Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study.

PURPOSE: Anaplastic lymphoma kinase (ALK) rearrangement confers sensitivity to ALK inhibitors (ALKis) in non-small-cell lung cancer (NSCLC). Although several drugs provided an impressive outcome benefit, the most effective sequential strategy is still unknown. We describe outcomes of real-life patients according to the treatment strategy received. PATIENTS: We retrospectively collected 290 ALK rearranged advanced NSCLC diagnosed between 2011 and 2017 in 23 Italian institutions. RESULTS: After a median follow-up of 26 months, PFS for crizotinib and a new generation ALKis were 9.4 [CI 95% 7.9-11.2] and 11.1 months [CI 95% 9.2-13.8], respectively, while TTF were 10.2 [CI 95% 8.5-12.6] and 11.9 months [CI 95% 9.7-17.4], respectively, being consistent across the different settings. The composed outcomes (the sum of PFS or TTF) in patients treated with crizotinib followed by a new generation ALKis were 27.8 months [CI 95% 24.3-33.7] in PFS and 30.4 months [CI 95% 24.7-34.9] in TTF. The median OS from the diagnosis of advanced disease was 39 months [CI 95% 31.8-54.5]. Patients receiving crizotinib followed by a new generation ALKis showed a higher median OS [57 months (CI 95% 42.0-73.8)] compared to those that did not receive crizotinib [38 months (CI 95% 18.6-NR)] and those who performed only crizotinib as target agent [15 months (CI 95% 11.3-34.0)] (P < 0.0001). CONCLUSION: The sequential administration of crizotinib and a new generation ALKis provided a remarkable clinical benefit in this real-life population, being an interesting option to consider in selected patients.

Experience with the first Internet-based course at the Faculty of Medicine, University of São Paulo.

PURPOSE: The Internet expands the range and flexibility of teaching options and enhances the ability to process the ever-increasing volume of medical knowledge. The aim of this study is to describe and discuss our experience with transforming a traditional medical training course into an Internet-based course. METHOD: Sixty-nine students were enrolled for a one-month course. They answered pre- and post-course questionnaires and took a multiple-choice test to evaluate the acquired knowledge. RESULTS: Students reported that the primary value for them of this Internet-based course was that they could choose the time of their class attendance (67%). The vast majority (94%) had a private computer and were used to visiting the Internet (75%) before the course. During the course, visits were mainly during the weekends (35%) and on the last week before the test (29%). Thirty-one percent reported that they could learn by reading only from the computer screen, without the necessity of printed material. Students were satisfied with this teaching method as evidenced by the 89% who reported enjoying the experience and the 88% who said they would enroll for another course via the Internet. The most positive aspect was freedom of scheduling, and the most negative was the lack of personal contact with the teacher. From the 80 multiple-choice questions, the mean of correct answers was 45.5, and of incorrect, 34.5. CONCLUSIONS: This study demonstrates that students can successfully learn with distance learning. It provides useful information for developing other Internet-based courses. The importance of this new tool for education in a large country like Brazil seems clear.

Efecto de un gel blanqueador de peroxido de Carbamida al 10 por ciento en la adhesion de discos de porcelana a esmalte humano / The effect of a bleaching gel of carbamide peroxide at 10 per cent in the adhesion of ceramic disks in human enamel

El proposito de este estudio fue investigar si la adhesion de las resinas compuestas al esmalte, se altera en dientes que han sido previamente tratados con un gel de peroxido de carbamida al 10 por ciento (peroxido de hidrogeno al 3 por ciento). Con este fin se seleccionaron veinte premolares recientemente extraidos, sin caries y sin restauraciones. Diez de ellos fueron sometidos a la accion del agente blanqueador ocho horas diarias, durante diez dias. Los otros diez se usaron como grupo control. Todos fueron mantenidos posteriormente durante 10 dias en una solucion de saliva artificial. A ellos se adhirieron por medio de cemento de resina discos de porcelana por carillas tratados segun procedimientos estandarizados. Posteriormente se los sometio a una fuerza de corte en una maquina de testeo universal para determinar la fuerza de adhesion obtenida y su variacion despues del tratamiento. No se observo diferencia estadisticamente significativa en cuanto a valores de adhesion observados entre ambos grupos. En todos los casos se observo fractura de tipo cohesiva a nivel del cemento de resina

