Perioperative, Oncological, and Functional Outcomes Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Randomized Clinical Trial.

PURPOSE: Limited high-quality studies have compared robot-assisted laparoscopic prostatectomy (RALP) vs open retropubic radical prostatectomy. We sought to compare their postoperative outcomes in a randomized setting. MATERIALS AND METHODS: In a single center, 354 men with newly diagnosed prostate cancer were assessed for eligibility; 342 were randomized (1:1). The primary outcome was 90-day complication rates. Functional outcomes and quality of life were assessed over 18 months, and oncological outcomes, biochemical recurrence-free survival, and additional treatment over 36 months. RESULTS: From 2014 to 18, 327 patients underwent surgery (retropubic radical prostatectomy = 156, RALP = 171). Complications occurred in 27 (17.3%) vs 19 (11.1%; P = .107). Patients undergoing RALP experienced lower median bleeding (250.0 vs 719.5 mL; P < .001) and shorter hospitalization time. Urinary EPIC (Expanded Prostate Cancer Index Composite) median scores were better for RALP over 18 months, with higher continence rate at 3 months (80.5% vs 64.7%; P = .002), 6 months (90.1% vs 81.6%; P = .036) and 18 months (95.4% vs 78.8%; P < .001). Sexual EPIC and Sexual Health Inventory for Men median scores were higher with RALP up to 12 months, while the potency rate was superior at 3 months (23.9% vs 5.3%; P = .001) and 6 months (30.6% vs 6.9%; P < .001). Quality of life over the 18 months and oncological outcomes over 36 months were not significantly different between arms. CONCLUSIONS: Complications at 90 days were similar. RALP showed superior sexual outcomes at 1 year, improved urinary outcomes at 18 months, and comparable oncological outcomes at 36 months. TRIAL REGISTRATION: Prospective Analysis of Robot-Assisted Surgery; NCT02292914. https://clinicaltrials.gov/ct2/show/NCT02292914?cond=NCT02292914&draw=2&rank=1.

Diversity and Flight Patterns of Caddisflies (Trichoptera) in an Atlantic Forest Fragment: Implications for Species Conservation in Threatened Ecosystems.

Anthropogenic activities have decimated the Atlantic Forest domain (AF) and increased the pressure on freshwater biota, such as Trichoptera, which is the most affected order by the current insect decline. Adult mobility is crucial for the colonisation of new environments unconnected by water sources. In this article, we describe the assemblage of caddisflies in a preserved AF fragment related to their functional feeding group and provide empirical data on the patterns of horizontal and vertical flight. Adults were collected using white sheet and light attraction traps, placed at different distances and heights from a stream in Pernambuco, Brazil. A total of 2934 specimens of 15 species from five families were collected, mostly collector-filterers. Horizontal flight was limited, with 80% of the abundance concentrated up to 20 m. Vertical stratification was also concentrated at lower heights. A female-biased proportion was observed at higher strata. The richness and abundance of species decreased with increasing distances and heights from the stream. Overall, Chimarra sp. and Macrostemum scharfi were the dominant species. Trichoptera is a key taxon used as a biological indicator of water quality, and here, knowledge on the diversity and flight patterns of adults is expanded. At the risk of intensive pollution of rivers in Atlantic forests, data on the adult dispersal can be incorporated in the assessment of endangerment status and in conservation strategies.

Cutaneous glands of the striped toad, Rhinella crucifer (Wied-Neuwied, 1821) (Amphibia: Bufonidae): Histological study and bioactivities of glandular secretions.

This study investigated the morphology of Rhinella crucifer cutaneous glands, as well as the protein/peptide profiles and bioactivities of body gland secretions (BGS) and parotoid macrogland secretions (PS). The parotoid as well as dorsal and ventral skin fragments of male and female individuals were processed for histological analysis. The protein and peptide profiles of male and female gland secretions were evaluated. Male secretions were also assessed for proteolytic, trypsin inhibiting, hemagglutinating, hemolytic, antimicrobial, and anticoagulant activities. The R. crucifer skin structure presented protuberances that are clearly visible and formed by the integument, which has cutaneous glands throughout the body. An average of 438 and 333 glands were identified in males in females, respectively. No significant differences were observed in the distribution of glands across the body as well as for area and perimeter of glands. Differences were observed in protein composition between the PS and BGS from males and females, and secretions from animals collected from undisturbed and anthropogenically disturbed areas. Proteins with similarities to catalase and elongation factor 1-alpha were detected in the PS. Zymography revealed proteolytic activity in both male BGS and PS. Male BGS showed antibacterial activity against Enterococcus faecalis and Escherichia coli and anticoagulant activity, being able to prolong prothrombin time by 6.34-fold and activated partial thromboplastin time by 2.17-fold. Finally, male PS and BGS caused a maximum hemolysis degree of 1.4%. The data showed that the cutaneous secretions of R. crucifer are potentially promising for biotechnological prospecting.

