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Introdução: O objetivo deste trabalho é aprofundar o conhecimento da doença peri-implantar e os tratamentos existentes descritos na literatura. Material e método: Revisão bibliográfica das doenças peri-implantares, com base em uma pesquisa nos indexadores Pubmed, Medline e Cochrane Library, utilizando os uni termos " peri-implantite, mucosite, dependência de tabaco, microbiota oral, sobrecarga oclusal, tratamento cirúrgico, terapia antimicrobiana, desintoxicação, terapia regenerativa, defeitos ósseos ". Desenvolvimento e discussão: Análise de fatores de risco, diagnóstico e tratamento de doenças peri-implantares. Conclusões: Fatores como tabaco ou histórico de periodontite, juntamente com falta de higiene bucal, são as principais causas da doença peri-implantar. Um diagnóstico correto da etiologia, bem como a escolha apropriada da terapêutica, pode interromper o avanço da doença peri-implantar. Após o tratamento realizado, será muito importante o monitoramento e manutenção regulares da higiene bucal adequada.

Introdução: As próteses fixas implanto-suportadas são alternativas de tratamentos cada dia mais frequente nas clinicas odontológicas. Elas podem ser parafusadas ou cimentadas dependendo do planejamento cirúrgico. As próteses parafusadas são reversíveis, tem maior infiltrado bacteriano, estética prejudicada pelo orifício dos parafusos. As próteses cimentadas têm dificuldades de reversão, perda da prótese em caso de afrouxamento de parafuso e uma melhor estética por não ter orifício do parafuso. Objetivos: Nesse contexto, o presente estudo, pretender avaliar os níveis de resistência a tração dos copping´s cimentados por 2 diferentes tipos de cimentos para fixação de coroas implanto-suportadas cimentadas. Metodologia: Foram confeccionados três corpos de prova com implantes e coroas cimentadas com diferentes matérias, onde cada um desses corpos de prova foi submetido a um teste de tracionamento. Resultados: Os copping´s cimentados com cimento fosfato de zinco (CP1 e CP4) exigiram uma força de tração de 118.02 kgf e 213.63 kgf respectivamente, enquanto os copping´s cimentados com cimento resinoso (C2 e C3) exigiram uma força de tração de 258.93 kgf e 228.87 kgf respectivamente. Conclusão: Dentro das limitações das atuais condições in vitro empregadas neste estudo, a retenção de copping’s de coroa cimentada nos pilares de implantes com cimento resinoso e cimento fosfato de zinco foi significativamente afetada pelo tipo de cimento. O cimento resinoso exigiu uma força de tração significativamente maior que o cimento fosfato de zinco para a remoção dos copipng’s.

Extensive rearing systems enable higher occurrence of helminths, which is a hindrance in poultry farming, significantly affecting productivity. A survey was conducted to determine the prevalence of gastrointestinal helminths in chickens reared in extensive system in the city of Viçosa, Minas Gerais, Brazil between December 2017 to September 2018. A total of 5579 specimens were recovered from the gastrointestinal tracts of most animals (81.55% of prevalence). Of the positive birds, only 41.67% had mixed infections, and of these, more than 90% were nematodes and cestodes co-infections. Three nematodes (Ascaridia galli, Heterakis gallinarum, Capillaria sp.), seven cestodes (Raillietina tetragona, R. echinobothrida, R. cesticillus, Choanotaenia infundibulum, Hymenolepis cantaniana, H. carioca and Davainea proglottina) and two trematodes (Postharmostomum commutatum and Echinostoma sp.) species were identified. The most dominant helminth species was H. gallinarum (60.19%), which also presented higher average intensity (35.46 ± 0.65) and abundance (21.34 ± 3.01) among all recovered species. The tapeworm species correspond to 42.23% of prevalence and the trematodes correspond to only 3.40%. Despite the scarcity of data in the Brazilian literature on poultry helminths reared in extensive systems, regional parasitological surveys are important. It is expected that these results will contribute to the adoption of prophylactic measures and alternative control strategies in order to reduce the risk of helminth infection in poultry Os sistemas de criação extensivos permitem maior ocorrência de helmintos, o que é um entrave na avicultura, afetando significativamente a produtividade. Um levantamento foi realizado para determinar a prevalência de helmintos gastrointestinais em frangos criados em sistema extensivo na cidade de Viçosa, Minas Gerais, Brasil, entre dezembro de 2017 a setembro de 2018. Um total de 5.579 espécimes foram recuperados do trato gastrointestinal da maioria dos animais (81,55% de prevalência). Das aves positivas, apenas 41,67% tiveram infecções mistas e, destas, mais de 90% foram coinfecções por nematóides e cestóides. Três espécies de nematoides (Ascaridia galli, Heterakis gallinarum, Capillaria sp), sete de cestóides (Raillietina tetragona, R. echinobothrida, R. cesticillus, Choanotaenia infundibulum, Hymenolepis cantaniana, H. carioca and Davainea proglottina) e dois trematódeos (Postharmostomum commutatum and Echinostoma sp.) foram identificadas. A espécie de helmintos mais dominante foi Heterakis gallinarum (60,19%), que também apresentou maior intensidade média (35,46 ± 0,65) e abundância (21,34 ± 3,01) entre todas as espécies recuperadas. As espécies de tênia correspondem a 42,23% da prevalência e os trematódeos correspondem a apenas 3,40%. Apesar da escassez de dados na literatura brasileira sobre helmintos avícolas criados em sistemas extensivos, levantamentos parasitológicos regionais são importantes. Espera-se que esses resultados contribuam para a adoção de medidas profiláticas e estratégias alternativas de controle, a fim de reduzir o risco de infecção por helmintos em aves.

