Background: The catheter of the esophageal pH monitoring is associated with nasal and throat discomfort, and different behave in patients. The capsule of the wireless pH monitoring may cause chest pain and complications. Aim: To compare the wireless and conventional pH monitoring concerning the degree of discomfort and limitations in daily activities, complications, ability to diagnose pathological reflux, and costs. Methods: Twenty-five patients with symptoms of gastroesophageal reflux were prospectively submitted, in a simultaneous initial period, to 24-hour catheter esophageal pH monitoring and 48-hour wireless system. After removing each system, patients underwent a specific clinical questionnaire. Results: Fifteen patients (60%) pointed a higher discomfort in the introduction of the capsule (p=0.327). Discomfort and limitations in daily activities were lower on 2nd day (p<0.05); however, continued to be expressive (32% to 44%). Chest pain occurred in 13 (52%) patients. The diagnostic gain of pathological reflux was 12% with the wireless system (p=0.355). Conclusions: 1) There is no significant difference between the discomfort mentioned in the introduction of the capsule and the catheter; 2) during reflux monitoring, the wireless system provides significant less discomfort and limitations in daily activities; 3) there is no significant difference between the two methods in the ability to diagnose pathological reflux; 4) wireless pH monitoring has higher cost.

Introduction: Immunotherapies are developed to overcome limitations of conventional cancer therapy through stimulating innate immune response against tumor antigen. Objective: Elaborate a review on CAR-T Immunotherapy (Chimeric T Cell Antigen Receptor) in cancer treatment. Methods: Bibliographic survey of systematic reviews published in PubMed in the last 5 years. Results: 21 studies were selected. Antitumor effect occurs through cell lysis, due to CAR-T lymphocytes release of cytokines. Tumor escape is related to tumor's ability to not expose its Major Histocompatibility Complex (MHC) and/or inability of the adaptive immune system to recognize tumor antigens. These molecular targets may be proteins, carbohydrates, or glycolipids, with CD19 standing out as target of this therapy and in neoplasms as leukemia and lymphoma. Four generations of CARs have been described, which differ in terms of co-stimulatory domains and consequent functional efficiency. The therapy is indicated for cases of recurrence/refractoriness of hematological neoplasms, however applicability in solid tumors has been studied. Adverse events of CAR-T immunotherapy described were: cytokine release syndrome, neurotoxicity, anaphylactic shock, autoimmune reactions, B cell aplasia, tumor lysis syndrome and graft-versus-host disease. Conclusions: CAR-T immunotherapy is a promising therapy against relapsed/refractory cancer. It’s mainly used in leukemias and lymphomas. Choice of dose and generation of CARs should be cautious, considering specific molecular targets of each neoplasm and its presence in healthy tissues, avoiding adverse events.