Linfadenectomía mediastinal por muestreo vs. linfadenectomía completa en el cáncer pulmonar / Sampling Mediastinal Lymphadenectomy versus Complete Lymphadenectomy in Lung Cancer

Introducción: El muestreo y la linfadenectomía completa son técnicas de acceso al mediastino. Su evaluación permite definir la conducta en el enfermo con cáncer del pulmón. Objetivo: Determinar los resultados de supervivencia en los enfermos con lesiones resecables por cáncer de pulmón con linfadenectomía completa o linfadenectomía por muestreo. Métodos: Se realizó un estudio longitudinal tipo serie de casos en 118 pacientes con lesiones resecables de cáncer de pulmón de células no pequeñas. El total de pacientes se subdividieron en dos grupos. A los 73 enfermos pertenecientes al grupo A se les realizó linfadenectomía por muestreo (1996-2010), mientras que a los 45 del grupo B se les realizó linfadenectomía completa (2011-2019). Se analizaron las complicaciones y la supervivencia a los cinco años. Resultados: Se resecaron mayor cantidad de ganglios por paciente y por regiones en la linfadenectomía completa, con una supervivencia de 50,6 por ciento, superior al 39,7por ciento obtenido en el grupo donde se realizó un muestreo. No se recogieron complicaciones inherentes a las técnicas quirúrgicas. Conclusiones: Los pacientes operados con resección y linfadenectomía completa tuvieron mayor sobrevida que los intervenidos mediante resección y linfadenectomía por muestreo(AU)

Introduction: Sampling or complete lymphadenectomy are techniques for accessing the mediastinum. Their assessment allows to define the approach in patients with lung cancer. Objective: To determine survival outcomes in ill patients with resectable lesions due to lung cancer after complete or sampling lymphadenectomies. Methods: A longitudinal case series study was performed in 118 patients with resectable lesions of nonsmall-cell lung cancer. All the patients were divided into two groups. The 73 ill patients from group A underwent sampling lymphadenectomy (1996-2010), while the 45 patients from group B underwent complete lymphadenectomy (2011-2019). Complications and five-year survival were analyzed. Results: A higher amount of nodes were resected per patient and per region in complete lymphadenectomy, with a survival of 50.6 por ciento, higher than the 39.7 por ciento corresponding to the sampling group. No complications inherent to the surgical techniques were collected. Conclusions: Patients operated on by resection and complete lymphadenectomy had higher survival figures than those operated on by resection and sampling lymphadenectomy(AU)

Abdomen agudo por vesícula biliar duplicada y complicada

RESUMEN Introducción: Las malformaciones de la vía biliar son extremadamente infrecuentes y en muchas ocasiones son un hallazgo en el acto quirúrgico. Cuando se presenta, el cuadro clínico es similar al del paciente que tiene vesícula sin malformaciones congénitas. Objetivo: Describir un caso de abdomen agudo por duplicidad de vesícula biliar complicada. Caso clínico: Paciente de 46 años, antecedentes de dispepsias, que acudió al cuerpo de guardia con dolor abdominal agudo. Se diagnostica gangrena vesicular y se decide tratamiento quirúrgico. En el transoperatorio, se constató doble sistema vesicular, uno con zona de necrosis y el otro con cambios inflamatorios crónicos. Se realiza colecistectomía a ambos órganos. La evolución fue favorable. Conclusiones: La ocurrencia de un abdomen agudo en un paciente con duplicidad vesicular es infrecuente. Se presenta el caso pues contribuye a profundizar en el conocimiento sobre la conducta a seguir en esta enfermedad.

ABSTRACT Introduction: Bile duct malformations are extremely rare, and generally do not present complications that justify urgent surgical intervention. When it occurs, the clinical picture is similar to that of a patient with a gallbladder without congenital malformations. Objective: Describe a case of acute abdomen due to complicated gallbladder duplication. Clinical case: 46-year-old patient with a history of dyspepsia, who came the emergency with acute abdominal pain. Gallbladder gangrene is diagnosed, and surgical treatment is decided. During surgery, a double vesicular system was found, one area of ​​necrosis and the other with chronic inflammatory changes. Cholecystectomy is performed on both organs. The evolution was favorable. Conclusions: The occurrence of an acute abdomen in a patient with gallbladder duplication is infrequent. The case is presented that contributes to deepen the knowledge about the course of action in this disease.

