiros/estatística & dados numéricos , Peixes/classificação , Região do Caribe , Colômbia , Estações do Ano , Água do MarRESUMO
Fishing activity in two artificial reefs (ARs) was monitored between August 2001 and August 2002 in the gulf of Morrosquillo, to investigate their possible impact on the fishery dynamics. We determined catch per unit effort (CPUE) and catch composition, and found 19 species in Punta de Piedra and 36 in Tolú (16 species common to both). In Punta de Piedra, CPUE was 0.40 kg/hour/fisherman and estimated annual catch was 1 830 kg (Tolú values: 0.42 kg/hour/fisherman and 4 820 kg). No significant differences in CPUE were found between ARs and no seasonal pattern was evident. The differences in total composition and extracted biomass between ARs were mainly a consequence of greater effort exerted in Tolú, whereas the absence of trends and correlation with environmental factors of CPUE and species caught suggests that the ARs are near their carrying capacity. As expected, the ARs supported and improved CPUE and fishing success in comparison with reported values of natural habitats, traditional fishing grounds and some artificial habitats in the zone, owing to their greater volume, structural complexity and vertical profile. However, this increase could also be the result of biomass aggregation, not production. The potential negative impacts of ARs on the environment require experimental research. The deployment of non-extractive ARs and the controlled usage for fishery purposes could be a useful tool for resource enhancement and management in the area.