RESUMO
BACKGROUND: Cancer research has made great progress in the recent years. With the increasing number of options in diagnosis and therapy the implementation of tumorboards (TUBs) has become standard procedure in the treatment of cancer patients. Adherence tests on tumor board decisions are intended to enable quality assurance and enhancement for work in tumor boards in order to continuously optimize treatment options for cancer patients. METHODS: Subject of this study was the adherence of the recommendations made in three of 14 tumorboards, which take place weekly in the Center for Integrated Oncology (CIO) at the University Hospital Bonn. In total, therapy recommendations of 3815 patient cases were checked on their implementation. A classification into four groups has been made according to the degree of implementation. A second classification followed regarding the reasons for differences between the recommendation and the therapy which the patient actually received. RESULTS: The study showed that 80.1% of all recommendations in the three TUBs were implemented. 8.3% of all recommendations showed a deviance. Most important reasons for the deviances were patient wish (36.5%), patient death (26%) and doctoral decision, due to the patient's comorbidities or side effects of the treatment (24.1%).Interestingly, deviance in all three tumor boards in total significantly decreased over time. CONCLUSIONS: Aim of the study was to clarify the use of tumor boards and find approaches to make them more efficient. Based on the results efficiency might be optimized by increased consideration of patients` preferences, improved presentation of patient-related data, more detailed documentation and further structuring of the tumor board meetings.
Assuntos
Fidelidade a Diretrizes , Oncologia Integrativa , Pesquisa Interdisciplinar/organização & administração , Neoplasias/terapia , Alemanha , HumanosRESUMO
Available studies are far from giving a complete figure for the germination requirements of many Mediterranean Basin species. In this study, we investigated the germination properties of Lavandula stoechas L. (Lamiaceae) in response to different light and temperature regimes. We performed comprehensive experiments to test the effect of fixed and alternating temperatures, dark versus light conditions, and thermodormancy or thermoinhibition on several germination properties in three populations of L. stoechas from southwestern Turkey. Germination patterns showed a substantial variation among populations. Germination percentage was higher in the light conditions than in the dark at most temperatures, and alternating temperatures substituted light for the germination. The requirement of L. stoechas seeds to light for germination gradually increased through lower and higher temperatures than 15 °C. High temperature (30 °C) reduced the germination percentage to zero. However, in the presence of light, seeds were able to germinate after transferring to the optimum temperature (thermoinhibition), but this was not the case in darkness (thermodormancy). Seed germination in L. stoechas was stimulated by light, suggesting that germination has a phytochrome-mediated response. Our study makes an inference to the fire-environment interactions in the germination of Mediterranean seeder species by showing that both light and alternating temperatures stimulate germination in L. stoechas, a species well-known with its fire-related germination. Comprehensive germination studies are required for a better understanding of the early life-stage adaptations of plants to Mediterranean conditions, and for developing more robust strategies for conservation and ecosystem restoration.
Assuntos
Germinação , Lavandula , Luz , Temperatura , Ecossistema , Lavandula/fisiologia , Dormência de Plantas , SementesRESUMO
Agricultural burning is used in farm management operations; however, information about the impact of fire cues on the release and/or induction of secondary dormancy in crop seeds is scarce. Seeds from two oilseed rape cultivars were induced for high (HD) or low (LD) secondary dormancy using polyethyleneglycol (PEG) pre-treatment, and their germination after exposure to various fire cues was compared to control PEG pre-treated and non-dormant seeds. Non-dormant seed germination was unaffected by various fire cues. Low doses of aerosol smoke released secondary dormancy in HD seeds, while higher doses increased dormancy of LD seeds. Dilute smoke water also released HD seed secondary dormancy, but concentrated smke water enhanced dormancy in both LD and HD seeds. The concentrated aqueous extracts from charred oilseed rape straw only promoted germination of HD seeds, while dilution inhibited LD seed germination. Heat shock (80 °C, 5 min) released secondary dormancy in HD seeds; however, higher temperatures and/or increased exposure time was associated with seed death. GC-MS analyses of smoke water revealed two butenolides and an array of monoaromatic hydroxybenzene compounds with potential germination inhibitor or promoter activity. The extent of secondary dormancy induction in seeds affects their subsequent responses to fire cues. Both aerosol smoke and smoke water have both germination promoter and inhibitor activity. Lacking any butenolides, aqueous extracts of charred straw contain a potential germination stimulating steroid, i.e. ergosterol. The significance of fire-derived cues on behaviour of oilseed rape seeds in the soil seed bank is discussed.