Resultados del tratamiento quirúrgico de pacientes con cáncer pulmonar / Results of surgical treatment of patients with lung cancer

RESUMEN Fundamento: la incidencia de cáncer de pulmón en la provincia Sancti Spíritus es alta y su diagnóstico por lo general, se realiza en etapas avanzadas por lo cual el tratamiento quirúrgico no siempre es posible. Objetivo: analizar las principales características y resultados de los pacientes operados por cáncer de pulmón. Métodos: se realizó un estudio observacional descriptivo de corte transversal en el servicio de Cirugía General del Hospital Universitario General Camilo Cienfuegos en la provincia Sancti Spiritus en el período comprendido entre enero de 1996 y diciembre de 2019. El universo consistió en 83 pacientes operados con cáncer de pulmón que se sometieron a resección acompañados de muestreo de ganglios linfáticos mediastinales. Resultados: el sexo masculino predominó en el grupo estudiado. Los grupos de edades más frecuentes para ambos sexos fueron los de 51 a 60 años y los mayores de 60 años. El hábito de fumar estuvo presente en la mayoría de los pacientes. La localización tumoral más predominó fue en los lóbulos superiores y la lobectomía fue la técnica más realizada. Las etapas patológicas que predominaron fueron la lB y llB, seguidas de la lllA. El carcinoma de células escamosas fue el tipo histológico más frecuente. Las atelectasias y las infecciones respiratorias fueron las complicaciones más frecuentes. Los fallecidos fueron pocos. Conclusiones: las características demográficas de los pacientes estudiados se corresponden a otras series de pacientes con cáncer del pulmón. La localización tumoral en los lóbulos superiores, el carcinoma epidermoide, así como las etapas tempranas, predominaron en la serie estudiada. La lobectomía fue la técnica quirúrgica que se utilizó con mayor frecuencia y dentro de las complicaciones, las respiratorias fueron las más frecuentes.

ABSTRACT Background: the incidence of lung cancer in the province of Sancti Spíritus is high and its diagnosis is usually made in advanced stages, for which surgical treatment is not always possible. Objective: to analyze the main characteristics and results of patients operated on for lung cancer. Methods: a cross-sectional descriptive observational study was carried out in the General Surgery service of the Camilo Cienfuegos General University Hospital in the Sancti Spiritus province in the period between January 1996 and December 2019. The universe consisted of 83 patients operated with lung cancer who underwent resection accompanied by mediastinal lymph node sampling. Results: the male sex predominated in the studied group. The most frequent age groups for both sexes were those from 51 to 60 years old and those over 60 years old. Smoking was present in most of the patients. The most frequent tumor location was in the upper lobes and lobectomy was the most performed technique. The pathological stages that predominated were lB and llB, followed by lllA. Squamous cell carcinoma was the most frequent histological type. Atelectasis and respiratory infections were the most frequent complications. The deceased were few. Conclusions: the demographic characteristics of the patients studied correspond to other series of patients with lung cancer. Tumor location in the upper lobes, squamous cell carcinoma, as well as early stages, predominated in the series studied. Lobectomy was the most frequently used surgical technique and among complications, respiratory ones were the most frequent.

Valor de la linfadenectomía mediastinal en la cirugía del cáncer pulmonar / The Value of Mediastinal Lymphadenectomy in Lung Cancer Surgery

RESUMEN Introducción: La evaluación del mediastino en los pacientes que reciben tratamiento quirúrgico por cáncer del pulmón tiene sus orígenes en la necesidad de definir la extensión anatómica de cada estación nodal, lo cual es indispensable para la categorización patológica de los nódulos linfáticos. Objetivo: Evaluar la utilidad de la linfadenectomía mediastinal en el tratamiento quirúrgico del cáncer pulmonar. Métodos: Se realizó un estudio analítico de carácter prospectivo en el período comprendido entre enero de 2015 al 31 de agosto de 2018. El universo estuvo conformado por 96 pacientes con algún tipo de linfadenectomía mediastinal en el tratamiento quirúrgico del cáncer pulmonar dentro del período señalado. Se utilizaron métodos estadísticos, teóricos y empíricos. Resultados: La edad promedio fue 58,69 ± 9,343, el sexo masculino fue el más afectado y el adenocarcinoma el tipo histológico que predominó. La etapa clínica y patológica mayoritaria fue la III A y la lobectomía superior derecha la intervención más realizada. Se efectuaron un total de 76 disecciones ganglionares sistemáticas, seguidas por 18 muestreos ganglionares y 2 biopsias. Las linfadenectomías realizadas provocaron cambios de estadios en 46 pacientes. El análisis del valor predictivo positivo y negativo, así como de la sensibilidad y la especificidad fueron altos, así como las complicaciones escasas. Conclusiones: La linfadenectomía mediastinal como parte del tratamiento quirúrgico en el cáncer pulmonar constituye un pilar fundamental en la estadificación patológica del TNM, al mostrar una exactitud diagnóstica alta(AU)

