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Cruz-Correa M, Shoskes DA, Sanchez P, et al. Clin Gastroenterol Hepatol 2006 Jun 4; [Epub ahead of print] BACKGROUND & AIMS: Familial adenomatous polyposis (FAP) is an autosomal-dominant disorder characterized [...]

The increase in solid waste generation arises in parallel with economic development. Therefore, the solid waste management converges to a growing importance, being fundamental to environmental, economic and social coherency. In this sense, the Didactic-Pedagogic Center arises as an alternative for the management of solid waste in IFFluminense - Campus Macaé, but, it's worth considering that it also tends to promote social inclusion, enabling social gains from the professional training lowincome people, on a pilot scale and provide environmental benefits, from the correct disposal of waste generated, not only for the IFFluminense-Campus Macaé, as well as for the city of Macaé. [ABSTRACT FROM AUTHOR]

We evaluated the consequences of excluding the first of three blood pressure (BP) readings in different settings: a random population sample (POS, n=1525), a general practice office (GPO, n=942) and a specialized hypertension center (SHC, n=462). Differences between systolic and diastolic BP (SBP and DBP) estimates obtained including and excluding the first reading were compared and their correlation with ambulatory BP monitoring (ABPM) was estimated. The samples were divided into quartiles according to the difference between the third and the first SBP (3-1ΔSBP). SBP decreased through sequential readings, 3-1ΔSBP was −5.5±9.7 mm Hg (P<0.001), −5.1±10.4 mm Hg (P<0.001) and −6.1±9.3 mm Hg (P<0.001) for POS, GPO and SHC, respectively. However, individuals included in the top quartile of 3-1ΔSBP showed their highest values on the third reading. The mean SBP estimate was significantly higher excluding the first reading (P<0.001), but the differences among both approaches were small (1.5-1.6 mm Hg). Moreover, the correlation between SBP values including and excluding the first reading and daytime ABPM were comparable (r=0.69 and 0.68, respectively). Similar results were observed for DBP. In conclusion, our study does not support the notion of discarding the first BP measurement and suggests that it should be measured repeatedly, regardless the first value. [ABSTRACT FROM AUTHOR]

Purpose: Hematology-oncology patients undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT) recipients are at risk for oral complications which may cause significant morbidity and a potential risk of mortality. This emphasizes the importance of basic oral care prior to, during and following chemotherapy/HSCT. While scientific evidence is available to support some of the clinical practices used to manage the oral complications, expert opinion is needed to shape the current optimal protocols. Methods: This position paper was developed by members of the Oral Care Study Group, Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT) in attempt to provide guidance to the health care providers managing these patient populations. Results: The protocol on basic oral care outlined in this position paper is presented based on the following principles: prevention of infections, pain control, maintaining oral function, the interplay with managing oral complications of cancer treatment and improving quality of life. Conclusion: Using these fundamental elements, we developed a protocol to assist the health care provider and present a practical approach for basic oral care. Research is warranted to provide robust scientific evidence and to enhance this clinical protocol. [ABSTRACT FROM AUTHOR]

Accelerated Partial Breast Irradiation (APBI) with external beam IMRT has emerged as an excellent treatment strategy for select early-stage breast cancer patients. Our institutional preference for APBI consists of 3000cGy in 5 non-consecutive fractions with IMRT per the Florence protocol. At our institution, this has recently evolved to include deep-inspiration breath-hold (DIBH) for motion management, along with the preferred use of radiopaque filament marker (FM) for target delineation and daily CBCT-based image guidance. The CTV to PTV margin has been reduced from 10-mm to 5-mm for such patients, in light of reduction in uncertainty of target localization and uncertainty of motion. We hypothesize a reduction in CTV-to-PTV margins from 10 mm to 5 mm with implementation of DIBH and filament marker for IMRT-based APBI will result in non-inferior local control compared to recently published contemporary data. This study was conducted through a retrospective chart review of 16 stage 0 and 57 stage 1 breast cancer patients including 60 "acceptable" and 13 "cautionary" patients per ASTRO APBI consensus guidelines treated at our institution from March 2021 through June 2023 with 5-fraction IMRT APBI, using DIBH for motion management and lumpectomy cavity delineation using a FM. Standard 10-mm margin was used to expand from lumpectomy cavity to CTV for all patients. A reduced 5-mm expansion from CTV to PTV was utilized (compared to 10-mm CTV to PTV expansion in Florence protocol) in light of motion management and target localization techniques described above. Cropping of PTV from skin surface and/or chest wall followed Florence guidelines. With a median follow up of 23.1 months, local control was 100% for patients treated with reduced 5-mm CTV to PTV margins. There were no cases of subacute radiation pneumonitis. Compared to the results of "standard" 10-mm CTV to PTV expansion, the use of 5-mm CTV to PTV margin reduced the mean PTV for these patients by approximately 112 cc (> 80% absolute volume reduction). For patients treated with 5-fraction external beam APBI, the use of DIBH for motion management and filament marker for target localization appears to allow for safe reduction in CTV-to-PTV expansion without reduction in local control. Absolute reduction in PTV with this approach is substantial, with potential implications for cosmetic outcome or other late effects. Longer term follow up will be needed to confirm the durability of these local control and toxicity results and may offer potential for improved cosmesis results. [ABSTRACT FROM AUTHOR]