Interoperability in public health has major advantages over agility gains throughout the state bureaucratic logistics system. This agility is fundamental to help relieve the highest demand in all areas of health sciences in the Brazilian public service. This short communication aims to inform the population of Amapa and the academic community about the implementation of interoperability of public health services in the state of Amapá. The service is already in its implementation phase and is expected to end and be fully used by early 2020.

In a microservice architecture, solutions are created by teams focused on specific domains and needs. They independently develop and deploy distributed services in the network. One characteristic of microservices is decentralized data management. Each microservice may use different data management technology which best fit its needs. Hence, it is an issue to integrate data of heterogenous microservices to come up with consolidate data views. Flexible and efficient solutions in this scenario are needed. This work is based on the use of a canonical data model as the mechanism for data integration in microservices. The canonical data model is the reference for query specifications and data integration. This work proposes and implements a microservice architecture based on this strategy and it is composed by nodes that intercommunicate through several mechanisms (e.g., SPARQL, GraphQL and JDBC queries, calls to REST services and proprietary APIs). The solution was analyzed in a proof of concept in a fictitious scenario but using real services available at DBPedia and Twitter. The evaluation goal was to qualitatively analyze the use of the architecture in the design, development and execution of microservices in order to identify the characteristics one should consider when using the canonical data model strategy. The evaluation employed the criteria of ISO/IEC 25010 model that most relate to the SOA challenges, which were: usability; performance; compatibility; and, maintainability. The identified advantages and disadvantages of using the architecture (i.e., the strategy) can be used by architects and developers to make their development decisions.

Rehabilitation of patients through implants in areas with severe bone resorption in the posterior mandible is a challenge in implant dentistry. In this context, extra short implants configure a treatment option for this type of patient, as they can avoid increased financial cost, treatment time and patient morbidity. The present study evaluated the marginal bone stability in individualized extra-short implants for masticatory function in the posterior mandible. Using digitized periapical radiographs of 13 extra-short implants performed on 7 patients. The mesial and distal regions of each implant were selected, from the bone crest to the region parallel to the apex, and the bone stability of this crest was measured using the Image J software immediate T1 and 1 year after rehabilitation (T2). The height of the bone crest remained stable, showing no statistically significant difference between T1 and T2 (p> 0.005) for both the mesial bone crest and the distal bone crest in individual or united crowns rehabilitation. Marginal bone stability was observed in extra short implants, corroborating the biological and biomechanical stability of these implants presented in the literature. Despite the limited sample size and proservation time, extra-short implants are predictive treatment options for patients with severe bone atrophy in the posterior mandible. Key words:Extra-short implants, marginal bone loss, mandibular bone atrophy.