ABSTRACT Introduction: Evaluation of the mediastinum in patients receiving surgical treatment for lung cancer has its origins in the need to define the anatomical extension of each node station, which is essential for the pathological categorization of lymph nodes. Objective: To evaluate the usefulness of mediastinal lymphadenectomy in the surgical treatment of lung cancer. Methods: A prospective and analytical study was carried out in the period from January 2015 to August 31, 2018. The universe consisted of 96 patients with some type of mediastinal lymphadenectomy in the surgical treatment of lung cancer within the indicated period. Statistical, theoretical and empirical methods were used. Results: The average age was 58.69 ± 9.343. The male sex was the most affected. Adenocarcinoma was the histological type that predominated. The most manifested clinical and pathological stage was III A. Right upper lobectomy was the most performed intervention. A total of 76 systematic lymph node dissections were performed, followed by 18 lymph node samples and two biopsies. The lymphadenectomies performed caused stage changes in 46 patients. The analysis of positive and negative predictive value, as well as sensitivity and specificity, were high. There were few complications. Conclusions: Mediastinal lymphadenectomy as part of the surgical treatment in lung cancer constitutes a fundamental procedure for the pathological staging of TNM, as it shows high diagnostic accuracy(AU)

Supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo / Survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling

RESUMEN Fundamentación: En la provincia Sancti Spíritus no se reportan estudios sobre la supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo. Objetivo: Evaluar la supervivencia de los pacientes con cáncer de pulmón sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo. Metodología: Se realizó una investigación retrospectiva en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus, desde el 1 de enero del 1996 al 31 de diciembre del 2007. Fueron incluidos 48 pacientes a los que se les realizó cirugía de resección pulmonar con linfadenectomía por muestreo. Como variable principal fue considerada la supervivencia global a los 5 y 10 años. Otras variables fueron: edad, sexo, clasificación histológica y estadio patológico del tumor primario. Resultados: Predominaron los pacientes del sexo masculino, los mayores de 50 años y con estadio patológico IB. La estirpe histológica predominante fue el carcinoma epidermoide. La mediana de supervivencia fue superior para los estadios tempranos. La mayor supervivencia a los 5 años correspondió a los estadios IA y IIA. A los 10 años no hubo diferencias en la supervivencia de los pacientes. Conclusiones: La mayor supervivencia a los 5 años de los pacientes sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo correspondió a los que se encontraban en estadios con menor extensión de la enfermedad. Entre los 5 y 10 años después de la cirugía hubo una estabilización en la sobrevida de todos los pacientes, indistintamente del estadio patológico inicial.

ABSTRACT Background: In Sancti Spiritus province there are no reports on the survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling. Objective: To evaluate the survival of patients with lung cancer undergoing lung resection surgery and lymphadenectomy by sampling. Methodology: A retrospective investigation was conducted at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus, from January 1, 1996 to December 31, 2007. They were included 48 patients who underwent lung resection surgery with lymphadenectomy by sampling. The main variable was considered overall survival at 5 and 10 years. Other variables were: age, sex, histological classification and pathological stage of the primary tumor. Results: Male patients, those older than 50 years and with pathological stage IB predominated. The predominant histological line was squamous cell carcinoma. The median survival was higher for the early stages. The greatest survival at 5 years corresponded to stages IA and IIA. At 10 years there were no differences in patient survival. Conclusions: The greatest survival at 5 years of patients undergoing lung resection surgery and lymphadenectomy by sampling corresponded to those who were in stages with less extension of the disease. Between 5 and 10 years after surgery there was stabilization in the survival of all patients, regardless of the initial pathological stage.

Supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo / Survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling

RESUMEN Fundamentación: En la provincia Sancti Spíritus no se reportan estudios sobre la supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo. Objetivo: Evaluar la supervivencia de los pacientes con cáncer de pulmón sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo. Metodología: Se realizó una investigación retrospectiva en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus, desde el 1 de enero del 1996 al 31 de diciembre del 2007. Fueron incluidos 48 pacientes a los que se les realizó cirugía de resección pulmonar con linfadenectomía por muestreo. Como variable principal fue considerada la supervivencia global a los 5 y 10 años. Otras variables fueron: edad, sexo, clasificación histológica y estadio patológico del tumor primario. Resultados: Predominaron los pacientes del sexo masculino, los mayores de 50 años y con estadio patológico IB. La estirpe histológica predominante fue el carcinoma epidermoide. La mediana de supervivencia fue superior para los estadios tempranos. La mayor supervivencia a los 5 años correspondió a los estadios IA y IIA. A los 10 años no hubo diferencias en la supervivencia de los pacientes. Conclusiones: La mayor supervivencia a los 5 años de los pacientes sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo correspondió a los que se encontraban en estadios con menor extensión de la enfermedad. Entre los 5 y 10 años después de la cirugía hubo una estabilización en la sobrevida de todos los pacientes, indistintamente del estadio patológico inicial.

ABSTRACT Background: In Sancti Spiritus province there are no reports on the survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling. Objective: To evaluate the survival of patients with lung cancer undergoing lung resection surgery and lymphadenectomy by sampling. Methodology: A retrospective investigation was conducted at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus, from January 1, 1996 to December 31, 2007. They were included 48 patients who underwent lung resection surgery with lymphadenectomy by sampling. The main variable was considered overall survival at 5 and 10 years. Other variables were: age, sex, histological classification and pathological stage of the primary tumor. Results: Male patients, those older than 50 years and with pathological stage IB predominated. The predominant histological line was squamous cell carcinoma. The median survival was higher for the early stages. The greatest survival at 5 years corresponded to stages IA and IIA. At 10 years there were no differences in patient survival. Conclusions: The greatest survival at 5 years of patients undergoing lung resection surgery and lymphadenectomy by sampling corresponded to those who were in stages with less extension of the disease. Between 5 and 10 years after surgery there was stabilization in the survival of all patients, regardless of the initial pathological stage.

[Health survey in Quilombola communities (descendants of Afro-Brazilian slaves who escaped from slave plantations that existed in Brazil until abolition in 1888) in Vitória da Conquista in the state of Bahia (COMQUISTA Project), Brazil: methodological aspects and descriptive analysis]. / Inquérito de Saúde em Comunidades Quilombolas de Vitória da Conquista, Bahia, Brasil (Projeto COMQUISTA): aspectos metodológicos e análise descritiva.

The scope of this article was to present the methodology, preliminary descriptive results and the reliability of the instruments used in the COMQUISTA Project. It involved a cross-sectional study with adults (>18 years) and children (up to 5 years old) of Quilombola communities in Vitória da Conquista, Bahia. Data collection consisted of individual and household interviews, anthropometric and blood pressure measurements. A semi-structured questionnaire adapted from the Brazilian National Health Survey (PNS) was used and the interviews were conducted using handheld computers. 397 housing units were visited and 797 adults and 130 children were interviewed. The demographic profile of the Quilombolas was similar to the Brazilian population with respect to sex and age, however, they had precarious access to basic sanitation and a low socioeconomic status. The analysis of reliability revealed the adequacy of strategies adopted for quality assurance and control in the study. The methodology used was considered adequate to achieve the objectives and can be used in other populations. The results indicate the need for implementing strategies to improve the quality of life and reduce the degree of vulnerability of the Quilombolas.

Inquérito de Saúde em Comunidades Quilombolas de Vitória da Conquista, Bahia, Brasil (Projeto COMQUISTA): aspectos metodológicos e análise descritiva / Health survey in Quilombola communities (descendants of Afro-Brazilian slaves who escaped from slave plantations that existed in Brazil until abolition in 1888) in Vitória da Conquista in the state of Bahia (COMQUISTA Project), Brazil: methodological aspects and descriptive analysis

O objetivo deste artigo foi apresentar a metodologia, resultados descritivos preliminares e a confiabilidade dos instrumentos utilizados no Projeto COMQUISTA. Estudo transversal com indivíduos adultos (>18 anos) e crianças (até cinco anos) de comunidades quilombolas de Vitória da Conquista, Bahia. A coleta de dados compreendeu a realização de entrevistas individuais e domiciliares, aferição de medidas antropométricas e pressão arterial. Utilizou-se o questionário semiestruturado da Pesquisa Nacional de Saúde (PNS), adaptado para a população quilombola, e as entrevistas foram realizadas em computadores portáteis. Foram visitados 397 domicílios e entrevistados 797 adultos e 130 crianças. O perfil demográfico dos quilombolas foi semelhante ao dos brasileiros quanto ao sexo e idade, porém, eles apresentaram precário acesso ao saneamento básico e baixo nível socioeconômico. A análise de confiabilidade demonstrou a adequação das estratégias adotadas para garantia e controle de qualidade no estudo. A metodologia empregada foi considerada adequada para o alcance dos objetivos e pode ser utilizada em outras populações. Os resultados sugerem a necessidade da implantação de estratégias para melhorar a qualidade de vida e reduzir o grau de vulnerabilidade dos quilombolas.

