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BACKGROUND AND OBJECTIVES: The primary treatment for locally advanced cases of cervical cancer is chemoradiation followed by high-dose brachytherapy. When this treatment fails, pelvic exenteration (PE) is an option in some cases. This study aimed to develop recommendations for the best management of patients with cervical cancer undergoing salvage PE. METHODS: A questionnaire was administered to all members of the Brazilian Society of Surgical Oncology. Of them, 68 surgeons participated in the study and were divided into 10 working groups. A literature review of studies retrieved from the National Library of Medicine database was carried out on topics chosen by the participants. These topics were indications for curative and palliative PE, preoperative and intraoperative evaluation of tumor resectability, access routes and surgical techniques, PE classification, urinary, vaginal, intestinal, and pelvic floor reconstructions, and postoperative follow-up. To define the level of evidence and strength of each recommendation, an adapted version of the Infectious Diseases Society of America Health Service rating system was used. RESULTS: Most conducts and management strategies reviewed were strongly recommended by the participants. CONCLUSIONS: Guidelines outlining strategies for PE in the treatment of persistent or relapsed cervical cancer were developed and are based on the best evidence available in the literature.
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Exenteración Pélvica/normas , Neoplasias del Cuello Uterino/cirugía , Anastomosis Quirúrgica , Brasil , Colostomía/métodos , Diagnóstico por Imagen , Drenaje , Femenino , Humanos , Laparoscopía , Escisión del Ganglio Linfático , Evaluación Nutricional , Estomía , Cuidados Paliativos , Diafragma Pélvico/cirugía , Lavado Peritoneal , Cuidados Posoperatorios , Cuidados Preoperatorios , Sociedades Médicas , Colgajos Quirúrgicos , Catéteres Urinarios , Reservorios Urinarios Continentes , Vagina/cirugía , Grabación en VideoRESUMEN
Investigation of novel 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused chlorins, derived from 5,10,15,20-tetrakis(pentafluorophenyl)porphyrin, as PDT agents against melanoma and esophagus cancer is disclosed. Diol and diester fluorinated ring-fused chlorins, including derivatives with 2-(2-hydroxyethoxy)ethanamino groups at the phenyl rings, were obtained via a two-step methodology, combining SNAr and [8π + 2π] cycloaddition reactions. The short-chain PEG groups at the para-position of the phenyl rings together with the diol moiety at the fused pyrazole ring promote a red-shift of the Soret band, a decrease of the fluorescence quantum yield and an increase of the singlet oxygen formation quantum yield, improving the photophysical characteristics required to act as a photosensitizer. Introduction of these hydrophilic groups also improves the incorporation of the sensitizers by the cells reaching cellular uptake values of nearly 50% of the initial dose. The rational design led to a photosensitizer with impressive IC50 values, 13 and 27 nM against human melanoma and esophageal carcinoma cell lines, respectively.
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Early cancer detection and perfect understanding of the disease are imperative toward efficient treatments. It is straightforward that, for choosing a specific cancer treatment methodology, diagnostic agents undertake a critical role. Imaging is an extremely intriguing tool since it assumes a follow up to treatments to survey the accomplishment of the treatment and to recognize any conceivable repeating injuries. It also permits analysis of the disease, as well as to pursue treatment and monitor the possible changes that happen on the tumor. Likewise, it allows screening the adequacy of treatment and visualizing the state of the tumor. Additionally, when the treatment is finished, observing the patient is imperative to evaluate the treatment methodology and adjust the treatment if necessary. The goal of this review is to present an overview of conjugated photosensitizers for imaging and therapy.
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Neoplasias/diagnóstico por imagen , Neoplasias/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Animales , Humanos , Ratones , Fármacos Fotosensibilizantes/química , Fármacos Fotosensibilizantes/farmacocinética , Medicina de PrecisiónRESUMEN
Drinking Water safety is critical for human's daily life. Real-time monitoring and early warning systems of harmful substances in drinking water is crucial to ensure the safety of tap water. This paper reports the fabrication of a graphene-based phototransistor, oriented towards an integrated system for high accuracy measure of the bioluminescent bacteria. Aliivibrio fischeri is a bioluminescence bacterium (light emission at 490nm), that has a significant light reduction in the presence of harmful contaminants. Each step of the phototransistor was designed and fabricated, including the mask used for the Oxygen Plasma Etching of Graphene and Electron Beam deposition of the gold pads and Spin coating of the polymer. All the fabrication process including experimental conditions were controlled to achieve a high phototransistor performance. Experimental tests were realized to evaluate the performance of the photodetector to the measurement of Vibrio Fischeri light emission The graphene-based phototransistor shows good sensitivity to detect the change of light intensity, for Aliivibrio fischeri. Compared with the traditional design method, this new design and fabrication can not only be more distinct and visualized, but also greatly reduce the cost and difficulty.
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Aliivibrio fischeri/aislamiento & purificación , Agua Potable/microbiología , Grafito/química , Procesos FotoquímicosRESUMEN
Water monitoring has an unquestionable value for people's safety. Despite this, most systems are expensive to operate due to high power consumption or high measuring time. This translates to an inefficient system. This study proposes a design for a low power consumption system to monitor water quality. By using a simple 3D printed design that includes UV LEDs, a filter, a lens and a photosensor. The tests performed in this paper is to show the effect the lens provides and the limited power consumption of the overall system as well as the sensitivity of the system.