A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy.

PURPOSE: Partial nephrectomy is the standard treatment for renal tumors <7 cm, and the trend toward minimally invasive surgery has increased. However, data that could support its use and benefits are still lacking. MATERIALS AND METHODS: We conducted a prospective, randomized controlled trial comparing surgical, functional and oncologic outcomes in patients undergoing open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN). Randomization was 1:1 to OPN or LPN for the treatment of renal tumors <7 cm. The primary endpoint was surgical complications up to 90 days after surgery. Secondary outcomes were comparison of surgical, oncologic and functional results. RESULTS: We randomized 208 patients between 2012 and 2020 (110 with OPN vs 98 with LPN). Operative data showed no differences in operative time, warm ischemia time, estimated blood loss, transfusions or length of hospital stay. Zero ischemia was more frequent in the OPN (35.4% vs 15.5%, p=0.02). OPN was associated with more abdominal wall complications (31.2% vs 13.1%, p=0.004). Regarding oncologic outcomes, no differences were noted. The LPN group had less kidney function reduction at 3 (-5.2% vs -10%, p=0.04; CI 0.09 to 9.46) and 12 months after surgery (-0.8% vs -6.3%, p=0.02; CI 1.18 to 12.95), and a lower rate of downstaging on the chronic kidney disease classification at 12 months (14.1% vs 32.6%, p=0.006). CONCLUSIONS: Surgical and oncologic outcomes of LPN were similar to OPN. Minimally invasive surgery may provide better preservation of kidney function. More studies, especially those involving robotic surgery, are necessary to confirm our findings.

Educação Física na escola indígena dos Borari da terra indígena Maró / Physical Education at the Borari indigenous school of the Maró indigenous land / Educación Física en la escuela indígena Borari de la tierra indígena Maró

Este trabalho resulta da pesquisa de mestrado do Programa de Pós-Graduação em Educação da Universidade Federal do Oeste do Pará (UFOPA) intitulada: Educação Física e Educação Escolar Indígena: o caso dos Borari da Terra Indígena Maró. A pesquisa teve como objetivo geral compreender o desenvolvimento do componente curricular Educação Física em uma escola indígena do município de Santarém-PA. A pesquisa caracterizou- se como um estudo exploratório e os dados produzidos foram analisados mediante a técnica da Análise de Conteúdo. Os resultados encontrados demonstraram que o componente curricular Educação Física estava organizado na escola indígena a partir de uma sistematização em três grandes categorias de ensino: Jogos e Brincadeiras, Práticas Corporais Tradicionais e a Modalidade Esportiva Futebol, conteúdos que foram sistematizados pelos docentes indígenas mediante a necessidade de implementar uma proposta de ensino diferenciada em sua escola, na qual os conhecimentos tradicionais presentes no cotidiano indígena são introduzidos na instituição escolar.

This work results from the master's research of the Graduate Program in Education of the Federal University of Western Pará (UFOPA) entitled: Physical Education and Indigenous School Education: the case of the Borari of the Maró Indigenous Land. The general objective of the research was to understand the development of the Physical Education curricular component in an indigenous school and can be characterized as an exploratory study in which the data produced were analyzed using the Content Analysis technique. The results found showed that the curricular component Physical Education was organized in the indigenous school from a systematization into three major categories of teaching: Games, Traditional Body Practices and the sport modality Football, contents that were systematized by indigenous teachers through the need to implement a differentiated teaching proposal in their school, in which the traditional knowledge present in the indigenous daily life is introduced in the school institution.

