OBJETIVO: Estudos anteriores pelo nosso grupo e por outros autores sugerem que o nível pré-tratamento do marcador tumoral CA 19-9 se correlaciona com a sobrevida global (SG) em pacientes com câncer de pâncreas avançado tratados com gencitabina. Nosso objetivo foi o de confirmar o papel prognóstico do nível pré-tratamento do CA 19-9 em pacientes com câncer de pâncreas avançado tratados com regimes variados de quimioterapia. MÉTODOS: Identificamos retrospectivamente 50 pacientes com câncer de pâncreas localmente avançado ou metastático tratados em primeira linha com gencitabina ou combinações contendo esse agente. Os pacientes poderiam ter recebido ainda tratamento em segunda linha com outros agentes. As estimativas de SG pelo método de Kaplan-Meier foram comparadas pelo teste log-rank, e a análise multivariada foi feita usando-se o modelo de Cox. RESULTADOS: Vinte e sete pacientes eram do sexo feminino, a idade média foi de 64,3 anos, e 82% tinham doença metastática ao diagnóstico. A mediana de SG para a amostra como um todo foi de 11 meses, e o nível mediano de CA 19-9 foi de 542 U/mL. Fatores preditivos de SG em análises univariadas foram o uso de quimioterapia combinada em primeira linha (p=0,006) e o uso de erlotinibe (p=0,002), com nível de significância limítrofe para nível pré-tratamento de CA 19-9 (p=0,052). Na análise multivariada, apenas o uso de erlotinibe (p=0,003) e o nível pré-tratamento de CA 19-9 (p=0,026) estiveram associados com SG de maneira significativa. CONCLUSÃO: Nosso estudo fornece evidência adicional para o uso do nível pré-tratamento de CA 19-9 como indicador prognóstico e como fator de estratificação em ensaios clínicos. A associação entre uso de erlotinibe e SG pode ter sido devida à seleção de pacientes, não obstante o resultado de um estudo randomizado recente mostrando o benefício desse tratamento.

OBJECTIVE: We and others have previously suggested that pretreatment levels of CA 19-9 correlate with overall survival (OS) among patients with advanced pancreatic cancer treated with gemcitabine. We sought to confirm the prognostic role of the pretreatment level of CA 19-9 in patients with advanced pancreatic cancer treated with chemotherapy. METHODS: We retrospectively identified 50 patients with locally advanced or metastatic pancreatic cancer treated in the first-line with single-agent gemcitabine or combinations. Patients could also have received second-line treatment. Kaplan-Meier estimates of OS were compared with the log-rank test, and multivariate analysis was done using the Cox model. RESULTS: Twenty-seven patients were female with a mean age of 64.3 years, and 82% were metastatic upon diagnosis. The median OS for the entire sample was 11 months, and the median CA 19-9 level was 542 U/mL. Significant predictors of OS in univariate analyses were the first-line use of combined chemotherapy (p=0.006) and use of erlotinib in any line (p=0.002), with borderline significance for pretreatment levels of CA 19-9 (p=0.052). In multivariate analysis, only use of erlotinib (p=0.003) and pretreatment CA 19-9 level (p=0.026) were significantly associated with OS. CONCLUSION: Our study lends further support to use of the pre-chemotherapy level of CA 19-9 as a prognostic indicator in clinical practice and as a stratification factor in clinical trials. The association between erlotinib use and OS may have been biased by patient selection, notwithstanding the positive results from a previous randomized trial.

O objetivo deste trabalho foi determinar o valor nutricional de diferentes fontes protéicas para o Dourado (Salminus brasiliensis). Trinta juvenis por grupo (33,51±1,4 g) foram alimentados ad libitum com ração referência (70%) mais ingredientes-teste (30%) e marcador de óxido de cromo III (0,1%). Foram determinados os coeficientes de digestibilidade aparente da energia bruta (CDA EB), proteína bruta (CDA PB) e aminoácidos. Entre os ingredientes de origem vegetal, a glutenose apresentou os melhores resultados para CDA EB e CDA PB (95,7 e 96,9%, respectivamente). A farinha de sangue se destacou entre os ingredientes de origem animal (94,1 e 96,3%, respectivamente). O farelo de trigo apresentou menor digestibilidade entre todos, 77% para CDA EB e 88,2% para CDA PB.

