Introduction: Androgen deprivation therapy (ADT) is the mainstay of therapy for advanced prostate cancer. Studies addressing the effi cacy of different depot formulations of long acting luteinizing hormone releasing hormone agonists in the Brazilian population are lacking. We aimed to compare the effi cacy of three schedules of leuprolide acetate in lowering PSA in a real world population. Materials and Methods: We reviewed the medical records of patients with prostate cancer seen at our institution between January 2007 and July 2018. We analyzed patients treated with long-acting leuprolide acetate and grouped these patients into three strata according to the administration of ADT every 1, 3 or 6 months. The primary outcome was the serum prostate specifi c antigen (PSA) levels at 6 and 12 months after treatment initiation. We used Friedman test to compare the distribution of PSA levels at baseline and at 6 and 12 months within each treatment stratum. We considered two-sided P values <0.05 as statistically signifi cant. We analyzed toxicity descriptively. Results: We analyzed a total of 932 patients, with a median age of 72 years and a median time since diagnosis of prostate cancer of 8.5 months. ADT was administered monthly in 115 patients, quarterly in 637, and semiannually in 180. Nearly half of the patients had locally advanced disease. In comparison with baseline, median serum PSA levels were reduced at 12 months by at least 99.7% in the three strata (P <0.001 in all cases). Sexual impotence and hot fl ashes were the most frequently reported toxicities. Conclusion: To our knowledge, this is the largest assessment of real-world data on alternative schedules of leuprolide in a Brazilian population. Our study suggests that PSA levels can be effectively be reduced in most patients treated with monthly, quarterly, or semiannual injections of long-acting leuprolide acetate.

Introduction: Next Generation Sequencing (NGS) is cost-effective, capable to investigate the genes faster but the protocol has challenges throughout its steps. Objective: We investigated different adjustments of protocol to screen the BRCA genes using Ion Torrent PGM sequencing and correlate the results with number of False Positive (FP) variants. Material and methods: Library preparation process, number of FP InDels, library concentration, number of cycles in amplify targets step, purity of nucleic acid, input, and number of samples/Ion 314 chip were analyzed in association with the results obtained by NGS. Results: 51 reactions and 9 adjustments of protocols were done and 8 FP InDels were observed in homopolymer regions. No FP Single-Nucleotide Polymorphism variant was observed. Protocol variables jointly are associated in 67.5% with the quality of results obtained(p<0.05). The number of FP InDels decreased when the quality of results increased. Conclusion: Ion AmpliSeq BRCA1/BRCA2 Community Panel had better performance with 4 samples per Ion-314 chip instead of 8 and the number of cycles in the amplification step, even using DNA with high quality, was better with 23. We observed better results when the manual equalization process was done, without the Ion Library Equalizer kit. These adjustments provided higher coverage of the variants and fewer artifacts (6.7-fold). Laboratories must perform the internal validation because FP InDel variants can vary according to the quality of results. NGS assay must be validated with Sanger.

RESUMOAntecedentes: Durante muito tempo acreditou-se que os recém-nascidos (RN) e lactentes eram incapazes de sentir dor. Um corpo substancial de conhecimentos solidificou-se e vem ramificandose nos últimos anos, comprovando não só que, a dor no período neonatal existe como, na realidade, esta é hiperálgica.Objetivo: Conhecer a eficácia da amamentação como técnica não farmacológica no alívio da dor aguda, no RN e lactentes sujeitos a procedimentos dolorosos.Método: Realizou-se uma Revisão Sistemática da Literatura, recorrendo a motores de busca e as bases de dados informáticas: CINAHL, MEDLINE e SCIELO. Foram seleccionados 6 artigos científicos, de acordo com os critérios de inclusão e exclusão e descritores pré-definidos. Os dados foram extraídos de forma independente e a qualidade dos estudos avaliada.Resultados: Os vários autores verificaram alterações tanto nas respostas comportamentais (choro, expressões faciais, comportamentos de auto-regulação e sucção) como nas respostas fisiológicas (Frequência Cardíaca, Saturação de Oxigénio e Tensão Arterial) e características da dor, quando RN e lactentes eram amamentados em comparação com aqueles que não eram amamentados.Conclusão: A amamentação influencia positivamente as respostas à dor. A amamentação é uma técnica não farmacológica eficaz no alívio da dor aguda, durante os procedimentos dolorosos causadores de stress e dor no tratamento ao RN e lactente. Torna-se importante os profissionais de

Objective: To identify the epidemiological characteristics of patients with prostate cancer and evaluate the treatment with Eligard® monthly, quarterly and semiannually according to efficacy and tolerance in HCM from January 2007 to July 2018. Methodology: Epidemiological, descriptive, retrospective, cross-sectional and quantitative research through the review of medical records . The population 932 patients with prostate neoplasia, treated at Cristiano Varella Foundation - HCM, MG state, Brazil, adult men (≥18 years old), with indication for Eligard® in monthly (7.5 mg) (n=115), quarterly (22.5 mg) (n=637) and semiannual (45 mg) (n=180) dosage. Results: Median age was 72 years (65-78). Median time since diagnosis was 8.5 months, with 598 (64.2%) of patients with a diagnosis of 12 months or less, and 158 (17%) with time since diagnosis of more than 4 years. The majority (63.4%) had low education, were married (69.9%) and non-white (66.41% black + brown). Regarding occupation, 541 (58.05%) are retired 148 (15.88%) and rural workers. Much of the information collected in the medical records about housing was not available 464 (49.8%), but 318 (34.12%) of the patients own their own homes. As for transportation, most 877 (94.1%) have the vehicles of the municipal health departments as their main means of transportation, which corroborates the information of low per capita income, low education, that is, low socioeconomic structure. All patients being treated at HCM with prostate cancer (100%) have support from the municipal health secretariats, the Basic Health Units, and also from the hospital itself. Regarding the nutritional status of patients, 754 (80.9%) have good nutrition (eutrophic), only 84 (9.02) were malnourished and 49 (5.22%) were obese. As for prevention (PSA exams), 444 subjects (42.4%) reported having had such an exam. Slightly more than 30% had a family history of cancer, and the same proportion for smokers and drinkers. Conclusions: Epidemiological characteristics (average age 75 years, non-white, married, with low education, retired, rural workers, depend on the support of the Health Departments of their municipalities, low per capita income, most have their own homes, are treated by SUS, do not smoke, do not drink, no family history); and clinical (most with stages II and III, treated with radiotherapy, comorbidities cardiovascular diseases, and adverse events considered the treatment itself). The results obtained allowed us to verify the efficacy of the hormone (Eligard® ), a LHRH agonist used in the treatment of patients with this neoplasm, in all stages. The tolerability of the patients regarding this medication was also verified, with very satisfactory results in approximately 99% of all patients.