Este trabajo, es el resultado de la investigación para la maestría del posgrado en Educación Física de la Universidad federal del Oste del Pará (UFOPA), titulada Educación Física y Educación Escolar indígena: el caso de los Borari de la tierra indígena Maró. La investigación tuvo como objetivo general comprender el desarrollo del componente curricular Educación Física en una escuela indígena, y puede ser caracterizado como un estudio de exploración, en que los datos recolectados se hicieron mediante una técnica de análisis de contenido. Los resultados encontrados demostraron que él comportamiento curricular Educación Física estaba organizado en la escuela indígena a partir de una clasificación de tres categorías de enseñanza, las cuales son: Juego y jugadas, practicas corporales tradicionales y la modalidad deportiva futbol, contenidos que fueron agrupado por los docentes indígenas, mediante las necesidad de implementar una propuesta de enseñanza diferente en su escuela, en la cual los conocimientos tradicionales presentados en el contenido indígena son introducidos en la institución escolar.

Robot-assisted simple prostatectomy: the evolution of a surgical technique

ABSTRACT Purpose: Enucleation of a large prostate is the best surgical choice for patients refractory to clinical treatment (1,2). Since the first robot-assisted simple prostatectomy (RASP) was described (3,4), some technical modifications (5-7) and different approaches to reach the adenoma have been proposed (8,9). The aim of this video is to demonstrate three different techniques of RASP. Materials and Methods: The first procedure begins with a transversal incision over the bladder neck, the second is a transvesical approach and the last one is a Retzius-sparing RASP. All techniques were performed with a vesico-urethral anastomosis. Results: Three patients underwent RASP, each one with a different approach. Patients presented mean age of 66±4.4 years, PSA baseline level of 7.8±3ng/mL, IPSS score of 17.7±4.5, maximum urine flow of 8.3±1.5mL/seg and 122.3±11.2cm3 of prostate volume. The mean operative time was 63±8 minutes, estimated blood loss of 106.7±11.5mL, prostate weight of the surgical specimen of 106.3±8 grams and 1 day of length of stay. No continuous bladder irrigation was required and there was no complication. The mean postoperative PSA and IPSS were 0.7±0.3ng/mL, 4.7±1.5. The maximum urine flow raised to 20±4.4mL/seg. Conclusions: RASP with vesico-urethral anastomosis allowed minimal blood loss, short length of stay and great functional outcomes. All the three approaches allowed to perform this technique in a safe way, while showing different alternatives to reach the adenoma.

Robot-assisted endoscopic inguinal lymphadenectomy: A review of current outcomes.

OBJECTIVE: To review the role of robot-assisted endoscopic inguinal lymphadenectomy (RAIL) in the management of penile cancer. METHODS: A PubMed search for all relevant publications regarding RAIL series up until August 2019 was performed using the keyword "robotic", "inguinal lymph node dissection", and "penile cancer". Weighted mean was calculated in the largest series for all outcomes using the number of patients included in each study as the weighting factor. RESULTS: We identified 23 articles, of note the three largest series that included 102, 27, and 20 RAIL in 51, 14, and 10 patients, respectively. Saphenous vein was spared in 88.93% of RAIL cases in these series and node yield was 11.42 per groin; 35.28% of patients had positive pathological nodes. The weighted mean of operative time was 87.98 min per RAIL and the estimated blood loss was 37.08 mL per patient. The mean length of hospital stay was 1.29 days and the drain was kept in place for 17.02 days; the major complication rate was only 5.31% in these series. The mean follow-up was 33.46 months with a recurrence-free survival of 96.33%. CONCLUSION: The literature regarding RAIL describes promising results, although it has shorter follow-up and higher costs when compared to historically series from the open approach. Initials series reported lower cutaneous complications compared to conventional approach, without compromising oncological outcomes. However, long-term results and larger trials are crucial to validate those findings.

Robot-assisted retroperitoneal lymphadenectomy: The state of art.

