Extranodal NK/T-cell lymphoma, nasal type with extensive cardiopulmonary involvement

Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin's lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples.

Fresh leaves of ora-pro-nóbis in cakes prepared from commercial pre-mixture / Folhas frescas de ora-pro-nóbis em bolos preparados a partir de pré-mistura comercial

Establishing good eating habits in childhood is quite important for proper growth and development. Vegetables such as the ora-pro-nóbis (an unconventional vegetable, known in English speaking countries as Barbados Goosenberry, scientific name Pereskia aculeata Miller) have leaves that are rich in proteins, fibers and minerals, such as iron. These nutrients can contribute to improving child food products. In order to improve the nutritional value of commercial chocolate cake premixes, in natura ora-pro-nóbis leaves were added at ratios of 0 (standard), 10, 20, 30 and 40% leaf weight per batter weight, which were covered with chocolate icing. Moisture, ashes, lipids, proteins, crude fiber, carbohydrates and total caloric content (TCC) were analyzed in the elaborated formulations. The cakes with green leaves of ora-pro-nóbis are technologically viable up to 40% of leaf inclusion. The results showed a significant increase in water retention, crude fiber content and decrease in total caloric content (TCC) in cakes to which ora-pro-nóbis leaves were added. Lipid content was not affected by treatments.

O estabelecimento de uma boa alimentação na infância é de suma importância para o crescimento e desenvolvimento adequados. Vegetais como a ora-pro-nóbis (hortaliça não convencional) que possuem em suas folhas proteínas, fibras e minerais como o ferro, podem contribuir para melhorar a alimentação infantil. Com objetivo de melhorar o valor nutricional de pré-misturas comerciais de bolo, foram adicionadas folhas de ora-pro-nóbis in natura na proporção de 0 (padrão), 10, 20, 30 e 40% de folhas em relação a massa de sólidos pré-formulada para elaboração do bolo de sabor chocolate, com cobertura de chocolate tipo brigadeiro. Foram realizadas análises de umidade, cinzas, lipídeos, proteínas, fibra bruta e determinados os teores de carboidratos e valor calórico total (VCT) nas formulações elaboradas. Os bolos elaborados com folhas de ora-pro-nóbis in natura são viáveis do ponto de vista tecnológico, até 40% de inclusão de folhas. Os resultados revelaram um aumento significativo na retenção de água, no teor de fibra bruta e diminuição do valor calórico total (VCT) nos bolos adicionados de folhas de ora-pro-nóbis. Não houve influência dos tratamentos sobre o conteúdo de lipídeos.

Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience

OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of "MEC" (mitoxantrone, etoposide, and cytarabine) and "FLAG-IDA" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR]=4.6, p<0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.