Role of salvage lymph node dissection in patients previously treated for prostate cancer: systematic review

ABSTRACT Prostate cancer is the most common invasive cancer in men. Radical prostatectomy (RP) is a definitive treatment option, but biochemical recurrence can reach 40%. Salvage lymphadenectomy is a relatively recent approach to oligometasis and has been rapidly diffused primarily due to improvement in imaging diagnosis and results showing possibly promising therapy. A systematic literature review was performed in March 2020, according to the PRISMA statement. We excluded studies with patients with suspicion or confirmation of visceral and / or bone metastases. A total of 27 articles were included in the study. All studies evaluated were single arm, and there were no randomized studies in the literature. A total of 1,714 patients received salvage lymphadenectomy after previous treatment for localized prostate cancer. RP was the most used initial therapeutic approach, and relapses were based on PET / CT diagnosis, with Coline-11C being the most widely used radiopharmaceutical. Biochemical response rates ranged from 0% to 80%. The 5 years - Free Survival Biochemical recurrence was analyzed in 16 studies with rates of 0% up to 56.1%. The articles do not present high levels of evidence to draw strong conclusions. However, even if significant rates of biochemical recurrence are not evident in all studies, therapy directed to lymph node metastases may present good oncological results and postpone the onset of systemic therapy. The long-term impact in overall survival and quality of life, as well as the best strategies for case selection remains to be determined.

Synchronous abdominal tumors: is combined laparoscopic surgery in a single approach a safe option?

ABSTRACT Background and Purpose: Recent advances in cancer treatment have resulted in bet- ter prognosis with impact on patient's survival, allowing an increase in incidence of a second primary neoplasm. The development of minimally invasive surgery has provided similar outcomes in comparison to open surgery with potentially less mor- bidity. Consequently, this technique has been used as a safe option to simultaneously treat synchronous abdominal malignancies during a single operating room visit. The objective of this study is to describe the experience of two tertiary cancer hospitals in Brazil, in the minimally invasive treatment of synchronous abdominal neoplasms and to evaluate its feasibility and peri-operative results. Materials and Methods: We retrospectively reviewed the data from patients who were submitted to combined laparoscopic procedures performed in two tertiary hospitals in Brazil from May 2009 to February 2015. Results: A total of 12 patients (9 males and 3 females) with a mean age of 58.83 years (range: 33 to 76 years) underwent combined laparoscopic surgeries for the treatment of at least one urological disease. The total average duration of surgery was 339.8 minutes (range: 210 to 480 min). The average amount of intraoperative bleeding was 276.6mL (range: 70 to 550mL) and length of hospitalization was 5.08 days (range: 3 to 10 days). Two patients suffered minor complications regarding Clavien system during the immediate postoperative period. Conclusions: Combined laparoscopic surgery for the treatment of synchronous tumors is feasible, viable and safe. In our study, there was a low risk of postoperative morbidity.

O uso da acupuntutra auricular na reabilitação de portadores de síndrome vestibular periférica / The use of auricular acupunture on rehabilitation in patients with peripheral vestibular disease

Trata-se de um estudo de coorte contemporâneo longitudinal com o objetivo de avaliar a melhora da qualidade de vida de vinte pacientes de sexo masculino e feminino com idade entre 18 e 71 anos (média 53,85 anos), com diagnóstico de síndrome vestibular periférica irritativa e que foram submetidos ao Dizziness Handicap Inventory brasileiro e a dez sessões de acupuntura auricular. Os métodos estatísticos utilizados foram Shapiro-Wilk, Wilcoxon e t student. Após o tratamento foi observada melhora em todos os domínios do DHI brasileiro e pudemos concluir que acupuntura auricular promoveu melhora na qualidade de vida da população estudada

Ácido fólico na prevenção dos defeitos de fechamento de tubo neural / Folic acid in the prevention of neural tube closing defects

O autor revê as causas dos defeitos de fechamento e a embriologia do tubo neural, recapitulando aspectos do metabolismo do ácido fólico e seu papel na prevençäo daquelas malformaçöes

Fenilquetonuria: aspectos clínicos y terapéuticos / Phenylketonuria: clinical and therapeutical aspects

La fenilcetonuria es un error innato del metabolismo transmitido por un gen autosómico recesivo, que consiste en un defecto enzimático de hidroxilación de fenilalanina, con producción de metabolitos nocivos para el desarrollo del sistema nervioso central, y consecuente deficiencia mental. La importancia fundamental de la fenilcetonuria es que por medio de su diagnóstico y tratamiento precoz, se está haciendo prevención de deficiencia mental grave, factor de gran valor en los países en vías de desarrollo, donde la incidencia de deficiencia mental tiene tasas tan elevadas (3-5% pudiendo llegar a 7-10%). En América Latina, donde no existe cobertura completa de todos los recién nacidos para detección precoz de los niveles de fenilalanina sanguínea, se tiene alta frecuencia de casos diagnosticados tardíamente, ya con deficiencia mental. Teniéndose presente la importancia del diagnóstico precoz es imprescindible la realización del test de selección poblacional y que la atención del pediatra estuviera volcada para esta patología, que tiene una incidencia de 1: 12.000 - 1: 15.000 (Ciudad de San Pablo)