OBJECTIVE: To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy (R-RPLND) in the management of testicular cancer. METHODS: A PubMed search for all relevant publications regarding the R-RPLND series up until August 2019 was performed. The largest series were identified, and weighted means calculated for outcomes using the number of patients included in each study as the weighting factor. RESULTS: Fifty-six articles of R-RPLND were identified and eight series with more than 10 patients in each were included. The weighted mean age was 31.12 years; primary and post chemotherapy R-RPLND were performed in 50.59% and 49.41% of patients. The clinical stage was I, II and III in 47.20%, 39.57% and 13.23% of patients. A modified R-RPLND template was used in 78.02% of patients, while 21.98% underwent bilateral full template. The weighted mean node yield, operative time and estimated blood loss were, respectively, 22.15 nodes, 277.35 min and 131.94 mL. The weighted mean length of hospital stay was 2 days and antegrade ejaculation was preserved in 92.12% of patients. Major post-operative complications (Clavien III or IV) occurred in 5.34%. Positive pathological nodes were detected in 24.54%, while the recurrence free survival was 95.77% with a follow-up of 21.81 months. CONCLUSION: R-RPLND has proven to be a reproducible and safe approach in experienced centers; short-term oncologic outcomes are similar to the open approach with less morbidity and shorter convalescence related to its minimal invasiveness. However, longer follow-up and new trials comparing head-to-head both techniques are expected.

Fresh frozen plasma: red blood cells (1:2) coagulation effect is equivalent to 1:1 and whole blood.

BACKGROUND: Preemptive treatment of trauma-associated coagulopathy involves transfusion of fresh frozen plasma (FFP) at 1:1 ratio with red blood cells (RBCs), but the optimal ratio remains controversial. In combat theaters, fresh whole blood (FWB) is also an option. The objective of this study was to determine the effect of FFP:RBC ratios 1:1, 1:2, 1:3 and FWB on coagulation during resuscitation. MATERIALS AND METHODS: Thirty-six rats were randomized in the following six groups: Group 1: sham; Group 2: hemorrhage followed by sole lactated Ringer (LR) infusion; Group 3: FFP:RBC (1:1); Group 4: FFP:RBC (1:2); Group 5: FFP:RBC (1:3); Group 6: FWB transfusion. Another 25 animals were used for blood harvesting. Hemorrhage was induced by withdrawing 40% of total blood volume, mean arterial pressure (MAP) decreased to 45% of baseline, and laparotomy. Animals underwent LR infusion followed by blood product transfusion preset for each group. Blood samples were obtained at baseline and in the 105th minute for thromboelastometry and lactate. RESULTS: Hemorrhage caused a significant decrease in MAP and increase in lactate (P < 0.05). MAP was persistently low in group 2 despite fluid infusion (P < 0.05), but not in the other groups after 20 min of resuscitation. Mean clot formation time, alpha angle, and maximum clot firmness decreased significantly (P < 0.05) in group 2 (LR) and group 5 (1:3) compared with other groups. CONCLUSIONS: FFP:RBC in a 1:2 ratio optimally harnessed hemostatic resuscitation and prudent use of blood products compared with 1:1 and 1:3 ratios and to FWB transfusion.

Effect of Typha domingensis cutting: response of benthic macroinvertebrates and macrophyte regeneration / Efeito do corte de Typha domingensis: resposta dos macroinvertebrados bentônicos e a regeneração da macrófita

Wetlands are important because they have high biodiversity and are considered, by environmental agencies, permanently protected areas due to their importance to conservation. In Southern Brazil the aquatic macrophyte Typha domingensis is harvested to be used in the manufacture of handicraft, being an important income source to small farmers. This work aims to test the cut effect of T. domingensis on benthic macroinvertebrates as well as on macrophyte regeneration. These phenomena were analyzed in small areas (1 m²) in a T. domingensis stand by comparing cut treatments and control treatments. Macroinvertebrate were sampled with a corer in the following time sequence after the cut event in both treatments: one day, 26 days, 60 days, 89 days, and 182 days. Macrophyte regeneration was monitored through monthly measurements at each treatment. The macroinvertebrate density did not differ between treatments (ANOVA, p < 0.05). Among the 23 taxa identified, Tubificidae was the only family to response to cut treatment. DCA showed an overlapping between treatments indicating a not clear pattern. The growth of T. domingensis shoots was not affected by the disturbance. Macrophyte regeneration was quick when comparing the treatments and statistical differences were found in one day after the disturbance and 26 days after the disturbance, whereas no differences were found in the remaining sampling dates (60, 89 and 182 days). Observing the macroinvertebrate response and the T. domingensis regeneration, our results suggest that sustainable use of this macrophyte is possible on a small scale.

