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1.
Restor Dent Endod ; 47(4): e40, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36518607

ABSTRACT

Objectives: This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Materials and Methods: Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Results: Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. Conclusions: This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

2.
Int J Mol Sci ; 23(24)2022 Dec 12.
Article in English | MEDLINE | ID: mdl-36555384

ABSTRACT

Nodularin (NOD) is a potent toxin produced by Nodularia spumigena cyanobacteria. Usually, NOD co-exists with other microcystins in environmental waters, a class of cyanotoxins secreted by certain cyanobacteria species, which makes identification difficult in the case of mixed toxins. Herein we report a complete theoretical DFT-vibrational Raman characterization of NOD along with the experimental drop-coating deposition Raman (DCDR) technique. In addition, we used the vibrational characterization to probe SERS analysis of NOD using colloidal silver nanoparticles (AgNPs), commercial nanopatterned substrates with periodic inverted pyramids (KlariteTM substrate), hydrophobic Tienta® SpecTrimTM slides, and in-house fabricated periodic nanotrenches by nanoimprint lithography (NIL). The 532 nm excitation source provided more well-defined bands even at LOD levels, as well as the best performance in terms of SERS intensity. This was reflected by the results obtained with the KlariteTM substrate and the silver-based colloidal system, which were the most promising detection approaches, providing the lowest limits of detection. A detection limit of 8.4 × 10-8 M was achieved for NOD in solution by using AgNPs. Theoretical computation of the complex vibrational modes of NOD was used for the first time to unambiguously assign all the specific vibrational Raman bands.


Subject(s)
Cyanobacteria , Metal Nanoparticles , Silver , Cyanobacteria/chemistry , Nodularia , Spectrum Analysis, Raman/methods
3.
Pract Radiat Oncol ; 12(4): e286-e295, 2022.
Article in English | MEDLINE | ID: mdl-35462055

ABSTRACT

PURPOSE: This study evaluated the toxicity associated with a short course dose-escalated hypofractionated radiation therapy (HFRT) using image guided RT with or without androgen suppression therapy in patients with prostate cancer. METHODS AND MATERIALS: This single-center prospective observational study included 132 patients with prostate cancer from 2016 to 2020. Patients received HFRT using image guided RT (84%) with 3-dimensional (91%) or intensity modulated RT (9%). Total prescribed doses were 66 Gy (63%), 63 Gy (12%), and 60 Gy (24%) in 22, 21, or 20 daily fractions depending on organ-at-risk dose constraints. Acute toxicity was scored using Radiation Therapy Oncology Group criteria and the international prostate symptom index. The expanded prostate cancer index composite questionnaire was used to collect quality of life data (ranging from 0-100). RESULTS: The study population consisted of 111 patients who completed RT during a period of 3 years. The risk groups were as follows: low risk (12%), intermediate (32%), and high (56%). None of the patients had suspicious lymph nodes. Ninety percent received androgen suppression therapy. Maximum acute genitourinary and gastrointestinal toxicity peaked at grade 3 in 4 of 111 evaluated patients (4%) and at grade 2 in 7 of 111 evaluated patients (8%), respectively. The average international prostate symptom score increased from 4.8 at pretreatment to 14.0 during week 4 and normalized (5.7) 3 months after treatment completion. CONCLUSIONS: The current HFRT dose-escalation trial has demonstrated the feasibility of administering 66 Gy in 22 fractions with low acute gastrointestinal and genitourinary toxicities. Further follow-up will report late toxicities and outcomes.