The objective of this work was to determine the nutritional value of different protein sources for "dourado" (Salminus brasiliensis). Thirty juveniles per group (33.51±1.4 g) were hand fed on a reference diet (70%) added of tested ingredients (30%) and chromium oxide III (0.1%). Apparent digestibility coefficients of the gross energy (ADC GE), crude protein (ADC CP) and amino acids of the tested ingredients were evaluated. Corn gluten meal yielded the best results for ADC GE and ADC CP (95.7 and 96.9%, respectively) amongst plant ingredients. Spray-dried blood meal yielded the best values of ADC GE and ADC CP amongst animal ingredients (94.1 and 96.3%, respectively). Wheat bran yielded poorest ADCs coefficients (77 for ADC GE and 88.2% for ADC CP).

O objetivo deste trabalho foi avaliar tempo de passagem do alimento e seqüência de repleção e depleção dos órgãos no trato gastrintestinal de Salminus brasiliensis. Cem peixes (38,8±7,6 g) foram mantidos em 20 gaiolas (60 L), a 24,8±0,2ºC e alimentados com ração contendo 1% de Cr2O3. A cada 60 min a partir da primeira alimentação foram sacrificados cinco peixes e foi verificada a localização da digesta no trato gastrintestinal. A partir da segunda hora depois da alimentação, observou-se redução gradativa do conteúdo estomacal e subseqüente presença de digesta no intestino. Esse padrão se mantém até a 16ª hora; uma e duas horas depois, estômagos e intestinos, respectivamente, encontram-se completamente vazios.

The objective of this work was to evaluate gastric transit time and sequence of repletion and depletion of Salminus brasiliensis gastrointestinal organs. One hundred fish (38.8±7.6 g) were kept in 20 cages (60 L) under 24.8±0.2ºC, and fed on practical feed, added of 1% Cr2O3. Every 60 minutes from the first feeding, five fish were sacrificed and it was verified the location of the digest in the gastrointestinal tract. From the second hour after the feeding, gradual reduction of the stomach content and subsequent presence of digest in the intestine were observed. This pattern was kept constant until the 16th hour. One and two hours later stomach and intestine were totally empty, respectively.

OBJECTIVES: In this preliminary study we report the development of the video urodynamic technique using magnetic resonance imaging (MRI). MATERIALS AND METHODS: We studied 6 women with genuine stress urinary incontinence, diagnosed by history and physical examination. Urodynamic examination was performed on multichannel equipment with the patient in the supine position. Coughing and Valsalva maneuvers were performed at volumes of 150, 250 and 350 mL. Simultaneously, MRI was carried out by using 1.5 T GE Signa CV/i high-speed scanner with real time fluoroscopic imaging possibilities. Fluoroscopic imaging was accomplished in the corresponding planes with T2-weighted single shot fast spin echo sequences at a speed of about 1 frame per second. Both studies were recorded and synchronized, resulting in a single video urodynamic examination. RESULTS: Dynamic MRI with cine-loop reconstruction of 1 image per second demonstrated the movement of all compartment of the relaxed pelvis during straining with the concomitant registration of abdominal and intravesical pressures. In 5 patients, urinary leakage was demonstrated during straining and the Valsalva leak point pressure (VLPP) was determined as the vesical pressure at leak subtracted from baseline bladder pressure. Mean VLPP was 72.6 cm H2O (ranging from 43 to 122 cm H2O). CONCLUSIONS: The concept of MRI video urodynamics is feasible. In a clinical perspective, practical aspects represent a barrier to daily use and it should be recommended for research purposes.