As áreas úmidas são importantes, pois apresentam alta biodiversidade e são consideradas pelos órgãos ambientais áreas de proteção permanente devido à sua importância para conservação. No Sul do Brasil a macrófita aquática Typha domingensis é colhida para ser usada na fabricação de artesanato, sendo uma fonte de renda importante para pequenos agricultores. Este trabalho teve como objetivo testar o efeito de corte de T. domingensis sobre os macroinvertebrados bentônicos, bem como sobre a regeneração da macrófita. Para avaliar o efeito do corte foram analisadas pequenas áreas (1 m²) em uma formação de T. domingensis onde comparou-se o tratamento de corte com tratamentos controle. Macroinvertebrados foram amostrados com um "corer" na seguinte sequência de tempo após o corte, em cada tratamento: um dia, 26 dias, 60 dias, 89 dias e 182 dias. A regeneração da macrófita foi monitorada através de medições mensais em cada tratamento. Não houveram diferenças significativas na densidade de macroinvertebrados entre os tratamentos (ANOVA, p < 0.05). Entre os 23 táxons identificados, Tubificidae foi a única família a responder ao tratamento de corte. A DCA mostrou uma sobreposição entre os tratamentos, indicando um padrão não claro. O crescimento dos ramos de T. domingensis não foi afetado pelo distúrbio. A regeneração da macrófita foi rápida quando se compararam os tratamentos, diferenças estatísticas foram encontradas em um dia e 26 dias após o corte, enquanto não foram encontradas diferenças nas datas de amostragem restantes (60, 89 e 182 dias). Observando a resposta dos macroinvertebrados e a regeneração de T. domingensis, sugere-se que o uso sustentável desta macrófita é possível em pequena escala.

Perfil dos pacientes submetidos à pieloplastia no Hospital Infantil Joana deGusmão de 1990 à 2009, um estudo comparativo entre duas décadas / Profile of patients submitted to pyeloplasty in Joana de Gusmão Children?s Hospital from 1990 to 2009, a comparative study of two decades

Objetivo: analisar e comparar o perfil dos pacientessubmetidos à pieloplastia no Hospital Infantil Joana deGusmão durante as décadas de 1990 e 2000. Métodos:observacional, transversal, retrospectivo e comparativode 138 pacientes submetidos à pieloplastia, nesse hospital,entre duas décadas. Resultados: em concordânciacom a literatura, houve predomínio, em ambas as décadas,de pieloplastias no sexo masculino, na unidade renalesquerda e em hidronefroses de grau 4. Observou-seaumento na mediana da idade cirúrgica de 15,7 mesesentre as décadas, o que possivelmente reflete o aprimoramentodos métodos de imagem ao longo dos anos,permitindo, em muitos casos, observações seriadas emdetrimento da indicação precoce de cirurgia. Na primeiradécada a principal forma do diagnóstico foi através damanifestação dos sintomas (45,9%), enquanto que nadécada seguinte houve equivalência nos diagnósticospré e pós-natal (42,9%). A principal via de acesso, emambas as décadas, foi a lombotomia posterior devido àsua facilidade técnica. No entanto, houve aumento significativo(p=0,01) na indicação do acesso abdominalanterior na segunda, o que pode ser justificado pela evoluçãodos métodos de imagem pré-cirúrgicos com umdirecionamento mais preciso, realizado principalmentesobre hidronefroses volumosas. Finalmente, durantetodo o período, foi observado predomínio das AnomaliasCongênitas dos Rins e das Vias Urinárias, o que sejustifica atentar para a possibilidade dessas associações.Conclusão: houve aumento, entre as décadas, no númerode diagnósticos de hidronefroses pré-natais, na medianada idade cirúrgica e foi estatisticamente significativo omaior uso da via de acesso anterior na segunda década.

Objective: to analyze and compare the profile of patientssubmitted to pyeloplasty in Joana de GusmãoChildren?s Hospital during the decades of 1990 and 2000.Methods: observational, cross-sectional, retrospectiveand comparative study of 138 patients submitted to pyeloplastyin this hospital between two decades. Results:according to the literature, pyeloplasties predominated, inboth decades, in males, in the left renal unit and in grade 4hydronephrosis. There was an increase in the median ageat surgery of 15.7 months between the decades, whichpossibly reflects the improvement of imaging techniquesalong the years, allowing in many cases, serials observationsinstead of the early indication for surgery. In the firstdecade the main way of diagnosis was through the manifestationof symptoms (45.9%), while in the next decadethere was equivalence of diagnostic pre and post-natal(42.9%). The main surgical access, in both decades, wasthe lombotomia posterior due to its technical simplicity.However, there was a significant increase (p = 0.01) in theindication of the anterior abdominal access in the seconddecade, which can be explained by the evolution of methodsof preoperative imaging with a better direction, performedmainly on massive hydronephrosis. Finally, duringthe whole period, it was observed predominance of theCongenital Anomalies of the Kidneys and Urinary Tract,which justifies paying attention to the possibility of theseassociations in these patients. Conclusion: there was anincrease, between the decades, in the number of diagnosesof prenatal hydronephrosis, median age at surgery andit was statistically significant the greater use of the anteriorabdominal access in the second decade.

