SELNET clinical practice guidelines for bone sarcoma.

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context.

Transient vocal fold lesion and hoarseness associated with the use of ramucirumab: Case report.

INTRODUCTION: Gastric cancer (GC) is among the leading neoplasms with highest morbidity and mortality in the world. Tumor angiogenesis represents one of important targets of antineoplastic treatment, as it has an important role in cell development and growth. CASE REPORT: Ramucirumab, an IgG1 monoclonal antibody (MoAb), inhibits the angiogenesis pathway by blocking the VEGFR-2 activation. The most common adverse events associated with angiogenic inhibitors are cardiovascular and healing disorders, such as systemic arterial hypertension (HTN), thromboembolism, bleeding, wound healing delay and fistulas. We report a case of vocal fold lesion associated with ramucirumab in a patient with metastatic gastric cancer. The patient presented with transient hoarseness that was related to the exposure to ramucirumab. DISCUSSION: Laryngeal toxicity due to anti-angiogenic agents is rare. Despite the fact that this adverse event is not a life-threatening complication, it can significantly impair quality of life and should be promptly recognized.

Postpartum follow up of gestational diabetes in a Tertiary Care Center.

BACKGROUND: Gestational diabetes is a risk factor for future development of type 2 diabetes. The primary aim of this study was to estimate the prevalence of postpartum glucose tolerance status evaluation in pregnancies complicated by gestational diabetes 6-12 weeks after delivery. The secondary one was to identify the factors that are implicated with postpartum glucose retesting. METHODS: This was a retrospective study performed with a cohort of women with gestational diabetes, with prenatal care and delivery at a tertiary care center, from January 2013 to April 2017. The diagnosis of gestational diabetes was based on IADPSG criteria (Fasting ≥ 92 mg/dl, 1 h ≥ 180 mg/dl and/or 2 h ≥ 153 mg/dl, respectively) and the diagnosis of type 2 diabetes and prediabetes were made using the 2016 ADA's criteria (fasting and 2 h after glucose load ≥ 126 mg/dl and/or ≥ 200 and 100-125 mg/dl and/or 140 and 199 mg/dl, respectively). All women had an appointment scheduled 6-12 weeks postpartum with the results of a 75-g oral glucose tolerance test (OGTT). RESULTS: Of the 152 evaluated women, 21 (13.8%) returned with the postpartum OGTT results. Of these, 9 (45.0%) had a diagnosis of prediabetes. The use of insulin during gestation was the only factor implicated in a higher adherence rate to postpartum testing OR 6.33 (p 0.002). No significance was found for other demographic and clinical variables (age, family income, years of study, parity, gestational age at first visit, smoking, family history of type 2 diabetes, diagnosis of gestational diabetes before the third trimester, pregestational body mass index, previous history of gestational diabetes and ethnicity). CONCLUSION: The majority of patients with gestational diabetes did not return postpartum to perform OGTT and in our study the only factor implicated in a higher postpartum return was the use of insulin during pregnancy. Considering that 45.0% were diagnosed with prediabetes, diabetes care teams should initially identify non-adherent patients.

Extended preoperative chemotherapy, extent of liver resection and blood transfusion are predictive factors of liver failure following resection of colorectal liver metastasis.

AIM: The aim of this study was to determine the incidence and prognostic factors of postoperative liver failure in patients submitted to liver resection for colorectal metastases. METHOD: Patients with CLM who underwent hepatectomy from 1998 to 2009 were included in retrospective analysis. Postoperative liver failure was defined using either the 50-50 criteria or the peak of serum bilirubin level above 7 mg/dL independently. RESULTS: Two hundred and nine (209) procedures were performed in 170 patients. 120 surgeries were preceded by chemotherapy within six months. The overall morbidity rate was 53.1% and 90-day mortality was 2.3%. Postoperative liver failure occurred in 10% of all procedures, accounting for a mortality rate of 9.5% among this group of patients. In multivariate analysis, extent of liver resection, need of blood transfusion and more than eight preoperative chemotherapy cycles were independent prognostic factors of postoperative liver insufficiency. This complication was not related with the chemotherapy regimen used. CONCLUSION: We conclude that postoperative liver failure has a relatively low incidence (10%) after CLM resection, but a remarkable impact on postoperative mortality rate. The amount of liver resected, the need of blood transfusion and extended preoperative chemotherapy are independent predictors of its occurrence and this knowledge can be used to prevent postoperative liver failure in a multidisciplinary approach.

