BackgroundConventional local treatment for medullary osteomyelitis (OM) includes insertion of antibiotic-loaded polymethylmethacrylate (PMMA) cement. Nevertheless, PMMA may delivery irregular concentration of antibiotic to surrounding tissue. We aimed to compare the in vitro antibacterial activity of Bioactive Glass (BAG) S53P4, which is a compound showing local antibacterial activity, to that of antibiotic-loaded PMMA against multidrug resistant bacteria from OM isolates.MethodsWe studied convenience samples of multidrug resistant (MDR) microorganisms obtained from patients presenting OM and prosthetic joint infection (PJI). Mixtures containing tryptic soy broth (TSB) and inert glass beads (2 mm), BAG-S53P4 granules (0.5–0.8 mm and < 45 mm) and Gentamicin or Vancomycin-loaded PMMA beads were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MR-CoNS), Pseudomonas aeruginosa or Klebsiella pneumoniae isolates. Glass beads (2.0 mm) were used as a control. Antibacterial activity was evaluated by means of time-kill curve, through seeding the strains on blood agar plates, and subsequently performing colony counts after 24, 48, 72, 96, 120 and 168 h of incubation. Differences between groups were evaluated by means of two-way analysis of variance (ANOVA) and Bonferroni’s t test.ResultsInhibition of bacterial growth started soon after 48 h of incubation, reached zero CFU/ml between 120 and 168 h of incubation for both antibiotic-loaded PMMA and BAG S53P4 groups, in comparison with inert glass (p < 0.05). No difference regarding time-kill curves between antibiotic-loaded PMMA and BAG S53P4 was observed.ConclusionsBAG S53P4 presented antibacterial properties as much as antibiotic-loaded PMMA for MDR bacteria producing OM and PJI.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3069-x) contains supplementary material, which is available to authorized users.

à saúde e prevenção de acidentes na infância: uma ação de estudantes de medicina / Health promotion and accident prevention in childhood: an intervention of medical students.Rev Med (São Paulo). 2013 abr.-jun.;92(2):119-27.

Background: A significant proportion of patients with non-small-cell lung cancer (NSCLC) do not respond to immune checkpoint inhibitors (ICIs). Since metabolic reprogramming with increased glycolysis is a hallmark of cancer and is involved in immune evasion, we used 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) to evaluate the baseline glycolytic parameters of patients with advanced NSCLC submitted to ICIs, and assessed their predictive value. Methods: 18F-FDG PET/CT results in the 3 months before ICIs treatment were included. Maximum standardized uptake values, whole metabolic tumor volume (wMTV), and whole-body total lesion glycolysis (wTLG) were evaluated. Cutoff values for high or low glycolytic categories were determined using receiver-operating characteristic curves. Progression-free survival (PFS) and overall survival (OS) were evaluated. Patients with a complete response and a matching group with resistance to ICIs underwent immunohistochemistry analysis. An unsupervised k-means clustering model integrating programmed cell death ligand 1 (PD-L1) expression, glycolytic parameters, and ICIs therapy was performed. Results: In all, 98 patients were included. Lower baseline 18F-FDG PET/CT parameters were associated with responses to ICIs. Patients with low wMTV or wTLG had improved PFS and OS. High wTLG, strong tumor expression of glucose transporter-1, and lack of responses were significantly associated. Patients with low glycolytic parameters benefited from ICIs, regardless of chemotherapy. Conversely, those with high parameters benefited from the addition of chemotherapy. Patients with higher wTLG and lower PD-L1 were associated with progression and worse survival to ICIs monotherapy. Conclusions: Glycolytic metabolic profiles established through baseline 18F-FDG PET/CT are useful biomarkers for evaluating ICI therapy in advanced NSCLC.

622 Background: Despite the advances in systemic therapy for mRCC, CN may benefit a subset of pts. We investigated the correlation of clinical outcomes with primary tumor radiomics and radiology measurements of primary and metastatic lesions in mRCC pts treated with CN. Methods: We searched our institutional database for mRCC pts referred for CN from July 2011 to October 2019. Key eligibility criteria included clear cell histology, measurable metastatic disease, and OS >60 days from CN, to avoid surgery-related deaths. Demographics and IMDC risk strata were collected from medical charts. Volumetry and radiomic features (first and second order) were assessed in the arterial phase abdominal computerized tomography (CT) of the primary lesion. Metastatic disease foci were segmented from venous phase CT and measured. Bone disease and <1cm visceral metastases were disregarded for 3-axial measurement. After dimensionality reduction of the radiomic features with Uniform Manifold Approximation and Projection, an unsupervised Gaussian Mixture Model (GMM) clustering was performed. Characteristics of different clusters were compared with Mann-Whitney U test and univariate Cox regression estimated the effect on outcomes. Results: From 54 mRCC pts treated with CN, 39 were included. Median age was 60 years-old. Most patients were male (74%) and intermediate-risk by IMDC (64%). Sites of metastasis included lung (44%), bone (38%), and adrenal (21%). GMM identified 4 distinct clusters from radiomic features, which were grouped according to median OS relative to all pts (2.8 years): Group A (below mOS) and Group B (above mOS). The table shows the association of different factors with OS. Group B had longer median OS (3.4 vs. 1.8 years, p=0.009), progression-free survival (16.8 vs. 9.8 months, p=0.024), systemic treatment-free survival (9.5 vs. 3.8 months, p=0.028), and survival during first-line tyrosine kinase inhibitor (2.2 vs. 0.9 years, p=0.016). Group men had a lower primary-to-whole-body burden ratio compared to Group A (median 0.83 vs. 0.99, p<0.01). Only IMDC risk criteria (HR 1.97, p<0.01) and radiomic group B (HR 0.35, p=0.01) correlated with OS in univariate Cox analysis. Conclusions: Our study suggests that radiomics of the primary lesion may predict OS in mRCC pts after CN, despite limited by its retrospective nature and small sample size. Further validation in larger datasets is warranted. Univariate Cox proportional hazards of prognostic factors on OS. [Table: see text]