This paper presents a proposal to introduce industrial demand side bidding to curtail their load, being part of the system load and frequency control resources, as a more economical alternative in substitution of thermal power plants dispatch, but, at the same time, keeping business profitability. Financial performance indicator from aluminum industry was used to simulate impact of curtailment on medium term power price model in terms of Operation Cost and Deficit Risk.

The magnitude of the pre-salt projects, most located in Brazil ultra-deep waters, coupled with the enormous potential already auctioned, leads to the following questions: what will be Brazil's share in the world's deep-water development? How should suppliers prepare themselves to assist Brazil in the task of making these opportunities viable? Since 2013, the country awarded over R$ 43 billion in signing bonuses. Despite the pessimism associated to the oil price drop in 2014, Brazil has gone forward with the development of pre-salt areas and the resume of the bidding rounds, reaching the top 10th position in world's biggest oil producers (BP 2019). This paper forecasts the oil potential for these areas, as well as the Brazilian oil production for the next 15 years and the demand for facilities to reach that potential. Those forecasts clarify the increasing importance of Brazilian deep-water oil in the global scenario.

A growing number of test data generation techniques and tools for Android applications (apps) has been proposed in the last years. As a consequence, a demand for evaluations comparing such tools has emerged. However, we find few studies only dedicated to this subject and there is a lack of studies considering the mutation score, spite of this is a measure largely used and recognized as effective to assess the quality of the test suites. A possible reason is the fact that Android mutation testing has been recently addressed in the literature, and most tools do not support the analyses of mutants in comparison with the original one, nor provide the score. To fulfill with these gaps, this work presents results from the evaluation of three state-of-the-art tools for Android apps: Monkey, Stoat and APE, regarding the ability of the test data generated by them to reveal faults described by the mutation operators of the tool MDroid+. To this end, we implemented a mechanism to automatically capture screenshots of apps execution and calculate the score, which is also described in the paper. In addition to this, we also evaluate aspects related to code coverage and runtime. Stoat reached the best general mean score, but Monkey takes significantly less time to execute, without great differences in the score and coverage.

Context: Model-Based Testing (MBT) is an approach that allows testers to represent the behavior of the system under test as models, specifying inputs and their expected outputs. From such models, existing tools might be employed to generate test cases automatically. While MBT represents a promising step towards the automation of test case generation, the quality of the model designed by the tester may impact, either positively or negatively, on its ability to reveal faults (i.e., the test effectiveness). Objective: In this context, we conducted a preliminary experiment to evaluate the impact caused by different testers when designing a test model for the same functionality. Method: In the experiment, the participants used Event Sequence Graphs and its supporting tool FourMA to create test models for two mobile apps: arXiv-mobile and WhoHasMyStuff. From the test models, test cases were generated using FourMA and concretized by means of the Robotium framework. In order to measure the impact of different testers, we employed code coverage (namely, instruction and branch coverage) as an estimation of test effectiveness. Results: Based on the results obtained, we observe high variation of code coverage among the testers. No tester was capable of producing a test model that subsumes all other testers' models with respect to code coverage. Moreover, factor learning seems not to reduce the code coverage variation. The relation between model size, modeling time, and code coverage were inconclusive. Conclusion: We conclude that further research effort on the MBT's modeling step is required to not only reduce the variation between testers, but also improving its effectiveness.

Breast cancer is one of the most common malignancies in women worldwide. In breast cancer, the cell proliferation rate is known to influence the cancer malignancy. Recent studies have shown that DNA replication initiation/licensing factors are involved in cancer cell proliferation as well as cancer cell migration and invasion. Licensing factors have also been reported as important prognostic markers in lung, prostrate, and bladder cancers. Here, we studied the role of MCM10, a novel licensing factor, in breast cancer progression. From the public database, NCBI, we investigated six independent breast cancer patient cohorts, totaling 1283 patients. We observed a significant association between high MCM10 mRNA expression with tumor grading and patients&rsquo, survival time. Most importantly, using breast cancer cohorts with available treatment information, we also demonstrated that a high level of MCM10 is associated with a better response to conventional treatment. Similarly, in in vitro studies, the expression level of MCM10 in breast cancer cell lines is significantly higher compared to paired normal breast epithelium cells. Knockdown of MCM10 expression in the cancer cell line showed significantly decreased tumorigenic properties such as cell proliferation, migration and anchorage independence. The MCF7 breast cancer cell line, after MCM10 expression knockdown, showed significantly decreased tumorigenic properties such as cell proliferation, migration, and anchorage independent growth. Mechanistically, MCM10 expression is observed to be regulated by an Estrogen Receptor (ER) signaling pathway, where its expression is suppressed by the inhibition of the ER or serum withdrawal. Our results suggest that MCM10 plays an important role in breast cancer progression and is a potential prognostic/predictive biomarker and therapeutic target for breast cancer patients.