Subject(s)
Prostatic Neoplasms , Radiotherapy, Intensity-Modulated , Androgens/therapeutic use , Brazil , Delivery of Health Care , Dose Fractionation, Radiation , Humans , Male , Prostatic Neoplasms/pathology , Quality of Life , Radiation Dose Hypofractionation , Radiotherapy, Intensity-Modulated/adverse effects , Radiotherapy, Intensity-Modulated/methods
4.
Spectrochim Acta A Mol Biomol Spectrosc ; 276: 121232, 2022 Aug 05.
Article in English | MEDLINE | ID: mdl-35429861

ABSTRACT

We report the development of highly sensitive substrates with great potential as Surface-enhanced Raman scattering (SERS) spectroscopy detection platforms, consisting of nanoimprint lithography (NIL) fabricated nanotrenches in plastic and covered by nanostructured silver (Ag) films with thicknesses in the 10-100 nm range deposited by direct current (DC) sputtering. The Ag film thickness was increased by using sequential deposition times and its contribution to the obtained enhancement factor was determined. The morphological and structural properties of the metalized nanotrenches were assessed by scanning electron microscopy (SEM) and atomic force microscopy (AFM) techniques. Crystal violet (CV) was used as analyte to test the SERS activity of the substrates prepared with or without the nanoimprinted pattern. Our original approach was to determine the resulted SERS enhancement from the synergy of three key aspects: the Ag metallization of cheap, flexible substrates, the effect of increasing the Ag film thickness and the periodic nanotrenches imprinted by NIL as substrate. We found a dramatical contribution in the SERS signal of the periodical Ag nanopattern in comparison to the Ag film quantified by a calculated enhancement factor (EF) up to 107 in case of the SERS detection platform with a 25 nm Ag layer on top of the periodic nanotrenches. The contribution of plasmonic nanostructures contained in the Ag films as well as the contribution of the periodical nanopatterned trenches was assessed, as a cumulative effect to the first contribution. This substrate showed a considerably lower limit of detection (LOD) for SERS, down to 10 pM, much better uniformity as well as more reproducible signals in comparison with the other thicknesses of the metallic film.


Subject(s)
Nanostructures , Silver , Limit of Detection , Nanostructures/chemistry , Silver/chemistry , Spectrum Analysis, Raman/methods , Surface Properties
5.
Spectrochim Acta A Mol Biomol Spectrosc ; 247: 119149, 2021 Feb 15.
Article in English | MEDLINE | ID: mdl-33188974

ABSTRACT

Advanced chemometric methods, such as fuzzy c-means, a semi-supervised clustering method, and fuzzy linear discriminant analysis (FLDA), a new robust supervised classification method in combination with principal component analysis (PCA), namely PCA-FLDA, have been successfully applied for characterization and classification of bacterial species detected at single-cell level by surface-enhanced Raman scattering (SERS) spectroscopy. SERS spectra of three species (S. aureus, E. faecalis and P. aeruginosa) were recorded in an original fashion, using in situ laser induced silver spot as metallic substrate. The detection process of bacteria was isolated inside a hermetically sealed in-house built microfluidic device, connected to a syringe pump for injecting the analytes and a portable Raman spectrometer as detection tool. The obtained results (fuzzy partitions) and spectra of the prototypes (robust fuzzy spectra mean corresponding to each fuzzy partition) clearly demonstrated the efficiency and information power of the advanced fuzzy methods in bacteria characterization and classification based on SERS spectra, and allowed a rationale assigning to a specific group. Also, this powerful detection and classification methodology generates the premises for future investigations of Raman and other spectroscopic data obtained for various samples.


Subject(s)
Spectrum Analysis, Raman , Staphylococcus aureus , Bacteria , Discriminant Analysis , Principal Component Analysis
6.
Pediatr Blood Cancer ; 68 Suppl 2: e28299, 2021 05.
Article in English | MEDLINE | ID: mdl-32743983

ABSTRACT

This report provides a summary of the global burden of childhood cancer morbidity and mortality, which disproportionately affects low- and middle-income countries as well as low- and middle-income communities within high-income countries. We review past successes and current challenges to improving clinical pediatric radiotherapy, education, and research in these regions. The Pediatric Radiation Oncology Society Taskforce in Low- and Middle-Income Countries recently outlined specific aims: (a) to increase access and quality of radiotherapy for children and adolescents afflicted with cancer; (b) to enumerate, engage, and educate a global community of providers of childhood and adolescent radiotherapy; and (c) to create evidence establishing the outcomes of setting-specific treatment standards of care when first-world standards are not achievable. This report will improve awareness of these disparities and promote attempts to correct them.