Assuntos
Brassica napus , Incêndios , Germinação , Dormência de Plantas , Sementes , Brassica napus/fisiologia , Sinais (Psicologia) , Germinação/fisiologia , Sementes/fisiologiaRESUMO
BACKGROUND: Malassezia furfur is lipodependent yeast like fungus that causes superficial mycoses such as pityriasis versicolor and dandruff. Nevertheless, there are no standard reference methods to perform susceptibility test of Malassezia species yet. AIMS: Therefore, in this study, we evaluated the optimized culture medium for growth of this lipophilic yeast using modified leeming-Notman agar and colorimetric resazurin microtiter assay to assess antimycotic activity of fluconazole against M. furfur. RESULTS: The result showed that these assays were more adjustable for M. furfur with reliable and reproducible MIC end-point, by confirming antimycotic activity of fluconazole with MIC of 2µg/ml. CONCLUSION: We conclude that this method is considered as the rapid and effective susceptibility testing of M. furfur with fluconazole antifungal activity.
Assuntos
Antifúngicos/farmacologia , Fluconazol/farmacologia , Malassezia/efeitos dos fármacos , Oxazinas/química , Xantenos/química , Colorimetria/métodos , Meios de Cultura/química , Dermatomicoses/microbiologia , Humanos , Malassezia/crescimento & desenvolvimento , Malassezia/fisiologia , Testes de Sensibilidade Microbiana/métodos , Tinha Versicolor/microbiologiaRESUMO
Although the presence of antibodies against double-stranded (ds) DNA is highly specific of systemic lupus erythematosus (SLE), it is not detected in all SLE patients, perhaps due to a lack of sensitivity of the tests routinely used to assay anti-(ds) DNA. Looking for an alternative assay, this study explored the applicability of a DNA-mobility shift assay for the detection of anti-(ds) DNA; furthermore, the study compared the use of Salmonella typhimurium DNA with that of calf thymus DNA in the assay. After electrophoresis, samples containing S. typhimurium DNA and IgG from SLE sera showed marked alterations in DNA electrophoretic mobility when compared to DNA alone. In our sampling, SLE patients who tested negative for anti-(ds) DNA antibodies with routinely used assays such as Crithidia luciliae immunofluorescence test, radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA), tested positive for anti-(ds) DNA with the DNA mobility shift assay using S. typhimurium DNA. Incubation with IgG from control sera in the same proportions as above did not affect S. typhimurium DNA electrophoretic mobility. When S. typhimurium DNA was replaced by calf thymus DNA, the effect on the DNA mobility was less pronounced and less reliable. These results indicated that a DNA-mobility shift assay would be a useful alternative for the unequivocal detection of abnormal titers of anti-(ds) DNA antibodies. Furthermore, data indicated a greater ability of the IgG from SLE patients to form complexes with S. typhimurium DNA than with calf thymus DNA, suggesting an alternative testing DNA which may lead to a more sensitive anti-(ds) DNA detection.
Assuntos
Anticorpos Antinucleares/imunologia , DNA Bacteriano/imunologia , Imunoglobulina G/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Salmonella typhimurium/genética , Anticorpos Antinucleares/sangue , Humanos , Imunoglobulina G/sangue , Lúpus Eritematoso Sistêmico/sangueRESUMO
In the present study, 115 stray dogs (56 males and 59 females, mixed breed), 86 golden jackal (Canis aureus, 42 males and 44 females), 60 red foxes (Vulpes vulpes, 33 males and 27 females), and three female wolves (Canis lupus) were examined for Echinococcus granulosus infection, as well as, 32,898 sheep, 10,691 goats, 15,779 cattle and 659 buffaloes for hydatid infection from five provinces in western Iran during 3 years (1997-2000). Meanwhile fertility rates of different types and forms of cysts isolated from infected animals and the viability of protoscolices were also determined. Results indicated that 19.1% of the dogs, 2.3% of the golden jackals and 5% of the red foxes were infected with Echinococcus granulosus. 11.1% of the sheep, 6.3% of the goats, 16.4% of the cattle and 12.4% of the buffaloes were also found to be infected with hydatid cyst. The cysts isolated from liver and lungs of the sheep show higher fertility rate than the cysts of liver and lungs of goats, cattle and buffaloes.
Assuntos
Animais Domésticos/parasitologia , Animais Selvagens/parasitologia , Carnívoros/parasitologia , Equinococose/veterinária , Ruminantes/parasitologia , Animais , Búfalos , Bovinos , Cães , Equinococose/epidemiologia , Feminino , Cabras , Irã (Geográfico)/epidemiologia , Masculino , OvinosRESUMO
The importance of Hospital Infection Control Committees (HICC) increases every year due to the emergence of multiresistant bacterial strains, hospital outbreaks, and other factors that cause HI. This demonstrates the fragility of the quality of hospital and medical care. Having a well-organized HICC benefits hospitals by improving quality, lowering costs and, most important, reducing patient morbidity and mortality. This review records the history of the development of HICCs, their present organizational structure, and offers recommendations for hte best methods of infection surveillance.