Background The main goal of anti-cancer therapy is to specifically inhibit the malignant activity of cancer cells, while leaving healthy cells unaffected. As such, for every proposed therapy, it is important to keep in mind the therapeutic index — the ratio of the toxic dose over the therapeutic dose. The use of immunotherapy has allowed a means to both specifically block protein–protein interaction and deliver cytotoxic events to a tumor-specific antigen. Review scope It is the objective of this review to give an overview on current immunotherapy treatment for cancers using monoclonal antibodies. We demonstrate three exciting targets for immunotherapy, TNF-α Converting Enzyme (TACE), Cathepsin S and Urokinase Plasmogen Activator and go over the advances made with one of the most used monoclonal antibodies in cancer therapy, Rituximab; as well as Herceptin, which is used for breast cancer therapy. Furthermore, we touch on other venues of immunotherapy, such as adaptive cell transfer, the use of nucleic acids and the use of dendritic cells. Finally, we summarize some ongoing studies that spell tentative advancements for anti-cancer immunotherapy. General significance Immunotherapy is at the forefront of anti-cancer therapies, allying both a high degree of specificity to general high effectiveness and fewer side-effects., Highlights • Current monoclonal antibodies for cancer immunotherapy have a bright future. • Immunotherapy presents opportunity to eliminate tumor growth that chemotherapy can't achieve. • Therapeutic antibodies for cancer immunotherapy show better results without undesirable side-effects.

DNA replication is a critical step in cell proliferation. Overexpression of MCM2-7 genes correlated with poor prognosis in breast cancer patients. However, the roles of Cdc6 and Cdt1, which work with MCMs to regulate DNA replication, in breast cancers are largely unknown. In the present study, we have shown that the expression levels of Cdc6 and Cdt1 were both significantly correlated with an increasing number of MCM2-7 genes overexpression. Both Cdc6 and Cdt1, when expressed in a high level, alone or in combination, were significantly associated with poorer survival in the breast cancer patient cohort (n = 1441). In line with this finding, the expression of Cdc6 and Cdt1 was upregulated in breast cancer cells compared to normal breast epithelial cells. Expression of Cdc6 and Cdt1 was significantly higher in ER negative breast cancer, and was suppressed when ER signalling was inhibited either by tamoxifen in vitro or letrozole in human subjects. Importantly, breast cancer patients who responded to letrozole expressed significantly lower Cdc6 than those patients who did not respond. Our results suggest that Cdc6 is a potential prognostic marker and therapeutic target in breast cancer patients.

Objectives Three infusion rates of remifentanil were used in isoflurane-anesthetized cats undergoing ovariohysterectomy. The aim of this study was to identify a dosage regimen that would provide optimal anesthetic and surgical conditions, as well as to compare cardiovascular response to surgical stimulation, postoperative analgesia, anesthetic duration and quality of recovery among the tested remifentanil infusion rates. Methods Twenty-seven client-owned, mixed-breed adult healthy female cats were randomized to receive remifentanil 0.1 µg/kg/min (REMI01), remifentanil 0.2 µg/kg/min (REMI02) or remifentanil 0.4 µg/kg/min (REMI04). After premedication with acepromazine and induction of anesthesia with propofol, cats were mechanically ventilated and anesthesia was maintained at approximately 1.0 minimum alveolar concentration (MAC) of isoflurane (1.63% end-tidal isoflurane [ETISO]). Remifentanil infusion rate was increased or decreased by 20% if blood pressure had increased or decreased by 20% from previous values. Pulse rate (PR), systolic arterial pressure (SAP), esophageal temperature, pulse oximetry, end-tidal partial pressure of CO2 and ETISO were recorded at different time points during surgery. Meloxicam was administered before the end of surgery. Data within each treatment group were analyzed using a mixed-model ANOVA and Friedman’s test followed by the Wilcoxon signed rank test. Bonferroni or Dunnett’s post-hoc tests were used. The Kruskal-Wallis test followed by Dunn’s post-hoc test were used to compare data between groups; significance was set at P Results Time to sternal recumbency and time to standing were significantly longer in REMI04 than in the other groups. SAP was higher when compared with baseline in REMI01 and REMI02 groups than in REMI04. No significant difference in PR among groups was observed. One cat in REMI01 and another in REMI02 required postoperative rescue analgesia. Conclusion and relevance The dosage regimen of 0.4 µg/kg/min seemed to be the most appropriate to be used in cats undergoing ovariohysterectomy and anesthetized with 1.0 MAC of isoflurane.