Subject(s)
Developing Countries/economics , Health Services Needs and Demand , Neoplasms/radiotherapy , Radiotherapy/methods , Child , Global Health , Humans , Neoplasms/economics , Neoplasms/pathology , Prognosis , Survival Rate
7.
Materials (Basel) ; 13(16)2020 Aug 17.
Article in English | MEDLINE | ID: mdl-32824443

ABSTRACT

The dissolution of the main metals (Cu, Zn, Sn, Pb and Fe) found in waste printed circuit boards (WPCBs) was investigated by electrochemical corrosion measurements (potentiodynamic polarization and electrochemical impedance spectroscopy (EIS)) in different bromide-based systems that could be used as lixiviants in hydrometallurgical route of metals recovery. The analysis of the corrosion products was carried out by X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) measurements. All measurements showed that the addition of bromine in the electrolyte favors to great extents the dissolution process of all studied metals as compared to bromine-free electrolytes. In the investigated experimental conditions, the highest dissolution rates of the metals were obtained in acidic KBr solution containing 0.01 mol/L bromine and they decreased in the following order: Zn >> Sn > Pb > Fe > Cu. The XRD and XPS chemical assessment allowed the identification of the dissolution products formed on the metallic surfaces after exposure to the electrolytes. They consisted mainly of oxides in the case of Cu, Zn, Sn and Fe, while the presence of PbBr2 was also noticed on the lead surface. Based on the results of EIS and surface investigations, several models explaining the corrosion behavior of the metals were proposed and discussed. The obtained results demonstrate that all studied metals could be successfully leached using brominated solutions, providing a viable alternative for the selective and efficient recovery of the base metals from WPCBs through a multi-step hydrometallurgical processing route.

8.
J Clin Med ; 9(1)2020 Jan 13.
Article in English | MEDLINE | ID: mdl-31941009

ABSTRACT

Early diagnosis based on screening is recognized as one of the most efficient ways of mitigating cancer-associated morbidity and mortality. Therefore, reliable but cost-effective methodologies are needed. By using a portable Raman spectrometer, a small and easily transportable instrument, the needs of modern diagnosis in terms of rapidity, ease of use and flexibility are met. In this study, we analyzed the diagnostic accuracy yielded by the surface-enhanced Raman scattering (SERS)-based profiling of serum, performed with a portable Raman device operating in a real-life hospital environment, in the case of 53 patients with gastrointestinal tumors and 25 control subjects. The SERS spectra of serum displayed intense bands attributed to carotenoids and purine metabolites such as uric acid, xanthine and hypoxanthine, with different intensities between the cancer and control groups. Based on principal component analysis-quadratic discriminant analysis (PCA-QDA), the cancer and control groups were classified with an accuracy of 76.92%. By combining SERS spectra with general inflammatory markers such as C-reactive protein levels, neutrophil counts, platelet counts and hemoglobin levels, the discrimination accuracy was increased to 83.33%. This study highlights the potential of SERS-based liquid biopsy for the point-of-care diagnosis of gastrointestinal tumors using a portable Raman device operating in a clinical setting.

9.
Nanomaterials (Basel) ; 9(11)2019 Oct 25.
Article in English | MEDLINE | ID: mdl-31731460

ABSTRACT

Plasmonic noble metal nanostructured films have a huge potential for the development of efficient, tunable, miniaturized optical sensors. Herein, we report on the fabrication and characterization of gold-coated nanopost arrays, their use as refractometric sensors, and their optimization through photonics simulations. Monolithic square nanopost arrays having different period and nanopost size are fabricated by nanoimprint lithography on polymer foils, and sputter-coated by gold films. The reflectivity of these gold nanopost-shell arrays present dips in the visible range, which are efficient for refractometric sensing. By finite-difference time-domain (FDTD) simulations we reproduce the experimental spectra, describe the electric fields distribution around the nanopost-shells, and then explain their good sensitivity, around 450 nm/RIU. Furthermore, we determine by simulations the influence of several geometrical parameters, such as array period, nanopost width, gold film thickness, and nanopost side coverage on both reflectivity spectra and sensing capabilities. Fully coated nanoposts provide an extremely deep reflectivity minimum, approaching zero, which makes the relative reflectivity change extremely high, more than two orders of magnitude higher than for partially coated nanoposts. These results contribute to the understanding of the plasmonic properties of metal coated nanopost arrays, and to the development of efficient platforms for sensing and other surface plasmon based applications.

