For stage IIIB cervical cancer, the addition of cisplatin offers a small but significant benefit in DFI, with acceptable toxicity.

Purpose Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. Methods The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan–Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. Results Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan–Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). Conclusion In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020. Electronic supplementary material The online version of this article (10.1007/s00259-019-04421-5) contains supplementary material, which is available to authorized users.

Fonte financiadora: Pharmacia (doou kits para dosagens).Artigo submetido em 01.09.03, aceito em 03.03.04. AbstractObjectives: To evaluate the positivity of Phadiatop ® in children from several Brazilian pediatric allergology centers and to compare its results with the presence of serum specific IgE to inhalant and food allergens.Patients and method: Phadiatop ® and serum specific IgE levels (RAST) to inhalant and food allergens (UniCAP ® -Pharmacia) were measured in 457 children from several pediatric allergy centers and in a non-allergic control group (n = 62), distributed across five age groups. No Brasil, as prevalências de diagnóstico médico de asma, rinite alérgica e eczema atópico foram determinadas pela primeira vez como parte de um estudo internacional e revelaram ser em média 12%, 39% e 8%, respectivamente 1-3 . Caracterizadas pela presença e produção aumentada de anticorpos específicos da classe IgE a antígenos usuais, as doenças alérgicas têm, nesse parâmetro, fonte importante de subsídio para a confirmação do seu diagnóstico 4 . Results

Objective: given that the most common allergic manifestations (asthma, rhinitis, dermatitis, food allergies) occur during childhood, because the immune system can be induced into sensitization rather than into allergenic tolerance at the beginning of life, we analyzed the main immunological aspects of fetuses and infant in terms of allergic sensitization and response.Methods: detailed bibliographic revision concerning nonspecific immune response (physical and chemical barriers, myeloid cells) and specific immune response (T and B lymphocytes, cytokines) of the fetus and infant, with special attention to studies carried out in the last fifteen years.Results: various compartments of the immune system in fetuses and infants are different from those present in older children and adults. Thus, developmental aspects of nonspecific and specific immunity may contribute to atopic disease.Conclusions: atopic predisposition is determined at the beginning of life and seems to originate not only from genetic factors, but also from intrauterine environment and initial stage of childhood, inducing the immune system to increase the synthesis of IgE.J Pediatr (Rio J) 2001; 77 (6): 441-6: hypersensitivity, autoimmunity, natural immunity, cellular immunity, antibody formation. ResumoObjetivo: considerando-se que é na infância que as manifestações alérgicas mais comuns (asma, rinite, dermatite, alergia alimentar) ocorrem, porque é no início da vida que o sistema imune pode ser induzido à sensibilização ao invés de tolerância alergênica, analisamos as principais peculiaridades imunológicas do feto e da criança jovem, inerentes à sensibilização e resposta alérgica.Métodos: os autores realizaram revisão literária detalhada concernente à resposta imune inespecífica (barreiras físico-químicas, células mielóides) e específica (linfócitos T e B, citocinas) do feto e de crianças mais jovens, enfatizando os estudos mais relevantes nos últimos quinze anos.Resultados: vários compartimentos do sistema imune do feto e de crianças mais jovens são diferentes daqueles da criança maior e do adulto. Conseqüentemente, aspectos relativos ao desenvolvimento da imunidade inespecífica e específica, podem contribuir para a geração de atopia.Conclusões: a predisposição atópica determina-se no início da vida e parece originar-se, além dos fatores genéticos, por aqueles ocorridos no ambiente intra-uterino e fase inicial da infância, os quais influenciam o sistema imune à síntese elevada de IgE.J Pediatr (Rio J) 2001; 77 (6): 441-6: hipersensibilidade, autoimunidade, imunidade natural, imunidade celular, formação de anticorpos. Imunidade relacionada à resposta alérgica no início da vidaImmunity related to allergic response at the beginning of life Joaquina M.M. Correa 1 , Antonio Zuliani 2 As alergopatias resultam de uma conjunção de fatores genéticos (produção de células, citocinas e imunoglobulina E, por exemplo) e ambientais específicos (alérgenos) ou inespecíficos (tabagismo, infecções, exercícios, alterações psicossociais, tratamento e outros). T...

SummaryObjective. To compare survival and toxicity of three different treatments for stage IIIB cervix cancer: low-dose-rate (LDR), high-dose-rate (HDR) brachytherapy and association of HDR and chemotherapy. MethOds. Between 1985 and 2005, 230 patients with FIGO stage IIIB squamous cell carcinoma of the uterine cervix received 4-field pelvic teletherapy at doses between 40 and 50.4 Gy, with a different complementation in each group. The LDRB group, with 42 patients, received one or two insertions of LDR, with Cesium-137, in a total dose of 80 to 100Gy at point A. The HDR group, 155 patients received HDR in 4 weekly 7 Gy fractions and 9 Gy to 14.4 Gy applied to the involved parametria. The CHT group, 33 patients, were given the same treatment as the HDR group and received 5 or 6 weekly cycles of cisplatin, 40 mg per m2. Results. The five-year progression-free survival (PFS) was 60% for the HDR group and 45% for the LDR group, and the two-year PFS for the CHT group was 65% (p = 0.02). The five-year Overall Survival (OS) was 65% for the HDR group and 49% for the LDR group. The two-year OS was 86% for the CHT group (p = 0.02). Rectum toxicity grade II was 7% for the LDR group, 4% for the HDR group and 7% for the CHT group that had one case of rectum toxicity grade IV. cOnclusiOn. Patients that received HDR had better OS and PFS. The Chemotherapy-HDR association showed no benefit when compared to HDR only. Toxicity rates showed no difference between the three groups.

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Rev. Nutr., Campinas, 16 (4) R E S U M O IntroduçãoA alergia ao látex tornou-se um risco crescente aos indivíduos expostos, como os profissionais da área da saúde, tendo como agravo a associação com hipersensibilidade a vários alimentos, especialmente frutas. ObjetivoAvaliar a freqüência de sensibilização ao látex e a frutas em profissionais da área da saúde. MétodosForam avaliados 53 profissionais da saúde, 81,9% do sexo feminino, aplicando-se questionário alergológico e testes cutâneos por puntura para alérgenos inaláveis, do látex e de frutas (mamão papaia, kiwi, abacate, banana, figo, tomate, noz). Resultados ConclusãoEstes achados demonstram a existência da alergia látex-fruta, como descrito na literatura, sendo de suma importância uma avaliação in vivo em profissionais da área de saúde, caracterizados como potencial grupo de risco.Termos de indexação: hipersensibilidade ao látex, reatividade cruzada, profissionais de saúde.

Fonte financiadora: Pharmacia (doou kits para dosagens).Artigo submetido em 01.09.03, aceito em 03.03.04. AbstractObjectives: To evaluate the positivity of Phadiatop ® in children from several Brazilian pediatric allergology centers and to compare its results with the presence of serum specific IgE to inhalant and food allergens.Patients and method: Phadiatop ® and serum specific IgE levels (RAST) to inhalant and food allergens (UniCAP ® -Pharmacia) were measured in 457 children from several pediatric allergy centers and in a non-allergic control group (n = 62), distributed across five age groups. No Brasil, as prevalências de diagnóstico médico de asma, rinite alérgica e eczema atópico foram determinadas pela primeira vez como parte de um estudo internacional e revelaram ser em média 12%, 39% e 8%, respectivamente 1-3 . Caracterizadas pela presença e produção aumentada de anticorpos específicos da classe IgE a antígenos usuais, as doenças alérgicas têm, nesse parâmetro, fonte importante de subsídio para a confirmação do seu diagnóstico 4 . Results