RESUMO
Characterization of the country internal variability of arsenic (As) accumulation in rice grain across different rice production regions is very important in order to analyze its compliance with international and regional limits. A robust sampling study scheme (n = 150 samples) was performed to determine total arsenic (tAs) and inorganic (iAs) levels from polished rice grain covering all rice producing regions along two growing seasons. The mean and median concentration of tAs were 0.178 mg kg-1 and 0.147 mg kg-1, with a minimum and maximum value of 0.015 mg kg-1 and 0.629 mg kg-1, respectively and a coefficient of variation of 63.6%. The mean and median concentration of iAs were 0.062 mg kg-1 and 0.055 mg kg-1 respectively ranging from 0.005 mg kg-1 up to a maximum of 0.195 mg kg-1 and a coefficient of variation of 51.5%. A moderate correlation was revealed within iAs and tAs. Levels of iAs in all of the samples were below the international limits of 0.2 mg kg-1 according to the international limits for human health by the Codex Alimentarius (FAO and WHO, 2019). Rice fields cultivated on soils originated from igneous geological material reported lower arsenic levels accumulated in rice grain in relation to sedimentary soils. Japonica cultivars presented significantly lower tAs and iAs concentrations than Indica ones (p = 0.0121 and p < 0.0001; respectively). Consumption of rice by male and female adults in Uruguay is safe according to its level of annual consumption and based on the mean iAs levels determined in this study.
Assuntos
Arsênio , Oryza , Poluentes do Solo , Adulto , Arsênio/análise , Grão Comestível/química , Contaminação de Alimentos/análise , Humanos , Poluentes do Solo/análiseRESUMO
PURPOSE: We retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution. METHODS AND PATIENTS: Electronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan-Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models. RESULTS: Forty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2-NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death. CONCLUSION: Overall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Inibidores de Checkpoint Imunológico/uso terapêutico , Ipilimumab/uso terapêutico , Melanoma/tratamento farmacológico , Nivolumabe/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Masculino , Melanoma/mortalidade , Melanoma/secundário , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Resultado do TratamentoRESUMO
The Ponseti method is the ideal treatment for the management of congenital clubfoot of any etiology; it corrects the deformity in more than 90% of cases. However, a small percent of idiopathic clubfoot cases, known as complex clubfoot, do not respond properly to this treatment and thus a modification of the original technique described by Doctor Ponseti for manipulating the forefoot is required. We present herein the case of a patient with complex congenital clubfoot treated during her first year of life with the modified Ponseti method with good results.
Assuntos
Pé Torto Equinovaro/terapia , Feminino , Humanos , Recém-NascidoRESUMO
Introducción: la valoración del riesgo cardiovascular permite identificar los grupos en los cuales se debe dar prioridad a las actividades de prevención (primaria y secundaria) dirigidas a reducir la morbimortalidad cardiovascular. Metodología: se incluyeron 2.167 pacientes hipertensos colombianos (edad media: 62,6 años; de los cuales 56,4% eran mujeres y 43,6% hombres) a quienes su médico realizó una encuesta estructurada y registró los resultados del examen físico y de las determinaciones bioquímicas para efectuar una estratificación del riesgo de enfermedad cardiovascular. Resultados: únicamente 32,1% de los pacientes tenía cifras de tensión arterial controladas al momento de la evaluación. El riesgo cardiovascular de la población en estudio fue bajo en 19,3%, moderado en 35,9%, alto en 30,6% y muy alto en 14%. La coexistencia de hipertensión arterial más diabetes incrementó la prevalencia de patologías renales, hipertrofia ventricular izquierda, enfermedad coronaria y enfermedad vascular periférica. Conclusiones: en pacientes hipertensos existe la necesidad de generar estrategias de detección y reducción efectiva del riesgo cardiovascular más allá del control de las cifras de tensión.
Introduction: with the assessment of cardiovascular risk physicians can identify those groups in which they must prioritize prevention activities (primary and secondary) to reduce cardiovascular morbidity and mortality. Methodology: we included 2,167 colombian hypertensive patients (average age: 62.6 years, 56.4% were women and 43.6% men), their doctors conducted a structured survey, recorded their results of physical examination and biochemical determinations for make a stratification of risk of cardiovascular disease. Results: only 32.1% of patients had controlled blood pressure levels at the survey time. This is the cardiovascular risk observed: low 19.3%, 35.9% moderate, high 30.6% and 14% very high. The coexistence of HBP + diabetes increased prevalence of kidney diseases, left ventricular hypertrophy, coronary disease and peripheral vascular disease. Conclusions: in hypertensive patients is necessary to generate strategies for detection and effective reduction of cardiovascular risk factors beyond the control of blood pressure levels.
Assuntos
Hipertensão , Fatores de RiscoRESUMO
Copper, mercury, and zinc levels were determined in muscle and liver (N = 163) of seven fish species caught in coastal waters off Montevideo and Piriapolis (control site): Odontesthes spp., Mugil platanus, Micropogonias furnieri, Urophycis brasiliensis, Cynoscion guatucupa, Menticirrhus americanus, and Mustelus schmitti. The local population commonly uses these species for consumption. Heavy metal concentrations determined in this study were generally below those obtained for fish caught in Argentinean and Brazilian coastal waters, with some exceptions in the case of mercury and zinc. Based on copper, mercury, and zinc levels in muscle tissue, we conclude that the fish studied here are acceptable for human consumption. Nevertheless, it is recommended not to consume the fish liver (up to 466 microg Zn g(-1) dry weight in liver) nor large specimens of the investigated species. Regional programs involving the neighboring countries should be established to assess the fisheries resources and potential risks for human health.