Clinical and imaging research in the diagnosis of anorectal melanoma with surgical outcome: a case report and literature review

Objective: This study aims to report the case of a 69-year-old female patient with a diagnosis of anorectal melanoma (AM) established by immunohistochemistry. Methods: Clinical case report, a descriptive and qualitative study. Results: The patient had a nodular and ulcerative lesion in the anal region, the imaging exams revealed an expansive lesion that affected the rectum and the vaginal wall. The chosen course of treatment was initial surgical intervention, the surgery and postoperative course progressed without complications, and the anatomopathological examination confirmed the diagnosis of invasive malignant melanoma of the distal rectum of anorectal transition. The anatomopathological examination confirmed the diagnosis of invasive malignant melanoma located in the distal rectum of the anorectal transition. Immunohistochemistry analysis showed infiltrative melanoma with microsatellites, as well as peri and intratumoral lymphocytic infiltrate, angiolymphatic invasion, and perineural invasion. The surgical resection margins, ovaries, posterior vaginal wall, and parametrium showed no signs of neoplastic involvement. Following the surgery, the patient began immunotherapy, which she is still undergoing. Conclusions: The survival rate of AM can be improved through various diagnostic and therapeutic modalities. However, further exploration of this topic through clinical studies is necessary to enhance both diagnosis and treatment. (AU)

KNOWLEDGE ABOUT THE MANAGEMENT OF WASTE CONTAMINATED AND POTENTIALLY CONTAMINATED BY SARS-COV-2 / CONHECIMENTO ACERCA DO MANEJO DE RESÍDUOS CONTAMINADOS E POTENCIALMENTE CONTAMINADOS POR SARS-COV-2

The coronavirus (COVID-19) is a respiratory disease with a high capacity to spread. Its prevention consists of respecting social distance, wearing a mask and performing adequate hygiene of hands and surfaces, which resulted in an increase in the amount of household solid waste generated during the period of social isolation. The objective of this study is to identify the knowledge of residents of Curitiba on the management of waste contaminated or potentially contaminated by SARS-CoV-2 through an exploratory-descriptive research with a quantitative approach with 420 participants. It was found that the population's lack of knowledge about the measures contained in the municipal protocol for the prevention of contamination by the coronavirus results in an inadequate disposal of masks, gloves, handkerchiefs and napkins, even those used in a preventive way, and incorrect storage of waste from suspected cases or confirmed cases of COVID-19, which increases the risk of contamination for both the population and public servants in public cleaning.

O coronavírus (COVID-19) é uma doença de acometimento respiratório com alta capacidade de disseminação. Sua prevenção consiste em respeitar o distanciamento social, usar máscara e realizar a higienização adequada de mãos e superfícies, o que resultou em um aumento na quantidade de resíduos sólidos domiciliares gerados durante o período de isolamento social. O objetivo deste estudo é identificar o conhecimento de residentes de Curitiba sobre o manejo de resíduos contaminados ou potencialmente contaminados por SARS-CoV-2 por meio de uma pesquisa exploratória-descritiva com abordagem quantitativa com 420 participantes. Foi constatado que o desconhecimento da população acerca das medidas contidas no protocolo municipal para a prevenção da contaminação pelo coronavírus resulta em um descarte inadequado de máscaras, luvas, lenços e guardanapos, mesmo os usados de forma preventiva, e armazenamento incorreto dos resíduos de casos suspeitos ou confirmados de COVID-19, o que eleva o risco de contaminação tanto para a população como para os servidores públicos na limpeza pública.

Fungal beta-glucans as adjuvants for treating cancer patients - A systematic review of clinical trials.

BACKGROUND & AIMS: Fungal ß-glucans have been considered as biological response modifiers (BRMs) promoting stimulation of immune system according to numerous scientific publications performed in vitro and in vivo. Some clinical trials involving such compounds started to be published since 1980's. This systematic review aimed to compile and compare clinical studies using these ß-glucans as adjuvants on patients undergoing cancer treatment. Healthy subjects and ß-glucans from other sources were excluded. METHODS: It was developed according to PRISMA-P guidelines (PROSPERO registered n. CRD42020151539), using PICO criteria and the following databases: PubMed, Scielo and LILACS. RESULTS: We found 1018 articles and after removing duplicated records, select by title/abstract and full-text, only 9 studies remained and 7 more were manually added, totalizing 16 trials involving 1650 patients, with arm sizes varying from 9 until 200 patients. The selected studies (published since 1992-2018) included subjects with diagnosis of 9 types of cancer. The studies used different sources of ß-glucans, such as yeast (Saccharomyces cerevisiae), mushrooms (Lentinula edodes and Schizophyllum commune) and non-described fungal sources. CONCLUSIONS: It was observed that the administration of ß-glucan is safe and well-tolerated. Most of the trials pointed that concomitant administration of ß-glucan with chemo or radiotherapy reduced the immune depression caused by such treatments and/or accelerated the recovery of white blood cells counts. However, some articles also commented that no statistical difference was encountered between ß-glucan treated vs. control groups, which gives a controversial conclusion about the ß-glucan effects. The great diversity among the methodology studies and insufficient information was an impeditive for achieving profound statistical analysis, therefore a narrative report of the included studies was performed indicating that further evidences are required to determine the efficacy of this adjuvant in the cancer treatment.