Edaphic macrofauna in degradation of animal and vegetable residues / Macrofauna edáfica no processo de vermicompostagem de resíduos animais e vegetais

Abstract The objective of this study was to evaluate the ability to degrade organic matter by edaphic macrofauna (worms), carbon/nitrogen (C/N) ratio and hydrogenation potential (pH) during the vermicomposting process in different organic residues. The treatments were constituted by organic residues of animal origin (bovine, ovine and equine manure) and vegetable (herb-checkmate and coffee drag), which were conditioned in plastic pots with a capacity of 10 liters, comprising five treatments in a completely randomized experimental design, with five replications. Were inoculated 150 earthworms of the species Eisenia foetida, into each plot. After 87 days, the evaluation of the multiplication of the earthworms was carried out, through its manual count and its cocoons. At the beginning and at the end of the experiment, the samples were submitted to analysis of humidity at 60 °C, pH, volumetric density, chemical analysis of macronutrients and C/N ratio. There was a dominance of worms and cocoons in the process of vermicomposting in the residues of ovine manure and herb-checkmate. The macronutrients (P, K and Mg) and C/N ratio were higher in the vegetal residues, while for N higher values were found in ovine manure and coffee drag treatments, and for Ca higher value among treatments was observed in the coffee drag treatment at the end and the lowest value at initiation. The results obtained in this study demonstrate the importance of the edaphic macrofauna to the vermicomposting process, since it allows more information about its influence on the continuity of soil organic matter decomposition processes.

Resumo Este estudo objetivou avaliar a capacidade de degradar a matéria orgânica pela macrofauna edáfica (minhocas), a relação carbono/nitrogênio (C/N) e o potencial hidrogeniônico (pH), durante o processo da vermicompostagem em diferentes resíduos orgânicos. Os tratamentos foram constituídos por resíduos orgânicos de origem animal (esterco bovino, ovino e equino) e vegetal (resíduo de erva-mate e borra-de-café), os quais foram acondicionados em vasos plásticos com capacidade de 10 litros, compondo cinco tratamentos em delineamento experimental inteiramente casualisado, com cinco repetições. Foram inoculadas 150 minhocas da espécie Eisenia foetida, em cada recipiente. Após 87 dias, foi realizada a avaliação da multiplicação das minhocas, através da sua contagem manual e seus casulos. Os resíduos foram submetidos, ao inicio e ao final do experimento, a análises de umidade a 60 °C, pH, densidade volumétrica, análise química de macronutrientes e relação C/N. Houve uma dominância de minhocas e casulos no processo da vermicompostagem nos resíduos de esterco ovino e erva-mate. Observou-se para os macronutrientes (P, K e Mg) e para a relação C/N uma maior quantidade nos resíduos vegetais, enquanto que para N valores maiores foram encontrados nos tratamentos esterco ovino e borra-de-café, e para Ca o maior valor entre os tratamentos foi observado no tratamento com borra de café ao final e o menor valor no inicio. Os resultados obtidos neste estudo demonstram a importância da macrofauna edáfica para o processo da vermicompostagem por possibilitar maiores informações sobre sua influência na continuidade dos processos de decomposição da matéria orgânica.

Characteristics of Ovarian Tumors in Lebanon 19 years of experience in a Tertiary Center

Background: Ovarian cancer is the 8th most common cancer among women in Lebanon. Despite new advances in the treatment of these tumors, their prognosis remains very poor. The histology of ovarian tumors and their stage at the time of diagnosis are the two most relevant prognostic factors. Epithelial tumors, including serous, mucinous, endometrioid, clear-cell, Brenner and seromucinous tumors, account for the vast majority of ovarian tumors. Germ cell tumors and tumors of the sexual cord are respectively the second and third subgroups of ovarian tumors. In Lebanon, there are no data concerning borderline and malignant ovarian tumors

Aim: We report the epidemiological and histological characteristics of borderline and malignant ovarian tumors in a Lebanese tertiary hospital

Material and Methods: This is a retrospective study evaluating the characteristics of borderline and malignant ovarian tumors diagnosed in 19 years [from 1999 to 2017] at the pathology laboratory of Hotel-Dieu de France, Saint Joseph University Hospital in Beirut, Lebanon. The data were extracted from the computerized registers of the laboratory. Statistical analysis was performed using SPSS 24.0

Results: Atotal of 996 ovarian lesions were found. Of these, 529 [53.1percent] were epithelial [342 [64.7percent] serous, 107 [20.2percent] mucinous, 23 [4.3percent] endometrioid, 18 [3.4percent] undifferentiated carcinoma, 15 [2.8percent] seromucinous, 12 [2.3percent] clear cell and 12 [2.5percent] Brenner]; 285 [28.6percent] were germinal [including 245 [86.0percent] mature teratomas, 12 [4.9percent] dysgerminomas and 7 [2.5percent] immature teratomas]; 83 [8.3percent] were stromal tumors of the sexual cord. Of the 529 epithelial tumors, 261 [49.3percent] were benign [60percent were serous cystadenomas], 46 [8.7percent] were borderline [26 serous, 18 mucinous and 2 serous] and 222 [42.0percent] were malignant [of which 139 [62.6percent] were high grade serous carcinomas, 19 [8.6percent] endometrioid, 18 undifferentiated, 12 low-grade serous and 12 clear cell]. Mean age for malignant epithelial tumors and borderline epithelial tumors were 54.3 years and 39.7 years respectively

Conclusion: Our data are compatible with those published in Western countries. Many studies will be launched on the basis of this database, including the evaluation of somatic and germinal ovarian panel mutations in high-grade ovarian serous carcinoma and in those with borderline tumor sequencing