Bladder cancer is one of the leading causes of cancer-related death in men, however, there was only limited effective treatment for invasive bladder cancer. DAPK1 has been shown to play important role in apoptosis and autophagy to suppress cancer progression. Previous results have shown that DAPK1 promoter was hypermethylated in the majority of bladder cancer specimens, however, the prognostic significance of DAPK1 in bladder cancer has yet to be demonstrated. In the present study, we found that DAPK1 expression was negatively associated with tumor stage and a low level expression of DAPK1 in bladder cancer specimens were associated with shorter survival in bladder cancer patients in 3 independent bladder cancer datasets (n = 462). Further investigation showed that FGFR3 knockdown resulted in downregulation of DAPK1 in bladder cancer cell line, suggesting that FGFR3 may be an upstream factor of DAPK1. Further analysis of the 3 independent bladder cancer datasets have identified ACOX1, UPK2, TRAK1, PLEKHG6 and MT1X genes had their expression significantly correlated with that of DAPK1. Knockdown of DAPK1 in bladder cancer T24 cells resulted in downregulation of ACOX1, UPK2 and TRAK1. Interestingly, TRAK1, by itself, was a favorable prognostic marker in the 3 independent bladder cancer datasets. Importantly, by using connectivity mapping with DAPK1-associated gene signature, we found that vemurafenib and trametinib could possibly reverse DAPK1-associated gene signature, suggesting that inhibition of Raf/MEK pathway may be a potential therapeutic approach for bladder cancer. Indeed, treatment of vemurafenib in T24 bladder cancer cells resulted in upregulation of DAPK1 confirming our connectivity mapping, while knockdown of DAPK1 resulted in reduced sensitivity towards inhibition of Braf signaling by vemurafenib. Together, our results suggest that DAPK1 is an important prognostic marker and therapeutic target for bladder cancer and have identified possible therapeutic agents for future testing in bladder cancer models with low DAPK1 expression.

The magnetocaloric effect (MCE) is the thermal response of a magnetic material to an applied magnetic field. Magnetic cooling is a promising alternative to conventional vapor compression technology in near room temperature applications and has experienced significant developments over the last five years. Although further improvements are necessary before the technology can be commercialized. Researchers were mainly focused on the development of materials and optimization of a flow system in order to increase the efficiency of magnetic heat pumps. The project, presented in this paper, is devoted to the improvement of heat pump and cooling technologies through simple tests of prospective regenerator designs. A brief literature review and expected results are presented in the paper. It is mainly focused on MCE technologies and provides a brief introduction to the magnetic cooling as an alternative for conventional vapor compression technology.DOI: http://dx.doi.org/10.5755/j01.sace.14.1.15927