10.
Eur Endod J ; 4(1): 15-20, 2019.
Article in English | MEDLINE | ID: mdl-32161881

ABSTRACT

OBJECTIVE: To compare the antimicrobial activity and tissue dissolution capacity of calcium hypochlorite (Ca(OCl)2) solution with sodium hypochlorite (NaOCl) solution at 0.5%, 1.0%, 2.5%, and 5.25% concentrations. METHODS: To determine the inhibition halos produced by the tested substances against Enterococcus faecalis, the agar diffusion method was employed. Additionally, the broth contact method was used to determine the time required for the inhibition of E. faecalis. Bovine pulp fragments were used to test the dissolution. Half of the pulps were freely deposited samples in cell culture wells, and the remaining samples were fixed on bovine dentine bases. RESULTS: For both Ca(OCl)2 and NaOCl solutions, the greatest inhibition zones were observed at 5.25% con-centration. However, the most significant inhibition zone was measured with 5.25% Ca(OCl)2 solution (17.38 mm). Hypochlorite solutions at 2.5% and 5.25% concentrations required less time to inhibit E. faecalis than those at 0.5% and 1.0% concentrations (P<0.05). There was no difference in inhibition times between 2.5% and 5.25% hypochlorite solutions (P>0.05). The most effective hypochlorite solution concentrations were 5.25% and 2.5% for dissolving pulp fragments (P<0.05). Additionally, suspended pulp fragments were more susceptible to dissolution than fragments attached to dentine blocks (P<0.05), except for 0.5% Ca(OCl)2. CONCLUSION: Ca(OCl)2 solutions showed antimicrobial activity against E. faecalis and can dissolve pulp tissues. Future studies are warranted to examine the suitability of Ca(OCl)2 in the chemico-mechanical preparation of the root canal system.

11.
Rev. CEFAC ; 20(5): 621-631, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-976874

ABSTRACT

ABSTRACT Purpose: the knowledge concerning care of the voice on the part of professional and amateur singers in Chile is relevant for voice professionals and also for speech pathologists who work in disorder prevention and voice care. It is important to know if there are differences between both groups regarding the knowledge of voice care. Methods: the "Vocal Awareness Questionnaire for Singers'' was applied to a sample of 66 singers: 33 professional and 33 amateur singers. Three areas of knowledge were evaluated: anatomy and physiology of the larynx, vocal hygiene and voice pathologies. Results: there were no significant differences in the knowledge of voice care between professional and amateur singers both at a general level and in specific areas of knowledge. The topic of vocal hygiene obtained the highest percentage of correct answers in both groups, while the lowest percentage was in the area of voice pathologies. Conclusions: there were no differences in the level of knowledge on voice care between the professional and amateur singers included in this study. In both groups, the level of knowledge was from low to moderate. This could increase the incidence of vocal pathologies in both groups.