Lung Cancer and Immunotherapy experience from second line and beyond

Introduction: Lung cancer represents the leading cause of cancer death worldwide. At diagnosis, the majority of patients present an advanced or metastatic disease. Despite the improvement in diagnostic and therapeutic strategies, lung cancer prognosis remains poor with less than 15 percent of patients surviving beyond 5 years. Advanced non-small-cell lung cancer [NSCLC] has been always treated by platinum-based regimens with various toxicity profiles However, with the discovery of the PD-1/PD-L1 pathway, novel checkpoint inhibitors emerged as promising agents for treating patients with advanced disease. When evaluated in clinical trials, they showed promising results and durable responses in a subset of patients treated in the first and second lines or beyond. The aim of this study is to assess the efficacy and responses of these agents in real-life practice when used in second line or after

Material and Methods: Patients with advanced [stage III and IV] NSCLC treated with immunotherapy between June 2015 and August 2018 were included. Patients should have received anti-PD-1 or anti-PD-L1 agent in the second, third of fourth line after failure of a prior first line regimen. Each patient should have received a minimum of 3 cycles of treatment and evaluation thereafter

Results: A total of 85 patients were included. The median age of our population was 65 years, and the majority were men [sex ratio = 2.3:1]. Around 95 percent of patients were smokers. Adenocarcinoma was the most frequent histologic subtype in 59.1 percent of cases, followed by squamous cell carcinoma in 35.5 percent of cases. At presentation, 81.7 percent of patients had metastatic deposits mainly in the bone and adrenals in 34.4 percent and 28 percent respectively. PD-L1 expression ranged from 0 to 100 percent with a median value of 45 percent. PD-L1 expression was >/= 50 percent, between1 and 50 percent, and less than 1 percent in 43 percent, 40 percent and 17 percent of patients respectively. Around half of patients [54 percent] underwent radiotherapy, with a curative intent in 42.5 percent and palliative intent in 57.5 percent. Checkpoint inhibitors were used in second line in 74.7 percent, third line in 21.8 percent and fourth line in 3.5 percent, and were balanced between Pembrolizumab and Nivolumab. The majority of patients progressed despite immunotherapy treatment in 41 percent of cases, presented a stability of the disease, partial response and complete response in 29.7 percent, 25.6 percent and 2.7 percent. The median progression-free survival [PFS] was 4.1 months [1-20.7]. Immune-related adverse events were present in around 7 percent of patients, and were mainly grade 2-3 managed with steroids and supportive care, with hormone replacement therapy in the case of thyroiditis

Conclusion: Checkpoint inhibitors represent a new hope for patients with advanced lung cancer who have few available effective treatments beyond first or second line

The Merit of Tyrosine Kinase inhibitors in the adjuvant setting of high-risk renal cell carcinoma Ameta-Analysis

Background: Loco-regional renal cell carcinoma [RCC] accounts for 15 to 20 percent of patients with RCC, with a risk of post-surgical relapse of 40 percent [1,2]. Following the adoption of tyrosine kinase inhibitors [TKIs] as the first-line treatment of metastatic RCC, multiple studies evaluated Sunitinib [3,4] and Pazopanib [5] in the adjuvant setting of high-risk resected RCC. However, these studies have yielded inconclusive results, and there are currently no meta-analyses combining the results of all trials evaluating TKIs in the adjuvant setting of high-risk RCC. The aim was to perform a meta-analysis to evaluate and compare the possible benefit of Sunitinib and Pazopanib on diseasefree survival [DFS] in the adjuvant setting of high-risk RCC

Methods: This meta-analysis included all the phase 3 randomized controlled trials [ASSURE 3, S-TRAC 4 and PROTECT 5] evaluating Sunitinib and Pazopanib in the adjuvant setting of high-risk RCC. A random-effects model was preferentially used to pool the data using the inverse variance method and a subgroup analysis including Sunitinib and Pazopanib subgroups was used in order to account for heterogeneity and allow comparison of the two subgroups. Two variations of the same analysis were undertaken as sensitivity analyses : first with a fixed-effects model, second while excluding the results of the ASSURE study. The primary outcome was the comparison of disease-free survival [DFS] between TKIs and placebo. Hazard ratios were reported along with their 95 percent confidence intervals [95 percentCI]

Results: A total of 3447 patients from the three trials were included in the analysis. There was a tendency for a significant overall effect of both TKIs on DFS; however, this tendency only reached the threshold for statistical significance in the fixed-effects model [HR = 0.91; 95 percentCI = 0.83-0.99; p = 0.03] but not in the random-effects model [HR = 0.85; 95 percentCI = 0.72-1.01; p = 0.06, Figure 1]. Significant between-study overall heterogeneity was observed [p = 0.07; I2 = 58 percent] and the subgroup analysis showed that this was largely due to the heterogeneity within the Sunitinib subgroup [p = 0.05; I2 = 73 percent, Figure 1]. Moreover, a sensitivity analysis excluding the ASSURE study led to results which were markedly more homogeneous [p = 0.48; I2 = 0 percent]. While the test for overall effect was found to be significant in the Pazopanib subgroup [HR = 0.80; 95 percentCI = 0.65-0.98; p = 0.03] but not in the Sunitinib subgroup [HR = 0.90; 95 percentCI = 0.67-1.19; p = 0.45], there was no significant difference between the subgroup effects [p = 0.51; I2 =0 percent; Figure 1]

Conclusion: Our analysis showed that Pazopanib and Sunitinib could still have a potential role in the armamentarium of adjuvant treatment in high-risk RCC. However, it failed to demonstrate a significant difference between these agents in this setting