Duanzheng Zhao,1 Libin Guo,2,* Henrique Neves,3,* Hiu-Fung Yuen,4 Shu-Dong Zhang,5 Cian M McCrudden,6 Qing Wen,5 Jin Zhang,2 Qi Zeng,4 Hang Fai Kwok,3,5,6 Yao Lin2 1College of Continuing Education, Nanjing University of Aeronautics andAstronautics, Nanjing, Jiangsu, People’s Republic of China; 2College of Life Sciences, Fujian Normal University, Fuzhou, Fujian, People’s Republic of China; 3Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau Special Administrative Region, People’s Republic of China; 4Institute of Molecular and Cell Biology, Biopolis Drive, Proteos, Singapore; 5Center for Cancer Research and Cell Biology, 6School of Pharmacy, Queen’s University ofBelfast, Belfast, UK *These authors have contributed equally to this work Abstract: Although PTP4A3 has been shown to be a very important factor in promoting cancer progression, the role of its close family member PTP4A2 is still largely unknown. Recent reports have shown contradicting results on the role of PTP4A2 in breast cancer progression. Considering this, we aimed to investigate the prognostic value of PTP4A2 in five independent breast cancer data sets (minimum 198 patients per cohort, totaling 1,124 patients) in the Gene Expression Omnibus Database. We found that high expression of PTP4A2 was a favorable prognostic marker in all five independent breast cancer data sets, as well as in the combined cohort, with a hazard ratio of 0.68 (95% confidence interval =0.56–0.83; P

A rabbit model for fentanyl-induced chest wall rigidity and the effect of apomorphine was evaluated. Eleven New Zealand adult rabbits were anesthetized and mechanically ventilated. An esophageal balloon catheter was used to estimate pleural pressure (P(pl)). Chest wall compliance (C(cw)) at baseline was calculated during pentobarbital anesthesia. A loading dose of 0.1 mg kg(-1) of fentanyl followed by infusion of 0.01 mg kg(-1) min(-1) was started in all animals, and C(cw) reassessed. In the rabbits that developed decreased C(cw), apomorphine 0.4 mg kg(-1) followed by a 0.004 mg kg(-1) min(-1) was administered and C(cw) was reassessed. C(cw) at baseline and after fentanyl and fentanyl+apomorphine were compared with one-way ANOVA followed by Bonferroni-Holm test (P

Some cancers like melanoma and pancreatic and ovarian cancers, for example, commonly display resistance to chemotherapy, and this is the major obstacle to a better prognosis of patients. Frequently, literature presents studies in monolayer cell cultures, 3D cell cultures or in vivo studies, but rarely the same work compares results of drug resistance in different models. Several of these works are presented in this review and show that usually cells in 3D culture are more resistant to drugs than monolayer cultured cells due to different mechanisms. Searching for new strategies to sensitize different tumors to chemotherapy, many methods have been studied to understand the mechanisms whereby cancer cells acquire drug resistance. These methods have been strongly advanced along the years and therapies using different drugs have been increasingly proposed to induce cell death in resistant cells of different cancers. Recently, cancer stem cells (CSCs) have been extensively studied because they would be the only cells capable of sustaining tumorigenesis. It is believed that the resistance of CSCs to currently used chemotherapeutics is a major contributing factor in cancer recurrence and later metastasis development. This review aims to appraise the experimental progress in the study of acquired drug resistance of cancer cells in different models as well as to understand the role of CSCs as the major contributing factor in cancer recurrence and metastasis development, describing how CSCs can be identified and isolated.

Dados do Registro Internacional de Transplante de Medula Óssea, International Bone Marrow Transplant Registry (IBMTR) contribuem para o progresso do transplante de medula óssea (TMO) em todo o mundo. Neste artigo relatamos a experiência brasileira em leucemia mielóide aguda e comparamos os resultados do TMO com os dados internacionais. Foi realizado um estudo retrospectivo com dados de tratamento de LMA com o TMO de 16 instituições brasileiras. A análise estatística dos transplantes da modalidade autogênica (TMO auto) e alogênica (TMO alo) foi realizada com o método de Kaplan-Meier e log-rank. Todos os valores de p foram bicaudados. Foram avaliados os dados de 731 pacientes (205 TMO auto e 526 TMO alo). A mediana de sobrevida global dos pacientes submetidos ao TMO auto foi superior à dos submetidos ao TMO alo (1.035 vs 466 dias, p=0,0012). A origem das células-tronco (OCT) no TMO alo em 73% dos pacientes foi de medula óssea (CTMO), em 23% de sangue periférico (CTSP) e em 4% de cordão umbilical. No TMO auto, a OCT foi 63% de CTSP, 22% CTMO e 15% de ambas as fontes. A OCT não teve impacto na sobrevida global (SG). Não houve diferença na SG também entre os pacientes segundo a classificação FAB no TMO alo, mas os pacientes com LMA M3 com o TMO auto tiveram SG longa. Como esperado, a principal causa de óbito entre os pacientes do TMO auto foi relacionada à recidiva de doença (60%), enquanto no TMO alo as principais causas foram a doença enxerto versus hospedeiro e infecções (38%). Em ambos os grupos foi observada SG mais longa nos pacientes tratados em primeira remissão completa (1RC) quando comparados aos de segunda remissão (2RC) e outras fases (p