Effects of cutting disturbance in Schoenoplectus californicus (C.A. Mey.) Soják on the benthic macroinvertebrates / Efeito do distúrbio de corte em Schoenoplectus californicus (C.A. Mey.) Soják sobre a fauna de macroinvertebrados bentônicos

Lagoons are considered protected areas because these systems play a key ecological role. However, the extraction of macrophyte Schoenoplectus californicus is held for manufacture of handcrafts, being an alternative income for riverbank communities. This study evaluated the impact of S. californicus experimental cutting on benthic macroinvertebrates trough a field experiment. Macroinvertebrates were sampled at 1, 12, 26 and 60 days after the macrophyte cutting in demarked plots (1 m²), as well at control plots. The families number was not statistically different (ANOVA, p > 0.05), but the total density of invertebrates, and the density of Ceratopogonidae were significant (ANOVA, p < 0.05) for interaction between sampling date and treatment. A Principal Components Analysis identified that the level of the water column was the variable that most influenced the variation between the samples gathered in the experiment. We concluded that the cutting of S. californicus, in this area, as the intensity of the cut held, did not affect considerably the aquatic macroinvertebrates. The results suggest that the small-scale extractivism in these regions carries little effect because the fauna of adjacent areas probably can quickly colonize the disturbed areas.

No Brasil, as margens de lagoas são consideradas áreas protegidas por desempenharem importante papel ecológico. No entanto, a extração da macrófita Schoenoplectus californicus é realizada para a fabricação de artesanato, sendo alternativa de renda para as comunidades ribeirrinhas. Este estudo teve como objetivo avaliar o impacto do corte de S. californicus sobre os macroinvertebrados bentônicos por meio de um experimento de campo. Os macroinvertebrados foram amostrados um dia, 12, 26 e 60 dias após o corte em macrófitas em parcelas demarcadas (1 m²), bem como nas parcelas-controle. As famílias de macroinvertebrados mais abundantes não apresentaram diferenças significativas (ANOVA, p < 0,05), mas a densidade total de invertebrados e a densidade de Ceratopogonidae foram significativas (ANOVA, p < 0,05) para a interação entre a data de amostragem e tratamento. A Análise de Componentes Principais identificou que a profundidade no local do experimento foi a variável que influenciou a variabilidade entre as amostras coletadas no experimento. Concluiu-se que o corte de S. californicus, nessa área, como a intensidade do corte realizado, não afeta drasticamente a composição de macroinvertebrados aquáticos. Os resultados sugerem que o extrativismo em pequenas escalas nessas regiões exerce pouca influência, pois a fauna em áreas adjacentes pode rapidamente colonizar as áreas perturbadas.

Rituximab and CHOP chemotherapy plus GM-CSF for previously untreated diffuse large B-cell lymphoma in the elderly: a Wisconsin oncology network study.

PURPOSE: Human recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) may potentiate rituximab activity by upregulating CD20 expression and activating effector cells necessary for antibody-dependent cellular cytotoxicity. GM-CSF was combined with standard rituximab + CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy (R-CHOP) in the treatment of elderly patients with de novo diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS: Thirty-eight patients over the age of 60 years with newly diagnosed DLBCL were treated with R-CHOP every 21 days for 6-8 cycles and GM-CSF 250 µg/m2 per day on days 3-10. Patients were evaluated for response after cycles 4, 6, and 8. The primary endpoint was the rate of complete response, and secondary endpoints were progression-free survival (PFS), event-free survival, and overall survival (OS). RESULTS: Thirty-eight patients were enrolled, with a median age of 72 years, and 29% of patients having high-risk disease (International Prognostic Index [IPI] score ≥ 4). A complete or unconfirmed complete response (CR) was achieved in 53% of patients. After a median follow-up of 51.1 months, the 3-year PFS and OS were 78% and 84%. Twenty-one percent of patients discontinued protocol treatment because of chemotherapy-related toxicity and 16% because of GM-CSF toxicity. Dose intensity for planned chemotherapy cycles was 81.1%. CONCLUSION: These data suggest that survival outcomes may be modestly improved when GM-CSF is combined with R-CHOP in the treatment of elderly DLBCL. GM-CSF had toxicity precluding planned administration in 16% of patients, which may limit usefulness of this agent. Further investigation of GM-CSF in combination with rituximab-containing chemotherapy is warranted.