Assuntos
Infecção Hospitalar/prevenção & controle , Hospitais , Controle de Infecções/organização & administração , Brasil , História do Século XIX , História do Século XX , Administração Hospitalar , Hospitais/normas , Hospitais/estatística & dados numéricos , Humanos , Controle de Infecções/história , Controle de Infecções/métodosRESUMO
The first report of occupational acquisition of HIV appeared in 1984, and, by June, 1997, the Centers for Disease Control and Prevention (CDC) had reported 52 documented cases of sero-conversion following occupational exposure to HIV-1 by health care workers of those cases. 47 (90.3%) were exposed to blood. The most frequent type of accident reported was percutaneous needlestick injury. Prospective studies have estimated that the risk of HIV transmission following percutaneous exposure to infected blood is 0.3% (Confidence Interval 95% = 0.2% to 0.5%). Following a mucous membrane exposure, the risk is 0.09% (CI 95% = 0.006% to 0.5%). The risk of hepatitis B acquisition ranges from 6% to 30%, and hepatitis C acquisition, 3% to 10%. Since 1992, the São Paulo Hospital s Hospital Infection Prevention and Control Service (SPCIH) has notified and treated all workers exposed to accidents involving biological materials. In the last six years, we have handled approximately 1,300 cases of reported accidents, of which 90% were percutaneous, most involving needlesticks. Such cases were frequently caused by the inadequate disposal and recapping of needles. In these accidents, 20% of the source patients were HIV positive, 10% were hepatitis C positive, and 7.6% were hepatitis B positive. This review summarizes the guidelines for a standardized response when dealing with accidents involving health care workers. Transmission of hepatitis B and HIV can be reduced if adequate preventive measures are taken in advance. If proper prophylaxis is not being done, it should be initiated immediately.
Assuntos
Acidentes de Trabalho/prevenção & controle , Acidentes de Trabalho/estatística & dados numéricos , Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Fármacos Anti-HIV/efeitos adversos , Líquidos Corporais/microbiologia , Brasil/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/prevenção & controle , Hepatite B/transmissão , Vírus da Hepatite B/isolamento & purificação , Hepatite C/prevenção & controle , Hepatite C/transmissão , Humanos , Exposição Ocupacional/prevenção & controle , Risco , Ferimentos Perfurantes/epidemiologiaRESUMO
We present the clinical and laboratory manifestations of encephalitis following measles in six patients which were diagnosed during the epidemics that occurred in the city of São Paulo, Brazil, in 1997. We performed retrospective case analysis of the six patients diagnosed as having encephalitis due to measles. Encephalitis was diagnosed based on clinical grounds and on the cerebrospinal fluid (CSF) alterations. All the cases were serologically confirmed. Of 467 patients with measles who presented themselves for medical care at the Instituto de Infectologia Emílio Ribas six were diagnosed with encephalitis. Patient's age was 2 months to 28 years old. The most frequent symptoms were drowsiness and nuchal rigidity. CSF showed an increased of white cell count in all cases. Four patients were admitted to the intensive care unit. Two of them required mechanical ventilation. In only two patients did the computerized tomography show abnormalities. All showed good recovery without sequelae.
Assuntos
Sarampo/complicações , Meningoencefalite/etiologia , Doença Aguda , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Meningoencefalite/líquido cefalorraquidiano , Estudos RetrospectivosRESUMO
To improve the quality of healthcare, we offer access to high quality guidelines to physicians as well as information harmonized with these guidelines to concerned patients via internet. We launched this service in 1994. Since then, we have been offering user-friendly access to the NCI's CancerNet via WWW (http://www.meb.uni-bonn.de/). Among other information, CancerNet by the National Cancer Institute contains up-to-date summaries on the prognosis, staging, and treatment of more than 80 major tumor types. To obtain information about how users navigate through this service, all users' activities are logged by using cookies for tracking them without injuring privacy. To get additional information about our users and their interests regarding our service, we performed user surveys in 1996 and 1997. The analysis of 538 valid answers in 1996 and 1001 in 1997 show that the attempt to bring high quality information and guidelines to physicians and patients was successful. About 95% of our users rated our service "excellent" or "good".
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Serviços de Informação/estatística & dados numéricos , Internet , Neoplasias , Feminino , Educação em Saúde , Humanos , Masculino , Oncologia/normas , Neoplasias/diagnóstico , Neoplasias/terapia , Guias de Prática Clínica como Assunto , Avaliação de Programas e Projetos de Saúde , Inquéritos e QuestionáriosRESUMO
The effect of a methanol extract of Rosa damascena Mill. flowers was studied, in comparison to the alpha-glucosidase inhibitor acarbose, in normal and diabetic rats. The inhibition mode of this extract was examined by measuring enzyme activity in different concentrations of substrate for Lineweaver-Burk plot analysis. The results show that Rosa damascena extract has an intensive inhibitory effect on alpha-glucosidase. Its inhibition was found to be noncompetitive. Oral administration of this plant extract (100 to 1000 mg/kg body wt.) significantly decreased blood glucose after maltose loading in normal and diabetic rats in a dose-dependent manner. These results suggest that Rosa damascena might exert an anti-diabetic effect by suppressing carbohydrate absorption from the intestine and can reduce the postprandial glucose level.
Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Experimental/tratamento farmacológico , Inibidores de Glicosídeo Hidrolases , Hipoglicemiantes/farmacologia , Fitoterapia , Rosa/química , Acarbose/farmacologia , Animais , Hipoglicemiantes/análise , Hipoglicemiantes/uso terapêutico , Cinética , Masculino , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Período Pós-Prandial/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
Acetylcholinesterase (AChE) is the main enzyme for the breakdown of acetylcholine. Nowadays, usage of the inhibitors of this enzyme is one of the most important types of treatment of mild to moderate neurodegenerative diseases such as Alzheimer's disease. Herbal medicines can be a new source of inhibitors of this enzyme. In this study we examined around 100 different plants to evaluate their inhibitory properties for AChE enzyme. Plants were scientifically identified and their extracts were prepared by methanol percolation. Acetylcholinesterase activity was measured using a colorimetric method in the presence or absence of the extracts. Eserine was used as a positive control. Methanol extracts of the Levisticum officinale, Bergeris integrima and Rheum ribes showed more than 50% AChE inhibitory activity. The inhibition kinetics were studied in the presence of the most effective extracts. L. officinale and B. integrima inhibited AChE activity in a non-competitive manner, while R. ribes competitively inhibitied the enzyme as revealed by double-reciprocal Linweaver-Burk plot analysis. Under controlled condition, K(m) and V(max) values of the enzyme were found to be 9.4 mM and 0.238 mM/min, respectively. However, in the presence of L. officinale, B. integrima, and R. ribes extracts, V(max) values were 0.192, 0.074 and 0.238 mM/min, respectively. Due to the competitive inhibition of the enzyme by R. ribes extract, the K(m) value of 21.2 mM was obtained. The concentration required for 50% enzyme inhibition (IC50 value) was 0.5, 0.9, and 0.95 mg/ml for the L. officinale, B. integrima and R. ribes extracts, respectively. The IC50 of the eserine was determined to be 0.8 mg/ml.
RESUMO
CancerNet from the National Cancer Institute contains nearly 500 ASCII-files, updated monthly, with up-to-date information about cancer and the "Golden Standard" in tumor therapy. Perl scripts are used to convert these files to HTML-documents. A complex algorithm, using regular expression matching and extensive exception handling, detects headlines, listings and other constructs of the original ASCII-text and converts them into their HTML-counterparts. A table of contents is also created during the process. The resulting files are indexed for full-text search via WAIS. Building the complete CancerNet WWW redistribution takes less than two hours with a minimum of manual work. For 26,000 requests of information from our service per month the average costs for the worldwide delivery of one document is about 19 cents.
Assuntos
Redes de Comunicação de Computadores , Hipermídia , Sistemas de Informação , Oncologia , Coleta de Dados , Humanos , Serviços de Informação/estatística & dados numéricos , Sistemas de Informação/estatística & dados numéricos , Neoplasias/diagnóstico , Neoplasias/terapiaRESUMO
PURPOSE: To evaluate the differentiation of benign from malignant breast tumors with T2*-weighted perfusion magnetic resonance (MR) imaging (blood volume imaging) versus that with dynamic T1-weighted contrast agent-enhanced MR imaging. MATERIALS AND METHODS: Ten healthy adult volunteers and 18 adult patients with benign or malignant lesions underwent both conventional T1-weighted dynamic contrast-enhanced breast MR imaging and repetitive first-pass, single-section, dynamic T2*-weighted perfusion MR imaging. Images were obtained before, during, and after injection of 20 mL of gadopentetate dimeglumine; peak gadopentetate dimeglumine concentrations were calculated from the maximal signal intensity loss on T2*-weighted images. RESULTS: No perfusion effect was detectable in healthy breast parenchyma. A strong susceptibility-mediated signal intensity loss occurred in malignant breast tumors. No or only minor perfusion effects were seen in fibroadenomas, in spite of their rapid enhancement at T1-weighted dynamic imaging. Perfusion imaging was possible after conventional dynamic contrast-enhanced breast MR imaging. CONCLUSION: T2*-weighted perfusion imaging exploits the susceptibility-mediated signal intensity loss of a first-pass bolus of gadopentetate dimeglumine within the capillary bed. First-pass perfusion imaging of breast lesions is feasible. It is promising in the differentiation of benign from malignant, rapidly enhancing lesions.