Serum tissue factor as a biomarker for renal clear cell carcinoma

ABSTRACT Purpose to determine the usefulness of serum TF as a potential marker for patients with clear cell RCC. Materials and Methods prospective study of 30 patients with clear cell RCC submitted to nephrectomy and 16 controls without clear cell RCC treated surgically for other conditions. TF is a endothelium marker that was correlated with worse prognosis in a variety of solid tumors including RCC. Serum TF was collected before surgery at the operating room and in the postoperative setting after at least four weeks. Serum samples were analyzed with a commercial ELISA kit for human TF (R&D Systems®). Results Mean preoperative serum TF levels in clear cell RCC patients and in controls were 66.8 pg/dL and 28.4 pg/dL, respectively (p<0.001). Mean postoperative serum TF levels in clear cell RCC patients were 26.3 pg/dL. In all patients with clear cell RCC postoperative serum levels of TF were lower, with a mean reduction of 41.6 pg/dL in the postoperative setting (p<0.001). Linear regression revealed that tumor size was correlated with the postoperative reduction of serum TF levels (p=0.037). Conclusions We have shown a 3-fold reduction in the median preoperative serum levels of TF in patients with clear cell RCC after surgery. We have also shown a difference of the same magnitude in the serum levels of TF compared with those of a control group of patients with benign diseases. TF appears to be a useful serum marker for the presence of clear cell RCC. Further studies are needed to validate these findings.

Serum tissue factor as a biomarker for renal clear cell carcinoma.

PURPOSE: to determine the usefulness of serum TF as a potential marker for patients with clear cell RCC. MATERIALS AND METHODS: prospective study of 30 patients with clear cell RCC submitted to nephrectomy and 16 controls without clear cell RCC treated surgically for other conditions. TF is a endothelium marker that was correlated with worse prognosis in a variety of solid tumors including RCC. Serum TF was collected before surgery at the operating room and in the postoperative setting after at least four weeks. Serum samples were analyzed with a commercial ELISA kit for human TF (R&D Systems®). RESULTS: Mean preoperative serum TF levels in clear cell RCC patients and in controls were 66.8 pg/dL and 28.4 pg/dL, respectively (p<0.001). Mean postoperative serum TF levels in clear cell RCC patients were 26.3 pg/dL. In all patients with clear cell RCC postoperative serum levels of TF were lower, with a mean reduction of 41.6 pg/dL in the postoperative setting (p<0.001). Linear regression revealed that tumor size was correlated with the postoperative reduction of serum TF levels (p=0.037). CONCLUSIONS: We have shown a 3-fold reduction in the median preoperative serum levels of TF in patients with clear cell RCC after surgery. We have also shown a difference of the same magnitude in the serum levels of TF compared with those of a control group of patients with benign diseases. TF appears to be a useful serum marker for the presence of clear cell RCC. Further studies are needed to validate these findings.

Torção testicular: suspeita clínica e abordagem / Testicular torsion: clinical suspicion and approach

A torção testicular é uma emergência urológica frequente e seu reconhecimento e conduta precoces são necessários visto que a janela terapêutica é estreita e são graves os prejuízos quando retardada a correção, que geralmente é cirúrgica.

Testicular torsion is a frequent urological emergency and its early recognition and management are imperative, since the therapeutic window is narrow and there are serious losses when the correction is delayed, which is usually surgical.

Tratamento cirúrgico das hérnias inguinais: análise crítica de sua indicação / Surgical treatment of inguinal hernias: critical analysis of the indication

A correção da hérnia inguinal é uma das cirurgias mais realizadas universalmente, estimando-se em cerca de vinte milhões de cirurgias/ano, em todo o mundo. O presente trabalho pretende analisar diferentes aspectos da indicação cirúrgica, em adultos, já que atualmente questiona-se a real necessidade da correção de todas as hérnias inguinais.

Inguinal hernia repair is one of the most common surgerys, estimed at about twenty million surgeries / year worldwide. This paper aims to analyze different aspects of surgical indication in adults, since currently it questions the real need of correction of all inguinal hernias.

Descrição de um modelo prático para o aprendizado do acesso venoso periférico por estudantes de medicina e enfermagem / Description of a practical model for learning of peripheral venous access by students of medicine and nursing

Objetivos: Descrever um modelo didático de acesso venoso periférico, simples e de baixo custo, desenvolvido pela Liga do Trauma da Pontifícia Universidade Católica do Rio Grande do Sul, que visa à aquisição de habilidades pelo estudante/profissional da saúde.Métodos: Para reproduzir a via periférica de acesso utilizamos um garrote de borracha, simulando uma veia, com uma extremidade em fundo cego, inserida em uma luva de látex preenchida com estopa de algodão. A outra extremidade foi conectada a uma bolsa de solução parenteral contendo 500 ml de soro fisiológico acrescido de corante, para simular sangue, através de equipos de infusão. A bolsa foi instalada em um suporte mais alto que a luva, facilitando a ação da gravidade. Com o regulador de fluxo completamente aberto, cria-se uma pressão através da presença do ar com o líquido dentro dos equipos de infusão e do garrote. A primeira punção com o cateter serve para retirar o ar de dentro das cânulas, o que permite a realização do procedimento.Resultados: A punção, realizada de forma adequada, ocasiona o refluxo do sangue artificial por dentro do cateter, ao contrário do que acontece quando há transfixação do garrote de borracha. Isso simula uma situação real de punção venosa, pois a pressão hidrostática no garrote é análoga à encontrada em uma veia.Conclusões: A descrição do modelo permite sua reprodutibilidade de maneira fácil, já que o mesmo utiliza materiais baratos e de fácil acesso. O modelo propicia a familiarização inicial com o procedimento, facilitando a prática no paciente ou em modelos mais sofisticados, ainda indispensáveis para o aprimoramento da técnica...

Aims: To describe a simple and low cost model of peripheral venous access, developed by the Trauma League of Pontifícia Universidade Católica do Rio Grande do Sul, which aims acquiring new skills by the health student/professional.Methods: In order to simulate the peripheral access via, we used a rubber tourniquet, which ended in a blind end, simulating a vein, inserted on a latex glove full of fill material. The other extremity was connected to a bag of parenteral solution containing 500 ml of physiologic serum with dye, to simulate blood, through infusion equipos. The bag was hanged higher than the glove, making the gravity laws work. With the flow meter completely open, a pressure is created by the presence of air with liquid inside the infusion equipos and the tourniquet. The first puncture with the catheter takes out the air inside the cannulas, which allows the procedure to be done properly.Results: The puncture, when done properly, causes the artificial blood to reflow into the puncture catheter, which does not happen when the rubber tourniquet is transfixed. This simulates a real life situation of venous puncture, because the hydrostatic pressure inside the tourniquet is analogous to that found in a vein.Conclusions: The description of the didactic model allows its reproducibility in an easy way, since the required materials are cheap and easily available. The model provides the initial familiarity with the procedure, making it easier to practice in the patient or in more sophisticated models, indispensable for the improvement of the technique...