Sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with node-positive breast cancer: guiding a more selective axillary approach.

PURPOSE: The role of sentinel lymph node biopsy (SLNB) in breast cancer patients who undergo neoadjuvant chemotherapy (NAC) remains controversial. This study aims to investigate if axillary lymph node dissection (ALND) could be safely omitted after a negative SLNB in cN1/2 patients who become cN0 after NAC. METHODS: We retrospectively assessed T1-4, cN1/2 patients who were submitted to NAC between 2010 and 2016. T1-T3 patients who achieved complete axillary clinical response underwent SLNB. Those whose SLNs were negative were not subjected to additional ALND. The oncological outcomes of the patients were analyzed. RESULTS: Fifty-nine T1-T3 patients (45.0%) achieved a complete axillary response (cN0), and were selected to undergo SLNB. SLNs were detected in 55 of them (93.2%). Seventeen of those patients (30.9%) had SLN metastases detected and subsequently underwent ALND. In contrast, 38 patients (69.1%) had no nodal metastases detected and were managed without complementary ALND. After a mean follow-up of 55.8 months, only one patient (2.6%) submitted to SLNB without a complementary ALND had axillary recurrence as compared with three patients (3.2%) in the ALND group (p = 0.71). Distant recurrence occurred more frequently among patients submitted to ALND (92.1%) than among those only submitted to SLNB (7.9%) (p < 0.0006). Overall survival and disease-free survival were significantly better in patients who were not submitted to ALND. CONCLUSION: SLNB could be successfully used in guiding a more selective axillary approach in cN+ patients that became cN0 after NAC. Omitting ALND in CN0 patients with negative SLNs did not seem to compromise disease control and oncological outcomes.

Alternative treatment with Johrei: A controlled randomized study evaluating seed physiological potential.

BACKGROUND: Johrei, a noncontact healing therapy that purportedly channels "universal energy", is an easily taught technique with numerous positive reports of healing in human trials. However, studies on humans have been limited by small sample sizes, the placebo effect and baseline differences between groups. Overcoming some of these limitations, this study evaluated the effect of Johrei on the physiological potential of lettuce seeds. METHODS: Lettuce seeds were subjected to thermal stress and then treated with Johrei before and after two years of storage. The seedling emergence percentage, emergence speed index, classification score, percentage of viable seedlings and root and shoot dry mass of the treated seeds were determined. RESULTS: Stress-treated seeds treated with Johrei had a greater seedling emergence percentage than those not treated with Johrei (p<0.0001). Johrei also resulted in a greater emergence speed index (p<0.0001), a higher percentage of viable seedlings with higher classification score (p<0.0001) and greater root and shoot dry mass regardless of the storage duration (p<0.0001). CONCLUSIONS: Johrei effectively preserved lettuce seed health, and the efficacy of Johrei can be assessed by evaluating its effects on the physiological potential of stress-treated seeds. Using live plants allows the influence of Johrei to be evaluated without interference from the placebo effect. Future studies should evaluate the influence of Johrei in primary aging processes in plants, such as cellular respiration by mitochondrial analysis, to gain insight into Johrei's mechanisms of action and enable inferences regarding similar cellular-level processes that occur in humans.

Estudo comparativo entre oxcarbazepina e carbamazepina contra crises convulsivas tônico-clônicas induzidas por eletrochoque em ratos / Effects of Oxcarbazepine and Carbamazepine as anticonvulsivants induced by electric shock in rats

O trabalho visa comparar a eficácia anticonvulsivante da oxcarbazepina e da carbamazepina e a relaçao dose-efeito das mesmas. Foram utilizados 64 ratos albinos Wistar divididos em sete grupos, que receberam doses de OCBZ e CBZ em diferentes concentraçöes, sendo submetidos 30 minutos depois a eletrochoque transcorneal de 100V po 0,2 segundos, sendo observado o período de latência e de início das crises convulsivas tônico-clônicas...