Computer-aided structure elucidation of neolignans.

This paper describes a new module of the expert system SISTEMAT used for the prediction of the skeletons of neolignans by 13C NMR, 1H NMR and botanical data obtained from the literature. SISTEMAT is composed of MACRONO, SISCONST, C13MACH, H1MACH and SISOCBOT programs, each analyzing data of the neolignan in question to predict the carbon skeleton of the compound. From these results, the global probability is computed and the most probable skeleton predicted. SISTEMAT predicted the skeletons of 75% of the 20 neolignans tested, in a rapid and simple procedure demonstrating its advantage for the structural elucidation of new compounds.

New improvements in automatic structure elucidation using the LSD (Logic for Structure Determination) and the SISTEMAT expert systems.

This article describes the integration of the LSD (Logic for Structure Determination) and SISTEMAT expert systems that were both designed for the computer-assisted structure elucidation of small organic molecules. A first step has been achieved towards the linking of the SISTEMAT database with the LSD structure generator. The skeletal descriptions found by the SISTEMAT programs are now easily transferred to LSD as substructural constraints. Examples of the synergy between these expert systems are given for recently reported natural products.

Litter production and aquatic macroinvertebrates on a headwater subtropical stream in Rio Grande do Sul State, Brazil - DOI: 10.4025/actascibiolsci.v31i3.355 / Produção de folhiço e fauna associada de macroinvertebrados aquáticos em curso dágua de cabeceira em Floresta Ombrófila do Estado do Rio Grande do Sul, Brasil - DOI: 10.4025/actascibiolsci.v31i3.355

The aim of the study was to verify the temporal variation of allochthonous material input into a stream, and which structures contribute to the organic material pool, as well as to analyze the occurrence of macroinvertebrates associated with the litter. Samples were taken from October, 2004 to October, 2005 in two transects along the riparian zone. At each transect, three sampling stations were chosen. At each one, submersed and suspended collectors (1.5 m above bottom) were installed. Input and retention of coarse benthic organic material were analyzed and classified as flowers and diaspores, (seeds and fruits) and vegetative structures (leaves and branches). There were no statistical differences between input of material in suspended and submersed collectors. Therefore, no statistical differences were verified for exposure time for both the suspended and submersed collectors. Vegetative and seeds and fruits and flowers structures differed in relation to their vegetal composition input for total exposure times for both collectors. Leaves were the most important structure for biomass. Aquatics insects, crustaceans, mussels and worms were the most common macroinvertebrates associated with litter. Insecta-Diptera, mainly Chironomidae and Oligochaeta were the most abundant taxa associated with the submerged and suspended collectors. The major taxa richness was found in submerged

Os objetivos deste estudo foram verificar a entrada sazonal de material alóctone e a composição de suas estruturas vegetais e da fauna de macroinvertebrados aquáticos associados ao material alóctone em um riacho de cabeceira em clima subtropical. Foram analisadas, trimestralmente, duas transecções longitudinais no curso dágua, onde foram instalados coletores submersos e suspensos (1,5 m acima da calha) de outubro de 2004 a outubro de 2005. Em ambos os coletores, não se verificou diferença para a entrada de material alóctone entre os períodos de coletas, o que sugere ausência definida de sazonalidade. Também não foram verificadas, temporalmente, diferenças para os componentes, flores, frutos e sementes (diásporos), folhas e galhos (vegetativas). O componente foliar foi o item com maior biomassa na formação do material alóctone em ambos os coletores. Larvas de insetos aquáticos, crustáceos, moluscos e vermes oligoquetos correspondem aos grupos com maior representatividade. Chironomidae (Insecta, Diptera) e Oligochaeta foram os taxa mais abundantes em ambos os coletores, porém a maior riqueza foi observada nos coletores submersos.