ObjectiveThe purpose of this study was to investigate retrospectively the clinical procedural performance of CT-guided needle biopsy for retroperitoneal lesions.Materials and MethodsCT-guided needle biopsy was performed in 74 consecutive patients (M:F = 44:30; mean age, 59.7 years) with retroperitoneal lesions between April 1998 and June 2009. The target lesion ranged from 1.5 to 12.5 cm in size. The biopsy access path ranged from 3.5 to 11.5 cm in depth. A biopsy specimen was obtained using an 18-gauge core needle under a CT or CT-fluoroscopy guidance and with the patient under local anesthesia. The histopathological diagnoses from the biopsies were obtained. The diagnostic confirmation of the subtype of lymphoma was evaluated.ResultsSatisfactory biopsy samples were obtained in 73 (99%) of 74 patients and a pathological diagnosis was made in 70 (95%) of 74 patients. Sixty three lesions were malignant (45 lymphomas, nine primary tumors, nine lymph node metastases) and seven were benign. The subtype of lymphoma was specified in 43 (96%) of 45 patients who were diagnosed with lymphoma. Analysis of the value of CT-guided biopsy in this series indicated 63 true positives, zero false positive, six true negatives and five false negatives. This test had a sensitivity of 93%, a specificity of 100% and an accuracy of 93%. No major complications were seen and minor complications were noted in seven patients (five with local hematomas, two with transient pain at the puncture site).ConclusionCT-guided needle biopsy for retroperitoneal lesions is highly practical and useful, and particularly for determining the subtypes in patients with lymphoma.

Background and study aims: Endoscopic submucosal dissection (ESD) has become widely accepted as a minimally invasive treatment for early gastric cancer (EGC), and opportunities to use ESD to treat EGC in elderly patients are increasing. The objective of this study was to elucidate the safety and efficacy of ESD in elderly patients. Patients and methods: Between April 2006 and March 2013, a total of 892 patients with EGC were prospectively recruited to undergo ESD according to definite inclusion criteria. The short-term outcomes and incidence of complications in 345 of these patients who were 75 years of age or older (elderly group) were compared with the short-term outcomes and incidence of complications in the remaining 547 patients (non-elderly group). Factors associated with the occurrence of pneumonia and delirium were also investigated. Results: The R0 resection rate did not differ between the two groups (96.2 % in the elderly group vs. 96.7 % in the non-elderly group; P = 0.65). The incidence of pneumonia (7.5 % vs. 1.8 %; P < 0.01) and incidence of delirium (10.1 % vs. 1.1 %; P < 0.01) were significantly higher in the elderly group. The incidence of post-ESD bleeding and incidence of perforation were similar in the two groups. No emergency surgery was required, but one patient in the non-elderly group died of aspiration pneumonia. On multivariate analysis, age 75 years or older, cerebrovascular disease, chronic obstructive pulmonary disease, delirium, and remnant stomach or gastric tube were independent risk factors for pneumonia, and age 75 years or older, diabetes, dementia, and pneumonia were independent risk factors for delirium. Conclusion: ESD for EGC was feasible for elderly patients in good condition. However, pneumonia and delirium may develop more frequently after ESD in elderly patients with co-morbidities.

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A chromatographic quantification method with two different mobile phases (elution conditions 1 and 2) was developed to determine carbonyl compounds (CCs) in air samples collected from charcoal production workplaces, using C18 cartridges coated with 2,4-dinitrophenylhydrazine (DNPHi). Several 2,4-dinitrophenylhydrazones (DNPHo) were separated and quantified using an HPLC system and UV detection. In 16 min, elution condition 1 successfully separated and quantified the DNPHo of 14 CC including acetaldehyde, acrolein, formaldehyde, and furfural, and estimated the sum of C4 isomers, butanal-isobutanal-butanone. This elution condition was able to resolve the pairs acrolein/furfural and propanone/propanal, which have been cited in the literature as difficult mixtures to be separated. The elution condition 2 allowed separation and quantification, in less than 30 min, of 13 out of the 17 CC listed above. This elution condition was also able to separate propanone from propanal and butanone from the other components of the C4 mixture. When the two mobile phases were used together, they allowed confirmation of the presence of the DNPHo in the real samples. Thus, both elution conditions have been shown to be appropriate to determine CC, in personal and stationary samples, collected in charcoal production plants.