Ocorrência de Aeromonas sp. e microrganismos psicrotróficos e estimativa do prazo de validade comercial de filé de pintado (Pseudoplatystoma coruscans) mantidos sob refrigeração / Occurrence of Aeromonas sp. and psychrotrophic microorganisms and estimate the shelf life of "pintado" (Pseudoplatystoma coruscans) fillets kept under refrigeration

Verificou-se a ocorrência de bactérias do gênero Aeromonas e estimou-se o prazo de validade comercial de filés de pintado (Pseudoplatystoma coruscans) com pele, durante estocagem em refrigeração por meio da quantificação de microrganismos heterotróficos aeróbios psicrotróficos e análises físico-químicas para determinação do pH e detecção de amônia e gás sulfídrico. Foram utilizadas 45 amostras de filé de pintado, com aproximadamente 100 gramas cada, embaladas individualmente em polietileno de alta densidade e armazenadas em câmara frigorífica entre 0ºC e 3ºC. A cada dois a três dias de estocagem, três unidades de filés foram submetidas a análises microbiológicas e físico-químicas, totalizando 15 análises durante o período de estocagem. As contagens de Aeromonas sp. e microrganismos heterotróficos aeróbios psicrotróficos variaram de 1,89 a 9,47logUFC/g e 0 a 6,54logUFC/g, respectivamente. A variação do pH foi de 6,20 a 6,97, e as análises de amônia e gás sulfídrico foram negativas durante todo o período. O pH dos filés de pintado atingiu o limite máximo de 6,4 aos 23 dias de estocagem, e estimou-se o seu prazo de validade comercial.

This word studied the occurrence of bacteria from genus Aeromonas and estimate the shelf life of "pintado" fish fillets (Pseudoplatystoma coruscans), during cold storage, through the quantification of psychrotrophic aerobic microorganisms, physical and chemical analyses for presence of ammonia and gas sulphide (H2S) and pH as used in 45 samples of "pintado" fillets with approximately 100 grams each, individually packed in high density polyethylene and stored in cold storage (0ºC to 3ºC). Every 2-3 days of storage, 3 units of fillets were subjected to microbiological and physicochemical analysis for a total of 15 days during the storage period. The Aeromonas sp. and psychrotrophic microorganisms count varied from 1.89 to 9.47logCFU/g and 0 to 6.54logCFU/g, respectively. The pH variation was from 6.20 to 6.97 and ammonia and H2S analyses were negative during the whole period. According under Brazilian legislation (Brazil, 1981) estimated the commercial shelf life of "pintado" fillets being 23 days when the pH reached a value of 6.4. The pH of the "pintado" fillets reached the maximum limit of 6.4 at 23 days of storage, being its estimated commercial shelf life.

Removal of methylene blue from colored effluents by adsorption on montmorillonite clay.

In this study, montmorillonite clay (MC) has been utilized as the adsorbent for the removal of a cationic dye, methylene blue (MB), from aqueous solution by the batch adsorption technique under different conditions of initial dye concentration, adsorbent concentration, contact time, solution pH, and temperature. Attempts were made to fit the isothermal data using Langmuir and Freundlich equations. The experimental results have demonstrated that the equilibrium data are fitted well by a Langmuir isotherm equation. Thermodynamic parameters such as the changes in enthalpy, entropy, and Gibbs' free energy were determined, showing adsorption to be an endothermic yet spontaneous process. Pseudo-first-order, pseudo-second-order, and intraparticle diffusion models were considered to evaluate the rate parameters. The experimental data fitted the pseudo-second-order kinetic model, with an activation energy of +28.5 kJ mol(-1). The results indicate that MC adsorbs MB efficiently and could be employed as a low-cost alternative in wastewater treatment for the removal of cationic dyes.

Humoral intestinal immunity in systemic lupus erythematosus.

Forty-five patients with systemic lupus erythematosus (SLE) underwent a cross-sectional study to evaluate intestinal secretory immunity. Peroral jejunal biopsy with histologic and immunohistochemical assessment of the mucosa were carried out in the patients and in 12 healthy volunteers. It was observed that an altered pattern of immunoglobulin-bearing plasma cells distributed in the lamina propria and complementary components were invariably present, mainly in the patients with active disease. The basement membrane of the intestinal crypt epithelium exhibited immunoglobulin and complementary deposits, similar to the lupus band test. None of the immunologic findings correlated with the medical treatment and with the peripheral blood analysis. The local changes in humoral immunity in patients with SLE did not correlate with gastrointestinal symptoms and may reflect the systemic effects of the disease.