Efecto de un gel blanqueador de peroxido de Carbamida al 10 por ciento en la adhesion de discos de porcelana a esmalte humano / The effect of a bleaching gel of carbamide peroxide at 10 per cent in the adhesion of ceramic disks in human enamel

El proposito de este estudio fue investigar si la adhesion de las resinas compuestas al esmalte, se altera en dientes que han sido previamente tratados con un gel de peroxido de carbamida al 10 por ciento (peroxido de hidrogeno al 3 por ciento). Con este fin se seleccionaron veinte premolares recientemente extraidos, sin caries y sin restauraciones. Diez de ellos fueron sometidos a la accion del agente blanqueador ocho horas diarias, durante diez dias. Los otros diez se usaron como grupo control. Todos fueron mantenidos posteriormente durante 10 dias en una solucion de saliva artificial. A ellos se adhirieron por medio de cemento de resina discos de porcelana por carillas tratados segun procedimientos estandarizados. Posteriormente se los sometio a una fuerza de corte en una maquina de testeo universal para determinar la fuerza de adhesion obtenida y su variacion despues del tratamiento. No se observo diferencia estadisticamente significativa en cuanto a valores de adhesion observados entre ambos grupos. En todos los casos se observo fractura de tipo cohesiva a nivel del cemento de resina (AU)

[Brazil within the concert of nations: the struggle against racism in the early days of Unesco]. / O Brasil no concerto das nações: a luta contra o racismo nos primórdios da Unesco.

This article has the objective of approaching the political and scientific context that led Brazil to the position of Unesco paradigm for racial matters. I set out from the hypothesis that soon after the Holocaust, the positive image of race relations in Brazil was in greater evidence, becoming sort of anti-Nazi Germany. At this time, a number of unforeseen efforts took place in the sense of striving for an association between the search for understanding the German totalitarian phenomenon, the radical critique of the scientific standing of the concept of race, the evidencing of socio-economic demands of underdeveloped countries, and the choice of Brazil as a socio-anthropological laboratory. This combination of aims only became viable from the onset of a transnational political-academic alliance universalistic in nature.

[The Rio de Janeiro Medical and Surgical Society: the genesis of an alternative institutional network]. / A Sociedade de Medicina e Cirurgia do Rio de Janeiro: a gênese de uma rede institucional alternativa.

Creation of the Rio de Janeiro Medical and Surgical Society serves as the basis for this study of late-19th-century medicine in Brazil. The hypothesis is that beginning in the 1880s changes to institutions and the diversification of medical community inaugurateed the structuring of a field of social relations specific to medical practitioners. With official medical institutions undergoing crises, alternative groups that emerged outside the government framework worked together toward common ends, particularly the construction of a kind of Brazilian medical knowledge that could play a role on the international scientific scenario.

[Brazilian physician Nina Rodrigues: analysis of a scientific career]. / A medicina de Nina Rodrigues: an lise de uma trajetória científica.

One of the most productive ways of investigating the history of Brazilian medical practice at the turn of this century is to focus on the fruitful and ambiguous careers of those physicians that played an important role in the changes affecting the medical field at that time. This paper aims at analyzing the scientific career of physician-anthropologist Raimundo Nina Rodrigues, taking as its conceptual basis Pierrre Bourdieu's notion of "scientific field ". The paper's point of departure is the notion that the medical field is a space of confrontation that is structurally determined by previous conflicts in which physicians try to monopolize claims to scientific authority and competence. Nina Rodrigues' medical profile appears in this context as a precise indicator of the process of specialization and competition that took place during that period.