Contemporary results from the PelvEx collaborative: improvements in surgical outcomes for locally advanced and recurrent rectal cancer

Aim: The PelvEx Collaborative collates global data on outcomes following exenterative surgery for locally advanced and locally recurrent rectal cancer (LARC and LRRC, respectively). The aim of this study is to report contemporary data from within the collaborative and benchmark it against previous PelvEx publications. Method: Anonymized data from 45 units that performed pelvic exenteration for LARC or LRRC between 2017 and 2021 were reviewed. The primary endpoints were surgical outcomes, including resection margin status, radicality of surgery, rates of reconstruction and associated morbidity and/or mortality. Results: Of 2186 patients who underwent an exenteration for either LARC or LRRC, 1386 (63.4%) had LARC and 800 (36.6%) had LRRC. The proportion of males to females was 1232:954. Median age was 62 years (interquartile range 52-71 years) compared with a median age of 63 in both historical LARC and LRRC cohorts. Compared with the original reported PelvEx data (2004-2014), there has been an increase in negative margin (R0) rates from 79.8% to 84.8% and from 55.4% to 71.7% in the LARC and LRRC cohorts, respectively. Bone resection and flap reconstruction rates have increased accordingly in both cohorts (8.2%-19.6% and 22.6%-32% for LARC and 20.3%-41.9% and 17.4%-32.1% in LRRC, respectively). Despite this, major morbidity has not increased. Conclusion: In the modern era, patients undergoing pelvic exenteration for advanced rectal cancer are undergoing more radical surgery and are more likely to achieve a negative resection margin (R0) with no increase in major morbidity

Chemical Control of Loxosceles intermedia (Araneae: Sicariidae) With Pyrethroids: Field and Laboratory Evaluation

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Bites from the recluse or brown spiders (genus Loxosceles) can cause necrotic lesions and systemic effects in humans throughout the world. In the state of Parana, Brazil, loxoscelism is considered a serious public health problem, and Loxosceles intermedia Mello-Leitao (Araneae: Sicariidae) is associated with the majority of reported accidents. In the present research we evaluated the susceptibility of L. intermedia to pyrethroid insecticides currently used for the control of spiders in both field and laboratory conditions. In laboratory tests, the most active pesticides in descending order were microencapsulated lambda-cyhalothrin(LC(50) = 0.023 mg/kg), nonmicroencapsulated lambda-cyhalothrin (LC(50) = 0.047 mg/kg), deltamethrin (LC(50) = 0.26 mg/kg), and cypermethrin (LC(50)) = 1.38 mg/kg). Cockroaches, Phoetalia circumvagans (Burmeister) (n = 30), killed with microencapsulated lambdacyalothrin, were offered to the spiders. L. intermedia fed on 63.3% of the (lead cockroaches during the first 6 h of experiment; none of the spiders died during the subsequent 15 d. Microencapsulated lambdacyalothrin was chosen for application in two contiguous houses. The mean volume applied was 22.8 mg (AI)/m(2). Dead spiders were found during all the inspections up to 60 d after the initial application. In total, 297 dead spiders were collected; 65.7% in the attic shared by the two homes, 10.8% inside the house that had most cracks and crevices sealed and 23.6% in the control house. The use of lamda-cyhalothrin-based products for L. intermedia control is discussed.o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.1031166171Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq [PRONEX 4711

A retrospective study of 40 victims of Crotalus snake bites: analysis of the hepatic necrosis observed in one patient

Forty patients with a diagnosis of snake bite were studied at the Infectious and Parasitic Disease Service of the Faculty of Medicine of Botucatu. Thirty were males and 10 females, ranging in age from 16 to 70 years. All were farm laborers and 35 of them were bitten in the lower limbs. Two of the 9 patients seen more than 6 hours after the bite died. The low mortality rate (5%) observed could be explained by the early care provided, by the use of appropriate doses of anti-crotalus serum, parenteral hydration, urine alkalinization with sodium bicarbonate and induction of osmotic diuresis with a mannitol solution. Anatomopathological examination of one of the patients who died revealed extensive hepatic necrosis. The authors discuss the possibility of the effect of a factor of snake venom in the genesis of hepatic necrosis and in the increased transaminase levels