RESUMEN Propósito: el conocimiento sobre los cuidados de la voz de los cantantes profesionales y amateur en Chile es relevante para los profesionales de la voz y también para los fonoaudiólogos que se desempeñan en la prevención y el cuidado de la voz. Es importante conocer si existen diferencias en ambos grupos en cuanto al conocimiento del cuidado de la voz. Métodos: se aplicó el "Vocal Awareness Questionnaire for Singers'' a una muestra de, 66 cantantes: 33 cantantes profesionales y 33 cantantes amateur. Se evaluaron tres áreas de conocimiento: anatomía y fisiología de la laringe, higiene vocal y patologías de la voz cantada. Resultados: no hubo diferencias significativas en el conocimiento del cuidado de la voz entre cantantes profesionales y amateur tanto a nivel general como en las áreas de conocimiento. El área de higiene vocal obtuvo el mayor porcentaje de respuestas correctas en ambos grupos y el menor porcentaje el área de patología de la voz cantada. Conclusiones: no se observaron diferencias en el nivel de conocimientos sobre cuidados de la voz entre los cantantes profesionales y amateur, en ambos grupos el nivel de conocimiento es bajo a moderado. Esto podría incrementar la incidencia de patologías vocales en ambos grupos.

12.
Brachytherapy ; 17(6): 935-943, 2018.
Article in English | MEDLINE | ID: mdl-30100273

ABSTRACT

PURPOSE: To identify if baseline patient or magnetic resonance imaging (MRI) features can predict which women are at risk for inadequate tumor coverage with only intracavitary tandem and ovoid (T + O) brachytherapy and to correlate tumor coverage with clinical outcomes. METHODS AND MATERIALS: We performed a retrospective study of 50 women with cervical cancer treated with chemoradiation at a single institution between January 2014 and December 2015. All patients had a 3T-MRI performed at baseline (MRI1) and at the completion of external beam radiation therapy (MRI2). Gross tumor volume initial (GTV-Tinit) was measured on MRI1 and high-risk clinical tissue volume (CTVHR) on MRI2. CTVHR extending beyond point A was classified as too large for adequate coverage with T + O and requiring interstitial needles. Multivariate analysis was performed to determine predictive factors of inadequate coverage. Kaplan-Meier and Cox Regression were performed to correlate inadequate coverage with outcomes. RESULTS: Mean patient age was 49.2 ± 13.2 years, and 84% had Federation of Gynecology and Obstetrics IIB/IIIB disease. Forty-two percent of women were estimated to have inadequate tumor coverage with T + O brachytherapy. The GTV-Tinit volume and dimensions (superior-inferior, left-right, anterior-posterior) on MRI1 were all important predictive factors of inadequate coverage on multivariate analysis. Receiver operating characteristics curves identified optimal thresholds of superior-inferior ≥ 4.5 cm (area under the curve [AUC] = 0.718), left-right ≥ 4.5 cm (AUC = 0.745), anterior-posterior ≥ 5.0 cm (AUC = 0.767), and GTV-Tinit ≥ 85 cm3 (AUC = 0.842). Patients with inadequate coverage had worse clinical outcomes. CONCLUSIONS: Baseline MRI tumor size may predict inadequate CTVHR coverage at the time of brachytherapy (i.e., the need for interstitial needles). This may help identify a subset of women requiring early referral to adequately resourced centers to improve clinical outcomes.


Subject(s)
Brachytherapy/methods , Catheters/statistics & numerical data , Chemoradiotherapy/methods , Uterine Cervical Neoplasms/therapy , Adult , Aged , Area Under Curve , Cervix Uteri/diagnostic imaging , Cervix Uteri/pathology , Female , Humans , Kaplan-Meier Estimate , Magnetic Resonance Imaging/methods , Middle Aged , ROC Curve , Radiotherapy Dosage , Retrospective Studies , Risk Assessment/methods
13.
Mater Sci Eng C Mater Biol Appl ; 75: 1343-1350, 2017 Jun 01.
Article in English | MEDLINE | ID: mdl-28415425

ABSTRACT

This work is focused on self-assembled monolayers (SAMs) fabrication, using two types of Au surfaces, by subsequent attachment of different layers in order to develop a stable platform consisting of covalent multilayer functionalized gold surfaces. The key step in the construction of SAMs is the covalent linkage to the gold surface, via an amino-thiol derivative, of a cyclooctyne unit exhibiting strained triple bonds which react fast (catalysts are not needed) and quantitatively with organic azides and enable the introduction of various chemical functionalized entities on the gold surface. The versatility of the system is demonstrated by the reaction of the cyclooctyne decorated gold surface with an azide functionalized terpyridine followed by step by step complexation with Fe(II) and another terpyridine unit resulting into a multilayer covered gold surface. The Au surfaces were characterized by XPS to determine the chemical composition of the resulting SAMs. SPR was applied for real-time monitoring of the molecular interactions that occurred on the Au surface for each deposited layer. DPN was used to direct pattern the terpyridine-ink on a pre-functionalized AuIDE electrode. The AFM topology resulted from DPN and PEIS demonstrated metal-coordinating ligand of Fe(II)-Terpy.