Organic solvents have been suggested as a possible risk factor for non-Hodgkin's lymphomas (NHL). We studied 109 NHL incident cases and 276 controls with other cancers (1990/1996) in the city of Salvador, Brazil. Occupational exposure to organic solvents was evaluated through standardized questionnaires and defined by industrial hygienists, taking into account individuals' lifetime history. An association between occupational exposure to organic solvents and NHL was observed, OR = 1.67 (95% CI, 0.97 to 2.87), especially among individuals less than 64 years, OR = 1.91 (95% CI, 0.99 to 3.67), and among those who used domestic insecticides, OR = 2.24 (95% CI, 1.01 to 3.97). Odds ratios were similar for nodal and diffuse NHL. These results suggest that organic solvents may contribute to the causation of NHL, especially among young individuals, and that synergism may play a role in the process of lymphomagenesis.

A prática da reabilitação profissional é a resposta pública à questão da incapacidade para o trabalho, mas aqui trataremos especificamente da incapacidade decorrente de sequelas de acidentes de trabalho e de agravos de etiologia ocupacional.No mundo ocidental capitalista, a obrigatoriedade legal da prestação dos programas de reabilitação profissional está tradicionalmente vinculada aos sistemas de Previdência Social, uma vez que seus resultados positivos reduzem o tempo e, consequentemente, os custos de concessão dos benefícios previdenciários, bem como evitam a incapacidade permanente para o trabalho (MOOM; GEICKER, 1998). No Brasil, com a estatização do Seguro do Acidente de Trabalho (SAT) em 1967, os serviços de reabilitação profissional foram implantados no então Instituto Nacional de Previdência Social (INPS) e, desmontados na década de 1990 pelo atual Instituto Nacional do Seguro Social (INSS), transformaram-se em procedimentos administrativos de retorno às empresas após alta pericial (TAKAHASHI; IGUTI, 2008).A construção teórica do modelo de atenção em reabilitação profissional é bastante escassa na literatura brasileira. A prática mostra ter potencialmente um papel socialmente mais relevante e, através de seus serviços e programas terapêuticos e de profissionalização, realiza uma intervenção estruturada com o objetivo de reduzir e superar as limitações funcionais, emocionais e sociais, intervindo no estabelecimento da incapacidade para o trabalho e possibilitando aos trabalhadores reabilitados os meios necessários para o retorno a um trabalho compatível e saudável. A eficácia e a efetividade destes programas são qualificações de resultados articulados diretamente a uma construção social mais ampla, permeada por interesses de classes e projetos políticos em disputa: o conceito de incapacidade. Da legitimidade deste processo depende a efetivação de políticas públicas de seguridade social mais abrangentes e inclusivas.Se, por um lado, as mudanças nas elaborações teóricas desta concepção, ao longo dos últimos dois séculos, refletem as transformações históricas, políticas e sociais das sociedades capitalistas ocidentais, por outro, retratam o acúmulo do conhecimento científico definidor e incorporador das ideias às práticas. Deste construto paradigmático hegemônico emanam as decisões consolidadas na implantação de políticas públicas e na organização estatal de modelos de atenção em serviços de atendimento à população com incapacidades. A evolução deste processo reflete um longo caminho de lutas políticas e conquistas sociais. Partindo da concepção de tragédia pessoal, segundo a qual a incapacidade é um problema individual e as "vítimas", por intolerância social e omissão do Estado, são confinadas ao ocultamento, contando apenas com o cuidado familiar e a benemerência da paróquia e da

Charcoal is an important source of energy for domestic and industrial use in many countries. Brazil is the largest producer of charcoal in the world, with ∼350,000 workers linked to the production and transportation of charcoal. To evaluate the occupational exposure to wood smoke and potential genotoxic effects on workers in charcoal production, we studied urinary mutagenicity in Salmonella YG1041 +S9 and urinary levels of 2-naphthol and 1-pyrenol in 154 workers of northeastern Bahia. Workers were classified into three categories according to their working location, and information about socio-demographic data, diet, alcohol consumption, and smoking was obtained using a standard questionnaire. Spot urine samples were collected to evaluate urinary mutagenicity and urinary metabolites. Urinary mutagenicity increased significantly with exposure to wood smoke and was modified by smoking. The prevalence odds ratio was 5.31, and the 95% confidence interval was 1.85; 15.27 for urinary mutagenicity in the highly exposed group relative to the nonexposed group. The levels of urinary metabolites increased monotonically with wood smoke exposure and were associated with the GSTM1 null genotype, which was determined previously. The prevalence odds ratio (95% confidence interval) for higher levels of 2-naphtol among the highly exposed was 17.13 (6.91; 42.44) and for 1-hydroxyprene 11.55 (5.32; 25.08) when compared with nonexposed workers. Urinary 2-naphthol was the most sensitive indicator of wood smoke exposure. This is the first reported measurement of internal exposure to wood smoke among charcoal workers, and the results showed that these workers receive a systemic exposure to genotoxic compounds.

Pathologic diagnosis and genetic analysis could be performed even for lung tumor specimens obtained immediately after RFA.