ABSTRACT
Introducción: La biopsia selectiva del ganglio centinela (BSGC) en cáncer de mama es el método estándar para estadificación axilar en pacientes con axila clínicamente negativa. Estudios indican evitar linfadenectomía axilar en pacientes con BSGC negativas incluyendo aquellos que recibieron previamente quimioterapia neoadyuvante (QTN). El objetivo del presente estudio es determinar la eficacia de la BSGC en detectar ganglios centinela posterior QTN en un instituto oncológico de referencia en Ecuador. Materiales y Métodos: Estudio observacional, analítico y retrospectivo, realizado en Hospital SOLCA Guayaquil, durante el período enero 2015 a diciembre 2020. Se evaluaron 81 pacientes con cáncer de mama con axila clínicamente negativa que recibieron QTN previo a cirugía. Las variables son biopsia de ganglio centinela, quimioterapia neoadyuvante, precisión diagnóstica y estadificación axilar. Se consideró el Odds Ratio del 95%, con una P<0.05. Resultados: De 81 pacientes operados, 52 pacientes recibieron BSGC con muestreo detectándose ganglio centinela en 92.3% de los casos. El porcentaje de falsos negativos es 21.7% posterior a QTN. Los 29 pacientes restantes recibieron linfadenectomía axilar. Conclusión: La BSGC es efectiva para detectar el ganglio centinela en pacientes con cáncer de mama y axila clínicamente negativa, incluso después de la quimioterapia neoadyuvante. Sin embargo, existe un riesgo significativo de falsos negativos después de la QTN, lo que puede llevar a la necesidad de realizar una linfadenectomía axilar adicional para una evaluación más precisa de la estadificación axilar.
Introduction: Selective sentinel lymph node biopsy (SLNB) in breast cancer is the standard method for axillary staging in patients with clinically negative axilla. Studies indicate avoiding axillary lymphadenectomy in patients with negative SLNB, including those who previously received neoadjuvant chemotherapy (NQT). This study aims to determine the efficacy of SLNB in detecting sentinel lymph nodes after QTN in a reference cancer institute in Ecuador. Materials and Methods: An observational, analytical, and retrospective study was conducted at Hospital SOLCA Guayaquil from January 2015 to December 2020. Eighty-one clinically negative axillary breast cancer patients who received CTN before surgery were evaluated. The variables are sentinel node biopsy, neoadjuvant chemotherapy, diagnostic accuracy, and axillary staging. An odds ratio of 95% was considered, with P <0.05. Results: Of 81 operated patients, 52 received SLNB, with sampling detecting sentinel nodes in 92.3% of the cases. The percentage of false negatives is 21.7% after QTN. The remaining 29 patients received axillary lymphadenectomy. Conclusion: SLNB effectively detects the sentinel node in patients with clinically negative breast and axillary cancer, even after neoadjuvant chemotherapy. However, there is a significant risk of false negatives after CTN, which may lead to the need to perform additional axillary lymphadenectomy for a more accurate assessment of axillary staging.
Subject(s)
Humans , Adult , Biopsy , Sentinel Lymph Node , Lymph Node Excision , General Surgery , Breast Neoplasms , Neoadjuvant Therapy , Observational StudyABSTRACT
Produced water (PW) is the main waste produced by oil and gas industry, and its treatment represents an environmental and economical challenge for governments and the industry itself. Microbial fuel cells (MFC) emerge as an ecofriendly technology able to harvest energy and remove pollutants at the same time, however high internal resistance is a key problem limiting their operating performance and practical application. In this work, a novel continuous up-flow MFC was designed and fed solely using PW under different flowrates. Effects of the different flowrates (0 mL/s, 0.2 mL/s, 0.4 mL/s, and 0.6 mL/s) in power production performance and pollutants removal were analyzed. Our results demonstrated the removal efficiency of all the pollutants improved when flowrate incremented from 0 to 0.4 mL/s (COD: 96%, TDS: 22%, sulfates: 64%, TPH: 89%), but decreased when 0.6 mL/s was applied. The best power density of 227 mW/m2 was achieved in a flowrate of 0.4 mL/s. Similar to the pollutant's removal, the power density increased together with the increment of flowrate and decreased when 0.6 mL/s was used. The reason for the performance fluctuation was the decrement of internal resistance from 80 Ω (batch mode) to 20 Ω (0.4 mL/s), and then the sudden increment to 90 Ω for 0.6 mL/s. A flow simulation revealed that until 0.4 mL/s the flow was organized and helped protons to arrive in the membrane faster, but flowrate of 0.6 mL/s created turbulence which prejudiced the transportation of protons incrementing the internal resistance. Microbial community analysis of the biofilm found that Desulfuromonas, Desulfovibrio and Geoalkalibacter were dominant bacteria in charge of pollutant removal and electricity production. This study can be helpful in guiding the use of continuous-flow MFC for PW treatment, and to accelerate the practical application of MFC technology in oil industry.
Subject(s)
Bioelectric Energy Sources , Microbiota , Electricity , Electrodes , Wastewater/analysis , WaterABSTRACT
Phthalates are chemical compounds employed as plasticizers in the plastic industry and have been reported to migrate into drug products. The extent of their migration into the drug product depends upon various factors including the chemical nature of the migrant and the permeability of its packaging container. Migration of semi-volatile phthalates such as Diethyl phthalate (DEP) into drug products is often related to the primary and secondary packaging but due to its chemical nature, it could also migrate from an ancillary component. Therefore, it is not only important to screen the primary and secondary components, but also the ancillary materials that are used during the handling of drug products. In our study, we discovered an ancillary material (scotch tape) to be the source of DEP found in an ophthalmic drug product using orthogonal mass spectroscopy techniques (GC-MS and LC-MS). It is evident from our data that DEP migrated from the scotch tape into the drug product crossing the physical barriers provided by the primary (LDPE container closure system) and secondary packaging (carton and label). The tape was used as an ancillary material to wrap the packaged drug product units together for storage in the stability chamber. The primary and the secondary packaging of the drug product did not exhibit any traces of DEP. The aim of this report is to demonstrate how a chemical compound can migrate into the drug product from an ancillary source (which is not a part of its packaging) and adulterate a drug product. The impact of ancillary materials on drug products should be evaluated appropriately prior to their implementation.