Subject(s)
Coated Materials, Biocompatible/chemistry , Gold/chemistry , Pyridines/chemistry , Click Chemistry/methods , Iron/chemistry , Microscopy, Atomic Force , Surface Properties
14.
PLoS One ; 11(7): e0156544, 2016.
Article in English | MEDLINE | ID: mdl-27367229

ABSTRACT

INTRODUCTION: To report a single-institutional experience with the use of Superficial X-Ray Therapy (SXRT) for head and neck non-melanoma skin cancer (N-MSC) and to compare outcomes by prescribed fractionation schedules. MATERIALS AND METHODS: The medical records of 597 patients with 1021 lesions (720 BCC, 242 SCC, 59 SCC in situ) treated with kilovoltage radiation from 1979-2013 were retrospectively reviewed. The majority of patients were treated according to 1 of 3 institutional protocols based on the discretion of the radiation oncologist: 1) 22 x 2.5 Gy; 2) 20 x 2.5 Gy; 3) 30 x 2.0 Gy. "T" stage at first presentation was as follows: Tis (59); T1 (765); T2 (175); T3 (6), T4 (9); Tx, (7). All patients were clinical N0 and M0 at presentation. Chi-square test was used to evaluate any potential association between variables. The Kaplan-Meier method was used to analyze survival with the Log Rank test used for comparison. A Cox Regression analysis was performed for multivariate analysis. RESULTS: The median follow up was 44 months. No significant difference was observed among the 3 prescribed fractionation schemes (p = 0.78) in terms of RTOG toxicity. There were no failures among SCC in situ, 37 local failures (23 BCC, 14 SCC), 5 regional failures (all SCC) and 2 distant failures (both SCC). For BCC, the 5-year LC was 96% and the 10-year LC was 94%. For SCC the corresponding rates of local control were 92% and 87%, respectively (p = 0.03). The use of >2.0 Gy daily was significantly associated with improved LC on multivariate analysis (HR: 0.17; CI 95%: 0.05-0.59). CONCLUSION: SXRT for N-MSC of the head and neck is well tolerated, achieves excellent local control, and should continue to be recommended in the management of this disease. Fractionation schedules using >2.0 Gy daily appear to be associated with improved LC.


Subject(s)
Head and Neck Neoplasms/radiotherapy , Skin Neoplasms/radiotherapy , X-Ray Therapy , Adult , Aged , Dose Fractionation, Radiation , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment Failure
15.
BMC Cancer ; 16: 556, 2016 07 28.
Article in English | MEDLINE | ID: mdl-27469349

