No abstract

Tyrosine kinase inhibitors are effective therapeutic agents for the treatment of progressive MTC. Nevertheless, it is not clear who will benefit the most from therapy, and the decision regarding when and how to initiate the treatment should be made based on the patient's medical history and tumor behavior. Hopefully, in the near future, molecular profiling of MTC can be used to determine the most effective molecular therapeutic target.

Objective: Although the prognostic role of BRAF V600E mutation in papillary thyroid carcinoma (PTC) is controversial, the American Thyroid Association (ATA) includes the mutational status in their risk stratification system. To evaluate the impact of the BRAF V600E mutation status on PTC risk stratification. Subjects and methods: PTC patients attending a university-based hospital who had the analysis of the BRAF V600E mutation were included. Persistent disease was defined as the presence of biochemical or structural disease. The performance of the ATA risk stratification system on predicting persistent disease with or without the BRAF V600E mutation status information was evaluated. Results: Of the 134 patients evaluated, 44 (32.8%) carried BRAF V600E mutation. The median tumor size was 1.7 cm (P25-75 1.0-3.0), 64 (47.8%) patients had lymph node, and 11 (8.2%) distant metastases. According to the ATA risk stratification system, patients were classified as low, intermediate, and high risk in 55 (41%), 59 (44%), and 20 (14%) patients, respectively. The data on BRAF V600E mutation reclassified 12 (8.9%) patients from low to intermediate risk. After a median follow-up of 8.5 years, the prevalence of persistent disease was similar in patients with and without BRAF V600E mutation (P = 0.42). Multivariate analysis failed to demonstrate an association between the BRAF V600E mutation and persistent disease status (RR 0.96; 95%CI 0.47-1.94). Notably, none of the patients reclassified from low to intermediate risk showed persistent disease on follow-up. Conclusion: Inclusion of BRAF V600E mutational status has a limited impact on risk stratification and does not add to the prediction of outcomes in PTC patients.

This article presents a study on the activities of the air traffic controllers of the Approach Control Area (APP) of Porto Alegre, Brazil, in different real scenarios. Based on interviews, questionnaires and the analysis of film of real scenes, the following were identified and analyzed: i) the perceptions of risk and complexity of the different air traffic scenes observed; ii) the cognitive factors (knowledge, strategy and attention dynamics) involved in the task and iii) the perception of the controller's workload. The results showed that the task complexity depends on the weather conditions, the number and type of aircraft in observation and that the controllers perceive the scenes in a similar way irrespective of their time in the profession and the type of control (radar or coordination). Attention is the cognitive factor with the greatest impact on the work and mental demand has the greatest impact on workload followed by time demand. The literature on the controllers work in Brazil is scarce and, therefore, this study aimed to contribute to the understanding of the work in one APP in order to promote future changes in the very problematic Brazilian air traffic system.