Abstract P6-11-06: Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil

Abstract Background: Chemotherapy-induced alopecia (CIA) is a distressing adverse effect of many chemotherapy (CT) agents. New strategies for prevention of CIA have been studied. Scalp cooling has been reported to prevent CIA. We conducted a retrospective study aimed to assess the efficacy of scalp cooling in preventing CIA among women receiveing chemotherapy for breast cancer. Methods: Was included clinical data of breast cancer patients at the Oncoclinicas Group from July/2015 to March/2017. All patients were elected to use scalp cooling to prevent CIA. Cooling started 30 minutes before infusion and was maintained throughout the infusion of the treatment and extended for 90 minutes after infusion. Degree of hair loss was rated by nurse assessment using CTCAE v4.0 scale in grade zero (without alopecia), 1 (&amp;lt;50%) or 2 (&amp;gt;50%), digital photographs and clinical assessment. Assessments were made before each chemotherapy treatment and at a follow up visit between 3 weeks and 3 months after the completion of chemotherapy. Success was defined when there was G0 or G1 alopecia at the end of the treatment, and failure when finished with G2 alopecia and patient withdrawal due to alopecia. Results: 330 patients were included. 283 with localized breast cancer and 47 with metastatic disease. 188 patients (57.0%) completed all tratment with scalp cooling. 72 patients (21.8%) withdrew from cryotherapy for alopecia of any degreee, 51 patients (15.4%) gave up cryotherapy for complaints unrelated to alopecia and 19 patients (5.8%) had their treatment interrupted due to external factors (progression of disease, change of CT protocol, among others). Among patients who completed chemotherapy (n=188), the degree of alopecia at the end was G0 = 27, G1 = 138, G2 = 23. Thus, the overall success rate with cryotherapy was 63.5%. CT protocols initiated with doxorubicin and cyclophosphamide, followed by taxanes, presented a success rate of 50%. The combintation of docetaxel and cyclophosphamide showed success of 71.9%. Scalp cooling: chemotherapy regimes and alopeciaChemotherapy (CT) regimeCompleted CT G0Completed CT G1Completed CT G2Abandoned SC G1Abandoned SC G2AC02011AC/taxanes65152527AC non sequential11100D alone or combi no AC319221DC6401134EC at 2nd part of CT01000EC at 1rst part of CT00111P alone or combi no AC613014No AC21000AC at 2nd part of CT310310Total27138233438A: doxorubicin; C: cyclophosphamide; D: docetaxel; E: epirubicin; P: paclitaxel; combi: combination In addition to alopecia, headache and cold sensation were common reasons for cryotherapy withdrawal. Conclusions: Scalp cooling appears to be effective in preventing CIA among breast cancer patients who underwent chemotherapy. Studies involving a psychological approach to the expectation and experience of alopecia with cryotherapy and better management of pain are necessary to increase adherence to treatment. Citation Format: Silva GB, Moreira RB, Gimenes DL, Silva ACP, Araújo BRC, Pacheco BP, Paiva RdCP, Sutmoller C, Hammermuller LMJ, Lima RO, Pimentel RVIA, Simões ÂAB, Mathias CMC, Lessa ÂMC, Costa MAD, Martins LCA, Ferrari BL. Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-06.</jats:p

Análise fotoelástica de parafuso de sistema de fixação vertebral The photoelastic analisys of vertebral fixation system screws

INTRODUÇÃO: A fotoelasticidade é utilizada para avaliar as tensões/deformações produzidas nos materiais fotoelásticos, quando submetidos a determinado carregamento, através da observação de efeitos óticos. O desempenho do parafuso e as funções mecânicas estão diretamente relacionados com a qualidade da fixação dos parafusos nas vértebras. A fotoelasticidade é uma ferramenta importante para realizar estudos comparativos desta natureza. OBJETIVO: O objetivo deste estudo foi comparar por meio da fotoelasticidade, as tensões internas produzidas pelo parafuso com 6 mm de diâmetro externo, quando submetido a duas diferentes forças de arrancamento. MATERIAIS E MÉTODOS: Para isso, foram confeccionados quatro modelos fotoelásticos. A simulação foi realizada utilizando duas forças de arrancamento 0,75 e 1,50 kgf. As tensões cisalhantes foram calculadas nos 19 pontos em torno dos parafusos, utilizando o método de compensação de Tardy. RESULTADOS: Os valores das tensões cisalhantes foram maiores quando utilizada a força de arrancamento de 1,50 kgf. CONCLUSÃO: Assim sendo, o parafuso estará mais suscetível ao arrancamento com a aplicação de força de maior intensidade. De acordo com as análises realizadas verificamos também que o local de maior tensão cisalhante foi observado no pico das cristas, principalmente próxima às pontas dos parafusos, independente da força utilizada.<br>INTRODUCTION: The photoelasticity is used for assessing the tensions/deformations involved in photoelastic materials when submitted to a given load by the observation of optical effects. The screw performance and mechanical functions are directly associated to the quality of the screws fixation in the vertebrae. Photoelasticity is an important tool to perform comparative studies of this nature OBJECTIVE: The aim of this study was to compare, by using photoelasticity, internal stresses produced by the screw with an external diameter of 6 mm, when submitted to two different pullout strengths. MATERIALS AND METHODS: For this, four photoelastic models were produced. The simulation was conducted by using two pullout strengths: 0.75 and 1.50 kgf. The maximum shear stresses were calculated on 19 points around the screws, using the Tardy compensation method. RESULTS: The values of maximum shear stress were higher with the load of 1.50 kgf. CONCLUSION: Thus, the screw will be more susceptible to pullout when heavier loads are applied. According to our analysis, we also found that the site with the highest maximum shear stress was found to be at the peak of creast, particularly near the tips of the screws, regardless of the load employed

Spatiotemporal transmission of SARS-CoV-2 lineages during 2020-2021 in Pernambuco-Brazil

SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics. Here, we investigate the spatiotemporal dispersion of SARS-CoV-2 lineages in the Pernambuco state (Northeast Brazil) throughout the distinct epidemiological scenarios that unfolded in the first 2 years of the pandemic. We generated a total of 1,389 new SARS-CoV-2 genomes from June 2020 to August 2021. This sampling captured the arrival, communitary transmission, and the circulation of the B1.1, B.1.1.28, and B.1.1.33 lineages; the emergence of the former variant of interest P.2; and the emergence and fast replacement of all previous variants by the more transmissible variant of concern P.1 (Gamma). Based on the incidence and lineage spread pattern, we observed an East-to-West to inner state pattern of transmission, which is in agreement with the transmission of more populous metropolitan areas to medium- and small-size country-side cities in the state. Such transmission patterns may be partially explained by the main routes of traffic across municipalities in the state. Our results highlight that the fine-grained intrastate analysis of lineages and incidence spread can provide actionable insights for planning future nonpharmacological intervention for air-borne transmissible human pathogens.IMPORTANCEDuring the COVID-19 pandemic, Brazil was one of the most affected countries, mainly due its continental-size, socioeconomic differences among regions, and heterogeneous implementation of intervention methods. In order to investigate SARS-CoV-2 dynamics in the state of Pernambuco, we conducted a spatiotemporal dispersion study, covering the period from June 2020 to August 2021, to comprehend the dynamics of viral transmission during the first 2 years of the pandemic. Throughout this study, we were able to track three significant epidemiological waves of transmission caused by B1.1, B.1.1.28, B.1.1.33, P.2, and P.1 lineages. These analyses provided valuable insights into the evolution of the epidemiological landscape, contributing to a deeper understanding of the dynamics of virus transmission during the early years of the pandemic in the state of Pernambuco