ABSTRACT

BACKGROUND: Diffusion Weighted (DW) Magnetic Resonance Imaging (MRI) has been studed in several cancers including cervical cancer. This study was designed to investigate the association of DW-MRI parameters with baseline clinical features and clinical outcomes (local regional control (LRC), disease free survival (DFS) and disease specific survival (DSS)) in cervical cancer patients treated with definitive chemoradiation. METHODS: This was a retrospective study approved by an institutional review board that included 66 women with cervical cancer treated with definitive chemoradiation who underwent pre-treatment MRI at our institution between 2012 and 2013. A region of interest (ROI) was manually drawn by one of three radiologists with experience in pelvic imaging on a single axial CT slice encompassing the widest diameter of the cervical tumor while excluding areas of necrosis. The following apparent diffusion coefficient (ADC) values (×10(-3) mm(2)/s) were extracted for each ROI: Minimum - ADCmin, Maximum - ADCmax, Mean - ADCmean, and Standard Deviation of the ADC - ADCdev. Receiver operating characteristic (ROC) curves were built to choose the most accurate cut off value for each ADC value. Correlation between imaging metrics and baseline clinical features were evaluated using the Mann Whitney test. Confirmatory multi-variate Cox modeling was used to test associations with LRC (adjusted by gross tumor volume - GTV), DFS and DSS (both adjusted by FIGO stage). Kaplan Meyer curves were built for DFS and DSS. A p-value < 0.05 was considered significant. Women median age was 52 years (range 23-90). 67 % had FIGO stage I-II disease while 33 % had FIGO stage III-IV disease. Eighty-two percent had squamous cell cancer. Eighty-eight percent received concurrent cisplatin chemotherapy with radiation. Median EQD2 of external beam and brachytherapy was 82.2 Gy (range 74-84). RESULTS: Women with disease staged III-IV (FIGO) had significantly higher mean ADCmax values compared with those with stage I-II (1.806 (0.4) vs 1.485 (0.4), p = 0.01). Patients with imaging defined positive nodes also had significantly higher mean (±SD) ADCmax values compared with lymph node negative patients (1.995 (0.3) vs 1.551 (0.5), p = 0.03). With a median follow-up of 32 months (range 5-43) 11 patients (17 %) have developed recurrent disease and 8 (12 %) have died because of cervical cancer. ROC curves based on DSS showed optimal cutoffs for ADCmin (0.488 × 10(-3)), ADCmean (0.827 × 10(-3)), ADCmax (1.838 × 10(-3)) and ADCdev (0.148 × 10(-3)). ADCmin higher than the cutoff was significantly associated with worse DFS (HR = 3.632-95 % CI: 1.094-12.054; p = 0.035) and DSS (HR = 4.401-95 % CI: 1.048-18.483; p = 0.043). CONCLUSION: Pre-treatment ADCmax measured in the primary tumor may be associated with FIGO stage and lymph node status. Pre-treatment ADCmin may be a prognostic factor associated with disease-free survival and disease-specific survival in cervical cancer patients treated with definitive chemoradiation. Prospective validation of these findings is currently ongoing.


Subject(s)
Diffusion Magnetic Resonance Imaging/methods , Uterine Cervical Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/therapy , Adult , Aged , Aged, 80 and over , Area Under Curve , Chemoradiotherapy , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Middle Aged , Prognosis , Proportional Hazards Models , ROC Curve , Retrospective Studies , Young Adult
16.
Brachytherapy ; 13(3): 281-4, 2014.
Article in English | MEDLINE | ID: mdl-24231148

ABSTRACT

PURPOSE: To evaluate the feasibility of reirradiation of the eye with plaque brachytherapy (REPBT) for local recurrence (LR) of malignant disease of the eye as an alternative to enucleation or other local salvage treatments. METHODS AND MATERIALS: It was performed a retrospective analysis of all patients who underwent REPBT for LR. The main parameters evaluated were local control and progression-free survival, besides the toxicity profile. RESULTS: There were eight patients who underwent REPBT, seven due to uveal melanoma and one due to retinoblastoma. The median time between the first plaque brachytherapy and the salvage plaque brachytherapy was 24 months (8-49 months). After a median followup of 30 months (8-70 months), the actuarial 2-year local control and progression-free survival was 87.5% and 60%, respectively. All patients evolved with worsening of the visual acuity and cataract. Other complications observed were maculopathy (two patients) and glaucoma (one patient). CONCLUSIONS: REPBT should be considered as an option for salvage therapy of LR of malignant disease of the eyes as it provides a high probability of tumor control and eye preservation without compromising disease-free survival.