The scope of this article was to present the methodology, preliminary descriptive results and the reliability of the instruments used in the COMQUISTA Project. It involved a cross-sectional study with adults (>18 years) and children (up to 5 years old) of Quilombola communities in Vitória da Conquista, Bahia. Data collection consisted of individual and household interviews, anthropometric and blood pressure measurements. A semi-structured questionnaire adapted from the Brazilian National Health Survey (PNS) was used and the interviews were conducted using handheld computers. 397 housing units were visited and 797 adults and 130 children were interviewed. The demographic profile of the Quilombolas was similar to the Brazilian population with respect to sex and age, however, they had precarious access to basic sanitation and a low socioeconomic status. The analysis of reliability revealed the adequacy of strategies adopted for quality assurance and control in the study. The methodology used was considered adequate to achieve the objectives and can be used in other populations. The results indicate the need for implementing strategies to improve the quality of life and reduce the degree of vulnerability of the Quilombolas.

Exhaled matrix metalloproteinase-9 in lung cancer.

BACKGROUND: Matrix metalloproteinase-9 (MMP-9) has been recognized in several types of tumor development and progression, including lung cancer, for its role in the degradation and remodeling of lung tissue. Furthermore, increased MMP-9 has been commonly described in the serum and airways of non-small cell lung cancer (NSCLC) patients. OBJECTIVE: The aim of this study was to investigate, for the first time, MMP-9 in the exhaled breath condensate (EBC) of NSCLC patients. PARTICIPANTS: We enrolled 40 NSCLC patients and 40 controls affected by transudative pleural effusion. MEASUREMENTS: MMP-9 concentrations were measured in the EBC, whole blood (WB), and pleural effusion (PE) of all the subjects under study using enzyme immunoassay (EIA) kits. RESULTS: MMP-9 levels were found to be significantly higher in EBC, WB, and PE of NSCLC patients compared with controls. A positive correlation was observed between MMP-9 in EBC, cigarettes smoked, and stage of cancer. CONCLUSION: Exhaled MMP-9 was elevated in NSCLC patients, especially during tumor progression, and could represent a suitable noninvasive marker in the diagnosis and monitoring of lung cancer.

Microsatellite alterations and cell-free DNA analysis: could they increase the cytology sensitivity in the diagnosis of malignant pleural effusion?

BACKGROUND: The exact diagnosis of malignant pleural effusions (PE) is difficult and often requires combined procedures, because the cytological examination of pleural fluid does not detect tumoral cells in 40% of malignant effusion cases. The aim of this study was to analyze microsatellite alterations (MA) in malignant PE and to determine their diagnostic value as an additional test to cytological examination. The increase in cell-free DNA levels was also evaluated as a signal of probable malignancy. METHODS: A total of 84 patients with PE were enrolled and underwent PE and whole blood and exhaled breath condensate analyses. Free DNA was measured by spectrophotometer analyses. DNA was extracted from all samples and analyzed for MA, using the microsatellite markers at chromosomes 3p, 12p, 5q, and 17p. RESULTS: The microsatellite analysis of PE exhibited a higher percentage of alterations in malignant PE than in benign PE. In addition to this, cell-free DNA in PE was seen to be significantly more elevated in malignant than in benign PE. The sensitivity of the sole cytology increased considerably when patients showed at least one MA or DNA>4 ng/µL in the PE. CONCLUSION: In conclusion, it was seen that the combination of the cytological examination with microsatellite analyses and cell-free DNA in pleural fluid could increase the sensitivity of the diagnosis in patients with PE who have a suspected malignancy, obviating the need for other invasive diagnostic procedures.

Could exhaled ferritin and SOD be used as markers for lung cancer and prognosis prediction purposes?