This is a retrospective analysis of 1084 patients who received an allogeneic HSCT in 10 Brazilian Centers, from February 1983 to March 2003, aiming to validate the EBMT risk score. Data from transplanted patients and donors regarding patients age, disease stage at transplantation, HLA full-match sibling donor or full-match unrelated donors, donor-recipient gender match and the interval from diagnosis to transplantation, were used as variables to calculate the EBMT risk score. This score was analyzed using Cox Proportional Hazards Model. The OS, DFS, TRM and relapse were analyzed using Kaplan-Meier and cumulative incidence, whenever appropriate. In all there were 647 (60%) males and 437 (40%) females, the median age was 32 years old (range 1 – 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1025 (95%) received HLA full-match sibling transplant and only 59 (5%) received an unrelated transplant. Female donor to male recipient occurred in 283 (26%) transplants. The interval from diagnosis to transplantation was less than 12 months in 223 (21%) cases and greater in 861 (79%). The OS, DFS, TRM and, relapse were 49%, 50%, 45%, 25%, respectively. The risk score 0–1 occurred in 179 (17%), score 2 in 397 (37%), score 3 in 345 (32%), score 4 in 135 (12%), and score 5–6 in 28 (2%). The risk scores 0–1 and 2 did not show any difference in terms of OS (58% and 55%, respectively) but they were significantly better than scores 3 or more (score 3 – 44%, 4 – 36 % and, 5-6 - 27%, respectively) (P

Uncertainty still exists with the effects of allogeneic PBSCT on the clinical outcomes of patients with hematological malignancies. Our aim was analyzed retrospectively the clinical outcomes of 483 patients who underwent an allo PBSCT in 9 Brazilians centers from May 1994 to February 2004. The analyzes included patients with hematological malignancies who underwent PBSCT from HLA identical siblings donors treated with G-CSF at a dose of 10mgr/kg/day, 5 days. Median age was 34ys old (2–57), advanced disease was present in 58%, conditioning without irradiation was 85%; GVHD prophylaxis with MTX/CsA was 91%; CD34+ median was 4.7X106/kg (0.51–71.6); the median follow-up for surviving patients was 797 days (8–3420); median day for neutrophils and platelets engraftment was 15 and 14, respectively; cumulative incidence (CI) for ³ 2 aGVHD was 38%; extensive cGVHD 63%; CI for transplant relate mortality (TRM) 59%; CI for relapse 37%; the estimates of OS and DFS at 9 ys are 33% and 42, respectively. The following factors were significantly associated with better outcomes for engraftment, aGVHD, cGVHD, OS, DFS, relapse, and TRM in univariate analyzes, respectively: neutrophils and platelets engraftment: CD34+ cell dose > 2.8X106/kg, GVHD prophylaxis other than MTX/CsA, and sex match other than female donor for male recipient; aGVHD: age 4.7X106/kg; cGVHD: age < 25ys, sex match other than female donor for male recipient, advanced disease and CD3+ dose < 170X106/kg; OS: early disease; DFS: early disease, CD34+ dose > 4.7X106/kg; relapse: age> 25ys, CD34+ cell dose > 2.8X106/kg, and early disease; TRM: early disease. All the results remained significant in multivariate analyzes, but CD34+ dose and platelet engraftment; age and CD34+ dose in aGVHD; age and CD3+ in cGVHD, and age in relapse. In our experience, sex match, CD34+ dose, GVHD prophylaxis may influence the engrafment, and sex match and disease phase the cGVHD. Furthermore, advanced disease had a negative impact on OS and TRM;. CD34+ higher dose and early disease were associated with better DFS and lower relapse.