Subject(s)
Brachytherapy/methods , Melanoma/radiotherapy , Neoplasm Recurrence, Local/radiotherapy , Retinal Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Uveal Neoplasms/radiotherapy , Adolescent , Adult , Child , Child, Preschool , Disease-Free Survival , Female , Humans , Male , Middle Aged , Retreatment , Retrospective Studies , Salvage Therapy/methods , Time Factors , Visual Acuity , Young Adult
17.
Brachytherapy ; 12(3): 235-9, 2013.
Article in English | MEDLINE | ID: mdl-22436517

ABSTRACT

PURPOSE: To evaluate outcomes in patients with posterior choroidal melanoma treated with ruthenium ((106)Ru) brachytherapy. METHODS AND MATERIALS: A retrospective single institutional analysis of 83 of 94 consecutive patients who underwent (106)Ru brachytherapy was performed. Disease was mainly staged as small- and medium-sized nonmetastatic melanoma. The main parameters evaluated were tumor control (local control [LC] and progression-free survival [PFS]) and ocular preservation (enucleation-free survival [EFS]). Besides, functional evaluation was performed and complications were described. RESULTS: The median follow-up was 39 (6-83) months. The median values of height and maximal basal diameter were 4.3 and 9.3mm, respectively. Median apical and basal doses were 100 and 307Gy, respectively. The actuarial 2-year LC, PFS, and EFS were 96.2%, 96.2%, and 95.5%, respectively. Actuarial 5-year LC, PFS, and EFS were 93.6%, 93.6%, and 84.1%, respectively. Preinsertion visual acuity (VA) maintenance was 34% (equal or better than before treatment). Approximately 56% of patients stayed with a minimum functional VA of 0.1 or more, from whom more than half stayed with 0.5 or more. Cataract was seen in 16% of treated eyes, and glaucoma was the rarest complication, with an incidence of 3%. CONCLUSIONS: Small- and medium-sized choroidal melanomas can be adequately treated with (106)Ru brachytherapy, with high rates of tumor control and ocular preservation. Moreover, acceptable incidence of complications such as glaucoma and cataract are seen, and a reasonable part of patients stay with a minimum functional VA.


Subject(s)
Brachytherapy/methods , Choroid Neoplasms/radiotherapy , Melanoma/radiotherapy , Radiation Injuries/prevention & control , Ruthenium Radioisotopes/therapeutic use , Visual Acuity , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Choroid Neoplasms/diagnosis , Choroid Neoplasms/mortality , Disease-Free Survival , Female , Follow-Up Studies , Humans , Incidence , Male , Melanoma/diagnosis , Melanoma/mortality , Middle Aged , Prognosis , Radiation Injuries/epidemiology , Retrospective Studies , Survival Rate/trends , Time Factors , Young Adult
18.
Appl. cancer res ; 32(1): 32-33, 2012.
Article in English | LILACS, Inca | ID: lil-661575

ABSTRACT

Historically, scleroderma and other collagenous diseases have been considered a relative contraindication to radiation. The literature has few studies describing poor outcomes and cosmesis in this situation and there are almost no data concerning about reirradiation and colagenosis. The authors describe a case of a patient with a soft tissue sarcoma in the arm submitted to conservative surgery. They describe the outcome, cosmesis and function of this rare twice-irradiated scleroderma patient.


Subject(s)
Humans , Brachytherapy , Scleroderma, Systemic , Radiotherapy
19.
Area urbana ; 2(5): 42, sep.-nov. 2005. ilus
Article in Spanish | BINACIS | ID: bin-140161

ABSTRACT

El autor presenta este informe que trata sobre el desarrollo de barreras geológicas naturales de baja permeabilidad basadas en la utilización de montmorillonitas sódicas (bentonitas) para la aislación de rellenos sanitarios


Subject(s)
Sanitary Landfill , Bentonite , Clay
20.
Areaurbana (B. Aires) ; 2(5): 42-sep.-nov. 2005. ilus
Article in Spanish | BINACIS | ID: biblio-1160672

ABSTRACT

El autor presenta este informe que trata sobre el desarrollo de barreras geológicas naturales de baja permeabilidad basadas en la utilización de montmorillonitas sódicas (bentonitas) para la aislación de rellenos sanitarios


Subject(s)
Clay , Sanitary Landfill , Bentonite
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