BACKGROUND: Today an increasing interest is being generated by the study of lung cancer markers in the exhaled breath condensate (EBC), precisely because this sample seems to lend itself to lung cancer early screening and follow-up. Indeed, ferritin and superoxide dismutase (SOD) have recently been recognized to play a role in lung cancerogenesis and patients' survival. The aim of this study was to evaluate the clinical value and the prognostic power of exhaled ferritin and exhaled SOD in patients with lung cancer. MATERIAL AND METHODS: Forty patients with nonsmall cell lung cancer (NSCLC) and 15 controls were enrolled in the study. All subjects under study underwent EBC collection and analysis of ferritin and SOD. A total of 36 patients were either given a follow-up of at least 25.5 months or followed up until death. RESULTS: Exhaled ferritin and SOD resulted as being higher in NSCLC than in controls and as being influenced by the stage of cancer. A pronounced survival difference was found in the presence of exhaled ferritin 300 ng/mL and exhaled SOD > 13.5 U/µL. CONCLUSIONS: In conclusion, although the results need to be confirmed on a larger and homogeneous population, we hypothesized that the notion of using the measurement of ferritin and SOD in the EBC could, if deemed feasible, have clinical implications in the monitoring of lung cancer and as an outcome predictor.

Neutrophilic airways inflammation in lung cancer: the role of exhaled LTB-4 and IL-8.

BACKGROUND: Recent advances in lung cancer biology presuppose its inflammatory origin. In this regard, LTB-4 and IL-8 are recognized to play a crucial role in neutrophil recruitment into airways during lung cancer.Notwithstanding the intriguing hypothesis, the exact role of neutrophilic inflammation in tumour biology remains complex and not completely known.The aim of this study was to give our contribution in this field by investigating LTB-4 and IL-8 in the breath condensate of NSCLC patients and verifying their role in cancer development and progression. METHOD: We enrolled 50 NSCLC patients and 35 controls. LTB-4 and IL-8 concentrations were measured in the breath condensate and the blood of all the subjects under study using EIA kits. Thirty NSCLC patients and ten controls underwent induced sputum collection and analysis. RESULTS: LTB-4 and IL-8 resulted higher in breath condensate and the blood of NSCLC patients compared to controls. Significantly higher concentrations were found as the cancer stages progressed. A positive correlation was observed between exhaled IL-8 and LTB-4 and the percentage of neutrophils in the induced sputum. CONCLUSION: The high concentrations of exhaled LTB-4 and IL-8 showed the presence of a neutrophilic inflammation in the airways of NSCLC patients and gave a further support to the inflammatory signalling in lung cancer. These exhaled proteins could represent a suitable non-invasive marker in the diagnosis and monitoring of lung cancer.

Crescimento, nutrição mineral e nível crítico foliar de K em mudas de umbuzeiro, em função da adubação potássica / Growth, mineral nutrition and foliar critical level of K in umbuzeiro seedlings, in function of the potassium fertilization

O umbuzeiro (Spondias tuberosa Arr. Cam.) é uma frutífera originária da região nordeste do Brasil e se caracteriza pela alta tolerância à seca. O crescimento, a nutrição mineral e o nível crítico foliar de potássio em mudas de umbuzeiros crescidas num Latossolo Vermelho distroférrico, em função de doses de potássio, foram avaliados neste experimento. O delineamento experimental utilizado foi o de blocos casualizados com quatro repetições e seis doses de potássio (0, 30, 60, 120, 240 e 480 mg dm-3). A adubação potássica foi realizada parceladamente, em quatro aplicações, tendo como fontes o sulfato de potássio e o cloreto de potássio. Enquanto para atingir a máxima produção de folhas a dose de potássio foi de 137 mg dm-3, a máxima produção de raízes só aconteceu na dose de 229 mg dm-3. Os teores foliares de potássio nas mudas do umbuzeiro aumentaram com a adubação potássica. O nível crítico de potássio nas folhas das mudas do umbuzeiro variou de 3,40 a 6,04 g kg-1.

The umbuzeiro (Spondias tuberosa Arr. Cam.) is original of the Northeast of Brazil and it is characterized by tolerance to the drought. The growth, the mineral nutrition and the foliar critical level of potassium in umbuzeiro seedlings, grown in distroferric Red Latosol, in function of potassium doses, were evaluated in this experiment. The experimental design was randomized blocks with four replications and six doses of potassium (0, 30, 60, 120, 240 and 480, mg dm-3). The potassium fertilization was accomplished in four applications, and the used sources were potassium sulfate and the potassium chloride. The highest production of leaves occurred in the dose of 137 mg dm-3 of potassium and the highest production of roots at the dose of 229 mg dm-3 of potassium. The foliar contents of potassium in the umbuzeiro seedlings increased with the potassium fertilization. The critical level of potassium in the leaves of the umbuzeiro seedlings ranged from 3.40 to 6.04 g kg-1.